Current Projects

R34 – Redesigning BRISC to Improve Reach in School Settings

Principal Investigators: Eric Bruns, PhD, Professor, Department of Psychiatry & Behavioral Sciences
Elizabeth McCauley, PhD, Professor, Department of Psychiatry & Behavioral Sciences
Jenna Van Draanen, PhD, Assistant Professor, School of Nursing and School of Public Health

Schools are the most common venue for youth mental health services, but school
mental health (SMH) typically does not use evidence-based strategies. Moreover, SMH is often delivered
inefficiently, with low rates of youth in need served and triage decisions not based on measurement of symptoms or progress. A multidisciplinary team thus developed and established the efficacy of the Brief Intervention for School Clinicians (BRISC), a four-session engagement, brief intervention, and triage strategy targeting a range of mental health (e.g., anxiety, depression, past trauma) and other problems (academic, peer, family). Like other evidence-based SMH strategies, however, integration of BRISC into authentic education settings has been inconsistent, with results from research and implementation evaluations of BRISC finding accompanying implementation strategies (IS) insufficiently tailored to the “real-world” SMH context. Moreover, stakeholders have observed that the reach of BRISC would be improved by adapting its implementation support strategies for use by school-employed practitioners such as school counselors rather than licensed MH clinicians working in schools. Locally-driven, user-focused redesign of BRISC ISs that maintains its core strategies thus hold promise for enhancing its reach, accessibility, and impact for youth with a wide array of MH concerns. To address serious MH workforce shortages and meet the need for accessible, contextually-appropriate, and engaging interventions for youth with emerging MH problems, the current project will iteratively adapt BRISC ISs for use by school-based providers (e.g., school counselors, school social workers) via the University of
Washington ALACRITY Center’s (UWAC) Discover, Design/Build, Test (DDBT) approach and methods drawn from the field of human-centered design. Adaptation will be led by a collaborative study redesign team comprised of researchers, UWAC Methods Core support staff, and school MH practitioners (SMHPs) from diverse (2 suburban/high-resource, 2 rural/low-resource) school districts.

The proposal first aims to iteratively redesign ISs to maximize BRISC usability, engagement, and contextual appropriateness during the Discover and Design/Build phases with a sample of school counselors (n = 10) and administrators (n = 5) (Aim 1). Next, in a pilot effectiveness-implementation hybrid type-3 trial during the Test phase, we will compare DDBT mechanisms (usability, engagement, appropriateness) and implementation outcomes (adoption, fidelity, adaptation, reach) for original BRISC ISs (BR-O) versus adapted BRISC ISs (BRA) (Aim 2). Finally, we will evaluate the potential for positive impact of original and adapted BRISC for students referred to or seeking SMH treatment on mental health outcomes (student top problems, anxiety, depression, MH functioning) (Aim 3). Participants in Aims 2 and 3 will include n = 12 school clinicians and n = 60 students. Data will be combined with other UWAC projects to inform overarching evaluation of the DDBT framework and the impact of redesign on implementation and clinical outcomes.