Dissemination of Youth ESTs: Ready for Prime Time?

Herschell, McNeil, and McNeil (this issue) provide a thoughtful assessment of and potential remedies for obstacles to dissemination of empirically supported child and adolescent treatments. Despite the compelling case for disseminating such treatments to clinical service settings, substantial differences between service clinics and research clinics justify the need for systematic effectiveness trials as part of the dissemination process. It is proposed that evidence from effectiveness trials will reveal features of treatments, such as engagement strategies, that require development or modification in order to optimize outcomes. Clear evidence for the superiority of empirically supported treatments (ESTs) over treatment as usual in service clinics will promote acceptance and implementation of ESTs in clinic practice. Key words: dissemination, empirically supported treatments, clinical child psychology, therapeutic alliance, clinical service settings, treatment outcomes, effectiveness trials.