Adapting a Clinic-Based Mental Health Program for Delivery Within Elementary Schools

from "Toward a Carolina Improvement Science Initiative: A Lightning Symposium" (video)
Desiree Murray
2017

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The Incredible Years® (IY) Dina Dinosaur Small Group program is an evidence-based program developed for implementation in clinics with young children diagnosed with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Although it holds potential for benefiting a broader range of children at risk for mental health disorders, the program requires adaptation and implementation supports for school delivery. Moreover, evidence of both feasibility and positive impact on educational outcomes is needed for educator buy-in and program adoption.

As part of a randomized controlled trial funded by the Department of Education, the Self-Regulation Skills for Success team has adapted session structure and developed implementation supports which may be informative to other school-based translational work. A key component of our approach has been partnering with school counselors who serve as co-leaders for the intervention groups, facilitate communication with families and other school staff, and help align the program with school policies and procedures. Monthly peer coaching has supported this partnership and enhanced counselors’ capacity for delivering effective social-emotional interventions. Other important implementation supports include consultation provided to teachers and parents as well as “recess coaching” (prompts and reinforcement for children on the playground) to support skill generalizability. Through work to date in 9 schools across 4 districts, program adherence and delivery quality have been high, as has stakeholder satisfaction. Challenges have included matching the program to student need, addressing differences between program philosophy and school culture, and educating administrators about research design and outcomes.

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