Sustainment of Mental Health Supports

Summary

Schools need sustainable systems to improve climate and address student mental health. This study compares two sustainment models for Tier 2 mental health interventions within a Positive Behavioral Interventions and Support (PBIS) framework. Using a 2-arm, cluster randomized Type-2 Hybrid trial, 12 urban public schools participated over three years each. School district intervention Implementers (e.g., school counselors) and district-level coaches participated throughout the study, while Tier 2 Team Members (e.g., social workers, behavioral health staff) were involved during the initial implementation phase only. Primary outcomes include fidelity, penetration, cost, and student outcomes (mental health and academic engagement) for evidence-based practices (Coping Power Program \[CPP\]; Cognitive Behavioral Therapy \[CBT\] for Anxiety Treatment in Schools \[CATS\]).

Conditions

• Behavior Disorders

Interventions

BEHAVIORAL

Coping Power Program (CPP)

CPP is an evidence-based intervention designed for students with externalizing behavior disorder. CPP consists of twelve 45-minute sessions. This EBP has been found to be effective at reducing aggressive behavior, covert delinquent behavior and substance abuse among aggressive boys, with gains maintained at one-year follow-up. Growth curve analyses showed that CPP had linear effects for three years after intervention on reductions in aggressive behavior and academic behavior problems.

BEHAVIORAL

Cognitive behavioral therapy (CBT) for Anxiety Treatment in Schools (CATS)

CATS is an adaptation of the Friends for Life (FRIENDS) intervention. The adapted protocol retains the core elements of evidence-based CBT for anxiety and the FRIENDS group format. Investigators implemented planned adaptations to the protocol based on collective experience. Changes were made to the language, cultural methods, number of sessions, and activities while maintaining the 5 essential components of the treatment. This resulted in a briefer (8-session) and more feasible, engaging, and culturally appropriate protocol for urban under-resourced schools than the original FRIENDS.

Sponsors & Collaborators

• University of Pennsylvania

  collaborator OTHER

• National Institute of Mental Health (NIMH)

  collaborator NIH

• Children's Hospital of Philadelphia

  lead OTHER

Principal Investigators

• Ricardo Eiraldi, PhD · Children's Hospital of Philadelphia

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

8 Years

Max Age

99 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-09-17

Primary Completion

2025-07-01

Completion

2025-07-01

Countries

• United States

Study Locations