July 2014: Teacher Consultation and Coaching Within Mental Health Practice

Cappella, E., Hamre, B., Kim, H. Y., Henry, D., Frazier, S., Atkins, M., & Schoenwald, S. (2012). Teacher consultation and coaching within mental health practice: Classroom and child effects in urban elementary schools. Journal of Consulting and Clinical Psychology, 80, 597–610.

Summary by Dr. Amie Grills


Managing the complex socioemotional needs of students is often a daunting task for teachers, and this fact is particularly true when teacher resources are scarce and/or child behavior problems are high. Supportive teacher-student interactions around instruction and socioemotional domains have been linked with positive classroom environments and student outcomes (see Hamre & Pianta, 2010). Programs to build supportive teacher-student interactions often include teacher consultations and classroom coaching provided by trained external (i.e., not school employees) intervention teachers, with significantly positive effects on child behavior and school performance found for children in various grades (e.g., Brown, Jones, LaRusson, & Aber, 2010; Raver et al., 2011). However, a next step in evaluating these findings is to determine the feasibility and sustainability of such programs when conducted with existing school personnel.

In this article, Cappella et al. (2012) detail a study of their own empirically developed, integrated “teacher consultation and coaching program delivered by school and community mental health professionals.” The initiative, Bridging Mental Health and Education in Urban Schools (BRIDGE), combines a mental health program with an education program. BRIDGE uses a two-tiered approach that includes both universal and targeted interventions. BRIDGE was designed to “promote effective emotional support and classroom organization, supportive teacher-student relationships, and children’s social, behavioral, and academic adjustment.” The program uses live classroom observations and teacher consultations aligned with those observations, as well as supportive coaching of teachers in universal and targeted interventions provided by mental health consultants who are existing members of the school community. The overall goal of this study was to evaluate whether BRIDGE could improve classroom interactions and outcomes for students in low-socioeconomic urban schools.

Key Points

In this study, 36 classrooms from five urban public elementary schools were randomly assigned to intervention or control. Assessments occurred across an academic year. Participants included 364 students (43% female, 90% Latino/a, 7% black, 1% white, 1% other) predominantly from low-socioeconomic families (99% qualified for free- or reduced-price lunch), 36 teachers (23 regular education and 13 special education or combined), and 12 mental health consultants employed by the school district or local agencies serving the schools. Teachers and consultants attended workshop trainings in the BRIDGE program.

During the 4 months of intervention (January to April), teachers and consultants followed the same three steps (preparation, consultation, and coaching and observation) for three to five different dimensions in the categories of emotional support (e.g., teacher sensitivity) or classroom organization (e.g., behavior management). Consultants received monthly supervision and observations from the research staff. Teachers in the control condition received training on reflective teaching and effective classroom interactions, as well as access to a website with additional information and videos of effective practices.

Several preintervention-postintervention outcomes were examined. For the BRIDGE group, there was no significant finding for classroom organization; however, emotional support changed such that those lower in emotional support at the start of the intervention benefited more from assignment to the BRIDGE group than those with higher initial emotional support. In addition, significant differences were found for students in the BRIDGE versus comparison groups on the following variables: teacher-student closeness, academic self-concept, and peer victimization. In all instances, students in the BRIDGE group fared better than students in the comparison group. The classroom variables of emotional support and classroom organization were not found to change over time for the comparison group. No significant group differences were found on the following variables: behavior regulation, teacher-student relationship conflict, or child aggressive behavior.


Several findings from this study are noteworthy. First, this study demonstrated a “next step” in the investigation of a program combining mental health and education interventions by working entirely with individuals linked with the school. Many intervention studies use specially trained outside staff, which is important in the early stages of studying a new intervention, as it allows for greater control. However, once an intervention has shown efficacy in this way, it is important to introduce more real-world conditions to achieve long-term implementation feasibility and sustainability. Importantly, this study used a group of mental health practitioners who were already linked with the schools receiving the intervention, which serves as a good model for future research. The majority of practitioners contacted agreed to participate in the program, and the positive findings demonstrated that this approach can be successfully applied. Further, this program required intensive training and regular meetings, which practitioners and teachers were able to integrate into their schedules. In addition, these findings were achieved in low-socioeconomic urban schools, where resources were scarce and demands high. Taken together, these findings support a model for translational research conducted in schools.

Another noteworthy aspect of this study was that it focused on teachers, yet resulted in positive teacher, child, and peer outcomes. Importantly, these positive outcomes primarily related to increases in positive socioemotional domains (better academic self-concept, peer relationships, teacher-student closeness) and demonstrated that teacher behaviors and classroom environment could be altered through mental health consultations and interventions with the teachers alone. These findings may be important for providing stressed and overwhelmed teachers with hope for making changes such as those in the universal and targeted intervention approaches used in the BRIDGE program, providing “buy-in” for teachers who are reluctant to make changes or who are reticent to add additional training or meetings into their schedules. This fact seems to be particularly relevant for teachers whose classrooms are characterized as low in emotional support, as the greatest gains were found in such classrooms.

Interestingly, the intervention did not significantly influence the more negative student behaviors (e.g., aggression, behavior management) or classroom organization variables (behavior management, engagement, productivity). Although the authors suggest several possibilities for these findings (i.e., measurement issue, conducting the study at the end of the school year), these findings may also suggest the need for a more targeted approach to handling these domains. For example, a separate intervention component that specifically addresses externalizing behavior in the classroom (aggression, behavior management, teacher-student conflict) may be beneficially applied at both the teacher and student levels.

These findings suggest that a combined intervention approach may be most beneficial. That is, schools may need to take a multipronged approach, wherein classroom environmental aspects are addressed primarily with teacher intervention programs, and student behavioral aspects are addressed with student or student-teacher (or better yet, student-teacher-parent) intervention programs.

Overall, this study demonstrated the powerful effects teacher-level interventions can have on classroom and student outcomes, including in urban schools. By working with school and community mental health personnel who were associated with the schools, this study demonstrated a highly feasible and likely sustainable model for consideration in future work.

For additional resources and information on positive behavioral interventions and supports and social-behavioral management programs successfully employed in schools (e.g., Good Behavior Game, Check and Connect) follow the links below:


Brown, J. L., Jones, S. M., LaRusson, M. D., & Aber, J. L. (2010). Improving classroom quality: Teacher influences and experimental impacts of the 4R program. Journal of Educational Psychology, 102, 153–167.

Hamre, B. K., & Pianta, R. C. (2010). Classroom environments and developmental processes: Conceptualization and measurement. In J. L. Meece & J. S. Eccles (Eds.), Handbook of research on schools, schooling, and human development (pp. 25–41). New York, NY: Routledge.

Raver, C. C., Jones, S. M., Li-Grining, C., Zhai, F., Bub, K., & Pressler, E. (2011). CSRPs impact on low-income preschoolers’ pre-academic skills: Self-regulation as a mediating mechanism. Child Development, 82, 362–378.