Iterative refinement and testing of a brief school-based intervention for internalizing symptoms via an academic-community partnership
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[EMBARGOED UNTIL 12/01/2024] Integrating evidence-based practices (EBPs) for youth mental health into routine school-based services has the potential to improve youth's access to high-quality mental health care. However, EBPs may need to be refined to reduce provider burden for successful delivery in schools. Active collaboration among school staff and treatment developers is crucial in this unique implementation context. The present study tested a second school-based iteration of Show Me FIRST, a package of common therapy elements with research support for youth internalizing problems. Based on quantitative results and qualitative feedback from providers in the randomized trial for the first iteration of Show Me FIRST, refinements were made to the treatment and implementation procedures. The refined Show Me FIRST intervention was then compared to usual care in 69 youth with elevated internalizing symptoms in a randomized between-groups trial. Seventy-six percent of youth received at least five of the six Show Me FIRST modules. Youth who received Show Me FIRST reported significantly better internalizing symptoms post-intervention compared to youth who received usual care, covarying for pre-intervention scores. For Show Me FIRST youth, session number predicted decreases in youth- and provider-reported severity ratings of their top problems. Providers' implementation experience was explored via thematic analysis. School-based interventions that are tailored to maximize their acceptability and feasibility while retaining their integrity and efficacy may help bridge the research-to- practice gap in youth mental health services.
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M.A.