Elsevier

Behavior Therapy

Volume 46, Issue 6, November 2015, Pages 844-855
Behavior Therapy

Developing Partnerships in the Provision of Youth Mental Health Services and Clinical Education: A School-Based Cognitive Behavioral Intervention Targeting Anxiety Symptoms in Children☆

https://doi.org/10.1016/j.beth.2015.07.003Get rights and content

Highlights

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    Collaborative project on mental health service delivery and clinical education

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    Examined effectiveness of school-based intervention for child anxiety against standard curriculum

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    Intervention reduced children’s anxiety symptoms compared to no change over time for standard curriculum

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    Intervention, but not standard curriculum, improved children’s perceptions of their social skills and coping estimates

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    Postintervention effects did not change by 12-month follow-up assessment

Abstract

Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5 children’s anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate students. Children in the active condition (N = 74) completed the CBI during regular class time, while children in the control condition (N = 77) received the standard classroom curriculum. Children’s anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12 months after the CBI (n = 76), symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education.

Section snippets

Participants

The present study formed part of an ongoing collaboration between the University and the Education Department. Children were recruited from a local primary school following approvals from the University, Education Department, and school principal. The school is a large, co-educational school for students in grades Prep to 12, including students from a range of ethnic and socio-economic backgrounds. All children in grade 5 over 2 consecutive years (N = 243) received the intervention during regular

Preliminary Comparisons

As shown in Table 1, there were no significant differences as a function of Condition (active; control) in children’s age, t(149) = .88, p = .38, gender, χ2 = 0.01, p = .91, or the country they were born in, χ2 < 2.40, p = .12. According to parent report on the family information sheet, there were no significant differences between the active and control conditions in how many children had previous mental health diagnoses (e.g., Asperger’s, posttraumatic stress disorder, dyspraxia), χ2 = 0.18, p = .67,

Discussion

The present study found that an evidence-based CBI for anxiety symptoms that was coordinated and implemented by staff and clinical students within a school-based psychology clinic arising from a partnership between the University and the Education Department produced a number of significant benefits. Children’s self-reported anxiety symptoms and perceptions of their social skills, as well as the number of children with high levels of anxiety symptoms, all declined significantly, and children’s

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

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    Thanks are due to the supportive staff at the participating primary school and the clinical psychology postgraduate interns for their assistance during this project.

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