Intervention scientists have published more than 600 randomized controlled trials (RCTs) of youth psychotherapies. Four decades of meta-analyses have been used to synthesize the RCT findings and identify scientifically and clinically significant patterns. These meta-analyses have limitations, noted herein, but they have advanced our understanding of youth psychotherapy, revealing (a) mental health problems for which our interventions are more and less successful (e.g., anxiety and depression, respectively); (b) the beneficial effects of single-session interventions, interventions delivered remotely, and interventions tested in low- and middle-income countries; (c) the association of societal sexism and racism with reduced treatment benefit in majority-girl and majority-Black groups; and, importantly, (d) the finding that average youth treatment benefit has not increased across five decades of research, suggesting that new strategies may be needed. Opportunities for the future include boosting relevance to policy and practice and using meta-analysis to identify mechanisms of change and guide personalizing of treatment.
Transgender and gender diverse (TGD) children and adolescents are an increasingly visible yet highly stigmatized group. These youth experience more psychological distress than not only their cisgender, heterosexual peers but also their cisgender, sexual minority peers. In this review, we document these mental health disparities and discuss potential explanations for them using a minority stress framework. We also discuss factors that may increase and decrease TGD youth's vulnerability to psychological distress. Further, we review interventions, including gender-affirming medical care, that may improve mental health in TGD youth. We conclude by discussing limitations of current research and suggestions for the future.
Racism constitutes a significant risk to the mental health of African American children, adolescents, and emerging adults. This review evaluates recent literature examining ethnic and racial identity, ethnic-racial socialization, religiosity and spirituality, and family and parenting as racial, ethnic, and cultural resilience factors that shape the impact of racism on youth mental health. Representative studies, purported mechanisms, and critiques of prior research are presented for each factor. Recent studies of racism and resilience revisit foundational resilience factors from prior research while reflecting new and important advances (e.g., consideration of gender, cultural context, structural racism), providing important insights for the development of prevention and intervention efforts and policy that can alleviate mental health suffering and promote health and mental health equity for African American youth.
Cognitive behavioral therapy (CBT) is often referred to as the "gold standard" treatment for mental health problems, given the large body of evidence supporting its efficacy. However, there are persistent questions about the generalizability of CBTs to culturally diverse populations and whether culturally sensitive approaches are warranted. In this review, we synthesize the literature on CBT for ethnic minorities, with an emphasis on randomized trials that address cultural sensitivity within the context of CBT. In general, we find that CBT is effective for ethnic minorities with diverse mental health problems, although nonsignificant trends suggest that CBT effects may be somewhat weaker for ethnic minorities compared to Whites. We find mixed support for the cultural adaptation of CBTs, but evidence for cultural sensitivity training of CBT clinicians is lacking, given a dearth of relevant trials. Based on the limited evidence thus far, we summarize three broad models for addressing cultural issues when providing CBT to diverse populations.
For many people worldwide, supernatural beliefs and attributions-those focused on God, the devil, demons, spirits, an afterlife, karma, or fate-are part of everyday life. Although not widely studied in clinical psychology, these beliefs and attributions are a key part of human diversity. This article provides a broad overview of research on supernatural beliefs and attributions with special attention to their psychological relevance: They can serve as coping resources, sources of distress, psychopathology signals, moral guides, and decision-making tools. Although supernatural attributions sometimes involve dramatic experiences seen to violate natural laws, people more commonly think of supernatural entities working indirectly through natural events. A whole host of factors can lead people to make supernatural attributions, including contextual factors, specific beliefs, psychopathology, cognitive styles and personality, and social and cultural influences. Our aim is to provide clinical psychologists with an entry point into this rich, fascinating, and often overlooked literature.
Over the past decade, behavioral interventions have become increasingly recognized and recommended as effective first-line therapies for treating individuals with tic disorders. In this article, we describe a basic theoretical and conceptual framework through which the reader can understand the application of these interventions for treating tics. The three primary behavioral interventions for tics with the strongest empirical support (habit reversal, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention) are described. Research on the efficacy and effectiveness of these treatments is summarized along with a discussion of the research evaluating the delivery of these treatments in different formats and modalities. The article closes with a review of the possible mechanisms of change underlying behavioral interventions for tics and areas for future research.
Research conducted over the past several decades has revolutionized our understanding of the role of the immune system in neural and psychological development and function across the life span. Our goal in this review is to introduce this dynamic area of research to a psychological audience and highlight its relevance for clinical psychology. We begin by introducing the basic physiology of immune-to-brain signaling and the neuroimmune network, focusing on inflammation. Drawing from preclinical and clinical research, we then examine effects of immune activation on key psychological domains, including positive and negative valence systems, social processes, cognition, and arousal (fatigue, sleep), as well as links with psychological disorders (depression, posttraumatic stress disorder, anxiety, schizophrenia). We also consider psychosocial stress as a critical modulator of neuroimmune activity and focus on early life adversity. Finally, we highlight psychosocial and mind-body interventions that influence the immune system and may promote neuroimmune resilience.
Since its inception, the discipline of psychology has utilized empirical epistemology and mathematical methodologies to infer psychological functioning from direct observation. As new challenges and technological opportunities emerge, scientists are once again challenged to define measurement paradigms for psychological health and illness that solve novel problems and capitalize on new technological opportunities. In this review, we discuss the theoretical foundations of and scientific advances in remote sensor technology and machine learning models as they are applied to quantify psychological functioning, draw clinical inferences, and chart new directions in treatment.
The Garrett Lee Smith (GLS) Memorial Act, continuously funded since 2004, has supported comprehensive, community-based youth suicide prevention efforts throughout the United States. Compared to matched communities, communities implementing GLS suicide prevention activities have lower population rates of suicide attempts and lower mortality among young people. Positive outcomes have been more pronounced with continuous years of implementation and in less densely populated communities. Cost analyses indicate that implementation of GLS suicide prevention activities more than pays for itself in reduced health care costs associated with fewer emergency department visits and hospitalizations. Although findings are encouraging, the heterogeneity of community suicide prevention programs and the lack of randomized trials preclude definitive determination of causal effects associated with GLS. The GLS initiative has never been brought fully to scale (e.g., simultaneously impacting all communities in the United States), so beneficial effects on nationwide suicide rates have not been realized.

