As with all health care professionals, psychologists are dedicated to offering the best level of care available by constantly evaluating and comparing the effects of various treatments for a variety of child and adolescent mental health problems. In other words, psychologists wish to discover which treatment is likely to work best for each individual. While there are many definitions one could use to categorize the level of research support for a psychological treatment, one of the most commonly used systems—and the one utilized by this website—is based on the criteria outlined by Chambless et al. (1998) as updated in a recent paper in the Journal of Clinical Child and Adolescent Psychology (Southam-Gerow & Prinstein, 2013).
A few notes before we summarize the categories below. Each treatment listed on this website has been evaluated for categorization to levels of research support for each problem area. That is, “Treatment A” may be at Level 3 (i.e., “Might Work”) for depression and at Level 1 (i.e., “Works Well”) for anxiety.
Also, as new evidence emerges, treatments may change levels, moving either up or down. EffectiveChildTherapy.com will strive to keep its list up to date.
To summarize, a given psychological treatment can be grouped as follows:
Level #1: Works Well; Well-Established Treatments
Level 1 treatments have the strongest research support to date. To meet this high standard, these treatments must satisfy a number of stringent criteria. Above all, there must be at least two large-scale randomized controlled trials (RCTs)
which have demonstrated the superior efficacy of the treatment to some other treatment (e.g., a placebo or another strong treatment). Further, these studies must have been conducted by independent investigatory teams working at different research settings. That is, the treatment must be one that works well for different scientists, not just the ones who developed the treatment.
Level #2: Works; Probably Efficacious Treatments
Level 2 treatments will have strong research support, too, but they will lack the independent investigator criteria from Level 1. It is also possible to reach Level 2 with one study if that study demonstrates the treatment is superior (or statistically equivalent) to a Level 1 treatment.
Level #3: Might Work; Possibly Efficacious Treatments
Level 3 treatments are what might be called “promising treatments.” There may be one strong treatment study showing that the treatment is better than no treatment. Or they may be a number of smaller clinical studies without all of the appropriate methodological controls. In short, confidence that a Level 3 treatment works is not as strong as it could be.
Level #4: Unknown/Untested; Experimental Treatments
Level 4 treatments are ones that are being used but have not been studied carefully. Some would suggest that these treatments should be avoided until further evidence is available. However, for some child/adolescent problem areas for which there is limited or no evidence that compares different treatments, a treatment at this level could be worth considering as an option.
Level #5: Does Not Work/Tested But Did Not Work
Level 5 treatments have been tested in well-designed studies and have not yet demonstrated positive findings. A Level 5 treatment may either not be better than no-treatment (or other comparison treatments) or else the treatment actually made things worse. Whereas it is possible that new evidence will show that a Level 5 treatment works better in the future, a treatment listed as Level 5 would not be a good treatment option.