About

Alan Kazdin is a Research Professor and Sterling Professor Emeritus of Psychology, as well as a Professor of Child Psychiatry (Emeritus) at Yale University. His work has primarily focused on the diagnosis, assessment, and treatment of childhood psychiatric disorders, especially Oppositional-Defiant Disorder and Conduct Disorder. He has developed, evaluated, and provided two evidence-based treatments—parent management training and cognitive problem-solving skills training—for clinically referred children and adolescents. His research aims to understand the nature and scope of child dysfunction, as well as the parent, family, and contextual factors in which child dysfunction is embedded. Kazdin has studied family engagement in treatment, premature termination, barriers to parent participation, and factors influencing treatment outcomes such as parent expectations and therapeutic alliance. In addition to providing treatment in New Haven and worldwide via online sessions, he helped develop a free online course to assist parents with everyday child-rearing challenges. Recently, his focus has shifted toward addressing the 'treatment gap'—the disparity between those in need of psychological services and those who receive them. His interest now lies in models of delivery that can scale evidence-based treatments to reach underserved populations, including individuals of color, ethnic minorities, victims of violence, children, adolescents, and the elderly. Kazdin works extensively with media outlets to bring psychological science to the public on issues related to child psychiatric disorders, mental health, parenting, stress management, school violence, bullying, and positive child development.

Research topics

• Political Science
• Psychiatry
• Psychology
• Public relations
• Medicine
• Business
• Nursing

Selected publications

• Indigenous mental health in Mexico: Challenges and promising leads.

  Practice Innovations · 2026-04-27

  articleSenior author
  PublisherDOI

• The Effect of Predicted Compliance With a Web-Based Intervention for Anxiety and Depression Among Latin American University Students: Randomized Controlled Trial

  JMIR Mental Health · 2025-02-28 · 2 citations

  articleOpen access

  Background Web-based cognitive behavioral therapy (wb-CBT) is a scalable way to reach distressed university students. Guided wb-CBT is typically superior to self-guided wb-CBT over short follow-up periods, but evidence is less clear over longer periods. Objective This study aimed to compare short-term (3 months) and longer-term (12 months) aggregate effects of guided and self-guided wb-CBT versus treatment as usual (TAU) in a randomized controlled trial of Colombian and Mexican university students and carry out an initially unplanned secondary analysis of the role of differential predicted compliance in explaining these differences. Methods The 1319 participants, recruited either through email and social media outreach invitations or from waiting lists of campus mental health clinics, were undergraduates (1038/1319, 78.7% female) with clinically significant baseline anxiety (Generalized Anxiety Disorder–7 score≥10) or depression (Patient Health Questionnaire–9 score≥10). The intervention arms comprised guided wb-CBT with weekly asynchronous written human feedback, self-guided wb-CBT with the same content as the guided modality, and TAU as provided at each university. The prespecified primary outcome was joint remission (Generalized Anxiety Disorder–7 score=0-4 and Patient Health Questionnaire–9 score=0-4). The secondary outcome was joint symptom reduction (mean scores on the Patient Health Questionnaire Anxiety and Depression Scale) at 3 and 12 months after randomization. Results As reported previously, 3-month outcomes were significantly better with guided wb-CBT than self-guided wb-CBT (P=.02) or TAU (P=.02). However, subsequent follow-up showed that 12-month joint remission (adjusted risk differences=6.0-6.5, SE 0.4-0.5, and P<.001 to P=.007; adjusted mean differences=2.70-2.69, SE 0.7-0.8, and P<.001 to P=.001) was significantly better with self-guided wb-CBT than with the other interventions. Participants randomly assigned to the guided wb-CBT arm spent twice as many minutes logged on as those in the self-guided wb-CBT arm in the first 12 weeks (mean 12.5, SD 36.9 vs 5.9, SD 27.7; χ21=107.1, P<.001), whereas participants in the self-guided wb-CBT arm spent twice as many minutes logged on as those in the guided wb-CBT arm in weeks 13 to 52 (mean 0.4, SD 7.5 vs 0.2, SD 4.4; χ21=10.5, P=.001). Subgroup analysis showed that this longer-term superiority of self-guided wb-CBT was confined to the 40% (528/1319) of participants with high predicted self-guided wb-CBT compliance beyond 3 months based on a counterfactual nested cross-validated machine learning model. The 12-month outcome differences were nonsignificant across arms among other participants (all P>.05). Conclusions The results have important practical implications for precision intervention targeting to maximize longer-term wb-CBT benefits. Future research needs to investigate strategies to increase sustained guided wb-CBT use once guidance ends. Trial Registration ClinicalTrials.gov NCT04780542; https://www.clinicaltrials.gov/study/NCT04780542 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-022-06255-3

  PublisherOA PDFDOI

• Effective Treatment for Mental and Substance Use Disorders in 21 Countries

  JAMA Psychiatry · 2025-02-05 · 16 citations

  article

  Importance: Accurate baseline information about the proportion of people with mental disorders who receive effective treatment is required to assess the success of treatment quality improvement initiatives. Objective: To examine the proportion of mental and substance use disorders receiving guideline-consistent treatment in multiple countries. Design, Setting, and Participants: In this cross-sectional study, World Mental Health (WMH) surveys were administered to representative adult (aged 18 years and older) household samples in 21 countries. Data were collected between 2001 and 2019 and analyzed between February and July 2024. Twelve-month prevalence and treatment of 9 DSM-IV anxiety, mood, and substance use disorders were assessed with the Composite International Diagnostic Interview. Effective treatment and its components were estimated with cross-tabulations. Multilevel regression models were used to examine predictors. Main Outcomes and Measures: The main outcome was proportion of effective treatment received, defined at the disorder level using information about disorder severity and published treatment guidelines regarding adequate medication type, control, and adherence and adequate psychotherapy frequency. Intermediate outcomes included perceived need for treatment, treatment contact separately in the presence and absence of perceived need, and minimally adequate treatment given contact. Individual-level predictors (multivariable disorder profile, sex, age, education, family income, marital status, employment status, and health insurance) and country-level predictors (treatment resources, health care spending, human development indicators, stigma, and discrimination) were traced through intervening outcomes. Results: Among the 56 927 respondents (69.3% weighted average response rate), 32 829 (57.7%) were female; the median (IQR) age was 43 (31-57) years. The proportion of 12-month person-disorders receiving effective treatment was 6.9% (SE, 0.3). Low perceived need (46.5%; SE, 0.6), low treatment contact given perceived need (34.1%; SE, 1.0), and low effective treatment given minimally adequate treatment (47.0%; SE, 1.7) were the major barriers, but with substantial variation across disorders. Country-level general medical treatment resources were more important than mental health treatment resources. Other than for the multivariable disorder profile, which was associated with all intermediate outcomes, significant predictors were largely mediated by treatment contact. Conclusions and Relevance: In addition to the gaps in treatment quality, these results highlight the importance of increasing perceived need, the largest barrier to effective treatment; the importance of training primary care treatment clinicians in recognition and treatment of mental disorders; the need to improve the continuum of care, especially from minimally adequate to effective treatment; and the importance of bridging the effective treatment gap for men and people with lower education.

  PublisherDOI

• Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys

  International Journal of Mental Health Systems · 2025-02-09 · 11 citations

  articleOpen access

  BACKGROUND: High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. METHODS: Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.7% female, median age [interquartile range]: 43 [31-57] years; 68.5% weighted average response rate) in the World Mental Health (WMH) surveys. We focus on the n = 5,136 respondents with 12-month DSM-IV anxiety, mood, or substance use disorders with perceived need for treatment. The n = 2,444 such respondents who did not receive treatment were asked about barriers to receiving treatment, whereas the n = 926 respondents who received treatment with a delay were asked about barriers leading to delays. Consistent with previous research, we distinguished five broad classes of barriers: low perceived disorder severity, two types of barriers in the domain of predisposing factors (beliefs/attitudes about treatment ineffectiveness and stigma) and two types in the domain of enabling factors (financial and nonfinancial). Baseline predictors of receiving treatment found in a prior report (i.e., comparing the n = 2,692 respondents who received treatment with the n = 2,444 who did not) were examined as predictors of barriers, while barriers were examined as mediators of associations between these predictors and treatment. RESULTS: = 3.8-199.8, p = 0.050- < 0.001). Barriers were predicted by low education, disorder type, age, employment status, and financial obstacles. Predictors varied as a function of barrier type. CONCLUSIONS: A wide range of barriers to treatment exist among people with mental disorders even after a need for treatment is acknowledged. Most such individuals have multiple barriers. These results have important implications for the design of programs to decrease unmet need for treatment of mental disorders.

  PublisherOA PDFDOI

• Patterns and predictors of 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys: treatment in the context of perceived need

  International Journal of Mental Health Systems · 2025-03-14 · 5 citations

  articleOpen access

  BACKGROUND: Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored the importance of perceived need for seeking treatment of mental disorders. However, little research has focused on treatment contact after adjusting for perceived need. We do so here in analysis of WMH data. METHODS: The WMH data considered here come from 25 community surveys implemented between 2001 and 2019 across 21 countries. n = 12,508 of the n = 117,739 respondents in these surveys aged 18 and older met criteria for one or more 12-month DSM-IV anxiety, mood, or substance use disorders assessed across all these surveys. Information was obtained about 12-month treatment of each disorder. The predictors considered were disorder type, socio-demographics, and history of prior treatment. RESULTS: Twelve-month treatment was obtained for 17.7% of the n = 18,702 12-month person-disorders in the sample, including 34.1% for the 46.5% with perceived need and 3.5% for the 54.5% without perceived need. After adjusting for perceived need, receiving treatment was most strongly associated with disorder characteristics (severity, and highest for major depressive, panic/agoraphobia, and generalized anxiety disorders; lowest for substance use disorders), health insurance, employment status (highest for students, the retired, and the unemployed/disabled), and several aspects of prior treatment. These associations were generally similar in cases with and without perceived need for treatment. 12-month treatment among cases who without perceived need and without history of prior treatment was rare (1.1%). CONCLUSIONS: Findings highlight the critical importance of perceived need for obtaining 12-month treatment in the context of other significant predictors involving complexity and severity of disorders and socio-demographic factors. The importance of prior treatment history was quite striking, as was the finding that absence of both perceived need and prior treatment history were associated with a nearly complete absence of treatment. Policy recommendations emerging from these results include the need to increase health literacy, reduce the stigmatization of mental disorder, enhance access through health insurance, and improve the quality of care given the clear evidence that prior experiences with treatment play an important role in determining the likelihood of again seeking treatment for current problems.

  PublisherOA PDFDOI

• Obsessive-compulsive disorder in the World Mental Health surveys

  BMC Medicine · 2025-07-09 · 18 citations

  articleOpen access

  BACKGROUND: National surveys have suggested that obsessive-compulsive disorder (OCD) is a prevalent and impairing condition. However, there are few cross-national data on OCD, with data particularly scarce in low- and middle-income countries. Here we employ data from the World Mental Health surveys to characterize the onset, course, severity, and treatment of OCD across a range of countries in different geographic regions of the world. METHODS: Data came from general population surveys carried out in 10 countries (Argentina, Australia, Colombia, Iraq, Poland, People's Republic of China, Portugal, Romania, Saudi Arabia, Spain) using a consistent research protocol and interview. A total of 26,136 adults were assessed for OCD in face-to-face interviews and were included in the present analyses. We examined lifetime and 12-month prevalence as well as age of onset, persistence, severity, and treatment of DSM-IV OCD in six high-income countries (HICs) and four low- or middle-income countries (LMICs). We also investigated socio-demographic variables and temporally prior mental disorders as predictors of OCD onset, persistence, severity, and treatment. RESULTS: Across the 10 countries surveyed, OCD has a combined lifetime prevalence of 4.1%. The 12-month prevalence (3.0%) is nearly as high, suggesting a highly persistent course of illness. Age of onset is early, with more than 80% of OCD cases beginning by early adulthood. Most OCD cases in the community are mild (47.0%) or very mild (27.5%), with a smaller percentage designated as moderate (22.9%) or severe (2.7%) by the Yale-Brown Obsessive-Compulsive Scale. Only 19.8% of respondents with OCD received any mental health treatment in the past year, with treatment rates much higher in HICs (40.5%) than LMICs (7.0%). Cross-nationally, OCD commonly emerges in adolescence or early adulthood against a backdrop of earlier-occurring mental disorders. With few exceptions (e.g., prior social phobia), the socio-demographic and psychopathological risk factors for OCD onset, persistence, severity, and treatment are distinct. CONCLUSIONS: These cross-national data underscore clinical lessons regarding the importance of early diagnosis of OCD and comprehensive evaluation of comorbidity; draw attention to OCD as an undertreated disorder, particularly in LMIC contexts; and emphasize the public health significance of this often-overlooked condition.

  PublisherOA PDFDOI

• Digital and Technological Means of Delivering Interventions

  2025-12-18

  book-chapter1st authorCorresponding

  Abstract There are remarkable and fast-moving advances in technology, digital media, artificial intelligence, machine learning, neural networks, and robotics, and their many variations, combinations, and applications. These advances can contribute greatly to reducing mental health problems and improving mental health more generally. Technology can bring diverse forms of psychotherapy to many more people than currently is the case, help extend the reach of everyday activities, and add new techniques such as serious games and social robots to deliver treatment. This chapter highlights selected uses of technology to deliver interventions. Many of the media used to deliver treatments are illustrated. Applications and internet programs, virtual and augmented reality, and socially assistive robots are discussed in-depth as ways of reducing mental health problems. The evidence is reviewed to draw conclusions about what is currently known regarding the use of these different technologies to reduce mental health problems.

  PublisherDOI

• Pathway to effective treatment for common mental and substance use disorders in the World Mental Health Surveys: Perceived need for treatment

  International Journal of Mental Health Systems · 2025-05-23 · 1 citations

  articleOpen access

  BACKGROUND: Perceived need for treatment is a first step along the pathway to effective mental health treatment. Perceived need encompasses a person's recognition that they have a problem and their belief that professional help is needed to manage the problem. These two components could have different predictors. METHODS: Respondents aged 18+ years with 12-month mental disorders from 25 representative household surveys in 21 countries in the World Mental Health Survey Initiative (n = 12,508). All surveys included questions about perceived need; 16 surveys (13 countries) included additional questions about respondents' main reason for perceived need-problem recognition or perceived inability to manage without professional help (n = 9814). Associations of three sets of predictors (disorder, socio-demographics, past treatment) with perceived need and its components were examined using Poisson regression models. RESULTS: Across the 16 surveys with additional questions, 42.4% of respondents with a 12-month mental disorder reported perceived need for treatment. In separate multivariable models for each predictor set: (1) Most disorder types (except alcohol use disorder, specific phobia), disorder severity, and number of disorders were associated with perceived need and both of its components; (2) Sociodemographic factors tended to differentially predict either problem recognition (females, 30-59 years, disabled/unemployed) or need for professional help (females, homemakers, disabled/unemployed, public insurance); (3) Past treatment factors (type of professional, psychotherapy, helpful or unhelpful treatment) were associated with perceived need and both components, except number of past professionals differentially predicted problem recognition. In a consolidated model: employment and insurance became non-significant; type and number of past professionals seen became more important; helpful past treatment predicted greater need for professional help while unhelpful treatment predicted lower problem recognition. Problem recognition was the more important component in determining perceived need for some groups (e.g., severe disorder, people who consulted non-mental health professionals). CONCLUSIONS: Greater clinical need is a key determinant of perceived need for treatment. Findings suggest a need for strategies to address low perceived need (e.g., in males, older people, alcohol use disorders) and lower endorsement of professional treatment in some groups, and to improve patient's treatment experiences which are important enablers of future help-seeking.

  PublisherOA PDFDOI

• Mental Health and Clinical Psychological Science in the Time of COVID-19: Challenges, Opportunities, and a Call to Action

  UNC Libraries · 2025-05-13

  articleOpen access

  COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond.

  PublisherDOI

• Mind–Body Interventions

  2025-12-18

  book-chapter1st authorCorresponding

  Abstract There are a variety of interventions that focus on the relations of mind, body, brain, behavior, lifestyle, and health. This chapters discusses yoga, mindfulness, meditation, tai chi, and qigong and their use as a means of alleviating mental health problems. These interventions vary in culture, tradition, and origin, but many of them share common practices. In this chapter, each is evaluated to identify if evidence supports their use as a means of alleviating mental health problems. Among the interesting features of these interventions are the multiple variations that are available and can be adapted to individual interests and physical abilities.

  PublisherDOI

Recent grants

• NIH Grant R34MH093326

  NIH · $735k · 2015

• NIH Grant R37MH035408

  NIH · $3.1M · 1996

• NIH Grant K02MH000353

  NIH · $272k · 1991

• NIH Grant R01MH059029

  NIH · $2.8M · 2007

• NIH Grant R01MH035408

  NIH · $816k · 1991

Frequent coauthors

• David H. Barlow

  142 shared

• Larissa Shamseer

  142 shared

• Michael Perdices

  Royal North Shore Hospital

  140 shared

• Robyn Tate

  139 shared

• Ulrike Rosenkoetter

  Children's Hospital of Eastern Ontario

  139 shared

• Thomas R. Kratochwill

  University of Wisconsin–Madison

  135 shared

• Robert H. Horner

  University of Oregon

  134 shared

• Skye McDonald

  UNSW Sydney

  133 shared