Effectiveness of a Brief Engagement, Problem-Solving, and Triage Strategy for High School Students: Results of a Randomized Study
Eric J. Bruns; Kristine Lee; Chayna Davis; Michael D. Pullmann; Kristy Ludwig; Mark Sander; Cheryl Holm-Hansen; Sharon Hoover; Elizabeth M. McCauley (2023). Retrieved from: https://eric.ed.gov/?id=ED627858
-
examining348Students, grades9-12
Single Study Review
Review Details
Reviewed: January 2026
- Single Study Review (findings for Brief Intervention for School Clinicians (BRISC))
- Randomized Controlled Trial
- Meets WWC standards with reservations because it is a cluster randomized controlled trial with high individual-level non-response, but provides evidence of effects on individuals by satisfying the baseline equivalence requirement for the individuals in the analytic intervention and comparison groups.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Columbia Impairment Scale (CIS) |
Brief Intervention for School Clinicians (BRISC) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
No |
-- |
|
Generalized Anxiety Disorder (GAD-7) |
Brief Intervention for School Clinicians (BRISC) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
No |
-- |
|
Patient Health Questionnaire (PHQ-9) |
Brief Intervention for School Clinicians (BRISC) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Brief Problem Checklist-Internalizing |
Brief Intervention for School Clinicians (BRISC) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
No |
-- |
|
Brief Problem Checklist-Externalizing |
Brief Intervention for School Clinicians (BRISC) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
No |
-- |
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
-
Female: 66%
Male: 34% -
- B
- A
- C
- D
- E
- F
- G
- I
- H
- J
- K
- L
- P
- M
- N
- O
- Q
- R
- S
- V
- U
- T
- W
- X
- Z
- Y
- a
- h
- i
- b
- d
- e
- f
- c
- g
- j
- k
- l
- m
- n
- o
- p
- q
- r
- s
- t
- u
- v
- x
- w
- y
Maryland, Minnesota, Washington
-
Race Asian 4% Black 28% Native American 1% Other or unknown 17% Pacific Islander 1% Two or more races 12% White 37% -
Ethnicity Hispanic 21% Not Hispanic or Latino 79% -
Eligible for Free and Reduced Price Lunch Free or reduced price lunch (FRPL) 61% No FRPL 39%
Study Details
Setting
The study took place in 15 school districts in 3 states: Maryland, Minnesota, and Washington. Maryland had 13 schools in 2 districts, Minnesota had 16 schools in 8 districts, and Washington had 20 schools in 5 districts.
Study sample
All students who sought or were referred to services from participating school mental health practitioners (SMHPs) in participating high schools were eligible and students were referred to or made requests for services through standard procedures used by their school/district. There were 26 schools randomized in each condition, with 259 students in the intervention group and 198 in the comparison group. The analytic sample included 21 schools in each condition, with 183 in the intervention group and 165 in the comparison group. Students who were currently or had in the past year received therapy or counseling or were in an acute crisis or did not speak English or Spanish were excluded. Sixty-six percent of students in the study were female. A total of 37% were White, 28% were Black, 4% were Asian, 1% were American Indian or Alaska Native, 1% were Native Hawaiian or Pacific Islander, 12% were multi-racial, and 17% reported another race. Twenty-one percent of students reported Latinx as their ethnicity. Thirty percent of students were in ninth grade, 25% were in tenth grade, 26% were in eleventh grade, and 18% were in twelfth grade with 61% eligible to receive free and reduced-price lunch and an average age of sixteen.
Intervention Group
The Brief Intervention for School Clinicians (BRISC) strategy was implemented in four sessions. In the first session the school mental health professional assesses the students' current functioning using standardized measures, engages the student, and finds "top problems". The student is then asked to monitor a behavior related to one of their top problems. The second session introduces a problem-solving framework and students choose a top problem to focus on. The third session teaches evidence-based, skill-based elements as needed. During the fourth session, the school mental health professional and student monitor progress and identify a "post-BRISC pathway". This can mean the resolution of the issue, or next steps for further support. The mental health professionals also received bi-weekly phone coaching, including reviewing adherence checklists and reviewing BRISC implementation.
Comparison Group
The comparison condition was business as usual, which included individual counseling or therapy as students usually would from their school mental health professional. Authors note that these professionals may use some of the techniques used in the intervention condition but less frequently and intensely.
Support for implementation
Study school mental health practitioners (SMHPs) included licensed mental health clinicians (N = 53) from community mental health agencies that provided SMH services in 41 schools and study schools where school counselors (N = 10) provided school mental health services to students in 9 schools. SMHPs attended a 1.5-day in-person training to learn and to incorporate strategies that were meant to help students learn new skills. SMHPs also engaged in bi-weekly phone consultation/coaching from the trainers that included adherence checklists completed by a clinician regarding for each session, case presentations, and review of and feedback on their BRISC implementation.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
An outcome is the knowledge, skills, and attitudes that are attained as a result of an activity. An outcome measures is an instrument, device, or method that provides data on the outcome.
A finding that is included in the effectiveness rating. Excluded findings may include subgroups and subscales.
The sample on which the analysis was conducted.
The group to which the intervention group is compared, which may include a different intervention, business as usual, or no services.
The timing of the post-intervention outcome measure.
The number of students included in the analysis.
The mean score of students in the intervention group.
The mean score of students in the comparison group.
The WWC considers a finding to be statistically significant if the likelihood that the finding is due to chance alone, rather than a real difference, is less than five percent.
The WWC reviews studies for WWC products, Department of Education grant competitions, and IES performance measures.
The name and version of the document used to guide the review of the study.
The version of the WWC design standards used to guide the review of the study.
The result of the WWC assessment of the study. The rating is based on the strength of evidence of the effectiveness of the intervention. Studies are given a rating of Meets WWC Design Standards without Reservations, Meets WWC Design Standards with Reservations, or >Does Not Meet WWC Design Standards.
A related publication that was reviewed alongside the main study of interest.
Study findings for this report.
Based on the direction, magnitude, statistical significance, and sample size of the findings within a domain, the WWC assigns effectiveness ratings as one of the following: Tier 1 (strong evidence), Tier 2 (moderate evidence), Tier 3 (promising evidence), uncertain effects, and negative effects. For more detail, please see the WWC Handbook.
The WWC may review studies for multiple purposes, including different reports and re-reviews using updated standards. Each WWC review of this study is listed in the dropdown. Details on any review may be accessed by making a selection from the drop down list.
Tier 1 Strong indicates strong evidence of effectiveness,
Tier 2 Moderate indicates moderate evidence of effectiveness, and
Tier 3 Promising indicates promising evidence of effectiveness,
as defined in the
non-regulatory guidance for ESSA
and the regulations for ED discretionary grants (EDGAR Part 77).