The Effectiveness of Psychosocial Interventions Delivered by Teachers in Schools: A Systematic Review and Meta-Analysis

Abstract

The growing mental health needs of students within schools have resulted in teachers increasing their involvement in the delivery of school-based, psychosocial interventions. Current research reports mixed findings concerning the effectiveness of psychosocial interventions delivered by teachers for mental health outcomes. This article presents a systematic review and meta-analysis that examined the effectiveness of school-based psychosocial interventions delivered by teachers on internalizing and externalizing outcomes and the moderating factors that influence treatment effects on these outcomes. Nine electronic databases, major journals, and gray literature (e.g., websites, conference abstract) were searched and field experts were contacted to locate additional studies. Twenty-four studies that met the study inclusion criteria were coded into internalizing or externalizing outcomes and further analyzed using robust variance estimation in meta-regression. Both publication and risk of bias of studies were further assessed. The results showed statistically significant reductions in students' internalizing outcomes (d = .133, 95% CI [.002, .263]) and no statistical significant effect for externalizing outcomes (d = .15, 95% CI [-.037, .066]). Moderator analysis with meta-regression revealed that gender (%male, b = -.017, p < .05), race (% Caucasian, b = .002, p < .05), and the tier of intervention (b = .299, p = .06) affected intervention effectiveness. This study builds on existing literature that shows that teacher-delivered Tier 1 interventions are effective interventions but also adds to this literature by showing that interventions are more effective with internalizing outcomes than on the externalizing outcomes. Moderator analysis also revealed treatments were more effective with female students for internalizing outcomes and more effective with Caucasian students for externalizing outcomes.

Characteristics of Effective School-Based, Teacher-Delivered Mental Health Services for Children

“…This study provides a meta-analysis using data from a systematic review. A detailed description of how the original data set was collected and created can be found in the article by Franklin et al (2017). Table 1 lists all of the included studies and study characteristics for this review.…”

“…Theoretical and empirical literature has discussed teachers’ involvements across tiers within the RTI framework (Mesmer & Mesmer, 2008). Yet the clinical effectiveness of teachers’ involvement in school-based mental health services remains inconclusive (Han & Weiss, 2005), with studies starting to report teachers being most effective in delivering Tier 1 interventions (Franklin et al, 2017, 2012).…”

“…Although previous research demonstrates the benefit of using teachers in school-based mental health services (Franklin, Kim, Ryan, Kelly, & Montgomery, 2012), these findings do not specify what makes teacher-delivered services effective or ineffective. A recent meta-analysis of school-based, teacher-delivered mental health interventions by Franklin et al (2017) assessed the overall effectiveness of mental health interventions delivered by teachers in school-based settings. Franklin et al found that teacher-delivered interventions were promising but not broadly effective, meaning that specific treatment characteristics may influence the effectiveness of these interventions.…”

Improving Mental Health Services: A 50-Year Journey from Randomized Experiments to Artificial Intelligence and Precision Mental Health

“…A Cochrane Review concluded, “We do not know whether psychological therapy, antidepressant medication or a combination of the two is most effective to treat depressive disorders in children and adolescents” (Cox et al 2014 , p. 3). Another meta-analysis of 24 studies on school-based interventions delivered by teachers showed a small effect for internalizing behaviors but no effect on externalizing ones (Franklin et al 2017a ). Similarly, a meta-analysis of 74 meta-analyses of universal prevention programs targeting school-age youth showed a great deal of variability with effect sizes from 0 to 0.5 standard deviations depending on type of program and targeted outcome (Tanner-Smith et al 2018 ).…”

Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT

“…7 A recent systematic review of teacher-led interventions for internalising and externalising symptoms reported weak evidence for the effectiveness of interventions on internalising problems (Cohen's d = 0.13) and no evidence for programmes on externalising problems. 8 Teachers report that disruptive behaviour and the task of managing the classroom can lead to high levels of stress and burnout. [9][10][11][12] Teachers themselves note the lack of training that they receive in the area of classroom management.…”