Inside IES Research

In May 2021, we launched a new blog series called Spotlight on School-based Mental Health to unpack the why, what, when, who, and where of providing mental health services in schools. This first post in the series focuses on the why by discussing three IES-funded projects that highlight the importance of these services.

Increasing access to needed services. A primary benefit of school-based mental health is that it can increase access to much-needed services. A 2019 report from the Substance Abuse and Mental Health Services Administration (SAMSHA) indicates that 60% of the nearly 4 million 12- to 17-year-olds who reported a major depressive episode in the past year did not receive any treatment whatsoever. What can be done to address this need? One idea being tested in this 2019 efficacy replication study is whether school counselors with clinician support can provide high school students a telehealth version of a tier-2 depression prevention program with prior evidence of efficacy, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST). Through individual and group sessions, the IPT-AST program provides direct instruction in communication and interpersonal problem-solving strategies to decrease conflict, increase support, and improve social functioning.   

Improving access to services for Black youth. Social anxiety (SA) is a debilitating fear of negative evaluation in performance and social situations that can make school a particularly challenging environment. The connection between SA and impaired school functioning is likely exacerbated in Black youth who often contend with negative racial stereotypes. In this 2020 development and innovation project, the research team aims to expand Black youth’s access to mental health services by improving the contextual and cultural relevance of a promising school-based social anxiety intervention, the Skills for Academic and Social Success (SASS). Through community partnerships, focus groups, and interviews, the team will make cultural and structural changes to SASS and add strategies to engage Black students in urban high schools who experience social anxiety.

Reducing stigma by promoting well-being. The second leading barrier cited by adolescents for not seeking mental health treatment include social factors such as perceived stigma and embarrassment. One way to counteract these barriers is to frame intervention in more positive terms with a focus on subjective well-being, a central construct in positive psychology. In this 2020 initial efficacy study, the research team is testing the Well-Being Promotion Program in middle schools in Florida and Massachusetts. In 10 core sessions, students low in subjective well-being take part in group activities and complete homework assignments designed to increase gratitude, acts of kindness, use of signature character strengths, savoring of positive experiences, optimism, and hopeful or goal-directed thinking.

These three projects illustrate why we need to carefully consider school-based mental health as a logical and critical part of success in school, particularly as we navigate the road to helping students recover from disengagement and learning loss during the coronavirus pandemic.  

Next in the series, we will look at the what of school-based mental health and highlight several projects that are developing innovative ways to support the mental health of students and staff in school settings.

Written by Emily Doolittle (Emily.Doolittle@ed.gov), NCER Team Lead for Social Behavioral Research at IES

This May as we recognize National Mental Health Awareness Month, schools around the country are welcoming students and educators back for in-person instruction after more than a year of remote or hybrid teaching and learning. One issue schools must consider during this transition back is the increase in mental health concerns among adults, young adults, and adolescents this past year. Here at IES, we support research that explores, develops, and tests innovative, field-initiated approaches to support mental health in schools and classrooms. This new IES blog series will explore school-based mental health by looking at IES-funded research that helps answer the five Ws:

• Why school-based mental health? The first blog in the series will consider the benefits of school-based mental health such as providing increased access to services, especially for children of color, and potentially counteracting the stigma some associate with mental health treatment.

• What can schools do to support the mental health of their students and staff? The second blog in the series will highlight several projects that are developing innovative new ways to provide mental health services in school settings.

• When during the school day can schools implement these mental health practices so that they do not compete with the academic/instructional goals of school? The third blog in the series will highlight a variety of projects that delve into the implementation challenges inherent to providing school-based mental health services and support.

• Who in the school should implement these mental health practices? The fourth blog in the series will explore the critical scale up challenge for schools of having staff with adequate time who can be appropriately trained to provide mental health supports to students.

• Where can these mental health practices be implemented? The final blog in the series will investigate the implementation challenges of different education settings (PreK, elementary, middle, high school, postsecondary) for school-based mental health programs and practices.  

See these blogs for more information about some of the school-based mental health research supported through the two IES research centers, the National Center for Education Research (NCER) and the National Center for Special Education Research (NCSER).  

Written by Emily Doolittle (Emily.Doolittle@ed.gov), NCER Team Lead for Social Behavioral Research at IES

The past year and a half have brought new meaning to May’s National Mental Health Awareness Month. As students, families, and school staff navigate virtual, hybrid, and new routines surrounding in-person learning, promoting mental wellbeing has been a large topic of discussion for supporting students and educators.

The National Center for Special Education Research (NCSER) funds projects that include an emphasis on the mental health of students with or at risk for disabilities and their educators. Below are examples of such projects, which focus on supporting students who have internalizing disorders or experienced trauma and preventing and reducing burnout in special education teachers.

Internalizing Disorders

At the University of Connecticut Health Center, Dr. Golda Ginsburg tested the efficacy of a cognitive behavioral therapy (CBT) intervention for youth ages 7-17 in special education with an anxiety disorder as part of the School-based Treatment of Anxiety Research Study (STARS) program. This intervention was designed to be implemented by a school-based mental health clinician and contains seven core modules to help students understand, manage, and cope with anxiety. STARS also includes similarly focused parent training modules. Results demonstrated that parent-reported level of child anxiety decreased after participating in the program. They also suggested that older youth, those with social phobia, and those with more severe anxiety at the start of the study were more likely to benefit from participating in the STARS program.

Dr. Ginsburg has been developing another intervention for anxiety, Teacher Anxiety Program for Elementary Students (TAPES). This is a professional development program that enhances teacher knowledge and skills for identifying and reducing anxiety in students with or without disabilities who have elevated anxiety symptoms. TAPES contains materials informed by CBT to be used class-wide and during teacher-parent-student meetings. The research team will soon be conducting a pilot test of this program.

Additionally, at the University of Wisconsin-Madison, Dr. Stephen Kilgus and colleagues are currently developing the Resilience Education Program (REP), a tier 2 intervention for elementary students at risk for internalizing behaviors. REP consists of three components: A cognitive behavioral instructional curriculum to promote acquisition of social-emotional skills, use of the Check In/Check Out (CICO) system (an existing intervention for promoting the maintenance of acquired skills), and parent skills training that promotes CICO implementation and facilitates positive parent-child relations.

Trauma

At SRI International, Dr. Carl Sumi and colleagues tested the efficacy of the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a school-based, structured, symptom-focused therapy program for middle school students who have experienced significant trauma and are experiencing related emotional or behavioral challenges. CBITS consists of 10 group therapy sessions and one individual session with a school-based mental health clinician with training on relaxation techniques, cognitive therapy, exposure, and social problem solving. The study found positive impacts of the intervention overall on social-emotional and academic outcomes, but the outcomes varied depending on level of behavioral concerns prior to beginning treatment. Specifically, for youth with more significant externalizing behavior problems (such as aggression), those who experienced CBITS had greater reductions in post-traumatic stress and other emotional and behavioral problems, as well as improved scores on a standardized literacy assessment. In addition, for students with internalizing behavior problems (such as anxiety), participation in CBITS led to better performance on standardized math tests 1 year later.

Teacher Burnout

At Ball State University, Dr. Lisa Ruble and colleagues are adapting an existing manualized intervention for mental health workers, Burnout Reduction: Enhanced Awareness, Tools, handouts, and Education (BREATHE), to be used with special education teachers to reduce burnout. BREATHE is both a prevention and intervention strategy, as it aims to prevent burnout from occurring and reduces burnout when present. Sessions cover CBT stress reduction techniques, meditation and relaxation practices, and social skills training to increase coping skills and the ability to manage stressful job demands.

This blog was written by Alice Bravo, virtual intern for IES and doctoral candidate in special education at the University of Washington, and Jackie Buckley, program officer for NCSER’s Social, Emotional, and Behavioral Competence program. Katie Taylor is the program officer for NCSER’s Educators and School-Based Service Providers program.

As the month of May draws to a close in this unprecedented time of COVID-19, recognizing May as National Mental Health Awareness Month has taken on new significance. Organizations such as the National Association of School Psychologists (NASP) have long advocated for school-based mental health services to address the lack of access to mental health treatment in the United States for children and youth. In a 2016 blog, we provided a snapshot of the PreK to 12 school-based mental health research that the National Center for Education Research (NCER) had supported up to that point. With schools closed and uncertainty about when they will open, we are keeping an eye on these and more recent projects to see how IES-funded researchers and their school partners have addressed or are addressing mental health needs.

Preschool

• Jason Downer (University of Virginia) developed the Learning to Objectively Observe Kids (LOOK) protocol to help prekindergarten teachers identify and understand children’s engagement in preschool and choose appropriate techniques to support children’s self-regulation skills.

Elementary School

• Golda Ginsburg (University of Connecticut) and Kelly Drake (Johns Hopkins University) developed the CALM (Child Anxiety Learning Modules) protocol for elementary school nurses to work with children who have excessive anxiety.
• Desiree Murray (University of North Carolina, Chapel Hill) is testing the Incredible Years Dina Dinosaur Treatment Program (IY-child) for helping early elementary school students with social-emotional and behavioral difficulties. This study is nearly complete, and findings will be available soon.
• Gregory Fabiano (SUNY-Buffalo) adapted the Coaching Our Acting Out Children: Heightening Essential Skills (COACHES) program for implementation in schools. This is a clinic-based program to help fathers of children with or at risk for attention-deficit/hyperactivity disorder (ADHD) get more involved and engaged in their child's school performance. 
• Aaron Thompson (University of Missouri) is testing the Self-Monitoring Training and Regulation Strategy (STARS) intervention to see if it can improve behavior, social emotional learning skills, and academic performance for fifth grade students who engage in disruptive or otherwise challenging classroom behaviors. The pilot study of promise is currently in progress.
• Karen Bierman (Pennsylvania State University) is testing whether an intensive, individualized social skills training program, the Friendship Connections Program (FCP), can remediate the serious and chronic peer difficulties that 10–15 percent of elementary school students experience. Most of these students have or are at risk for emotional or behavioral disorders and exhibit social skill deficits (for example, poor communication skills, inability to resolve conflict) that alienate peers. This study is almost complete, and findings should be available soon.
• Linda Pfiffner (UC San Francisco) is completing development of a web-based professional development program for school mental health providers to gain the skills needed to implement evidence-based practices (EBPs) for student attention and behavior problems.

Middle School

• Joshua Langberg (Virginia Commonwealth University) refined the HOPS (Homework, Organization, and Planning Skills) program for middle school counselors and psychologists to support students with ADHD who need help with organization and time management. Dr. Langberg recently completed an efficacy trial of HOPS. In 2019, an independent research team at Children’s Hospital of Philadelphia received a grant to test the effectiveness of HOPS.
• William Pelham (Florida International University) and colleagues at SUNY Buffalo are testing the efficacy of adaptive, evidence-based classroom interventions (such as Tier 1 and Tier 2 interventions delivered through a Response to Intervention framework) for children with ADHD in a Sequential Multiple Assignment Randomized Trial (SMART) design framework.
• Thomas Power (Children’s Hospital of Philadelphia) is testing the efficacy of a school-based organizational skills training program (OST-S) for students in 3rd through 5th grade with deficits in organization, time management, and planning (OTMP), key executive function skills that support success in school.
• Desiree Murray (UNC Chapel Hill) is completing the development of a self-regulation intervention for middle school students. The intervention will adapt and integrate strategies from existing evidence-based practices that intentionally target self-regulatory processes that develop during early adolescence.
• Catherine Bradshaw (University of Virginia) is adapting the Early Adolescent Coping Power (EACP) to the rural school context. The Rural-EACP will address the cultural and contextual challenges of providing appropriate supports to help youth with aggressive behavior challenges in rural settings.   

High School

• Tamar Mendelsohn (Johns Hopkins University) is leading an evaluation of RAP Club, a prevention program intended to improve coping skills and academic outcomes in low-income urban middle school students. 
• Margaret Sibley (Florida International University) developed the STRIPES (Students Taking Responsibility and Initiative through Peer-Enhanced Support) intervention to promote engagement with schools to improve behavioral and academic outcomes for high school students with ADHD. 
• In 2016, Eric Bruns (University of Washington) and his colleagues received an efficacy grant to test the impact of the Brief Intervention for School Clinicians (BRISC), a school-based mental health intervention, on student outcomes. The BRISC allows school-based clinicians to quickly assess high school students’ needs, develop treatment strategies, and monitor progress.
• Jesse Suter (University of Vermont) is testing RENEW (Rehabilitation, Empowerment, Natural supports, Education and Work), an individualized intervention for high school students with emotional and behavioral challenges (EBC). This study is nearly complete, and findings will be available shortly.
• Shannon Suldo and Elizabeth Shaunessy-Dedrick (University of South Florida) are developing a prevention program to help high school students in Advanced Placement (AP) and International Baccalaureate (IB) classes manage the stress inherent in this type of accelerated coursework. This project applies findings from a recently completed IES Exploration study, Intrapersonal Factors Associated with Academic Success among High School Students in Advanced Placement and International Baccalaureate (AP-IB) Programs. They are completing the pilot study of promise.
• Jami Young (Children’s Hospital of Philadelphia) is testing whether the Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) Tier 2 depression prevention program is effective when implemented by school counselors.

Policy

• Sandra Chafouleas (University of Connecticut) identified current policies and national practice related to school-based behavioral assessment to determine whether current practice follows recommended best practice, and to develop policy recommendations for behavioral screening in schools. 

Written by Emily Doolittle (Emilly.Doolittle@ed.gov), Team Lead for Social and Behavioral Research at IES, National Center for Education Research

The United States has observed Mental Health Awareness Month every May since 1949 to raise awareness and educate the public about mental illnesses, including strategies and resources for supporting mental health and wellness. Mental health needs prior to the coronavirus pandemic were already enormous with 1 in 6 school age youth needing mental health support but unlikely to receive it. In fact, a recent study found that half of the estimated 7.7 million U.S. children with a treatable mental health disorder did not receive the necessary treatment from mental health professionals. This service gap is even greater in rural areas. How can rural schools support students, families, and staff during a global pandemic that has shut down school buildings and increased demand for mental health supports?

The IES-funded National Center for Rural School Mental Health is supporting partnerships with rural school districts in three states (Missouri, Virginia, and Montana) to develop and test ways to support the mental health needs of their students. In response to the COVID-19 crisis, the center has compiled a set of resources for families, schools, teachers, and youth on a wide range of pandemic-related challenges.

Visit https://www.ruralsmh.org/covid19/ for information ranging from how to navigate online learning to resources for suicide prevention and protecting children exposed to drug abuse at home. Among the many resources you can find here are tips for parents to encourage cooperative behavior at home, stress management tools for educators, and telehealth tips for youth and teens. For more information about mental health needs in rural settings and how Dr. Wendy Reinke, the Center’s director, and her colleagues are working on approaches to support the mental health needs of their students, please see this previous blog post.  

Written by Emily Doolittle (Emily.Doolittle@ed.gov), National Center for Education Research (NCER) Team Lead for Social Behavioral Research