Preventing Depression

High School Transition Study

Study Aims

The High School Transition Study is a preventative intervention study for adolescents at risk for depression. Funded by the National Institute of Mental Health, the High School Transition Study has two main goals:

1. To determine if middle school students who are risk of problems associated with depression and who participate in early intervention have a more successful transition to high school. A successful transition is measured by improved school performance, decreased substance involvement, and lower depression scores in ninth grade.
2. To determine if students who participate in the HSTS intervention demonstrate enhanced self-esteem and social support.

Study Design

The High School Transition Study was carried out in six Seattle middle schools. Eighth graders were invited to participate in school-based screening. As in the Developmental Pathways Project, teams of UW screeners visited classrooms and administered two brief standardized questionnaires that were used to assess depression and disruptive behavior problems in adolescents. Students who screened in the top 20% for depression and did not have high levels of behavior problems were invited to participate in the HSTS intervention. Two hundred students who consented were assigned to the intervention, and an equal number were assigned to a minimal intervention control group.

The 8th grade in-school intervention involved 2 one-hour meetings a week for six consecutive weeks. The intervention was designed as a pull-out program during the school day. We worked with schools to rotate the times of these meetings to ensure that students were not missing the same class repeatedly. The program was implemented following a manualized curriculum in which a trained adult leader worked with a group of 6-8 8th grade students over the course of 6 weeks. The curriculum taught refusal skills, emotional regulation skills, and social skills to prepare students for high school. The program had a home-based parent component. During 9th grade the students met individually 4 times with their intervention specialist to practice the skills and apply them in the high school setting. The HSTS intervention was delivered to parents in English, Spanish, and Vietnamese.

Students in the intervention and control groups completed questionnaires at 6 time points over a period of 18 months (January of 8th grade through June of 9th grade). Their parents completed questionnaires at 3 points over this same time period. Homeroom teachers were asked to complete one 15-minute paper-and-pencil questionnaire. Students, parent/guardians, and teachers received monetary compensation for completing questionnaires.

Early results show that while students in the control group experienced increased depressive symptoms through the end of 9th grade, as would be expected of adolescents with early risk as they undergo a challenging developmental transition, students in the intervention group experienced a significantly smaller increase in depressive symptoms.

 

Prevention in Action:

Evidence-based Treatment Training and Consultation for School-based Mental Health Counselors

Since 2005, the Developmental Pathways Research Program investigators have worked with the Seattle/King County Health Department to provide training and consultation to the 18 school-based mental health counselors in Seattle Public Schools Teen Health and Wellness Centers. Their aim is to facilitate the utilization of elements of evidence-based treatments in school-based mental health counselors’ therapeutic encounters with students. This work has involved convening the counselors for workshops and monthly case consultations and encouraging their participation in monthly Child and Adolescent Psychiatry Grand Rounds presentations and other university-sponsored clinician training events. In 2009 we began to implement the Managing and Adapting Practice System, developed by Dr. Bruce Chorpita of UCLA, as a way to support SBMHC’s learning and use of elements of evidence-based practice. An evaluation is being conducted to track use of these elements and student’s progress in treatment. In 2012 we received funding from the Department of Education to develop and implement a brief school-based intervention to address emotional health problems that interfere with academic performance.

Middle School Support Project

Since 2006, the Developmental Pathways Research Program has provided support to developing and implementing the Middle School Support Project (MSSP). MSSP is a program funded by the local Nesholm Family Foundation. Four care coordinator, who are master’s level child mental health professionals employed by a local mental health agency, are each assigned to a Seattle middle school. Students who have mental health needs, are involved in multiple systems, and are having academic problems are referred by principals to MSSP. Care coordinators facilitate wrap around services, coordinating with student, family, teachers, counselors, and other professionals to plan and implement a strong foundation of support for the students. Program goals are improved school performance and mental health. DPRP conducts the MSSP program evaluation.