Remote Mental Health Training for Mental Illness

Overseen By Jessica Goldstein, MPH

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Children's Hospital of Philadelphia

Disqualifiers: Intellectual disability, Developmental delays, Psychotic disorders, Autistic spectrum, others

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

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores new methods to train school staff in rural areas to better support children's mental health. The goal is to evaluate the effectiveness of remote video training and coaching in helping school personnel implement programs for managing anxiety and behavior issues in students. Participants from schools using the PBIS framework will try different approaches, including initial training alone, training with video modules, and training with video plus coaching. This trial suits school principals, assistant principals, counselors, social workers, and teachers working with students in grades 4-8 who need extra mental health support. As an unphased study, this trial offers educators a unique opportunity to enhance their skills and directly impact student well-being.

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 shows that remote mental health training programs, like those in this trial, are generally safe and manageable. Studies have found that videos and coaching effectively help school staff learn mental health practices. Importantly, these methods have not been linked to any major safety issues.

For the "Initial Training plus Video" group, a quick review found that using videos for education is safe, with no significant problems reported. Testing elsewhere has shown that adding coaching to video training, in what is called "Initial Training plus Video plus Coaching," also presents no major safety concerns.

Overall, these training programs aim to improve skills and knowledge rather than provide medical treatments, making them low-risk for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to deliver mental health training remotely to school personnel, potentially transforming how anxiety and related issues are managed in schools. Unlike traditional methods, which often require in-person training and frequent on-site support, this trial tests a blend of live remote training, video modules, and coaching to equip school staff with effective strategies like CBT for Anxiety Treatment in Schools (CATS) and Coping Power Program (CPP). The trial aims to find out if adding video modules and coaching can enhance the effectiveness of initial training, making it easier for schools to implement evidence-based practices without needing frequent in-person interventions. This could lead to more accessible and scalable mental health support for students.

What evidence suggests that this trial's treatments could be effective for mental illness?

Research has shown that cognitive behavioral therapy (CBT), one of the treatments used in this trial, effectively reduces anxiety and depression. The trial tests the Initial Training plus Video method to help school staff better implement these therapies. One study found that adding videos improved understanding and use of the techniques. Another approach in this trial includes coaching added to the video training, which proved even more effective, leading to better results for students. This combination of training tools ensures correct and consistent practice, crucial for successfully treating mental health issues in schools. ^{6 7 8 9 10}

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 counselors, social workers, or teachers from schools using PBIS with students in grades 4-8. Principals and assistant principals can also participate. Students eligible are those attending these schools who need extra support after Tier 1 intervention and score high on the SDQ for emotional or conduct issues.

Inclusion Criteria

I am a student in grades 4-8, not helped by initial school support, and scored high on a behavior or emotional test.

Behavioral Health Staff: Any counselor, social worker, or teacher from participating schools implementing PBIS who work with students in grades 4-8

Administrator: Any school principal or assistant principal from participating schools implementing PBIS

Exclusion Criteria

Students: Students who do not meet screening or group participation criteria, students with a history of intellectual disability or serious developmental delays according to school records, students with a history of psychotic or autistic spectrum disorders as reported by parents

Administrator: School staff who are not principals or assistant principals

Behavioral Health Staff: School staff who are not part of the PBIS team and who do not work with students in grades 4-8

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Training

School personnel participate in an initial live remote training to learn about implementing the three EBPs

2 weeks

1 visit (virtual)

Remote Video Training

School personnel receive access to asynchronous video training modules about the EBPs

4 weeks

Ongoing access (virtual)

Remote Video Training plus Coaching

School personnel receive coaching support by study staff regarding the implementation of EBPs

4 weeks

Weekly sessions (virtual)

Follow-up

Participants are monitored for fidelity and effectiveness of the interventions

Up to 3 years

What Are the Treatments Tested in This Trial?

Interventions

• CBT for Anxiety Treatment in Schools (CATS)
• Check-in/Check-out (CI/CO)
• Coping Power Program (CPP)
• Initial Training (CC)
• Initial Training plus Video plus Coaching (RV+)
• Initial Training plus Video (RV)

Trial Overview

The study tests a remote training strategy to help school staff implement mental health practices effectively. It compares initial training alone (CC), with added video (RV), and both plus coaching (RV+). Interventions include CPP, CATS, and CI/CO within a PBIS framework.

How Is the Trial Designed?

Group I: Initial training plus video, plus coaching Experimental Treatment 4 Interventions

School personnel will implement CATS or CPP and CICO with students in the school setting. They will participate in an initial live remote training, receive access to asynchronous video training modules about the EBPs, and receive coaching support by study staff (RV+). The coaching will be from a study consultant regarding the implementation of EBPs.

Group II: Initial training plus video Experimental Treatment 4 Interventions

School personnel will implement CATS or CPP and CICO with students in the school setting. They will participate in an initial live remote training and receive access to asynchronous video training modules about the EBPs (RV).

Group III: Initial training Active Control 4 Interventions

School personnel will implement CATS or CPP and CICO with students in the school setting. They will participate in an initial live remote training to learn about implementing the three EBPs (CC).

Who Is Running the Clinical Trial?

Children's Hospital of Philadelphia

Lead Sponsor

Trials

749

Recruited

11,400,000+

Devereux Center for Effective Schools

Collaborator

Trials

3

Recruited

1,200+

Agency for Healthcare Research and Quality (AHRQ)

Collaborator

Trials

415

Recruited

6,777,000+

Published Research Related to This Trial

A large-scale controlled trial involving 2,745 children demonstrated that the 'Journey of the Brave' cognitive behavioural therapy (CBT)-based program significantly reduced anxiety symptoms in the intervention group compared to the control group.

The intervention group showed a mean reduction in anxiety scores of -4.91, while the control group had a reduction of -2.53, indicating that the program was effective in lowering anxiety levels among children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Classroom-based cognitive behavioural therapy: a large-scale non-randomised controlled trial of the 'Journey of the Brave'. Urao, Y., Ohira, I., Koshiba, T., et al.[2021]

Internet-based cognitive-behavioral therapy (CBT) is an effective self-help program that allows patients to receive psychological support via the Internet, making therapy more accessible, especially for those unable to attend traditional sessions.

This form of therapy has shown particular effectiveness in treating conditions like panic disorder, social phobia, and depression, indicating its potential to reach and help a wider range of individuals in need of mental health support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Internet-based cognitive-behavioral therapy in the treatment of psychiatric disorders]. Holmberg, N., Kähkönen, S.[2022]

In a study involving 308 postsecondary students undergoing internet-delivered cognitive behavioral therapy (ICBT), 54% completed the treatment, showing significant improvements in depression and anxiety symptoms that were sustained at 1 and 3 months post-treatment.

While motivational interviewing (MI) before treatment did not enhance completion rates, students who accessed self-guided booster lessons after treatment experienced greater reductions in depressive symptoms, suggesting that timing and support for boosters may be crucial for effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet-Delivered Cognitive Behavioral Therapy for Postsecondary Students: Randomized Factorial Trial for Examining Motivational Interviewing and Booster Lessons. Peynenburg, V., Hadjistavropoulos, H., Thiessen, D., et al.[2022]

The Improving Access to Psychological Therapies (IAPT) service in the UK effectively monitors and reports clinical outcomes for over 537,000 patients annually, revealing that specific organizational factors, such as the number of treatment sessions and timely access to care, significantly predict better mental health outcomes.

Improvements in service organization could enhance clinical outcomes by 11-42%, indicating that how psychological therapies are delivered is as crucial as the treatments themselves, and this model could be beneficial for mental health services globally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transparency about the outcomes of mental health services (IAPT approach): an analysis of public data. Clark, DM., Canvin, L., Green, J., et al.[2023]

Cognitive Behavioral Therapy (CBT) is an effective treatment for youth anxiety, but there is a significant gap in access to this therapy, highlighting the need for flexible delivery methods.

The paper reviews various adaptations of CBT for youth anxiety, including delivery in schools, community settings, telehealth, online programs, and by caregivers, providing strategies to maintain treatment effectiveness while increasing accessibility.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Kendall, PC., Ney, JS., Maxwell, CA., et al.[2023]

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Remote Mental Health Training for Mental Illness

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