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Published in final edited form as: Early Educ Dev. 2010 Oct 12;21(5):765–779. doi: 10.1080/10409289.2010.497452

Aligning Research and Policy on Social-Emotional and Academic Competence for Young Children

Erum Nadeem 1, Kristi Maslak 2, Anil Chacko 3, Kimberly Eaton Hoagwood 4
PMCID: PMC4306577  NIHMSID: NIHMS250962  PMID: 25632216

Abstract

Research Findings

The purpose of this article is to describe current education policies as they relate to the promotion of social, emotional, and academic (SEA) development and competence for young children. Academic and social–emotional competencies are described and conceptualized as developmentally linked, reciprocal processes that should be supported by education in an integrated, holistic manner.

Practice or Policy

The article reviews major public policies and national initiatives that have implications for the education of young children (e.g., Head Start, No Child Left Behind, IDEA) and highlights opportunities within these policies to promote programs that can support SEA competencies, as well as the limitations of these policies. The article also includes a review of the limitations of existing resources available to educators to identify evidence-based programs that support SEA competencies and concludes with recommendations for better alignment between research and policy to support SEA competencies.


Over the past decade, a number of policies have put pressure on schools to increase their responsibility for students’ academic achievement (e.g., the No Child Left Behind Act [NCLB]). The increasingly unilateral focus on accountability for academic achievement has trickled down even to young children, with a growing number of mandates imposed on early education programs to be responsible for young children's academic readiness and learning (Meisels, 2007). However, the prominent emphasis placed on academic achievement, when juxtaposed with the abundant scientific literature on the importance of social and emotional competencies for the long-term success of young children, suggests that some current educational policies may be misaligned. As we argue here, attention to the development of and synergy between social, emotional, and academic (SEA) competencies is essential for maximizing the overall healthy development of children (Raver, 2002).

In this article, we cover four areas. First, we briefly discuss the importance of SEA competencies for young children. Second, we describe current educational policies and national initiatives and discuss how these policies and initiatives promote as well as miss the mark for supporting SEA competencies in young children. Third, we review the limitations of resources available to educators to identify evidence-based programs that support SEA competencies. Lastly, we conclude with recommendations for better alignment between research and policy to support SEA competencies.

THE IMPORTANCE OF SEA COMPETENCIES

Academic competence can be and has been defined in various ways. Although a strict definition based on standardized test performance is one way of defining academic competence, and arguably a necessary method of doing so, it is by no means sufficient. A more appropriate definition from Alexander (this issue), states that academic competence “is viewed as a developmental process rather than a year-by-year, course-by-course treatment of instructional content” and that the goal of education is to produce a “populace with a hunger for knowledge, the ability to reflect deeply on critical issues, and the skills to deal effectively with the many demands of a complex and rapidly changing world.” According to this view, assessing academic competence using instructional content, standards-based test performance fails to assess the acquisition of and disposition to apply the critical and flexible thinking skills that are crucial for the development of students as learners.

Likewise, social–emotional competence can be defined as the acquisition of a discrete set of social skills. However, a more nuanced definition of social competence recognizes that children must develop both the ability and disposition to use and integrate social-emotional knowledge, regulatory abilities, empathy, perspective taking, and social skills in a seamless manner that is appropriate for the child within the given social context (Denham et al., 2003). Thus, what we expect of young children with respect to the developmental processes of both academic and social competence is quite complex.

It is important to note that the constructs of academic and social-emotional competence are not mutually exclusive but are developmentally linked and reciprocal in nature (Furrer & Skinner, 2003; Ladd & Troop-Gordon, 2003; Meehan, Hughes, & Cavell, 2003; Wentzel, 1991, 1999). Data suggest that children's academic competence during their school years is greatly influenced by their social–emotional competencies during the early childhood period (Ladd, Kochenderfer, & Coleman, 1997). Children who have lower social–emotional competence are less likely to perform well academically (Arnold et al., 1999); reciprocally, children with lower academic competence often suffer from subsequent social-emotional difficulties (Gagnon, Craig, Tremblay, Zhou, & Vitaro, 1995; Haapasalo & Tremblay, 1994; Kochenderfer & Ladd, 1996; Raver & Knitzer, 2002). Moreover, social-emotional competence often uniquely predicts academic success, even when other key factors, such as early academic competence, are taken into account (Bohlin, Hagekull, & Rydell, 2000; Izard et al., 2001; O'Neil, Welsh, Parke, Wang, & Strand, 1997; Shields et al., 2001; Waters, Wippman, & Sroufe, 1979). Thus, we are defining social-emotional and academic competence not as discrete areas but rather as an integrated, developmentally focused concept.

Given that SEA competence is critical to the present and future success of young children, one would expect national and state policies, particularly educational policies, to support SEA development in a manner that emphasizes an integrative and comprehensive approach when educating young children.

MAJOR PUBLIC POLICIES AND EDUCATIONAL INITIATIVES SUPPORTING SEA COMPETENCE

Although federal involvement in public education has a long history in the United States, it was not until 1957 that (in response to the Soviet launch of Sputnik) the United States substantially increased federal involvement and funding in public education. From that point on, federal involvement in education expanded based in large measure on the rationale that this would reduce educational disparities caused by poverty and racial injustice. Recently, accountability among schools for ensuring that all students achieve set educational goals has been a leading edge of educational policies (Jaynes, 2007; McGuinn, 2006). Because federal policies can incentivize how schools address (or ignore) the development of SEA competencies in young children, we discuss here several policies that have a direct impact on young children.

Head Start and Early Head Start

Head Start, which has enrolled more than 25 million children since its inception in 1964, is one of the most notable federal preschool programs of relevance to SEA competence. The 1994 reauthorization of the Head Start Act established the Early Head Start program for low-income families with children aged 0 to 3. Head Start's goals, directly linked to SEA development, include developing low-income children's social and learning skills, improving health and nutrition, and strengthening families’ ability to provide nurturing environments through parental involvement and linkages to social services. Early Head Start similarly focuses on promoting healthy prenatal outcomes for pregnant women, enhancing development, and promoting healthy family functioning. Key services include early education, home visits, parenting education, health and mental health services, and child care services. In addition, Head Start programs are required to screen for mental health problems (Administration for Children and Families, 2010b).

With Head Start's recognition of the ecological context in which children develop, classroom-based social skills and academic instruction, the implementation of mental health screening, and emphasis on parent involvement, there is clear opportunity to promote SEA competencies. In fact, by the end of their preschool year, children who received Head Start demonstrated better cognitive functioning, school readiness skills, social–emotional well-being, and health than children who did not receive Head Start or who were in alternative care settings (Administration for Children and Families, 2010a). However, many of these effects were not sustained through the end of first grade, highlighting the importance of continued and integrated supports for SEA development throughout children's educational experiences.

Elementary and Secondary Education Act of 1965 (ESEA) and NCLB

Both Head Start and ESEA emerged out of the Civil Rights movement with the goal of promoting equal opportunity for low-income student populations (Jaynes, 2007). However, unlike Head Start, ESEA is less focused on the ecology of the child and more focused on improving academic outcomes through provisions that provide funding to local educational agencies (LEAs). Although ESEA does not maintain the development of SEA competence as a goal per se, the cycle of congressional reauthorizations and amendments every 5 years has resulted in provisions that expand the role of ESEA and are relevant to SEA competence, including Title IV, Part A (Safe and Drug-Free Schools); and Title V, Part D, Subpart 2 (Elementary and Secondary School Counseling Programs), Subpart 3 (Partnerships in Character Education), and Subpart 14 (Grants to Improve the Mental Health of Children; U.S. Department of Education, n.d.-b). The amendments, including a recent reauthorization of ESEA known as the No Child Left Behind Act of 2001 (NCLB), epitomize the accountability movement in education by linking funding support to student progress monitoring, satisfactory annual gains in student academic achievement, and the use of scientifically supported instruction and intervention (Jaynes, 2007; McGuinn, 2006).

NCLB, although providing accountability for academic outcomes, has largely missed the mark in terms of supporting the development of SEA competencies in young children. First, NCLB has been criticized for its overemphasis on content standards-based test scores as barometers of successful academic development (Jaynes, 2007; McGuinn, 2006). Second, NCLB does not include language that supports a developmental focus upon academic or social-emotional competence, nor does its language recognize the synergy between the two. Because NCLB, by design, does not outline a national curriculum, and because SEA development is not part of the policy, it is incumbent upon LEAs interested in supporting SEA competencies to identify ways to fit such programming into their existing policies and funding streams. As such, there are no policy-supported standardized practices or models for supporting SEA competencies once children enter elementary school through NCLB.

Individuals With Disabilities Education Act of 2004 (IDEA)

Originally enacted as the Education for All Handicapped Children Act of 1975, and most recently reauthorized as the Individuals with Disabilities Education Act in 2004, IDEA offers potentially the most intensive array of services for children who may be at highest risk for poor SEA development. IDEA mandates that all children, including children with disabilities, receive a free and appropriate public education (FAPE), and it supplies federal grants for states and LEAs to provide services to children with disabilities from ages 3 to 21 and 0 to 3 (U.S. Department of Education, n.d.-a). Specifically, a child classified as having an emotional or learning disability is eligible to receive services described in an individualized education plan (IEP) that is developed by a multidisciplinary team to address the SEA supports the student requires to ensure FAPE access.

Although IDEA is a policy that has the ability to promote the development of SEA competence, it is designed to address the education needs of children with disabilities only and thus does not constitute a broadly applied framework for educating all young children. Moreover, there are two key challenges to the implementation of IDEA. First, the nature of a child's disability may not require both social-emotional and academic services to ensure FAPE, and, as such, IEPs may not always address SEA competence. Second, there has been long-standing debate about the IDEA definitions of emotional disability (Gresham, 2005) and of specific learning disabilities (Fletcher & Reschly, 2005; Kavale, Kaufman, Naglieri, & Hale, 2005; Shrank et al., 2005). These differing interpretations have raised questions about the reliability and validity of methods used to determine service eligibility (Fuchs, Mock, Morgan, & Young, 2003).

Stemming from this growing dissatisfaction with IDEA definitions and traditional approaches for determining emotional and specific learning disabilities, the current iteration of IDEA (“IDEA Regulations,” 2006, Section 1) allows for the use of a response to intervention (RTI) approach to determine the presence of a disability and whether more intense interventions are needed. RTI is designed to reduce the base rates of problems in the general population through the use of universal interventions that are followed by increasingly more intense services (secondary and tertiary interventions) for students presenting with emotional, behavioral, and educational problems who are not responding to the less intensive interventions (Kratochwill, Clements, & Kalymon, 2007; Reschly & Bergstrom, 2009). Although implementing an RTI approach to determining eligibility criteria under IDEA could increase the number of children who receive support across a range of SEA competencies before they need intensive and expensive services, this approach is still being defined in practice, and there is a dearth of empirical evidence to support RTI's effectiveness (Reynolds & Shaywitz, 2009).

Section 504 and the Americans With Disabilities Act Amendments

Section 504 of the Rehabilitation Act of 1973 is an antidiscrimination law that protects children with disabilities from being denied FAPE (U.S. Department of Education, 2009). Unlike IDEA, which defines eligibility criteria and designates funding for special education services, Section 504 defines the rights of children within the school setting to receive disability accommodations. Under Section 504, children must have a documented “physical or mental impairment that substantially limits one or more major life activities” (U.S. Department of Education, 2009, “Students Protected Under Section 504,” Para. 1). Until recently, major life activities were defined as “functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working” (Para. 3). However, the recent passage and enactment of the American with Disabilities Act Amendments (ADAA) in 2009 expanded the definition of “major life activity” to include reading, thinking, and concentrating (Zirkel, 2009, p. 68).

With ADAA, overlap in coverage between Section 504 and IDEA remains, but opportunities to address a wider range of factors that interfere with learning, including social-emotional factors, has broadened. For example, students diagnosed with attention-deficit/hyperactivity disorder (ADHD) or who meet DSM-IV-TR diagnostic criteria for mood or adjustment disorders may not meet eligibility criteria for special education services under IDEA but may be eligible to receive school-based accommodations that facilitate the development of SEA competence through Section 504 (Zirkel, 2009). However, both IDEA and Section 504 apply to specific populations of children, and the policies place the burden of identifying appropriate programs and interventions to effectively and reliably address the development of SEA competencies upon LEAs.

AVAILABLE RESOURCES FOR EDUCATORS ON EVIDENCE-BASED PROGRAMS

There is a growing body of literature on promising interventions and programs that support the development of SEA competence. However, selecting the appropriate evidence-based programs can be challenging in part because of fragmented dissemination of information through the myriad program publisher catalogs and scholarly research journals. In order to address this fragmentation and provide a centralized, publicly accessible resource for “what works” in education, the Institute of Education Sciences (established by the Education Sciences Reform Act of 2002 as an organization within the U.S. Department of Education) created the What Works Clearinghouse (WWC; Institute of Education Sciences, n.d.). The WWC maintains an online database of programs and interventions for which the evidence base has undergone systematic WWC reviews. To date, the WWC has reviewed 468 programs within the eight topic areas of Character Education (n = 41), Early Childhood Education (n = 76), Beginning Reading (n = 170), Adolescent Literacy (n = 2), Elementary School Math (n = 72), Middle School Math (n = 49), English Language Learners (n = 31), and Dropout Prevention (n = 27).

With the aim of identifying the availability of SEA programs directed toward young children, clarifying for whom and in what settings the programs are implemented, and ascertaining the program evidence base, Kristi Maslak summarized the programs listed in the WWC in Table 1. Summaries were obtained by reviewing the 127 available WWC program reports and supplementing this with Internet searches of program websites. Programs directed toward an adolescent population (n = 84) were not included in the summary, and programs identified as duplicate listings (n = 39) or separate units within the same program (n = 18) were consolidated, resulting in a final pool of 324 WWC programs targeting SEA competencies in young children.

TABLE 1.

Programs and Interventions Directed Toward Young Children as Reviewed by the What Works Clearinghouse

Area of Development Grade
Service Tier
Setting
Evidence Standards
Total
Pre-K to 2nd 3rd to 6th Combined Universal Targeted Intensive Combined Home School Community Combined Met Met (Reservations) Not Met No Evidence Found
Social-emotional
    Charcter
education
2 1 25 28 1 18 9 3 4 23 1 31
Academic
    Reading and
literacy
80 15 57 96 33 8 15 7 129 2 14 34 7 119 13 173
    Mathematics 6 8 30 38 3 1 2 41 1 2 4 3 52 2 61
    Combined 5 2 27 24 2 2 6 1 31 2 1 2 29 7 39
SEA integrated 12 1 7 17 1 2 14 2 4 4 1 11 4 20
Total 105 27 146 203 39 11 25 9 233 5 31 46 17 234 27

Note. Grade, service tier, and setting are not summarized for 45 of the programs listed in the What Works Clearinghouse (3 character education, 20 reading and literacy, 17 mathematics, 5 combined), as program descriptions could not be found. SEA = social-emotional and academic.

Area of Development

Academic competence programs in the areas of reading, literacy, and mathematics are well represented through the WWC. However, the number of programs targeting social-emotional competence only or both social-emotional and academic competencies is much more limited (n = 51). Within the social-emotional domain, the WWC limits reviews to Character Education programs that emphasize citizenship and responsible decision making rather than reviewing programs within a more broad-based perspective for social-emotional development. Furthermore, among the SEA integrated programs (n = 20), social-emotional and academic components are frequently included as separate strands within the program and do not take full advantage of the synergy between the two developmental areas.

Service Type

The WWC programs tend to emphasize reading and literacy, particularly among programs for pre-K to second-grade students. Most programs (n = 203) are prevention focused and designed for delivery to all students (universal). However, with the exception of reading and literacy programs, very few programs address the specific needs of secondary (at-risk) or tertiary (identified) students. Moreover, most of the programs are designed for delivery in schools, with very few programs (n = 45) that address contexts of development beyond school grounds.

Evidence Base

The WWC reviews programs according to evidence standards that consider both research design and methodology. Few programs (n = 46) met the WWC's most rigorous standards for study quality, which require the use of experimental designs and random assignment. Although some programs met the WWC's standards with reservations (n = 17), the majority of programs failed to utilize designs sufficient for determining program effectiveness. However, the WWC evidence standards do not include guidelines with respect to the outcome measures used to evaluate programs beyond their reliability and psychometric validation processes. Without standards that gauge the appropriateness of the match between outcome measures and the program constructs, a determination that a program has positive or negative effects cannot be justified.

Links to Policy

With the wealth of reading programs reviewed, the limit within the social-emotional domain to character education, and a focus upon methodological rigor that does not include the relevance of the metric used to measure program outcomes, the findings from this WWC review mirror the emphasis upon static measures of academic achievement and insufficient integration of social-emotional development for which NCLB has been criticized. The programs in the WWC reflect the fact that educational research and policy tend to follow similar trends. For example, research often evaluates what is being or can be implemented according to policy-driven funding (e.g., program grants, initiatives). As a result, educators have limited access to information about programs addressing SEA competence and development.

CURRENT EDUCATIONAL INITIATIVES: MOVES TOWARD INNOVATION AND REFORM

Current federal policies are inconsistent with respect to fully supporting SEA development. The research evidence points to a “whole child” approach that recognizes the importance of the ecological context and the reciprocal relation between academic and social-emotional competence (Raver, 2002). Programs like Head Start have taken this perspective in their conceptualization; however, this is the exception rather than the rule. Current educational policy does not directly address SEA development, nor does it integrate programs and practices emerging from the scientific literature. As such, it has been incumbent upon LEAs to recognize the importance of children's development of SEA competence and to formulate strategies that incorporate programs targeting SEA development into existing policies and funding streams.

Cashman and Rosser (2009) recently reviewed three of the overarching educational agendas being put forth by key educational and policy groups and highlighted their common components and the linkages to behavioral health in schools. Specifically, they noted that the P-16 and P-20 initiatives (promoted by the National Governors Association, Education Commission of the States, National Conference of State Legislatures, Gates Foundation, and 21st Century Skills), the Next Generation Learners initiative from the Council of Chief State School Officers (CCSSO), and the Breaking Ranks initiative from the National Association of Secondary School Principals (NASSP) share an emphasis on individualized learning; flexibility in the delivery of learning; assessment, monitoring, and early intervention for both academic and behavioral issues; and youth leadership and youth voice. They also all include specific language to support social and behavioral programs for students.

What is most noteworthy about these approaches is their emphasis on child-centered education with a holistic and integrative view across the lifespan that includes specific mention of engaging students in learning, personalizing the educational experience, and supporting both academic and social-emotional well-being throughout students’ educational careers versus the more narrow focus on accountability for single indicators of academic progress (i.e., test scores) that is evident in policies such as NCLB. For example, the P-16 and P-20 initiatives represent an effort to create an educational system that integrates a student's education beginning in preschool (as early as 3 years old) through a 4-year college degree (or graduate school) and emphasize skills that are thought to be important for school and career success (e.g., academic skills, flexibility, adaptability, social and cross-cultural skills). The recommendations associated with Breaking Ranks stress “personalization and flexibility” of the school environment and include a focus on individual learning styles and strengths, engagement of students in their own learning, school–community collaborations, emotional and behavioral programs, smaller schools, development of leadership that can create school climates conducive to learning, and ongoing assessment and accountability.

Although all of these initiatives emphasize using data and monitoring outcomes, they represent a significant departure from the language of existing federal policies, most notably NCLB with its emphasis on accountability for single indicators of academic progress (i.e., standardized test scores). Instead, data are used as part of continuous quality improvement efforts across a range of domains. To date, the extent to which the principles in these initiatives have influenced local educational practice is not clear; however, they represent a clear indication that legislators and educators are developing strategies for shaping education in a way that emphasizes an integrative conceptualization of children's learning and success. If such movements are successful in improving student educational outcomes, these ideas could potentially transform educational policy.

DISCUSSION AND RECOMMENDATIONS

Despite the fact that a growing body of empirically validated interventions exists to document the effectiveness of integrated ecological, academic, and social–emotional supports on children's learning, federal policies tend to support splintered rather than integrated programs like those espoused recently by major educational and legislative groups (Cashman & Rosser, 2009) and supported by research linking SEA development. This is in part because of a fragmented system that separates social-emotional support from learning, administrative structures that fail to support alignment, and persistent underfunding. Research too has paid limited attention to issues most relevant to educational policy and practice, such as how best to fit effective interventions into the context of schools. Thus, the gaps between research and policy continue to widen. In our review, we have highlighted some of these gaps. In what follows, we outline a paradigm for research with the goal of improving the alignment between programs to promote SEA development and educational policies.

First, there is a gap between research on young children's SEA and financing. A primary challenge under the current policy structure is that even when specific provisions within federal policies could be leveraged to support SEA competencies, financing for these provisions is limited. On the local level, schools or schools districts have to make difficult decisions about how to spend federal or state funding for programming to enhance SEA competence among students, and there is considerable variability in how services and programs are staffed, conceptualized, and supported across the country. Because of this fragmentation, a broader evidence base for effective interventions that could be supported by relevant provisions in NCLB, IDEA, and Head Start is lacking. Future research should focus on (a) evaluating SEA programs that can be directly tied to SEA-related language in current public policies and (b) building an evidence base for integrative, holistic approaches to education that are advocated by researchers and by an increasing number of national organizations.

Second, mental health research and practice has been, by and large, a parochial enterprise, operating with the assumption that schools will follow suit as there are advances in the prevention and intervention fields. However, the drivers of educational change are focused first and foremost on academic achievement (Jaynes, 2007; McGuinn, 2006). Researchers examining social and emotional development must reorient around educational priorities. The literature demonstrates that social and emotional competence and development is tied to children's academic success over time (Raver, 2002). Research on preventive interventions for young children would be enhanced by a focus on the direct and indirect long-term impacts of these interventions on outcomes such as grades, attendance, classroom behavior, standardized test scores, and disciplinary actions. This approach would allow us to make linkages between intervention effects on indicators of SEA development that are typically used by researchers (e.g., behavior, symptoms, adjustment, self-concept, cognition) and the outcomes that are important to educators and policymakers. By solidifying the relations among these constructs and demonstrating their value in promoting SEA competencies, one can make the case for a broader conceptualization of educational outcomes. Such steps can help to realign the language used by mental health researchers with the current federal policies.

Third, research on programming to support children's SEA development and competence has generally been conducted in a decontextualized manner. A growing body of literature points to the importance of organizational culture and climate and implementation support for improving the quality of services (Fixsen, Naoom, Blasé, Friedman, & Wallace, 2005). In schools, a number of organizational factors impact implementation of programs, such as financing, administrative support, social context for openness to innovations, logistical issues, and staff experience (Domitrovich et al., 2008). As researchers develop and test the impact of programs on children's outcomes, the implementation context of schools needs to be considered.

Fourth, from a practical standpoint, attention should be given to the lack of a centralized resource to link relevant research findings on SEA programs to the current policies and initiatives that are geared toward educators. Although the WWC purports to house a centralized resource for what works in education, the range of program topic areas in the area of social-emotional learning is very limited, especially for young children. Furthermore, the scope of SEA competencies found essential to early childhood development and of interest to educators is not adequately represented. A centralized resource for what works in education should include programs that address the following key elements of social-emotional learning: understanding emotions, setting and working toward goals, interpreting and predicting social cues, making and sustaining friendships, and making responsible decisions (Denham & Brown, this issue). The research base through which the WWC determines program effectiveness targeting SEA generally does not include studies employing rigorous methodologies; thus, one important research agenda is to increase the number of rigorous studies on programs targeting SEA for young children. Moreover, the WWC does not evaluate the appropriateness of the metrics used to measure student outcomes; thus, a second research agenda is to identify and utilize meaningful metrics and consider the appropriateness of metrics when evaluating program effectiveness.

Finally, as a research agenda is built for SEA development and competence, attention should be paid to the implications of this work for the pre-service and in-service training of teachers. Classroom management techniques that are in line with Positive Behavioral Intervention and Supports (PBIS) and other school-wide programs are one potential area of focus. However, teacher education also has not typically included an emphasis on social-emotional development as it relates to learning. As experts are building research knowledge on SEA programs and flexible, individualized learning approaches, it will be important to conduct research with teachers and disseminate emerging information to teachers, principals, and other frontline school staff.

In summary, a growing body of literature empirically links social-emotional and academic competencies in young children. Major federal programs and policies that address the educational context for children provide some opportunities to infuse into educational settings programs that can help to develop and support these competencies. Yet there are limitations to the extent to which these policies fully support a holistic vision for SEA development over time. Future work in this area should focus on research and practical tools for educators that specifically integrate the scientific knowledge on SEA development with major policy initiatives.

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Contributor Information

Erum Nadeem, Division of Mental Health Services and Policy Research at New York State Psychiatric Institute Columbia University.

Kristi Maslak, Department of Counseling and Personnel Services University of Maryland.

Anil Chacko, Department of Psychology Queens College, The City University of New York.

Kimberly Eaton Hoagwood, Division of Mental Health Services and Policy Research at New York State Psychiatric Institute Columbia University.

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