This study examined the effectiveness of a school-based intervention process known as Prevent-Teach-Reinforce for children with a combination of externalizing and internalizing behaviors compared to children with only externalizing behaviors. The dependent variables examined were social skills, problem behaviors, and academic engaged time. Data for the current study were taken from archival data collected by the Florida Mental Health Institute that included students in kindergarten through 8th grade. A series of repeated-measures analysis of variance (ANOVA) was used to identify differences in improvement on the dependent variables for the two groups of students. Research questions focused on the main effects as well as interaction effects between the type(s) of behavioral problems displayed (i.e., externalizing only, combination of externalizing and internalizing). Behavior problem classification was determined by calculating students' individual subscale scores on the Social Skills Rating Scale. The current study found support for the use of the Prevent-Teach-Reinforce intervention for children with varying behavioral profiles. Significant improvements were found in social skills, behavioral problems, and academic engaged time for students. Additionally, results of this study indicate that internalizing behaviors did not serve as a moderator to treatment effectiveness for students with externalizing behavior problems who received the PTR intervention. That is, improvements were similar for both groups, demonstrating that PTR is a process that can be used in an equally-effective way for both populations.

Background: Difficulties with anxiety among children and young people are common and can impact upon their developmental trajectory leading to adverse outcomes in later life. There is, therefore, a need to increase access to early intervention services. Existing research has indicated that school-based cognitive behavioural interventions are effective for children and young people experiencing difficulties with anxiety, yet there remains a proportion of the population for whom they are not effective. In addition, there is a lack of research on how these may be implemented in real world settings as opposed to a research trial. The present research focuses on the provision of cognitive behavioural school-based interventions in two parts: a systematic review of psychological, interpersonal and social variables as predictors, mediators and moderators of mental health outcomes following a school-based intervention and an empirical mixed methods evaluation of the facilitators and barriers to the implementation of a school-based intervention. Method: A systematic search of electronic databases for studies examining interpersonal, psychological and social predictors, moderators and mediators of mental health outcome following school-based cognitive behavioural interventions was conducted. Effect sizes for these analyses were calculated and the quality of eligible studies was assessed using a standardised rating tool. Within the empirical project, the implementation of a school-based cognitive behavioural intervention was evaluated through a mixed methods approach. Semi-structured interviews with stakeholders in the intervention were analysed using grounded theory integrated with framework analysis. Quantitative data on the reach of the intervention, practitioner evaluation of training and coaching as well as routine outcome measures from children and young people receiving the intervention was collected. Results: Within the systematic review, twenty-two studies (N=22) met the predefined eligibility criteria. There was heterogeneity in the variables explored, effect size of these on treatment outcome and the quality of the literature within the included studies. Cognitive style was found to mediate treatment outcome, but there was limited evidence for other predictors, mediators and moderators of treatment outcome within the review. Quantitative results of the empirical project indicated that the model of the intervention was acceptable to both practitioners and children and young people, and preliminary data indicated a significant improvement in mental health outcomes. Facilitators that emerged from qualitative data included an enabling context, therapeutic engagement, motivation and congruence, self-efficacy and containment and encouragement. The exclusivity of the intervention, a lack of systemic understanding and transparency as well as demands and pressure on resources were barriers to implementation. Conclusions: Although preliminary evidence for potential predictors, mediators and moderators is presented, further research with improvements in the design and reporting of explanatory variables on treatment outcome is required prior to informing clinical decision-making. The successful implementation of school-based interventions requires multi-agency integration and collaboration as well as on-going support in managing systemic pressures and skill development.

This study examined the effectiveness of child centered play therapy (CCPT) with academically at-risk 1st graders. In this quasi-experimental design, twenty-one 1st grade students were assigned to the experimental group and 20 students were assigned to the no treatment control group. The children in the experimental group received two 30 minute play therapy sessions per week for the duration of eight weeks. Three hypotheses were analyzed. A two-factor repeated measures analysis of variances (SPANOVA) were performed on each dependent variable to determine if the experimental group performed differently from the control group across time according to the pretest and posttest results of the Young Child's Achievement Test (YCAT), the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSAYC), and the Student-Teacher Relationship Scale (STRS). Additionally, partial η2 was calculated to determine practical significance. One hypothesis was retained at the .05 level of significance. Findings indicated that academically at-risk 1st graders who participated in CCPT scored statistically significant higher on academic achievement. Specifically, children assigned to the experimental group demonstrated a statistically significant increase in Early Achievement Composite (p = .03) when compared to children assigned to the no treatment control group. No statistical significant results were found on Self-Concept and Student-Teacher Relationship Stress.