A Meta-Systems Approach to Evidence-Based Practice for Children and Adolescents

• Published in: The American psychologist 2010-02, Vol.65 (2), p.85-97
• Main Authors: Kazak, Anne E, Hoagwood, Kimberly, Weisz, John R, Hood, Korey, Kratochwill, Thomas R, Vargas, Luis A, Banez, Gerard A
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Behavior modification; Biological and medical sciences; Child; Child Psychiatry - organization & administration; Child psychology; Child welfare; Child Welfare - psychology; Children; Children & youth; Clinical psychology; Evidence; Evidence based medicine; Evidence Based Practice; Evidence-Based Practice - methods; Family; Family - psychology; Family Environment; Family Intervention; Health Needs; Health Policy; Health Services Needs and Demand; Human; Humans; Juvenile Delinquency; Juvenile Justice; Medical sciences; Mental Disorders - psychology; Mental Disorders - therapy; Mental Health; Mental Health Services; Mental Health Services - organization & administration; Miscellaneous; Outcomes of Treatment; Paediatrics; Patient Care Team; Prevention; Problem Solving; Psychological aspects; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapies. Psychological and clinical counseling; Schools - organization & administration; Social Environment; Substance abuse; Substance-Related Disorders - therapy; Systems Approach; Treatment Outcome; Treatment Outcomes; Treatments
• ISSN: 0003-066X; 1935-990X
• DOI: 10.1037/a0017784

Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Improving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of the meta-system for children with emotional or behavioral needs include families, cultural norms and values, and service sectors such as schools, pediatric health centers, specialty mental health systems, juvenile justice systems, child protection services, and substance use treatment systems. We describe each component of the meta-system, noting challenges to the provision of evidence-based practice (EBP) and highlighting ways to optimize outcomes. Our focus is on the inclusion of evidence-based assessment and interventions, including prevention, within a developmentally driven and culturally responsive contextual model. Recommendations for addressing disparities in research funding and essential steps to foster communication and coordination of EBP across settings are provided.