Toward Large-Scale Implementation of Empirically Supported Treatments for Children: A Review and Observations by the Hawaii Empirical Basis to Services Task Force

Mental health practice is witnessing a new era in the development and implementation of treatments supported by research (e.g., Barlow, 1994; Chambless & Hollon, 1998). Many of these changes have followed the reports of the American Psychological Association (APA) Clinical Division, as well as numerous contributions and commentaries by clinical scientists (e.g., Chambless et al., 1996; Chambless et al., 1998; Task Force on Promotion and Dissemination of Psychological Procedures, 1995; Task Force on Psychological Intervention Guidelines, 1995). These efforts have greatly increased the attention given to the quality of evidence for various psychological treatments and have provided new criteria with which to understand, evaluate, and select treatments for various mental health problems. Over the past five years, these reports, their updates, and associated commentaries have constituted a substantial movement within psychology for the selection and implementation of the best psychosocial treatments (Barlow, 2000). Many of these developments formally originated with the APA Task Force on Psychological Intervention Guidelines (1995). This group outlined a template for measuring the quality of psychosocial treatments, with the goal of establishing guidelines to determine which treatments are best for various mental health problems. The group outlined the two well-known dimensions along which treatments should be evaluated: (a) efficacy, i.e., how well a treatment is known to bring about change in a target disorder in clinical research, and (b) effectiveness, i.e., how well a treatment is expected to perform in a real world setting. These terms have been defined and dis-