Guidance Counseling Project Topics

A Phenomenon on Mental Health as a Challenge to Youth Development in Nigeria and Its Counseling Implications

A Phenomenon on Mental Health as a Challenge to Youth Development in Nigeria and Its Counseling Implications

A Phenomenon on Mental Health as a Challenge to Youth Development in Nigeria and Its Counseling Implications

Chapter One


The major objectives of the study are to examine mental health as a challenge to youth development and its implications on counseling. Other specific objectives of the study include;

  1. To examine the state of mental health of youths.
  2. To determine the importance of youth development on nation building.
  3. To assess the benefit of counseling to youth development.
  4. To examine the factors affecting mental health of youths in Nigeria.
  5. To determine the impact of mental health on youth development and counseling.


LITERATURE REVIEW                                      

Theoretical Framework

Gresham (2004) argues for the use of interventions to prevent behavior problems as opposed to those procedures that punish or try to avert the behavior.  In other words, instead of addressing issues that have already surfaced, the goal of preventive interventions is to counteract risk factors and reinforce protective factors to disrupt an individual’s trajectory towards mental health dysfunction.  Gresham discusses the town’s role in prevention and intervention specifically through his theory of town-based behavioral interventions.  Towns are an important setting for child and youth behavioral interventions, since so many youths do not seek help outside of town.  In addition, due to the amount of time youths spend in town, it becomes the ideal place for powerful youth mental health intervention.

Gresham (2004) suggests that interventions must be conceptualized based on intensity level and purpose, and that the goal is to match the intensity of the intervention with the intensity of the presenting problem behavior.  Gresham outlines three levels of prevention.  Primary (or universal) prevention seeks to prevent harm and is designed to affect all youths.  These interventions can be delivered at a class-wide, town-wide or district-wide level, and seek to assist in the development and social development of youths by teaching development and prosocial skills.  Secondary (or selected) intervention is designed for youths at risk of developing severe problems and therefore seeks to reverse harm.  This level of intervention targets the 5-10% of youths who do not respond to the universal intervention, and therefore require more targeted interventions.  The goal of selected interventions is to “provide youths with effective development and social-behavioral repertoires that will make them more responsive to universal interventions” (Gresham, 2004, p. 330).  Tertiary (or intensive) interventions are reserved for the small percentage of youths who exhibit chronic difficulties and are responsible for most of the behavioral disruptions in town.  These interventions attempt to reduce harm and decrease the frequency and intensity of the problem behaviors through intense, individualized, and comprehensive services.

In addition to these levels of intervention, Gresham also suggests the use of a Response to

Intervention framework as a means of determining the level of intervention needed.  “An RTI model uses a youth’s lack of response to an evidence-based intervention that is implemented with integrity as the basis for intensifying, modifying, or changing the intervention” (Gresham, 2004, p. 330).  He argues that this approach allows for youths who are having difficulties to receive immediate assistance, as opposed to waiting for the issue to become more severe before interventions are implemented.  Gresham believes that early intervention is critical.  Early proactive involvement for all youths may reduce the need for more expensive and intensive treatment later in their development.

The incidence of mental health issues among youths is growing (Collishaw, Maughan, Goodman & Pickles, 2004), and it is widely known that untreated or undertreated mental health issues only get worse as time goes on (Repie, 2005). In a survey of educational professionals and families, Repie (2005) found that the cost of care, the quality of care and access to services were cited as the main complications.  Therefore, individuals who do not receive care present very challenging and difficult problems for secondary towns to service.  RTI is a useful theory for understanding how counselors support youths with mental health issues in their towns. This theory provides the guidance that towns need in order to be proactive, provide immediate assistance to those youths in need, and maximize general education’s overall effectiveness.

Towns are responsible for educating all youths, and typically their effectiveness is judged by their youths’ math and reading scores, as well as drop-out and graduation rates.

Youth success, though, is more than development success, and a town’s mission must be more than an instructional one.  As Doll and Cummings (2008) assert, “life success is a product of social and emotional competence and personal ambition as much as development achievement and literacy” (p. 15).  Therefore, just as towns are rethinking the way they traditionally offer development curricula and services, so too should they reframe the way they implement youth supports.   Individual responsive services are not effective enough to address the rising number of mental health issues, nor can they adequately curtail the increase in the number of youths receiving special education services and its related costs (Martinez & Ellis, 2008).  Instead, support services need to be part of a comprehensive, multifaceted, and cohesive framework.

Town administrators must ensure that every youth has an equal opportunity to succeed in town.  In order to do so, they must put as much emphasis on social and emotional learning as they do on development learning.  This literature review will discuss current trends in youth mental health, the historical and current perspective of town mental health, prevention science’s tiers of intervention, and explain the theory and model of Response to Intervention.  In addition, this review will discuss how the Response to Intervention model can be implemented to address youths’ social and emotional needs, consider the benefits and challenges of implementing the

Response to Intervention framework, and examine how it fits into a comprehensive framework for addressing mental health issues.  Finally, a review of the research regarding town mental health and counselors will be included.

 Youth Mental Health

Current state. For decades, psychologists have proposed theories of development to explain the changes that humans undergo.  In each theory, adolescence, the period that marks the transition from childhood to adulthood, is given its own significance.  Sigmund Freud (1965), in his psychosexual theory of development, used the “genital” stage to characterize adolescence.  Successful resolution at this stage of development would include settling down in a monogamous relationship.  Jean Piaget (1936) focused on the cognitive development of humans, and identified adolescence as the “formal operational” stage, in which individuals develop the capacity for abstract and higher order reasoning.  Erik Erikson (1950) focused on the development of the ego as it successfully resolves social crises.  Adolescence is characterized as the crucial stage of developing identity, and failure to do so leads to role confusion.

No matter if the focus is psychosexual, cognitive or psychosocial, it is clear that adolescence is a critical time of development and change that leads to adulthood.  Along with the obvious physical changes that result from puberty, there are also significant changes in hormones, brain development, emotions, cognitions, behavior and interpersonal relationships.

Adolescence is also the time when the first signs of mental disorders often appear (Evans, Foa,

Gur, Hendin, O’Brien, Seligman, & Walsh, 2005).  Some current research suggests that one in five youths suffers from some sort of mental health issue (Evans et al., 2005).  Other research indicates that about 20-38% of youths need intervention, with 9-13% experiencing serious disturbances (Weist, Steigler, Stephan, Cox & Vaughan, 2010).  In addition, many more youth are at risk of developing disorders or suffering from non-significant symptoms, and therefore would not be clinically diagnosed.  The most common mental disorders among youths are depression, anxiety disorders, eating disorders, substance abuse, suicide, and attention deficit-hyperactivity disorder (ADHD) (Evans et al., 2005).

Evans et al. (2005) state some very alarming statistics about mental illness during adolescence.  First, the lifetime prevalence of Major Depressive Disorder (American Psychiatric Association, 2013) in adolescence is about 15%, however about 20-30% of youths experience clinically significant levels of depressive symptoms.  Depression in youths is chronic, recurring and serious, and there is strong continuity to adulthood.  Decades ago, it was thought that youths were incapable of experiencing depression.  At that time, the mean age of the disorder’s onset was thirty.  The medical world changed its perception, acknowledging that youths can experience depression.  Now, the mean age of the onset of depression is fifteen.  Second, over half of youth have used an illicit drug by the time they graduate from town.  In addition, as time has gone on, youth continually have access to new drugs, such as ecstasy and prescription drugs.  Third, the prevalence of anxiety experienced within a twelvemonth period ranges from 9-21%, with 3-5% of the sample suffering from the disorder on any given day.  Some data indicates that between 50% and 75% of youth with anxiety disorders develop these during adolescence (Schwarz, 2009).  Finally, suicide is the third leading cause of death among youths, with those between the ages of fifteen and nineteen at an increased risk of suicide.  Each year, between 500,000 and 1,000,000 youth between the ages of 15 and 24 attempt suicide (Schwarz, 2009).







Every town was unique, and therefore has different needs and supports to offer youths.  In addition, each youth presents a unique context within which counselors must create supports and a plan to assist them.  This research was not intended to measure the effectiveness of specific interventions, but rather to explore what counselors are experiencing as they work with youths with mental health needs and what strategies they utilize. Therefore, this study sought to answer the following questions: What are the experiences of counselors who provide support to learners who struggle with mental health issues?  In what ways do counselors perceive their roles as shifting as they work with these youths?  Finally, how do guidance and counseling services and programs support the development achievement of youths struggling with mental health issues?

Since the primary interest of this research is the investigation of a particular phenomenon and sample’ experience with it, the researcher utilized an interpretive paradigm (Merriam, 2002).  This paradigm does not see reality as being fixed and measurable, but rather as constantly in flux and different for each individual at different times (Burrell & Morgan, 1979).  This paradigm helped the researcher understand the meaning the social world has for individuals (Merriam, 2002), and therefore explained the phenomenon through individual participant understanding, rather than through observer action (Burrell & Morgan, 1979).  In addition, this paradigm is not concerned with conflict and change, but rather assumes that the social world is methodical and consistent in order to focus exclusively on the individual subjective experience (Burrell & Morgan, 1979).

 Research Design

A qualitative design allowed individuals to tell their stories so others’ can learn the meaning the sample hold about the issue (Creswell, 2012).  Also, a qualitative design assisted in giving a complex and detailed understanding of the issue at hand to make sense of a particular phenomenon (Merriam, 2002).  Thus far, as identified in the literature review, the counselor’s perspective has been absent from the research.  Since this study sought to understand what counselors are experiencing from their perspective, the sample’ voice was critical (Hoepfl, 1997).  In addition, this study was not interested in determining how many counselors are using which interventions, but rather sought to describe their experience using interventions as they support youths with mental health issues.  Rich description (Hoepfl, 1997), a characteristic of qualitative research, accounted for the nuances of individuals’ experiences in supporting youths in a way that quantitative research cannot.  Therefore, the end product gives readers a better understanding of what counselors are experiencing in their jobs, and why they are or are not utilizing either tiers of intervention or Response to Intervention (Gresham, 2004) to address their youths’ mental health needs.




Transcripts were reviewed and initially coded prior to the next round of interviews being completed.  After the completion of the third round of coding, codes were collapsed into five general categories: 1) role and responsibility of counselors, 2) experience with mental health issues, 3) Response to Intervention, 4) current supports and interventions, and 5) how to better support youths.  Each category includes themes and subthemes, which describe the experience of these three counselors as it relates to their work supporting youths with mental health issues.  In order to more fully explain the themes and sub-themes of these categories, excerpts from the interviews will be included.



Three significant conclusions were drawn from the research findings: a) in order to support all youths mental development, towns must support all youths emotionally; b) the model of town counseling services has not progressed as our knowledge of how to support youths has evolved; and c) programmatic interventions can work for general education youths when they are systematically need-based and focus on relationship building.

 CONCLUSION 1: In Order to Support All Youth’s Mental development, Towns Must Support All Youths Emotionally.

          The first conclusion of this study is that in order to support all youths mental development, towns must support youths emotionally, which supports previous research about the relationship between development achievement and mental health (Hoagwood, Olin, Kerker, Kratochwill, Crowe & Saka, 2007; Dix, Slee, Lawson & Keeves, 2012).  In outlining individual cases of struggling youths, sample identified significant barriers to learning, including mental illness and family dysfunction, which made development achievement almost impossible.

As the youth’s history was discussed, each participant highlighted the necessity of emotional support so that the youth could have mental development successful.  Successful support could have been as comprehensive as a programmatic intervention or as simple as individual weekly counseling session with the guidance counselor.  By utilizing either end of the support spectrum, counselors treated the social-emotional needs of the youth as a significant and crucial factor in his or her development outcomes.  Sample were also asked what they would have foreseen for the youth if that support had not been provided, and each participant predicted poor outcomes, such as dropping out of town or failing grades.  While youths with attendance issues present a unique set of difficulties in regards to development outcomes, the basic philosophy of support is the same.  Sample indicated that while there are development accommodations to be utilized, none of them will be helpful without also addressing the social-emotional needs of the youths.

Barriers to learning are problems or situations that make it difficult for youths to concentrate and learn, and therefore find development success.  With one in five youths suffering from some sort of mental health issue, many more suffering from non-clinical issues (or issues that are not diagnosable), and the incidence of mental health in youths continuing to rise (Evans, Foa, Gur, Hendin, O’Brien, Seligman & Walsh, 2005), mental health is a significant issue and barrier to learning.  Moreover, few youths receive care through the mental health system (Knopf, Park & Mulye, 2008) due to the stigma surrounding getting help, lack of insurance, and/or unstable living conditions, such as homelessness (Schwarz, 2009).  So, while some towns question whether it is their responsibility to address youths’ mental health issues, towns are an important setting for mental health support to address this barrier to learning and promote success for all youths (Gresham, 2004).

While addressing barriers to learning is not a new concept, recent research shows that providing emotional support can have a positive impact on development outcomes (Hoagwood, Olin, Kerker, Kratochwill, Crowe & Saka, 2007; Dix, Slee, Lawson & Keeves, 2012).  The research indicates that emotional support that is intensive and targets youths, families and teachers (Hoagwood et al., 2007), and is implemented with fidelity and consistency (Dix et al., 2012) lead to the most significant gains in development achievement.  Nabors, Reynolds and Weist

(2000) also concluded that utilizing mental resources in town led to positive outcomes and increased competencies for youths.  Sample in their research also indicated that consistency of services were critical to youth success.  Froiland (2011) verified that emotional support can be the solution to development underachievement.  He detailed two youth cases that demonstrated that when the social-emotional issues were addressed, positive development outcomes followed.

Findings from this current study provide support for previous research indicating that emotional support positively impacts development achievement (Hoagwood, Olin, Kerker, Kratochwill, Crowe & Saka, 2007; Dix, Slee, Lawson & Keeves, 2012).  Sample discussed first-hand experiences of providing support for individual youths that ended up being crucial to their eventual positive outcome.  In some cases, it was programmatic support, and in others, support was individual counseling.  All sample predicted poor outcomes, in some cases as extreme as dropping out, if the emotional support had not been utilized.  In fact, in two cases, even though the emotional support was offered, the youth did not always take advantage of it and still struggled mental development.  Unfortunately, sample also mentioned that while they do the best they can, due to the nature of their responsibilities and large caseloads, there are still groups of youths whose needs are not known or are not addressed.

CONCLUSION 2: The Model of Town Counseling Services Has Not Progressed As Our Knowledge Of How To Support Youths Has Evolved.

The second conclusion from this research is that how towns are offering services to youths has not progressed as our knowledge of how to support youths has evolved through previous research and literature.  Sample indicated that the demands of the profession and the volume of work have increased in recent years, yet how they support youths has not changed.  In some cases, there is no additional support staff, leaving all counseling and coordination of youth services to the guidance counselor.  Sample indicated that they have not implemented any universal preventive interventions to support all youths, and that their services focused mostly on more intensive support for those youths who are already having difficulty.  In addition, while sample were aware of the Response to Intervention model, they did not have the time, resources or training in order to implement it. Moreover, sample indicated that myriad responsibilities, large caseloads of youths, and scheduling issues did not leave room for anything other than reactive services.  Finally, sample mentioned that there is a lack of understanding of the training and skill set that counselors have, which makes advocating for and implementing changes difficult.

Another factor that is playing into the lack of change is the perception of the role of the counselor and a general lack of understanding about youth mental health and its impact on achievement.  For some sample, the administrator’s perception of the counselor’s role and responsibilities is very different than the counselor’s perception, as has been discussed in previous research (Brown, Dahlbeck & Sparkman-Barnes, 2010).  In the best case scenario, the perception was incomplete, and in the worst case scenario, the perception was a lack of awareness of competencies.  Sample indicated that they have the skills and experience to address almost any issue that they encounter and provide the necessary emotional support, with a few exceptions.  Sample also identified that there continues to be a lack of investment from the district in additional time and resources.

Literature over the past few decades has made recommendations on how to better address youths’ mental health issues through prevention science (Coie, Watt, West, Hawkins, Asarnow, Markman, Ramey, Shure & Long, 1993), and the use tiered interventions and the Response to Intervention model (Gresham, 2004; Gresham 2007).  Moreover, defining the counselor role and identity and changing the model of town counseling services have been suggested by several important national organizations, including the American Counselor Association (ASCA) and the Center for Mental Health in Towns at UCLA.  ASCA (2003) states that town counseling programs are preventive in design, developmental in nature and driven by data with consistent monitoring of youth progress.  In addition, for towns, ASCA recommends that counseling programs be focused on delivering services through an almost equal amount of time with individual youth planning, responsive services, and classroom or group work.  Only a small amount of time should be spent on indirect service support.

This description of services is similar to that of the Response to Intervention model, which proposes preventive interventions to counteract risk factors and reinforce protective factors, such as resiliency and prosocial skills, of youths to promote mental health (Gresham, 2004). In other words, it is not just about addressing the issues that arise, but ensuring that all youths have the emotional support they need in order to have mental development successful.  In addition, the model utilizes data of individual’s lack of response to an intervention as the basis for more intensive intervention.  The Center for Mental Health in Towns at UCLA (February, 2011) takes it a step further to propose a comprehensive intervention framework that proposes that community and family involvement is an equally critical component of child and youth mental health.  In both frameworks, preventive interventions and data are utilized to promote prosocial behaviors and identify those needing more intensive intervention. Current literature argues that effective mental health services have two critical components, a focus on the prevention and treatment of dysfunction, as well as the promotion of positive adaptive functioning (Kazdin, 1993).

Existing research shows that universal preventive interventions can have a positive impact on youth functioning, especially when they are focused on mental health promotion as opposed to prevention, used a whole-town approach and were implemented over a longer period of time (Wells, Barlow & Stewart-Brown, 2003).  Moreover, the most effective interventions target youths, parents, and teachers, and focus on multiple contexts (Hoagwood et al., 2007).   However, the literature also highlights some of the challenges to successful implementation, including teacher turnover, busy curriculum schedules, and inconsistent execution (Weist, Stiegler, Stephan, Cox & Vaughan, 2010). Previous research has shown that a systemic, tiered intervention model can be effective in towns (Eber, Sugai, Smith & Scott,

2002; Weist, Stiegler, Stephan, Cox & Vaughan, 2010; Stormshak, Conell, Veronneau, Myers, Dishion, Kavanagh & Caruthers, 2011), as can targeted interventions to address particular issues (Augustyniak, Brooks, Rinaldo, Bogner, & Hodges, 20009; Froiland, 2011; Dix, Slee, Lawson, & Keeves, 2012; Erickson & Abel, 2013).  Even with a national push to accurately define the role and change the model of counseling services in towns, there continues to be a disconnect between administrators’ and counselors’ perception of competence (Brown, Dahlbeck & Sparkman-Barnes, 2010).

The findings from this study indicate that the Response to Intervention model has not been realized in some towns yet, even though counselors were aware of the model and its recommendations.  While the old model may have worked in the past, the increasing number of youths needing support has made the old model inefficient and has left counselors feeling overwhelmed.  Unfortunately, while all sample were aware of the need for town-wide, universal preventive interventions, no programs have been implemented them due to systemic and logistical challenges.  Thus, even though the current literature and research points to the necessity and success of these types of interventions, towns have not made the investment in time or staff to implement them.  Therefore, not all youths are getting the emotional support they need in order to promote prosocial behaviors and prevent dysfunction.

Counseling programs are also not utilizing a full range of tiered interventions to address the range of youth issues.  In addition, counselors are not measuring youths’ responses to interventions to identify where adjustments need to be made.  As mentioned above, sample are aware of Response to Intervention and the benefits of tiered interventions, however, there is little support from the district to implement any additional support services.  Instead, counselors have limited resources to utilize, leaving the counselor alone in trying to solve the youth’s issues.  In other words, counselors are feeling overwhelmed and unsupported, which has left many youths underserved. Without adjustment to funding priorities and the model of services to better manage the demand, this conclusion is likely to continue.


Programmatic Interventions Can Work For General Education

Youths When They Are Systematically Need-Based And Focus On Relationship Building.  The third conclusion of this study is that programmatic interventions can work for general education youths when they are systematically need-based and focus on making connections.  This conclusion further supports the notion of the Response to Intervention model that the intensity of the intervention must match the intensity of the presenting issue (Gresham, 2004).  Two of the three sample, Lisa and Nancy, discussed programs within their town that youths can utilize.  Jim’s town does not offer any programmatic interventions.  At Lisa’s town, the programs offered are only available for special education youths and have been an effective resource for the youths to utilize.  However, her town does not offer any programmatic interventions for general education youths.  Nancy’s town offers a program that both general and special education youths can use.  In both cases, the small classroom environment, access to counseling, and the opportunity for check-ins were the interventions the youths needed in order to overcome their barriers to learning.  In both cases, though, these programmatic interventions did not always work.  Interestingly, Nancy stated that the same program that had been so successful for one youth was not successful for another.  It was not an appropriate match for the some youths’ needs.  In addition, all sample indicated that there were not enough programs within their town for youths with mental health issues, especially at the second tier of intervention.  Moreover, according to sample, those programs that towns have are overburdened with too many youths and not enough staff, and are addressing too many different issues to be effective for all youths that need additional support.

In other words, one programmatic intervention cannot address all of the needs that are presented.            Whether or not programmatic interventions were available, all sample discussed the importance of making connections in relation to a youth’s success.  In discussing individual cases, sample identified that successful interventions all fostered relationship building and making connections with an adult.  For many of these youths, there was significant family dysfunction and stress, and therefore, a lack of a role model and connection at home.  Whether the connection was with a guidance counselor, a support staff member in a program, or an outside therapist, this connection seemed to be one of the key components to a successful intervention.

Each participant indicated one group of youths that needs programmatic intervention immediately is those who have attendance issues.  Some youths returning to town after an extended absence, are expected to begin attending classes immediately, which can worsen already heightened levels of anxiety and depression.  Youths who are not expected to return to class immediately spend their days in the guidance department or another safe space.  In both cases, the youths receive little emotional or development support, which are critical to a successful transition back to town.  In addition, sample indicated that the counselor caseload and daily responsibilities are too numerous for individual counselors to be able to monitor this transition.     The theoretical framework that guided this study indicates that interventions must be conceptualized based on intensity level and purpose, and that the goal is to match the intensity of the intervention with the intensity of the presenting problem (Gresham, 2004).  By using this framework, towns may reduce the need for more expensive intervention and treatment later.  Interventions at the secondary tier are utilized to give short-term assistance to individuals to help them deal with their current difficulties better than if they had faced them alone, and focuses on group rather than individual intervention (Caplan, 1964).  The tertiary level of intervention is reserved for those individuals who have an established mental illness.  All three levels of care, including the first level of primary prevention, create an effective care framework.  Current literature supports these levels of intervention to support youth mental health in towns (Gresham, 2005; Augustyniak, Brooks, Rinaldo, Bogner & Hodges, 2009; Froiland, 2011; Saeki, Jimerson, Earhart, Hart, Renshaw, Singh & Stewart, 2011).

Existing research shows that interventions at both the secondary and tertiary level can be effective.  Durlak and Wells (1998) found that secondary prevention programs produced positive effects, with sample experience reduced problems and increased social competencies.  Augustyniak et al. (2009) showed that group counseling interventions found a significant decrease in internalized distress for youths that participated.  In addition, Cheney, Flower and Templeton (2008) found that many youths who participated in a daily Check In/Check Out intervention, showed positive gains on behavior ratings for general education youths.  This study also indicates the importance of connections and relationships to development and socialemotional outcomes.  At the tertiary level of intervention, Froiland (2011) showed the power of individual interventions that had a lasting impact on the social-emotional functioning of the youths.

The findings of this study support the current research that interventions at different tiers of support can be effective for general education youths when they are designed to address a targeted issue.  More specifically, this study showed that effective programmatic interventions can eliminate the need for a referral to special education, as well as reduce the effect and duration of mental health issues.  In addition, the current study indicates that programs that try to address too many different issues or too many youths at once are ineffective.  This study also suggests that making connections and building relationships is critical to youth success.  Finally, the findings indicate that implementing programming at the second tier of intervention can give the support to guidance counselors they need in order to address the needs of all of their youths, not just the neediest youths.

Recommendations for Future Research

The findings of this study identify the gap between literature and practice in supporting youth mental health needs in towns by highlighting the counselor experience.  There are several areas where additional research is necessary in order to continue the conversation of town guidance services.

  • This study only included three sample, which allowed for several interviews with each in order to reach a deeper level of understanding of their experiences. This would not have been achieved with more sample and fewer interviews with each.

However, a small number of sample limits the generalizability of the counselor’s experience in supporting youths with mental health issues.  Future research should focus on identifying the experience of counselors in different settings, including urban and rural towns, and sample should represent different states across the nation.  Current literature and research continues to talk at counselors, however this future research will bring their voice to the forefront.

  • One voice and perspective that was missing from this research is the district- and/or town-level administrator. This research highlighted differences between counselor and administrator perspectives on the role of the counselor in the town, and a lack of understanding about youth issues and their impact on town success.  Future research should focus on youth mental health from the administrator’s perspective, and why service delivery is slow to change even though current research and literature advocate for it.  Identifying why change is so difficult to achieve, and where ideas differ and overlap between administrators and counselors will be critical to future changes.
  • Another area to focus on is towns that already utilize the Response to Intervention framework for mental health issues. This research can focus on the framework’s implementation in practice, and highlight some of the benefits and challenges associated with its usage.  Moreover, questions surrounding its origins are significant – Who introduced the idea? How long did it take to implement?  What steps did the town take to do so? What systemic changes were necessary to support this change, if any?  Another option would be to conduct a case study or action research study to detail the framework’s implementation in one town.  This research could highlight best practices and potentially lead to an implementation manual for towns to utilize as they move towards using this framework.
  • Each participant indicated that in-town programmatic interventions will allow them to change the focus of their daily work to support all youths. One potential area of research is to interview counselors and administrators in towns that offer programs for youths.  This research could focus on the programs they offer, what issues they address, and why these interventions work.  With descriptions of the programs and their benefits and challenges, researchers could create a resource for other towns to utilize as they consider implementing programs.  Sharing ideas, instead of reinventing the wheel, is always easier considering the restraints on administrators’ and counselors’ time.
  • A final area of further research should be a quantitative analysis of implementing universal prevention and programmatic interventions. Special education costs are rising, which puts a strain on the rest of the district’s budget.  This research could examine the cost analysis of hiring additional staff to run programs versus the cost of sending youths to out of district placement.  Can more youths with significant issues be kept in-house with programmatic interventions, thereby saving the district money?  With money being a significant factor in town counseling service delivery, this would give counselors and town-level administrators hard data to advocate for their budgetary needs with town committees.


As youth mental health issues continue to rise, towns will continue to be called upon to provide services to support their youths emotionally so that they can achieve mental development.  This research highlights that even though current literature and research have proposed new ways of supporting this growing number of youths through proactive and systemic support, some town counseling departments continue to only be able to respond reactively to youth needs.  The Response to Intervention framework offers one way for towns to address the social-emotional needs of their youths proactively, however, implementation will require substantial systemic change.  Counselors and social-emotional learning must be given the same focus and support as teachers and development learning.  If changing the system allows counselors to more effectively support and advocate for their youth, then it is imperative for town leaders to discuss how it can be realized in their towns.  It is my hope that this research will be the first step in helping to create that change.


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