Dr. Weissman and his colleagues have been involved in the development and evaluation of four innovative transdiagnostic treatments for youth emotional and behavioral challenges:
1. Modular Approach to Therapy for Children with Anxiety, Depression, Trauma or Conduct Problems (MATCH-ADTC)
2. Compassion Focused Parent Therapy
3. Individual and/or Group Behavioral Activation Therapy
4. Cognitive Therapy
Modular Approach to Therapy for Children with Anxiety, Depression, Trauma or Conduct Problems: Most structured, manual-guided youth psychotherapies are focal and linear, focusing on one type of disorder or problem (e.g., depression), with treatment content presented in relatively fixed order. In contrast, youths referred for treatment often present with multiple disorders or problems, and their most pressing problems may fluctuate from session to session. To address these characteristics of clinic-referred youths, MATCH spans four broad problem domains (anxiety, depression, post-traumatic stress, and conduct problems), offering therapists a menu of 33 “modules”—i.e., empirically supported treatment procedures for the four problem areas (Chorpita & Weisz, 2009). Flowcharts guide therapists in selecting and sequencing the modules, to create a personalized treatment for each youth (Ng & Weisz, 2016). Initial multi-site RCETs of MATCH have shown superior clinical outcomes versus usual clinical care, and versus standard individual treatment protocols for anxiety, depression, and conduct problems (Weisz… Weissman, & Jensen-Doss, 2018; Weisz, Bearman, Ugeto, Herren, Evans, Cheron, Alleyne, Weissman, et al., 2019).
CFPT (Weissman et al., in preparation) combines the most evidence-based positive parenting strategies for child anxiety and behavioral issues with compassionate, parent-centered therapy drawing from CBT, DBT, CFT, ACT, Schema Therapy, Shame Resilience and Attachment-Based Work.
CFPT understands that each parent brings their own psychological and cultural histories, including intergenerational trauma, into the therapy room which is deeply connected to their personal views on parenting, their strengths and limitations as a parent, and their desire, readiness, and ability to implement evidence-based parenting techniques to enact lasting change in the parent-child relationship. So in a sense, the therapist-parent relationship serves as a microcosm for rebuilding the parent-child relationship, providing structure, safety, perceived control, skills to manage difficult or unwanted emotions, and clear paths toward progress and success for both the parent and child alike.
IBAT was developed as an individually based transdiagnostic treatment targeting avoidance across internalizing disorders (Chu, Colognori, Weissman, & Bannon 2009). IBAT is a manual-based, individual behavioral activation therapy aimed at treating youth with anxiety, depression, and anger. The program consists of 10-14 weekly 60-minute sessions.
It uses behavioral activation (BA) strategies to target avoidance by helping youth identify stuck points in their lives through functional assessment of numerous life domains, including family and peer interactions, school, extracurricular activities, and health and self-care. Across sessions, youth learn and practice skills as they work towards achieving goals and improving functioning in these numerous domains.
The overall structure of the program employs 4 core principles of behavioral activation:
After identifying areas in need of improvement and establishing concrete, meaningful goals, youth are taught skills via the TRAP acronym (Trigger, Response, Avoidance Pattern) and TRAC acronym (Trigger, Response, Active Coping; Addis & Martell, 2004), which helps youth to recognize avoidance patterns and replace them with approach-oriented solutions.
Throughout each session, youth are able to practice these skills through behavioral experiments, which help to solidify the information, provide experiential learning, model active choices, and offer real-time coaching from the therapist. Additionally, by practicing in session, potential barriers can be identified and problem-solved with the help of the clinician.
The latter half of the manual incorporates extended Behavioral Activation and In Vivo Exposure exercises to optimize experiential learning. Given consistent findings that exposures are typically not implemented by clinicians, the IBAT manual includes a number of elements specifically aimed at increasing use of these techniques, such as clear, simplified explanations, lists of potential exposures for clinicians to use, and vignettes to serve as models for clinicians.
Cognitive therapy is based on the premise that thoughts influence emotions and behaviors and determine how bodies physically respond—all within the environmental context. Cognitive therapy is a relatively short treatment—6 months or less— and focuses on changing thoughts that may result from—and contribute to—a wide range of challenging emotions, with the goal of alleviating distress and enhancing wellbeing.
(CFPT, Weissman et al., in preparation)
(IBAT, GBAT; Chu, Colognori, Weissman, & Bannon, 2009).
(MATCH-ADTC; Weisz… Weissman, & Jensen-Doss, 2018; Weisz, Bearman, Ugeto, Herren, Evans, Cheron, Alleyne, Weissman, et al., 2019).
