About ChAAMP Lab

Program Goals 

Our program centers on the development and testing of effective and efficient interventions for anxiety and depression in children and adolescents. To date, there have been over 1500 controlled investigations of psychotherapy for youth. Results of these studies tell a consistent story -- we can produce substantial changes in youths' symptoms, with treatment effect sizes in the moderate to large range. This would appear to be good news for the families of the millions of youth seeking mental health services each year and for the public and private organizations charged with their care. However, while we have copious evidence that interventions for youth can work well (i.e., are efficacious), we still have little information about whether treatments for youth do work well in the samples and settings of active, community practice (i.e., are effective).

To address this knowledge gap, Dr. Robin Weersing and her collaborators engaged in an initial program of work defining the models of treatment used in community practice, testing the effectiveness of these community therapies for depressed and anxious youth, and assessing the outcomes of evidence-based treatments (EBT) under conditions approximating real world clinical service. These studies revealed that (1) the outcomes of community mental health care for youth depression and anxiety may not exceed the natural remission rates for these disorders, and (2) it may be possible to improve community treatment outcomes by disseminating EBT to research settings and implementing them into active clinical practice.

This work served as the foundation for a series of treatment development studies aimed at designing a short, efficient, transdiagnostic treatment model to simultaneously address anxiety and depression in youths. Using a deployment-focused framework, the brief behavioral therapy (BBT) model was developed to target the core mechanism of behavioral avoidance and withdrawal in the face of negative affect common to both anxiety and depression. This behavioral model does not rely on cognitive restructuring, a central ingredient in other EBTs that may be challenging for clinicians to learn and deploy and for youth to assimilate. In contrast, BBT combines simpler techniques of exposure and behavioral activation, both identified as key elements for treatment response. In a multi-site randomized controlled trial based in pediatric primary care, BBT outperformed referral to treatment-as-usual and eliminated disparities in access and outcomes for Latinx youths. The BBT project page provides additional information on the longer-term effects of the program, evidence for mechanism, cost-effectiveness, and downstream impacts on other outcomes. On the basis of these promising results, BBT was adapted to a digital health platform (STEP-UP) to increase scalability and is currently being tested in low-resource community health centers as part of a hybrid implementation-effectiveness trial.

In addition to ChAAMP research on the effectiveness of treatments, we have a long history of research on the prevention of depression and internalizing disorders in youth, including studies designed to interrupt the intergenerational transmission of depression. Details on these prevention projects and other associated studies can be found on the Other Projects page.