Promoting Youth Self-Regulation through Psychotherapy: Redesigning Treatments to Fit Complex Youth in Clinical Care

Abstract

Improving self-regulation can be seen as a central objective of youth psychotherapy. Five decades of psychotherapy research have produced an array of evidence-based psychotherapies (EBPs), but meta-analyses have shown that these EBPs show only a modest advantage over treatments-as-usual. This suggests a need for therapies that can clearly improve upon usual practice. The Modular Approach to Therapy for Children protocol (MATCH; Chorpita & Weisz, 2009) was designed to meet this objective. MATCH integrates treatment components involving at least three forms of self-regulation and addressing anxiety, depression, and misconduct. An initial randomized trial of MATCH showed significant support, in comparison to both usual care and standard EBPs. Further improvements in MATCH and other treatments may come about through increased focus on strengthening self-regulation in cognitive, emotional, and behavioral forms.

In the very full agenda of what girls and boys need to accomplish during development, a centerpiece is the shift from external monitoring and control to self-regulation. Psychotherapy with children and adolescents (herein “youth”) has diverse goals, but many of these fit within the broad rubric of promoting effective self-regulation. This chapter focuses on what has been learned from youth psychotherapy research, what self-regulation processes appear to be involved, an emerging strategy for improving therapy outcomes for clinically referred youths, and ways an improved understanding of self-regulation may enhance and strengthen youth psychotherapy.