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

716 Participants Needed

Trial Summary

What is the purpose of this trial?

Schools are in great need of service delivery systems that can improve school climate and also attend to students' mental health. One effective approach is Positive Behavioral Interventions and Supports (PBIS), a multitiered framework for defining and organizing practices and interventions (including mental health practices).

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment 'Coaching for Mental Health Support in Schools'?

Research shows that coaching, which includes in-person modeling and support, is effective in implementing evidence-based practices in schools. A study in Michigan demonstrated that trained coaches improved their knowledge and use of cognitive behavioral therapy (CBT), helping to address mental health care gaps for youth. Additionally, ongoing expert consultation and coaching are critical for the successful implementation of evidence-based practices in school settings. ^{1 2 3 4 5}

Is coaching for mental health support in schools safe for participants?

The research articles do not provide specific safety data for the coaching interventions in school mental health settings. However, they describe the feasibility and acceptability of these interventions, suggesting that they are generally well-received and implemented without reported safety concerns. ^{1 2 5 6 7}

How does the 'Coaching for Mental Health Support in Schools' treatment differ from other treatments for mental health in children?

This treatment is unique because it involves school-based coaches who work directly with students, teachers, and parents to create a healthy school environment, which is different from traditional mental health treatments that often occur outside of school settings. The involvement of coaches with or without research consultant support from CHOP aims to integrate mental health support into the daily school routine, making it more accessible and sustainable. ^{2 8 9 10 11}

Research Team

Ricardo Eiraldi, PhD

Principal Investigator

Children's Hospital of Philadelphia

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Can We Move the Needle on School Mental Health Quality Through Systematic Quality Improvement Collaboratives? [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Developing a statewide network of coaches to support youth access to evidence-based practices. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Consultation as an implementation strategy for evidence-based practices across multiple contexts: unpacking the black box. [2022]

4. England 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. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of a Brief Engagement, Problem-Solving, and Triage Strategy for High School Students: Results of a Randomized Study. [2023]

6. England pubmed.ncbi.nlm.nih.gov

From distal to proximal: Routine educational data monitoring in school-based mental health. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

The implementation of a team training intervention for school mental health: Lessons learned. [2023]

8. Croatia pubmed.ncbi.nlm.nih.gov

Do 'school coaches' make a difference in school-based mental health promotion? Results from a large focus group study. [2014]

9. United States pubmed.ncbi.nlm.nih.gov

Illustrating the multiple facets and levels of fidelity of implementation to a teacher classroom management intervention. [2013]

10. United States pubmed.ncbi.nlm.nih.gov

The effectiveness, feasibility and scalability of the school platform in adolescent mental healthcare. [2021]

11. England pubmed.ncbi.nlm.nih.gov

Impact of a pediatric primary care health-coaching program on change in health-related quality of life in children with mental health problems: results of the PrimA-QuO cohort study. [2023]