Catherine Bradshaw, PhD, M.Ed.Johns Hopkins Center for Prevention and Early Intervention

Johns Hopkins Center for the Prevention of Youth Violence

Department of Mental Health, Johns Hopkins Bloomberg School of Public HealthJune 2010

Strengths of the Science in Behavior Disorders:

Reflections and Future Directions

What works for whom, under what circumstances?

Moderated effectsIdentify profiles of responders (and non-responders)Inform research on tiered interventions (RtI, PBIS)

and adaptive or tailored interventions Interventions that “assign different dosages of certain program

components across individuals, and/or within individuals across time,” and “the assignment of a particular level of dosage and/or type of treatment is based on the individual’s values on variables that are expected to moderate the effect of the treatment component” (Collins, Murphy, & Bierman, 2004).

Contextual factorsFidelity of implementation, school disorder (Bradshaw, Koth et al.,

2009, Prevention Science)

Looking inside the ‘black box’Identifying mechanisms and testing the theory of

changeKnow little about critical components of interventionsUnpacking programs

Do components work independent of the package?Ordering/sequencingProgram adaptation Should we emphasize programs or frameworks/models (e.g.,

RtI, PBIS)?Research approaches

Components analysis or factorial designsWhat elements are hardest or easiest to implement?

Model of the Integration Process

Rationale for Integrated Models

of Prevention

• Single interventions may not adequately address the underlying mechanisms contributing to the development of problem behavior.• Integrated models keep the unique strategies of each intervention model and merge those that overlap, resulting in a model that delivers a broader set of approaches simultaneously.• Through a shared conceptual framework and language, integrated models maximize students’ exposure to intervention processes.• Intervention elements are streamlined so that there is less repetition and duplication of effort.

(Domitrovich, Bradshaw, Greenberg et al., 2009; Psychology in the Schools)

School Mental Health

Student Services

Social Emotional

Learning

Truancy

ReductionSuspension

Reduction

Special Education Assessment and Referral

Bullying Prevention/Reduction

Tiered Prevention Framework

Positive Behavioral Interventions and

Supports

What is it going to take to do it well?

Implementation fidelityContextual influences (Domitrovich, Bradshaw, Poduska et al., 2008)

Support systemCoaching and on-site technical assistance

Models of coaching (e.g., Technical/Expert, Problem-Solving, Team-Building, Reflective Practice; Denton & Hasbrouck, in press)

Process for training and supporting coachesCoaching as an adaptive/tailored process

PartnershipModels of partnership with teachers, administrators, district,

stateSpecial issue of Administration and Policy in Mental Health and Mental

Health Services Research titled  “Forging and Sustaining Partnerships to Support Child Mental Health Prevention and Services Research” (with Katherine Taylor Haynes)

What is it going to take to move it out?

Dissemination and Type II Translational Research (Spoth, 2008; Woolf, 2008)

What factors contribute to dissemination of programs?Cultural/political shift toward accountability

What makes programs attractive to districts, schools, & teachers?Theory, ease of implementation, access, costData to document behavioral vs. social-emotional

competenciesPhilosophical and theoretical differences

Teacher-focused, management & compliance oriented vs. child-focused, promotion of competencies

Immediate impact vs. long-term pay off