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Clinical Child and Family Psychology Review

, Volume 3, Issue 4, pp 223–241 | Cite as

School-Based Mental Health Services: A Research Review

  • Michelle Rones
  • Kimberly Hoagwood
Article

Abstract

This paper provides a synthetic review of research on school-based mental health services. Schools play an increasingly important role in providing mental health services to children, yet most school-based programs being provided have no evidence to support their impact. A computerized search of references published between 1985 and 1999 was used to identify studies of school-based mental health services for children. Study inclusion was determined by (i) use of randomized, quasi-experimental, or multiple baseline research design; (ii) inclusion of a control group; (iii) use of standardized outcome measures; and (iv) baseline and postintervention outcome assessment. The application of these criteria yielded a final sample of 47 studies on which this review is based. Results suggest that there are a strong group of school-based mental health programs that have evidence of impact across a range of emotional and behavioral problems. However, there were no programs that specifically targeted particular clinical syndromes. Important features of the implementation process that increase the probability of service sustainability and maintenance were identified. These include (i) consistent program implementation; (ii) inclusion of parents, teachers, or peers; (iii) use of multiple modalities; (iv) integration of program content into general classroom curriculum; and (v) developmentally appropriate program components. Implications of these findings and directions for future research are discussed.

schools children mental health services prevention outcomes effectiveness emotional and behavioral disorders 

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REFERENCES

  1. Aber, J., Jones, S., Brown, J., Chaudry, N., & Samples, F. (1998). Resolving conflicts creatively: Evaluating the developmental effects of a school-based violence prevention program in neighborhood and classroom context. Development and Psychopathology, 10, 187-213.Google Scholar
  2. Adelman, H. S., & Taylor, L. (1998). Mental health in schools. Moving forward. School Psychology Review, 27, 175-190.Google Scholar
  3. Adelman, H. S., & Taylor, L. (1999). Mental health in schools and system restructuring. Clinical Psychology Review, 19, 137-163.Google Scholar
  4. Allen, J., Philliber, S., Herrling, S., & Kuperminc, G. (1997). Preventing teen pregnancy and academic failure: Experimental evaluation of a developmentally based approach. Child Development, 64, 729-742.Google Scholar
  5. Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57-87.Google Scholar
  6. Angold, A., Costello, E. J., & Worthman, C. M. (1998). Puberty and depression: the roles of age, pubertal status and pubertal timing. Psychological Medicine, 28, 51-61.Google Scholar
  7. Battistich, V., Schaps, E., Watson, M., & Solomon, D. (1996). Prevention effects of the Child Development Project: Early findings from an ongoing multisite demonstration trial. Journal of Adolescent Research, 11, 12-35.Google Scholar
  8. Bickman, L. (1999). Practice makes perfect and other myths about mental health services. American Psychologist, 54, 965-979.Google Scholar
  9. Bierman, K., Miller, C., & Stabb, S. (1987). Improving the social behavior and peer acceptance of rejected boys: Effects of social skill training with instructions and prohibitions. Journal of Consulting and Clinical Psychology, 55, 194-200.Google Scholar
  10. Botvin, G., Baker, E., Dusenbury, L., Tortu, S., & Botvin, E. (1990). Preventing adolescent drug abuse through a multimodal cognitive-behavioral approach: Results of three studies. Journal of Consulting and Clinical Psychology, 58, 437-446.Google Scholar
  11. Botvin, G., Schinke, S., Epstein, J., & Diaz, T. (1994). Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority youths. Psychology of Addictive Behaviors, 8, 116-127.Google Scholar
  12. Botvin, G., Baker, E., Dusenbury, L., Botvin, E., & Diaz, T. (1995a). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Journal of the American Medical Association, 273, 1106-1112.Google Scholar
  13. Botvin, G., Schinke, S., Epstein, J., Diaz, T., & Botvin, E. (1995b). Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority adolescents: Two-year follow-up results. Psychology of Addictive Behaviors, 9, 183-194.Google Scholar
  14. Brandenburg, N. A., Friedman, R. M., & Silver, S. E. (1990). The epidemiology of childhood psychiatric disorders: Prevalence findings from recent studies. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 76-83.Google Scholar
  15. Braswell, L., August, G., Bloomquist, M., Realmuto, G., Skare, S., & Crosby, R. (1997). School-based secondary prevention for children with disruptive behavior: Initial outcomes. Journal of Abnormal Child Psychology, 25, 197-208.Google Scholar
  16. Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E., & Erkanli, A. (1995). Children's mental health service use across service sectors. Health Affairs, 14, 147-159.Google Scholar
  17. Burns, B. J., Hoagwood, K., & Mrazek, P. (1999). Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review, 2, 199-254.Google Scholar
  18. Catron, T., Harris, V., & Weiss, B. (1998). Posttreatment results after 2 years of services in The Vanderbilt School-Based Counseling project. In M. Epstein & K. Kutash (Eds.), Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices (pp. 633-656). Austin, TX: Pro-Ed, Inc.Google Scholar
  19. Catron, T., & Weiss, B. (1994). The Vanderbilt School-Based Counseling Program: An interagency, primary-care model of mental health services. Journal of Emotional and Behavioral Disorders, 2, 247-253.Google Scholar
  20. Cecil, M., & Forman, S. (1990). Effects of stress inoculation training and coworker support groups on teacher's stress. Journal of School Psychology, 28, 105-118.Google Scholar
  21. Clarke, G., Hawkins, W., Murphy, M., & Sheeber, L. (1993). School-based primary prevention of depressive symptomatology in adolescents: Findings from two studies. Journal of Adolescent Research, 8, 183-204.Google Scholar
  22. Clarke, G., Hawkins, W., Murphy, M., Sheeber, L., Lewinsohn, P., & Seeley, J. (1995). Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: A randomized trial of a group cognitive intervention. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 312-321.Google Scholar
  23. Conduct Problems Prevention Research Group (1992).A developmental and clinical model for the prevention of conduct disorder: The FAST Track Program. Development and Psychopathology, 4, 509-527.Google Scholar
  24. Conduct Problems Prevention Research Group (1999). FAST Track update. National Institute of Mental Health, Rockville, MD.Google Scholar
  25. Conduct Problems Prevention Research Group (1999a). Initial impact of the Fast Track prevention trial for conduct problems: I. The high-risk sample. Journal of Consulting and Clinical Psychology, 67, 631-647.Google Scholar
  26. Conduct Problems Prevention Research Group (1999b). Initial impact of the Fast Track prevention trial for conduct problems: II. Classroom effects. Journal of Consulting and Clinical Psychology, 67, 648-657.Google Scholar
  27. Costello, E. J. (1989). Developments in child psychiatric epidemiology: An epidemiological study of behavior characteristics in children. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 836-841.Google Scholar
  28. Costello, E. J., Angold, A., Burns, B. J., Stangl, D. K., Tweed, D. L., Erkanli, A., & Worthman, C. M. (1996). The Great Smoky Mountains Study of Youth: Goals, design, methods and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 1129-1136Cunningham, C., Cunningham, L.,Martorelli, V., Tran, A., Young, J., & Zacharias, R. (1998). The effects of primary division, student-mediated conflict resolution programs on playground aggression. Journal of Child Psychology, Psychiatry, and the Allied Disciplines, 39, 653-662.Google Scholar
  29. Dent, C., Sussman, S., Stacy, A., Craig, S., Burton, D., & Flay, B. (1995). Two-year behavior outcomes of a Project Towards No Tobacco Use. Journal of Consulting and Clinical Psychology, 63, 676-677.Google Scholar
  30. Dielman, T., Shope, J., Butchart, T., & Campanelli, P. (1986). Prevention of adolescent alcohol misuse: An elementary school program. Journal of Pediatric Psychology, 11, 259-282.Google Scholar
  31. Dolan, L., Kellam, S., Brown, C., Werthamer-Larson, L., Rebok, G., Mayer, L., Laudolff, J., Turkkan, Ford, C., & Wheeler, L. (1993). The short-term impact of two classrooms-based preventive interventions on aggressive and shy behaviors and poor achievement. Journal of Applied Developmental Psychology, 14, 317-345.Google Scholar
  32. Dupper, D., & Krishef, C. (1993). School-based social-cognitive skill training for middle school students with school behavior problems. Children and Youth Services Review, 15, 131-142.Google Scholar
  33. Ellickson, P., Bell, R., & McGuigan, K. (1993). Preventing adolescent drug use: Long-term results of a junior high program. American Journal of Public Health, 83, 856-861.Google Scholar
  34. Ennett, S., Tobler, N., Ringwalt, C., & Flewelling, R. (1994). How effective is drug abuse resistance education? A meta-analysis of project DARE outcome evaluations. American Journal of Public Health, 84, 1394-1400.Google Scholar
  35. Federal Interagency Forum on Child and Family Statistics. (1998). America's Children: Key National Indicators of Well-Being. Washington, DC: U.S. Government Printing Office.Google Scholar
  36. Friedman, R. M. (1992). Mental health and substance use services for adolescents: Clinical and service system issues. Administration and Policy in Mental Health, 19, 191-206.Google Scholar
  37. Friedman, R. M. (1999). The practice of psychology with children, adolescents and their families: A look to the future. In J. Hughes, J. Conoley, & A. La Greco (Eds.), Handbook of psychological interventions for children and adolescents (pp. 1-34). Oxford: Oxford Press.Google Scholar
  38. Friedman, R. M., Katz-Leavy, J. W., Mandersheid, R. W., & Sondheimer, D. L. (1996). Prevalence of serious emotional disturbance in children and adolescents. In Center for Mental Health Services. Mental Health, United States, 1996 (p. 83).Google Scholar
  39. Manderscheid, R. W. & Sonnenschein, M. A. (Eds.). DHHS Pub. No. (SMA) 96-3098. Washington, DC: Supt. of Docs., U.S. Government Printing Office.Google Scholar
  40. Fuchs, D., Fuchs, L., & Bahr, M. (1990). Mainstream assistance teams:Ascientific basis for the art of consultation. Exceptional Children, 57, 128-139.Google Scholar
  41. Gillham, J., Reivich, K., Jaycox, L.,& Seligman, M. (1995). Prevention of depressive symptoms in school children: Two-year follow-up. Psychological Science, 6, 343-351.Google Scholar
  42. Gottfredson, D., Gottfredson, G., & Hybl, L. (1993). Managing adolescent behavior: A multiyear, multischool study. American Educational Research Journal, 30, 179-215.Google Scholar
  43. Greenbaum, P. E., Prange, M. E., Friedman, R. M., & Silver, S. E. (1991). Substance abuse prevalence and comorbidity with other psychiatric disorders among adolescents with severe emotional disturbance. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 575-583.Google Scholar
  44. Greenberg, M., Kusche, C., Cook, E., Quamma, J. (1995). Promoting emotional competence in school-aged children: The effects of the PATHS curriculum. Development and Psychopathology, 7, 117-136.Google Scholar
  45. Grossman, D., Neckerman, H., Koepsell, T., Liu, P., Asher, K., Beland, K., Frey, K., & Rivara, F. (1997). Effectiveness of a violence prevention curriculum among children in elementary school: A randomized controlled trial. Journal of the American Medical Association, 277, 1605-1611.Google Scholar
  46. Hawkins, J. D., Catalano, R. F., Kosterman, R., Abbott, R., & Hill, K. (1999). Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatric and Adolescent Medicine, 153, 226-234.Google Scholar
  47. Henderson, P., Kelbey, T., & Engerbreston, K. (1992). Effects of a stress-control program on children's locus of control, self-concept, and coping behavior. The School Counselor, 40, 125-130.Google Scholar
  48. Hoagwood, K., & Koretz, D. (1996). Embedding prevention services within systems of care: Strengthening the nexus for children. Applied and Preventive Psychology, 5, 225-234.Google Scholar
  49. Hostetler, M., & Fisher, K. (1997). Project C.A.R.E. substance abuse prevention program for high-risk youth: A longitudinal evaluation of program effectiveness. Journal of Community Psychology, 25, 397-419.Google Scholar
  50. Hudley, C., & Graham, S. (1993). An attributional intervention to reduce peer-directed aggression among African-American boys. Child Development, 64, 124-138.Google Scholar
  51. Huffman, L. C., Mehlinger, S. L., Kerivan, A. S. (1999). What are the risk factors for academic and behavioral problems at the beginning of school? Science and Policy for Young Children: Social and Emotional School Readiness. Monographs of the Foundations and Agencies Network. In press.Google Scholar
  52. Journal of the American Academy of Child and Adolescent Psychiatry. (1997). Practice parameters for the assessment and treatment of children and adolescents with conduct disorder. 36, 122S-139S.Google Scholar
  53. Journal of Clinical Child Psychology. (1998). Special issue on empirically supported psychosocial interventions for children. 27, 138-226.Google Scholar
  54. Kazdin, A. (1997). Practitioner review: Psychosocial treatments for conduct disorder in children. Journal of Child Psychology and Psychiatry, 38, 161-178.Google Scholar
  55. Kellam, S., Rebok, G., Ialongo, N., & Mayer, L. (1994). The course and malleability of aggressive behavior from early first grade into middle school: Results of a developmental epidemiologically-based preventive trial. Journal of Child Psychology, Psychiatry, and the Allied Disciplines, 35, 259-281.Google Scholar
  56. Kessler, R. C. (1994). The National Comorbidity Survey of the United States. International Review of Psychiatry, 6, 365-376.Google Scholar
  57. King, C., & Kirschenbaum, D. (1990). An experimental evaluation of a school-based program for children at risk: Wisconsin early intervention. Journal of Community Psychology, 18, 167-177.Google Scholar
  58. Klingman, A., & Hochdorf, Z. (1993). Coping with distress and self harm. The impact of a primary prevention program among adolescents. Journal of Adolescence, 16, 121-140.Google Scholar
  59. Knoff, H., & Batsche, G. (1995). Project ACHIEVE: Analyzing a school reform process for at-risk and underachieving students. School Psychology Review, 24, 579-603.Google Scholar
  60. Leaf, P. J., Alegria, M., Cohen, P., Goodman, S. H., Horowitz, S., Hoven, C. W., Narrow, W. E., Vaden-Kiernan, M., & Regier, D. A. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889-896.Google Scholar
  61. Lewinsohn, P. M., Clarke, G. N., Hops, H., Seeley, J. R. (1996). A course in coping: A cognitive-behavioral approach to the treatment of adolescent depression. In Hibbs, E. D.,& Jensen, P. S. (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically-based strategies for clinical practice (pp. 109-135). Washington, DC: American Psychological Association.Google Scholar
  62. Lochman, J., Coie, J., Underwood, M., & Terry, R. (1993). Effectiveness of a social relations intervention program for aggressive and nonaggressive, rejected children. Journal of Consulting and Clinical Psychology, 61, 1053-1058.Google Scholar
  63. Lochman, J., & Curry, J. (1986). Effects of social problem solving training and self-instruction training with aggressive boys. Journal of Clinical Child Psychology, 15, 159-164.Google Scholar
  64. Nastasi, B. (1998). A model for mental health programming in schools and communities: Introduction to the mini-series. School Psychology Review, 27, 165-174.Google Scholar
  65. National Institutes of Health. (1996). A Plan for Preventive Research for the National Institute of Mental Health (NIH Publication No. 96-4093). Rockville, MD: Author.Google Scholar
  66. National Institutes of Health. (1998). Diagnosis and treatment of attention deficit hyperactivity disorder (ADHD). NIH Consensus Statement, 16, 1-21.Google Scholar
  67. Office of Juvenile Justice and Delinquency Prevention (1999): The Blueprint Programs. Google Scholar
  68. Parish, T. B. (1996). Special education finance: Past, present, and future. Policy Paper Number 8. Center for Special Education Finance.Google Scholar
  69. Pepler, D., King, G., Craig, W., Byrd, B., & Bream, L. (1995). The development and evaluation of a multisystem social skills group training program for aggressive children. Child and Youth Care Forum, 24, 297-313.Google Scholar
  70. Perry, C., Williams, C., Veblen-Mortenson, S., Tommey, T., Komro, K., Anstine, P., McGovern, P., Finnegan, J., Forster, J., Wagenaar, A., & Wolfson, M. (1996). Project Northland: Outcomes of a community-wide alcohol use prevention program during early adolescence. American Journal of Public Health, 86, 956-965.Google Scholar
  71. Quinn, K. P., & Epstein, M. H. (1998). Characteristics of children, youth, and families served by local interagency systems of care. In Epstein, M. H., Kutash, K., & Duchnowski, A. (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families (pp. 81-114). Austin, TX: Pro-Ed.Google Scholar
  72. Reid, J., Eddy, M., Fetrow, R., & Stoolmiller, M. (1999). Description and immediate impacts of a preventive intervention for conduct problems. American Journal of Community Psychology, 27, 483-517.Google Scholar
  73. Roberts, R. E., Attkinsson, C. C., & Rosenblatt, A. (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155, 715-725.Google Scholar
  74. Robins, L. N. (1981). Epidemiolocal approaches to natural history research: Antisocial disorders in children. Journal of the American Academy of Child and Adolescent Psychiatry, 20, 566-680.Google Scholar
  75. Rosal, M. (1993). Comparative group art therapy research to evaluate changes in locus of control in behavior disordered children. The Arts in Psychotherapy, 20, 231-241.Google Scholar
  76. Rosenbaum, D., Flewelling, R., Bailey, S., Ringwalt, C., & Wilkinson, D. (1994). Cops in the classroom: A longitudinal evaluation of Drug Abuse Resistance Education (DARE). Journal of Research in Crime and Delinquency, 31, 3-31.Google Scholar
  77. Rosenbaum, D., & Hanson, G. (1998). Assessing the effects of school-based drug education: A six-year multilevel analysis of project D.A.R.E. Journal of Research in Crime and Delinquency, 5, 381-412.Google Scholar
  78. Shaffer D., Fisher P., Dulcan, M. K., Davies, M., Piacentini, J., Schwab-Stone, M. E., Lahey, B. B., Bourdon, K., Jensen, P. S., Bird, H. R., Canino, G., & Regier, D. A. (1996). The NIMH Diagnostic Interview Schedule for Children Version 2/3 (DISC 2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 7, 865-877.Google Scholar
  79. Stroul, B. A., & Friedman, R. M. (1986). A system of care for severely emotionally disturbed children and youth. Washington, DC: Georgetown University Child Development Center.Google Scholar
  80. Stroul, B. A., & Friedman, R. M. (1996). The system of care concept and philosophy. In Stroul, B. A. (Ed.), Children's mental health: Creating systems of care in a changing society (pp. 3-21). Baltimore, MD: Paul H. Brookes.Google Scholar
  81. Sussman, S., Dent, C., Stacy, A., Sun, P., Craig, S., Simon, T., Burton, D., & Flay, B. (1993). Project Towards No Tobacco Use: 1-year behavioral outcomes. American Journal of Public Health, 83, 1245-1250.Google Scholar
  82. Suter, D., & Kehle, T. (1988). Evaluation of the Primary Mental Health Project model of early identification and prevention of school adjustment problems. Special Services in the Schools, 4, 89-107.Google Scholar
  83. Tremblay, R., Pagani-Kurtz, L., Masse, L., Vitaro, F., & Pihl, R. (1995). A bimodal preventive intervention for disruptive kindergarten boys: Its impact through mid-adolescence. Journal of Consulting and Clinical Psychology, 63, 560-568.Google Scholar
  84. Vitaro, F., & Tremblay, R. (1994). Impact of a prevention program on aggressive children's friendships and social adjustment. Journal of Abnormal Child Psychology, 22, 457-475.Google Scholar
  85. Vitiello, B., Bhatara, V. S., Jensen, P. S. (1999). Current knowledge and unmet needs in pediatric psychopharmacology. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 501-502.Google Scholar
  86. Weiss, B., Catron, T., Harris, V., & Phung, T. (1999). The effectiveness of traditional child psychotherapy. Journal of Consulting and Clinical Psychology, 67, 82-94.Google Scholar
  87. Weisz, J. R., & Jensen, P. S. (1999). Efficacy and effectiveness of child and adolescent psychotherapy and pharmacotherapy. Mental Health Services Research, 1, 125-158.Google Scholar
  88. Weisz, J. R., Weiss, B., & Donenberg, G. R. (1993). The lab versus the clinic: Effects of child and adolescent psychotherapy. Annual Progress in Child Psychiatry and Child Development, 47, 1578-1585.Google Scholar
  89. Weisz, J. R., & Weersing V. R. (1999). Psychotherapy with children and adolescents: Efficacy, effectiveness, and developmental concerns. In Cicchetti, D., and Toth, D. L. (Eds.). Rochester symposium on developmental psychopathology, Vol. 9: Developmental approaches to prevention and intervention. Rochester, NY: University of Rochester Press.Google Scholar
  90. Zahner, G., Pawelkiewicz, W., DeFrancesco, J. J., & Adnopoz, J. (1992). Children's mental health service needs and utilization patterns in an urban community: An epidemiological assessment. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 951-960.Google Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Michelle Rones
    • 1
    • 2
  • Kimberly Hoagwood
    • 2
  1. 1.George Washington UniversityUSA
  2. 2.National Institute of Mental HealthBethesda

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