FIRST Model and Therapy Programs
Our FIRST Model: Empirically Supported Principles of Change, the FIRST Psychotherapy Program, and Brief Digital Interventions based on FIRST
Our most recent work on the youth psychotherapy front is built on our effort to identify empirically supported principles of change (ESPCs) and translate them into a psychotherapy program for children and adolescents. Support for the principles of change is found in a review and meta-analysis by graduate student Olivia Fitzpatrick and others in our lab (Fitzpatrick et al., online advance). The principle-guided psychotherapy program we have developed is called FIRST (see Reference below). Our book/treatment manual for FIRST was published by Guilford Press (Weisz & Bearman, 2020). Our initial published open benchmarking trials of FIRST, implemented by psychotherapists and trainees in clinics, are reported in articles by Weisz et al. (2017) and Cho et al. (2020). We are currently conducting a multisite randomized controlled trial of FIRST, funded by NIMH.
As an adjunct to the full FIRST psychotherapy program delivered by therapists, we have built brief digital interventions based on the four FIRST principles that are typically implemented with children and adolescents directly. Each of these brief digital interventions can be self-administered by youths online (we suggest an age range of 7-15 years), and each one requires 30-40 minutes to be completed. The interventions have been piloted and implemented in schools in the U.S. and Canada over the past two years, as described by Cwinn et al. (in press), and we are carrying out randomized controlled trials of them. The interventions have been registered with Open Science Framework, and the pdf versions of them are provided here:
Project SOLVE as used in Fitzpatrick et al., 2023
Project Success as used in Fitzpatrick et al., 2023
References
Cho, E., Bearman, S.K., Woo, R., Weisz, J.R., & Hawley, K.M. (2021). A second and third look at FIRST: Testing adaptations of a principle-guided youth psychotherapy. Journal of Clinical Child and Adolescent Psychology, 50(6), 919-932. https://doi.org/10.1080/15374416.2020.1796678
Cwinn, E., Barry, E.A., Weisz, J.R., Bailin, A., Fitzpatrick, O.M., Venturo-Conerly, K., & Crooks, C.V. (in press). Brief digital interventions: An implementation-sensitive approach to addressing school mental health needs of youth with mild and emerging mental health difficulties. Canadian Journal of Community Mental Health, 1-19.
https://doi.10.7870/cjcmh-2022-026
Fitzpatrick, O.M., Schleider, J.L., Mair, P., Harisinghani, A., Carson, A., & Weisz, J.R. (2023). Project SOLVE: Randomized, school-based trial of a single-session digital problem-solving intervention for adolescent internalizing symptoms during the coronavirus era. School Mental Health, 15, 955-966. https://doi.org/10.1007/s12310-023-09598-7
Steinberg, J.S., Fitzpatrick, O.M., Khurana, S., Kim, M.Y., Mair, P., Schleider, J.L., Haztenbuehler, M.L., & Weisz, J.R. (2024, online advance). Is there a place for cognitive restructuring in brief, self-guided interventions? Randomized controlled trial of a single-session digital program for adolescents. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2024.2384026
Steinberg, J.S., Sun, J., Venturo-Conerly, K.E., Sood, G., Mair, P., Porzak, R., Ougrin, D., & Weisz, J.R. (2025). Randomized trial testing a self-guided digital mental health intervention teaching calming skills for Ukrainian children. Nature Partner Journals (npj) Mental Health Research 4:20, 1-14. https://doi.org/10.1038/s44184-025-00134-w [Published in Collection entitled "The development, maintenance, and treatment of student mental health difficulties."]
Weisz, J.R., & Bearman, S.K. (2020). Principle-Guided Psychotherapy for Children and Adolescents: The FIRST Treatment Program for Behavioral and Emotional Problems. New York: Guilford Press.
Weisz, J.R., Bearman, S.K., Santucci, L., & Jensen-Doss, A. (2017). Initial test of a principle-guided approach to transdiagnostic psychotherapy with children and adolescents. Journal of Clinical Child and Adolescent Psychology, 46(1), 44-58. https://doi.10.1080/15374416.2016.1163708
Weisz, J.R., Fitzpatrick, O.M., Venturo-Conerly, K., & Cho, E. (2021). Process-based and principle-guided approaches in youth psychotherapy. World Psychiatry, 20 (3), 378-380. http://doi.10.1002/wps.20887
Weisz, J.R., Steinberg, J.S., Sun, J., Mair, P., Fitzpatrick. O.M., Karapata, N., Yusyn, M., Sood, G., Danese, A., Adams, K.M., & Ougrin, D. (2025). Effects of a brief digital problem-solving intervention on depression and anxiety symptoms in Ukrainian children and adolescents displaced by war: A randomised controlled trial. The Lancet Primary Care, 1(1), 1-11. https://doi.org/10.1016/j.lanprc.2025.100001