Evidence-Based Mental Health Programs in Schools: Barriers and Facilitators of Successful Implementation

Abstract

Although schools can improve children’s access to mental health services, not all school-based providers are able to successfully deliver evidence-based practices. Indeed, even when school clinicians are trained in evidence-based practices (EBP), the training does not necessarily result in the implementation of those practices. This study explores factors that influence implementation of a particular EBP, Cognitive Behavioral Intervention for Trauma in Schools (CBITS). Semi-structured telephone interviews with 35 site administrators and clinicians from across the United States were conducted 6–18 months after receiving CBITS training to discuss implementation experiences. The implementation experiences of participants differed, but all reported similar barriers to implementation. Sites that successfully overcame such barriers differed from their unsuccessful counterparts by having greater organizational structure for delivering school services, a social network of other clinicians implementing CBITS, and administrative support for implementation. This study suggests that EBP implementation can be facilitated by having the necessary support from school leadership and peers.

Assessing the Role of Faith-Based Organizations in Health Promotion

“…Thus, researchers must invest more time and resources in order to reach organizational members. This study supported findings in the literature, that despite an organization's position on the readiness continuum, several barriers may exist, including: program execution, long-term maintenance of behavioral elements, and sustainability (Langley, Nadeem, Kataoka et al, 2010;Weiner, 2009;Glasgow, Lichtenstein, & Marcus, 2003;Shediac-Rizkallah & Bone, 1998).…”

“…Specifically, the level of participant "buy-in" is an important consideration for program success (Langley, Nadeem, Kataoka et al, 2010). Even if an organizational entity is prepared, structurally speaking, to engage in health promotion initiatives, as demonstrated, many factors could impede progress.…”

“…When risk is not apparent, individuals are less likely to take action; additionally, they must realize that the proposed lifestyle change is beneficial (Glanz, Rimer, & Lewis, 2002). In addition to the aforementioned notion, confidence may also impact personal application because individuals must believe they possess the ability to conquer the intended objectives (Langley, Nadeem, Kataoka et al, 2010;Glanz, Rimer, & Lewis, 2002). Weiner (2009) suggests that organizational readiness to change may be greatest when individuals are motivated and self-assured.…”

“…This is because health literacy transcends ethnicity, finances, and age (Speros, 2005). Also noted are circumstantial issues which should be considered in the program execution phase (Langley, Nadeem, Kataoka et al, 2010;Weiner, 2009). An evaluation of a group-based psychological well-being initiative explicitly outlined barriers to successful program execution, which included: conflicting obligations and beliefs about the program (Langley, Nadeem, Kataoka et al, 2010).…”

Exploring Grade 3 Teachers’ Perspectives on the Acceptability and Efficacy of MindMasters 2

“…Time was often cited by teachers as a barrier, and is reported in other school-based programs (i.e. Fixsen, Naoom, Blasé, Friedman, & Wallace, 2005;Langley, Nadeem, Kataoka, Stein, & Jaycox, 2010). Fortunately, activities found within the MindMasters 2 resource are relatively short, ranging from 5 to 15 minutes in length.…”