A Meta-Systems Approach to Evidence-Based Practice for Children and Adolescents

Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Im-proving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of the meta-system for children with emotional or behavioral needs include families, cultural norms and values, and service sec-tors such as schools, pediatric health centers, specialty mental health systems, juvenile justice systems, child protection ser-vices, and substance use treatment systems. We describe each component of the meta-system, noting challenges to the pro-vision of evidence-based practice (EBP) and highlighting ways to optimize outcomes. Our focus is on the inclusion of evidence-based assessment and interventions, including preven-tion, within a developmentally driven and culturally responsive contextual model. Recommendations for addressing disparities in research funding and essential steps to foster communication and coordination of EBP across settings are provided