CHOICES Youth Psychopathology and Treatment Lab
David A. Langer, Ph.D., ABPP
To learn more about Dr. David Langer and his work, please visit his faculty page.
Current Research Projects
Personalizing Treatment through Shared Decision-Making for Youth Psychotherapy
Research evidence supports a growing array of effective treatments for youth depression and anxiety, yet as the collection of evidence-based treatments (EBTs) expands, so do the challenges of utilizing the evidence: clinicians must be able to (1) access, integrate, and apply the available evidence, and (2) engage in a collaborative process with each family to develop a plan that is responsive to each family’s unique characteristics, preferences, and goals. Such collaboration, frequently referred to as shared decision-making (SDM), is a hallmark of evidence-based practice. However, empirical support is lacking, particularly in the area of youth mental health treatment. The absence of such research is unfortunate, given the potential for SDM to facilitate the dissemination and implementation of EBTs and to personalize the use of established treatments to increase acceptability, retention, satisfaction, and overall effectiveness. Supported by an NIMH K23 Award, this is a 3-phase study to: 1) develop an SDM protocol using mixed methodology and consultation with experts in EBTs, SDM, and family/youth advocacy, 2) conduct a case series to further refine the protocol prior to pilot testing, and 3) test the feasibility and acceptability of SDM through a pilot RCT of 40 youths (ages 7-15) meeting diagnostic criteria for an anxiety or depressive disorder. The RCT compares an EBT that is planned collaboratively with youths and caregivers using the SDM protocol, to an EBT that is planned by the clinician and supervisor using pretreatment assessment data. The grant is currently nearing the end of Phase III.
Increasing Treatment Efficiency Using SMART Methods for Personalizing Care
Increasing the efficiency of existing treatments for anxiety and depressive disorders is critical for substantially improving the treatments’ impact on public health. In this project, funded by the National Institute of Mental Health, 60 adult participants with heterogeneous anxiety disorders (and comorbid conditions, including depression) will be enrolled in a pilot sequential multiple assignment randomized trial (SMART). Patients will be randomly assigned to one of three sequencing conditions: transdiagnostic treatment administered in its standard module order, module sequences that prioritize capitalizing on relative strengths, and module sequences that prioritize compensating for relative weaknesses. Next, after 6 sessions, participants will be randomly assigned to either continue or discontinue treatment to evaluate post-treatment change at varying levels of engagement of the core process (avoidant reactions to emotional experiences). This project is being conducted in collaboration with Dr. Shannon Sauer-Zavala in the University of Kentucky.
Clinician Perspectives on Treatment Planning in Youth Mental Health Care: A Mixed-Methods Study
Even if it is clear that an SDM approach enhances treatment planning, challenges remain in disseminating and implementing SDM in community-based practice. There is substantial evidence that proceeding to the dissemination and implementation of any practice-related changes without understanding current practices and providers’ perspectives significantly decreases the likelihood that dissemination efforts will be fruitful. Despite ample data on community-based therapeutic approaches, as a field we lack data on how these treatments are planned. Specifically, we need to identify community-based therapists’ perspectives on the degree to which treatment plans are developed and/or discussed with families, and describe therapists’ perspectives regarding the incorporation of the research base into treatment planning and the active inclusion of youth and caregivers. The goals of this mixed-methods study are to interview and assess therapist perspectives, identifying challenges and opportunities for the dissemination and implementation of SDM.
Observational Coding of Treatment Planning Practices
Many clinicians report that they are engaging youth and families in the treatment planning process, but there is limited data on the degree to which clinicians regularly involve youth and families in treatment planning. In fact, there is limited data on how treatment plans are shared and discussed in any capacity. In this study, we are developing and using an observational coding measure to identify and describe treatment planning discussions in youth psychotherapy provided in usual care settings.
References and Materials
Weisz, J. R., Bearman, S. K., Ugueto, A. M., Herren, J. A., Evans, S. C., Cheron, D. M., Alleyne, A. R., Weissman, A. S., Tweed, J. L., Pollack, A. A., Langer, D. A., Jensen-Doss, A. (in press). Testing Robustness of Child STEPs Effects with Children and Adolescents: A Randomized Controlled Effectiveness Trial. Journal of Clinical Child and Adolescent Psychology.
*Holly, L. E., *Fenley, A. R., *Kritikos, T. K., Merson, R. A., Abidin, R. R., & Langer, D. A. (in press). Evidence-base update for parenting stress measures in clinical samples. Journal of Clinical Child and Adolescent Psychology.
*Keller, A. E., Langer, D. A., Pincus, D. B., *Elkins, R. M., Kerns, C. E., & Comer, J. S. (in press). A psychometric evaluation of the distress intolerance index for youth. Journal of Psychopathology and Behavioral Assessment.
*O’Connor, E. E, & Langer, D. A. (2019). I Heard it Through the Grapevine: Where and What Parents Learn about Youth Mental Health Treatments. Journal of Clinical Psychology, 75(4), 710-725.
Langer, D. A. & Jensen-Doss, A. (2018). Shared decision-making in youth mental health care: Using the evidence to plan treatments collaboratively. Journal of Clinical Child and Adolescent Psychology, 47(5), 821-831.
De Los Reyes, A. & Langer, D. A. (2018). Assessment and the Journal of Clinical Child and Adolescent Psychology’s Evidence Base Updates Series: Evaluating the Tools for Gathering Evidence. Journal of Clinical Child and Adolescent Psychology, 47(3), 357-365.
*David, J. G., Lo, M. S., & Langer, D. A. (2018). Adolescent and caregiver perspectives on medical decision-making for chronic illness. Families, Systems, and Health, 36(2), 248-251.
Tompson, M.C., Sugar, C. A., Langer, D. A., & Asarnow, J. R. (2017). A randomized clinical trial comparing family focused treatment and individual supportive therapy for depression in childhood and early adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 515-523.
*O’Connor, E. E., Langer, D. A., & Tompson, M. C. (2017). Maternal depression and youth internalizing and externalizing symptomatology: Course of past maternal depression and maternal current functioning. Journal of Abnormal Child Psychology, 45(3), 557-568.
*Rabner, J., *Mian, N. D., Langer, D. A., Comer, J. S., & Pincus, D. (2017). The relationship between worry and dimensions of anxiety symptoms in children and adolescents. Behavioural and Cognitive Psychotherapy, 45(2), 124-138.
*Reid, G. M., Grills, A. E., *Mian, N. D., Reid, A. A., *Merson, R. A., & Langer, D. A. (2017). Using research-informed pedagogical practices to maximize learning in youth cognitive behavioral therapy. Evidence-Based Practice in Child and Adolescent Mental Health, 2(2), 82-95.
Tompson, M. C., Langer, D. A., Hughes, J. L., & Asarnow, J. R. (2017). Family-focused treatment for childhood depression: Model & case illustrations. Cognitive and Behavioral Practice, 24(3), 269-287.
*Kemp, G. N., Langer, D. A., & Tompson, M. C. (2016). Childhood mental health: An ecological analysis of the effects of neighborhoods characteristics. Journal of Community Psychology, 44(8), 962-979.
Langer, D. A., Wood, J. J., Wood, P. A., Garland, A. F., Landsverk, J., & Hough, R. L. (2015). Mental health service use in schools and non-school-based outpatient settings: Comparing predictors of service use. School Mental Health, 7, 161-173.
Tompson, M. C., *O’Connor, E. E., *Kemp, G. N., Langer, D. A., & Asarnow, J. R. (2015). Depression in childhood and early adolescence: Parental expressed emotion and family functioning. Annals of Depression and Anxiety, 2, 1070-1077.
Chiu, A. W., Langer, D. A., McLeod, B. D., Har, K., Drahota, A., Galla, B. M., Jacobs, J., Ifekwunigwe, M., & Wood, J. J. (2013). Effectiveness of modular cognitive behavioral therapy for anxiety in schools: A randomized, controlled trial. School Psychology Quarterly, 28, 141-153.
Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., Daleiden, E. L., Ugueto, A. M., Ho, A., Martin, J., Gray, J., Alleyne, A., Langer, D. A., Southam-Gerow, M. A., Gibbons, R. D., and the Research Network on Youth Mental Health. (2012). Testing standard and modular designs for psychotherapy with youth depression, anxiety, and conduct problems: A randomized effectiveness trial. Archives of General Psychiatry, 69, 274-282.
Langer, D. A., McLeod, B. D., & Weisz, J. R. (2011). Do treatment manuals undermine youth-therapist alliance in youth clinical practice? Journal of Consulting and Clinical Psychology, 79, 427-432.
Langer, D. A., Wood, J. J., Bergman, L., & Piacentini, J. (2010). A multitrait-multimethod analysis of the construct validity of child anxiety disorders in a clinical sample. Child Psychiatry and Human Development, 41 (5), 549-561.
Current Graduate Students
I am a first-year graduate student in the Clinical doctoral program at Suffolk University. I graduated from Capital University in Columbus, Ohio with a B.A in Psychology and minor in Biology. After completing my undergraduate degree, I spent three years at Brown University focusing on interventions for adolescent substance use and truancy under the mentorship of Drs. Sara Becker and Anthony Spirito. My research interests include developing, evaluating, and disseminating brief interventions for high risk youth and uncovering the role of parents in child development and treatment outcomes.
I am a third-year graduate student in the Clinical Psychology doctoral program at Suffolk University. I graduated cum laude from New York University in 2017 with a B.S. in Applied Psychology and minors in English and American Literature and Creative Writing. My research interests center on understanding the ways in which we can make mental health treatments more individualized to promote positive outcomes for youth. My clinical interests include child and adolescent anxiety and related disorders. In my second year at Suffolk, I completed a practicum at the Concord Center, a clinical psychology private practice in Concord, MA, where I provided CBT and DBT to youth clients. As an undergraduate at NYU, I interned at Kurtz Psychology, a clinical psychology private practice in New York City that specializes in parent-child interaction therapy (PCIT) and PCIT adapted for selective mutism. Prior to joining the doctoral program at Suffolk University, I worked at Weill Cornell Medicine as a research assistant for the Youth Anxiety Center and the Pediatric OCD, Anxiety, and Tic Disorders Program.
Bennett, S.M., Hindin, J., Mohatt, J., Bauer, C., Schild, J.S., Falk, A., Sullivan, P., Specht, M., Woods, D., Walkup, J. (2021). Proof of concept study of an oral orthotic in reducing tic severity in Tourette syndrome. Child Psychiatry and Human Development.
Zendegui, E.A., Bennett, S.M., Desai, P., Schild, J.S., Beaumont, R.B., Chiu, A.W. (2021). The school interference questionnaire: examining a novel measure of mental health-related academic functional impairment in youth. Journal of Emotional and Behavioral Disorders.
Temkin, A., Schild, J.S., Falk, A., & Bennett, S.M. (2020). Mobile apps for youth anxiety disorders: A review of the evidence and forecast of future innovations. Professional Psychology: Research and Practice.
Zendegui, E., Beaumont, R., Chiu, A., Schild, J.S., Bennett, S.M. (2019). Evaluating clinical outcomes in practice settings: Beyond the limits of grant-funded clinical research. Professional Psychology: Research and Practice.
Fenley, A.R., Nelson Darling, L., Schild, J.S., Langer, D.A. (2021). Depression in children and adolescents. In G. Asmundson (Ed.), Comprehensive clinical psychology, 2nd edition – children and adolescents: clinical formulation & treatment. New York, NY: Elsevier.
Beaumont, R., Lemelman, A., Schild, J.S., Tang, K. (2019). Coping Skills Training. In J. L. Matson (Ed.), Handbook of intellectual disabilities: Integrating theory, research and practice. New York, NY: Springer.
Catarozoli, C., Mishan, L., Schild, J.S., Bennett, S.M. (2019). Pediatric panic disorder and agoraphobia. In S. Compton, M.A. Villabo, & H. Kristensen (Eds.), Pediatric anxiety disorders. New York, NY: Elsevier.
Selected Posters and Presentations
Farina, D.S., Schild, J.S., Langer, D.A. (2020). Treatment planning method and therapeutic alliance in cognitive behavioral treatment for youths. Poster session presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, Virtual Conference.
Schild, J.S., Bennett, S.M. Specht, M. (2020). Longitudinal Evaluation of psychiatric comorbidity in youths with tic disorders. Presented at the biennial meeting of the Tourette Association of America, Virtual Conference.
Schild, J.S., Catarozoli, C., Hindin, J., Bauer, C., Mohatt, J., Specht, M., Bennett, S.M. (2020). A single case series ABAB investigation of tic reduction and heart rate variability associated with wearing an oral orthotic. Poster session presented at the biennial meeting of the Tourette Association of America, Virtual Conference.
Schild, J.S., Farina, D.S., Langer, D.A. (2020). You can sometimes get what you want: Exploring parent and youth psychosocial treatment knowledge of and preferences for evidence-based approaches. Poster session presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, Virtual Conference.
Schild, J.S., Catarozoli, C., Hindin, J., Bauer, C., Mohatt, J., Specht, M., Bennett, S.M. (2019). A single case series ABAB investigation of tic reduction and heart rate variability associated with wearing an oral orthotic. Poster session presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, Atlanta, Georgia.
Kurtz, S.M.S. & Schild, J.S. (2018). Anxiogenic behaviors among parents of children with selective mutism. In R. Catchpole & S.M.S. Kurtz (Chairs), New Directions in Selective Mutism Research: Theoretical Conceptualization and Intervention Models. Symposium conducted at the meeting of the Anxiety and Depression Association of America, Washington D.C.
Schild, J.S., Desai, P., Beaumont, R.B., Bennett, S.M. (2018). Satisfaction with passive sensing technology in anxious youth. Poster session presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, Washington D.C.
Avny, S., Schild, J.S., Kurtz, S.M.S. (2017). WeSpeak: A novel treatment to address the under-addressed needs of older kids with selective mutism. Workshop presented at the annual meeting of the Anxiety and Depression Association of America, San Francisco, California.
Goldman, R., Schild, J.S., Bauer, C., Hindin, J., Mohatt, J., Woods, D., … Bennett, S.M. (2017). Secondary outcomes of a pilot feasibility study of an oral orthotic in decreasing tic severity in youth with Tourette syndrome. Poster session presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, San Diego, California.
Schild, J.S., Adler, J., Kurtz, S.M.S. (2017). Barriers to PCIT completion for very low fee families. Poster session presented at the annual PCIT International Convention, Traverse City, Michigan.
Schild, J.S., Goldman, R., Rowe, J., Dure, L., Walkup, J., Bennett, S.M. (2017). Change in parent responses to child tics following CBIT with an occupational therapist. Poster session presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, San Diego, California.
I am a first-year graduate student in the Clinical Psychology doctoral program at Suffolk University. In 2019, I graduated summa cum laude from the College of the Holy Cross with a B.A. in Psychology and Deaf Studies. As an undergraduate, I participated in the Concealable Stigmatized Identities Lab and studied the physical and mental health impact of social stigma (2016-2019). Before joining the doctoral program at Suffolk, I was a full-time clinical research coordinator at Massachusetts General Hospital in the Division of Child and Adolescent Psychiatry, investigating the use of the Pediatric Symptom Checklist in the U.S. and Chile (2019-2021). During this time, I was also a volunteer research assistant in the Nock Lab at Harvard University. I am interested in researching the implementation and evaluation of treatments for adolescents with anxiety and depression with a specific focus on recalcitrant depression and suicidal ideation.
Holcomb, J. M., Arauz Boudreau, A., Riobueno-Naylor, A., Haile, H., Lucke, C., Bergmann, P., Joseph, B. Jellinek, M., Murphy, J. M. (2020). Beyond initial screening: One-year follow-up of adolescents with internalizing problems on the Pediatric Symptom Checklist. Journal of Developmental and Behavioral Pediatrics, 42(4), 283-290. doi: 10.1097/DBP.0000000000000890.
Jellinek, M. Bergmann, P., Holcomb, J. M., Riobueno-Naylor, A., Dutta, A., Haile, H., Sturner, R., Howard, B., Murphy, J. M. Recognizing adolescent depression with the parent- and youth-report screens in pediatric primary care. (2021). Journal of Pediatrics, 223, 220-226. https://doi.org/10.1016/j.jpeds.2021.01.069.
Murphy, J. M., Riobueno-Naylor, A., Haile, H., Holcomb, J. M., Dutta, A., Kandru, R., Shui, A. M., Lee, H., Jellinek, M. Behavioral health screening and service use in a statewide sample of Medicaid-eligible pediatric outpatients. (2020). Psychological Disorders and Research, 3(3), 3-6. doi: 10.31487/j.PDR.2020.03.04.
Murphy, J. M., Stepanian, S., Riobueno-Naylor, A., Holcomb, J. M., Haile, H., Dutta, A., Giuliano, C. P., Bernstein, S. C., Joseph, B., Jellinek., M. (2020). Implementation of an electronic approach to psychosocial screening in a network of pediatric practices. Academic Pediatrics, 21(4), 702-709. https://doi.org/10.1016/j.acap.2020.11.027.
Riobueno-Naylor, A., Williamson, H., Canenguez, K., Kogosov, A., Drexler, A., Sadeq, F., DePamphilis, M., Holcomb, J. M., Stoddard, F. J., Lydon, M., Murphy, J. M., Sheridan, R. K. (2020). Appearance concerns, psychosocial outcomes, and the feasibility of implementing an online intervention for adolescents receiving outpatient burn care. Journal of Burn Care & Research, 42(1), 32-40. https://doi.org/10.1093/jbcr/iraa108.
Arauz Boudreau, A., Riobueno-Naylor, A., Haile, H., Holcomb, J. M., Lucke, C., Joseph, B., Jellinek, M., Murphy, J. M. (2019). How an electronic health record system facilitates psychosocial screening in pediatric primary care. Clinical Pediatrics, 59(2), 154-162. doi: 10.1177/0009922819892038.
Kushalnagar, P., Holcomb, J., & Sadler G. (2019). Genetic testing and eHealth platform usage in deaf and hard-of-hearing women. Journal of Genetic Counseling, 28(5), 933-939. doi: 10.1002/jgc4.1134.
Interested in Joining the Lab?
Students seeking admission into the PhD program in clinical psychology are encouraged to visit the departmental admission webpage which lists all of the faculty members taking students in the upcoming year.
There are also lots of helpful details about the clinical doctoral program available at the clinical doctoral program webpage.
Frequently Asked Questions
How can I find out whether Dr. Langer intends to take a student for the upcoming year?
A list of faculty accepting students is available on our departmental admission webpage.
Should I contact Dr. Langer directly to express my interest?
There is no need to contact me in advance of submitting your application. I do try to respond to all emails I receive, though due to the large volume of applicants to our program, I may not be able to correspond via email with everyone who is potentially interested in applying. I will look forward to reviewing your application, though!
What type of applicant are you looking for?
I am looking for applicants who are passionate about the field and excited about the training and work that they will be engaged in during their graduate studies and beyond. I work best with students who are intellectually curious and capable, hard-working, self-motivated, open to feedback, and interested in research as well as clinical training. Successful applicants are likely to have strong academic credentials, outstanding letters of recommendation, and solid clinical and/or research experience. I recognize that the clinical and research opportunities available to each applicant vary, and I will evaluate each application as a whole (in other words, applicants who are more junior or weak in a certain area may still be competitive if they’ve demonstrated strength and promise in other areas). Applicant research interests do not need to be identical to my research interests, but should be related to our lab’s work and match my areas of expertise.
Suffolk Undergraduates Interested in Becoming Involved in Research
If you are an undergraduate seeking a volunteer or independent research experience (Psych 510), please email Dr. Langer directly.