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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved as exempt by the University of Hawai\u02bbi at M\u0101noa\u2019s Committee on Human Studies Institutional Review Board as well as the State Department of Health\u2019s Child and Adolescent Mental Health Division. Clinical documentation of all client and therapist data within the State Department of Health\u2019s Child and Adolescent Mental Health Division adhere to Health Insurance Portability and Accountability Act (HIPAA) standards and are recorded and stored in compliance with state standards (CAMHD, ). Following Institutional Review Board and State Department of Health approval, a limited data set was electronically extracted from the Child and Adolescent Mental Health Division system.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Upon entry into system of care, youths\u2019 legal guardians receive informed consent, which includes consent for the use of data for research purposes.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}}]}}