Measures

Top Problems Assessment (TPA) is an idiographic measure used within clinical populations to identify parent and child target problems, treatment goals, and problem severity (Weisz et al., 2011; Herren et al., 2018). At the first session of the UP-C/A, the child and parent identified the top problems they would like to focus on throughout treatment. In accordance with the UP-C/A protocol, clinicians obtained problem severity ratings at each session on a Likert scale by asking for the level of difficulty that the problem posed for the client during the previous week (0 = no difficulty to 8 = extreme difficulty). Child- and parent-identified problems were not required to match, but clinicians often tried to find agreement to create shared treatment goals. All problems identified in the study were clinically relevant. The minimum number of problems identified was 2 and the maximum number of problems identified was 5 (M = 3.17; SD = 0.46). Since top problem content varies across participants, Cronbach’s alpha is not an appropriate indicator of internal validity, however prior studies have shown that the TPA demonstrates strong convergent and discriminant validity, test-retest reliability, and sensitivity to change during treatment (Weisz et al., 2011; Weisz et al., 2012; Weisz et al., 2019).

Anxiety Disorder Interview Schedule for the DSM-IV and DSM-5, Child Version (ADIS-IV-C and ADIS-5-C) are clinician administered semi-structured interviews that assess for a variety of psychopathology in youth (Silverman & Albano, 1996; Silverman & Albano, in press). Past work shows that the ADIS-IV-C demonstrates sufficient interrater and test-retest reliability along with good concurrent and convergent validity (Lyneham et al., 2007; Silverman et al., 2001; Wood et al., 2002). Clinicians were trained prior to the administration of the ADIS- IV- or -5-C to establish reliability. To establish inter-rater reliability, clinicians had to perform a literature review on the interview measure, observe four training videos for which they had to score the ADIS and generate diagnostic impressions, and complete a live collaboration interview with a reliable evaluator along with a live “match” interview. If the clinician and evaluator diagnosed the same clinical disorder and assigned Clinical Severity Rating scores within a one-point deviation of the evaluator, then the ratings were considered as a “match.” Once clinicians performed these steps, they were determined to be reliable in administering the

ADIS-IV- or -5-C.

Mini International Neuropsychiatric Interview for Children and Adolescents is used to assist the DSM-IV/V and ICD-10 psychiatric disorders in youth (MINI-KID; Sheehan et al., 1998). It is a structured clinical interview that demonstrates strong interrater and test- retest reliability, and good convergent and discriminant validity (Duncan et al., 2018; Sheehan et al., 2010). Clinician reliability was established using the same process as the ADIS-IV-C and ADIS-5-C.

Revised Children’s Anxiety and Depression Scale (RCADS) is a 47-item self- report questionnaire used to measure anxiety and depression symptoms in youth (Chorpita et al., 2000). There are six subscales in the RCADS that correspond with the DSM-IV/V: separation anxiety disorder, social phobia, generalized anxiety disorder, obsessive compulsive disorder, panic disorder, and major depressive disorder. The RCADS also produces a total anxiety score comprised of all anxiety- related subscales; therefore, in this study, we utilized the major depressive disorder subscale and the total anxiety subscale. RCADS items are rated on a 4-point Likert- scale from 0 to 3 where 0 represents “never” and 3 represents “always.” Greater symptom severity was observed with higher scores. The RCADS has demonstrated sufficient convergent and discriminant validity, and good test-retest reliability (Chorpita et al., 2000; Chorpita et al., 2005). The RCADS subscales demonstrated good to excellent internal consistency in this study for the child (α = .88). Similar results were exhibited for the parent (α = .85).