Skip to main content

Advertisement

SpringerLink
Log in

Developing Self-concept, Coping Skills, and Social Support in Grades 3–12: A Cluster-Randomized Trial of a Combined Mental Health Literacy and Dialectical Behavior Therapy Skills Program

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

Abstract

A multisite cluster-randomized trial (by school) was conducted to examine the effects of a combined mental health literacy and dialectical behavior therapy skills program implemented by teachers on three protective factors related to social and emotional well-being. The sample of eight schools that were randomly assigned to intervention included 995 students in 40 3rd–12th grade classrooms in two Canadian cities. Student-reported measures of self-concept, coping skills, and social support were collected three times in the year (October, February, and June). Results indicated large effects for the program on all measures (g = 1.00 to 1.39). Program effectiveness did differ by city, but did not differ between elementary versus secondary schools, or by student gender, ethnicity, or disability status. The implications of the study for universal school-based mental health programming are discussed.

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

References

  • Bates, D., Maechler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software,67, 1–48. https://doi.org/10.18637/jss.v067.i01.

    Article  Google Scholar 

  • Busby Grant, J., Bruce, C. P., & Batterham, P. J. (2016). Predictors of personal, perceived and self-stigma towards anxiety and depression. Epidemiology and Psychiatric Sciences,25(3), 247–254. https://doi.org/10.1017/S2045796015000220.

    Article  PubMed  Google Scholar 

  • Canadian Association for Mental Health. (2016). Social and emotional learning. School Years Evidence Brief. Retrieved from http://www.eenet.ca.

  • Cantave, C. Y., Langevin, S., Marin, M. F., Brendgen, M., Lupien, S., & Ouellet-Morin, I. (2019). Impact of maltreatment on depressive symptoms in young male adults: The mediating and moderating role of cortisol stress response and coping strategies. Psychoneuroendocrinology,103, 41–48. https://doi.org/10.1016/j.psyneuen.2018.12.235.

    Article  PubMed  Google Scholar 

  • Carrara, B. S., & Ventura, C. A. A. (2018). Self-stigma, mentally ill persons and health services: An integrative review of literature. Archives of Psychiatric Nursing,32(2), 317–324. https://doi.org/10.1016/j.apnu.2017.11.001.

    Article  PubMed  Google Scholar 

  • Child Development Project. (2005). Sense of classroom as a community. Downloaded from https://www.collaborativeclassroom.org/resources/scales-from-student-questionnaire-child-development-project-for-elementary-school-students-grades-3-6/.

  • Cleverley, K., & Kidd, S. A. (2011). Resilience and suicidality among homeless youth. Journal of Adolescence,34(5), 1049–1054. https://doi.org/10.1016/j.adolescence.2010.11.003.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Academic Press.

    Google Scholar 

  • Corrigan, P. W., Kosyluk, K. A., & Rüsch, N. (2013). Reducing self-stigma by coming out proud. American Journal of Public Health,103(5), 794–800. https://doi.org/10.2105/AJPH.2012.301037.

    Article  PubMed  PubMed Central  Google Scholar 

  • Davidson, M. L., & Kmelkov, V. T. (2006). A global portrait of social and moral health for youth. Retrieved from http://www.cortland.edu/character/instruments.asp.

  • Demaray, M. K., & Malecki, C. K. (2014). Best practices in assessing and promoting social support. In P. L. Harrison & A. Thomas (Eds.), Best practices in school psychology: Student-level services (pp. 239–249). Bethesda, MD: National Association of School Psychologists.

    Google Scholar 

  • Ditzen, B., & Heinrichs, M. (2014). Psychobiology of social support: The social dimension of stress buffering. Restorative Neurology and Neuroscience,32(1), 149–162. https://doi.org/10.3233/RNN-139008.

    Article  PubMed  Google Scholar 

  • Dixon-Gordon, K., Chapman, A., & Turner, B. (2015). A preliminary pilot study comparing dialectical behavior therapy emotion regulation skills with interpersonal effectiveness skills and a control group treatment. Journal of Experimental Psychopathology,6(4), 369–388. https://doi.org/10.5127/jep.041714.

    Article  Google Scholar 

  • Dray, J., Bowman, J., Campbell, E., Freund, M., Wolfenden, L., Hodder, R. K., et al. (2017). Systematic review of universal resilience-focused interventions targeting child and adolescent mental health in the school setting. Journal of the American Academy of Child and Adolescent Psychiatry,56, 813–824. https://doi.org/10.1016/j.jaac.2017.07.780.

    Article  PubMed  Google Scholar 

  • Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development,82, 405–432. https://doi.org/10.1111/j.1467-8624.2010.01564.x.

    Article  PubMed  Google Scholar 

  • Feingold, A. (2009). Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis. Psychological Methods,14, 43–53. https://doi.org/10.1037/a0014699.

    Article  PubMed  PubMed Central  Google Scholar 

  • Flay, B., Biglan, A., & Boruch, R. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science,6, 151–175.

    Article  PubMed  Google Scholar 

  • Flynn, D., Joyce, M., Weihrauch, M., & Corcoran, P. (2018). Dialectical behaviour therapy–skills training for emotional problem solving for adolescents (DBT STEPS-A): Evaluation of a pilot implementation in Irish post-primary schools. Child and Adolescent Mental Health,23, 376–380. https://doi.org/10.1111/camh.12284.

    Article  PubMed  Google Scholar 

  • Gottfredson, D. C., Cook, T. D., Gardner, F. E. M., Gorman-Smith, D., Howe, G. W., Sandler, I. N., et al. (2015). Standards of evidence for efficacy, effectiveness, and scale-up research in prevention science: Next generation. Prevention Science,16(7), 893–926. https://doi.org/10.1007/s11121-015-0555-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gulliver, A., Griffiths, K. M., Christensen, H., King, M., Nazareth, I., Levy, G., et al. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry,10, 113. https://doi.org/10.1186/1471-244X-10-113.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harris, M. A., Wetzel, E., Robins, R. W., Donnellan, M. B., & Trzesniewski, K. H. (2018). The development of global and domain self-esteem from ages 10 to 16 for Mexican-origin youth. International Journal of Behavioral Development,42(1), 4–16. https://doi.org/10.1177/0165025416679744.

    Article  Google Scholar 

  • Ijadi-Maghsoodi, R., Marlotte, L., Garcia, E., Aralis, H., Lester, P., Escudero, P., et al. (2017). Adapting and implementing a school-based resilience-building curriculum among low-income racial and ethnic minority students. Contemporary School Psychology,21, 223–239. https://doi.org/10.1007/s40688-017-0134-1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Karaman, E., & Efilti, E. (2019). Investigation of social support perception and self-esteem as predictors of psychological resilience of parents who have children with special educational needs. Asian Journal of Education and Training,5(1), 112–120. https://doi.org/10.20448/journal.522.2019.51.112.120.

    Article  Google Scholar 

  • Karatas, Z., & Cakar, F. S. (2011). Self-esteem and hopelessness, and resiliency: An exploratory study of adolescents in Turkey. International Education Studies,4(4), 84–91. https://doi.org/10.5539/ies.v4n4p84.

    Article  Google Scholar 

  • Katz, J. (2018). Ensouling Our Schools. Winnipeg, MB: Portage & Main Press.

    Google Scholar 

  • Katz, J., & Porath, M. (2011). Teaching to diversity: Creating compassionate learning communities for diverse elementary school students. International Journal of Special Education, 26(2), 1–13.

    Google Scholar 

  • Kidd, S., & Shahar, G. (2008). Resilience in homeless youth: The key role of self-esteem. American Journal of Orthopsychiatry,78(2), 163–172. https://doi.org/10.1037/0002-9432.78.2.163.

    Article  Google Scholar 

  • Kramer, U. (2017). The role of coping change in borderline personality disorder: A process-outcome analysis on dialectical-behaviour skills training. Clinical Psychology and Psychotherapy,24(2), 302–311. https://doi.org/10.1002/cpp.2017.

    Article  PubMed  Google Scholar 

  • Kutcher, S., Venn, D., & Szumilas, M. (2009). Mental health: The next frontier of health education. Education Canada,49(2), 44–45.

    Google Scholar 

  • Kutcher, S., Wei, Y., & Coniglio, C. (2016). Mental health literacy: Past, present, and future. Canadian Journal of Psychiatry,61, 154–158. https://doi.org/10.1177/0706743715616609.

    Article  PubMed  PubMed Central  Google Scholar 

  • Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford.

    Google Scholar 

  • Lohbeck, A., Grube, D., & Moschner, B. (2017). Academic self-concept and causal attributions for success and failure amongst elementary school children. International Journal of Early Years Education,25(2), 190–203. https://doi.org/10.1080/09669760.2017.1301806.

    Article  Google Scholar 

  • Mackay, B. A., Shochet, I. M., & Orr, J. A. (2017). A pilot randomised controlled trial of a school-based resilience intervention to prevent depressive symptoms for young adolescents with autism spectrum disorder: A mixed methods analysis. Journal of Autism and Developmental Disorders,47(11), 3458–3478. https://doi.org/10.1007/s10803-017-3263-5.

    Article  PubMed  Google Scholar 

  • Marsh, H. W., Ellis, L. A., Parada, R. H., Richards, G., & Heubeck, B. G. (2005). A short version of the Self-Description Questionnaire II: Operationalizing criteria for short-form evaluation with new applications of confirmatory factor analyses. Psychological Assessment,17, 81–102. https://doi.org/10.1037/1040-3590.17.1.81.

    Article  PubMed  Google Scholar 

  • Mazza, J., Dexter-Mazza, E., Miller, A., Rathus, J., & Murphy, H. (2016). DBT skills in schools: Skills training for emotional problem solving for adolescents. New York: Guilford.

    Google Scholar 

  • Milin, R., Kutcher, S., Lewis, S. P., Walker, S., Wei, Y., Ferrill, N., et al. (2016). Impact of a mental health curriculum on knowledge and stigma among high school students: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry,55, 383–391. https://doi.org/10.1016/j.jaac.2016.02.018.

    Article  PubMed  Google Scholar 

  • Miller, A. L., Rathus, J. H., & Linehan, M. M. (2006). Dialectical behavior therapy for suicidal adolescents. New York: Guilford.

    Google Scholar 

  • O’Conner, R., De Feyter, J., Carr, A., Luo, J. L., & Romm, H. (2017). A review of the literature on social and emotional learning for students ages 3–8: Characteristics of effective social and emotional learning programs (part 1 of 4). Retrieved from https://ies.ed.gov/ncee/edlabs/projects/project.asp?projectID=443.

  • Oberle, E., Schonert-Reichi, K. A., & Zumbo, B. D. (2011). Life satisfaction in early adolescence: Personal neighborhood, school, family, and peer influences. Journal of Youth and Adolescence,40, 889–901. https://doi.org/10.1007/s10964-010-9599-1.

    Article  PubMed  Google Scholar 

  • Oosterhoff, B., Kaplow, J. B., & Layne, C. M. (2018). Links between bereavement due to sudden death and academic functioning: Results from a nationally representative sample of adolescents. School Psychology Quarterly,33, 372–380. https://doi.org/10.1037/spq0000254.

    Article  PubMed  Google Scholar 

  • Pannebakker, F. D., van Genugten, L., Diekstra, R. F. W., Gravesteijn, C., Fekkes, M., Kuiper, R., & Kocken, P. L. (2019). A social gradient in the effects of the skills for life program on self-efficacy and mental wellbeing of adolescent students. Journal of School Health,89(7), 587–595. https://doi.org/10.1111/josh.12779.

    Article  Google Scholar 

  • Penuel, W. R., Fishman, B. J., Yamaguchi, R., & Gallagher, L. P. (2007). What makes professional development effective? Strategies that foster curriculum implementation. American Educational Research Journal,44, 921–958. https://doi.org/10.3102/0002831207308221.

    Article  Google Scholar 

  • Perepletchikova, F., Axelrod, S. R., Kaufman, J., Rounsaville, B. J., Douglas-Palumberi, H., & Miller, A. L. (2011). Adapting dialectical behaviour therapy for children: Towards a new research agenda for paediatric suicidal and non-suicidal self-injurious behaviours. Child and Adolescent Mental Health,16(2), 116–121. https://doi.org/10.1111/j.1475-3588.2010.00583.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Perepletchikova, F., Nathanson, D., Axelrod, S. R., Merrill, C., Walker, A., Grossman, M., et al. (2017). Randomized clinical trial of dialectical behavior therapy for preadolescent children with disruptive mood dysregulation disorder: Feasibility and outcomes. Journal of the American Academy of Child and Adolescent Psychiatry,56(10), 832–840. https://doi.org/10.1016/j.jaac.2017.07.789.

    Article  PubMed  Google Scholar 

  • Powell, T., & Thompson, S. J. (2016). Enhancing coping and supporting protective factors after a disaster: Findings from a quasi-experimental study. Research on Social Work Practice,26(5), 539–549. https://doi.org/10.1177/1049731514559422.

    Article  Google Scholar 

  • R Core Team. (2017). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. Retrieved from http://www.R-project.org.

  • Ricard, R. J., Lerma, E., & Heard, C. C. (2013). Piloting a dialectical behavioral therapy (DBT) infused skills group in a disciplinary alternative education program (DAEP). The Journal for Specialists in Group Work,38, 285–306. https://doi.org/10.1080/01933922.2013.834402.

    Article  Google Scholar 

  • Robbins, A., Kaye, E., & Catling, J. (2018). Predictors of student resilience in higher education. Psychology Teaching Review,24(1), 44–52.

    Google Scholar 

  • Roepke, S., Schröder-Abé, M., Schütz, A., Jacob, G., Dams, A., Vater, A., et al. (2011). Dialectic behavioural therapy has an impact on self-concept clarity and facets of self-esteem in women with borderline personality disorder. Clinical Psychology and Psychotherapy,18(2), 148–158. https://doi.org/10.1002/cpp.684.

    Article  PubMed  Google Scholar 

  • Rojas-Andrade, R., & Bahamondes, L. L. (2018). Is implementation fidelity important? A systematic review on school-based mental health programs. Contemporary School Psychology. https://doi.org/10.1007/s40688-018-0175-0.

    Article  Google Scholar 

  • Rowe, H., & Trickett, E. J. (2018). Student diversity representation and reporting in universal school-based social and emotional learning programs: Implications for generalizability. Educational Psychology Review,30, 559–583. https://doi.org/10.1007/s10648-017-9425-3.

    Article  Google Scholar 

  • Sambrook, S., Abba, N., & Chadwick, P. (2007). Evaluation of DBT emotional coping skills groups for people with parasuicidal behaviours. Behavioural and Cognitive Psychotherapy,35(2), 241–244. https://doi.org/10.1017/S1352465806003298.

    Article  Google Scholar 

  • Schonfeld, D. J., Adams, R. E., Fredstrom, B. K., Weissberg, R. P., Gilman, R., Voyce, C., et al. (2015). Cluster-randomized trial demonstrating impact on academic achievement of elementary social-emotional learning. School Psychology Quarterly,30, 406–420. https://doi.org/10.1037/spq0000099.

    Article  PubMed  Google Scholar 

  • Schulte, A. C., Easton, J. E., & Parker, J. (2009). Advances in treatment integrity research: Multidisciplinary perspectives on the conceptualization, measurement, and enhancement of treatment integrity. School Psychology Review,38, 460–475.

    Google Scholar 

  • Shatkin, J. P., Diamond, U., Zhao, Y., DiMeglio, J., Chodaczek, M., & Bruzzese, J. M. (2016). Effects of a risk and resilience course on stress, coping skills, and cognitive strategies in college students. Teaching of Psychology,43(3), 204–210. https://doi.org/10.1177/0098628316649457.

    Article  Google Scholar 

  • Smith, A., Stewart, D., Poon, C., Peled, M., Saewyer, E., & McCreary Centre Society. (2014). From Hastings Street to Haida Gwaii: Provincial results of the 2013 BC Adolescent Health Survey. Vancouver, BC: McCreary Centre Society.

    Google Scholar 

  • Solomon, D., Battistich, V., Kim, D., & Watson, M. S. (1996). Teacher practices associated with students’ sense of the classroom as a community. Social Psychology of Education,1(3), 235–267.

    Article  Google Scholar 

  • Song, M. (2004). Two studies on the Resilience Inventory (RI): Toward the goal of creating a culturally sensitive measure of adolescent resilience. Dissertation Abstracts International: Section B - The Sciences and Engineering,64, 4089.

    Google Scholar 

  • Taylor, R. D., Oberle, E., Durlak, J. A., & Weissberg, R. P. (2017). Promoting positive youth development through school-based social and emotional learning interventions: A meta-analysis of follow-up effects. Child Development,88, 1156–1171. https://doi.org/10.1111/cdev.12864.

    Article  PubMed  Google Scholar 

  • Tippin, G. K., & Maranzan, K. A. (2019). Efficacy of a Photovoice-based video as an online mental illness anti-stigma intervention and the role of empathy in audience response: A randomized controlled trial. Journal of Applied Social Psychology. https://doi.org/10.1111/jasp.12590.

    Article  Google Scholar 

  • Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology,71, 1–20.

    Article  PubMed  Google Scholar 

  • Weist, M. D., Eber, L., Horner, R., Splett, J., Putnam, R., Barrett, S., et al. (2018). Improving multitiered systems of support for students with “internalizing” emotional/behavioral problems. Journal of Positive Behavior Interventions,20, 172–184. https://doi.org/10.1177/1098300717753832.

    Article  Google Scholar 

  • Worsley, J. D., McIntyre, J. C., & Corcoran, R. (2019). Cyberbullying victimisation and mental distress: Testing the moderating role of attachment security, social support, and coping styles. Emotional and Behavioural Difficulties,24(1), 20–35. https://doi.org/10.1080/13632752.2018.1530497.

    Article  Google Scholar 

  • Yang, X., & Mak, W. W. S. (2017). The differential moderating roles of self-compassion and mindfulness in self-stigma and well-being among people living with mental illness or HIV. Mindfulness,8(3), 595–602. https://doi.org/10.1007/s12671-016-0635-4.

    Article  Google Scholar 

  • Yoon, K. S., Duncan, T., Lee, S. W. Y., Scarloss, B., & Shapley, K. (2007). Reviewing the evidence on how teacher professional development affects student achievement (Issues & Answers, REL 2007, No. 033). Washington, DC: Institute of Education Sciences.

    Google Scholar 

  • Zapolski, T., & Smith, G. T. (2017). Pilot study: Implementing a brief DBT skills program in schools to reduce health risk behaviors among early adolescents. The Journal of School Nursing,33, 198–204.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by funding from the University of British Columbia and the Social Sciences and Humanities Research Council of Canada (SSHRC Insight Grant #435-2018-0428).

Author information

Authors and Affiliations

  1. Department of Educational and Counselling Psychology and Special Education, University of British Columbia, #2420-2125 Main Mall, Vancouver, BC, V6T 1Z4, Canada

    Jennifer Katz, Sterett H. Mercer & Sarah Skinner

Authors
  1. Jennifer Katz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sterett H. Mercer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarah Skinner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer Katz.

Ethics declarations

Conflict of interest

As the author of the book “Ensouling Our Schools”, in which the intervention herein evaluated is published, Dr. Katz receives royalties from sales of the book. For this reason, Ms. Skinner collected and entered all data, and Dr. Mercer conducted all statistical analyses, in order to ensure unbiased evaluation occurred. Dr. Katz was involved in teacher training, and all teachers in the study were provided with the book free of cost. We are prepared to include as supplementary material a manual with the lesson plans for the program, so as not to require your readers to purchase the book should they wish to replicate the study.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. University ethics approval was granted from the University of British Columbia Behavioral Research Ethics Board Certificate # H16-02623. Both school districts also formally approved the research.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Consent was received from the school districts, principals, teachers, and parents of students involved in the study using approved consent forms from UBC. Student assent was also sought and received. At each data collection point, students were reminded that participation was voluntary, and they could withdraw at any time.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Katz, J., Mercer, S.H. & Skinner, S. Developing Self-concept, Coping Skills, and Social Support in Grades 3–12: A Cluster-Randomized Trial of a Combined Mental Health Literacy and Dialectical Behavior Therapy Skills Program. School Mental Health 12, 323–335 (2020). https://doi.org/10.1007/s12310-019-09353-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12310-019-09353-x

Keywords

Search

Navigation