Adolescent Psychiatry

Lois T. Flaherty
Harvard University Medical School
Cambridge, MA


Maryland's Evolving System of Social, Emotional, and Behavioral Interventions in Public Schools: The Maryland Safe and Supportive Schools Project

Author(s): Catherine P. Bradshaw, Katrina J. Debnam, Sarah Lindstrom Johnson, Elise T. Pas, Patricia Hershfeldt, Andrea Alexander, Susan Barrett, Philip J. Leaf.


Background: Schools serve as an important context for the prevention of behavioral and mental health problems. There is growing interest among educators in the application of a three-tiered public health prevention model to prevent a range of behavioral and mental health concerns, and in turn, improve academic and social-emotional outcomes for students. One such multi-tiered system of supports framework used by schools is called Positive Behavioral Interventions and Supports (PBIS). This model has been widely disseminated in over 20,000 schools across the U.S., with the goal of improving social, emotional, and behavioral outcomes among youth. Yet, most of the implementation efforts and research on PBIS have focused on elementary schools.

Method: This paper describes a collaborative state-wide effort, called Maryland Safe and Supportive Schools, to disseminate this model in high schools and conduct a randomized trial to determine the impact of PBIS on adolescents. The model uses a collaborative, team-focused coaching framework and draws upon school climate data to implement a continuum of evidence-based prevention programs. The goal of this effort is to reduce behavioral, academic, and mental health problems among adolescents. This paper summarizes the design, implementation, and lessons learned through this unique school/non-profit/university partnership-based approach to implementing a comprehensive three-tiered model of support within the state of Maryland.

Results: A relatively large and diverse sample of 58 schools voluntarily participated in the school-level group randomized controlled trial. Annual measures of school climate were collected via self-reports from over 25,000 students and through observations across 25 classrooms per school. Fidelity of tier 1 and 2 supports was generally high among the intervention schools. Preliminary findings from the randomized trial testing the impact of MDS3 suggest a positive impact on school climate and other safety related concerns following the first year of implementation.

Conclusions: The MDS3 project promoted a framework for helping the school leadership teams develop data-based decision- making skills, generate data reports to establish need, optimize evidence-based program implementation, and use data to monitor progress toward goals and celebrate successes. Lessons learned include the importance of 1) obtaining data at the student and school levels; and communicating and sharing data with the schools in a way that makes sense to them and is consistent with the school’s mission.

Keywords: Positive Behavioral Interventions and Supports, prevention, randomized controlled trial, school-based, school climate.

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Article Details

Year: 2014
Page: [194 - 206]
Pages: 13
DOI: 10.2174/221067660403140912163120
Price: $58