Research on Child and Adolescent Psychopathology - RCAP Special Issue Call for Papers

Primum non nocere: Understanding the Role of Harm in Treatment for Youth Mental Health Concerns

Guest Editors

Dean McKay, Ph.D. (Fordham University; mckay@fordham.edu)

Samuel D. Spencer, Ph.D. (Baylor College of Medicine; samuel.spencer@bcm.edu)

Type of Issue: Special Issue: An introduction/overview by the guest editors, approximately 8-10 original submissions and 2 commentaries. 

Manuscript Selection/Invitation Process: Invited Submissions (i.e., the authors are invited by the guest editors to submit manuscripts) and (limited) Open Call for Submissions (i.e., the guest editors advertise an open call for submissions, and review and select either brief proposals or full manuscripts for consideration in the special issue).

Overall Aims of the Special Issue

• Explicate the parameters of the concept of harm or non-beneficence within treatments for mental health concerns and apply this framework to child and adolescent populations.
• A collection of conceptual/review and empirical articles outlining the identification and assessment of potential for harm in youth mental health treatment specific to particular treatment settings or psychological disorders common in childhood and adolescence.
• A theoretical discussion of the implications of a focus on the under-examined area of harm within youth mental health treatment for both clinicians and researchers, along with practical strategies for assessing and addressing harm in youth mental health treatment. 

Overview of the Special Issue

Much of the extant literature supporting evidence-based treatments for mental health conditions has focused almost exclusively on salutary treatment effects, often measured via symptom reduction or improved functionality. Indeed, the American Psychological Association guidelines on empirically supported treatments (EST) uses rigorous studies demonstrating comparative efficacy of a proposed intervention compared to placebo or another treatment as the sole evaluative criteria for EST status. We certainly do not deny that symptom reduction and improved functionality are important outcomes in and of themselves. Nevertheless, potential iatrogenic or nonbeneficial effects of treatments for mental health conditions remain notably underexamined in both research and clinical settings, despite their insidious nature.

Potentially iatrogenic or nonbeneficial effects of treatments are complex in nature and can extend beyond clear cases of harm to patients (e.g., suffocation death due to rebirthing therapeutic techniques). For example, (a) use of ineffectual interventions (when efficacious ones are available) contributing to financial, time, and opportunity costs; (b) clinician failure to notice and correct for worsening/non-improving symptom course; and (c) a lack of critical assessment of reasons for patient drop out are all scenarios that could conceivably fall under the umbrella of intervention-related harm. At present, potentially harmful effects of treatment are typically considered only within the context of monitoring for imminent adverse effects in clinical research trials, with such monitoring being much more clearly explicated within pharmacological interventions compared to psychological ones. This results in greater difficulty in accurately drawing conclusions about the level of potential risk for harm within psychotherapy-based interventions compared to pharmacological ones.

Fortunately, there has been a growing line of conceptual and theoretical work explicating the importance of considering the potential iatrogenic or nonbeneficial effects of interventions for mental health concerns. However, much of this foundational work is often broad in nature, focusing less on specific disorders or populations, and more so on clarifying conceptual definitions of harm and applying this framework to mental health treatments on a general basis. More recently, a special issue in Clinical Psychology: Science and Practice (McKay & Jensen-Doss, 2021; https://psycnet.apa.org/PsycARTICLES/journal/cps/28/1) sought to move down the knowledge development funnel from broad to specific by commissioning a special issue on harmful treatments in psychotherapy, with articles devoted to potential iatrogenic treatments for specific psychological disorders, as well as empirical methods for identifying such harmful effects. 

However, research endeavors within identifying potential harm in mental health treatments have predominantly focused almost exclusively on adult populations. As such, a glaring gap in the literature exists concerning our understanding of potentially harmful treatments for youth mental health issues. In terms of application, the process of downward adaptation of intervention principles from adult to child populations has served as a useful framework in clinical science. However, the intricacies of child mental health and unique developmental considerations mean that rote application of considerations for harmful treatments in adults to youth populations is likely insufficient. Additionally, several contextual factors unique to youth mental health, including the prominent role of parents and teachers in both youth psychopathology and treatment, may have significant implications for understanding potentially harmful intervention effects in this population. Indeed, harmful effects of interventions can conceivably extend beyond the patient themselves to include a detrimental impact on family members or other individuals close to the patient– an assertion that may be especially relevant for treatment of youth. Hence, greater attention to the role of harm in the treatment of youth mental health concerns is warranted, with such research offering potential to contribute substantially to the literature on child and adolescent mental health.

In this Special Issue, “Primum non nocere: Understanding the Role of Harm in Treatment for Youth Mental Health Concerns,” we will bring together a selection of original and rigorous theoretical/review, methodological, and empirical papers to further our understanding of potential for harm in treatments for youth mental health concerns. This will be accomplished by soliciting a collection of papers that explicate potential for harm or non-beneficence in treatment for specific youth psychological disorders, as well as offer practical suggestions for how to identify and address potential for harm in both research and clinical settings.

All proposed manuscripts in this Special Issue will provide original conceptual/theoretical, methodological, or empirical research on the role of harm or non-beneficence in the treatment of youth mental health concerns. Here, we consider treatment in its broadest sense to include any intervention designed to treat a psychological condition. We encourage submissions that provide a thorough, evidence-based, definition and framework for considering harm or non-beneficence within mental health treatment and include clear applications of this definition to a specific area of psychopathology or system of youth mental healthcare.

To date, we have already secured/plan to secure agreements with contributors for papers in this special issue explicating the role of harm in youth mental health treatment for the following conditions or areas: anxiety disorders, autism, obsessive-compulsive disorder, tic disorder/Tourette’s syndrome, misophonia, as well as the role of harm in youth community mental health treatment settings and for 2SLGBTQIA+ youth. However, in our open call for papers, we welcome submissions that focus on the role of harm/nonbeneficial effects of treatment for other commonly occurring youth psychological disorders beyond the ones listed above, including, but not limited to, conduct disorder, ADHD, substance use, and internalizing/externalizing spectra broadly considered. We will also consider papers that are framed more broadly to consider the role of harm in treatment for youth mental health conditions across more macro or systemic levels, including system of care (e.g., school counseling, applied behavior analysis, integrated behavioral healthcare/primary care) or setting (e.g., inpatient, partial hospitalization, outpatient, in-home).

All papers should address implications of the authors’ findings (either empirical, methodological, or conceptual) for future clinical and research endeavors, with an eye toward tangible and practical recommendations. Papers with original data examining the role of harm within treatment or assessment/methodological approaches for identifying harm will be particularly prioritized. To that end, papers that focus on innovative methodological practices for advancing the systematic assessment of potential harm or adverse effects of youth mental health treatments in applied research and practice settings are also especially encouraged. However, conceptual/theoretical review articles that make a unique contribution to the literature beyond existing conceptual work in this area are also welcome.

An open, limited, call for papers for this special issue will be posted on several academic professional listservs (e.g., Div 53 of APA; Association for Behavioral and Cognitive Therapies; Society for a Science of Clinical Psychology). Authors interested in contributing a manuscript for this Special Issue should submit a letter of intent by December 15, 2023, including the following: (1) tentative title; (2) brief description of 500 words or less (structured as Background, Methods/Sample, Proposed Analyses; or otherwise adjusted for conceptual or review papers); (3) brief justification of how the proposed submission contributes to one or more of the aims of the Special Issue; and (4) author affiliations and contact information for the Corresponding Author. The Guest Editors will review the letters of intent for fit with the Special Issue and work to provide an inclusive set of papers that best advances theoretical and empirical knowledge regarding the externalizing psychopathology spectrum in childhood and adolescence with intensive longitudinal data.

Letters of intent should be sent electronically as a PDF or word file to Dean McKay (mckay@fordham.edu) and Samuel Spencer (samuel.spencer@bcm.edu) with the subject line noted as "Special Issue of Harmful Treatments for Youth." All letters of intent will be reviewed by January 15, 2024 and invited contributors will be asked to submit a full manuscript through the online review system by May 15, 2024. Invited contributors may be asked to serve as reviewers for other invited manuscripts. Manuscripts will be sent out for full peer review in accordance with the standard Research on Child and Adolescent Psychopathology review guidelines.

Questions concerning letters of intent can be directed to Dean McKay and/or Samuel Spencer. For additional information on the journal and author guidelines, see https://www.springer.com/journal/10802 (this opens in a new tab)

Proposed Timeline

September 15, 2023: Formal Call for Papers announced. Guest editors will invite potential contributors.

December 15, 2023: Interested contributors will submit a letter of intent/abstract.

January 15, 2024: Guest Editors will invite submissions.

May 15, 2024: Invited contributors will submit a full manuscript through the online review system. Guest editors assign reviewers.

July 31, 2024: Initial reviews of submissions completed and returned to contributors.

September 15, 2024: Revised manuscripts of submissions submitted.

October 15, 2024: Final submitted manuscripts submitted to invite comment contributors.

December 15, 2024: Final set of papers, and comments, submitted to journal for publication.