Student Outcomes of Integrative Mental Health Services

President and Fellows of Harvard College

Status: Completed

Conditions: Behavior Problems; Trauma; Depression; Anxiety

Treatments: Other: Monitoring and Feedback System; Behavioral: Treatment as usual; Behavioral: Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, and Conduct Problems

Study type: Interventional

Funder types: Other

Identifiers

NCT02877875

R305A140253

Details and patient eligibility

About

The study will compare the impact of Child STEPs (see Weisz et al., 2012) versus usual school-based therapy on students' mental health and school-related outcomes, and test whether changes in school outcomes are mediated by changes in student mental health.

Full description

This project will implement and evaluate the Child STEPs (see Weisz et al., 2012) treatment approach through a randomized controlled trial (RCT) at 27 K-8 public schools. The STEPs model has two components: (1) a modular protocol that combines 33 modules-i.e., descriptions of common elements within evidence-based therapies for anxiety, depression, post-traumatic stress, and conduct problems; and (2) a web-based system for monitoring student responses to treatment and providing weekly feedback to therapists, to guide their selection and sequencing of the STEPs modules. The project will include an evaluation of the effectiveness of STEPS compared to "treatment as usual" (known as Usual Care or UC) on students' mental health and school-related outcomes, and an analysis of whether changes in school outcomes are mediated by changes in student mental health.

Enrollment: 143 patients

Sex: All

Ages: 7 to 14 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Enrolled in grades 2-7
2. Have a primary clinical problem in the areas of anxiety, depression, conduct, or posttraumatic stress
3. Clinically elevated problem levels on the Internalizing, Externalizing, Anxious-Depressed, Withdrawn-Depressed, Aggressive Behavior, or Rule-Breaking Behavior scales of the Child Behavior Checklist or Youth Self-Report or on the UCLA Post-traumatic Stress Disorder Reaction Index

Exclusion criteria

1. Mental retardation
2. Pervasive developmental disorder
3. Eating disorders
4. Children for whom attention problems or hyperactivity are the primary referral concern
5. Active psychosis and/or a suicide attempt in the previous year

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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143 participants in 2 patient groups

Child STEPS

Experimental group

Description:

Child STEPs includes (1) a treatment protocol, Modular Approach to Therapy for Children with Anxiety, Depression, Trauma or Conduct Problems (MATCH-ADTC;Chorpita \& Weisz, 2009), and (2) a youth monitoring and feedback system (MFS).

Treatment:

Other: Monitoring and Feedback System

Behavioral: Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, and Conduct Problems

Usual Care

Active Comparator group

Description:

Treatment in the UC condition will use the procedures therapists and their supervisors consider appropriate and believe to be effective, and researchers will not influence their work.

Treatment:

Behavioral: Treatment as usual