Academic journal article The Professional Counselor

Counseling Self-Efficacy, Quality of Services and Knowledge of Evidence-Based Practices in School Mental Health

Academic journal article The Professional Counselor

Counseling Self-Efficacy, Quality of Services and Knowledge of Evidence-Based Practices in School Mental Health

Article excerpt

There are major gaps between the mental health needs of children and adolescents and the availability of effective services to meet such needs (Bums et al., 1995; Kataoka, Zhang, & Wells, 2002). This recognition is fueling efforts to improve mental health services for youth in schools (Mellin, 2009; Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007). At least 20% of all youth have significant mental health needs, with roughly 5% experiencing substantial functional impairment (Leaf, Schultz, Kiser, & Pruitt, 2003). Further, less than one third of children with such mental health needs receive any services at all.

The President's New Freedom Commission on Mental Health (2003) documented the position of schools as a point of contact and universal natural setting for youth and families, recognizing schools as a key factor in the transformation of child and adolescent mental health services (Stephan et al, 2007). In the past 2 decades, there has been a significant push for full-service schools that expand beyond a sole focus on education, and employ community mental health practitioners to respond to the emotional and behavioral needs of students (Conwill, 2003; Dryfoos, 1993; Kronick, 2000). The education sector is the most common provider of mental health services for children and adolescents (Farmer, Bums, Phillips, Angold, & Costello, 2003), with 70%-80% of youth who receive any mental health services obtaining them at school (Bums et ah, 1995; Rones & Hoagwood, 2000). Therefore, attention must be paid to the quantity, quality and effectiveness of school mental health (SMH) services.

School Mental Health

In recent years, SMH programs, supported by both school staff (e.g., school psychologists, social workers, counselors) and school-based community mental health clinicians, have emerged as a promising approach to the provision of mental health services for students and families (Weist, Evans, & Lever, 2003). The growth of these programs has facilitated investigation of what constitutes high-quality SMH service provision (Nabors, Reynolds, & Weist, 2000; Weist et al., 2005). This work has been supported and furthered by the Center for School Mental Health, a federally funded technical assistance and training program to advance SMH programs within the United States. In collaboration with other SMH centers (e.g., UCLA Center for Mental Health in Schools) and interdisciplinary networks focused on school health, consensus was reached to develop a guiding framework defining best practices in SMH (Weist et al, 2005). These principles call for appropriate service provision for children and families, implementation of interventions to meet school and student needs, and coordination of mental health programs in the school with related community resources, among other things. For further explication of the framework and its development, see Weist et al. (2005).

Simultaneously, research developments through the Center for School Mental Health facilitated implementation of modular evidence-based practices (EBP; see Chorpita, Becker & Daleiden, 2007; Chorpita & Daleiden, 2009). A modular approach for intervention involves training clinicians in core, effective strategies for disorders frequently encountered in children (e.g., attention-deficit/hyperactivity disorder [ADHD], anxiety, depression, disruptive behavior disorders [DBD]). This approach enables individualized, flexible implementation of evidence-based strategies without the constraints of a manualized approach (Curry & Reinecke, 2003). The third guiding component to enhance quality in SMH practices is development of strategies to effectively engage and empower families (see Hoagwood, 2005).

Despite the development of such a framework, SMH clinicians often struggle to implement high-quality, evidence-based services (Evans et al, 2003; Evans & Weist, 2004). These clinicians are constrained by a lack of sufficient time, training in EBP, appropriate supervision, and internal and external resources (Shemoff, Kratchowill & Stoiber, 2003). …

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