Date of Submission

2011

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Robert A. DiTomasso, Ph.D., ABPP

First Advisor

Virginia Salzer, Ph.D., Chairperson

Second Advisor

Elizabeth Gosch, Ph.D.

Third Advisor

Dr. Nissley-Tsiopinis

Abstract

School-based mental health services are in high demand due to the increased prevalence of diagnosable mental health disorders among the pediatric population, Attention Deficit/Hyperactivity Disorder (ADHD) foremost among them. The majority of research examining school-based services has been conducted in highly controlled settings and there has been a lack of research investigating such services within the actual school environment. The purpose of this study was to investigate the Catch Nurture Program, a school-based intervention, in the treatment of school-aged children with behavioral and/or emotional disturbances in the real-world setting. This study also examined the impact of gender and diagnosis on the program‟s effectiveness. The Nurture Program was evaluated by examining archival data (Achenbach CBCL and TRF) that had been collected on 115 students enrolled in the program for at least 4 months. The internalizing, externalizing, and ADHD subscales of the CBCL and TRF were examined at the time of intake and again 4 months later to evaluate the participants‟ progress over time. All of the participants attend public elementary schools located in low income, inner-city communities in South Philadelphia. The participants‟ ages range from 6 to16 years old; 73% are male; 73% are African American. The results of this study indicated that both parents and teachers observed small, but significant improvements in the participants‟ externalizing behaviors over time. However, only parents observed improvements in their children‟s ADHD symptoms over time. In addition, when comparing children diagnosed with ADHD to children without the disorder, parent reports showed that the internalizing behaviors of participants without ADHD are improving more significantly overtime. Finally, teacher reports showed that the female participants‟ internalizing behaviors are
improving over time, compared with males. Overall, although this study demonstrates some significant improvements in the participants‟ behaviors overtime, all of the effect sizes are small, and much lower compared with what has typically been found by other researchers examining school based intervention programs. Furthermore, because of the unstructured nature of the program under investigation, it is unknown exactly what interventions are being implemented on a consistent basis, therefore making it difficult to assess what is responsible for producing change among the participants. There is no assurance regarding the integrity of the implementation of the intervention components, and deviations from the program components could have produced unintended consequences on program outcomes. This study highlights the importance of standardizing community interventions as a means of establishing treatment integrity, because this is one of the most important aspects of treatment outcome research and a key ingredient to intervention success.

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