Skip to main content

Advertisement

SpringerLink
Log in

Training School Mental Health Providers to Deliver Cognitive-Behavioral Therapy

  • Original Paper
  • Published:
School Mental Health Aims and scope Submit manuscript

Abstract

Anxiety disorders are among the most prevalent mental health difficulties experienced by youth. A well-established literature has identified cognitive-behavior therapy (CBT) as the gold-standard psychosocial treatment for youth anxiety disorders. Access to CBT in community clinics is limited, but a potential venue for the provision of CBT for child anxiety disorders is the school setting. The present study examined a subset of data from a larger study in which therapists from a variety of settings, including schools, were trained in CBT for child anxiety (N = 17). The study investigated the relationship between provider- and organizational-level variables associated with training and implementation among school mental health providers. The present findings indicate a positive relationship between provider attitudes and adherence to CBT. Self-reported barriers to implementation were also identified. Integrating CBT into school mental health providers’ repertoires through training and consultation is a critical step for dissemination and implementation of empirically supported psychosocial treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. A check of the data suggests that there was sufficient variability in the organizational-level data (i.e., scores ranged on average from 20 to 50).

References

  • Aarons, G. A. (2005). Measuring provider attitudes toward evidence-based practice: Consideration of organizational context and individual differences. Child and Adolescent Psychiatric Clinics of North America, 14, 255–271. doi:10.1016/j.chc.2004.04.008.

    Article  PubMed  Google Scholar 

  • Aarons, G. A., & Sawitzky, A. C. (2006). Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services, 3, 61–72. doi:10.1037/1541-1559.3.1.61.

    Article  PubMed  Google Scholar 

  • Albano, A. M., Chorpita, B. F., & Barlow, D. H. (2003). Anxiety Disorders. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (2nd ed., pp. 279–329). New York: The Guilford Press.

    Google Scholar 

  • Beidas, R. S., Barmish, A. J., & Kendall, P. C. (2009). Training as usual: Can therapist behavior change after reading a manual and attending a brief workshop on cognitive behavioral therapy for youth anxiety? The Behavior Therapist, 32, 97–101. Retrieved from http://www.abct.org/docs/PastIssue/32n5.pdf.

  • Beidas, R. S., Edmunds, J. E., Marcus, S. C., & Kendall, P. C. (in press). An RCT of training and consultation as implementation strategies for an empirically supported treatment. Psychiatric Services.

  • Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17, 1–30. doi:10.1111/j.1468-2850.2009.01187.x.

    Article  Google Scholar 

  • Benjamin, C., Beidas, R., Edmunds, J., Cohen, J., & Kendall, P. (2010). Identification and treatment of anxious youth. Unpublished instrument.

  • Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: controversies and evidence. Annual Review of Psychology, 52, 685–716. doi:10.1146/annurev.psych.52.1.685.

    Article  PubMed  Google Scholar 

  • Costello, J. E., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844. doi:10.1001/archpsyc.60.8.837.

    Article  PubMed  Google Scholar 

  • Davy, L., Gantwerk, B., & Martz, S. (2009). Commissioner’s annual report to the education committees of the senate and general assembly on violence. Trenton, NJ: Vandalism and Substance Abuse in New Jersey Public Schools.

    Google Scholar 

  • Dimeff, L. A., Koerner, K., Woodcock, E. A., Beadnell, B., Brown, M. Z., Skutch, J. M., et al. (2009). Which training method works best? A randomized controlled trial comparing three methods of training clinicians in dialectical behavior therapy skills. Behavior Research and Therapy, 47, 921–930. doi:10.1016/j.brat.2009.07.011.

    Article  Google Scholar 

  • Farmer, E. M., Burns, B. J., Philips, S. D., Angold, A., & Costello, E. J. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54, 60–66. doi:10.1176/appi.ps.54.1.60.

    Article  PubMed  Google Scholar 

  • Fisher, P., Masia-Warner, C., & Klein, R. (2004). Skills for social and academic success: A school-based intervention for social anxiety disorder in adolescents. Clinical Child and Family Psychology Review, 7, 241–249.

    Article  PubMed  Google Scholar 

  • Fixsen, D., Naoom, S. F., Blase, D. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, Florida. Retrieved from http://nirn.fmhi.usf.edu/resources/publications/Monograph/index.cfm.

  • 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 Ment Health Journal, 32, 341–352.

    Article  Google Scholar 

  • Forman, S., Olin, S., Hoagwood, K., Crowe, M., & Saka, N. (2009). Evidence-based intervention in schools: Developers’ views of implementation barriers and facilitators. School Mental Health, 1, 26–36. doi:10.1007/s12310-008-9002-5.

    Article  Google Scholar 

  • Garland, A. F., Brookman-Frazee, L., Hurlburt, M. S., Accurso, E. C., Zoffness, R. J., Haine-Schlagel, R., et al. (2010). Mental health care for children with disruptive behavior problems: a view inside therapists’ offices. Psychiatric Services, 61, 788–795. doi:10.1176/appi.ps.61.8.788.

    Article  PubMed  Google Scholar 

  • Ginsburg, G., Becker, K. D., Kingery, J. N., & Nichols, T. (2008). Transporting CBT for childhood anxiety disorders into inner-city school-based mental health clinics. Cognitive and Behavioral Practice, 15, 148–158. doi:10.1016/j.cbpra.2007.07.001.

    Article  Google Scholar 

  • Glisson, C., & Green, P. (2011). Organizational climate, services, and outcomes in child welfare systems. Child Abuse and Neglect, 35, 582–591. doi:10.1016/j.chiabu.2011.04.009.

    Article  PubMed  Google Scholar 

  • Glisson, C., & James, L. R. (2002). The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior, 23, 767–794. doi:10.1002/job.162.

    Article  Google Scholar 

  • Glisson, C., Schoenwald, S. K., Hemmelgarn, A., Green, P., Dukes, D., Armstrong, K. S., et al. (2010). Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy. Journal of Consulting and Clinical Psychology, 78, 537–550. doi:10.1037/a0019160.

    Article  PubMed  Google Scholar 

  • Henggeler, S. W., Chapman, J. E., Rowland, M. D., Halliday-Boykins, C. A., Randall, J., Shackelford, J., et al. (2008a). Statewide adoption and initial implementation of contingency management for substance-abusing adolescents. Journal of Consulting and Clinical Psychology, 76, 556–567. doi:10.1037/0022-006X.76.4.556.

    Article  PubMed  Google Scholar 

  • Henggeler, S. W., Sheidow, A. J., Cunningham, P. B., Donohue, B. C., & Ford, J. D. (2008b). Promoting the implementation of an evidence-based intervention for adolescent marijuana abuse in community settings: testing the use of intensive quality assurance. Journal of Clinical Child and Adolescent Psychology, 37, 682–689. doi:10.1080/15374410802148087.

    Article  PubMed  Google Scholar 

  • Henry, W. P., Schacht, T. E., Strupp, H. H., Butler, S. F., & Binder, J. L. (1993). Effects of training in time-limited dynamic psychotherapy: Mediators of therapists’ responses to training. Journal of Consulting and Clinical Psychology, 61, 441–447.

    Article  PubMed  Google Scholar 

  • Herschell, A. D., Kolko, D. J., Baumann, B. L., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review, 30(4), 448–466. doi:10.1016/j.cpr.2010.02.005.

    Article  PubMed  Google Scholar 

  • Ialongo, N. S., Edelsohn, G., Werthamer-Larsson, L., Crockett, L., & Kellam, S. (1995). The significance of self-reported anxious symptoms in first grade children: Prediction to anxious symptoms and adaptive functioning in fifth grade. Journal of Child Psychology and Psychiatry, 36, 427–437.

    Article  PubMed  Google Scholar 

  • Jaycox, L., Stein, B., Paddock, S., Miles, J. N., Chandra, A., Meredith, L. S., et al. (2009). Impact of teen depression on academic, social, and physical functioning. Pediatrics, 124, e596–e605. doi:10.1542/peds.2008-3348.

    Article  PubMed  Google Scholar 

  • Kendall, P. C., Safford, S., Flannery-Schroeder, E., & Webb, A. (2004). Child anxiety treatment: outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up. Journal of Consulting and Clinical Psychology, 72, 276–287. doi:10.1037/0022-006X.72.2.276.

    Article  PubMed  Google Scholar 

  • Langley, A. K., Nadeem, E., Kataoka, S. H., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental health srograms in schools: Barriers and facilitators of successful implementation. School Ment Health, 2, 105–113. doi:10.1007/s12310-010-9038-1.

    Article  PubMed  Google Scholar 

  • Lehman, W., Greener, J., & Simpson, D. (2002). Assessing organizational readiness for change. Journal of Substance Abuse Treatment, 22, 197–209. doi:10.1016/S07405472(02)00233-7.

    Article  PubMed  Google Scholar 

  • Lomas, J. (1993). Diffusion, dissemination, and implementation: Who should do what? Annals of the New York Academy of Science, 703, 226–235.

    Article  Google Scholar 

  • Lyon, A., Charlesworth-Attie, S., Vander Stoep, A., & McCauley, E. (2011). Modular psychotherapy for youth with internalizing problems: Implementation with therapists in school-based health centers. School Psychology Review, 40, 569–581. Retrieved from http://www.nasponline.org/publications/spr/abstract.aspx?ID=3254.

  • Masia-Warner, C., Fisher, P., Shrout, P., Rathor, S., & Klein, R. (2007). Treating adolescents with social anxiety disorder in school: An attention control trial. Journal of Child Psychology and Psychiatry, 48, 676–686. doi:10.1111/j.1469-7610.2007.01737.x.

    Article  PubMed  Google Scholar 

  • Masia-Warner, C., Klein, R., Dent, H., Fisher, P., Alvir, J., Albano, A., et al. (2005). School-based intervention for adolescents with social anxiety disorder: Results of a controlled study. Journal of Abnormal Child Psychology, 33, i707–i722. doi:10.1007/s10802-005-7649-z.

    Article  Google Scholar 

  • Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J., & Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72, 1050–1062. doi:10.1037/0022-006X.72.6.1050.

    Article  PubMed  Google Scholar 

  • Mufson, L. H., Dorta, K. P., Olfson, M., Weissman, M. M., & Hoagwood, K. (2004). Effectiveness research: transporting interpersonal psychotherapy for depressed adolescents (IPT-A) from the lab to school-based health clinics. Clinical Child and Family Psychology Review, 7, 251–261. doi:10.1007/s10567-004-6089-6.

    Article  PubMed  Google Scholar 

  • Mychailyszyn, M. P., Mendez, J., & Kendall, P. (2010). School functioning in youth with and without anxiety disorders: Comparisons by diagnosis and comorbidity. School Psychology Review, 39, 106–121. Retrieved from http://www.nasponline.org/publications/spr/pdf/spr391mychailyszyn.pdf.

  • New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final report. Rockville, MD: US Department of Health and Human Services. Retrieved from http://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport.htm.

  • Perepletchikova, F., Treat, T. A., & Kazdin, A. E. (2007). Treatment integrity in psychotherapy research: Analysis of the studies and examination of the associated factors. Journal of Consulting and Clinical Psychology, 75, 829–841. doi:10.1037/0022-006X.75.6.829.

    Article  PubMed  Google Scholar 

  • Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services, 38, 65–76. doi:10.1007/s10488-010-0319-7.

    Article  Google Scholar 

  • Rakovshik, S. G., & McManus, F. (2010). Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance. Clinical Psychology Review, 30, 496–516. doi:10.1016/j.cpr.2010.03.004.

    Article  PubMed  Google Scholar 

  • Ryan, J., & Masia-Warner, C. (2012). Treating adolescents with social anxiety disorder in schools. Child and Adolescent Psychiatric Clinics of North America, 21, 105–118. doi:10.1016/j.chc.2011.08.011.

    Article  PubMed  Google Scholar 

  • Schoenwald, S. K., Chapman, J. E., Kelleher, K., Hoagwood, K. E., Landsverk, J., Stevens, J., et al. (2008). A survey of the infrastructure for children’s mental health services: Implications for the implementation of empirically supported treatments (ESTs). Administration and Policy in Ment Health and Mental Health Services, 35, 84–97. doi:10.1007/s10488-007-0147-6.

    Article  Google Scholar 

  • Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., et al. (2009). Mind the gap: Improving the dissemination of CBT. Behavior Research and Therapy, 47, 902–909. doi:10.1016/j.brat.2009.07.003.

    Article  Google Scholar 

  • Silverman, W. K., Pina, A. A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 37, 105–130. doi:10.1080/15374410701817907.

    Article  PubMed  Google Scholar 

  • Society for Research in Child Development. (2009). Healthy development: A summit on young children’s mental health. Partnering with Communication Scientists, Collaborating across Disciplines and Leveraging Impact to Promote Children’s Mental Health. Washington, DC. Retrieved from http://www.apa.org/pi/families/summit-report.pdf.

  • Storch, E.A., & Crisp, H.L. (2004). Taking it to the schools- transporting empirically supported treatments for childhood psychopathology to the school setting. Clinical Child and Family Psychology Review, 191–193. doi:10.1007/s10567-004-6084-y.

  • U.S. Department of Health and Human Services. (2000). Report of the surgeon general’s conference on children’s mental health: A national action agenda. Washington, DC. Retrieved from http://www.surgeongeneral.gov/topics/cmh/childreport.html.

  • Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New England Journal of Medicine, 359, 2753–2766. doi:10.1056/NEJMoa0804633.

    Article  PubMed  Google Scholar 

  • Weiner, B. J., Lewis, M. A., & Linnan, L. A. (2009). Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. Health Eduation cand Research, 24, 292–305. doi:10.1093/her/cyn019.

    Article  Google Scholar 

  • Weingardt, K. R., Cucciare, M. A., Bellotti, C., & Lai, W. P. (2009). A randomized trial comparing two models of web-based training in cognitive-behavioral therapy for substance abuse counselors. Journal of Substance Abuse Treatment, 37, 219–227. doi:10.1016/j.jsat.2009.01.002.

    Article  PubMed  Google Scholar 

  • Weist, M. D., Goldstein, J., Evans, S. W., Lever, N. A., Axelrod, J., Schreters, R., et al. (2003). Funding a full continuum of mental health promotion and intervention programs in the schools. Journal of Adolescent Health, 32, 70–78. doi:10.1016/S1054-139X(03)00067-3.

    Article  PubMed  Google Scholar 

  • Woodward, L. J., & Fergusson, D. M. (2001). Life course outcomes of young people with anxiety disorders in adolescence. Journal of the American Academy of Child and Adolescen Psychiatry, 40, 1086–1093. doi:10.1097/00004583-200109000-00018.

    Article  Google Scholar 

Download references

Acknowledgments

Research supported by National Institute of Mental Health Grants F31MH083333 awarded to Rinad Beidas and Philip Kendall.

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA

    Rinad S. Beidas, Muniya S. Khanna & Margaret Mary Downey

  2. Division of Psychology/Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA

    Matthew P. Mychailyszyn

  3. Department of Psychology, Temple University, Philadelphia, PA, USA

    Julie M. Edmunds & Philip C. Kendall

Authors
  1. Rinad S. Beidas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew P. Mychailyszyn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julie M. Edmunds
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Muniya S. Khanna
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Margaret Mary Downey
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Philip C. Kendall
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rinad S. Beidas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Beidas, R.S., Mychailyszyn, M.P., Edmunds, J.M. et al. Training School Mental Health Providers to Deliver Cognitive-Behavioral Therapy. School Mental Health 4, 197–206 (2012). https://doi.org/10.1007/s12310-012-9074-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12310-012-9074-0

Keywords

Search

Navigation