Purpose: The purpose of this project is to develop, refine, and pilot test an IES-funded program (Be CALM Counseling) to increase counselors' attunement to the stress-related needs of the diverse middle school populations they serve. Stress is highly prevalent among adolescents, even more so in the present times, and disrupts students' learning as well as their emotional wellbeing. Although many different individual and contextual factors have been shown to promote stress resilience, emotion regulation is one of the most malleable and mindfulness is the approach with the strongest evidence for strengthening emotion regulation. Mindfulness is being widely used in U.S. classrooms. However, it has had limited application within school counseling, where more intensive skills instruction could occur for those students who are most vulnerable to the effects of stress, including those from disadvantaged backgrounds and with minoritized identities.

Project Activities: The research team will use an iterative development process that actively engages a variety of stakeholders and that leverages focus groups with school counselors and students and obtain input from academic and practice-based expert consultants. Researchers will collect information on student stress experiences using a novel methodology — Ecological Momentary Assessment or EMA (phase 1). In phase 2, professional development activities and student instruction will be field-tested in three schools in two iterative trials and implementation measures will be developed. Adaptations will be made based on this feedback from students and counselors and review of implementation data. Phase 3 will include a small randomized controlled trial (RCT) of the refined intervention across 14 rural NC schools, where counselors will deliver the Be CALM Counseling program or provide counseling as usual.

Products: The products of this project will include a fully developed program for middle school counselors, including materials for professional development workshops and to support skills instruction with students (i.e., a counselor manual and student workbook). In addition, dissemination products will include a series of practitioner briefs that include information on integrating mindfulness into professional school counseling, and peer-reviewed publications and presentations for both practitioners and researchers that address implementation considerations and pilot study findings. There will also be a program website.

Structured Abstract

Setting: The study will take place in racially and ethnically diverse rural middle schools in central North Carolina.

Sample: Approximately 90 middle schoolers with high levels of stress will participate, including 70 in the RCT. The student sample is sociodemographically diverse (35 to 40 percent Black, 15 to 20 percent Hispanic, 40 to 45 percent Caucasian, and 5 to 10 percent other/ multiracial), the majority of whom are expected to be eligible for free/reduced-price lunch. This sample is intended to represent public school adolescents in the rural Southeast. Participants will also include approximately 44 school counselors.

Intervention: The intervention will include 2 main components: (1) professional development (PD) for middle school counselors including practice-based consultation and (2) a modular student curriculum targeting emotion regulation skills through mindfulness-based activities to build stress resilience. Counselor PD will focus on building their mindfulness skills and attunement to diverse student needs. Skills instruction will allow for flexible delivery based on student need and schedule options (1:1 or group), with key modules addressing stress physiology, emotional awareness, inhibitory control, mindful coping, self-compassion, and conflict resolution. Specific content, activities, and session materials will be informed by development work and preliminary data.

Research Design and Methods: Development work in phase 1 will include focus groups and EMA (brief surveys completed 4 times daily for 1 week). Phase 2 will include field testing (obtaining feedback through mixed methods on initial intervention), with ongoing stakeholder feedback and consultation for refinement of program components and professional development content and approaches. For the small wait-list controlled RCT in phase 3, 14 counselors (1 per school) will be randomized to implement either the Be CALM Counseling invention or business-as-usual (BAU) counseling. For each counselor, the research team will recruit 5 students with high levels of stress and evaluate them over 6 months. They will also examine change in counselor attunement and mindfulness and implementation processes. The research team will collect pre-post student outcome measures and information on costs. Wait-list schools will receive training following collection of post-test data. Analyses will account for baseline differences in characteristics among counselors (e.g., training, years of experience), baseline competing counselor duties/responsibilities, and other universal and targeted supports students received.

Control Condition: Schools assigned to the control condition will provide school counseling as usual (BAU), in a comparable number of sessions with topics and activities being tracked.

Key Measures: Student inclusion will require above-average scores on the Perceived Stress Scale (PSS). Implementation measures will include activity and session checklists, attendance and time logs, student ratings of mindfulness practice and working alliance. Key student outcomes assessed in the RCT include pre-post measures of Difficulties in Emotion Regulation Scale (DERS) and Cognitive Emotion Regulation Questionnaire (CERQ) as well as daily report of stress and use of mindfulness skills through EMA. Distal student outcomes include overall stress, resilience, academic engagement (by student and teacher report), and school grades.

Data Analytic Strategy: The research team will examine implementation processes using descriptive analyses. For the RCT, they will examine student outcomes using hierarchical linear modeling to account for nesting of students within counselor/school. The team will use an intent-to-treat model with baseline scores as covariates for all pre-post measures and sensitivity analyses will examine robustness of results with varying implementation conditions. For EMA data, the researchers will examine within-person time-covarying associations using mixed-model trajectory analysis to identify how stress reactivity and coping may vary by intervention condition. They will use exploratory moderator analyses to see how counselor attunement, student mindfulness practice, and outcomes vary based on student identities and socio-demographics.

Cost Analysis: Researchers will use the ingredients approach to track and calculate costs associated with Be CALM Counseling, using data from project staff time logs, activity and session checklists, budgets, and interviews with school and project staff.

Project Website: https://www.becalmprogram.com

Related IES Projects: Promoting Self-Regulation to Enhance Social, Behavioral, and Academic Adjustment in Middle School (R305A170172)