Evidence Based Practices for Children

Modular Approach to Therapy for Children 

Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, and Conduct Problems (MATCH - ADTC) is an evidence-based treatment designed for children ages 6 - 17. Unlike most treatment approaches that focus on single disorders, MATCH is designed to treat four common behavioral health concerns among children, including anxiety, depression, post traumatic stress, and behavior problems. MATCH-ADTC is comprised of 33 modules (e.g., praise, rewards, etc.) representing treatment components that are frequently included in cognitive behavioral therapy (CBT) protocols for depression, anxiety including post-traumatic stress, and behavioral parent training for disruptive behavior. Based on the child's primary concern, treatment is sequentially organized and flexible in order to tailor treatment to each child's specific characteristics and needs.

Ecosystemic Structural Family Therapy 

ESFT is an evidence-informed, six to eight month in-home, intensive family treatment approach, originally developed in 1988 through a collaboration between Philadelphia Child Guidance Center and the Commonwealth of Pennsylvania. In addition to being grounded in systems theory, the approach is trauma-informed and attachment-focused.

ESFT has been specifically designed to treat children and adolescents, ages three to 18, with serious emotional disturbance who live in multi-stressed families.  Children and adolescents treated with this model have typically received multiple previous behavioral health services with limited success.   In addition, both children and their caregivers often have a history of Complex

Developmental Trauma.  The model directly addresses the impacts of this history on current family organization and functioning.  Although ESFT is not a specific treatment for single incident trauma and PTSD, it is compatible with and complements evidence-based treatments such as Trauma Focused CBT.   

 

Children and adolescents treated with ESFT have serious difficulty regulating emotions and behavior and tend to carry multiple diagnoses. The most common presenting problems include oppositional defiance, aggression, problems with impulse control, ADHD, mood lability, depression (with suicidality), and anxiety. ESFT has also been successfully applied to families in which the identified child is on the Autism Spectrum (mild to moderate impairment) or has other developmental disabilities. However, the primary focus must be on the child’s emotional/behavioral problems and/or family functioning, not the developmental disability itself.

Since most interventions flow through caregivers, ESFT is not appropriate when there is no caregiver who is willing and able to commit to ongoing involvement in the treatment.  There is no requirement, however, that the child be living with their caregivers.  For example, this model has been successfully applied to children in foster care when both the foster family and the biological parents are willing and able to participate in the treatment, and the plan is reunification.

 

ESFT is the appropriate service when the adolescent is engaged in mild to moderate anti-social behavior and/or is abusing substances, such as alcohol and marijuana, when the child’s social-emotional problems are primary.  ESFT may not be the best fit for adolescents, however, when their primary issues involve more serious crime/delinquency or substance abuse.

ESFT is based on the assumption that chronic SED symptoms are created and maintained by a hyper-arousing, under-supportive relational environment.  This environment is driven by 1) underdeveloped emotional regulation skills (caregivers and child), 2) problematic parent-child attachments, 3) weak executive structure in the family, and 4) inadequate support for the caregivers.

Primary Goals: Child-Focused 

  1. Emotional/behavioral symptoms and safety concerns are reduced 

  2. Child can participate more fully in home, school and the community

  3. Reduced risk for out-of-home-placement.  Caregivers believe they can parent the child in home

 

Mediating Goals: Family-Focused

  1. Caregivers is better able to work together to establish/maintain reasonable household rules/routines

  2. Caregivers able to be more emotionally available to child as a consistent source of support

  3. Family is better able to de-escalate conflict and use problem solving skills when tension is high 

  4. Child is better able to use coping skills and develop resilience  

Family Centered Treatment (FCT)

Family Centered Treatment (FCT) is part of Carolina Outreach’s continuum of care for at-risk children and their families. FCT is an evidence-based, in-home service that helps to preserve the family and prevent out-of-home placements.

FCT services are conducted in the family’s home and include:

  • Individualized Service Plans

  • Case management

  • Counseling / behavioral therapy

  • Skills training

  • Resource coordination

  • 24/7 Crisis interventions

 

For youth in therapeutic foster care and residential programs, we utilize the FCT model to help reunite them with their families when it is in the best interest of the child. For children and adolescents living at home, our skilled therapists bring FCT services into their home, where they and their parents/caregivers can learn the skills they need to succeed in their everyday lives.

 

The FCT model includes multiple contacts with the family each week, excluding the ramping up period (first month) and the slowing down period (last month of treatment). Lengthier and more frequent sessions are available based on assessed need.

 

On-call support is available 24/7/365. The average length of treatment is 6 months, but the length of treatment is driven by family need and progress and may be shorter or longer in duration.

FCT services are typically conducted in a(n):

  • Adoptive home

  • Birth family home

  • Foster/kinship care

Parent-Child Interaction Therapy

Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment model backed by over 30 years of research. PCIT focuses on improving the quality of the parent-child relationship by changing parent-child interaction patterns. PCIT was developed for children ages 2–7 years with externalizing behavior disorders. In PCIT, parents are taught specific skills to establish or strengthen a nurturing and secure relationship with their child while encouraging pro-social behavior and discouraging negative behavior.


PCIT is designed to help both parents and children through skills training, observation, and live coaching. PCIT aims to empower parents to be their child’s therapist, which makes change happen faster and last longer than with traditional play therapy. Parents and children in the PCIT program work together to improve the quality of the parent-child relationship, to build the child’s self-esteem, to improve the child’s compliance and listening skills, and to teach parents the skills necessary to manage their child’s severe behavior problems.


The basic abuse program provides group support and education for those with an abuse diagnosis. Groups meet twice weekly, for 16 sessions, for 90 minutes each session.

Trauma-Focused Cognitive Behavioral Therapy

The goal of Trauma-Focused Cognitive Behavior Therapy (TF-CBT) is to help address the biopsychosocial needs of children with Post-traumatic Stress Disorder (PTSD) or other problems related to traumatic life experiences, and their parents or primary caregivers. TF-CBT is an evidence-based model of psychotherapy that combines trauma-sensitive interventions with cognitive behavioral therapy. Children and parents are provided knowledge and skills related to processing the trauma; managing distressing thoughts, feelings, and behaviors; and enhancing safety, parenting skills, and family communication.

 

Therapeutic elements of TF-CBT can be easily remembered, based on the “PRACTICE” acronym:

  • Psychoeducation and Parenting skills

  • Relaxation

  • Affective Expression and Regulation

  • Cognitive Coping

  • Trauma Narrative Development and Processing

  • In Vivo Gradual Exposure

  • Conjoint Parent-Child Sessions

  • Enhancing Safety and Future Development

  • Family Systems/Family-Based Therapy