Whereas traditional MTSS frameworks may focus on one domain (e.g., reading), an I-MTSS framework emphasizes (a) selection of research-informed practices within each domain and (b) careful integration of key practices across domains (e.g., embedding opportunities to prompt key behavioral skills within an academic lesson, scripting praise for contextually appropriate behavior and correct academic responses). Teachers may need to engage additional students in a more intense MTSS level if they are struggling at home with distance learning. Students who were already receiving Tier 2 and Tier 3 support prior to the school closures last spring may have regressed in any progress they might have made. These new challenges are an addition to the academic and behavioral challenges that some children may have already been facing.
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A good MTSS framework should encompass academics and mental health. “Access to care and services is much easier in schools, and it’s easier to refer to school-based services.” Stress from the pandemic, social unrest, and more recently, the war in Ukraine, have all led to widespread reports of a spike in behaviorial incidents among students. Moreover, this model proposes a novel partnership between schools and community-based mentoring programs with the goal of expanding the reach of school-based services for youth, which directly relates to school psychologists’ work. At present, there is a shortage of school psychologists and other mental health providers in the United States (Behavioral Health & Economics Network, 2018; NASP, 2017) https://www.sri.com/publication/education-learning-pubs/how-a-researcher-learns-from-practice/ and an increasing demand for services among children and adolescents. This discrepancy leads to unmanageable caseloads for providers and reduced access to quality services for youth, and highlights a need to expand the school-based workforce to meet student needs.
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Garner et al. (2011) entered attitudes, perceived control, and subjective norm simultaneously as predictors of implementation outcomes with the experimental condition variable. Only one study tested individual characteristics as a predictor of implementation outcomes while controlling for the experimental manipulation. Four of the five mediators (attitudes, readiness to change, self-efficacy, and subjective norm) were significantly related to implementation outcomes in models that did not control for the implementation strategy. Agency supportive practices significantly predicted implementation fidelity in a trial of motivational interviewing even after controlling for the effect of the implementation strategy; however, since the strategy did not influence supportive practices it was not a mediator (Baer et al. 2009). Only one mediator from this group was tested as a predictor of implementation outcomes in a model that included the implementation strategy. The most common reason was the implementation strategy failed to influence the mediator—in seven unique tests none of the implementation strategies successfully manipulated mediators from the inner setting domain.
- When the Maternal and Child Health Bureau implemented an initiative in 1995 to support mental health for school-age children and youth by strengthening the capacity of school-linked health programs to address psychosocial issues and mental health problems, two national centers and five state projects were developed.
- Although several additional variables representing characteristics of the inner setting and characteristics of the individuals involved in implementation were significantly related to implementation outcomes, these were not influenced by the implementation strategies and therefore did not mediate the strategies’ effects.
- For example, a student at tier 2 also receives all of the support available at tier 1.
Your SEL and mental health team may also want to inventory the types of supports your school can offer and, if needed, to augment these supports with additional trainings or hires. Through the analysis of existing models, study of promising practices and incorporation of technology, the authors envision a model and propose a programme that can provide prevention and remediation support for mental health in schools. Recent studies suggest that students may benefit from a preventative approach to mental health and well-being.
In addition, school-based team members are prime candidates for identifying local champions to advocate for a particular implemented program (next section). A more specific SISTER strategy, developing academic partnerships, refers to accessing training and research skills for an implementation project (Lyon et al., 2019). Other potential external partners include local businesses, preschools, and those mentioned throughout this article (e.g., faith settings, primary care centers). These strategies also focus on methods that best meet local needs, ease fidelity assessment, and remove procedures (e.g., data forms, rubrics, reports) that have little added or less significant value to making informed decisions (Lyon et al., 2019). Several key SISTER strategies important for setting the basis for the sample MTSS model involve promoting adaptability and making implementation easier by removing burdensome documentation tasks. Linchpin and readiness strategies must be fully established and in place prior to any formal implementation.
School psychologists, as part of a multidisciplinary team, coordinated the use of these screening data to engage in preventive consultation with administration to make decisions regarding the refinement and Correspondence should be sent to Erin Dowdy, The problem with both rationales is that, when proposals emphasize another specific approach, another initiative, another team, and so forth, the fragmentation of efforts to focus on the “total child” at a school and throughout a district tends to increase. This issue of Contemporary School Psychology with its emphasis on promising approaches to wellness, social skills, and life competencies mainly reflects the second agenda. And school policy makers have a lengthy history of trying to assist teachers in dealing with problems that interfere with schooling.
In addition, evidence for a gradient relationship between M and Y in which increased activation of M contributes to increased change in Y provides further evidence to support the hypothesized mediation process. These features help establish a causal timeline from X to M to Y and, in concert with well-articulated theory, enable investigators to build a strong case that the implementation strategy activated the mediator which in turn influenced the implementation or clinical outcome of interest (Mathieu et al. 2008). Of course, the strength of causal inferences from any mediation study depends on the soundness of its guiding theory, research design and measurement, and data analysis (Mathieu et al. 2008). The aims of the study are to (a) assess whether the implementation strategy engaged the targeted mediator (i.e., X to M), and (b) examine the extent to which engagement of the mediator explained the strategy’s effect on the targeted outcome (i.e., M to Y adjusted for X). Once investigators understand how an implementation strategy works they can match it to those situations in which it will be most beneficial and avoid applying it in situations where it may be ineffective. For example, if an implementation strategy fails to influence the targeted implementation or clinical endpoint, mediation analyses can provide clues regarding the extent to which this occurred because of failure to activate the targeted mediating mechanism or failure of the mediating mechanism to influence the outcome.