Mood and anxiety disorders affect 20–30 percent of school-age children, contributing to academic failure, substance abuse, and adult psychopathology, with immense social and economic impact. These disorders are treatable, but only a fraction of students in need have access to evidence-based treatment practices (EBPs). Access could be substantially increased if school professionals were trained to identify students at risk and deliver EBPs in the context of school-based support services. However, current training for school professionals is largely ineffective because it lacks follow-up supported practice, an essential element for producing lasting behavioral change. The paper aims to discuss these issues.
In this pilot feasibility study, the authors explored whether a coaching-based implementation strategy could be used to integrate common elements of evidence-based cognitive behavioral therapy (CBT) into schools. The strategy incorporated didactic training in CBT for school professionals followed by coaching from an expert during co-facilitation of CBT groups offered to students.
In total, 17 school professionals in nine high schools with significant cultural and socioe-conomic diversity participated, serving 105 students. School professionals were assessed for changes in confidence in CBT delivery, frequency of generalized use of CBT skills and attitudes about the utility of CBT for the school setting. Students were assessed for symptom improvement. The school professionals showed increased confidence in, utilization of, and attitudes toward CBT. Student participants showed significant reductions in depression and anxiety symptoms pre- to post-group.
These findings support the feasibility and potential impact of a coaching-based implementation strategy for school settings, as well as student symptom improvement associated with receipt of school-delivered CBT.
Ethical approval: all procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research reported in this paper was supported by funds from the Center of Medicare and Medicaid Services through the Michigan Department of Health and Human Services (F048524) and The Michigan Health Endowment Fund (NO2202), and through generous foundation and private gifts to the University of Michigan Comprehensive Depression Center. The funding sources had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The views expressed in this paper are those of the authors and do not necessarily represent the views of any public or not for profit institution. The authors would like to thank the schools and school professionals without whose collaboration this research could not have been accomplished.
Koschmann, E., Abelson, J.L., Kilbourne, A.M., Smith, S.N., Fitzgerald, K. and Pasternak, A. (2019), "Implementing evidence-based mental health practices in schools: Feasibility of a coaching strategy", The Journal of Mental Health Training, Education and Practice, Vol. 14 No. 4, pp. 212-231. https://doi.org/10.1108/JMHTEP-05-2018-0028
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