Evidence-Based Practice in the Juvenile Justice System: Balancing Clinical Expertise with Best Available Research and Client Variables

Each year, thousands of adolescents are processed through the juvenile justice system -- a system that is complicated, expensive, and inadequately addressing the needs of the youth in its care. While there is extensive literature available in support of interventions for youthful offenders that are clinically superior to current care and more cost-effective than the existing structure, there is a gap between research and practice that is preventing their implementation. The use of Evidence-Based Practice in Psychology (EBPP) as defined by the American Psychological Association is presented as one method to bridge this gap. This paper identifies and discusses each of five barriers to effective use of EBPP: cost, fragmentation of the mental health system, historical and systemic variables, research methodology, and clinician variables. These barriers are first defined and then illustrated using examples from the author's experience working in the juvenile justice field. Finally, recommendations for the field are presented.

Program Evaluation of an After-School Socialization Group Program

Use of evidence-based practice is becoming more expected and necessary for mental health practitioners. This allows for proof, accountability, and rigorous standards to be upheld, facilitates healthcare reimbursement, and provides a wider range of services to more clients. Appropriate monitoring and outcome measurement is essential to determine the effectiveness of a given intervention. An organization providing group social skills interventions for children 7-18 years was analyzed to facilitate the best plan for evaluating treatment effectiveness. Measurable goals and objectives consistent with the organizations mission and values were developed. Appropriate social skills measurement tools were identified. Strengths and weaknesses of each measure were compared, and existing literature was reviewed to ensure cohesion between this evaluation and current standards in literature. Parent report, self report, and teacher report on Piers-Harris II, BASC-2, and Skills Improvement System Rating Scales were determined to be the most relevant measures of social skills development. A timeline for administration and plan for how to implement measurement and use data was suggested as well as considerations for future research.

The Eating Disorder Inventory-III Maturity Fears Scale and Treatment Outcome in an Intensive Outpatient Eating Disorder Program

Eating disorders present a significant physical and psychological problem with a prevalence rate of approximately six percent in the United States. Despite the extensive literature, identifying the consistent risk factors for predicting the course of treatment in eating disorders remains difficult. The present study explores the use of a standardized assessment, using the consistently validated Eating Disorder Inventory-III (EDI-3), in predicting treatment outcome. Specifically, the study investigates the particular scale of Maturity Fears (MF) on the EDI-3, hypothesizing that higher scores on the MF scale would predict lower rates of recovery and treatment completion. The participants were 52 eating disorder patients (19 AN, 18 BN, and 15 EDNOS), consecutively admitted to a five-month long intensive outpatient program (IOP). The participants completed an EDI-3 self-report at pre and post treatment, and their score on the MF scale did not show a significant predictive relationship to treatment completion or change in symptoms, as measured by the Eating Disorder Risk Composite (EDRC) scale on the EDI-3. This finding primarily suggests that maturity fears are not a significant predictive factor in an outpatient setting with adults, as compared to previous studies that found a relationship between maturity fears and treatment outcome, primarily with adolescent and inpatient populations.