Current (lack of) status of theory in child and adolescent psychotherapy research.

Considers fundamental issues raised by current child and adolescent psychotherapy research, including the neglect of theory in psychotherapy research, the distinction between theories of onset of dysfunction and therapeutic change, and the progression of knowledge from description to explanation and from risk factors to causal agents. The complex relations of proposed influences and clinical outcomes and constraints of current statistical models illustrate key challenges for understanding the nature of clinical disorders and therapeutic change. Much more attention to understanding how treatment achieves therapeutic change is needed, not only to address conspicuous lacunae in the knowledge base but also to optimize the effects of treatment in clinical work.