Sharon Stephan - Academia.edu (original) (raw)

Papers by Sharon Stephan

School Mental Health Services for Adolescents, 2017

Beginning in the 1980s, mental health programs in schools began to expand beyond those delivered ... more Beginning in the 1980s, mental health programs in schools began to expand beyond those delivered solely by schools and school employees. This was related to growing recognition of the limitations of separate community and school mental health efforts, and of the benefits of working together. These “expanded” school mental health (SMH) programs began to gain momentum in the 1990s and are now a major national force. This chapter reviews key milestones in the history of the field and the critical policy themes (e.g., federalism, school decision-making, healthcare reform, financing) that are being confronted. It concludes with a review of major opportunities for the further growth and development of the field, including embedding programs within multi-tiered systems of support, improving training and workforce development, improving interdisciplinary and cross-system collaboration, enhancing high-quality and evidence-based practice, and developing effective systems of implementation sup...

International Journal of Education Policy and Leadership, 2014

Despite a growing number of collaborative partnerships between schools and community-based organi... more Despite a growing number of collaborative partnerships between schools and community-based organizations to expand school mental health (SMH) service capacity in the United States, there have been relatively few systematic initiatives focused on key strategies for large-scale SMH capacity building with state and local education systems. Based on a framework of ten critical factors for capacity building, as well as existing best practices, two case studies were utilized to develop a replicable capacity-building model to advance interagency SMH development. Seventy education and mental health stakeholders from two selected states participated in baseline assessments of skill com-petency and critical factor implementation followed by two-day trainings (one in each state); 29 (41%) of the participants also completed a six month follow-up assessment. Targeted competencies increased significantly for participants from both states, with large effect sizes (d = 2.05 and 2.56), from pre- to ...

Journal of child and adolescent psychopharmacology, Jan 16, 2016

The purpose of this study was to describe the potential and limits of school telemental health (T... more The purpose of this study was to describe the potential and limits of school telemental health (TMH) to support a full continuum from mental health promotion to intervention, particularly for students less likely to access community care. A review of school TMH literature and model programs, and of data from focus groups with child psychiatry fellows, was undertaken to inform best practices and future directions for TMH in schools. Existing data suggest that TMH with children and adolescents is promising and well received. Child and adolescent psychiatrists use various models for conducting school-based TMH, which differ in the level of direct care and types of services provided. Literature review and focus group data suggest that advantages of school TMH include greater efficiency, the capacity for higher volume, and increased access to care for many students who would be unlikely to reach traditional community mental healthcare because of barriers such as transportation and health...

The Journal of nervous and mental disease, Jan 30, 2015

The Patient Protection and Affordable Care Act focuses on improving consumer engagement and patie... more The Patient Protection and Affordable Care Act focuses on improving consumer engagement and patient-centered care. This article describes the design and rationale of a study targeting family engagement in pediatric mental health services. The study is a 90-day randomized trial of a telephone-delivered Family Navigator services versus usual care for parents of Medicaid-insured youth younger than 13 years with serious mental illness. Youth are identified through a pediatric antipsychotic medication preauthorization program. Family Navigators offer peer support to empower and engage parents in their child's recovery. Outcomes include parent report of empowerment, social support, satisfaction with child mental health services, and child functioning as well as claims-based measures of psychotherapy service utilization and antipsychotic medication dosage. The focus on "family-centered" care in this study is strongly supported by the active role of consumers in study design a...

School Mental Health, 2011

This manuscript presents the process and findings of a national quality improvement collaborative... more This manuscript presents the process and findings of a national quality improvement collaborative, the Mental Health Education and Training (MHET) initiative, designed to improve mental health service provision in school-based health centers (SBHCs), with an emphasis on enhancing collaboration between physical and mental health providers. MHET participants included multidisciplinary teams from 19 SBHCs in six states: Colorado,

School Mental Health, 2012

Increasingly, research is focusing on strategies to make evidence-based practice more achievable ... more Increasingly, research is focusing on strategies to make evidence-based practice more achievable in school mental health. A significant theme is training and implementation of ''common elements'' or specific therapeutic skills associated with positive clinical outcomes for children and youth, as compared to ''manualized'' interventions, which can be difficult to implement, especially in the school setting. As part of a larger study on quality assessment and improvement and evidence-based practice in school mental health (SMH) in three US states, this study analyzed 29 SMH clinicians' knowledge and use of common elements and the relation of knowledge and use to independent ratings of therapy quality. There was high variability in knowledge and use of the common elements and strong associations between knowledge and use and ratings of treatment quality/effectiveness. Results are discussed in relation to advancing research and clinical practice on achievable evidence-based practice in SMH.

The Professional Counselor, 2014

Counseling self-efficacy (CSE), defined as one's beliefs about his or her ability to effectively ... more Counseling self-efficacy (CSE), defined as one's beliefs about his or her ability to effectively counsel a client, is an important precursor of effective clinical practice. While research has explored the association of CSE with variables such as counselor training, aptitude and level of experience, little attention has been paid to CSE among school mental health (SMH) practitioners. This study examined the influence of quality training (involving quality assessment and improvement, modular evidence-based practices, and family engagement/empowerment) versus peer support and supervision on CSE in SMH practitioners, and the relationship between CSE and practice-related variables. ANCOVA indicated similar mean CSE changes for counselors receiving the quality training versus peer support. Regression analyses indicated that regardless of condition, postintervention CSE scores significantly predicted quality of practice, knowledge of evidence-based practices (EBP) and use of EBP specific to treating depression. Results emphasize the importance of CSE in effective practice and the need to consider mechanisms to enhance CSE among SMH clinicians.

Child and adolescent psychiatric clinics of North America, 2015

Schools provide an ideal setting for screening, brief interventions, and outpatient treatment for... more Schools provide an ideal setting for screening, brief interventions, and outpatient treatment for substance use disorders (SUD). Individual treatment for SUD is effective at decreasing substance use as well as substance-related harm. In some contexts, rather than being helpful, group interventions can result in harm to participants; therefore, individual treatment may be preferred. Early interventions for adolescents who are using alcohol and other drugs (AOD) are generally effective in decreasing frequency and quantity of AOD use as well as decreasing risky behaviors.

Advances in School Mental Health Promotion, 2014

The current educational policy context in the United States necessitates that school-based progra... more The current educational policy context in the United States necessitates that school-based programs prioritize students' academic outcomes. This review examined the quantitative research on school mental health (SMH) early interventions and academic outcomes for atrisk high school students. Seven articles met the inclusion criteria for this review. All articles were examined according to study design and demographics, early intervention characteristics, and outcomes. Of the studies included, most were conducted in urban settings, involved the implementation of group-based early intervention strategies, and monitored GPA as a distal academic outcome. Counselors were frequent implementers of these early interventions. A meta-analysis found no statistically significant effect on the academic outcomes most commonly assessed in the studies (i.e., GPA, attendance, and discipline). Findings suggest the need for more rigorous research in this area. Implications for SMH early intervention research and practice are discussed.

Encyclopedia of Cross-Cultural School Psychology, 2010

is committed to facilitating the full participation of students with disabilities in the life of ... more is committed to facilitating the full participation of students with disabilities in the life of the University. Student Disability Services is responsible for determining eligibility as well as the types of accommodations for students with disabilities. If you are a student with a disability, please contact the Student Disability Services office as early as possible to initiate services.

Issues in Clinical Child Psychology, 2013

The Lancet Psychiatry, 2014

Mental health services embedded within school systems can create a continuum of integrative care ... more Mental health services embedded within school systems can create a continuum of integrative care that improves both mental health and educational attainment for children. To strengthen this continuum, and for optimum child development, a reconfiguration of education and mental health systems to aid implementation of evidence-based practice might be needed. Integrative strategies that combine classroom-level and student-level interventions have much potential. A robust research agenda is needed that focuses on system-level implementation and maintenance of interventions over time. Both ethical and scientific justifications exist for integration of mental health and education: integration democratises access to services and, if coupled with use of evidence-based practices, can promote the healthy development of children.

School Mental Health, 2009

The purpose of this study was to test a three component framework for enhancing quality in school... more The purpose of this study was to test a three component framework for enhancing quality in school mental health (SMH), focusing on quality assessment and improvement (QAI), family engagement/empowerment, and modular evidence-based practice (EBP) implementation in three established SMH programs. The study involved a 2-year, multisite (Delaware, Maryland, Texas) formative evaluation with clinicians randomly assigned to participate in either the QAI (target) intervention or a Wellness Plus Information (WPI, comparison) intervention. As hypothesized, clinicians who participated in the QAI condition demonstrated significantly greater implementation of quality indicators and greater implementation of EBP as compared to clinicians in the WPI condition. However, contrary to original hypotheses, findings did not reveal differences between the conditions in knowledge or attitudes toward EBP, clinician self-efficacy, or student psychosocial outcomes. Implications for future research on quality improvement in SMH are discussed, with an emphasis on the need to examine the impact of increased implementation and resource support to SMH clinicians.

School mental health, 2014

Cognitive and Behavioral Practice, 2015

Psychiatric Services, 2007

te ev ve en n A Ad de el ls sh he ei im m, , M M. .D D.. C Ca ar rr ri ie e M Mi il ll ls s, , B ... more te ev ve en n A Ad de el ls sh he ei im m, , M M. .D D.. C Ca ar rr ri ie e M Mi il ll ls s, , B B. .S S. .