Consultants’ Perceptions of School Counselors’ Ability to Implement an Empirically-Based Intervention for Adolescent Social Anxiety Disorder

Abstract

Social anxiety is highly prevalent but goes untreated. Although school-based CBT programs are efficacious when delivered by specialized psychologists, it is unclear whether school counselors can implement these interventions effectively, which is essential to promote sustainable school programs. We present an initial consultation strategy to support school counselor implementation of group CBT for social anxiety and an evaluation of counselors’ treatment fidelity. Counselors were highly adherent to the treatment, but competence varied based on measurement. Counselors and consultants demonstrated good agreement for adherence, but relatively modest correspondence in competence ratings. We discuss future directions for school-based implementation efforts informed by these initial findings.

Interpersonal Counseling in the Treatment of Adolescent Depression: A Randomized Controlled Effectiveness and Feasibility Study in School Health and Welfare Services

“…It may be that IPC counselors need more training in the IPC in order to use IPC techniques effectively. Similarly, in a previous study, the novelty of treatment-specific components influenced school counselors' ability to implement a CBTbased program (Masia Warner, Brice, Esseling, Steward, Mufson, & Herzig, 2013). This might be a possible reason for not obtaining differences between the IPC and BPS.…”

Implementation Science in School Mental Health: Key Constructs in a Developing Research Agenda

“…For example, there may be unique benefits to audit and feedback procedures (Ivers et al, 2012) that could be borrowed from the healthcare field and applied to SMH. Similarly, there may be added value in training implementers to self-monitor integrity and compare such ratings to those made by a coach to determine the most effective dose and type of coaching (Masia Warner et al, 2013). …”

“…A third issue is highlighted by studies indicating that adherence is variable (e.g., Owens, Murphy, Richerson, Girio, & Himawan, 2008) and declines rapidly in the absence of ongoing coaching or accountability for teachers as implementers (e.g., Noell, Witt, Gilbertson, Ranier, & Freeland, 1997) or SMH professionals as implementers (e.g., Masia Warner et al, 2013). Given that this variability and decline are documented under monitored research conditions, these rates likely underrepresent the true variability and decline that occurs in everyday practice.…”

“…Yet, the knowledge base to illuminate what adaptations lead to success versus failure in SMH is sparse. Further, for many EBPs, core components have yet to be identified (Masia Warner et al, 2013). Given that adaptation influences PD and coaching processes (i.e., which content and skills to promote), integrity (i.e., which activities to monitor), and sustainment (i.e., which activities continue), documenting adaptations and examining their impact may become a common requirement of future IS studies.…”

Social Anxiety and Phobia in Adolescents

“…Information is also lacking regarding what level of treatment quality is suffi cient to produce positive student outcomes. Examining links between treatment elements, program quality, and clinical outcomes will help determine critical treatment features and priorities for training (Masia Warner et al 2013 ). Such research advances have the potential to result in more empirically informed approaches to training and consultation that may be effective, yet less labor intensive.…”