Quantity vs. Quality of Experiential Learning: What Matters Most in Youth Mental Health Treatment?

Background The evidence base for youth mental health interventions is robust, but there is still room to improve implementation and increase the effectiveness of these interventions for youth who receive services in routine care settings. Adaptations to the delivery of evidence-based treatments (EBTs) can affect the impact of intervention components and may help maximize treatment outcomes. In-session experiential learning strategies such as modeling, role-play, and in vivo practice of skills are a feature of numerous EBTs; however, the application of these strategies in youth mental health treatment is understudied.Objective The current study used data from two randomized controlled effectiveness trials in community mental health testing EBTs to characterize the use of experiential learning strategies and evaluate their relationship with youths’ symptom reduction over the course of treatment.Method Observational coding of therapy sessions (N = 899) was used to assess the quantity and quality of experiential learning strategies that youth (N = 96, Mage = 9.93 years, SD = 2.55) with anxiety, depression, trauma, and/or disruptive behavior received across a course of a modular treatment that includes elements of behavioral and cognitive behavioral therapy.Results Averaged across episodes of care, 9% of total therapy time was devoted to experiential learning, most often in the context of relaxation and exposure. Results of growth curve modeling suggested that the quality of experiential learning (measured by specificity, collaborative processing, and personalization of content), but not the quantity, had a modest but significant association with youth-reported symptom reduction.Conclusion Higher quality experiential learning may help to maximize the effectiveness of evidence-based therapeutic content in reducing youth symptoms in routine care settings.