Research on Child and Adolescent Mental Health

esearch agenda on clinical interventions for
youth to accomplish four tasks: (1) synthesize
(through reviews of the evidence base) the status
of science on promising interventions, (2) assess
quality indicators of outcomes to improve
standards of clinical practice, (3) evaluate
outcome measures, and (4) develop a new
research phase model for connecting research to
practice. Important to this effort is not only
identifying the evidence base on service
effectiveness but also attending to the models of
dissemination that will enable it to be used in
clinical practice. The aim is to address historically
intractable problems through learning how to
shift relevant evidence-based interventions to
youth with the most severe disorders. Critical
activities will include (1) establishing criteria for
interventions to be disseminated, (2) developing
“user-friendly” training and supervisory and
quality monitoring materials, and (3) conducting
dissemination research to test theoretical and
empirical approaches for changing practitioner
and organizational behavior.
A comprehensive dissemination and knowledge
transfer program would involve all three of these
classes of activities. It would require that research
findings, after having successfully gone through
rigorous scientific peer review procedures, be
provided in formats and language appropriate for
other audiences, such as providers and
consumers. Above and beyond the preparation of
appropriate materials, a comprehensive and
effective dissemination effort requires an
interpersonal component. The National Center for
the Dissemination of Disability <strong>Research</strong> (NCDDR)
(1996) reported that perhaps the most consistent
and ubiquitous finding in the literature on
knowledge utilization is the primacy of personal
interaction, and Crandall (1989) indicated that
“adequate materials and procedural guidelines,
coupled with responsive, in-person assistance
during later implementation, are imperative for
maximum success.” This finding is consistent
with the finding that credibility of the source of
information is critical for knowledge utilization.
“Credibility” refers to both the level of perceived
expertness and trustworthiness (NCDDR, 1996).
Personal interaction is very important for
promoting a level of trust that is more likely to
result in utilization of research findings.
The implications are that even with advances in
technology, in the complex area of interventions
for child mental health disorders, effective
knowledge transfer is labor-intensive and
expensive. <strong>Research</strong>ers who have developed
successful interventions need to be prepared to
respond to requests for assistance and to
proactively generate interest from groups that
may implement the intervention with high fidelity
to its principles and processes. Agencies such as
NIMH and CMHS that are interested in promoting
the use of evidence-based interventions in
children’s mental health need to identify
mechanisms to study and support this process.
CROSSING THE BOUNDARIES
It is increasingly clear that a goal of public health
science is ensuring that science-based services are
embedded into everyday practice and used by all.
Doing so necessitates new areas of
investigation— what might be called
dissemination and implementation science—to
understand how best to position and sustain
effective services in communities and identify
factors that impede this positioning. Achieving
this goal requires both a new genre of study and
persistent attention to questions about why
services are effective. Toward this end, scientists
must engage families, providers, and other mental
health stakeholders to increase the likelihood that
the research is relevant to their needs and will
produce findings that are credible and
scientifically valid.
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