The Seattle Children’s Department of Psychiatry and Behavioral Medicine is at the cutting edge of developing interventions to address the needs of adolescents who engage in high risk behaviors that reflect poor problem solving and emotional control. However, access to hospital and clinic-based mental health interventions is limited, and most youth who need such services do not get them. One effective way that faculty from Seattle Children’s address the problem of limited access is by taking their expertise into the community.

In 2016, the Seattle Children’s Guild Association Executive Committee awarded Elizabeth McCauley, PhD, Molly Adrian, PhD, Mylien Duong, PhD, and Ann Vander Stoep, PhD, one of their three annual grants. The group proposed to test a new approach for teaching skills for dealing effectively with intense emotional experiences in Seattle-area high schools. They developed a curriculum called Skills Training for Emotion Problem Solving (STEPS) that is based on UW Professor Marcia Linehan’s Dialectical Behavioral Therapy. While these skills have proven effectiveness in decreasing self-harm and emotion dysregulation in youth at high risk of depression, suicide, and substance abuse, they are also healthy practices that all young people can employ to rebound from setbacks and cope with stress.

Last year, the STEPS team tested and evaluated a six-week stress management curriculum with 9th graders enrolled in health classes at Garfield High School. Based on what they learned in the Garfield pilot, the STEPS team modified the curriculum and recently launched a six-week series to teach interpersonal effectiveness, emotion regulation, distress tolerance, and mindfulness in health classes at Ingraham High School. The curriculum is lively and engages students in small group work to learn and practice skills, didactic sessions about the physiology of stress, and homework assignments to try out skills in situations where students experience distress.

There is an increasing demand for a wide range of school-based emotional health supports, including those that can be offered universally. Society recognizes that good emotional health is a critical ingredient to school success and healthy social relationships. In the US, schools are the number one place where children and adolescents receive mental health services. The STEPS team is comparing students in 9th grade health where they are offering their curriculum with students in classes where health teachers are giving 1-2 lectures on stress management. If the pilot evaluations show that STEPS has a positive impact on students’ stress levels and coping strategies, then the team will apply for funding to carry out a large scale implementation and evaluation project.