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The central thesis of this article is that advances in psychotherapy research for children and adolescents are limited, despite the large number of controlled studies and consistent conclusions about demonstrated effectiveness. The ways in which individual studies are conducted and the lack of an overall plan for the progression of research to identify effective treatments have contributed to the limited conclusions. In this article, I identify steps toward developing effective treatment that entail conceptualization and investigation of clinical problems, processes of change, and conditions that influence treatment outcome. Progress will not only require more systematic accretion of research, but also expansion in the range of questions, outcomes, and models of treatment delivery that are examined. Efforts to improve the knowledge base and to integrate knowledge into clinical practice can also be greatly enhanced by modifying the ways in which clinical work is conducted and specifically by systematically monitoring treatment implementation and patient progress.
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