Treatment-as-usual therapy targets for comorbid youth disproportionately focus on externalizing problems

Psychological Services
Matthew Milette-Winfree, Charles W Mueller

Abstract

This study examined whether psychological treatment for youth with comorbid externalizing and internalizing disorders targets externalizing rather than internalizing pathology. Therapist-reported treatment targets for youth (N = 679) with (a) only internalizing diagnoses (n = 195); (b) only externalizing diagnoses (n = 314); (c) a primary internalizing diagnosis and at least 1 additional externalizing diagnosis (n = 75); and (d) a primary externalizing diagnosis and at least 1 additional internalizing diagnosis (n = 95) receiving treatment-as-usual in a public mental health system of care were examined. Treatment targets that appeared significantly more often in the externalizing-only and internalizing-only diagnostic groups were empirically determined, and a derived proportional measure of these targets was analyzed across all 4 diagnostic groups, controlling for effects of additional client and treatment characteristics. As required by the target selection method, the proportion of externalizing targets selected in treatment was greatest for youth with externalizing-only diagnoses and least for youth with internalizing-only diagnoses. Importantly, the co-occurrence of a secondary externalizing disorder with a primary internal...Continue Reading

Citations

Nov 28, 2017·Administration and Policy in Mental Health·Daniel P WilkieCharles W Mueller
May 29, 2020·Administration and Policy in Mental Health·Kaitlin A HillBrad J Nakamura
Jul 15, 2020·Administration and Policy in Mental Health·Daniel P Wilkie, Charles W Mueller
Feb 25, 2021·Administration and Policy in Mental Health·Emilee H Turner, Charles W Mueller

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