Virginia Department of Education's Training and Technical Assistance Center at Virginia Commonwealth University

Understanding and addressing internalizing behaviors: A guide for educators

Part 2: Practices to support youth with internalizing behaviors

Internalizing behaviors are often seen in children and adolescents and reflect emotional struggles that can lead to issues like depression and anxiety, social withdrawal, and negative self-perceptions. These challenges may result in reduced academic engagement, feelings of loneliness, and an increased risk of self-harm (Fiat et al., 2017; Hubbard et al., 2018). It is important to recognize and address these behaviors to support the emotional well-being of young individuals (Weist et al., 2018).

Multi-Tiered Systems of Support (MTSS) is a comprehensive framework that offers structured assistance to students encountering various challenges, including internalizing behaviors (Weist et al., 2018). MTSS effectively meets the needs of youth facing these issues in several ways:

1. Holistic approach: MTSS integrates academic, behavioral, and mental health support, addressing the full scope of a student’s needs (Kern et al., 2022; Weist et al., 2018).

2. Tiered interventions: MTSS employs a tiered model of support, which allows for (Kern et al., 2022):

1. Tier 1: Targeted support for at-risk students through small group interventions.
2. Tier 2: Targeted interventions for students identified as at risk, providing additional support through small group interventions or check-ins.
3. Tier 3: Intensive, individualized support for those with significant challenges.

3. Data-informed decision making: Using regular screening and monitoring to identify and support struggling students (Weist et al., 2018; Eber et al., 2019).

4. Collaboration among stakeholders: Involving educators, mental health professionals, and families in creating a supportive environment (Hoover et al., 2019).

5. Focus on early identification and intervention: Recognizing signs of distress early to prevent escalation, such as social withdrawal, excessive anxiety, low self-esteem, increased absences, tardies, and visits to the school clinic (Hartman et al., 2017).

6. Culturally responsive Practices: Ensuring interventions consider students’ unique backgrounds (Kern et al., 2022).

7. Integration of evidence-based practices: Integrating proven strategies like Cognitive Behavioral Therapy (CBT) and mindfulness programs (Bruhn & McDaniel, 2021; Guo et al., 2017). 8. Building trusting relationships: Strong connections between students and educators promote engagement and willingness to seek help (Kern et al., 2022).

Implementing structured, tiered interventions, promoting collaboration, and employing data-driven practices allows MTSS to significantly enhance mental wellness among youth. These factors ultimately contribute to better academic and social outcomes (Eber et al., 2019; Weist et al., 2018).

Part 1 of this article

Resources

National Center for Rural Mental Health Hub

National Center for School Mental Health

National Center for School Mental Health Quality Guides

School Avoidance Alliance

VTSS-T/TAC Mental Wellness Workgroup resources

References

Bruhn, A.L.  & McDaniel, S.C. (2021). Tier 2: Critical issues in systems, practices, and data.  Journal of Emotional and Behavioral Disorders, 29(1), 34-43.

Eber, L., Barrett, S., Perales, K., Jeffrey-Pearsall, J., Pohlman, K., Putnam, R., Splett, J., & Weist, M.D. (2019). Advancing education effectiveness: Interconnecting school mental health and school-wide PBIS, Volume 2: An implementation guide. Center for Positive Behavior Interventions and Supports. 

Fiat, A.E., Cook, C.R., Zhang, Y.; Renshaw, T.L., DeCano, P., & Merrick, J.S. (2017). Mentoring to promote courage and confidence among elementary school students with internalizing problems: A single-case design pilot study. Journal of Applied School Psychology,33(4), 261–287.

Guo, Y., Rousseau, J., Renno, P., Kehoe, P.,  Daviss, M., Flores, S., Saunders, K., Phillips, S., Chin, M., Evangelista, L.S. (2017). Feasibility of an emotional health curriculum for elementary school students in an underserved Hispanic community. Journal of Child and Adolescent Psychiatry, 30(3), 133–141.

Hartman, K., Gresham, F. M., & Byrd, S., (2017). Student internalizing and externalizing behavior screeners: Evidence for reliability, validity, and usability in elementary schools. Behavioral Disorders,42(3), 108–118.

Hoover, S., Lever, N., Sachdev, N., Bravo, N., Schlitt, J., Acosta Price, O., Sheriff, L. & Cashman, J. (2019). Advancing comprehensive school mental health: Guidance from the field. Baltimore: National Center for School Mental Health, University of Maryland School of Medicine. 

Hubbard, G., Woods-Giscombe, C. L., Hageman, A., & Vimba, N. (2018). Innovative clinical training site for psychiatric mental health nurse practitioner students: Elementary school-based group therapy (Manuscript ID UMHN-2017-0143). Issues in Mental Health Nursing, 39(4), 357–361.

Kern, L., Weist, M.D., Mathur, S.R., & Barber, B.R. (2022). Empowering school staff to implement effective school mental health services. Behavioral Disorders,47(3), 207–219.

Weist, M.D., Eber, L., Horner, R., Splett, J., Putnam, R., Barrett, S., Perales, K., Fairchild, A.J., & Hoover, S. (2018). Improving multitiered systems of support for students with “internalizing” emotional/behavioral problems. Journal of Positive Behavior Interventions, 20(3), 172–184.

For more information, contact Kristen O’Sullivan ([email protected]) or Whitney Jones ([email protected]), Program Specialists, T/TAC at VCU.

Categories Autism Spectrum Disorder, Behavior, Inclusive Practices, Intellectual Disabilities