The Research Forum is designed to drive the research policy agenda for child and adolescent psychiatry by creating an environment that encourages scientific exploration and collaboration of investigators across disciplines. The primary audience for the Research Forum is researchers, although others are invited to attend.

 

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The publication of findings from the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study this spring can be seen as completing a first round of adequately powered, multi-site intervention studies that compared medication and psychotherapy for the common disorders of childhood and adolescence (MTA, TADS, CAMS, POTS, and ADAPT). These studies brought together teams of child psychiatrists, psychologists, methodologists, and biostatisticians who have both changed the shape of child psychiatry practice and research and raised as many questions as they have answered.

Sponsored by the Work Group on Research, and under the leadership of Drs. David Shaffer, David A. Brent, and Neal D. Ryan, the Research Forum was stimulated by questions arising from the psychotherapy components of these studies: How can we respect parent choice for or against a particular mode of treatment? Psychotherapy is more time consuming and expensive than psychopharmacology; it sets out to provide the child and family with skills to reduce risk or to minimize the impact of an underlying condition. Is it reasonable to expect a more enduring outcome from psychotherapy and how do we interpret studies that fail to show this?

Manualization is essential to ensure that a treatment can be replicated by other professionals but their value is not always apparent. What do we make of site differences? Should they be highlighted and lead to careful revision of training practices and manual construction or can we assume that more experienced clinicians will always be different to less experienced ones? The imprimatur of “evidence-based” is sought by all practitioners but under what circumstances can that be applied broadly or should it be limited to therapy practiced in concordance with a single manual?

Finally, research in adults has noted that certain elements of therapy may have greater value than others. In cognitive behavioral therapy (CBT), for example, activation and exposure seem especially valuable for depression and anxiety respectively. Can we conclude that similar rules apply for children and adolescents? While not all of these questions will be answered at the Research Forum, the speakers presenting are a thoughtful and critical group of experts who will not shy away from such difficult questions and whose views and findings should be valuable for all.

Safety Issues in Psychotherapy Research
David A. Brent, M.D.

Modular Architecture in Psychosocial Treatments: Advantages for Efficacy, Efficiency, and Effectiveness
Bruce F. Chorpita, Ph.D.

Patient Choice and Adaptive Treatment Strategies
Philip W. Lavori, Ph.D.

Intervention Research that Combines Psychotherapy and Medication: Rationale and Methodological Considerations
John S. March, M.D., M.P.H.

Problem Solving as a Component of Psychotherapy
Laura Mufson, Ph.D.

Reappraising CBT for Adolescent Depression
V. Robin Weersing, Ph.D.

Neuroimaging and Neural Mechanisms that May Be Involved in Psychotherapy
Greg J. Siegle, Ph.D.

Empirical Research on Psychodynamic Psychotherapy: Can We Count What Counts?
Andrew J. Gerber, M.D., Ph.D.