This paper reports on an evaluation of dialectical behavior therapy and structured psychotherapy for adolescents responding to crisis as part of an enhanced treatment method used in schools, compared with standard school-based mental health services, and expanded treatment; it discusses the project’s methodology and its mixed results in student and staff sentiment.
Many schools offer mental health services, which vary between schools, but often include access to counselors, psychologists, or social workers who can provide prevention programming, early identification of mental health challenges, and treatment options. Two particular types of evidence-based treatments, dialectical behavior therapy and structured psychotherapy for adolescents responding to crisis, have the potential to benefit students, but their efficacy in the school setting has not yet been tested. National Institute of Justice-funded researchers from RTI International partnered with Charlotte-Mecklenburg Schools in North Carolina to conduct a randomized controlled trial focusing on evaluating the use of these types of mental health services in schools to help address safety. The study examined three levels of school-based mental health treatments: treatment as usual, expanded treatment, and enhanced treatment. The expanded and enhanced treatments did not result in the outcomes that the researchers had anticipated. The intensive training and time commitment that was required to implement the interventions may have reduced the amount of time providers could spend with the students. Researchers posit that meeting students’ mental health care needs and improving safety in their schools may require additional providers with more time to devote to the provision of school-based mental health services.