Characterizing Graduate Training in Discrete Practice Elements: An Exploratory Study of School-Based Behavioral Health Providers.

Authors

Tristan J Maesaka, Mason V Fraser, Ayada Bonilla, Brad J Nakamura

Published in

Evidence-based practice in child and adolescent mental health. Pages 1-19. Nov 10, 2026. Epub Nov 10, 2026.

Abstract

Although pre-service education for eventual behavioral health providers is a critical period for promoting evidence-based practices (EBP) competencies, graduate training in EBP remains inconsistent across programs. Research examining pre-service training activities has predominantly operationalized EBP in terms of brand-named manuals or broad treatment modalities (e.g. cognitive behavioral therapy). Distillation and modularity offer a complementary framework for characterizing training in discrete treatment components.
Utilizing data from a school mental health modular therapy training initiative, this cross-sectional study aimed to characterize graduate training experiences in different discrete treatment techniques, or practice elements (PEs), and explore relationships between depth of prior training and intentions to use PEs commonly included in evidence-based treatment protocols for youth with anxiety and disruptive behavior problems.
Participants included 81 school-based behavioral Health (SBBH) providers and 21 supervisors who completed a retrospective, self-report measure assessing the degree to which they were trained in different PEs in graduate school and a measure assessing intentions to use different PEs to treat hypothetical anxiety and disruptive behavior presentations. Descriptive analyses and visual displays characterized graduate training profiles for SBBH and supervisors separately, and multiple linear regression analyses explored associations between prior training and treatment intentions.
Master's-level SBBH reported broad but relatively shallow training across diverse PEs, whereas doctoral-level supervisors reported greater depth of training. Both SBBH providers and supervisors reported relatively limited training in core internalizing PEs, namely exposure and activity scheduling. Prior training experience was not significantly associated with treatment intentions, although doctoral-level providers endorsed more techniques derived from the evidence base for treating disruptive behavior.
This exploration suggests that school-based providers self-report training experiences in diverse treatment components and provides preliminary support for the feasibility of investigating graduate training at the discrete PE level.

PMID:
43007065
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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