Abstract:

Interest in the field of clinical neuroscience has exploded in the past decade (Weingarten & Strauman, 2015). However, direct contributions of neuroscience to clinical assessment and treatment are rare. It is natural and appropriate for clini- cians and policymakers to ask where and when translational gains from neurosci- ence will emerge in clinical practice. In this chapter we identify a number of paths through which neuroscience might inform superior assessment and treatment of children and adolescents in the future. We focus on three potential contributions that neuroscience can make to clinical assessment and treatment. First, neurosci- ence might be used to identify individuals who are more or less likely to respond to specific psychosocial treatments. Given that a substantial minority of people fail to improve in treatment, even with our most empirically supported approaches, identifying people who are likely to fail and why might point us toward innova- tive new approaches for improving clinical outcomes. Second, neuroscience might facilitate the process of matching individuals to treatments from which they are most likely to benefit, in part by identifying clinically meaningful subgroups within specific diagnoses. Finally, neuroscience can potentially identify mechanisms of effective clinical change, allowing for the development of more efficient evidence- based treatments. We use the term “neuroscience” throughout the chapter to refer to the application of neuroscience to study cognitive and affective processes, and their development in humans.

After a brief review of common neuroscience methods, we discuss existing research within these three broad themes. Clinical applications of neuroscience remain limited, particularly with children and adolescents. Thus, we focus primarily on what is possible in terms of these applications (for additional review, see Fournier & Price, 2014; Weingarten & Strauman, 2015). At the same time, it is important to acknowledge the current practical constraints of integrating neuroscience methods into clinical practice. Accordingly, we end with a discussion of obstacles, limitations, and future directions that might facilitate the application of neuroscience to clini- cal intervention for children and adolescents. As translational research in children is still limited, we discuss relevant research on children and adolescents where pos- sible and highlight examples from research with adults when pediatric research is not available. Many of the reviewed neuroimaging studies focus on neural networks involved in salience and reward processing. The primary brain regions in each of these networks are depicted in Figures 30.1 and 30.2, respectively. We focus on incorporating neuroscience methods into the evaluation of evidence-based treat- ments. We do not cover treatments that are not empirically supported.