Harnessing non-specialist providers to promote social-emotional learning for youths in summer camp: Findings from two pilot studies

Abstract

Despite substantial efforts to address youth mental health challenges, overall rates of youth mental illness persist, especially among racial and ethnic minority youths. This problem is exacerbated by limited access to services and limited implementation of evidence-based interventions in natural settings where youths spend significant time. Leveraging non-specialist providers offers a promising solution, enabling interventions to be delivered by trusted community members who do not have formal education in mental health. This dissertation presents a mixed-methods exploration of an intervention that combines multiple evidence-based social-emotional learning (SEL) components (i.e., an evidence-informed intervention) tailored to a diverse youth population in a summer camp setting and delivered by non-specialist providers. Three key objectives guided this research: (1) developing an evidence-informed SEL intervention for a summer program serving predominately low-income, youths of color, (2) assessing the intervention’s feasibility and acceptability across multiple camp sites through two open pilot studies, and (3) evaluating potential pre-post intervention changes in youth outcomes as indicators of effectiveness. Through collaboration with a community partner, the I FEEL (Identifying Emotions, Feeling Calm, Empowering my Identity, Empathizing with Others, Learning to Problem Solve) intervention was developed. Two open pilot trials took place during 2020 and 2021, adapting to a virtual summer camp format due to the COVID-19 pandemic. In Study 1, I FEEL was implemented with youths in grades one through eight within one camp site (N=48) by undergraduate, non-specialist counselors. Counselors demonstrated good adherence and competence while implementing the program, and high satisfaction scores from both youth campers and counselors underscored the program's acceptability. Pre-post comparisons showed nonsignificant differences in internalizing and externalizing symptoms, but youths reported significant improvement in their prosocial behaviors from pre-to post intervention, aligning with the intervention's focus on bolstering social awareness. Qualitative interviews with counselors revealed insights into implementation challenges, including time constraints and youth engagement issues, potentially related to the virtual setting. In Study 2, I FEEL was refined based on insights from Study 1 and was implemented in five diverse camp sites across the greater Boston area (N=79). The dosage of counselor training and consultation was increased, and analyses showed improved counselor competence in intervention implementation, relative to Study 1. Results also affirmed the intervention’s acceptability across camp sites, and there were significant pre-to-post improvements in youths’ ability to differentiate emotions and attend to others' emotions. These findings contribute to the emerging literature on youth interventions implemented by non-specialists. The significant improvements from pre- to post-intervention in prosocial behavior (Study 1) and emotion awareness (Study 2) suggest the potential value of future randomized controlled trials testing the effects of I FEEL. The results also highlight the importance of training and support mechanisms and underscore the potential of undergraduate students to convey impactful social-emotional learning strategies to diverse youth. Future research should examine immediate and longer-term intervention effects through randomized-controlled trials, encompass diverse outcome measures, and further explore the role of youths’ racial and ethnic identities to bolster the intervention's cultural validity.