Trial reportResearch on child and adolescent psychopathology2025
Understanding How and When Therapists Misstep: Navigating Engagement Challenges in Youth Mental Health Services.
Trial report in Research on child and adolescent psychopathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Demographics, Services, and Practices in Attention-Deficit/Hyperactivity Disorder Coaching in the US.JAMA network open · 2026Article
- ADHD coaching since the COVID-19 pandemic: Is there a new wave of ADHD coaches?Frontiers in psychiatry · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Therapist "missteps" (i.e., inadvertent, less optimal, or noncollaborative therapist behaviors) have the potential to negatively impact youth and family engagement in community mental health services. The present study explores potential misstep occurrences and whether they varied across various distal and proximal factors related to treatment planning, preparation, and clinical context. Data were drawn from a multi-site cluster-randomized controlled trial focused on promoting therapist use of evidence-informed procedures to engage youth and families in urban and rural community mental health services. Audio recordings from 391 treatment sessions delivered by 92 therapists were transcribed and coded for missteps occurrences. Missteps were sporadic, but occurred in most sessions, frequently manifesting as advice giving, but taking a variety of other forms. Their occurrence appeared to be lower when supervision involved preparing a plan for engaging the client, when there was a single participant in the session, and when treatment sessions occurred soon after supervision. Engaging in preparatory activities in supervision and receiving timely supervision prior to treatment delivery may be more protective against therapist missteps than simply selecting a practice to deliver. Additionally, unique challenges of family sessions may increase the likelihood of missteps occurring, highlighting the importance of specialized training for conducting family sessions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.