Many adults suffering from mental health problems often report that the onset of these concerns began in adolescence, highlighting the importance of identifying and treating mental health concerns from an early age. In high schools, some students are identified as having externalizing or internalizing disorders. The majority of these students, especially those with internalizing symptoms, go untreated. One potential reason may be that limited school resources are used to correct behavior problems, leaving those with internalizing disorders to silently suffer, which often exacerbates the issues. Recent research suggests many individuals have high levels of resilience which can be taught, and which positively contributes to mental health. Social emotional learning (SEL) is one approach to teaching resilience. In this study we implemented an SEL program called Strong Teens at the high school level. The high school identified students with internalizing symptoms and provided them with this curriculum, intended to reduce those symptoms. We used a time series design to evaluate changes in internalizing symptoms (e.g., depression, anxiety, and withdrawal) and resilience. Results indicated that with the implementation of the Strong Teens curriculum, student levels of internalizing symptoms decreased from pretest to posttest, according to self-report. Teacher reports did not indicate any significant change in internalizing symptoms or resilience. This study supports the findings o fthe Strong Teens curriculum as a generalizable program which significantly reduces internalizing symptoms.

There is compelling evidence that helping adolescents develop certain traits (especially related to resiliency) can mitigate the confounding effects of suicide. Specific demographics of youth appear to have higher rates of suicidal behavior including those with mental health diagnoses and educational disabilities that affect students' academic achievement. We looked at evidence based social and emotional learning programs (SEL) that fostered adaptive coping skills and resilience. We identified Strong Teens (Carrizales-Engelmann, Merrell, Feuerborn, Gueldner, & Tran, 2016) as a program that could be easily administered and adapted into traditional and nontraditional school settings. This study was conducted in a residential treatment center (RTC) for adolescent males. The RTC permitted one of their therapists to implement the Strong Teens over the course of two consecutively run groups. Group 1 included seven boys and Group 2 included four boys. We relied on the therapist's self-assessment of modifications made to the program; the researcher's field notes collected during observations; emails between the therapist and researcher; the researcher's notes taken during conversations between the therapist and researcher; monthly Youth Outcome Questionnaire Self Report (Y-OQ-SR) test scores; youth Strong Teens pre and post test scores; and youth exit surveys conducted in one-one interviews at the conclusion of the Strong Teens lessons. Fidelity of program implementation was measured by the therapist and researcher completing the Strong Teens fidelity checklist (included in the Strong Teens manual). Based on collected data, we make the following recommendations: Adapt the Strong Teens program to increase student participation and receptiveness; carefully consider the size of the group, taking into account the capacity of the group leader to manage the group's behaviors and attend to individual needs; consider conducting groups sessions in settings that help youth feel safe and comfortable--groups held outside may be preferable to groups held inside classrooms; mental health professionals and teachers who lead the Strong Teens lessons may consider learning about a variety of basic therapeutic strategies and how these strategies might fit participants' needs; when evaluating the effectiveness of Strong Teens, carefully gather, consider, and contextualize a variety of data (quantitative and qualitative) from a variety of sources (youth participants, group leaders, and others who interact with the youth); in addition to focusing on teaching information and skills, group leaders must consider motivational strategies; focus initial conversations on why one would use such strategies to benefit oneself--later conversations may expand to include how strategies benefit others.

Strong Teens is a curriculum designed to help students develop the social-emotional skills needed to manage challenges and become successful socially and academically (Carrizales- Engelmann et al., 2016). Strong Teens has shown promise among adolescents, but this was the first study to evaluate the newly updated version of the intervention in a high school setting. The curriculum was implemented by a special education teacher with students at-risk for emotional and behavioral disorders. A mixed method design was used to evaluate outcomes with 16 ninth grade students. Overall findings suggest that Strong Teens was effective at improving students' social emotional knowledge over a 3-month period. However, there was a worsening of students' internalizing symptoms and teacher-student relationships. The teacher implemented the curriculum with low to moderate fidelity. Students were mostly neutral in their view of Strong Teens, while the teacher held a more favorable view. Future studies should include a larger sample size, offer training to educators on the implementation of Strong Teens, and consider using a more effective collection method to ensure students' anonymity.