Measurement-based care implementation by K-12 public school clinicians: A mixed-methods proof of concept study.

Area of Science:

• Mental Health Services Research
• Implementation Science
• School Psychology

Background:

• Measurement-based care (MBC) is crucial for effective mental health services.
• Implementing MBC in K-12 school settings presents unique challenges.
• The FOCUSS strategy was developed to address these challenges.

Purpose of the Study:

• To assess the feasibility and acceptability of the FOCUSS implementation strategy for MBC.
• To demonstrate proof of concept for MBC adoption by school-employed clinicians.
• To gather data on implementation outcomes for future refinements.

Main Methods:

• A mixed-method, single-arm pilot study with 10 school mental health clinicians over one academic year.
• Monthly fidelity monitoring of MBC measure entry.
• Pre-training and follow-up surveys (3, 6, 9 months) on clinician attitudes and practices.
• School year-end qualitative interviews to explore implementation experiences.

Main Results:

• 60% of clinicians met or exceeded the target of implementing MBC with five students.
• MBC was adopted for 65 students, demonstrating feasibility.
• Qualitative data indicated MBC is clinically valuable, providing consistency and structure, and is well-regarded by students and parents.
• FOCUSS supports, particularly performance feedback emails, were found helpful.

Conclusions:

• This study provides the first demonstration of MBC implementation with school-employed mental health professionals in the US.
• Results support the feasibility of MBC using the FOCUSS strategy in K-12 schools.
• The findings support the potential for district-wide adoption of FOCUSS to implement MBC.