Applying new evidence standards to youth cognitive behavioral therapies - A review

- 136 youth CBT trials were assessed for effects: (A) on multiple measures, (B) at follow-up, and (C) against an active group.
- A subset of 87 trials produced at least one post-treatment result, but smaller subsets passed Standard A, B, or C individually.
- Fewer CBT trials met two standards simultaneously, and only 11 produced results to meet all three standards simultaneously.

This review included 136 published randomized controlled trials (RCTs) of youth cognitive behavioral therapy (CBT) treatments. We aimed to test the premise that evidence-based youth treatments can be better differentiated from each other by applying more nuanced standards of evidence. Accordingly, we applied three standards to this article sample to determine how many treatments produced significant results: (a) on multiple target symptom measures, (b) at follow-up, and/or (c) against an active comparison group. We identified how many trials met standards individually and in combination. Although 87 of the 136 articles produced at least one significant treatment result at post-assessment, the subsets of “passing” articles were smaller and varied for any one of our three standards, with only 11 articles (8%) meeting all three standards simultaneously. Implications are discussed regarding the definition of “evidence-based,” the need for multi-parameter filtering in treatment selection and clinical decision making, and future directions for research. We ultimately argue the value in assessing youth treatments for different types of evidence, which is better achieved through dynamic sets of standards, rather than a single approach to assessing general strength of evidence.