Académique Documents
Professionnel Documents
Culture Documents
Jennifer Rivas
WC: 2,259
BEST PRACTICE RESEARCH PAPER 2
Being free of disease does not solely indicate health; one must also have the ability to
cope with the environment and be in control of ones emotions. Mental health is a key component
to have a healthy status, but it is not a widely discussed aspect. The U.S. Department of Health
and Human Services (HHS) describes mental health as, “ . . . our emotional, psychological, and
social well being. It affects how we think, feel, and act” (HHS, n,d.). According to Healthy
People 2020, “Mental disorders are one of the most common causes of disability. The resulting
disease burden of mental illness is among the highest of all diseases” (Healthy People 2020,
n.d.). With the scope of the problem put into perspective, around 43.6 million U.S adults who are
18 years and older suffer from a mental illness in a given year. (HP 2020, n.d.) Mental health
disorders and conditions don’t only affect adults. It has been reported that most mental illness
starts at a young age, and can develop to a serious debilitating mental disorder or illness. Data
from the National Health and Nutrition Examination Survey (NHANES) indicate that, “…13
percent of children ages 8-15 had a diagnosable mental disorder within the pervious year
(National Institute of Mental Health, n.d.). Mental health disorders and illness may lead to
substance abuse, suicide, as well major adverse social and economic outcomes. Although there is
numerous factors that contribute to mental health some factors include, trauma, stressful life
situations, medical conditions, self-esteem, and biological factors. Through various methods,
interventions have been implemented to prevent and reduce mental disorder. Children and
adolescents, disregarding race and ethnicity as well sexual orientation, are the target group that
Literature Review
To maintain a healthy mental health state, several interventions that have been effectively
implemented highlight and indicate the use of several methods to have a successful outcome. In
BEST PRACTICE RESEARCH PAPER 3
the journal, “Prevention of anxiety symptoms in primary school children: Preliminary results
from a universal school based trial,” a three intervention method implementation at a primary
school illustrates great preventative results for anxiety symptoms in children. The intervention
sample consisted of 489 school-aged children, from eight different primary schools, in which the
children ranged from 10 to 12 years of age. The primary schools were, “… randomly assigned to
intervention (TI), or a standard curriculum (usual care) with monitoring condition (SC)” (Barrett
& Turner, 2001). For the teacher-led and the psychologist-led intervention, the “Friends for
Children” intervention program was implemented which consisted of 10 weeks for 75 minute
session a week, meanwhile the students in the usual care with monitoring condition took part the
intervention aims to “assists children in learning important skills and techniques that help them
cope with and manage anxiety… techniques include relaxation, cognitive restructuring, attention
training, parent-assisted exposure, and family and peer support” (Barrett & Turner, 2001).
Results from the study showed that there was a significant decrease in self reported anxiety from
the teacher- and psychologist led interventions, compared to the standard curriculum. Although
stronger statistical data supported the PI and TI conditions, all interventions reflected
improvement on the self report measures of anxiety. It is important to note that characteristics of
anxiety are a well-known risk factor for several depressive and anxiety disorders in adolescences.
These practices show effective ways mental health can be improved and encouraged at an early
based practice, COPE is guided by the cognitive theory and cognitive behavioral therapy to
reduce anxiety and depression disorders and symptoms among adolescents. In the intervention, a
sample of 16 teenagers ranging from 10 to 17 years of age with history of mental health
problems, such as anxiety and depression from two high schools were gathered. The program
included seven cognitive behavioral skills building (CBSB) sessions in which COPE “ teaches
the adolescents that how they think directly impacts how they feel and how they behave”
(Melnyk, Kelly & Lusk, 2014). The sessions where incorporated in a group session, and were 50
minutes long held once a week. Finding from the intervention demonstrate that there was
significant decrease in depression score from the pre-COPE to the post-COPE measurements
evaluations, as well a decrease in anxiety scores. The positive outcomes with the students, who
identified with having negative mental health symptoms, indicated that the COPE program was
effective way to implement a prevention program in a school based setting with at-risk youth.
Since mental heath illnesses such as depression have a public health impact, this intervention
represented a great best practice approach to target adolescents for preventative practices.
FIRST” (Child and Family Interagency, Resource, Support, and Training) is a home based,
psychotherapeutic intervention that aims to address multiple factors such as depression and
behavioral problems and trauma and exposure to violence. The method of the intervention
Included a randomized sample of 78 children in the Child First group and 79 in the usual care
group; the children were age 6-36 months. The group in the Child First program received
by the needs of the children and the parent. The usual care group had access to services from the
community providers. The families where assessed at 6 months as well as at the end of the 12
BEST PRACTICE RESEARCH PAPER 5
month program, which included of weekly visits of the Child First ranging up to 50 minutes a
day. In children who were assigned to the Child First program, he outcomes of the intervention
resulted in improved language and externalizing symptoms compared to those who were in the
usual care (Lowell, Carter, Godoy, Paulicin, & Brigg-Gowan, 2011). There was also a
mental health. The results conclude that Child First is a best practice in intervention and
prevention of mental health. To improve the receipt of services like mental health and decrease
behavioral and externalizing behaviors shows the effectiveness of personalized home based
Similar to the Child Frist intervention, the intervention “Early Pathways,” is a mental
health, home-based program focused on young children. Early Pathways is designed with the
strengthen prosocial behavior, and using time limited strategies for reducing disruptive
The early pathway intervention was aimed a children, both toddles and preschoolers, living in
poverty through weekly treatment sessions ranging from one to two hour. The sample included
199 children ranging from the ages 1 to 5 and that would be consider to be in poverty, that was
sectioned off to a randomly assigned treatment group such as the “immediate treatment (IT) or
wait list control (WL) conditions. The therapy was terminated after the parent and clinician met
the treatment goals (Harris et al, 2015). From the outcomes, “results indicated that parents in the
BEST PRACTICE RESEARCH PAPER 6
behaviors…)” (Harris et al, 2015). This outcome signifies the effectiveness of an home based
treatment that can target children who are at risk and susceptible to development of negative
behavioral and cognitive functioning and who may not have access to a service treatment, such
as in school settings.
Finally, the last interventions distinguishes the effectiveness a public health approach to
prevent morbidity from mental health. The journal, “Outcomes Evaluation of a Public Health
prevention programs was implemented as a public health approach targeting youth on American
Indian reservation. The program was involved in extensive out reach providing workshops and
session to the community in schools or public facilities. A lot of the sessions were aimed at
identifying individuals with risk as well as risk factors involved. The educational and awareness
program was implemented for the span of 15 years, which mainly targeted adolescents in the
ages ranging from 11 to 18 years old. Youth members of the community that had risk for suicide
where treated or refereed to services that would be able to complete diagnosis and develop a
treatment. The outcomes of the suicide prevention program illustrated and an “an annual mean
number of total self-destructive acts dripped from 36 to 14 between 1988 and 2002, an absolute
drop of 61.1%” (May, Serna, Hurt, & DeBruyn, 2005). This public health approach, indicated
that a consistent prevention program that includes mental health services is a best practice to
reduce the number of suicidal behavior and attempts, while addressing all risk factors not only
specific ones. With this prevention program, adolescent who come from historic trauma or
susceptive to psychological and social issues, can be targeted while having community support
and engagement.
BEST PRACTICE RESEARCH PAPER 7
Intervention Proposal
After thorough research for the best evidence based practices, for my intervention I
would implement a cognitive behavior therapy (CPT) and pair it with mindfulness Based
cognitive therapy (MBST). The intervention would include a sample of roughly 150-250
students from minority background in a Hispanic based city or town. The target student age
group would be from 11 to 13 years of age, or middle school students. The reason for this
specific age group is to have them gain the necessary skills to cope with more stressful situation
and mange their emotions; as well improves mental health status and practices at a younger age.
The main goal for the intervention, like Healthy people 2020 Mental Health and Disorder Goals,
is to implement successful prevention programs and methods to improve mental health and
receive the necessary skill to access and seek appropriate mental health services. Since the
adolescent will be attending school, the best way to implement the program would be in the
The method of the intervention will include the framework for cognitive behavior therapy
and mindfulness therapy. With parental and school consent, student will take part in the weekly
program that will take place once a week for 45 minutes. Before the program therapy begins,
students will take a pre-survey and mental health test to identify risk and symptoms regarding
mental health illnesses or disorders such as stress, depression, and anxiety. During the six-month
program implementation, using CBT, students will engage in ways to identify thoughts and
emotions and how to deal with them appropriately. With this group therapy, negative emotions,
thoughts, and behavior identification and construct management planning, can be addressed and
reach a wider amount of individuals, instead of one to one. The MBST will aim to help
individuals cope with a menthe health problem such as depressions that already exist and help
BEST PRACTICE RESEARCH PAPER 8
reduce symptoms. Techniques like relaxation practices, and management skills will help students
be more cognitive aware and decipher their emotions. At the end of the 6-month intervention,
students will be asked to take a post survey and test to compare results with students that only
Due to the target adolescent population at a minority town, there might be several
limitations and barriers that can interfere with the intervention. Since the intervention is focused
on only Hispanic students in a small town, there might be cultural aspects like belief or lack of
trust, that parents may not want their child to engage in such program. There might also be
questions of generalizability due to the fact that the study is focused on one ethnicity and a
specific age group. School conferences and meeting as well as activities, may interfere with the
sessions that would be conducted during that time span. Since the pre and post surveys and test
are self-reported, the data may not be accurate as students may fell uncomfortable sharing their
actual symptoms or disorders. With these limitations and barriers, more intricate intervention
Conclusion
Mental disorders are not uncommon among children and adolescents and if not treated,
symptoms may develop as one ages which can be fatal. It general, it is important to address
mental health but targeting young age groups have shown to reduce the symptoms of progressing
mental illnesses or disorders and promote healthy lifestyles. With suicide being on the top charts
for leading cause of death among adolescents, mental health is an aspect of health that needs to
be further implements and advocated to decrease the overall progressive burden of disease. The
intervention applications, mindfulness therapies and the public health approach, have shown to
BEST PRACTICE RESEARCH PAPER 9
be effective best practices to promote a positive mental heath status as well reduce and manage
the negative mental health aspects. With an intervention that focuses on both cognitive behavior
therapy and a construct mindfulness practice, adolescents will have the skills to cope and manage
their emotions and thoughts and start practicing healthy behaviors that will be beneficial to
improve their mental health and practice strategies that can prevent mental disorders.
BEST PRACTICE RESEARCH PAPER 10
References
Barrett, P., & Turner, C. (2001). Prevention of anxiety symptoms in primary school children:
Harris, S. E., Fox, R. A., & Love, J. R. (2015). Early Pathways Therapy for Young Children in
doi:10.1177/2150137815573628
Healthy People 2020. (n.d.). Mental Health and Mental Disorders. Retrieved April 9, 2017, from
https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-
disorders
Lowell, D.I., Carter, A. S., Godoy, L., Paulicin, B., & Brigg-Gowan, M. J. (2011). A randomized
doi:10.1111/j.1467-8624.2010.01550.x
9, 125–132. http://doi.org/10.2147/PRBM.S63949
May, P. A., Serna, P., Hurt, L., & DeBruyn, L. M. (2005). Outcome Evaluation of a Public
Melnyk, B. M., Kelly, S., & Lusk, P. (2014) Outcomes and feasibility of a manualized cognitive-
behavioral skills building intervention: Group COPE for depressed and anxious
National Institute of Mental Health (NIMH). (n.d.). Any Disorder Among Children. Retrieved
among-children.shtml
U.S. Department of Health and Human Services (HHS). (n.d) What Is Mental Health? Retrieved
health/index.html