CHOICES Youth Psychopathology and Treatment Lab

The Collaborating to Help Optimize Interventions for Children Experiencing Stress (“CHOICES”) Lab is committed to improving youth mental health through the study of youth psychopathology and psychosocial treatment approaches. We are especially committed to developing and evaluating methods to empower and actively include youth and their families in the treatment planning process, integrating youth and family values with the best available evidence on the efficacy of their treatment options.

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.

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.

Publications

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.

*student/mentee co-author

Current Graduate Students

My name is Jennifer Schild and I am a first-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. 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. My research interests center on child and adolescent anxiety disorders and understanding the ways in which we can make treatments more individualized to promote positive outcomes.

Invited Book Chapters

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.

Posters and Presentations

Schild, J.S., Desai, P., Beaumont, R.B., Bennett, S.M. (2018, November). 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.

Kurtz, S.M.S. & Schild, J.S. (2018, April). 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., Goldman, R., Rowe, J., Dure, L., Walkup, J., Bennett, S.M. (2017, November). 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.

Goldman, R., Schild, J.S., Bauer, C., Hindin, J., Mohatt, J., Woods, D., … Bennett, S.M. (2017, November). 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.

Kurtz, S.M.S., Tadros, C., Schild, J.S. (2017, October). Treating the tough ones: Comorbid SM with Disruptive Behavior Disorder. Presented at the annual meeting of the Selective Mutism Association, Boston, Massachusetts.

Schild, J.S., Adler, J., Kurtz, S.M.S. (2017, September). Barriers to PCIT completion for very low fee families. Poster session presented at the annual PCIT International Convention, Traverse City, Michigan.

Avny, S., Schild, J.S., Kurtz, S.M.S. (2017, April). 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.

Tadros, C., Kurtz, S.M.S., Ezell, E., & Schild, J.S. (2016, October). Selective Mutism University: Engaging caregivers and teachers in an age of internet-based learning. Presented at the annual meeting of the Selective Mutism Group, Manhattan Beach, California.

Interested in Joining the Lab?

If you are an undergraduate seeking a volunteer or independent research experience (Psych 510), please email Dr. Langer directly.

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:

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!

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.