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Preliminary Outcomes of a Multi-site, School-based Modular Intervention for Adolescents Experiencing Mood Difficulties

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Abstract

Many evidence-based programs to address the emotional needs of youth experiencing mood difficulties are based on implementing “manualized” interventions. This approach often presents feasibility challenges in the school setting. In contrast, modular strategies, which involve implementing the most effective practices for specific emotional/behavioral problems, may be more feasible. Research, however, on the feasibility, acceptability, and effectiveness of modular approaches in schools to address youth experiencing mood difficulties is lacking. The multi-site current study tested the effectiveness, feasibility, and acceptability of a modular intervention approach delivered in schools for youth presenting with mood disorder symptoms. The pilot study included 20 participants (ages 12–16) and parents/caregivers for each student. Data were collected at baseline, throughout treatment, and following intervention or end of school year. The intervention, called the Student Emotional and Educational Development (SEED) project, included a modularized manual of efficacious and common practice elements for the treatment of mood disorders among adolescents. Decision making protocols guided provision of specific modules based on baseline and treatment data. Statistically significant differences were found between pretest and posttest assessments with modest to large effect sizes for youth and/or parents’ report of mood-related symptoms, including reduced symptoms of depression, anxiety and inattention. Clinically significant findings were also detected with more than 50 % of participants demonstrating reliable improvement on a global assessment of mental health symptoms. With regards to feasibility, these results were achieved with an average of nine, 45-min sessions across 2–3 months, and a subsample of participants overwhelmingly supported the acceptability of SEED. Although limited by the lack of a controlled comparison and small sample size, findings from this pilot study suggest this modular intervention focused on internalizing symptoms in students can be feasibly implemented in the school setting, is acceptable to students, and holds promise for improving their psychosocial functioning.

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References

  • Addis, M. E., & Krasnow, A. D. (2000). A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology, 68(2), 331.

    Article  PubMed  Google Scholar 

  • Albright, A. E., Michael, K. D., Massey, C. S., Sale, R., Kirk, A., & Egan, T. E. (2013). An evaluation of an interdisciplinary rural school mental health program in Appalachia. Advances in School Mental Health Promotion, 6, 189–202. doi:10.1080/1754730X.2013.808890.

    Article  Google Scholar 

  • American Academy of Child and Adolescent Psychiatry. (2007). Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. Journal American Academy of Child Adolescent Psychiatry, 46, 1503–1526.

    Article  Google Scholar 

  • Aseltine, R. H., Gore, S., & Gordon, J. (2000). Life stress, anger and anxiety, and delinquency: An empirical test of general strain theory. Journal of Health Social Behavior, 41, 256–275.

    Article  PubMed  Google Scholar 

  • Baskin, T. W., Slaten, C. D., Crosby, N. R., Pufahl, T., Schneller, C. L., & Ladell, M. (2010). Efficacy of counseling and psychotherapy in schools: A meta-analytic review of treatment outcome studies. The Counseling Psychologist, 38, 878–903.

    Article  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Ward, C., & Mendelson, M. (1961). Beck depression inventory (BDI). Archives of General Psychiatry, 4(6), 561–571.

    Article  PubMed  Google Scholar 

  • Borntrager, C. F., Chorpita, B. F., Higa-McMillan, C., & Weisz, J. R. (2009). Provider attitudes toward evidence-based practices: Are the concerns with the evidence or with the manuals?. Psychiatric Services, 60(5), 677–681.

    Article  PubMed  Google Scholar 

  • Burlingame, G. M., Dunn, T., Hill, M., Cox, J., Wells, M. G., Lambert, M. J., & Brown, G. S. (2004). Administration and scoring manual for the Y-OQ-30.2: Youth. Wilmington, DE: American Professional Credentialing Services.

    Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M., & Erkanli, A. (1995). Children’s mental health service use across service sectors. Health Affairs, 14(3), 147–159.

    Article  PubMed  Google Scholar 

  • Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S., et al. (2007). Guidelines for adolescent depression in primary care (GLAD-PC): II. Treatment and ongoing management. Pediatrics, 120, 1313–1326.

    Google Scholar 

  • Chorpita, B. F., & Daleiden, E. L. (2007). 2007 Biennial Report: Effective psychosocial interventions for youth with behavioral and emotional needs. Honolulu, Hawaii: Hawaii Department of Health, Child and Adolescent Mental Health Division. http://hawaii.gov/health/mental-health/camhd/library/pdf/ebs/ebs012.pdf.

  • Chorpita, B. F., & Daleiden, E. L. (2009). Mapping the evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials. Journal of Consulting and Clinical Psychology, 77(3), 566–579.

    Article  PubMed  Google Scholar 

  • Chorpita, B. F., Daleiden, E. L., & Weisz, J. R. (2005). Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research, 7, 5–20. doi:10.1007/s11020-005-1962-6.

    Article  PubMed  Google Scholar 

  • Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weersing, V. R., & Curry, J. (2004). Cognitive-behavioral therapy for anxiety and depressive disorders in children and adolescents: An evidence-based medicine review. Journal of the American Academy of Child and Adolescent Psychiatry, 43(8), 930–959.

    Article  PubMed  Google Scholar 

  • Costello, E. J., He, J., Sampson, N. A., Kessler, R. C., & Merikangas, K. R. (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey—Adolescent. Psychiatric Services, 65(3), 359–366. doi:10.1176/appi.ps.201100518.

    Article  PubMed  PubMed Central  Google Scholar 

  • Evans, S. W., Serpell, Z. N., Schultz, B. K., & Pastor, D. A. (2007). Cumulative benefits of secondary school-based treatment of students with attention deficit hyperactivity disorder. School Psychology Review, 36(2), 256.

    Google Scholar 

  • Evans, S. W., & Weist, M. D. (2004). Implementing empirically supported treatments in schools: What are we asking? Clinical Child and Family Psychology Review, 7, 263–267.

    Article  PubMed  Google Scholar 

  • Flaherty, L. T., Weist, M. D., & Warner, B. S. (1996). School-based mental health services in the United States: History, current models and needs. Community Mental Health Journal, 32, 341–352.

    Article  PubMed  Google Scholar 

  • Fontanella, C. A., Hiance-Steelesmith, D. L., Phillips, G. S., Bridge, J. A., Lester, N., Sweeney, H. A., & Campo, J. V. (2015). Widening rural-urban disparities in youth suicides, United States, 1996–2010. JAMA Pediatrics, 169(5), 466–473. doi:10.1001/jamapediatrics.2014.3561.

    Article  PubMed  PubMed Central  Google Scholar 

  • Foster, S., Rollefson, M., Doksum, T., Noonan, D., Robinson, G., & Teich, J. (2005). School Mental Health Services in the United States, 2002–2003. DHHS Pub. No. (SMA) 05-4068. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • George, M. W., McDaniel, H. L., Michael, K. D., & Weist, M. D. (2014). Clinician and caregiver perspectives on family involvement in school mental health services for youth receiving mood disorders treatment. Report on Emotional & Behavioral Disorders in Youth, 14, 16–21.

    Google Scholar 

  • George, M. W., Taylor, L. K., Schmidt, S. C., & Weist, M. D. (2013). A review of school-based mental health programs in SAMHSA’s National Registry of Evidence-Based Programs and Practices. Psychiatric Services, 64(5), 483–486.

    Article  PubMed  Google Scholar 

  • Ghuman, H. S., Weist, M. D., & Sarles, R. M. (2013). Providing mental health services to youth Where they are: School and community based approaches. New York: Routledge.

    Google Scholar 

  • Hawton, K., Saunders, K. E., & O’Connor, R. C. (2012). Self-harm and suicide in adolescents. Lancet, 379, 2373–2382.

    Article  PubMed  Google Scholar 

  • Hoagwood, K., Burns, B. J., Kiser, L., Ringeisen, H., & Schoenwald, S. K. (2001). Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52, 1179–1189.

    Article  PubMed  Google Scholar 

  • Iachini, A. L., Warren, M. E., Splett, J. W., George, M. W., Taylor, L. K., & Weist, M. D. (2014). Evaluating the impact of a pre-service interprofessional Intervention for school mental health trainees. Journal of Interprofessional Care, 2, 1–3.

    Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • Kahn, J. S., Kehle, T. J., Jensen, W. R., & Clark, E. (1990). Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychology Review, 19, 196–211.

    Google Scholar 

  • Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among US children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159(9), 1548–1555.

    Article  PubMed  Google Scholar 

  • Kutcher, S. P., Wei, Y., & Weist, M. (2015). School mental health: Global challenges and opportunities. Cambridge, UK: Cambridge University Press.

    Book  Google Scholar 

  • Langley, A. K., Nadeem, E., Kataoka, S. H., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School mental health, 2(3), 105–113.

    Article  PubMed  PubMed Central  Google Scholar 

  • McClendon, D. T., Warren, J. S., M Green, K., Burlingame, G. M., Eggett, D. L., & McClendon, R. J. (2011). Sensitivity to change of youth treatment outcome measures: A comparison of the CBCL, BASC-2, and Y-OQ. Journal of Clinical Psychology, 67(1), 111–125.

    Article  PubMed  Google Scholar 

  • McDermott, B., Baigent, M., Chanen, A., et al. (2011). Beyondblue: Expert Working Committee clinical practice guidelines: Depression in adolescents and young adults. Melbourne: Beyondblue.

    Google Scholar 

  • McWhirter, B. T., & Page, G. L. (1999). Effects of anger management and goal setting group interventions on state-trait anger and self-efficacy beliefs among high risk adolescents. Current Psychology, 18, 223–237.

    Article  Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academic of Child and Adolescent Psychiatry, 49, 980–989. doi:10.1016/j.jaac.2010.05.017.

    Article  Google Scholar 

  • Michael, K. D., Albright, A., Jameson, J. P., Sale, R., Massey, C. S., Kirk, A., & Egan, T. E. (2013). Does cognitive-behavioral therapy in the context of a rural school mental health program have an impact on academic outcomes? Advances in School Mental Health Promotion, 6, 247–262.

    Article  Google Scholar 

  • Michael, K. D., & Crowley, S. L. (2002). How effective are treatments for child and adolescent depression? A meta-analytic review. Clinical Psychology Review, 22, 247–269.

    Article  PubMed  Google Scholar 

  • Michael, K. D., Renkert, L. E., Wandler, J., & Stamey, T. (2009). Cultivating a new harvest: Rationale and preliminary results from a growing interdisciplinary rural school mental health program. Advances in School Mental Health Promotion, 2, 40–50.

    Article  Google Scholar 

  • Mychailyszyn, M. P., Brodman, D. M., Read, K. L., & Kendall, P. C. (2012). Cognitive-behavioral school-based interventions for anxious and depressed youth: A meta-analysis of outcomes. Clinical Psychology Science and Practice, 19, 129–153.

    Article  Google Scholar 

  • National Collaborating Centre for Mental Health. (2005). Depression in children and young people: Identification and management in primary, community and secondary care. Leicester and London: British Psychological Society and Royal College of Psychiatrists.

    Google Scholar 

  • Ng, M. Y., Eckshtain, D., & Weisz, J. R. (2015). Assessing fit between evidence-based psychotherapies for youth depression and real-life coping in early adolescence. Journal of Clinical Child & Adolescent Psychology, 1–17. doi: 10.1080/15374416.2015.1041591.

  • No Child Left Behind Act of 2001. (2002). Pub. L. No. 107-110, § 115, Stat. 1425.

  • Owens, J. S., Murphy, C. E., Richerson, L., Girio, E. L., & Himawan, L. K. (2008). Science to practice in underserved communities: The effectiveness of school mental health programming. Journal of Clinical Child & Adolescent Psychology, 37(2), 434–447.

    Article  Google Scholar 

  • Owens, J. S., Watabe, Y., & Michael, K. D. (2013). Culturally responsive school mental health in rural communities. In C. S. Clauss-Ehlers, Z. Serpell, & M. D. Weist (Eds.), Handbook of culturally responsive school mental health: Advancing research, training, practice, and policy (pp. 31–42). New York, NY: Springer.

    Chapter  Google Scholar 

  • Prout, H. T., & DeMartino, R. A. (1986). A meta-analysis of school-based studies of psychotherapy. Journal of School Psychology, 24, 285–292.

    Article  Google Scholar 

  • Prout, S. M., & Prout, H. T. (1998). A meta-analysis of school-based studies of counseling and psychotherapy: An update. Journal of School Psychology, 36, 121–136.

    Article  Google Scholar 

  • Reynolds, W. M., & Coats, K. I. (1986). A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653–660.

    Article  PubMed  Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2004). BASC-2: Behavior assessment system for children manual (2nd ed.). Circle Pines, MN: AGS Publishing.

    Google Scholar 

  • Sander, M. A., Everts, J., & Johnson, J. (2011). Using data to inform program design and implementation and make the case for school mental health. Advances in School Mental Health Promotion, 4, 13–21.

    Article  Google Scholar 

  • Schaeffer, C. M., Bruns, E., Weist, M. D., Stephan, S. H., Goldstein, J., & Simpson, Y. (2005). Overcoming challenges to evidence-based interventions in schools. Journal of Youth and Adolescence, 34, 51–58.

    Article  Google Scholar 

  • Schiffman, J., Becker, K. D., & Daleiden, E. L. (2006). Evidence-based services in a statewide public mental health system: Do the services fit the problems? Journal of Clinical Child and Adolescent Psychology, 35(1), 13–19.

    Article  PubMed  Google Scholar 

  • Shirk, S. R., Kaplinksi, H., & Gudmundsen, G. (2009). School-based cognitive-behavioral therapy for adolescent depression: A benchmarking study. Journal of Emotional and Behavioral Disorders, 17, 106–117.

    Article  Google Scholar 

  • Splett, J. W., Schmidt, S. C., Iachini, A. L., Page, H. E., & Massey, C. (2014). Common elements approach to treat mood disorders in youth: Case examples from school settings. Report on Emotional and Behavioral Disorders in Youth, Special Issue, 14(1), 9–15.

    Google Scholar 

  • Stephan, S., Westin, A., Lever, N., Medoff, D., Youngstrom, E., & Weist, M. (2012). Do school-based clinicians’ knowledge and use of common elements correlate with better treatment quality? School Mental Health, 4(3), 170–180.

    Article  Google Scholar 

  • Sulkowski, M. L., & Michael, K. D. (2014). Meeting the mental health needs of homeless students in schools: A multi-tiered system of support framework. Children and Youth Services Review, 44, 145–151.

    Article  Google Scholar 

  • TADS. (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for adolescents with depression study (TADS) randomized controlled trial. JAMA, 292, 807–820.

    Article  Google Scholar 

  • TADS. (2007). The treatment for adolescents with depression study (TADS): Long-term effectiveness and safety outcomes. Archives of General Psychiatry, 64, 1132–1144.

    Article  Google Scholar 

  • United States Department of Health and Human Services. (1999) Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

  • United States Department of Health and Human Services (2003). New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report. Pub. No. SMA-03-3832. Rockville, MD.

  • Weist, M. D., Lever, N. A., Bradshaw, C. P., & Owens, J. S. (2014). Handbook of School Mental Health (2nd ed.). New York: Springer.

    Book  Google Scholar 

  • Weist, M. D., Lever, N., Stephan, S., Youngstrom, E., Moore, E., Harrison, B., et al. (2009). Formative evaluation of a framework for high quality, evidence-based services in school mental health. School Mental Health, 1(4), 196–211.

    Article  Google Scholar 

  • Weist, M. D., & McDaniel, H. (2013). The international emphasis of advances in school mental health promotion. Advances in School Mental Health Promotion, 6(2), 81–82.

    Article  Google Scholar 

  • Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., & Gray, J. (2012). Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: A randomized effectiveness trial. Archives of General Psychiatry, 69(3), 274–282.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., McCarty, C. A., & Valeri, S. M. (2006). Effects of psychotherapy for depression in children and adolescents: A meta-analysis. Psychological Bulletin, 132, 132–149.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weisz, J. R., Ng, M. Y., & Bearman, S. K. (2014). Odd couple? Reenvisioning the relation between science and practice in the dissemination-implementation era. Clinical Psychological Science, 2, 58–74.

    Article  Google Scholar 

  • Weisz, J. R., Ugueto, A. M., Cheron, D. M., & Herren, J. (2013). Evidence-based youth psychotherapy in the mental health ecosystem. Journal of Clinical Child & Adolescent Psychology, 42(2), 274–286.

    Article  Google Scholar 

  • Zhou, X., Hetrick, S. E., Cuijpers, P., Qin, B., Barth, J., Whittington, C., et al. (2015). Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis. World Psychiatry, 14, 207–222.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zirkelback, E. A., & Reese, R. J. (2010). A review of psychotherapy outcome research: Considerations for school-based mental health providers. Psychology in the Schools, 47, 1084–1100.

    Article  Google Scholar 

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Acknowledgments

This research was partially supported by an ASPIRE research award from the Office of Research, USC.

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Authors and Affiliations

  1. Department of Psychology, Appalachian State University (ASU), 222 Joyce Lawrence Lane, Boone, NC, 28608-2109, USA

    Kurt D. Michael

  2. Prevention Research Center, Colorado State University, Fort Collins, CO, USA

    Melissa W. George

  3. University of Florida, Gainesville, FL, USA

    Joni W. Splett

  4. ASU, Boone, NC, USA

    John Paul Jameson

  5. ASU, University of Texas, Austin, TX, USA

    Rafaella Sale

  6. ASU, University of South Carolina (USC), Columbia, SC, USA

    Abby A. Bode

  7. USC, Columbia, SC, USA

    Aidyn L. Iachini & Mark D. Weist

  8. DePelchin Children’s Center, Houston, TX, USA

    Leslie K. Taylor

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Michael, K.D., George, M.W., Splett, J.W. et al. Preliminary Outcomes of a Multi-site, School-based Modular Intervention for Adolescents Experiencing Mood Difficulties. J Child Fam Stud 25, 1903–1915 (2016). https://doi.org/10.1007/s10826-016-0373-1

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