Some structured, manual-guided treatments may show reduced effects when they are implemented in more clinically representative contexts and compared to usual practice in those contexts. This may be because treatments tend to be developed away from the clinical practice. There are several potential mismatches between evidence-based practice and real-world clinical care:

1. Clinicians in practice settings typically carry diagnostically diverse caseloads but most evidence-based practices on one problem or a homogeneous cluster.
2. Clinically referred youth typically present with comorbidity.
3. Treatment may need to shift during treatment while evidence-based practice often does not take this into account.
4. Everyday clinical care often has an unpredictable course contrary to the design of evidence-based practices which are standardized.

The deployment-focused model of treatment development and testing includes a series of steps aimed at building and testing interventions with the clients and clinicians and within real-world contexts.

Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction. In addition to that, there is a presence of restricted, repetitive patterns of behaviour, interests or activities. The symptoms cause clinically significant impairment in social, occupational or other important areas of functioning.

The Early Start Denver Model (ESDM) is a treatment that addresses the needs of children with ASD under three years of age. It is designed for children ages 12 to 60 months who are diagnosed with ASD or are at risk for ASD. The goal is to accelerate children’s developmental rates in cognitive, social-emotional, language, and adaptive domains and to reduce the disabling effect of ASD symptoms.

The Denver Model states that it is important to build close relationships between children with ASD and other children and adults to facilitate development. Following this model, EDSM includes sensory social

Trauma-focused cognitive behavioural therapy (TF-CBT) addressed problems specifically associated with traumatic events that children experience or witness (e.g. PTSD). TF-CBT targets PTSD symptoms and outcomes associated with trauma. A PTSD diagnosis is not required.

PTSD includes negative cognitions about oneself, others or the world and negative affective states. There may be dysregulation in affective, behavioural, cognitive and physiological areas of functioning. TF-CBT targets reregulation in each of these areas with the goal of optimizing children’s adaptive functioning after trauma.

The main goal of TF-CBT is to help children overcome traumatic avoidance (1), shame (2), sadness (3), fear (4) and other trauma-specific emotional and behavioural difficulties (5). TF-CBT is not a first line treatment but can help children after they have stabilized.

TF-CBT includes cognitive-behavioural, attachment, family, humanistic, and psychodynamic therapy principles. The overall level s of adjustment in all areas (e.g. physiological;

Anxiety disorders are common in youth with a prevalence rate of 10% to 20%. It is associated with difficulties in academic achievement, social and peer relations and future emotional health. It is a risk factor for comorbidity and comorbidity is also very common.

Anxiety consists of a behavioural (1), physiological (2) and cognitive component (3). Anxiety is part of normal development (i.e. it cautions one against danger) and can bolster performance (e.g. tests). However, too much anxiety can quickly become distressing. Youth with anxiety view the world as dangerous (1), experience physical complaints (2) and avoid certain situations (3). Avoidance reinforces feelings of anxiety and avoidance behaviours.

Coping Cat is a treatment for anxiety disorders for children from the age of 7 to 13. This treatment targets all aspects of anxiety (i.e. tripartite model). It includes psychoeducation (1), somatic management skills (2), cognitive restructuring