Coaching for Mental Health Support in Schools

Overseen By Quinn Rabenau-McDonnell

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Children's Hospital of Philadelphia

Disqualifiers: Intellectual disability, Psychotic, Autistic, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program designed to improve mental health support in schools using Positive Behavioral Interventions and Supports (PBIS). The research examines the effectiveness of school coaches in implementing the program with varying levels of consultant support. Schools in the trial will receive assistance from Children's Hospital of Philadelphia (CHOP) consultants in the first year, with some schools continuing to receive this support in different forms over the next two years. This trial suits schools in Philadelphia already using PBIS and students in grades 4-8 who meet specific screening criteria for mental health support. As an unphased trial, it offers schools a unique opportunity to enhance mental health support systems and directly benefit students.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that school-based mental health programs, like those supported by the Children's Hospital of Philadelphia (CHOP), receive positive feedback. These programs use proven methods to help students improve their mental health and cope with trauma, backed by solid research and generally safe for students.

In schools with CHOP-supported coaches, the focus remains on providing effective mental health help. This approach aims to remove obstacles and make mental health services more accessible. Evidence suggests these methods can be used safely and effectively.

In schools without direct CHOP support, the goal remains to offer strong mental health support through trained school district coaches. These coaches ensure students receive the help they need, even without extra consultant support. Research has shown that these practices are also safe and effective.

Overall, both approaches prioritize student well-being and have been shown to be safe for use in schools. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different levels of support for school coaches can impact mental health interventions in schools. Unlike traditional methods that might rely solely on external consultants, this trial examines the effectiveness of empowering school district coaches with varying degrees of assistance from experts at the Children's Hospital of Philadelphia (CHOP). The trial aims to assess whether school-based coaches can sustain effective mental health support with limited external input, potentially offering a more sustainable and scalable model for schools to improve student mental health outcomes.

What evidence suggests that this trial's treatments could be effective for improving school climate and attending to students' mental health?

Research has shown that Positive Behavioral Interventions and Supports (PBIS) can improve school environments and support student mental health. In this trial, some schools will have coaches supported by experts from the Children's Hospital of Philadelphia (CHOP), which has been associated with better student outcomes, such as reduced anxiety. Other schools will have coaches who rely on school district coaches without direct assistance from CHOP experts. Both methods aim to provide effective mental health support in schools, though results may vary. ^{1 5 6 7 8}

Who Is on the Research Team?

Ricardo Eiraldi, PhD

Principal Investigator

Children's Hospital of Philadelphia

Are You a Good Fit for This Trial?

This trial is for Philadelphia schools using PBIS, their staff involved in PBIS leadership or Tier 2 interventions, and students in grades 4-8 eligible for PBIS with certain emotional or behavioral difficulties. Schools not implementing PBIS at Tier 1, unrelated personnel, and students with intellectual disabilities or specific disorders are excluded.

Inclusion Criteria

Tier 2 Team Members: Any staff from participating schools involved in the PBIS leadership team at that school.

Tier 2 Implementers: Any Masters-level staff assigned by their school's principal to deliver Tier 2 interventions.

Students: Any student at participating schools in grades 4-8 who scores as eligible for PBIS based on the Social, Academic, and Emotional Behavioral Risk Screener (SAEBRS), which is standard screening criteria in the SDP for Tier 2 services and scores above > 1 SD above the mean on the Emotional Symptoms or Conduct Problems scales of the Strengths and Difficulties Questionnaire (SDQ) plus Impact Supplement scores of 1 (A medium amount) or 2 (A great deal) completed by a parent or a teacher

Exclusion Criteria

Tier 2 Team Members and Implementers: Any school personnel that are not involved in the leadership team or tier 2 team.

Students: Any student with a Special Education classification of "Intellectual Disability;" or with a history of psychotic or autistic spectrum disorders according to school records will be excluded because they would be unlikely to benefit from our tier 2 interventions.

Schools: Any schools not currently implementing PBIS at Tier 1.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Year 1

Schools receive support for Tier 2 interventions provided by CHOP research consultants

1 year

Intervention Year 2

Schools in Sustainment 1 receive reduced support from school district coaches with diminished support from research consultants; Sustainment 2 receives support from school district coaches without research consultant help

1 year

Intervention Year 3

Schools implement Tier 2 interventions with support from school district coaches; no direct assistance from research consultants

1 year

Follow-up

Participants are monitored for cost-effectiveness and changes in student mental health and academic engagement

up to 5 years

What Are the Treatments Tested in This Trial?

Interventions

• Coaches with Children's Hospital of Philadelphia (CHOP) Research Consultant Support
• Coaches without CHOP Research Consultant Support

Trial Overview The study tests the effectiveness of school-based mental health supports by comparing two groups: one receives coaching support from CHOP Research Consultants while the other does not. The goal is to see if this improves school climate and student mental health.

How Is the Trial Designed?

Group I: Sustainment 1: Coaches with CHOP Support Active Control 2 Interventions

In Year 1 of participation, schools in both arms will receive support for Tier 2 interventions provided by Children's Hospital of Philadelphia (CHOP) research consultants. In Year 2, schools in Sustainment 1 will receive reduced support for Tier 2 interventions provided by school district coaches. The coaches will in turn receive diminished support from research consultants. In Year 3, schools in both conditions will implement Tier 2 interventions with support from school district coaches; coaches will not receive direct assistance from research consultants.

Group II: Sustainment 2: Coaches without CHOP Support Active Control 1 Intervention

In Year 1 of participation, schools in both arms will receive support for Tier 2 interventions provided by CHOP research consultants. In Years 2 and 3, schools in Sustainment 2 will receive support from school district coaches but coaches will not receive help from research consultants.

Who Is Running the Clinical Trial?

Children's Hospital of Philadelphia

Lead Sponsor

Trials

749

Recruited

11,400,000+

University of Pennsylvania

Collaborator

Trials

2,118

Recruited

45,270,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Devereux Center for Effective Schools

Collaborator

Trials

3

Recruited

1,200+

Published Research Related to This Trial

In a study involving 169 school professionals across 94 high schools in Michigan, the adaptive implementation strategy that included Replicating Effective Programs (REP) and added Facilitation for slower-responding schools led to the highest average delivery of cognitive behavioral therapy (CBT) sessions (154.1 sessions).

Contrary to expectations, the combination of REP, Coaching, and Facilitation did not significantly increase the number of CBT sessions delivered compared to REP alone, indicating that not all implementation strategies may enhance service delivery equally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan. Smith, SN., Almirall, D., Choi, SY., et al.[2022]

The TRAILS program successfully trained 86 community clinicians in Michigan to become coaches in cognitive behavioral therapy (CBT), significantly improving their knowledge and application of CBT strategies.

This coaching model, which includes in vivo support and personalized consultation, effectively addresses the shortage of mental health providers for youth by enhancing the implementation of evidence-based practices in schools.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a statewide network of coaches to support youth access to evidence-based practices. Meyer, AE., Rodriguez-Quintana, N., Miner, K., et al.[2023]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38273369/

Implementation fidelity, student outcomes, and cost ... - PubMed Implementation outcomes were implementation fidelity and treatment dosage. Student outcomes were child- and parent-reported symptoms of anxiety, ...

2. research.chop.edu research.chop.edu/project-rise

Project RISE (Resources and Internal Supports for Evidence ... Project RISE aims to compare fidelity, cost effectiveness, and student outcomes of Tier 2 mental health interventions across two sustainment models.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3896840/

A cluster randomized trial to evaluate external support for ... The study follows six K – 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus- ...

4. research.chop.edu research.chop.edu/care

Coaching and Asynchronous Remote Training for Evidence ... The CARE (Coaching and Asynchronous Remote Training for Evidence-Based Practices) study is a partnership between CHOP, Devereux Center for Effective Schools ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT02651402

A Hybrid Effectiveness-Implementation Trial of Group CBT ... Therapists implement FRIENDS (a CBT protocol for students with anxiety) in the school setting, while supported by their supervisor assigned to the Train-the- ...

6. chop.edu chop.edu/news/program-eliminates-barriers-and-increases-access-mental-health-treatment-bringing-services

Program Eliminates Barriers and Increases Access to ... We aim to provide students with evidence-based, culturally appropriate mental health services and supports, to lessen the impact of trauma and ACEs on youth.

7. policylab.chop.edu policylab.chop.edu/blog/supporting-student-mental-health-key-takeaways-school-and-district-staff

Supporting Student Mental Health: Key Takeaways From ... In particular, schools are well-suited to provide mental health prevention programs to support the well-being of all students, which are known ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12242779/

Generating Actionable Evidence for School-Based Mental ... This paper describes strategic program evaluation of school-based mental health services for students conducted for over a decade through ...