A central problem in adolescent mental health is that youth tend to engage only superficially in therapy and to drop out prematurely. Although there is a robust body of empirical evidence about how to promote youth engagement in services, these practices are seldom used. The investigators will test a Coordinated Knowledge System (CKS) within school-based mental health services to improve the use of research evidence. The CKS embeds training on research-informed practices into routine supervision meetings between clinical supervisors and therapists. In those meetings the supervisor and therapist identify engagement problems within youth’s treatment plans, select research-informed responses that fit youth’s needs, monitor progress, and adapt treatment to promote engagement. Findings from pilot work suggest CKS holds promise. The current study involves a cluster randomized trial focusing on supervisors and supervisees’ use of research evidence to increase youth engagement in mental health services. Supervisors and therapists in the CKS condition will receive a two-day training and ongoing feedback in how to use: 1) an engagement screen to assess students’ degree of participation in therapy and risk of dropping out; 2) the REACHing Families Worksheet to develop a collaborative plan for decisions and actions that are consistent with the research; and 3) a clinical dashboard to measure the use of research evidence. Each tool coordinates knowledge, and, together, they embed research into decision making and point to actionable steps to enhance students’ engagement. The investigators will use digital recordings and data analysis to assess the extent and appropriateness of the research used in the clinical supervision and therapy sessions.
Does the Coordinated Knowledge System intervention increase clinical supervisors’ use of research evidence in working with therapists and in therapists’ work with students?