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Grant Closed

Student Outcomes of Integrative Mental Health Services

NCER
Program: Education Research Grants
Program topic(s): Social, Emotional, and Behavioral Context for Teaching and Learning
Award amount: $3,499,669
Principal investigator: John Weisz
Awardee:
Harvard University
Year: 2014
Award period: 4 years (08/01/2014 - 07/31/2018)
Project type:
Efficacy
Award number: R305A140253

Purpose

There is a growing need for school-based interventions to address the behavioral and academic challenges of the growing number of students who experience mental health problems. Although many evidence-based mental health interventions are being implemented in schools, they tend to address a single mental health disorder (e.g., anxiety) and do not adequately address the complex, multiple problems facing many children in schools.   One evidence-based intervention, ChildSTEPS, is a flexible, integrative, modular approach to psychotherapy that provides school clinicians with an approach that integrates multiple evidence-based practices for multiple child problems.  Prior research indicated ChildSTEPS was more effective than usual treatment for improving mental health outcomes. The purpose of this study is to further explore the efficacy of ChildSTEPS by assessing its impact on mental health and academic outcomes.

Project Activities

Elementary age students referred for school-based mental health intervention will be randomly assigned to receive the ChildSTEPS intervention or to a services-as-usual condition.  Student assessments will be conducted at pre-treatment, weekly throughout treatment, monthly throughout treatment, at immediate post-treatment, and at 6-months post-treatment. Researchers will use multiple measures to assess student behavioral and academic outcomes. Researchers will also examine factors that moderate or mediate the impact of the intervention on student outcomes.

Structured Abstract

Setting

The study will take place in eight elementary schools in a large urban district in the Boston area.

Sample

The sample will consist of approximately 200 students in grades 3-7, ages 7-13.  All students have been referred for mental health services.

Intervention

The ChildSTEPS program has two components: 1) an integrative, flexible protocol which includes evidence-based interventions using treatment modules that provide guidance for treating students for multiple mental health diagnoses, and 2) an online system that provides clinicians weekly feedback on child treatment response. The program can be used for a variety of mental health disorders, and the modules can be adjusted for use in varied lengths of time and allow clinicians to choose the order in which to use them, based on student need.

Research design and methods

 Researchers will address three main questions: (1) What is the impact of Child STEPs, compared to usual services, on student mental health? (2) What is the impact of Child STEPs, compared to usual care, on students’ school-related outcomes (e.g., attendance, engagement, academic skills, and discipline problems)? (3) Are the effects of Child STEPs on students’ school-related outcomes mediated by changes in student mental health?

Elementary age students referred for school-based mental health intervention will be randomly assigned to receive the ChildSTEPS intervention or to a services as usual condition.  Researchers will recruit approximately 70 students per year for three years to participate in the study. The study will use double block randomization, with both clinicians and students randomly assigned to the treatment or control groups.  Student assessments will be conducted at pretreatment, weekly throughout treatment, monthly throughout treatment, at immediate post treatment, and at 6-months post-treatment.   Researchers will also examine factors that moderate or mediate the impact of the intervention on student outcomes.

Control condition

Students in the control group will receive mental health services typically provided by the schools.

Key measures

A variety of outcome measures will be used to assess mental health, school functioning, and academic outcomes.  Mental health outcomes will be assessed using standardized checklists completed by students, clinicians, caregivers, and teachers (e.g. the Post Traumatic Stress Disorder Index). School functioning will be assessed using record reviews, attendance reports, and office referral rates. Academic outcomes will be assessed using record reviews, reports from teachers and students, and the School Engagement Measure. The researchers will collect data on fidelity of implementation of ChildSTEPS using coded observations. They will also collect data on moderators (student gender and ethnicity, initial problem severity, and clinician type) and one mediator (whether changes in school functioning are mediated by changes in mental health).

Data analytic strategy

The researchers will use a variety of analytic strategies including multilevel modeling with repeated measures (Level 1) nested within students (Level 2) who are nested within therapists (Level 3).  Researchers will use latent variable regressions to determine the effects of ChildSTEPS on improving mental health and academic outcomes.  In addition, the research team will also explore moderators and mediators of intervention effects.

People and institutions involved

IES program contact(s)

Jacquelyn Buckley

Deputy Commissioner
NCSER

Products and publications

Products: The products of this project will be evidence of the efficacy of the ChildSTEPS intervention program. Peer reviewed publications will also be produced.

Journal article, monograph, or newsletter

Bearman, S.K., and Weisz, J.R. (2015). Comprehensive Treatments for Youth Comorbidity-Evidence-Guided Approaches to a Complicated Problem. Child And Adolescent Mental Health, 20(3), 131-141.

Ng, M.Y., and Weisz, J.R. (2016). Annual Research Review: Building a Science of Personalized Intervention for Youth Mental Health. Journal of Child Psychology and Psychiatry, 57(3), 216-236.

Questions about this project?

To answer additional questions about this project or provide feedback, please contact the program officer.

 

Tags

Data and Assessments

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Questions about this project?

To answer additional questions about this project or provide feedback, please contact the program officer.

 

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