Community Recommendations for Adapting an Evidence-Based Mental Health Intervention for Racially/Ethnically Diverse Schools: A Qualitative Study

Abstract

The goal of this qualitative study was to understand the perspectives of school community members (adolescents, parents, school administrators, teachers, mental health providers) regarding the adaptation of an evidence-based transdiagnostic mental health treatment, known as the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents, for delivery in racially/ethnically diverse schools. Thirty-three school community members (n = 9 adolescents, n = 4 parents, n = 5 school administrators, n = 10 teachers, n = 5 mental health providers) participated in a series of focus groups or individual interviews. We used a rapid qualitative analysis to summarize their recommendations for adapting our intervention across seven themes: (1) consider social determinants of health, (2) include content related to social media and digital literacy, (3) provide teachers and staff with training on identifying and referring to mental health services and basic psychoeducation, (4) build trust and reduce stigma, (5) use qualified mental health providers to conduct culturally relevant sessions in person during school hours, (6) consider flexible format offerings and extended intervention delivery window, and (7) anticipate low parental engagement. These data were critical for informing systematic content and procedural modifications to our adapted intervention, such as scheduling sessions for school lunch hours and identifying coaches (e.g., teachers, school administrators) to support students with check-ins regarding session attendance and skill practice. These adaptations may be applied more broadly to the implementation of evidence-based mental health interventions in diverse school settings.