A review of psychotherapy outcome research: Considerations for school‐based mental health providers

Evaluating psychotherapeutic outcome is an important endeavor given psychology's focus on identifying effective treatments. There is ample evidence to suggest that psychotherapy interventions for children and adolescents are effective. Unfortunately, the child and adolescent psychotherapy outcome literature lags behind the adult‐focused outcome literature in some important areas, as children and adolescents are often viewed as extensions of adults. This review analyzes the pertinent youth meta‐analyses, examining treatment, client, and therapist variables relevant to positive outcomes. We also consider the impact of variables that have received more attention in the adult psychotherapy outcome literature (i.e., the therapeutic alliance, therapist effects, and allegiance effects) and their possible impact on child and adolescent outcomes. Our hope is that this discussion benefits school‐based mental health professionals when discerning what works best with the youth population. © 2010 Wiley Periodicals, Inc.     

A meta‐analysis of school‐wide positive behavior support: An exploratory study using single‐case synthesis

Positive Behavior Support (PBS) for behavioral problems was included in the 1997 Individuals With Disabilities Education Act reauthorization, reflecting the increased implementation and strengthening empirical evidence for PBS in schools. Whereas PBS can be used reactively, its flexibility has led to a popular comprehensive school‐wide model used for prevention. School‐Wide Positive Behavioral Support (SWPBS) has been used across a variety of school environments and various demographics and has been evaluated using a variety of different outcome measures. The authors conducted a meta‐analysis of SWPBS research spanning 16 years and 20 articles. Specifically, single‐case studies were evaluated using a regression‐based procedure. Results show promising early trends in the data across dependent variables with a need for further research in specific areas. © 2011 Wiley Periodicals, Inc.     

The effectiveness of digital game‐based vocabulary learning: A framework‐based view of meta‐analysis

This study presents the results of a meta‐analytic study about the effects of digital game‐based learning (DGBL) on vocabulary. The results of the study showed that the effects of DGBL on vocabulary learning may vary with game design features (Q = 5.857, df = 1, p = .016), but not with learners' age (Q = 0.906, df = 1, p = .341) or linguistic background (Q = 0.0001, df = 1, p = .994). In light of the research findings, Csikszentmihalyi's ( 1990 ) Flow Theory was adopted to theorize the role of game design in DGBL. It is proposed that a hierarchy should exist on the “challenge” axis in the Flow Theory, with adventure‐oriented games above non‐adventure‐based games along the “challenge” axis. The theoretical underpinning is that the dynamic equilibrium between challenge and abilities can function independently of the effects of learners' age and linguistic background.     

Implementation of school‐based wellness centers

This article describes the planning, implementation, and evaluation of school‐based Wellness Centers operated by the Riverside Unified School District in Riverside, CA, as part of the Safe Schools/Healthy Students Initiative funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). We describe the program as planned in terms of the theoretical model for the intervention and the evaluation design, and discuss the actual implementation including accomplishments and challenges. The program was designed to promote positive development and wellness for individual students via self‐ and teacher‐referrals for personal and mental health problems handled through a case management and referral process, support groups, and other activities such as after‐school programs, mentoring, tutoring, and parent training. An effort was also made to promote wellness at the school level by providing wellness campaigns, information, and compatible policies and procedures designed to enhance healthy development. Our observations are based on a qualitative assessment that was a component of the evaluation. A more detailed evaluation examining the impact of school‐wide and student‐focused activities on academic and behavioral outcomes is currently underway. However, we do include comments from students suggesting that the Wellness Center concept holds much promise for school‐based mental health and violence prevention services. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 473–487, 2003.     

Evaluation in school‐based health centers

School‐Based Health Centers (SBHCs) are ideal primary care settings for improving children's access to and utilization of health care services. In this era of shrinking funding for social service programs, SBHCs may provide services to youth from low‐income families, who otherwise might lack access to health care services. However, the growth of SBHCs has outpaced evaluation efforts. More information is needed about what services are being provided, and for whom services are effective. This article reviews information that will assist in the development of evaluation efforts for SBHCs. A review of evaluation theory, ideas for evaluation in SBHCs, challenges to implementing research in schools, and future directions for evaluation efforts are presented. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 309–320, 2003.     

Relaxation and guided imagery: A school‐based intervention for children with asthma

Asthma, a disease of the respiratory system, is the most common chronic medical condition among children. School‐aged children with asthma evidence increased absenteeism, decreased school performance, restriction of various activities, poor peer relationships, and emotional and behavioral difficulties. Asthma can be triggered and exacerbated by emotions and stress, and therefore, it has been treated with psychological interventions. Relaxation and guided imagery (RGI), an intervention based on the theoretical position that the mind and body interact in determining health, has been shown to be effective in improving mental and physical health outcomes with a myriad of medical conditions, yet it has not been adequately studied with childhood asthma. This investigation analyzed the effect of RGI on lung function [forced expiratory volume in 1 second (FEV₁) and forced expiratory flow 25–75 (FEF_25–75)] and anxiety by employing a multiple baseline design across four middle school students with asthma. With the introduction of the intervention, it was found that FEV₁ improved and anxiety decreased in all students. FEF_25–75 improved in three of the four participants. The effect sizes for the four participants ranged from ?0.98 to ?1.88 for FEV₁, 0.20 to ?1.93 for FEF_25–75, and 2.19 to 4.06 for anxiety. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 657–675, 2003.     

A school‐based violence prevention model for at‐risk eighth grade youth

This study examined the effectiveness of a school and community‐based violence prevention program for at‐risk eighth‐grade students in three public schools in Florida. School officials matched intervention students with community‐based mentors in an employment setting to allow targeted youth to explore careers and receive one‐on‐one intervention from an adult mentor. Intervention students were compared to a control group of students not receiving mentorship services. This study used MANOVA and t‐test analyses to examine six outcomes measured: (1) unexcused absences; (2) number of in‐school suspensions; (3) number of days of in‐school suspensions; (4) number of out‐of‐school suspensions; (5) number of days of out‐of‐school suspensions; and (6) total number of infractions committed on school property. The findings suggested that mentored students, as compared to control group students, had significant reductions in total number and days of suspensions, days of sanction, and infractions committed on school property. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 403–416, 2003.     

Cultural‐competence considerations for contemporary school‐based threat assessment

Threat‐assessment procedures are advanced for their utility in reducing racial disparities in punitive and exclusionary school discipline outcomes. Generally unexamined, however, is bias in who gets referred for school‐based threat assessment and under what circumstances. Cultural‐competence considerations hold promise for addressing sources of bias in the evaluation of threats made in the school setting. Using a quantitative approach, this systematic literature review examines the degree to which contemporary cultural‐competence considerations are embedded in 24 school‐based threat‐assessment articles published between 2007 and 2017. Results indicate generally poor coverage of considerations for cultural competence both within and across threat‐assessment articles. An analysis of change in cultural‐competence considerations by year of publication suggests that more recently published threat‐assessment literature has generally not integrated concurrent advancements in concepts of cultural competence. Preliminary guidance for incorporating contemporary cultural‐competence considerations into school‐based threat‐assessment procedures are provided.     

Antisocial behavior and the prediction of violence: A meta‐analysis

Youthful antisocial behavior is often viewed as a precursor to later violent and threatening behavior. Olweus (1979) reported aggressive reaction patterns in males that over time approached the stability of intelligence. While Olweus did not examine violent behavior directly, his study is often cited as evidence for the stability of violence. To examine the evidence for this assertion, this study synthesized the evidence from 82 reports of 58 prospective studies that followed individuals over some period of their life span. After correcting effect sizes for exogenous study features, the grand mean correlation of antisocial and substance misusing behaviors with later crimes against persons was estimated to be r = .33, a far cry from the stability of intelligence. Because these predictors are often used to select people into intervention, this study estimated the conditional error rates associated with identification for preventive intervention. Overall, selection failed to identify 66% of those who displayed later violence, while on average, 60% of those engaging in antisocial or substance‐using behavior were not later violent. © 2001 John Wiley & Sons, Inc.     

Addressing escape‐maintained behavior for students with developmental disabilities: A systematic review of school‐based interventions

Students with developmental disabilities have been found to exhibit higher rates of problem behavior in the classroom than their typically developing peers. Effectively addressing these students’ behavior concerns requires the identification of interventions that can be implemented in an educational setting. Furthermore, matching intervention strategies to the function of a student's problem behavior may increase its effectiveness. There are data to suggest that students with disabilities exhibit escape‐maintained problem behavior in the classroom twice as frequently as problem behavior maintained by other consequences such as attention or access to tangibles. Thus, the purpose of this systematic review was to identify school‐based intervention strategies that have been used to reduce the disruptive behavior of students with developmental disabilities. In total, 12 articles met search criteria, with escape extinction, curricular modification, and noncontingent escape serving as the most frequently employed intervention strategies. Limitations and future directions are discussed.     

Quality assurance and school‐based mental health services

Clinicians affiliated with expanded school mental health (ESMH) programs provide a range of mental health services for youth in schools. ESMH services offer unique opportunities for collaboration between school psychologists and mental health clinicians from the community to increase the quality of care for youth receiving mental health services. The number of ESMH programs is increasing; therefore, developing quality assurance (QA) activities for these programs is important to document accountability and provide evidence for effectiveness. In this paper, suggestions for phases and objectives for QA programs in ESMH programs and examples of suggested activities are presented. Assessment of the program structure as well as treatment process and outcome are critical phases. Important QA activities include examining staff training activities, assessment of stakeholder perceptions of services, conducting satisfaction surveys, examining therapy process, and investigating treatment outcomes. Results of QA evaluations should inform policy.QA programs need to be developed and the impact of QA activities in enhancing the quality of care provided by clinicians in schools should be evaluated. © 1999 John Wiley & Sons, Inc.     

Parent and teacher satisfaction with school‐based psychological reports

School psychologists spend a great deal of time translating assessment results into a psychoeducational report. The importance of creating reports that are both useful and understandable to the readers of the report while also being efficient for the school psychologist cannot be overstated. This study examines parent and teacher perceptions regarding the quality, understandability, and usefulness of school‐based psychological reports. Results of the surveys indicate that both parents and teachers perceive psychological reports as focusing more on tests and test scores as opposed to information that helps to understand the child or assists with intervention development. Strategies for upgrading reports to better meet the needs of parent and teacher readers are discussed.     

Self‐regulation empowerment program: A school‐based program to enhance self‐regulated and self‐motivated cycles of student learning

This article describes a training program, Self‐Regulation Empowerment Program (SREP), that school professionals can use to empower adolescent students to engage in more positive, self‐motivating cycles of learning. It is a two‐part approach whereby self‐regulated learning coaches (SRC) (a) use microanalytic assessment procedures to assess students' self‐regulation beliefs and study strategies and (b) train students to use these strategies in a cyclical, self‐regulation feedback loop. Ultimately, students learn how to set goals, select and monitor strategy effectiveness, make strategic attributions, and adjust their goals and strategies. The program was developed from social‐cognitive theory and research and integrates many of the essential features of the problem‐solving model. Interventions used in the SREP include graphing, cognitive modeling, cognitive coaching, and structured practice sessions. A case study is presented to illustrate procedures for implementing the program. Implications for school psychologists and teachers also are presented and discussed. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 537–550, 2004.     

A professional development model for the positive practice of school‐based reading consultation

This paper reports on two years of a multiyear consultation/professional development project based on socioconstructivist principles (situated cognition, social context, and scaffolded instruction) that are consistent with key elements of positive psychology. The consultation model used a case analysis framework to engage 12 elementary school teachers in workshops, demonstration lessons, ad hoc inquiry groups, and coaching. Interview, questionnaire, and field note data from the participants identified “control and choice,” “focus on student needs,” “applicability to classroom practices,” “direct instruction of skills,” and “consultant feedback” as key elements of the model. Changes in classroom practices were reported by 78% of the participants with changes in confidence noted from pre‐ to posttests. Better learning for students was mentioned by 89% of the teachers. Discussion focuses on critical theoretical elements associated with positive psychology. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 51–65, 2004.     

Implementing a school‐based health center: The Winston‐Salem/Forsyth County experience

This article traces the inception and implementation of school‐based health centers in the Winston‐Salem/Forsyth County (NC) school system. The challenges that arose during implementation are discussed, along with the opportunities that SBHCs provide to enhance the provision of comprehensive services for children. The involvement of the several school psychologists in the initial planning, organization and implementation of these centers is delineated as an example for other school psychologists who are interested in working with school‐based health centers. School‐based health centers represent an opportunity for school psychologists to assume a leadership role in the delivery of enhanced health and mental health services for children and families. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 289–296, 2003.     

The effects of team training on team outcomes: A meta‐analysis

A meta‐analysis was conducted to determine relationships between team training and team effectiveness. Results from the 21 studies provided evidence that training is positively related to team effectiveness and effectiveness in five outcome categories: affective, cognitive, subjective task‐based skill, objective task‐based skill, and teamwork skill.     

Transversal traits in science education research relevant for teaching and research: A meta‐interpretative study

This study is a meta‐interpretative analysis that focuses on research conducted and published by other researchers. Concepts central to this study include global practical relevance, curriculum design, and formative situation. We analyzed 35 studies selected from 374 published studies in the years 2000 and 2001 in three journals referenced in the International Scientific Index. Using a replicable methodology developed specifically for this research, we found evidence of s clusters of variables that suggest the existence of transversal traits in the 35 science education research studies. These results form a reference framework of theoretical and practical knowledge relevant for research and practice pertaining to teaching and learning science. © 2008 Wiley Periodicals, Inc. J Res Sci Teach 45: 574–599, 2008     

Project start: An evaluation of a community‐wide school‐based intervention to reduce truancy

The study evaluated the effectiveness of a community‐based court intervention aimed at reducing truancy in a large urban school district. A quasi‐experimental design was used to assess attendance outcomes for 567 truants matched on demographics and drawn from three categories of intervention (no court referral, traditional court referral, and court referral with community‐based services). A court group by time ANOVA was conducted. Truancy levels remained high and unchanged for nonreferred truants throughout the study. Both court groups showed a significant drop in absences 30 days post court. During the subsequent 30‐day period, the community‐based court maintained the reduced rates, while the traditional court group showed higher truancy levels than the community‐based court group. No significant interaction effects were found between court groups and sex, age group, or ethnic categories. At one year follow‐up, the community‐based court group continued to show significantly lower levels of unexcused absences compared to the other two experimental groups. © 2005 Wiley Periodicals, Inc. Psychol Schs 42: 657–667, 2005.