Client Progress Monitoring and Feedback in School-Based Mental Health

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Highlights

  • Research in evidence-based practice tends to focus on treatment protocols and less on evidence-based assessment

  • Progress monitoring is an important aspect of evidence-based assessment

  • We describe two studies on school-based mental health and progress monitoring

  • The ‘lessons learned’ from project implementation are described

  • Recommendations are provided for incorporating mental health and academic indictors in progress monitoring

Abstract

Research in children’s mental health has suggested that emotional and behavioral problems in are inextricably tied to academic difficulties. However, evidence-based programs implemented in school-based mental health tend to focus primarily on treatment practices, with less explicit emphasis on components of evidence-based assessment (EBA), such as progress monitoring and feedback. The current paper describes two studies that incorporated standardized assessment and progress monitoring/feedback into school-based mental health programs. Barriers to implementation are identified, recommendations for clinicians implementing EBA in the school setting are provided, and examples of mental health and academic indicators are discussed.

Section snippets

EBA Principles and Evidence

Notably, the definition of EBA provided above includes both methods and processes for care. When referencing methods, EBA includes (a) standardized assessment tools, which have empirical support for their reliability, validity, and clinical utility (Jensen-Doss & Hawley, 2010), and (b) idiographic assessment approaches, defined as quantitative variables that have been individually selected or tailored to maximize their relevance for a particular individual (Haynes, Mumma, & Pinson, 2009).

EBA in School-Based Mental Health

Within an SBMH framework, EBA is an important element of effective service delivery, the principles and characteristics of which are consistent with leading models of educational interventions. For instance, EBA—and, in particular, progress monitoring—is highly compatible with the increasingly popular Response to Intervention (RtI; Bradley, Danielson, & Doolittle, 2007) frameworks in schools. RtI is a model for best practice in the education field, which incorporates data collection and

Aims of the Current Paper

Given the underutilization of EBA processes and tools in SBMH settings, the aims of the current paper are to (a) provide an overview of two projects implementing progress monitoring and feedback in schools within the context of modular psychotherapy (described below); (b) describe the principles of progress monitoring that informed those projects, relevant data about the EBA processes, and provide recommendations for monitoring and feedback in schools; and (c) describe barriers that were

Behavioral Education Systems Training (B.E.S.T.)

The overarching purpose of the B.E.S.T. project was to develop and provide a continuum of emotional and behavioral supports and interventions for children by building a unified network of mental health and school professionals trained to utilize evidence-based practices (EBPs). Given the emphasis on EBPs, EBA tools and processes of EBA were introduced throughout training and consultation. In addition, at the initiation of the project, schools within the participating district were at varying

Current and Future Directions

There are a number of recommendations for current and future directions that can be made based on the lessons learned within the B.E.S.T. and Excellence projects. These recommendations are summarized in Table 1 and also relevant to the EBA literature (e.g., Lyon, Borntrager, et al., 2013). For example, given the difficulties encountered relevant to clinician comfort and knowledge of EBA and its uses, SBMH agencies would benefit from specific, ongoing professional development in the tools and

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  • This publication was made possible, in part, by funding from the Montana Mental Health Settlement Trust grant entitled “Comprehensive Training Network for Children’s Mental Health Services” awarded to the first author and also by grant number K08 MH095939, awarded to the second author from the National Institute of Mental Health.Dr. Lyon is also an investigator with the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI).

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