Researchers examining Multidimensional Family Therapy (MDFT) have gone beyond studying its effectiveness, which includes reducing cannabis use and other mental health concerns for young people. They have also examined the link between practitioner fidelity — or how closely clinicians follow and implement the treatment as it was originally designed — and youth outcomes. In one study, independent raters reviewed videotaped sessions from 25% of MDFT cases to ensure a range of cases and sessions for each therapist.  Researchers found that MDFT adherence ratings predicted significant decreases in both youth substance use frequency and cannabis “dependence” at six months. (Because the study began in 2006, the researchers used this older “dependence” diagnosis in some of their analyses rather than the current term, cannabis use disorder.) These findings underscore the importance of delivering effective treatments as intended. Policy-makers can support practitioners to deliver with fidelity in typical community settings, for example, by ensuring needed training is available.

For more information, see Vol. 17, No. 3 of the Children’s Mental Health Research Quarterly.

Children with multiple mental health conditions often face added challenges. Experiencing more than one mental disorder has been associated with an increased likelihood of attempting suicide and dying by suicide.

Children with concurrent disorders are also more likely to experience greater impairment overall as well as in specific situations, including at school, at home and in relationships. In addition, these children are at greater risk for experiencing poorer quality of life and more peer problems, and they are more likely to drop out of treatment and have poorer treatment responses than those with one disorder only.

These findings underscore the importance of ensuring that children with concurrent disorders receive effective treatments that address all of their mental health needs and that are delivered in a manner than encourages their ongoing engagement.

For more information, see Vol. 17, No. 3 of the Children’s Mental Health Research Quarterly.

Researchers tracked the rates of concurrent mental disorders for more than 600 Indigenous children to determine if there were changes as they reached adolescence. The children, who were living in one of eight Indigenous communities in Canada or the United States, were assessed when they were ages 10 to 12 years, and then again at ages 12 to 15. At the first time point, 9.2% met criteria for two mental disorders. By the second time point, this percentage had increased to 26.6%. This latter concurrence rate was similar to other populations of children — potentially reflecting the strength of Indigenous children, given that many faced added challenges, including limited service access and economic disadvantage.

For more information, see Vol. 17, No. 3 of the Children’s Mental Health Research Quarterly.

Image credit: CIRA

June 21 is National Indigenous Peoples Day — a time to celebrate the strength, innovation, culture and histories of First Nations, Inuit and Métis Peoples.

The day is held on the summer solstice in recognition of the many celebrations and community gatherings traditionally held by Indigenous peoples at this time of year. These gatherings include traditional cultural activities, parades, festivals, dancing, music and food. You can find a list of public gatherings and celebrations in BC at the Indigenous Tourism BC website.

Cultural connections — like those made during these annual summer celebrations — offer important mental health benefits for Indigenous youth. Mental health practitioners can promote well-being by supporting Indigenous young people to connect with their cultures, and policy-makers can also play a role by supporting Indigenous communities to ensure their cultures flourish. For more information, see Vol. 17, No. 2, page 3 (sidebar on enhancing mental health for Arctic Indigenous youth) of the Children’s Mental Health Research Quarterly.

Each June, Action Anxiety Day educates Canadians about anxiety, raises awareness and reduces stigma around anxiety disorders. It offers parents and educators an opportunity to empower children and youth with coping strategies and knowledge.

Anxiety Canada established Action Anxiety Day in 2021. Though Anxiety Canada closed their doors on April 30, 2025, the event lives on in schools and communities. Resources and educator toolkits will remain available on the Anxiety Canada website until March 2026.

A systematic review from the Children’s Health Policy Centre found that anxiety disorders are the most commonly experienced child and youth mental health concern. At any given time, approximately 5.2% of four-to-18-year-olds will meet criteria for an anxiety disorder. But evidence-based interventions such as cognitive-behavioural therapy (CBT) can help.

To learn more about preventing and treating anxiety in children and youth, see Vol. 19, No. 1 and Vol. 19, No. 2 of the Children’s Mental Health Research Quarterly.

Celebrated in Canada and around the world each June, Pride Month brings LGBTQ+ communities and allies together to celebrate the achievements and resilience of LGBTQ+ people, advocate for equal rights and gather in support and solidarity.

Pride commemorates the Stonewall Uprising of 1969, which marked a turning point in the fight for LGBTQ+ rights. Since then, Pride has become a global movement, with celebrations taking place worldwide throughout the summer.

Pride Month also offers an opportunity to address the mental health impact of anti-LGBTQ+ discrimination, particularly on young people. LGBTQ+ youth often deal with serious social inequities and, as a result, experience an unequal burden of mental health concerns. Trans and non-binary youth in particular often face significant challenges compared to their cisgender peers, including peer victimization and harassment.

Much can be done to support LGBTQ+ youth. Adults can make a difference by educating themselves about LGBTQ+ issues, modeling acceptance, creating environments free from harassment and supporting transgender youth in taking steps to express their identity. To learn more, see Volume 11, No. 2 of the Children’s Mental Health Research Quarterly.

Children who experience one mental health condition often face more than one — what is commonly referred to as having concurrent or co-occurring conditions. But just how common is this experience? A systematic review that combined data from 14 population-based surveys found that for children who met criteria for one mental disorder, 26.5% met criteria for two or more. Researchers have found even higher concurrent rates for children receiving mental health treatment services and for those in foster care.

Research on which disorders are more likely to co-occur is crucial for informing both prevention and treatment efforts. And the co-occurrence of substance use and other mental disorders has been particularly well studied. A systematic review of 21 population-based surveys compared young people with any substance use, including those whose use reached the level of a disorder, to individuals without any substance use. When young people had any substance use or a substance use disorder, their odds of having other disorders significantly increased. This included nearly eight times greater odds of also experiencing conduct, oppositional defiant or attention-deficit/hyperactivity disorders, slightly more than four times greater odds of co-occurring depressive disorders, and approximately two times greater odds of co-occurring anxiety disorders.

Data are more limited on the co-occurrence of disorders that do not involve substance use. A population-based survey of Puerto Rican children nevertheless provides insights on the overlap of conduct/oppositional defiant disorders, attention-deficit/hyperactivity disorder (ADHD), anxiety disorders and depression. Researchers found high levels of co-occurrence across all four conditions. But levels were particularly high for children whose primary diagnosis was conduct/oppositional defiant disorder — with anxiety disorders co-occurring for 55.3%, ADHD for 35.7%, and depression for 17.6%.

For more information, see Vol. 17, No. 3 of the Children’s Mental Health Research Quarterly.

A recent systematic review by the Children’s Health Policy Centre found that transdiagnostic interventions that addressed common risk factors underlying multiple disorders prevented or reduced symptoms of multiple childhood mental disorders. These results suggest six implications for practice and policy:

• Consider effective transdiagnostic prevention programs for better efficiency. Because multiple symptoms can be prevented using one intervention, greater efficiencies are possible. Efficiencies are also enhanced when programs address particularly common problems such as anxiety, depression, behaviour and substance use concerns. Such efficiencies, in turn, can help mitigate Canada’s limited public prevention investments.
• Build on the power of parents. Three of the four programs in the systematic review that produced beneficial outcomes for children included parents (or other caregivers). Consequently, including caregivers may be particularly helpful for prevention efforts.
• Deliver interventions according to need. To optimally support all children, a public mental health strategy should be employed. Such a strategy typically includes promoting healthy development for all children, preventing disorders for those at risk, providing treatment to those with disorders and monitoring outcomes. This approach aligns with efforts to reduce inequities by supporting all children, with an intensity tailored to levels of need.
• Offer programs that build on solid underlying approaches. Two of programs in the systematic review — Strengthening Families and Strong African American Families–Teen — used parenting training, which is backed by many studies showing reduced child behaviour and substance use problems. Similarly, the Super Skills for Life and EMOTION programs used cognitive-behavioural therapy techniques, which are supported by many studies showing reduced child anxiety and depressive symptoms. But there is only one high-quality randomized control trial evaluating each of these four programs for preventing symptoms of concurrent disorders. So replication evaluations are warranted. As well, adaptations may be needed for the Canadian context, including ensuring that content is culturally safe and relevant.
• Consider transdiagnostic interventions with children of varying ages. The four successful interventions in the systematic review were delivered to children spanning ages six to 16. This shows it is possible to use these efficient interventions with children at various of developmental stages.
• Know that effective program delivery can occur in a variety of settings. The four successful programs were delivered to children, and to parents as well in some cases, in community settings including schools. This demonstrates that these programs can be offered in venues that are convenient and accessible for children and families.

Children with one mental health problem often have more than one — resulting in added challenges for them and for their families, and for society when avoidable problems impede young people from flourishing. This systematic review indicates that transdiagnostic prevention programs can effectively and efficiently address multiple mental health needs, including symptoms associated with some of the most common childhood conditions. These programs should therefore be expanded so that more children can be helped. Expansion of transdiagnostic prevention programs may have the added benefit of reducing “downstream” treatment costs.

For more information, see Vol. 17, No. 2 of the Children’s Mental Health Research Quarterly.

Child and Youth Mental Health Day reminds us of the need to actively support children and youth who are experiencing mental health challenges. The theme for this year’s event is “I Care About You.”

Established by BC-based organization FamilySmart in 2007, the day aims to spark meaningful conversations about mental health between young people and adults. It is about building positive connections that help young people feel seen, heard and valued.

FamilySmart offers resources to help facilitate caring conversations, including a toolkit, videos and activities. You can find these resources and learn how to get involved at FamilySmart’s website.

Mental health disorders can be profoundly destabilizing for young people. Prevention programs can avert or reduce the impact of common disorders, but these efforts must be expanded in order to reach more children in need. To learn more about effective interventions that help prevent childhood mental disorders, see Volume 14, No. 1 of the Children’s Mental Health Research Quarterly.

A recent systematic review by the Children’s Health Policy Centre looked at Super Skills for Life, a targeted program which aimed to prevent depression and anxiety disorders for children who already had symptoms of them. The program produced multiple benefits for young children at one-year follow-up, including reducing symptoms of both disorders. Researchers then examined how children’s participation in and satisfaction with Super Skills for Life influenced their outcomes. First, they divided children into two groups based on their experiences with the program. The high-fidelity group included children who scored above 50% on three markers: attended seven or eight (of the eight) scheduled sessions, completed five to seven (of the seven) homework assignments, and rated their satisfaction with the program as nine or 10 (out of 10). This classification resulted in 61.2% of children being in the high-fidelity group and 38.8% in the low-fidelity group.

Children who participated in Super Skills for Life had significantly fewer anxiety and depressive symptoms compared to the control group, with no difference based on fidelity classification. However, for emotional symptoms and behavioural problems, only the high-fidelity group outperformed the control group at one-year follow-up. These findings suggest that while children can experience benefits from prevention programs even when their engagement is more limited, maximum gains occur when maximum fidelity is achieved. The take-away message for practitioners is to continue their efforts to engage children, including encouraging children’s attendance in sessions and their practice of skills outside of sessions, knowing the potential positive payoffs.

For more information, see Vol. 17, No. 2 of the Children’s Mental Health Research Quarterly.