Date of Award


Document Type

Open Access Dissertation



First Advisor

Mark D. Weist


There are high levels of unmet need in youth mental health services. To address this gap there is an increasing emphasis on multi-tiered systems of support involving promotion/prevention (Tier 1), early intervention (Tier 2) and intervention (Tier 3) to promote positive emotional/behavioral functioning in students. While research on these multi-tiered frameworks is increasing, there remains a relative dearth of empirically supported and feasible early intervention Tier 2 programs. To help address this gap, we developed the Tier 2 program, Footprints, which utilizes two Motivational Interviewing sessions to promote engagement in six group-based modularized Cognitive-Behavioral Therapy sessions and aims to enhance academic protective factors in students. This manuscript describes the rationale and background for the Footprints program, feasibility and acceptability findings, and impacts from a randomized experimental study to evaluate its preliminary efficacy. Descriptive statistics from both Footprints participants and providers indicate high levels of program feasibility and acceptability. Additionally, compared to a waitlist control group (n = 22), the participants randomly assigned into the Footprints program (n = 21) demonstrated statistically significant and positive changes in self-efficacy for regulating behavior, math grades, academic press, and academic motivation, and showed decreased levels of depression and anxiety. There were no significant effects found for other academic areas and other measures of psychosocial functioning. These data suggest preliminary yet highly tentative support for the acceptability, feasibility, and effectiveness of Footprints, as a Tier 2 program within a school-based multi-tiered system of support.


© 2016, John Terry