How Effective Are School Professionals at Identifying Students Who Might Benefit From Cognitive Behavioral Therapy? Baseline Data From the Adaptive School-Based Implementation of Cognitive Behavioral Therapy Trial

Seo Youn Choi,Amy M Kilbourne,Joseph A Himle,Elizabeth Koschmann,Shawna N Smith,Annalise Lane,Amy Rusch,Daniel Eisenberg,Kate D Fitzgerald,James L Abelson,Emily L Bilek,Celeste Liebrecht

doi:10.3389/feduc.2022.814157

Abstract

School professionals (SPs) are increasingly tasked with providing mental health treatment for students. Successful implementation of school-based mental health evidence-based practices (EBPs) can reduce students’ depression and anxiety, but requires identification of appropriate students to benefit from these interventions. We examined the ability of SPs to identify students appropriate for cognitive behavioral therapy (CBT), using baseline data collected from a large-scale implementation trial. One hundred sixty-nine SPs from 94 Michigan high schools were asked to identify up to 10 students whom they believed could benefit from CBT. Identified students were asked to complete a baseline survey. We examined the proportion of consented students who screened positive for depression or anxiety, based on the Patient Health Questionnaire modified for teens and the Generalized Anxiety Disorder questionnaire, overall and by key school- and SP-level factors. Of the 1,347 students identified by 149 SPs, 899 students completed the survey. Of those students, 87% exhibited any depression or anxiety symptoms (score of five or higher) and 66% showed moderate/severe symptoms (score of ten or higher). Per SP, the proportion of consented students who screened positive for any depression or anxiety symptoms was, on average, 0.88. The effectiveness of SPs’ student identification did not vary significantly by school-specific role, prior CBT training, or geography. Results suggest that SPs can effectively identify students appropriate for CBT given minimal training and resources, an important first step in increasing student access to school-based mental healthcare.

Highlights

Schools provide promising venues for increasing adolescents’ access to evidence-based practices (EBPs) for mental health disorders (Stephan et al, 2007; Beidas et al, 2012; Lyon et al, 2013; Sanchez et al, 2018; Koschmann et al, 2019)
Using a subset of baseline data collected from a large-scale implementation trial of school-based CBT, we explored how effective school professionals (SPs) were at identifying students with depression and anxiety
Of 169 Adaptive School-based Implementation of CBT (ASIC)-participating SPs, 163 SPs (96%) completed the SP baseline survey; about half of SPs were from rural schools (49%), most of them had a graduate degree (93%), 38% reported no prior CBT experience, and SPs had been in their position for 8 years, on average (Standard deviation, SD = 7.8) (Table 1)

Summary

Introduction

Schools provide promising venues for increasing adolescents’ access to evidence-based practices (EBPs) for mental health disorders (Stephan et al, 2007; Beidas et al, 2012; Lyon et al, 2013; Sanchez et al, 2018; Koschmann et al, 2019). At least one in five adolescents experience mental health disorders, including depression and anxiety (Kessler et al, 2001; Merikangas et al, 2010), and mental health challenges among children and adolescents have further increased as a result of the COVID19 pandemic (American Academy of Pediatrics, 2021; Racine et al, 2021). While less than 20% of youth have access to mental healthcare, 35–50% of adolescents receiving help do so within the school setting (Weist et al, 2007; Green et al, 2013; Duong et al, 2020), indicating that increasing school-based mental health access holds promise for reaching students in need of care

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Results

Discussion

Conclusion