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Age at autism diagnosis is associated with sex assigned at birth (hereafter, "sex"), such that girls/women are more likely to be delayed or "missed" entirely in the diagnostic process compared to boys/men. Later diagnosed individuals, especially girls/women, demonstrate increased anxious/depressive symptoms. Data on autistic youth from clinic-based (n = 1035; 22.9% assigned female) and sex-balanced research-based (n = 128; 43% assigned female) samples were probed via regression-based mediation models to understand relationships between diagnostic age, sex, and symptoms of anxiety/depression. We hypothesized diagnostic age would mediate the relationship between sex and anxious/depressive symptoms. In both samples, later diagnostic age predicted greater anxious and depressive symptoms, and sex did not directly predict anxious symptoms. In the clinic-based but not the research-based sample, individuals assigned female at birth were later diagnosed than those assigned male, and there was a significant indirect effect of sex on anxious and depressive symptoms through diagnostic age, such that those assigned female and later diagnosed experienced greater symptoms. Within the research-based sample only, sex predicted depressive symptoms. The present study provides an important impetus for further evaluating the implications of diagnostic timing, enhancing tools for recognizing autism in individuals assigned female at birth, and grounding research with real-world ascertainment strategies.

Background: Sleep problems are common in adults with ADHD and may be bidirectionally associated with ADHD severity and other psychiatric symptoms. We investigated the prevalence of positive screenings for various sleep disorders, and their association with psychiatric comorbidities in a large sample of adults with ADHD from a specialized outpatient clinic. Methods: We included data of 3,691 adult patients diagnosed with ADHD, who had filled out a screener for sleep disorders (Holland Sleep Disorders Questionnaire (HSDQ)) as part of routine diagnostic assessment. The HSDQ screens for the sleep disorders insomnia, parasomnia, hypersomnia, circadian rhythm sleep disorders (CRSD), restless legs syndrome (RLS)/periodic limb movement disorder (PLMD), and sleep-related breathing disorders (SBD). As delayed sleep phase syndrome (DSPS) is very frequent in ADHD, we additionally screened for DSPS. Psychiatric comorbidities were diagnosed through clinical assessment and the Mini International Neuropsychiatric Interview (M.I.N.I.) Plus, which assesses 26 psychiatric disorders following the classification of the DSM-5. All data were retrieved from the electronic patient files. Results: Mean age was 35.4 and 49.4% of the patients were female. About 60% of the adults with ADHD screened positive for any sleep disorder. Highest prevalences were found for symptoms of DSPS (36%), insomnia (30%), and RLS/ PLMD (29%). Sleep problems in adults with ADHD were associated with comorbid depression, anxiety, substance use disorder, personality disorder, and post-traumatic stress disorder. Conclusion: Adults with ADHD often report sleep problems, which are associated with specific psychiatric comorbidities. Systematic screening for sleep disorders in adult patients with ADHD can contribute to a better understanding of their complaints and may aid improved and integrated treatment for the sleep and psychiatric problems.

Numerous stressors, such as test anxiety, imposter phenomenon, and perfectionism. The association between the imposter phenomenon and perfectionism is well-studied, but test anxiety as a mediator of this association is not examined. The present study aimed to explore the mediating role of test anxiety on the imposter phenomenon and perfectionism among Pakistani high-achieving students. Additionally, we investigated gender and grade differences for junior and senior high school students. In the present cross-sectional survey study, participants (n = 250) aged 15-18 years responded to the Clance Imposter Phenomenon Scale, Frost Multidimensional Perfectionism Scale, and Westside Test Anxiety Scale. Findings showed that perfectionism increased by 39% with a one-unit increase in the imposter phenomenon. Test anxiety was a significant positive mediator of the association between imposter phenomenon and perfectionism. T-test showed girls had higher scores on the imposter phenomenon and test anxiety than boys. One-way ANOVA revealed significant educational grade differences with small effect sizes, and junior high school students scored higher than senior high school students on study variables. About 44% and 48% of 250 participants reported having moderate and frequent imposter symptoms, respectively. Almost 36.5% of high-achievers had low test anxiety, and 50% of high-achievers had normal test anxiety. The study presents a discussion of the merits and demerits.

Given the high prevalence of psychological distress among vocational training (VT) students, this study aimed to assess the role of interpersonal emotional competence as a resilience factor promoting the educational success of this population. We postulated that emotional competence would promote educational success, both directly and indirectly by fostering students' help-seeking intentions when facing a personal or school-related problem. To test these hypotheses, we used a sample of 219 VT students from the Canadian province of Quebec (68% women, M[subscript age] = 24.58; SD[subscript age] = 7.95) enrolled in various programs (e.g. institutional and home care assistance, welding and fitting, secretarial studies, and professional cooking). These students were assessed two times, during the first half of their training and again after their training. Results from structural equation modelling revealed that emotional competence was a positive predictor of help-seeking intentions and educational success. However, having the intention to seek help did not translate into higher levels of educational success. Overall, these results highlight the importance of supporting VT students in the development and strengthening of their emotional competence to promote their educational success. Future research is needed to further understand the help-seeking process among VT students and its implications for their academic outcomes.

Pragmatic measures of evidence-based practice (EBP) implementation can support and evaluate implementation efforts. We examined the predictive validity of therapist reports of EBP strategy delivery for children's mental health outcomes. Data were obtained from 1,380 sessions with 248 children delivered by 76 therapists in two county systems. Children (M[subscript age]=11.8 years, SD = 3.7) presented with internalizing (52%), externalizing (27%), trauma (16%), and other (5%) concerns. Therapists reported their delivery of EBP strategies on a revised version of the EBP Concordant Care Assessment (ECCA; Brookman-Frazee, et al., "Administration and Policy in Mental Health and Mental Health Services Research," 48, 155-170, 2021) that included 25 content (e.g., parenting, cognitive behavioral) and 12 technique strategies (e.g., modeling, practice/role-play). On average, 5.6 ECCA session reports (SD = 2.3) were obtained for each client, and caregivers reported symptoms on the Brief Problem Checklist (Chorpita, et al., "Journal of Consulting and Clinical Psychology," 78(4), 526-536, 2010) at baseline, weekly over two months, and again at four months. Multilevel models examined whether the mean extensiveness of each EBP strategy predicted trajectories of child outcomes. More individual technique (6 of 12) than content strategies (1 of 25) were associated with outcome trajectories. For techniques, more extensive use of Performance Feedback and Live Coaching and less extensive use of Addressing Barriers were associated with greater declines in total symptoms, and more extensive use of Establishing/Reviewing Goals, Tracking/Reviewing Progress, and Assigning/Reviewing Homework was associated with declines in externalizing symptoms. For content, more extensive use of Cognitive Restructuring was associated with declines in total symptoms. In addition, higher average extensiveness ratings of the top content strategy across sessions was associated with greater declines in total and externalizing symptoms. Therapist-reported delivery of some EBP strategies showed evidence of predictive validity and may hold utility in indexing quality of care.

K-12 schools are a major sector for efforts to prevent and treat student mental health problems. In the United States, these efforts have led to the emergence of the MultiTiered System of Supports (MTSS) universal prevention, early intervention, and treatment policy framework. With a major focus on behavioral and mental health, MTSS has been adopted by all fifty state education departments. However, multi-level complexities of addressing student mental health within and across organizational structures complicate MTSS and broader policy development, implementation, and evaluation; disconnects between policy writers and practitioners obstruct progress, limiting positive outcomes. To bridge these policy-to-practice gaps, a multi-component solution is needed. The authors propose integrating the following elements: the Massachusetts School Mental Health Consortium's Five Guiding Principles for Building a Coordinated School Mental Health System, the comprehensive school improvement methodology Evolutionary Systems Improvement (ESI); and the ontological framework of BioPsychoSocioTechnical Systems Theory (BPST). Individual application of these components has already yielded systems-level improvements outperforming compliance-driven procedures. Used together, these components offer a multi-level solution for establishing conceptually-guided, measurement-based loops that transcend the restrictions of uninformed policy, supporting stakeholders as they work to systematically eliminate barriers and improve student mental health.

This is a qualitative study that employed exploratory design to inquire from 15 participants of Central University (Ghana) about their experience with the COVID-19 pandemic in Ghana. An in-depth interview was conducted, and data were analyzed using thematic analysis. The findings indicate that participants experienced fear expressed in four key domains reported under four key themes thus: Experiencing psychological distress; Burden of economic hardships; Fear of inefficient health system; and Educational disruptions and worries involved in online teaching and learning. The study concludes that the upsurge of COVID-19 has triggered psychological, economic, and educational conundrums that have to be addressed. This paper contributes to the growing body of studies on COVID-19 and effects on lecturers and students. The burgeoning evidence of the mental health distress following COVID-19 should be a wake-up call for universities and Ghana as a whole to invest both in infrastructure and manpower in this area of health care delivery. Vaccine hesitancy research must be conducted to improve upon health educational campaigns. The significant disruption from the pandemic is a fair warning to all stakeholders to make educational e-learning infrastructure resilient against similar future shocks. The implications of the findings for health and educational policies in Ghana are addressed.

Purpose: Understanding the experiences of people with developmental disabilities during the initial period of COVID-19 pandemic. Methods: Individuals with developmental disabilities and their caregivers completed baseline and up to five follow-up online surveys using the CRISIS-AFAR measures, between July 2020 and September 2021. We used qualitative (thematic analysis) and quantitative (MANOVA) analytic methods. Results: One hundred and eighteen participants (64 caregivers on individuals 6-62 years, 54 self-reporting individuals aged 17-55 years) completed baseline survey; 46 participants (23 caregivers, 23 self-reporting adults) completed [greater than or equal to] 1 follow-up. Qualitative themes included uncertainty, and negative and positive influences on behaviours and routines, daily life and mental wellness. Those experiencing positive impacts did not stably perceive so longitudinally. Conclusions: Despite both negative and positive influences on individuals with developmental disabilities and their families, the prolonged pandemic had wide-ranging repercussions. Emergency preparedness planning should consider the disruptive effects of public health measures on routine and support for this vulnerable population.

Firearm-related violence is the leading cause of death for adolescents and can have lifelong ramifications, including to one's mental health and well-being. Through a scoping review of existing literature published since 1980, the current study describes nuanced pathways through which exposure to firearm violence (direct or indirect) can contribute to the development and exacerbation of posttraumatic symptomatology during adolescence (ages 10-19). Furthermore, this review explores moderators and mediators of this relationship, shedding light on the interplay between individual, familial, and societal factors. Findings from the reviewed studies (N = 16) demonstrate various links between direct and indirect firearm exposure and short- and long-term posttraumatic symptomatology in adolescents and point to necessary solutions that encompass consistent firearm violence prevention and mental health support. Results can inform future research, policy development, and intervention strategies to mitigate the adverse psychological effects of firearm violence on the vulnerable adolescent population.

School teachers have demonstrated poor mental health and low levels of wellbeing, globally. Despite the high prevalence of depression, burnout, stress, and anxiety, few programs have been developed in collaboration with teachers that are appropriate for their needs and circumstances. The current mixed-methods study involved consultation with members of the teaching workforce in Australia to understand their preferences for a program to address their mental health and wellbeing. The sample included teachers and other key representatives from the education sector in New South Wales, Australia. There were 47 participants who completed online surveys, with a subset (n = 16) also attending two group workshops (n = 10 in the first workshop, n = 6 in the second workshop). Data were collected between May 2021 and October 2021. Descriptive statistics were calculated to summarise quantitative survey data, and thematic analysis was used to analyse qualitative data. Results from surveys and workshops found that a new approach is needed to address teacher mental health and wellbeing in schools. Participants expressed a preference for a strategy that combined a face-to-face approach with a digital component and focused on three areas: staff relationships, supportive leadership, and practical skill development. The results of this study provide guidance about areas to target to improve teacher mental health and wellbeing.

Teachers play a critical role in school mental health. They aid in the identification and referral of students in need of mental health services and are key players in implementing interventions. Nevertheless, teachers often lack the education and training needed to support youths' mental health. Increasing teachers' mental health literacy (MHL) is recognized as a needed area of focus in improving systems' responses to youths' mental health needs, yet no current tools assess teachers' complete MHL. A measure of MHL for in-service teachers based on current conceptualizations of MHL in the context of schools was developed and tested. The 24-item scale was tested in a sample of 407 full-time teachers in the United States and initial psychometric testing supports its use. The analytic strategy included an exploratory factor analysis (EFA), reliability analysis via Cronbach's a, and convergent validity analysis via zero-order correlations between the Teachers' MHL Scale and theoretically linked constructs. The final scale includes four subscales that measure teachers' understanding of how to promote well-being, recognize potential problems, link students in need to appropriate resources, and the link between well-being and school success. The underlying theory supporting the tool's development and suggestions for its use are discussed.

Rural adolescents are at a greater risk for substance abuse and other mental health challenges. There is a need for enhanced evidence-based prevention efforts. This case study evaluated both remote and in-person instruction of "Second Step®", a social-emotional learning (SEL) curriculum aimed to improve school-based prevention efforts. "Second Step®" was implemented in a rural Midwestern middle school from Fall 2020 to Spring 2022. Pre- and post-surveys were given to 7th grade (n = 233) and 8th grade (n = 146) students. To evaluate program implementation, t-tests were conducted. Post-survey scores were compared to evaluate remote versus in-person learning. Seventh grade students showed significant improvement of self-efficacy in overcoming obstacles, and this was expanded via in-person instruction. Eighth grade students increased knowledge of identifying and disrupting bullying, and the goal-setting unit showed more success taught via remote instruction. "Second Step®" shows promise in increasing self-efficacy and knowledge of SEL topics. Exploratory results suggest both in-person and remote implementation should be considered.

The presence of communication within the family can be considered as a protective factor in preventing the development of mental health problems in school by acting as a buffer against mental health problems in adolescents. Thus, this study, which was designed to reveal the potential mechanisms between family communication and bi-dimensional student mental health (psychological well-being/distress) in Turkish adolescents, examined the serial mediator role of digital game addiction and school belongingness. The study sample consists of a total of 397 volunteering Turkish adolescents, including 206 girls (51.9%) and 191 boys (48.1%). The participants' ages range from 14 to 17 (M = 14.63 years, SD = 0.60). In this study, a cross-sectional and explanatory design based on structural equation modeling was used. The main findings of the study are as follows: (1) digital game addiction mediated the relationship between family communication and psychological well-being/distress, (2) school belongingness mediated the relationship between family communication and psychological well-being/distress, and (3) the relationship between family communication and psychological well-being/distress was serially mediated by both digital game addiction and school belongingness.

Suicide is a complex, multifaceted crisis affecting children and adolescents, and has become a major public health concern. While there is a plethora of research on this topic among neurotypically developing youth, much less is known about the nature of suicidality in autistic individuals. Autistic youth show an increased vulnerability for suicidal tendencies that are poorly understood among school mental health (SMH) professionals, who report a range of competency and self-efficacy to address suicidality in school settings (Debski et al., 2007; O'Neill et al., 2020). Co-occurring mental health difficulties pose significant challenges in the early detection of suicide risk in autistic youth. Given that suicide is the leading cause of death among autistic individuals, the incidence of suicidality among autistic youth is of particular concern. This article provides a practice-friendly review of the research outlining innate vulnerabilities that present risk factors for suicide among autistic youth, along with assessment considerations that help inform the management of suicide risk in autistic youth. We conclude with recommendations for integrating a multi-tiered neurodiverse-affirming approach with sensitivity for student intersecting identities and system-level influences on student mental health that enables SMH professionals to create supportive school environments for autistic youth that prevent further harm.

Autistic adults experience disproportionate rates of co-occurring mental health problems. Psychotherapy has been recognized as an appropriate treatment approach, but evidence is limited. Researchers used a qualitative research paradigm to explore the experiences of mental health providers who provide psychotherapy to autistic adults. The Enhanced Critical Incident Technique was used to interview 13 mental health providers regarding perceptions of facilitating therapy with autistic adults. This research highlights challenges to providing psychotherapy to autistic adults while also illuminating ways that mental health providers have worked to ameliorate such challenges and create positive experiences in therapy. This research also contrasts therapy for autistic adults relative to the general population. Practice recommendations and suggestions for future research are offered.

Data from the National Survey of Children's Health 2016-2020 was used to examine the association between physical activity and anxiety and depression among autistic youth, non-autistic youth with ADHD, and non-autistic non-ADHD youth. There was a significant negative association between physical activity and anxiety among all groups. Reduction in anxiety or depression associated with greater physical activity was at least as large or larger among autistic or nonautistic youth with ADHD than among non-autistic non-ADHD youth. Unfortunately, even autistic youth who were physically active 4 to 7 days a week showed very high rates of anxiety (54.5%) and depression (23.1%). Very high levels of dual diagnosis of anxiety and depression in autistic youth and youth with ADHD also emerged. Findings highlight a need to determine the cause-and-effect relationships among physical activity, anxiety, and depression across groups and to prioritize mental health screenings and support for autistic youth and youth with ADHD.

The COVID-19 pandemic has strained the resources of the world's healthcare systems. Most individuals with neurodevelopmental disabilities (NDDs) experience significant mental health issues and face substantial barriers in accessing appropriate supports which have been exacerbated during the pandemic. It is unknown the extent to which COVID-19 impacted the demand for and effectiveness of inpatient care for those with NDDs. The impact of COVID-19 on the number of admissions of youth with NDDs to pediatric inpatient psychiatry units, as well as their functioning and length of stay during the first two years of the pandemic was analyzed using Bayesian structural time series models. Admission data of youth with NDDs from four pediatric inpatient units in Alberta, Canada (n = 2144) was examined. Inpatient admissions of youth with NDDs significantly increased following the onset of the pandemic. Compared to the period prior to the pandemic, patients with NDDs had significantly worse overall functioning and received fewer days of treatment. These findings highlight the need for increased resources to support the mental health needs of this vulnerable population and are consistent with other studies in the general population examining the utilization of inpatient psychiatric units during the pandemic.

First-generation college students (FGCS) are at risk for suffering from mental health issues, which have direct implication for their retention and academic success. Past investigators consistently find that college students are more likely to discuss mental health issues with their peers than with college personnel. The first step in peer-to-peer mental health support is screening students on campus to gain a baseline understanding of how they respond when encountering a peer in mental distress. The Mental Distress Response Scale (MDRS) is a screening tool for appraising students' responses to a peer in mental distress. Score validation is a crucial step, as FGCS are a unique college student population and the psychometric properties of instrumentation can vary between different populations. Psychometric testing yielded support for the validity of scores on the MDRS with FGCS. Findings have direct implications for aiding student affairs officials' universal screening efforts to support FGCS' mental health and retention.

We examined early adolescent predictors of later distress and adaptive coping in early adulthood, using data from a prospective longitudinal cohort study (n = 786). In early adolescence (age 13), we assessed indicators of mental health (internalizing symptoms), stressor exposure (cumulative stressful life events), and family socialization (supportive parent-child interactions). In early adulthood (age 22), during the first COVID-19-related Swiss national lockdown, we assessed cumulative pandemic-related stressors, distress (poor well-being, hopelessness, and perceived disruptions to life) and adaptive coping. Early adolescent internalizing symptoms predicted lower well-being, more hopelessness, and perceived lifestyle disruptions in early adulthood, during the pandemic. Cumulative stressful life events during early adolescence moderated the association between cumulative pandemic-related stressors and perceived lifestyle disruptions. Supportive parent-child interactions fostered subsequent engagement in adaptive coping, which, in turn, predicted less hopelessness and better well-being. Findings reveal that early adolescent development is linked with distress and adaptive coping in later periods.

The Journey of Hope (JoH) is an evidence-based behavioral health prevention intervention model designed for disaster-affected children and youth. While the in-person JoH model has been extensively delivered and studied, the virtual implementation of this intervention, specifically tailored for the unique needs of children and youth during the COVID-19 pandemic, has not been previously explored. In this context, authors of this article adapted the JoH to a virtual delivery model, aiming to provide access to behavioral health preventive services for children and youth during the COVID-19 pandemic when in-person services were not feasible. This adaptation, utilizing the dynamic adaptation process (DAP) and community-based participatory research (CBPR) principles, was carefully designed to meet pandemic-related challenges while maintaining the core components of the original intervention. The primary objectives of this article are twofold: (1) to provide an overview of the theoretical and conceptual underpinnings of the JoH-C19, including the framework that guided the adaptation, and (2) to describe the virtually adapted curriculum and initial pilot of the JoH-C19. This adaptation represents a crucial step in ensuring the accessibility of virtual behavioral health interventions for young populations facing various collective traumas and challenges in a rapidly evolving world.

Background: Undergraduate engineering students experiencing distress are less likely than peers to ask for professional help. A population-specific instrument to facilitate the identification of factors that influence mental healthcare utilization could guide development and testing of interventions to increase help seeking. Purpose: We used mixed methods guided by the Integrated Behavioral Model (IBM) to develop and evaluate the Undergraduate Engineering Mental Health Help-Seeking Instrument (UE-MH-HSI). Method: First, we adapted existing measures of mental health help-seeking intention and mechanisms (i.e., attitudes, perceived norm: injunctive, perceived norm: descriptive, personal agency: autonomy, personal agency: capacity). Second, we coded qualitative interviews (N = 33) to create population-specific mental health help-seeking belief measures (i.e., outcome beliefs, experiential beliefs, beliefs about others' expectations, beliefs about others' behavior, beliefs about barriers and facilitators). Third, we tested the psychometric properties using data from 596 undergraduate engineering students at a historically White, research-focused institution in southern United States. Results: Psychometric analyses indicated that (1) help-seeking mechanism and intention measures demonstrated unidimensionality, internal consistency, construct replicability, and sufficient variability; (2) mechanism measures demonstrated criterion evidence of validity; and (3) most items within the belief measures demonstrated sufficient variability and convergent evidence of validity. Conclusions: The UE-MH-HSI is an evidence-based tool for investigating mental health help-seeking factors and their relationship to help-seeking behavior, well-being, academic success, and engineering identity formation. Guidelines for use are provided.

Background: The wellbeing of college students today is at risk because of rising occurrences of mental health issues in higher education. Concurrently, undergraduate students perceive engineering courses and programs to be among the most arduous, and least welcoming and accommodating, in higher education. Although research related to mental health and wellbeing (MHW) in engineering is growing, a systematic review of this research has yet to be conducted. Purpose: This systematic literature review identifies and synthesizes empirical scholarship related to the MHW of undergraduate engineering students. Scope/Method: Specified search terms and inclusion criteria were used to identify 34 empirical studies related to engineering undergraduates' MHW. Content and qualitative thematic analyses were conducted to characterize and synthesize trends in research quality and outcomes across studies. Results: Undergraduate engineering students experience a variety of mental health issues that negatively affect their experiences in engineering education. Stress is the most prevalent mental health issue identified; anxiety, depression, and post-traumatic stress disorder (PTSD) are also reported. Heavy academic workloads, sleep issues, and the nature of engineering education culture are identified as impediments to MHW in engineering education. Conclusions: Although MHW in engineering is a growing area of research internationally, current MHW research in engineering is nascent and focused on the characterization of student mental health issues. Researchers underutilize qualitative and mixed-methods approaches, longitudinal and experimental designs, guiding frameworks, and robust sampling techniques. Academic and mindfulness interventions, as well as the use of mental wellness constructs from positive psychology, show promise for supporting MHW in engineering.

Academic staff experience high levels of work-related stress and poor mental health. As a result, many institutions face high staff turnover. These outcomes may be driven by complex and, at times, apparently oppositional objectives academics need to meet around research and teaching. These factors may present both practical and social identity-based incompatibilities. The current study tested the role of these incompatibilities upon mental well-being and turnover. A sample of 141 UK resident academics completed scales measuring levels of social identification with being an academic, an educator and a researcher, identity based and practical incompatibility, mental health, experience of the workplace and turnover intention. No direct links were found between practical incompatibility and outcomes. However, higher identity incompatibility was related to poorer mental health. Identity incompatibility was also related to turnover intention, mediated by both mental health and workplace experience. Contrary to predictions, these effects were not moderated by identity difference or identity strength. The current findings present evidence that role-based incompatibilities have both practical and identity-based foundations and highlight important caveats to the benefits of multiple identities on well-being observed in other domains. The findings also suggest practical steps through which complex occupational roles can be best structured to improve mental health and reduce turnover.

Despite well-established health disparities between transgender and cisgender youth, state bills restricting gender-inclusive school supports and health care have dramatically expanded since 2019. While parental support for transgender youth strengthens healthy development, unsupportive parents contribute to suicidality and homelessness. This study examines (1) whether school climate and health gender inequities hold in Wisconsin, a politically contested state without nondiscrimination or bullying legislative protections for transgender youth, and (2) gender differences among adolescents who sought help when depressed or anxious.

Embedding musicians' occupational health training in music education curricula is widely recommended due to the well-documented high prevalence of performance-related health problems (PRHPs) among musicians across their lifespan. A scoping review was conducted to examine the range of evidence from implementations of musicians' health education programs, regarding the maintenance of hearing, musculoskeletal, psychological, and vocal health, as well as injury prevention strategies to minimize the risk of PRHP. Eligible sources of evidence included published and unpublished studies reporting occupational health education programs (which may have incorporated information on physical or psychological health, exercise, or somatic movement training) implemented with pre-tertiary and tertiary music students and teachers. Studies reporting stand-alone psychological health education were excluded. Key characteristics from included studies were extracted and charted. Data charts outline commonalities across the reported results, including physical, psychological, educational, and behavioral change outcome measures. Out of 46 records included for data extraction, 35 reported programs with tertiary-aged music students, seven reported programs with pre-tertiary-aged music students, two reported programs with music teachers, and two reported systematic reviews. Reported benefits from this research with both pre-tertiary and tertiary music students suggest that musicians' health education and injury prevention strategies reduce self-reported playing-related pain and music performance anxiety. However, future implementation studies need to address identified challenges such as effective behavior change and the enablers and barriers to the long-term adoption of strategies for optimal music performance and health outcomes. This review highlights the need for further research into designing and embedding musicians' health education into all music training settings, including more implementations with pre-tertiary music students, as well as training to support the professional development needs of instrumental and vocal teachers.

Studies on the impact of the COVID-19 pandemic on autistic children's psychosocial outcomes have shown mixed results. In the current study we aimed to gain a better insight into the effect of the COVID-19 pandemic by comparing psychosocial outcomes collected pre-pandemic with data collected during the pandemic. We used the Strengths and Difficulties Questionnaire (SDQ) to examine change over time in psychosocial outcomes of autistic children from pre-pandemic (T0) to lockdown I (T1) and lockdown II (T2) in the Netherlands. We expected a deterioration in psychosocial outcomes. There were 224 participants in T0 and T1, of which 141 also participated in T2. The results showed a surprising improvement in psychosocial outcomes from T0 to T1. Special education and female gender were associated with increased difficulties over time, while higher age was associated with decreased difficulties. At the subdomain level we found that emotional problems remained stable, while hyperactivity, conduct problems, and peer problems decreased, and prosocial behavior increased. Attending special education predicted increased peer problems over time, while higher age predicted both decreased conduct problems and increased prosocial behavior over time. The COVID-19 pandemic may have temporarily improved the fit between the psychosocial needs and the environment for children with autism in the Netherlands.

People thrive in compassionate environments. For autistic people, their environments are often non-conducive to care and support. We propose that cultivating autistic people's self-compassion may be an antidote to the mental health difficulties arising from environmental causes. The current study aimed to pilot a self-guided online self-compassion program for autistic adults to assess its feasibility, acceptability, and outcomes related to completing this program. The program was co-produced with autistic individuals. Thirty-nine autistic adults aged 20-77 years (M[subscript age] = 45.28, SD[subscript age] = 11.92) completed the online program. They also provided feedback about their self-compassion practices every week. They completed pre- and post-intervention online surveys measuring self-compassion, symptoms of anxiety and depression, positive and negative affect, emotion regulation difficulties, and psychological well-being. As hypothesized, there were significant group improvements in all outcome measures. Preliminary results suggest that the program is feasible and accepted by participants. Approximately half of the autistic participants reported experiences of backdraft, which are adverse reactions associated with self-compassion practices. Based on our findings, we provided clinical recommendations on how self-compassion can be taught to autistic adults.

Social camouflaging in autism involves hiding social differences and autistic traits to fit in with neurotypical settings and is associated with poorer mental health in both autistic adolescents and adults. This study explored the association between self-reported social camouflaging behaviours and adolescents' self-report of generalised anxiety disorder and depressive symptoms compared with caregiver reports. A clinical sample of 43 autistic and 39 non-autistic adolescents (14-19 years), without intellectual disability and matched on social anxiety, and their primary caregiver completed questionnaires reporting the young person's autistic traits, generalised anxiety disorder and depression symptoms. Using response surface analysis, congruence between adolescent and caregiver rated autistic traits, generalised anxiety disorder and depression symptoms were not associated with greater camouflaging scores. Response surface analysis parameters showed that camouflaging was greater when both adolescent and caregivers rated high levels of autistic traits and generalised anxiety disorder symptoms, and when adolescents exceeded caregiver ratings on autistic traits, generalised anxiety disorder and depression symptoms. Adolescents who experience greater anxiety and autistic traits may engage in more (though less effective) social camouflaging behaviours, which in turn may contribute towards poorer mental health outcomes. Clinicians may benefit from collaboratively creating with adolescents a person-centred formulation that considers the associations between autistic traits and mental health outcomes.

Mental health conditions are more prevalent in autistic people than non-autistic people. The Strengths and Difficulties Questionnaire is a commonly used screening tool for emotional and behavioural difficulties in autistic children and adolescents. However, few studies have assessed the psychometric properties of the Strengths and Difficulties Questionnaire in populations of autistic people, especially measurement invariance, to examine whether the underlying latent structure is consistent across time or groups. Measurement invariance of the parent-reported Strengths and Difficulties Questionnaire in a nationally representative cohort study was examined: longitudinal invariance (autistic 11-, 14- and 17-year-olds) and group invariance (autistic and non-autistic 17-year-olds). Differential item functioning was explored in the autistic/non-autistic group analysis. The five-factor structure showed inadequate fit, especially in the autistic group; by extension, measurement invariance could not be established. Differential item functioning was observed for several conduct problems, prosocial behaviour and peer problems subscale items, as well as reverse-coded items. Poor structural validity and item-level invariance may confound findings from research within and between populations of autistic and non-autistic adolescents, as well as screening of mental health conditions in autistic adolescents. This research calls for the development and improvement of screening tools for emotional and behavioural difficulties in populations of autistic people while accounting for their heterogeneity.

The rapid development of social reform and the economy has brought great challenges to the mental health of college students. However, there are few studies on the impact of these psychological problems on college students' English learning. As a special group about to enter society, studying the mental health of college students in foreign language learning is of great significance. This paper discusses the principle of Artificial Intelligence (AI) technology and the interactive mechanism to support college students' foreign language learning. Additionally, the adaptability supporting college students' foreign language learning is analyzed according to the current situation of AI supporting foreign language learning. Then, the mental health of college students in the AI environment is investigated and analyzed. This paper takes foreign and non-foreign language majors of Changchun University of Technology as the object and uses questionnaires, interviews, and classroom observation to obtain basic data. The results show that college students' adaptability to foreign language learning is higher than that of non-foreign. Students' intelligent operation and knowledge storage level impact their adaptability to foreign language learning. Psychological health problems include learning anxiety, loneliness, depression, and inferiority in college students' foreign language learning. These negative emotions, to a certain extent, affect the learning effect of college students' foreign language learning. This paper is of great significance to the adaptability of college students' foreign language learning to the intelligent environment and the analysis of their mental health problems. This paper hopes to provide data reference for the research on improving college students' foreign language learning effects.

Objectives: Community sites, including schools, are important settings for interventions to promote children and young people's mental health and wellbeing. A central provision to support mental health in the UK is school- and community-based counselling services. However, the evidence-base for school counselling services is limited by weak evaluation designs, lack of understanding of different counselling approaches in use, and a failure to conceptualise counselling services as part of a wider complex system. To address the last point, this article takes a complex system-focused perspective to explore how a 'system disruption', that is counselling service implementation, can be optimised in the Welsh education system. Design: The approach used in this study is a mixed-method qualitative design. Setting: Participants were recruited from school and community settings. They included children and young people, parents, carers, school staff, counsellors and stakeholders from health and education. Method: Consultations, key system stakeholder interviews and school case studies were conducted. All stakeholders were asked about their experiences of local authority-funded school- and community-based counselling services in Wales. Interview and consultation data were analysed using a thematic analysis approach. Results: Data converged into three main themes focusing on the specifics of counselling sessions, counselling services as part of universal mental health provision and a whole education system approach. These three themes are brought together into a complex systems-focused model of an optimised school- and community-based counselling service. Conclusion: The model offers an opportunity to address issues with current counselling services in Wales and improve outcomes and sustainability by increasing the likelihood they will become embedded in the whole education system.

Natural disasters happen across the world. The situations are different but the disruption to children's education and wellbeing is similar. This study focused on the school context changes caused by the COVID-19 global disaster, and the impact of these changes on children's mental health. The aim was to better understand the associations between any mental health changes and children's school level of deprivation and pre-disaster involvement in bullying. Cross-sectional data were collected from 4316 children aged 6-11 years old, from 57 schools across England and Wales. Data were collected before the national lockdowns, early 2020, and 3-5 months after the final return to school, summer 2021, when schools were operating under a range of context restrictions. Child data included bullying involvement at school and health-related quality of life; teacher data included reports of each child's internalising, externalising and prosocial behaviours. School-level disadvantage was determined by the proportion of children in each school eligible to receive free school meals (an indicator of family disadvantage). The results showed that victims of bullying pre-lockdown, and pupils from schools with a higher concentration of disadvantage, had significantly reduced externalising behaviours once back in the restricted school context. Victims had also increased their prosocial behaviours. It is possible that the restricted school context may have been a relief for the most vulnerable pupils. This study adds a new phase of understanding to the global disaster literature and the initial return to school when the environment is the same but the context has changed.

This study examined the associations between race, ethnicity, help-seeking behavior and perceptions of mental health treatment among college students with depression. This cross-sectional study included pooled data from the Fall 2018 and Spring 2019 semesters for n = 654 students from one large, public university. Baseline surveys were administered to undergraduate students at the beginning of each semester. Findings indicated that Asian students with depression have a 77% increased odds (aOR = 1.77, 95% CI: (1.17, 2.68), p value = 0.007) of seeking help compared to White students with depression. Asian students with depression have two times the odds of regretting not seeking help compared to White students (aOR = 2.00, 95% CI: (1.05, 3.89), p value = 0.03) while Hispanic students with depression have 1.72 times the odds of regretting not seeking help compared to White students (aOR = 1.72, 95% CI: (0.94, 3.16), p value = 0.079). Asian race modified the effect of general anxiety on help-seeking behavior, reducing the odds of help-seeking by 53% (interaction OR: 0.47 (95% CI: (0.20, 1.10), p value = 0.08). Findings show that the psychosocial landscape of Asian minorities among students with depression is changing; future research should focus on these shifting attitudes to encourage help-seeking behavior and tailor treatment.

This study examines the effects of racist microaggressions and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)-related minority stressors (i.e., identity concealment, family rejection, internalized LGBTQ-phobia, victimization, and racialized heterosexism/cisgenderism) on psychological distress among Latinx LGBTQ+ young people, specifically college students. Participants are a Latinx subset (n = 80) from a national online nonprobability cross-sectional survey of LGBTQ+ college students. The study aim was examined using linear/logistic regression. Findings indicated that racist microaggressions and family rejection were associated with psychological distress. In addition, racist microaggressions were the only stressor associated with clinically significant psychological distress that may warrant psychiatric/psychological treatment. Therefore, racist microaggressions and family rejection are unique stressors that may saliently affect mental health among Latinx LGBTQ+ students. There is a great need to integrate minority stress theory with other critically-oriented theories, such as intersectionality, in research and intervention to eliminate mental health inequities faced by Latinx LGBTQ+ young people.

Academic burnout seriously affects the academic performance and mental health of college students. This study developed a multi-mediation model to investigate the relationship between academic self-efficacy and academic burnout. A total of 1431 undergraduate students (51.85% female) were recruited to participate in this study. And we used SPSS PROCESS developed by Hayes to examine the mediating role of academic self-efficacy and academic burnout. The results indicated that academic self-efficacy can negatively predict academic burnout. Moreover, intrinsic motivation and learning engagement have a significant mediating effect between academic self-efficacy and academic burnout. Finally, we constructed a model comprising four variables and found that it explained 47.62% of the variance in academic burnout. These findings can be conducive to a suitable intervention path to reduce academic burnout of Chinese college students, so as to develop effective instructional strategies to improve their learning performance.

Background: Religious institutions play a crucial role in health promotion and hold significant influence in the public health field. Aim: The aim of this review is to examine outcomes of health-promoting interventions involving the use of mosques as the intervention venue, its role in promoting health behavior change, and the role of theory in each intervention. Methods: A scoping review was conducted across 17 databases for relevant publications published up to and including August 2023 that involved the use of mosques as the intervention venue. Fourteen articles met inclusion criteria and were reviewed. Results: The studies featured a wide range of interventions. However, only eight of these studies integrated theoretical frameworks into their approaches, indicating a need for more structured guidance in this field. These theoretical frameworks included Participatory Action Research (PAR), the theory of planned behavior, behavior-change constructs, the patient-centered outcomes research (PCOR) framework, and prolonged exposure techniques within Islamic principles. The review identified three main health-focused intervention categories: mental health, prevention, and communication, each providing valuable insights into initiatives within Muslim communities. Conclusions: This review underscores the significance of inclusive and culturally sensitive health interventions, emphasizing the effectiveness of faith-based approaches in improving health outcomes, promoting positive health behaviors, and addressing communication and cultural barriers. The reviews findings stress the need for further research that incorporates theoretical frameworks and tailored interventions to meet the specific cultural needs of these communities, ultimately contributing to enhanced well-being within them.

Anxiety and depression are among the most common mental health concerns in youth, with rates of these internalizing problems continuing to rise. Universal school-based interventions have shown promising results in improving poor mental health outcomes; however, more research is needed across different cultural contexts. This study is part of an ongoing evaluation of "A Lust for Life Schools Programme," a universal process-based cognitive behavioral therapy intervention for Irish primary school children. This study investigated the efficacy of the program through a cluster randomized controlled trial. Nine schools were randomly allocated to the intervention or control groups. Four hundred and seventy participants completed measures at three timepoints (baseline, post-intervention, and 6-week follow-up) assessing internalizing problems, anxiety, and depressive symptoms (primary outcomes) and avoidance, problem-solving, seeking social support, academic self-efficacy, social self-efficacy, and emotional self-efficacy (secondary outcomes). Although participants reported that they were mostly satisfied with the intervention, results revealed that the intervention did not have a significant effect on the outcome variables compared to the control group. Implications of the findings and recommendations for future research are discussed.

The current study examined financial stress, career-related optimism, and psychological distress from the age of 19 (2013; n = 5,787), until the age of 25 (2019; n = 2,933) using the Longitudinal Surveys of Australia Youth (2009 cohort). Longitudinal mediation using latent growth curve modeling observed trajectories of change across young adulthood, whereby financial stress and career-related optimism decreased, while psychological distress increased across time. The inclusion of regression parameters in the analyses indicated that participants with shallower reductions in financial stress reported steeper increases in distress, and this effect was mediated by shifting career-related optimism. With ongoing financial pressures around the world disproportionately impacting young people, our work further illustrates how these stressors can shape the life course via shifts in vocational optimism and subsequent mental health. Moving forward, policies and timely clinical interventions should be implemented to assist young adults in navigating this pivotal developmental period.

This study investigated the prevalence of receiving sexts among adolescents and its relationship with depressive symptoms and self-esteem. A survey was administered to 728 high school students in Sweden in 2019 and 2020 (50.4% girls and 46.4% boys) using a cross-sectional design. Findings showed that significantly more boys (28.4%) than girls (12.6%) reported having happily received a sexual picture, while significantly more girls (48.8%) than boys (s.2%) reported having received an unwanted sexual picture at least once in their life. Happily receiving a sexual picture was not related to any of the investigated mental health correlates among girls, whereas it was positively associated with depressive symptoms among boys. Receiving an unsolicited sexual picture was associated with higher depressive symptoms and lower self-esteem for both boys and girls. This work offers a novel approach to studying the reception of sexual images by teenagers Practical implications of the present findings are discussed.

An approach to action research of innovative and disruptive socioecological understandings of young people's wellbeing, resilience, and engagement in middle school was piloted with a coalition of school principals, lead teachers, police, and community development professionals by an RMIT research team. This coalition was built around the Hume-Whittlesea Local Learning and Employment Network and the Whittlesea Youth Commitment Committee in outer northern Melbourne, Australia. Action research facilitated the collaborative design of interventions for reducing middle school disengagement. These were then expressed in logic model terms to guide implementation and subsequent evaluation. Logic models clarified how local innovations, situated in an authorizing environment, can develop promising practices that contribute to system reform. Our project involved characterizing ecologies of young people's engagement, resilience, and wellbeing as part of a place-based strategy.

Guided by social cognitive theory and past empirical findings, the study's conceptual model posited that parent-child trust promotes positive youth mental health through the pathways of social self-efficacy and self-blame. Using longitudinal data from 129 children aged 10-14 who participated over three waves of data collection in fall 2019, spring 2020, and spring 2021, this study extends current knowledge by examining potential mediators of the relationship between child-reported parent-child trust and youth mental health. Significant indirect pathways indicated that social self-efficacy fully mediated the association between perceived parent-child trust and youth mental health, and self-blame did not. Results of the study aligned with the social cognitive theory perspective that youth outcomes can be influenced by the acquisition of social skills through observational learning of healthy models, such as parents. Findings suggest that a tiered intervention model that utilizes social emotional learning and parent-based prevention could improve adolescent mental health.

Teachers are returning to schools during the COVID-19 pandemic under the weight of unprecedented stressors to engage a student body that has also experienced stress and trauma. In this study, we examined how confident 454 teachers (55% Black) from 41 charter schools in New Orleans, Louisiana, were in their ability to address students' social-emotional needs upon their return to school. Results showed that Black teachers were more likely to report a greater sense of efficacy in addressing students' needs. Both Black and White teachers identified the top three resources needed to assist students: mental health supports, trainings, and in-class resources.

Background: The COVID-19 pandemic has had a substantial impact on children and families worldwide. Children's mental health has been at the forefront of pandemic research, with several observational studies documenting its decline. Limited person-centred research exists, however, investigating the diverse mental health responses of vulnerable children during COVID-19. Objective: The purpose of this study is to examine the profiles of 289 low-income children's mental health transitions from pre-COVID-19 to during COVID-19. Methods: Mothers' reports of children's mental health using the Strengths and Difficulties Questionnaire from before ([x-bar] = 2.73 years, SD = 0.23) and during ([x-bar] = 5.31 years, SD = 0.59) COVID-19 were used. Results: Three comparable profile solutions were identified pre- and early during the pandemic. Latent transition analysis revealed diverse patterns of children's mental health trajectory from prior to during COVID-19. Based on transition probabilities, the majority of children in the "Average Levels of Internalizing/Externalizing Problems" and "Externalizing Problems" profiles pre-pandemic showed stability in profile membership. Interestingly, most children in the high levels of "Internalizing/Externalizing Problems" profile pre-pandemic experienced some improvement in their mental health. Pre-pandemic maternal mental health and parenting had significant associations with children's profile membership at both time points. Conclusions: Our findings reveal the heterogeneity in children's mental health responses in times of large-scale crises. They also identify how pre-existing maternal risk factors may underlie the diverse experiences of children who underwent declining, stable, or improving mental health profiles during the COVID-19 pandemic.

Background: As autistic children are being diagnosed at a younger age, the need to identify appropriate early supports has increased. Therapist-delivered and parent-mediated autism intervention may benefit children and parents. Objective: This pilot study examined developmental outcomes for autistic pre-schoolers and mental health and wellbeing outcomes for their parents (n = 53) following a 10-month intervention period. Methods: All families were accessing therapist-delivered interventions--the Early Start Denver Model (ESDM) or usual community services--and some families also received additional parent-coaching ESDM (P-ESDM). Families were assessed at 3 timepoints. Results: Overall children made significant gains in cognitive skills and adaptive behaviour, with no differences between groups. Parents overall reported increased parenting stress over time. P-ESDM conferred no added benefit for child outcomes, and similarly, no clear benefit for parent outcomes. Conclusions: Our findings suggest that children receiving early intervention make developmental gains, regardless of type of intervention, and challenges assumptions that, as an adjunct to other intervention programs, P-ESDM improves child or parent outcomes. Further research is needed to explore the effects of parent-mediated programs.

Several meta-analyses have demonstrated that bullying prevention programs are successful in reducing bullying. However, scant research addresses if and how such anti-bullying efforts affect long-term internalizing health problems and even less on later use of pharmacotherapy and psychotherapy. This study explores how the school-based Olweus Bullying Prevention Program (OBPP) affects the likelihood of being prescribed antidepressant drugs, anxiolytics, hypnotics, and sedatives, using a difference-in-difference design with population-wide Norwegian register data, including the Norwegian Prescription Database. Generally, we find that student cohorts from schools with a higher proportion of victimized students have more prescribed drugs at ages 17-22. Although OBPP substantially reduces victimization, and, hence, assumedly internalizing problems, our results indicate that the OBPP increased the likelihood of being prescribed drugs for internalizing problems between ages 17 and 19. Our interpretation of these findings is that the OBPP had increased awareness of bullying in school and its damaging consequences, and thereby reduced the mental and attitudinal barriers that often prevent students from seeking help for internalizing problems. It should be noted, however, that the victimization data in our study were linked to schools only and not to register data for individual students. Accordingly, we were restricted to studying average program effects at the school level. The power to detect long-term effects would have been better with student-linked data for both the victimization and register variables.

Autism and sensory-friendly events are an increasingly common feature of community life. One predictable aspect of these events is the presence of sensory havens, which serve as a respite or self-regulation zone for neurodiverse children, family, friends, and, occasionally, their service animals. When research evidence contributes to the design of these spaces, they can positively impact the length of time people attend events and the quality of their experiences. The authors detail autism architecture guidelines and sensory regulation research, and provide practical strategies for designing and operating havens.

This article explores the effectiveness of virtual reality (VR) interventions in reducing anxiety and stress among music students, employing a quantitative, experimental methodology. Utilizing the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS) as measurement tools, the study engaged 120 volunteer musicians from South Ukrainian National Pedagogical University named after K.D. Ushynsky, Ukraine. These participants were randomly assigned to either a control group or an experimental group engaging in tailored VR interventions over a six-month period. The results showed a significant decrease in anxiety and perceived stress levels among the experimental group, as indicated by the STAI and PSS scores. These findings suggest that VR interventions can effectively enhance psychological well-being in music education. The study contributes to interdisciplinary knowledge, combining technology with educational methods, and recommends incorporating technology-driven approaches in curricula to address the emotional and mental health challenges faced by students. Furthermore, the article broadens the existing understanding of VR's impact on anxiety and stress reduction and offers practical insights for educators, psychologists, and policymakers, particularly advocating for the adoption of these methods across Asia.

Educators have embraced the promotion of social emotional development, student well-being, and mental health as essential educational objectives to promote academic readiness and growth. To address known research-to-practice gaps and limited availability of evidence-based, universal high school programs, we took a community-based participatory research (CBPR) approach to develop a contextually and developmentally appropriate program addressing social emotional learning, community, and student well-being. We employed the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) model of systematic instructional design for 2 school years. We collected quarterly anonymous open- and close-ended surveys from students and teachers and open-ended session-specific surveys from teachers; led student advisory and teacher focus groups; and documented coach feedback and observations. Researchers conducted qualitative descriptive and quantitative descriptive analyses. We summarize how CBPR and the ADDIE model of systematic instructional design was applied to ensure contextual fit and acceptability in high schools. We present how findings from the data sources were used to design and develop content and highlight results on comfort, content of interest, and optimal time dedicated to content. We describe how we developed the components of Well Connected©. We conclude with lessons learned for co-developing programs and engaging in participatory research.

The rising prevalence of mental health challenges among youth has created a pressing need for effective, feasible, equitable, and contextually relevant interventions. Educators and school mental health professionals face critical challenges in helping students overcome such barriers to school success. This makes the need for school-based intervention development research particularly that conducted in the context of collaborative research-practice partnerships, greater than ever. Despite the critical importance of iterative intervention development work, such work often receives less in attention in the published literature compared to studies about the outcomes of interventions. The goal of this special issue is to highlight innovative and rigorous research that describes the process of iteratively developing school mental health services in partnership with educators. Each paper in the special issue describes how education partners (and others including students, families, and other community partners) contributed to the development of an intervention or implementation strategy (i.e., a method or technique to enhance intervention adoption, implementation, or sustainment), how data informed iterations of the intervention or strategy, considerations related to contextual appropriateness, and lessons learned related to community-partnered school-based intervention development. In this introduction paper, we provide a context for this work and highlight innovations across papers in the special issue.

Bridging Mental Health and Education (BRIDGE) is an evidence-based model for embedding teacher consultation and coaching activities into school-based mental health clinicians' regular workflow. Here we describe the process of adapting BRIDGE in partnership with a large urban school district and a local managed care organization during a large-scale implementation effort. We also report the feasibility and perceived effectiveness of the adapted training and consultation model as reported by clinicians in one school year. Over 93% of trained clinicians (n = 75) initiated coaching sessions with assigned teachers. Eighty-five percent of coaching sessions were completed as scheduled (n = 505 of 592). After the completion of coaching visits, clinicians attended bi-weekly virtual group sessions for two months. Ninety percent of virtual group sessions were completed as scheduled. Clinicians indicated high levels of satisfaction and high likelihood of using BRIDGE in future. Additionally, clinicians' self-reported knowledge of BRIDGE practices and their comfort with training others in these evidence-based classroom practices improved from pre- to post- training and coaching. Expert coaches indicated that clinicians' knowledge of BRIDGE strategies, commitment to BRIDGE consultation, and likelihood of continuing to use BRIDGE strategies were high. These findings suggest that the adapted BRIDGE model is feasible and was perceived to be effective. We share lessons learned related to community-partnered, school intervention adaptation and implementation.