(PS9-33) Investigating Moderating Effects of Strength-based Practice Elements for Internalizing Symptoms to Inform Treatment Delivery

Assessments that measure youth self-report usage of positive mental health skills exist but typically target single skill sets and do not provide comprehensive screening across numerous domains. The Social Emotional, Evidence-Based Developmental Strengths Assessment (SEEDS; Ebesutani, 2019) is a novel youth-report tool that leverages distillation methodology to provide comprehensive screening of youth social-emotional competencies across important practice element (PE) skills, all towards the larger goal of reliably and validly assessing the extent to which youth utilize essential CBT elements (e.g., Exposure) in their daily lives. Youth scores on the SEEDS have the potential for therapists to create a modular, client-specific treatment plan matching youth to relevant PEs. This PE-based approach to evidence-based practice has been found to be associated with increased accessibility of evidence-based treatments and enhanced efficiency in clinical settings when working with diverse youth populations (Bernstein et al., 2015). However, there is a need to further our understanding of the interrelationships between various PE usage patterns and youth mental health psychopathology.

Our current study will investigate the relationship between CBT PE skill usage (measured by the SEEDS) commonly used in treatment (e.g., Activity Scheduling, Problem Solving, Relaxation; PracticeWise PWEBS) for internalizing symptoms (measured by the Strengths and Difficulties questionnaire; Goodman 1998). More specifically, we will examine multiple regression models to explore the moderation effects of Exposure on four PEs’ (i.e., Cognitive Restructuring, Relaxation, Psychoeducation, Activity Scheduling) relationships with internalizing symptoms. This study is an extension of Matsui and Nakamura’s (2022) psychometric investigation of the SEEDS, included 402 youth for analyses, and consisted of 43.8% (n = 176) fourth graders, 33.6% (n = 136) fifth graders, and 22.6% (n = 91) sixth graders. Participants were between the ages of 8.96 and 12.75 (M = 10.63, SD = .86), and 50.2% were male (n = 202). Predominant self-reported ethnicities were highly consistent with recent census data for the state of Hawaiʻi and included 58.5% (n =235) multiethnic (i.e., reported more than one ethnicity), Asian (n = 76, 18.9%), White (n = 48, 11.9%), and Native Hawaiian or Other Pacific Islander (n = 16, 4.0%). All data have been collected, cleaned, and preliminarily investigated. Given the theoretical (Craske et al., 2014) and empirical (Higa-McMillan et al., 2016) importance of Exposure for treating youth anxiety, we predict that self-reported Exposure usage will moderate the relationships between CBT skill usage for Cognitive Restructuring, Relaxation, Psychoeducation, and Activity Scheduling, and internalizing symptoms. For instance, we hypothesize that higher self-reported Cognitive Restructuring scores will be associated with lower internalizing symptoms, but only for youth who also report higher Exposure usage. Moderation trends across all models, implications, future directions, and potential limitations will be presented.