Aidyn L. Iachini

Background: Despite the demonstrated effectiveness of school-based behavioral, social-emotional and mental health interventions, implementation in real-world settings is often disappointing. Implementation strategies are key to attaining desired outcomes. This scoping review examined the distribution of peer-reviewed research on implementation strategies for school behavioral health interventions within a multi-tiered framework, disaggregating the body of research by intervention intensity (e.g., universal/Tier 1, targeted/Tier 2, intensive/Tier 3) and content area (e.g., externalizing problems, internalizing problems, social-emotional competencies) to identify patterns and gaps that will inform directions for future research. Methods: Three academic databases were searched for empirical, peer-reviewed articles published in English between 2011 and 2024 examining implementation strategies for school interventions targeting internalizing, externalizing, or social-emotional outcomes. Only articles with at least one implementation outcome were included. The School Implementation Strategies Translating ERIC Resources (SISTER) compilation guided coding of strategies. Data were also extracted on study characteristics (location, design, sample, setting), intervention characteristics (intervention name/description, intensity/tier, and content area), implementation strategy characteristics (actor, action, action target, temporality, dose, outcome, and justification), and findings. Results: Based on a review of 78 articles, findings indicated that 33 distinct implementation strategies were investigated, either singularly or in combination with other strategies. Most of the articles focused on support strategies for interventions that targeted externalizing behavior, with relatively few examining strategies for internalizing or social-emotional interventions. More of the research focused on universal (Tier 1) interventions than on targeted (Tier 2) or intensive (Tier 3) interventions. Conclusions: Recent increases in youth internalizing problems, though troubling, were not reflected in the observed distribution of implementation strategies in the research on school behavioral health interventions. Improving outcomes for all youth necessitates greater research on implementation strategies for intensive social-emotional and mental health interventions to achieve a full continuum of quality supports and services. Registration: This review was registered with Open Science Framework.

Youth mental health (MH) needs have intensified in the United States since the COVID-19 pandemic, with rural youth experiencing disproportionately high suicide rates and persistent barriers to MH care. Because schools often serve as a primary access point for identifying and addressing MH concerns, school mental health professionals (SMHPs) serve a critical role, especially in rural contexts. Unfortunately, however, many receive limited preparation for the practical realities of rural school MH (SMH) practice. This study sought to understand how SMHPs working in rural schools in one southeastern state navigate the challenges they encounter in delivering youth MH care. Secondary data collected from 15 semi-structured interviews were analyzed using a constructivist grounded theory approach. Findings highlighted four interconnected categories of navigation strategies: (1) orienting through identity and mindset, (2) building relational foundations, (3) educating oneself and others, and (4) delivering services and navigating systems. These findings position rural SMHPs as strategic navigators who legitimize and sustain their work through internal grounding, relational processes, knowledge translation, and adaptive service delivery. Implications are discussed for school and district practices that support rural SMH, graduate training and professional preparation of SMHPs, and future research on SMHP navigation strategies in rural school contexts.

Objectives: While school-based mindfulness programs (SBMP) have been shown to improve youth mental and behavioral health, their implementation in low-income schools remains poorly understood. This scoping review aimed to synthesize existing evidence on the barriers and facilitators to SBMP implementation in PreK-12, low-income schools in the United States, applying the Consolidated Framework for Implementation Research (CFIR) to map extracted evidence and identify actionable strategies for SBMP research and practice. Method: The searches were conducted in PsycINFO, ERIC, PubMed, and Web of Science. Study characteristics were summarized and qualitative data on implementation barriers and facilitators were extracted and analyzed using the CFIR. Results: Seven articles met the inclusion criteria and were included in the qualitative synthesis. A total of 53 implementation factors were mapped onto the CFIR, with 34 (64%) identified as facilitators and 19 (36%) as barriers. All studies discussed implementation factors related to the inner setting, such as classroom noise and peer pressure. Most ( n = 5, 71%) identified factors related to innovation characteristics, individual characteristics, and the implementation process. Only two studies (n = 2, 29%) reported outer setting factors, such as collaboration with community organizations to support implementation. Conclusions: Findings highlight the complexity of implementing SBMPs in low-income settings, emphasizing the need for researchers and schools to assess potential barriers and facilitators across different CFIR domains and to integrate these considerations into implementation planning for SBMPs. Implications for mindfulness research in low-income school settings are discussed. Preregistration: This study was not preregistered.

Mental health and substance use are nationwide public health concerns and the leading causes of disease burden in the United States (US; Fish & Mittal, 2021; Healthy People, 2021). Estimates sugges...

Student mental health needs continue to rise across the United States and many students and families rely on schools to provide services to meet these needs. Yet, an overwhelming number of available frameworks and approaches to school mental health (SMH) and overlapping terminology surrounding SMH supports like trauma‐informed (TI) approaches, social and emotional learning (SEL), and others can lead to confusion and potentially less effective implementation of services and supports for students. In this paper, we aim to mitigate this confusion and offer a solution that integrates several of these approaches into a single complementary model with a special emphasis on the role of SEL. We first present an overview of commonly used SMH frameworks. Next, we present the Trauma‐Informed Multi‐Tiered Systems of Support Model (TI‐SEL MTSS)–an adaptation of the TITI‐SEL MTSS–to include and emphasize the specific role of SEL as a critical foundational layer within a multi‐tiered system of support. The proposed adapted model maintains the key structure of a MTSS while highlighting the importance of embedding SEL pedagogy in daily teaching practices and all aspects of school life. A case study is used to illustrate how the proposed model adaptations can be used in practice and in tandem with TI and SMH services without being conflated as the same service as SEL. Practical implications for implementation are discussed.

The purpose of this mixed-methods study was to explore the feasibility, acceptability, and preliminary effectiveness of a Tier 2 classroom-based motivational interviewing (MI) intervention—the Aspire Group Intervention (AGI)—designed for ninth-grade students identified as being at high risk for school dropout. The nine-lesson AGI curriculum was grounded in self-determination theory and positive youth development, and aligned with the four processes that characterize MI (i.e., engaging, focusing, evoking, and planning). The intervention was implemented with 38 ninth-grade students in two classrooms in one southeastern high school. Data were collected through pre/post student surveys, implementation fidelity checklists, and teacher interviews. Results suggest students were satisfied and found the intervention helpful. Teachers were satisfied with the intervention overall but shared concerns regarding student engagement and group size due to classroom delivery of the intervention. Implementation data suggest that lessons were slightly longer than a class period and most activities were implemented as intended. The article concludes with a discussion of implications of this study for future refinement of the intervention, along with more general implications for school social work practice.

The supply of school mental health (SMH) providers and services cannot meet the demand of students in-need, and this gap is expected to widen in coming years. One way to increase the reach of helpful services for youth is to grow the SMH workforce through task-shifting to paraprofessionals. Task-shifting could be especially promising in expanding Motivational Interviewing (MI) interventions, as MI can be molded to target a number of academic and behavioral outcomes important to schools. However, no review of training exclusively paraprofessional samples in MI has yet been conducted. The current paper provides a scoping review of 19 studies of training paraprofessional providers to use MI to evaluate trainee characteristics, training content and format, and outcomes. Of these 19 studies, 15 reported that paraprofessionals improved in using MI following training. Nine studies reported that task-shifting MI was positively received by clients and/or providers. Six studies examined task-shifting MI in youth-serving contexts, and four examined the practice in traditional school contexts, suggesting its potential for use in SMH. Other findings and implications, such as client behavior change and provider fidelity, are shared, along with ideas for advancing research, practice, and policy in this subfield.

Schools worldwide are developing innovative models in response to, and in anticipation of, societal changes. Aiming to address non-academic barriers to learning, while capitalizing on out-of-school time, some school and community leaders have prioritized family and community partnerships, especially in the United States (U.S.). The Community Collaboration Model (CCM) is one such U.S. partnership-oriented model of expanded school improvement. In contrast to some partnership-oriented models, the CCM prioritizes improvements in classrooms and communities, aiming to support students, assist teachers, and improve relationships beyond the typical school day. This scoping review examines 14 peer-reviewed articles which describe CCM-centered innovations and documented outcomes. Barriers and facilitators associated with CCM adoption and implementation in diverse U.S. school and community settings also are explored. CCM’s contributions to important student and school outcomes (e.g., increased access to mental health services, improved school climate, decreased discipline referrals) are documented in this scoping review. Some researchers have also described implementation-related facilitators (e.g., partnerships with universities) and barriers (e.g., initial resistance by educators) that influence the utility of the model in practice. Drawing on prior research, the authors discuss findings and implications for future research, educational policy, and practice.

BACKGROUND: Understanding teachers' appraisals of student wellness services and supports during COVID‐19 is essential to strengthening services and improving student health outcomes. This mixed‐method study aimed to examine US PK‐12 teachers' appraisals of student wellness services and supports during COVID‐19.METHODS: This study focuses on qualitative data from 291 teachers' open‐ended responses to the question: “What do you wish your school leaders knew about this (wellness support) aspect of your work?” and whose responses described wellness services and supports. A qualitative content analysis was conducted by an interdisciplinary research team using open‐ and axial coding.RESULTS: Three main themes emerged. (1) insufficient access to mental health professionals and programming at schools, (2) concern about the quality of available services, and (3) a need for teacher professional development and support on student wellness. Statistically significant differences in teacher appraisals of insufficient access to mental health professionals and programming were found based on grade level taught and percentage of immigrant students in the school.CONCLUSION: With amplified student wellness needs, school personnel, including school leaders, must consider ways to allocate additional resources/staffing, assess the quality of services and supports, and design professional development opportunities to support teachers' involvement in supporting student wellness needs.

This article describes how two Southeastern social work programs delivered integrated behavioral healthcare training to MSW students and social work practitioners during the COVID-19 pandemic. COVID-19 posed challenges across five domains, including: (a) adaptations to course curricula; (b) adaptations to field education curricula; (c) experiences of grief, distress, and behavioral health issues by stakeholders; (d) organizational strain to universities and departments; and (e) effects on clients and the community. This article describes specific ways in which these two training programs were impacted in these five areas and modified in response, as well as similarities and differences experienced across institutions. Implications for these training programs, and social work education programs in general, are offered.