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20-04-2024 | Anxiety | Original Paper

Psychological Treatment with Youth: Style, Informed by Science

Author: Philip C. Kendall

Published in: Journal of Contemporary Psychotherapy

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Abstract

Following statements about preferences for terminology, I describe three therapist characteristics (i.e., diagnostician educator, collaborator) deemed of value when providing psychological treatment for youth. Implementing an empirically supported treatment (EST) is a therapist decision, and while most therapists are aware of an EST that can fit for a specific client, many therapists ask “But is it right for my client?” This paper discusses therapist’s mental processes that may misinform decisions when answering this key question. To assist optimal decision making, and with an eye on maladaptive anxiety in youth as the exemplar, the active components of successful treatments are described, along with illustrations of flexibility within treatment fidelity (Flexibility within fidelity: Breathing life into a psychological treatment manual. Oxford University Press, 2022). Flexibility in implementing active components (e.g. rapport, psychoeducation, cognitive change, exposure tasks), as well as flexibility across modalities of treatment (e.g., in person, online) and working with parents are described.
Literature
go back to reference Applications of The Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142–153. [contains video]. Applications of The Coping Cat Program for anxious youth. Cognitive and Behavioral Practice, 17, 142–153. [contains video].
go back to reference Bandura, A. (Ed.). (1997). (Ed.). Self-efficacy: The exercise of control. New York: W. H. Freeman; 1997. Bandura, A. (Ed.). (1997). (Ed.). Self-efficacy: The exercise of control. New York: W. H. Freeman; 1997.
go back to reference Beidas, R., Benjamin, C., Puleo, C., Edmunds, J., & Kendall, P. C. (2010). Flexible. Beidas, R., Benjamin, C., Puleo, C., Edmunds, J., & Kendall, P. C. (2010). Flexible.
go back to reference Chiappini, E., Gosch, E., Compton, S., Olino, T., Birmaher, B., Sakolsky, D., Peris, T., Piacentini, J., Albano, A., Keeton, C., Walkup, J., Ginsburg, G., & Kendall, P. C. (2020). In-session involvement in anxious youth receiving CBT with/without medication. Journal of Psychopathology & Behavioral Assessment, 42, 615–626.CrossRef Chiappini, E., Gosch, E., Compton, S., Olino, T., Birmaher, B., Sakolsky, D., Peris, T., Piacentini, J., Albano, A., Keeton, C., Walkup, J., Ginsburg, G., & Kendall, P. C. (2020). In-session involvement in anxious youth receiving CBT with/without medication. Journal of Psychopathology & Behavioral Assessment, 42, 615–626.CrossRef
go back to reference Creed, T., & Kendall, P. C. (2005). Empirically supported therapist relationship building behavior within a cognitive-behavioral treatment of anxiety in youth. Journal of Consulting and Clinical Psychology, 73, 498–505.CrossRefPubMed Creed, T., & Kendall, P. C. (2005). Empirically supported therapist relationship building behavior within a cognitive-behavioral treatment of anxiety in youth. Journal of Consulting and Clinical Psychology, 73, 498–505.CrossRefPubMed
go back to reference Cummings, C., Caporino, N., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140, 816–845.CrossRefPubMed Cummings, C., Caporino, N., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140, 816–845.CrossRefPubMed
go back to reference Cummings, C., Caporino, N., Settipani, C., Read, K., Compton, S., & March, J., et al. (2013). The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth. Journal of Consulting and Clinical Psychology, 81, 859–864. Cummings, C., Caporino, N., Settipani, C., Read, K., Compton, S., & March, J., et al. (2013). The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth. Journal of Consulting and Clinical Psychology, 81, 859–864.
go back to reference Dawes, R., Faust, D., & Meehl, P. (1989). Clinical versus actuarial judgement. Science, 243, 1668–1674.CrossRefPubMed Dawes, R., Faust, D., & Meehl, P. (1989). Clinical versus actuarial judgement. Science, 243, 1668–1674.CrossRefPubMed
go back to reference Drabick, D., & Kendall, P. C. (2010). Developmental psychopathology and the diagnosis of mental health problems among youth. Clinical Psychology: Science and Practice, 17, 272–280.PubMed Drabick, D., & Kendall, P. C. (2010). Developmental psychopathology and the diagnosis of mental health problems among youth. Clinical Psychology: Science and Practice, 17, 272–280.PubMed
go back to reference Frank, H., Titone, M., Kagan, E., Alloy, L., & Kendall, P. C. (2021, December). The role of comorbid depression in youth anxiety treatment outcomes. Child Psychiatry and Human Development, 52, 1024–1031. Frank, H., Titone, M., Kagan, E., Alloy, L., & Kendall, P. C. (2021, December). The role of comorbid depression in youth anxiety treatment outcomes. Child Psychiatry and Human Development, 52, 1024–1031.
go back to reference Grove, W., & Lloyd, M. (2006). Meehl’s contribution to clinical versus prediction. Journal of Abnormal Psychology, 115, 192–194.CrossRefPubMed Grove, W., & Lloyd, M. (2006). Meehl’s contribution to clinical versus prediction. Journal of Abnormal Psychology, 115, 192–194.CrossRefPubMed
go back to reference Kazdin, A. (1974). Covert modeling, model similarity, and reduction of avoidance behavior. Behavior Therapy, 5, 325–340.CrossRef Kazdin, A. (1974). Covert modeling, model similarity, and reduction of avoidance behavior. Behavior Therapy, 5, 325–340.CrossRef
go back to reference Kendall, P. C. (Ed.). (2022). (Ed.). Flexibility within Fidelity: Breathing Life into a psychological treatment Manual. Oxford University Press. Kendall, P. C. (Ed.). (2022). (Ed.). Flexibility within Fidelity: Breathing Life into a psychological treatment Manual. Oxford University Press.
go back to reference Kendall, P. C., & Hedtke, K. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual (3rd ed.). Workbook Publishing. Kendall, P. C., & Hedtke, K. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual (3rd ed.). Workbook Publishing.
go back to reference Kendall, P. C., & Hedtke, K. (2006a). Coping Cat Workbook (2nd ed.). Workbook Publishing. Kendall, P. C., & Hedtke, K. (2006a). Coping Cat Workbook (2nd ed.). Workbook Publishing.
go back to reference Kendall, P. C., & Peterman, J. (2015). CBT for anxious adolescents: Mature yet still developing. American Journal of Psychiatry, 172, 519–530.CrossRefPubMed Kendall, P. C., & Peterman, J. (2015). CBT for anxious adolescents: Mature yet still developing. American Journal of Psychiatry, 172, 519–530.CrossRefPubMed
go back to reference Kendall, P. C., Choudhury, M., Hudson, J., & Webb, A. (2002). The C.A.T. project workbook for the cognitive-behavioral treatment of anxious adolescents. Workbook Publishing. Kendall, P. C., Choudhury, M., Hudson, J., & Webb, A. (2002). The C.A.T. project workbook for the cognitive-behavioral treatment of anxious adolescents. Workbook Publishing.
go back to reference Kendall, P. C., Robin, J., Hedtke, K., Suveg, C., Flannery-Schroeder, E., & Gosch, E. (2005). Considering CBT with anxious youth? Think exposures. Cognitive and Behavioral Practice, 12, 136–148.CrossRef Kendall, P. C., Robin, J., Hedtke, K., Suveg, C., Flannery-Schroeder, E., & Gosch, E. (2005). Considering CBT with anxious youth? Think exposures. Cognitive and Behavioral Practice, 12, 136–148.CrossRef
go back to reference Kendall, P. C., Hudson, J., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76, 282–297.CrossRefPubMed Kendall, P. C., Hudson, J., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76, 282–297.CrossRefPubMed
go back to reference Kendall, P. C., Comer, J., Marker, C., Creed, T., Puliafico, A., Hughes, A., Martin, E., Suveg, C., & Hudson, J. (2009). In-session exposure tasks and therapeutic alliance across the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 77, 517–525.CrossRefPubMed Kendall, P. C., Comer, J., Marker, C., Creed, T., Puliafico, A., Hughes, A., Martin, E., Suveg, C., & Hudson, J. (2009). In-session exposure tasks and therapeutic alliance across the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 77, 517–525.CrossRefPubMed
go back to reference Kendall, P. C., Compton, S., Walkup, J., Birmaher, B., Albano, A. M., Sherrill, J., Ginsburg, G., Rynn, M., McCracken, J., Gosch, E., Keeton, C., Bergman, L., Sakolsky, D., Suveg, C., Iyengar, S., March, J., & Piacentini, J. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24, 360–365.CrossRefPubMedPubMedCentral Kendall, P. C., Compton, S., Walkup, J., Birmaher, B., Albano, A. M., Sherrill, J., Ginsburg, G., Rynn, M., McCracken, J., Gosch, E., Keeton, C., Bergman, L., Sakolsky, D., Suveg, C., Iyengar, S., March, J., & Piacentini, J. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24, 360–365.CrossRefPubMedPubMedCentral
go back to reference Kendall, P. C., Ney, J., Maxwell, C., Lehrbach, K., Jakubovic, R., Mcknight, D., & Friedman, A. (2023b). Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Frontiers in Psychiatry, 1, 14:1067047.CrossRef Kendall, P. C., Ney, J., Maxwell, C., Lehrbach, K., Jakubovic, R., Mcknight, D., & Friedman, A. (2023b). Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Frontiers in Psychiatry, 1, 14:1067047.CrossRef
go back to reference Kendall, P. C., Meyer, M., & Ney, J. (in press). Trends, advances, and directions in cognitive-behavioral therapy for adolescent anxiety. World Psychiatry, in press. Kendall, P. C., Meyer, M., & Ney, J. (in press). Trends, advances, and directions in cognitive-behavioral therapy for adolescent anxiety. World Psychiatry, in press.
go back to reference Khanna, M., & Kendall, P. C. (2021). ). The Resilience recipe: A parent’s guide to raising Fearless kids in the age of anxiety. New Harbinger. Khanna, M., & Kendall, P. C. (2021). ). The Resilience recipe: A parent’s guide to raising Fearless kids in the age of anxiety. New Harbinger.
go back to reference Latinjak, A., Morin, A., Brinthaupt, T., Hardy, J., Hatzigeorgiadis, A., Kendall, P. C., Neck, C., Oliver, E., Puchalska-Wasyl, M., Tovares, A., & Winsler, A. (2023). Self-talk: An interdisciplinary review and transdisciplinary model. Review of General Psychology, 27, 355–386.CrossRef Latinjak, A., Morin, A., Brinthaupt, T., Hardy, J., Hatzigeorgiadis, A., Kendall, P. C., Neck, C., Oliver, E., Puchalska-Wasyl, M., Tovares, A., & Winsler, A. (2023). Self-talk: An interdisciplinary review and transdisciplinary model. Review of General Psychology, 27, 355–386.CrossRef
go back to reference Lebowitz, E. (2021). Breaking free of child anxiety and OCD: A program for parents. Oxford University Press. Lebowitz, E. (2021). Breaking free of child anxiety and OCD: A program for parents. Oxford University Press.
go back to reference March, J., & Mulle, K. (1998). OCD in children and adolescents: A cognitive-behavioral treatment manual. Guilford. March, J., & Mulle, K. (1998). OCD in children and adolescents: A cognitive-behavioral treatment manual. Guilford.
go back to reference Marker, C., Comer, J., Abramova, V., & Kendall, P. C. (2013). The reciprocal relationship between alliance and symptom improvement across the treatment of childhood anxiety. Journal of Clinical Child and Adolescent Psychology, 42, 22–33.CrossRefPubMed Marker, C., Comer, J., Abramova, V., & Kendall, P. C. (2013). The reciprocal relationship between alliance and symptom improvement across the treatment of childhood anxiety. Journal of Clinical Child and Adolescent Psychology, 42, 22–33.CrossRefPubMed
go back to reference Meehl, P. (1957). When shall we use our heads instead of a formula? Journal of Counseling Psychology, 4, 268–273.CrossRef Meehl, P. (1957). When shall we use our heads instead of a formula? Journal of Counseling Psychology, 4, 268–273.CrossRef
go back to reference Meichenbaum, D. (1971). Examination of model characteristics in reducing avoidance behavior. Journal of Personality and Social Psychology, 17, 298307.CrossRef Meichenbaum, D. (1971). Examination of model characteristics in reducing avoidance behavior. Journal of Personality and Social Psychology, 17, 298307.CrossRef
go back to reference Peris, T., Compton, S., Kendall, P. C., Birmaher, B., Sherill, J., March, J., Gosch, E., Ginsburg, G., Rynn, M., McCracken, J., Keenan, C., Sakolsky, D., Suveg, C., Aschenbrand, S., Almirall, D., Iyengar, S., Walkup, J., Albano, A., & Piacentini, J. (2015). Trajectories of change in youth anxiety during cognitive-behavior therapy. Journal of Consulting and Clinical Psychology, 83, 239–252.CrossRefPubMed Peris, T., Compton, S., Kendall, P. C., Birmaher, B., Sherill, J., March, J., Gosch, E., Ginsburg, G., Rynn, M., McCracken, J., Keenan, C., Sakolsky, D., Suveg, C., Aschenbrand, S., Almirall, D., Iyengar, S., Walkup, J., Albano, A., & Piacentini, J. (2015). Trajectories of change in youth anxiety during cognitive-behavior therapy. Journal of Consulting and Clinical Psychology, 83, 239–252.CrossRefPubMed
go back to reference Peris, T., Caporino, N., O’Rourke, S., Kendall, P. C., Walkup, J., Albano, A. M., Bergman, L., McCracken, J., Birmaher, B., Ginsburg, G., Sakolsky, D., Piacentini, J., & Compton, S. (2017). Therapist-reported features of exposure tasks that predict differential treatment outcome for anxious youth. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 1043–1052.CrossRef Peris, T., Caporino, N., O’Rourke, S., Kendall, P. C., Walkup, J., Albano, A. M., Bergman, L., McCracken, J., Birmaher, B., Ginsburg, G., Sakolsky, D., Piacentini, J., & Compton, S. (2017). Therapist-reported features of exposure tasks that predict differential treatment outcome for anxious youth. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 1043–1052.CrossRef
go back to reference Peterman, J., Carper, M., & Kendall, P. C. (2015a). Anxiety disorders and comorbid sleep problems in school-aged youth Review and future research directions. Journal of Child Psychiatry and Human Development, 46, 376–392. Peterman, J., Carper, M., & Kendall, P. C. (2015a). Anxiety disorders and comorbid sleep problems in school-aged youth Review and future research directions. Journal of Child Psychiatry and Human Development, 46, 376–392.
go back to reference Peterman, J., Read, K., Wei, C., & Kendall, P. C. (2015b). The art of exposure: Putting science into practice. Cognitive and Behavioral Practice, 22, 379–392.CrossRef Peterman, J., Read, K., Wei, C., & Kendall, P. C. (2015b). The art of exposure: Putting science into practice. Cognitive and Behavioral Practice, 22, 379–392.CrossRef
go back to reference Podell, J., Kendall, P. C., Gosch, E., Compton, S., March, J., Albano, A. M., Rynn, M., Walkup, J., Sherrill, J., Ginsburg, G., Keeton, C., Birmaher, B., & Piacentini, J. C. (2013). Therapist factors and outcomes in CBT for anxiety in youth. Professional Psychology: Research and Practice, 44, 89–98.CrossRefPubMed Podell, J., Kendall, P. C., Gosch, E., Compton, S., March, J., Albano, A. M., Rynn, M., Walkup, J., Sherrill, J., Ginsburg, G., Keeton, C., Birmaher, B., & Piacentini, J. C. (2013). Therapist factors and outcomes in CBT for anxiety in youth. Professional Psychology: Research and Practice, 44, 89–98.CrossRefPubMed
go back to reference Rifkin, L., Myerberg, L., Gosch, E., Norris, L., Crane, M., & Kendall, P. C. (2022). How to bend but not break an empirically supported treatment for anxiety in youth. In P. Kendall (Ed.), Flexibility within Fidelity: Breathing Life into a psychological treatment Manual. Oxford University Press. Rifkin, L., Myerberg, L., Gosch, E., Norris, L., Crane, M., & Kendall, P. C. (2022). How to bend but not break an empirically supported treatment for anxiety in youth. In P. Kendall (Ed.), Flexibility within Fidelity: Breathing Life into a psychological treatment Manual. Oxford University Press.
go back to reference Shirk, S., & Karver, M. (2003). Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71, 452–464.CrossRefPubMed Shirk, S., & Karver, M. (2003). Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71, 452–464.CrossRefPubMed
go back to reference Springer, K., & Tolin, D. (2020). The big book of exposures: Innovative, creative, and effective CBT-based exposures for treating anxiety-related disorders. New Harbinger. Springer, K., & Tolin, D. (2020). The big book of exposures: Innovative, creative, and effective CBT-based exposures for treating anxiety-related disorders. New Harbinger.
go back to reference Storch, E., Wood, J., Guzick, A., Small, B., Kerns, C., Ordaz, D., Schneider, S., & Kendall, P. C. (2022, February). Moderators of response to personalized and standard care cognitive-behavioral therapy for youth with Autism Spectrum Disorder and comorbid anxiety. Journal of Autism and Developmental Disabilities, 52, 950–958. Storch, E., Wood, J., Guzick, A., Small, B., Kerns, C., Ordaz, D., Schneider, S., & Kendall, P. C. (2022, February). Moderators of response to personalized and standard care cognitive-behavioral therapy for youth with Autism Spectrum Disorder and comorbid anxiety. Journal of Autism and Developmental Disabilities, 52, 950–958.
go back to reference Swan, A., & Kendall, P. C. (2016). Fear and missing out: Youth anxiety and functional outcomes. Clinical Psychology: Science and Practice, 23, 417–435. Swan, A., & Kendall, P. C. (2016). Fear and missing out: Youth anxiety and functional outcomes. Clinical Psychology: Science and Practice, 23, 417–435.
go back to reference Tiwari, S., Kendall, P. C., Hoff, A., Harrison, J., & Fizur, P. (2013). Characteristics of exposure sessions as predictors of treatment response in anxious youth. Journal of Clinical Child and Adolescent Psychology, 42, 34–43.CrossRefPubMed Tiwari, S., Kendall, P. C., Hoff, A., Harrison, J., & Fizur, P. (2013). Characteristics of exposure sessions as predictors of treatment response in anxious youth. Journal of Clinical Child and Adolescent Psychology, 42, 34–43.CrossRefPubMed
Metadata
Title
Psychological Treatment with Youth: Style, Informed by Science
Author
Philip C. Kendall
Publication date
20-04-2024
Publisher
Springer US
Keyword
Anxiety
Published in
Journal of Contemporary Psychotherapy
Print ISSN: 0022-0116
Electronic ISSN: 1573-3564
DOI
https://doi.org/10.1007/s10879-024-09626-w