Leveraging Idiographic and Nomothetic Approaches to Examine Associations Between Treatment Components and Internalizing Symptoms Among Youth

Despite evidence that cognitive behavioral therapy (CBT) is effective for youths with internalizing disorders, many youths do not demonstrate substantial symptom improvement after therapy. Examining the specific treatment components that are associated with symptom change for individual youths using an idiographic approach is a key step towards building an evidence base to inform efforts to personalize and improve the effectiveness of treatment.

This study examined the use of CBT skills among (N = 11) youths receiving therapy for internalizing disorders. Ecological momentary assessment data of symptoms and skill use was collected twice daily throughout the course of treatment and youths completed a and semi-structured interview about CBT skill use at a post-treatment assessment. Idiographic mediation models were used to examine the use of specific CBT skills as candidate mediators of symptom change. Mediators varied by youth and the promises and challenges of using idiographic mediation models in practice-based research are discussed. Qualitative analysis of semi-structured interviews identified barriers and facilitators of CBT skill use outside of therapy sessions. The most helpful skills youths reported differed across individuals. Lack of understanding, lack of support, and emotional interference were identified as barriers to skill use.

This body of work contributes to a growing body of literature identifying active ingredients of psychotherapy and which treatment components may work best for whom.

Major Professor: Dr. Mei Yi Ng