For years, clinicians have been grappling with the issue of what characterizes a successful intervention. In 2005, Chorpita and his colleagues tackled this question by proposing a Distillation and Matching Model (DMM) in which evidence-based practices are distilled into profiles of practice elements. By developing these profiles, treatment providers may select the best intervention for an individual, matching on age, gender, ethnicity, diagnosis, procedures, and other potential variables based on what is included in the manuals. These researchers took the DMM further (Chorpita et al., 2007) by identifying implementation barriers, suggesting potential solutions, and emphasizing the value of the DMM in providing flexibility based on clinical judgment. They clarified that the modular approach does not mean that clinicians can pick and choose the practice elements that they want and introduce them out of sequence—the core elements must still be delivered with fidelity. What it does mean is that clinicians able to individualize the treatment plan so that it addresses multiple problems that a client may have since treatment manuals usually focus on one issue.

In 2009, Chorpital and Daleiden reported on a study in which they applied the DMM to 322 randomized clinical trials for child mental health interventions. After coding on specific practice elements, they found that the treatments arranged themselves in clusters, generally around problem areas such as anxiety, depression, conduct disorders, autism, and trauma. They advanced these findings in 2011, when they noted that they were able to identify the minimum number for treatments for the maximum number of clients in children’s mental health services. Cognitive behavioral therapy was the intervention in over 40% of the treatment groups that did significantly better than the control groups. Lindsey and his colleagues used the same methodology to identify common practice elements in family engagement strategies and found that assessment and accessibility promotion were two practice elements present in at least half of the treatment groups that outperformed a control group (2013).

The result of these studies have implications for treatment providers in North Carolina in that the treatment practices that they adopt should include the common practice elements in successful interventions. National registries such as SAMHSA’s National Registry for Evidence-based Programs and Practices (NREPP); the California Evidence-based Clearinghouse for Child Welfare; and the Model Programs of the Office of Juvenile Justice and Crime Prevention provide practice elements for each of the interventions that they deem to be evidence-based.

References:
Chorpita BF, Becker KD, Daleiden EL. Understanding the common elements of evidence-based practice: Misconceptions and clinical examples. Journal of the American Academy of Child and Adolescent Psychiatry, 2007;46(5):647-52.

Chorpita BF, Bernstein A, Daleiden EL. Empirically guided coordination of multiple evidence-based treatments: An illustration of relevance mapping in children’s mental health services. Journal of Counseling and Clinical Psychology, 2011;79(4):470-80.

Chorpita BF, Daleiden EL. Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials. Journal of Counseling and Clinical Psychology, 2009;77(3):566-79.

Chorpita BF, Daleiden EL, Weisz JR. Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research, 2005;7(1):5-20

Lindsey MA, Brandt NE, Becker KD, Lee BR, Barth RP, Daleiden EL, Chorpita BF. Identifying the common elements of treatment engagement interventions in chidlren’s mental health services. Clinical Child and Family Psychology Review, published online December 31, 2013.