Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Jill Ehrenreich-May

Second Committee Member

Amanda Jensen-Doss

Third Committee Member

Rebecca Shearer

Fourth Committee Member

Saneya Tawfik

Fifth Committee Member

Batya Elbaum


Usual care of youth emotional and behavioral disorders is important to study in order to target dissemination efforts and to provide a baseline from which these efforts can be evaluated. Treatment for youth psychological concerns occurs primarily in educational settings. However, little is known about the types and frequency of treatment services received by youth in school settings. Aims of this investigation were: 1) to modify a self-report questionnaire of therapy procedures for use by school-based personnel, 2) to identify clinical characteristics of school-based mental health providers, 3) to identify therapy techniques used in school-based mental health treatment for youth, and 4) to identify child, clinician, and organizational variables associated with the use of cognitive and behavioral treatment strategies, the dominant evidence-based approach for psychological disorders in youth, in school based settings. Data collection occurred through two stages: qualitative interviews utilized to pretest and modify survey items with seven participants, followed by more extensive and updated surveys administered electronically to 97 school-based mental health providers in the state of Florida. Qualitative data from phase one of data collection indicated that a shortened Therapy Procedures Checklist is well-suited for use with school based mental health clinicians. Results from phase two of this investigation indicated that there is great variability in clinical characteristics of school-based mental health providers, with the majority of school-based mental health providers reporting that they are licensed and that their highest level of education is a master’s degree. Results also indicated high variability in the primary presenting problem, length of sessions, average number of sessions, and treatment techniques utilized with students. Predictors of cognitive, behavioral, and psychodynamic strategy use in schools were also examined. Use of behavioral strategies was negatively associated with child age, and was more commonly reported for use with youth exhibiting externalizing concerns versus internalizing concerns. Results of this investigation highlight the variability in school-based mental health service provision and potential challenges to implementation of traditional evidence-based treatments to this setting.


School-based mental health care; usual care