Abstract
Mental health treatment in schools has the potential to improve youth treatment access. However, school-specific barriers can make implementing evidence-based interventions difficult. Task-shifting (i.e., training lay staff to implement interventions) and computer-assisted interventions may mitigate these barriers. This paper reports on a qualitative examination of facilitators and barriers of a school-based implementation of a computer-assisted intervention for anxious youth (Camp Cope-A-Lot; CCAL). Participants (N = 45) included school staff in first through fourth grades. Providers attended a training in CCAL and received weekly, hour-long group consultation calls for 3 months. In the second year, the sustainability of CCAL use was assessed. Qualitative interviews were conducted after the first year (initial implementation) and second year (sustainability). Interviews were analyzed using the Consolidated Framework for Implementation Research domains to classify themes. Although participants reported that CCAL included useful skills, they expressed concerns about recommended session length (45 min) and frequency (weekly). Time burden of consultation calls was also a barrier. School staff facilitated implementation by enabling flexible scheduling for youth to be able to participate in the CCAL program. However, the sustainability of the program was limited due to competing school/time demands. Results suggest that even with computer-assisted programs, there is a need to tailor interventions and implementation efforts to account for the time restrictions experienced by school-based service providers. Optimal fit between the intervention and specific school is important to maintain the potential benefits of computer-assisted treatments delivered by lay service providers in schools.
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This project was funded by a National Institute of Mental Health (NIMH) research grant awarded to Philip C. Kendall (R01MH086438). Manuscript preparation was supported by NIMH grants (F31MH124346 to Mrs. Crane; F31MH123038 to Mrs. Norris; F31MH112211 to Dr. Frank). Dr. Kendall receives royalties from the sales of published materials related to the treatment of youth, and his spouse operates and receives income from the publisher.
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Crane, M.E., Phillips, K.E., Maxwell, C.A. et al. A Qualitative Examination of a School-Based Implementation of Computer-Assisted Cognitive-Behavioral Therapy for Child Anxiety. School Mental Health 13, 347–361 (2021). https://doi.org/10.1007/s12310-021-09424-y
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DOI: https://doi.org/10.1007/s12310-021-09424-y