Abstract and Keywords
This chapter outlines challenges to the successful dissemination of evidence-based treatments and to the realization of a broad public health impact of scientifically informed treatments. Themes include focusing on treatment designs, service systems, and training models that emphasize flexible interfaces for individual differences and exception management routines for real-time challenges. Examples include (a) modular treatment systems that balance laboratory-derived structure and expertise with real-time feedback, client input, and supervisory guidance; (b) service systems to accommodate youth for whom no evidence-based treatment is available or one has failed to achieve the intended benefit; and (c) training models that allow multiple starting points and pathways or strategies to achieve competencies across many evidence-based treatments. It is contended that the field must adopt new architectures in these areas to retain the many gains made by the proliferation of evidence-based treatments while also advancing the ability of evidence to guide practice in working systems.
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