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Dialectical Behavior Therapy Skills and Mental Health Literacy: A Cluster Randomized Trial of a Universal School-Based Mental Health Program

Sat, April 6, 8:00 to 10:00am, Metro Toronto Convention Centre, Floor: 200 Level, Room 203A

Abstract

The inclusion of students with mental health challenges requires trauma informed care in order for students to successfully manage the stress of the academic environment and the expectations of social interactions (Blitz, Anderson, Saastamoinen, 2016). Although youth today are experiencing elevated rates of mental illness, help-seeking and access to needed supports among this population is limited—roughly 75 - 80% of the students with mental health challenges significant enough to warrant intervention do not receive it (Gulliver et al, 2010). As schools are the only public institution with access to all youth, programming in schools is critical to reach youth not currently accessing needed supports, and proactively develop knowledge and coping skills in youth.
To develop resiliency and promote help-seeking behavior, it is important to address MHL so that youth (a) understand mental disorders and their treatments and (b) to address stigma related to mental disorders to support help-seeking behavior (Kutcher, Wei, & Coniglio, 2016). Emotion regulation and distress tolerance are critical factors in resiliency, as the ability to persevere and “bounce back” is related to one’s ability to avoid being overwhelmed and managing stress. Finally, interpersonal effectiveness may result in a sense of belonging through the formation of social support networks. DBT skills modules have been shown to improve emotion dysregulation, stress reactivity, interpersonal skills and distress tolerance (Miller, Rathus, & Linehan, 2006; Wilks et al., 2016). DBT has therefore been promoted as a possible proactive school-based intervention (Mazza, Dexter-Mazza, Miller, Rathus, & Murphy, 2016).

The purpose of this study was to evaluate the effects of a teacher-delivered Tier 1 SBMH program incorporating elements of mental health literacy and DBT skills on outcomes related to Grade 3-12 students' resiliency.
Specifically, we address the following research questions:
1. Are there differences in change in student self-concept, coping, belongingness, and perceptions of classroom climate between the intervention and control schools?
2. Are differences due to intervention moderated by school level (elementary vs. secondary), school location (city) or by student characteristics, including gender, and whether or not a student has a designated disability, and/or has Aboriginal status?

Four elementary and four secondary schools located in two different Canadian cities were randomly assigned to participate in the intervention or control conditions. Within these schools, a total of 995 students (Grades 3-12) in 40 classrooms participated in the study. Quantitative and qualitative data were collected through observations, surveys (student and teacher completed), interviews of the teachers and students, and artifacts (journals of teachers and students, work samples, etc.), this presentation focuses on quantitative results.
There were statistically significant time*group interactions for self-concept (p = .002), resiliency (p = .005), belongingness (p = .002), and classroom climate (p = .002), indicating that there was more positive change on these variables in the intervention schools across the school year. Effect sizes were large, with g = 1.12, 1.39, 1.15, and 1.00, respectively. Results will be discussed in terms of implications for both practice and future research.

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