Teacher consultation and coaching within mental health practice: classroom and child effects in urban elementary schools.

Children in high poverty urban schools experience mental health difficulties and academic underachievement at elevated rates (Atkins, Hoagwood, Kutash, & Seidman, 2010; Whipple, Evans, Barry, & Maxwell, 2010). Underfunded schools struggle to meet student needs and teachers report difficulties motivating and managing students (Reinke, Stormont, Herman, Puri, & Goel, 2011). Observations in elementary classrooms reveal inconsistent access to effective classrooms in schools with high proportions of economically disadvantaged students (Pianta, Belsky, Houts, Morrison, & NICHD Early Child Care Research Network, 2007). Effective classrooms are defined by the presence of supportive teacher-student interactions (instructional, emotional, and behavioral) which together create a classroom environment conducive to academic and social-emotional development (Hamre & Pianta, 2010). When children with adjustment problems are in effective classrooms, their achievement has been shown to match that of their typically developing peers (Hamre & Pianta, 2005). Promoting effective teaching practices in elementary classrooms in low-income schools may thus benefit the adaptation of all students – those with and without behavioral difficulties. Recent efforts to promote effective teaching through teacher consultation and classroom coaching have been promising. Preschool teachers in high poverty schools who received training, coaching, and consultation improved in their management of behavior and provision of emotional support; and, children increased their self-regulation skills and academic performance beyond the skills and performance of comparison children (Raver et al., 2008; Raver et al., 2011). Similarly, in elementary schools assigned to receive training and coaching as a part of a social-emotional and academic learning program (4Rs; Brown, Jones, LaRusso, & Aber, 2010), intervention teachers demonstrated greater instructional and emotional support compared to control group teachers. The promise of these models is tempered by concerns about sustainability. Across studies, researchers employ external coaches and consultants as primary interventionists (e.g., Jones, Brown, & Aber, 2011; Raver et al., 2008). These interventionists are unfamiliar to teachers at the start of the study and depart when the study ends. Recent scholarship suggests the importance of considering issues of intervention feasibility and sustainability from the start (Aarons, Hurlburt, & Horwitz, 2011; Wandersman et al., 2008). Employing individuals already working in the school to deliver novel interventions may increase their sustainability (Atkins et al., 2008). In addition, to advance the learning and development of children with behavioral difficulties and their classmates, school mental health services may need to be re-conceptualized to include a focus on universal prevention (Nastasi, 2004) and effective classrooms (Cappella, Frazier, Atkins, Schoenwald, & Glisson, 2008). Accordingly, we designed and evaluated a teacher consultation and coaching program – Bridging Mental Health and Education in Urban Schools (BRIDGE; Cappella, Jackson, Wagner, Hamre, & Soule, 2011) – to increase effective classroom interactions and improve the functioning of children with behavioral challenges and their classmates. Embedded within the regular activities of school mental health professionals, BRIDGE represents a step toward the broader goal of enabling school and community mental health resources to support effective classrooms. Rather than focus only on the whole classroom or students with behavioral problems, BRIDGE applies a two-tiered approach to improving classroom interactions for all children (universal) and children with behavioral difficulties (targeted). A randomized trial of the initial effects of this program illuminates the extent to which school mental health staff can support teachers to increase effective teaching and promote the academic, behavioral, and social adaptation of children in urban poor schools.