Developments in Child Maltreatment Services and Future Directions to Support Community Providers
3 - (Sym 14) Integrating Teacher-child Interaction Training (TCIT) into a Large-scale Head Start Mental Health Consultation Program
Friday, November 18, 2022
10:00 AM – 11:00 AM EST
Location: Broadhurst/Belasco, 5th Floor
Keywords: Evidence-Based Practice, Service Delivery, Implementation Recommended Readings: Kolko, D. J., Herschell, A. D., Baumann, B. L., Hart, J. A., & Wisniewski, S. R. (2018). AF-CBT for families experiencing physical aggression or abuse served by the mental health or child welfare system: An effectiveness trial. Child Maltreatment, 23(4), 319–333. https://doi.org/10.1177/1077559518781068 McGuier, E. A., Kolko, D. J., & Dubowitz, H. (2021). Public policy and parent-child aggression: Considerations for reducing and preventing physical punishment and abuse. Aggression and Violent Behavior. https://doi.org/10.1016/j.avb.2021.101635 Valenstein-Mah, H., Greer, N., McKenzie, L., Hansen, L., Strom, T. Q., Stirman, S. W., Wilt, T. J., & Kehle-Forbes, S. M. (2020). Effectiveness of training methods for delivery of evidence-based psychotherapies: A systematic review. Implementation Science, 15(1), 1–17. https://doi.org/10.1186/s13012-020-00998-w
Associate Professor Medical University of South Carolina Charleston, South Carolina
Given that the preschool years are a critical period for socioemotional development, and that 75% of children in need of mental health services do not receive assistance (Dougherty et al., 2015), school-based interventions targeting behavioral health in the early years are imperative. The current study examines outcomes of a multicomponent mental health consultation program developed for a countywide Head Start program. The consultation program incorporates strategies from the evidence-based practice Teacher-Child Interaction Training (TCIT). Through large group professional development trainings before the school year, comprehensive feedback reports based on observations, in-class coaching via modeling and performance feedback on teachers' use of TCIT skills, the consultation program served 55 Head Start classrooms with 789 children. Outcome data are presented on teachers' improvement in TCIT skill use and the relative effectiveness of two coaching methods (i.e., modeling and performance feedback) used during consultation. At time of initial observation, 155 children were flagged with behavioral, emotional, and/or developmental concerns in the classroom (M=2.10, SD=1.42, range=0-5), with 178 flagged at mid-year observation (m=2.69, SD=1.77, range=0-7). Results from multilevel modeling analyses indicated that teachers improved in the use of multiple observed TCIT skills between the initial and midyear assessment, including increased frequency of labeled praises, reflections, behavioral descriptions, and commands that were compiled with, and decreased frequency of commands that children did not have an opportunity to comply with. Additionally, teachers who received coaching in the form of performance feedback, in comparison to modeling, exhibited greater gains in the frequency of labeled praises and commands that resulted in compliance. A great deal of disparity exists between the number of preschool children who will exhibit difficulties with socioemotional development and the number who are likely to receive help from a trained professional (Kazdin & Blase, 2011). Given the disparity, the type of service delivery model presented is needed to expand the reach of evidence-based practice to populations such as the economically disadvantaged families served by Head Start. Discussion focuses on implementation of evidence-based practice in large-scale prevention early interventions, study limitations, and directions for future research.