Motivational Interviewing to Promote the Effectiveness of Selective Prevention: an Integrated School-Based Approach

Beyond Jacobson and Truax: Estimation of Clinical Significance Trajectories in the Coping Power Intervention Using Measurement Error-Corrected Multilevel Modeling

Coping Power (CP) is a preventive intervention that focuses on reducing child externalizing problems. Although it is typically delivered in a group format (GCP), individually delivered CP (ICP) has produced greater mean reductions in externalizing problems. However, standard analysis of randomized trials loses individual-level information regarding which youth improve, fail to improve, or get worse, whereas clinically significant change (CSC) metrics capture information on individual change. The present study is a secondary analysis of an ICP/GCP trial (N = 360) that examines differences in CSC-based individual-level inferences on externalizing. A novel method for assessing CSC under measurement error-corrected multilevel modeling was used, overcoming three limitations of traditional CSC methods: (a) restriction to two time points, (b) use of total scores, and (c) assumption of constant reliability across time and participants. Because of concerns about Type II errors with all CSC methods, an individual-level effect size metric for CSC was also developed. Based on individualized Cohen's d estimates, individual-level improvements in externalizing from 4th through 11th grades of d ≥ 0.5 were significantly greater in ICP (73%) versus GCP (45%). Further, GCP saw significantly higher percentages of youth with worsening of externalizing, underscoring concerns about diminished effects for GCP. Half of the sample had improvement that was not statistically significant but exceeded d ≥ 0.5, highlighting the susceptibility to Type II errors of CSC's results based on statistical significance. An examination of ICP/GCP differences under advanced CSC analysis gives more nuanced information than conventional randomized controlled trial analysis and greater precision in estimating individual-level outcomes than standard CSC methodologies.

A Scoping Review of Prevention Classification in Mental Health: Examining the Application of Caplan's and Gordon's Prevention Frameworks (2018-2024)

Mental health prevention is a global priority owing to the increasing burden of mental disorders exacerbated by global crises such as the COVID-19 pandemic, climate change, economic instability, and armed conflicts. These crises have heightened the need for effective preventive strategies addressing mental health across different life stages and populations. To structure and classify such strategies, Caplan's and Gordon's frameworks have been widely used, with one focusing on disease progression and the other on population risk. Although both frameworks are frequently used in mental health prevention, their application in clinical trials remains unexplored. This review addresses this gap by examining how Caplan's and Gordon's frameworks have been applied in mental health prevention, identifying research gaps, and exploring their potential for their combined application to enhance prevention strategies. A scoping review was conducted following PRISMA-ScR guidelines. Studies were selected based on predefined criteria and the data were synthesized. The search spanned PubMed, Scopus, APA PsycArticles, and PubPsych, covering peer-reviewed clinical trials, including randomized controlled trials, published between 2018 and 2024 in English or German. Eligible studies classified interventions based on Caplan's framework, which focuses on disease stage (primary, secondary, tertiary), or Gordon's framework, which categorizes prevention by population risk (universal, selective, indicated). Studies had to focus on mental health prevention, include populations relevant to mental health and well-being, and report mental health or well-being outcomes. Of the 40 included studies, six applied Caplan's framework, 30 applied Gordon's framework and three used a modified classification based on Gordon's approach. One study applied both frameworks, highlighting that their complementary use is rare. Studies were conducted in 19 countries, with the highest number from Germany (n = 8), the USA (n = 8), and the Netherlands (n = 6), across four continents (Asia, n = 5; Australia, n = 5; Europe, n = 22; North America, n = 8). Gordon's framework was applied more frequently, particularly in universal (n = 15) and indicated prevention (n = 12), while Caplan's framework was used mainly in primary prevention (n = 4). Depression (n = 25), anxiety (n = 21), stress (n = 8), and general mental health (n = 8) were the most frequently assessed outcomes. The studies targeted diverse populations, including children (n = 7), adolescents (n = 8), children and adolescents (n = 1) parents and their children or adolescents (n = 2), university students (n = 6), working adults (n = 7), older adults (n = 1), and adults without specifying (n = 8). This review highlights the underutilized potential of integrating Caplan's and Gordon's frameworks in mental health interventions. Two application examples illustrate how these frameworks can be combined to structure prevention strategies more effectively. Future research should explore combining these frameworks to enhance prevention strategies and address the emerging global health challenges.

Motivational interviewing for students in school settings: A meta-analysis

Motivational Interviewing (MI) is a brief counseling intervention with demonstrated efficacy in ameliorating unhealthy habits across populations, behaviors, and settings. Although prior research underscores its benefit with adolescents, a comprehensive examination of its application in school settings remains unexplored. Therefore, the primary aim of the present meta-analysis was to calculate the average estimated effect of all studies examining the use of MI with students in school settings. Second, we sought to examine heterogeneity in effects through meta-regression models. Our final model included a meta-analysis of 38 studies with 207 effect sizes evaluating the efficacy of school-based MI. We estimated multivariate models using robust variance estimation with and without outliers. Our results demonstrate a significant estimated effect in favor of using MI to treat an array of behaviors (g = 0.18, 95% Prediction Interval [-0.26, 0.61]). Findings from the meta-regression analyses indicated three significant moderators: (a) the role of the interventionist, (b) target behaviors, and (c) dosage. We offer potential explanations of the findings and discuss current limitations and implications for future work regarding MI in school settings.

Expanding School-Based Motivational Interviewing Through Delivery by Paraprofessional Providers: A Preliminary Scoping Review

The supply of school mental health (SMH) providers and services cannot meet the demand of students in-need, and this gap is expected to widen in coming years. One way to increase the reach of helpful services for youth is to grow the SMH workforce through task-shifting to paraprofessionals. Task-shifting could be especially promising in expanding Motivational Interviewing (MI) interventions, as MI can be molded to target a number of academic and behavioral outcomes important to schools. However, no review of training exclusively paraprofessional samples in MI has yet been conducted. The current paper provides a scoping review of 19 studies of training paraprofessional providers to use MI to evaluate trainee characteristics, training content and format, and outcomes. Of these 19 studies, 15 reported that paraprofessionals improved in using MI following training. Nine studies reported that task-shifting MI was positively received by clients and/or providers. Six studies examined task-shifting MI in youth-serving contexts, and four examined the practice in traditional school contexts, suggesting its potential for use in SMH. Other findings and implications, such as client behavior change and provider fidelity, are shared, along with ideas for advancing research, practice, and policy in this subfield.

Collective Motivational Interviewing for Individuals with Drug Use Problems: A Pre-Post-Follow-Up, Uncontrolled Pilot Study

Collective motivational interviewing (CMI) is a novelty motivational approach which optimises the motivational interviewing (MI) for individuals from collectivistic cultures. While MI has been empirically tested as an effective intervention for addictive disorders and has had a positive effect on facilitating lifestyle changes, CMI has retained the potency of MI as an individualistic intervention, and it further invites the social network resources to strengthen the level of motivation and cultivate a joint change partnership. This pilot study was the first clinical study of CMI to work with individuals with drug use problems (IDUPs) by involving concerned significant others (CSOs) in the three-session intervention, and the fidelity control was assessed by the Collective Motivational Interviewing Treatment Integrity (CMITI) scale. This pre-post−follow-up and uncontrolled feasibility study was conducted between 2017 and 2019, with dyads of 20 IDUPs and their CSOs. The potential impacts of CMI were examined by measures at baseline, post-intervention, and 1-month and 3-month post-intervention. All clinical sessions were audio-recorded, and four cases were randomly selected for fidelity review by two trained coders. The normality of data at the baseline was checked by a Shapiro−Wilk test. Non-parametric Wilcoxon-signed-rank test and repeated-measures ANOVA were employed for quantitative analysis. The results showed that six IDUPs had reduced drug use, and ten maintained drug abstinence with the support of CSOs, whereas four IDUPs remained unchanged or increased drug use. Overall, at the 3-month follow-up, drug use was reduced (p > 0.05), social support was strengthened (p < 0.05), and the IDUPs’ motivation for change was enhanced (p < 0.05). However, the small sample sizes, non-random sampling, and lack of control group may limit the generalizability and confirmation of the outcomes and of the “real effects”. This finding of the study suggests that the CMI is a feasible and acceptable therapeutic tool to motivate IDUPs with the support of CSOs to achieve mutually agreed-upon goals. Further development and evaluation with robust methodology are warranted.

School educational models and child mental health among K-12 students: a scoping review

BACKGROUND

The promotion of mental health among children and adolescents is a public health imperative worldwide, and schools have been proposed as the primary and targeted settings for mental health promotion for students in grades K-12. This review sought to provide a comprehensive understanding of key factors involved in models of school education contributing to student mental health development, interrelationships among these factors and the cross-cultural differences across nations and societies.

METHODS

This scoping review followed the framework of Arksey and O'Malley and holistically reviewed the current evidence on the potential impacts of school-related factors or school-based interventions on student mental health in recent 5 years based on the PubMed, Web of Science, Embase and PsycExtra databases.

RESULTS/FINDINGS

After screening 558 full-texts, this review contained a total of 197 original articles on school education and student mental health. Based on the five key factors (including curriculum, homework and tests, physical activities, interpersonal relationships and after-school activities) identified in student mental development according to thematic analyses, a multi-component school educational model integrating academic, social and physical factors was proposed so as to conceptualize the five school-based dimensions for K-12 students to promote student mental health development.

CONCLUSIONS

The lessons learned from previous studies indicate that developing multi-component school strategies to promote student mental health remains a major challenge. This review may help establish appropriate school educational models and call for a greater emphasis on advancement of student mental health in the K-12 school context among different nations or societies.

Design-Based Approaches to Causal Replication Studies

Recent interest in promoting replication efforts assumes that there is well-established methodological guidance for designing and implementing these studies. However, no such consensus exists in the methodology literature. This article addresses these challenges by describing design-based approaches for planning systematic replication studies. Our general approach is derived from the Causal Replication Framework (CRF), which formalizes the assumptions under which replication success can be expected. The assumptions may be understood broadly as replication design requirements and individual study design requirements. Replication failure occurs when one or more CRF assumptions are violated. In design-based approaches to replication, CRF assumptions are systematically tested to evaluate the replicability of effects, as well as to identify sources of effect variation when replication failure is observed. The paper describes research designs for replication and demonstrates how multiple designs may be combined in systematic replication efforts, as well as how diagnostic measures may be used to assess the extent to which CRF assumptions are met in field settings.

Taking a Motivational Interviewing Approach to Prevention Science: Progress and Extensions

This commentary reviews advances gleaned from the current set of papers to Motivational Interviewing (MI) in prevention science. We begin by acknowledging the pioneering work of Miller and Rollnick to develop the construct of MI, then Dishion's use of MI principles to adapt applications of MI for the field of prevention science. We then highlight some of the contributions provided by the current set of papers and other recent extensions of MI. These novel applications are directed to parents, teachers, and older youth in the service of facilitating behavior change to promote youth development.