Mix and MATCH: The use of a Modular Approach for Youth Psychotherapy in Routine Clinical Care and Associations with Outcomes

Abstract

The Modular Approach to Therapy for Children (MATCH) consists of individual evidence-based components (modules) that clinicians can flexibly select to target a range of emotional and behavioral symptoms. The treatment manual includes flowcharts that outline a sequence of modules recommended for each problem area: anxiety, depression, and conduct problems. This study explored the use of modules and associations with outcomes for youths who received MATCH in routine clinical care. The sample included 964 youths ages 3–17 (51% female, 52% White, 35% Hispanic, 9% Black) with primary anxiety, depression, or conduct problems. Youths typically received modules from the MATCH flowchart for their primary problem as well as some modules from other problem areas. The use of more modules from the flowchart for the youth’s primary problem predicted greater clinician-rated improvement (Clinical Global Impressions-Improvement; CGI-I). In addition, youths with primary depression improved more when they received more modules from the anxiety flowchart and youths with primary conduct problems improved more when they received more modules from the depression flowchart, based on the CGI-I at the last timepoint. Providing more modules from the flowchart for a youth’s primary problem area predicted the severity of top problems (Top Problems Assessment; TPA) at the last timepoint for youths with primary depression (based on caregiver and youth report) and primary conduct problems (based on caregiver report). Results suggest that clinicians should generally use modules from the flowchart for the youth’s primary problem and incorporate modules from other problem areas to address additional concerns as needed.