Lessons Learned About Barriers to Implementing School-Based Interventions for Adolescents: Ideas for Enhancing Future Research and Clinical Projects.

The majority of youth with mental health problems do not receive treatment, highlighting the critical need to transport evidence-based interventions into community settings, such as schools. Despite being able to reach a large number of adolescents and minority youth, the process of implementing evidence-based interventions to schools is challenging. This paper discusses some expected and unexpected challenges experienced during the implementation of an open trial and a pilot randomized controlled trial examining the acceptability and effectiveness of a school-based preventive intervention for adolescents at risk for internalizing disorders.

Trajectories and Predictors of Response to the Challenging Horizons Program for Adolescents With ADHD.

The Challenging Horizons After School Program is one of the only psychosocial interventions developed specifically for adolescents with attention-deficit/hyperactivity disorder (ADHD) that has demonstrated efficacy in multiple randomized controlled trials. To date, however, all research with the intervention has evaluated outcomes at the group level, and it is unclear whether all adolescents respond similarly, or if the intervention is particularly well suited for certain adolescents with ADHD. This type of information is needed to guide stakeholders in making informed choices as part of dissemination and implementation efforts.

Mental health screening in kindergarten youth: a multistudy examination of the concurrent and diagnostic validity of the Impairment Rating Scale.

Using a multistudy approach, we examined the utility of the Impairment Rating Scale (IRS; Fabiano et al., 2006) as a screening tool for detecting kindergarten children who are at risk for social, emotional, academic, and behavioral problems. In Study 1 (N = 568), we evaluated the concurrent validity, discriminant validity, and diagnostic efficiency of the parent and teacher IRS test score inferences in relation to scores from the Behavioral Assessment System for Children (BASC-2; Reynolds & Kamphaus, 2004).

Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD.

The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions to increase specificity. Participants were 310 young adolescents (ages 10-14; 71% male, 78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression.

Using flexible clinical processes in the Unified Protocol for the Treatment of Emotional Disorders in Adolescence.

The purpose of this manuscript is to highlight the Unified Protocol for the Treatment of Emotional Disorders in Adolescents (UP-A) as an exemplar model of a principle-based, flexible treatment for adolescents with either depressive or anxiety disorders. The theoretical basis, mechanism of change, and research support for three of the UP-A's guiding treatment principles are presented. Verbal exchanges between UP-A therapists and adolescent clients are shared to demonstrate clinical processes related to UP-A techniques that follow such guiding principles.

Pediatricians may address barriers inadequately when referring low-income preschool-aged children to behavioral health services.

Background: Low-income parents often seek help from pediatricians for early childhood social-emotional problems but seldom follow through with referrals to behavioral health services.

Objective: We sought to understand low-income parents' experiences seeking help from pediatricians for social-emotional problems and how those experiences influenced decisions about accessing behavioral health services.

Methods: We conducted 20 semi-structured interviews with low-income parents with concerns about their children's behavior or emotions.

Predictors of Response and Mechanisms of Change in an Organizational Skills Intervention for Students with ADHD.

The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6-8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use.

Low-income parents' perceptions of pediatrician advice on early childhood education.

The American Academy of Pediatrics recommends that pediatricians promote early childhood education (ECE). However, pediatricians have met resistance from low-income parents when providing anticipatory guidance on some topics outside the realm of physical health. Parents' views on discussing ECE with the pediatrician have not been studied.

Incremental benefits of a daily report card intervention over time for youth with disruptive behavior.

This study examined the percentage of children who respond positively to a daily report card (DRC) intervention and the extent to which students achieve incremental benefits with each month of intervention in a general education classroom. Participants were 66 children (87% male) with attention-deficit hyperactivity disorder or disruptive behavior problems who were enrolled in a school-based intervention program in rural, low-income school districts in a Midwest state. The DRC was implemented by each child's teacher, who received consultation from a graduate student clinician, school district counselor, or school district social worker.

Perceived barriers to help-seeking among parents of at-risk kindergarteners in rural communities.

This study examined help-seeking and perceived barriers to children's mental health service utilization in a large sample of parents living in rural communities who are at various stages in the help-seeking process. The goals were to (a) obtain a demographic profile of at-risk kindergarteners and their parents, (b) examine parent-reported help-seeking behaviors, and (c) assess barriers to mental health service use. Parent and teacher report of the Behavior Assessment System for Children, Second Edition, were used to screen children (N = 597) at kindergarten entry and to identify their risk status.

Evaluation of the Homework, Organization, and Planning Skills (HOPS) Intervention for Middle School Students with ADHD as Implemented by School Mental Health Providers.

The purpose of the study was to evaluate the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD) as implemented by school mental health (SMH) providers using a randomized trial design. Seventeen SMH providers from five school districts implemented the HOPS intervention. Forty-seven middle school students with ADHD (grades 6-8) were randomly assigned to receive the HOPS intervention or to a waitlist comparison group.

Refinement of an Organizational Skills Intervention for Adolescents with ADHD for Implementation by School Mental Health Providers.

The purpose of the study was to modify, test, and refine the Homework, Organization, and Planning Skills (HOPS) intervention for adolescents with ADHD for use by school mental health (SMH) providers. Ten SMH providers from three school districts implemented the HOPS intervention with 11 middle school students with ADHD. Parent and teacher ratings of materials organization and homework management were collected pre- and post-intervention and treatment fidelity was assessed.