Abstract
Student views of treatment acceptability of an intervention is important but still is neither regularly assessed nor studied beyond non-behavioral interventions. Furthermore, assessment of treatment acceptability across time is almost never considered. Using data from a longitudinal, randomized controlled trial, we examined variables that predicted students’ treatment acceptability of Check & Connect, a mentoring intervention with promise for promoting school engagement. A series of multiple regressions with multiple imputations revealed that students’ treatment acceptability ratings in Year 1 significantly predicted Year 2 ratings. Other variables examined, including dosage, change in mentor, and student and mentor characteristics, were not significant in predicting students’ treatment acceptability ratings in Year 2. Implications for using treatment acceptability to facilitate buy-in and further replications are discussed.
Providing effective interventions for high school students with emotional and behavioral problems is imperative. Students with problem behavior are at high risk of school disengagement (Reschly & Christenson, 2006; Zablocki & Krezmien, 2013). Their disengagement manifests in performing poorly in academics (e.g., low grade point average, low rates of homework completion; Kent et al., 2011), frequently receiving office disciplinary referrals (Flannery, Fenning, Kato, & Bohanon, 2011), and engaging in risk behaviors (e.g., substance abuse; McNamara & Willoughby, 2010). Consequently, they are prone to dropping out of school (Chapman, Laird, Ifill, & KewalRamani, 2011). Failure to complete high school further interferes with becoming productive and healthy citizens in adulthood (U.S. Department of Labor Statistics, 2012).
Mentoring is a promising intervention to address the difficulties that high school students experience (DuBois, Porttillo, Rhodes, Silverthorn, & Valentine, 2011). In particular, Check & Connect (C&C) is one of the few mentoring programs that has been evaluated with students who engage in problem behavior (Sinclair, Christenson, & Thurlow, 2005). Built on the theoretical framework of resilience, system theory, cognitive-behavioral theory, and intrinsic motivation, C&C emphasizes a caring student–adult relationship; involvement of students, families, and schools; use of problem-solving skills; and self-efficacy (Kern, Custer, & Tsai, 2018). C&C promotes student engagement by establishing a trusting relationship between the student and a mentor who believes in the student and is willing to persevere with the student via regular meetings for at least 2 years (Sinclair, Christenson, Lehr, & Anderson, 2003). During meetings, a mentor monitors the student’s signs of school disengagement (e.g., absence, low grades), teaches the student problem-solving skills to tackle challenges, and encourages the student to persist. Despite the growing body of research on the effectiveness of C&C (e.g., Sinclair, Christenson, Elevo, & Hurley, 1998; Sinclair et al., 2005), students’ treatment acceptability has not yet been addressed.
Treatment acceptability refers to the extent to which intervention recipients or consumers deem the goals(s) of an intervention to be socially significant, the procedures of an intervention to be appropriate, and the outcomes to be positive (Wolf, 1978). It is typically obtained by asking various intervention recipients about their perceptions of an intervention using questionnaires or interviews. Treatment acceptability plays a crucial role in the intervention research. According to Witt and Elliott (1985), an intervention must be deemed as acceptable in order for intervention recipients to use it and implement it with fidelity, which consequently is more likely to increase intervention effectiveness, further reinforcing the acceptability of an intervention. Assessing students’ treatment acceptability is particularly important because existing research suggests they have unique perspectives and preferences. For example, Elliott, Turco, and Gresham (1987) compared adults’ and students’ acceptability ratings for three types of group contingencies and found that adults favored one over the others while students perceived all three as only slightly acceptable.
Despite the importance, research on students’ treatment acceptability is limited. Compared with investigations on adults’ treatment acceptability, only a handful of studies have examined variables that may influence students’ treatment acceptability (i.e., Elliott et al., 1987; Elliott, Witt, Galvin, & Moe, 1986; Turco & Elliott, 1986a, 1986b). Like the adult treatment acceptability literature, intervention type and severity of the target student’s behavior have been most frequently studied; yet, other variables such as implementers’ years of experience and students’ special education labels, which have been studied in the adult treatment acceptability literature, beg for further investigation relative to student treatment acceptability. In addition, as the Witt and Elliott (1985) model depicts, the relation among initial treatment acceptability, use of treatment (i.e., dosage), and later treatment acceptability has not yet been examined with empirical data. Researchers also have echoed a need for examining students’ treatment acceptability over time (Kern & Manz, 2004). Furthermore, the current treatment acceptability literature is analogue in nature and predominately focused on behavior-based interventions. Little is known about how pertinent variables play out in students who have actually received an intervention. In addition, in C&C, mentors are expected to make a long-term commitment with students. This expectation, however, may not be always feasible for some mentors. Some students, inevitably, may experience more than one mentor during mentoring. Given that C&C is a relationship-based intervention, forming a consistent relationship may be vital. Therefore, whether change in mentors would affect students’ acceptability would deserve further examination.
To date, only one study specifically examined whether the variables identified in the literature to influence treatment acceptability would hold true in C&C (Tsai & Kern, 2018). The results showed that the critical variables such as student behavior severity, students’ special education classification, and adults’ work experience did not predict C&C mentors’ acceptability ratings. However, the study by Tsai and Kern only addressed adults’ perspectives and it remains unclear if it is also the case for students’ treatment acceptability of C&C. Therefore, the purpose of the study was to address gaps in C&C and the treatment acceptability literature by investigating students’ acceptability ratings of C&C. The research questions were as follows:
Method
This study used the randomized control trial (RCT) data collected by the Center for Adolescents Research in Schools (CARS; Kern et al., 2015). CARS was a 5-year center grant funded by the Institute of Education Sciences (IES) to address the poor outcomes of secondary-age students with emotional/behavioral disorders. During the first 3 years, CARS developed a comprehensive intervention package that was subsequently tested during a 2-year RCT with 54 high schools in Kansas (5), Missouri (7), Ohio (16), Pennsylvania (10), and South Carolina (16). Schools were selected based on the proximity to universities of principal investigators and school staff’s willingness to participate.
Pertaining to school demographics, the average total number of students attending each high school was 1,349 (SD = 672) and the size of the schools varied, ranging from 482 to 3,141. There were three schools smaller than 500 students, 16 with 501 to 1,000 students, 11 with 1,001 to 1,500 students, 16 with 1,501 to 2,000 students, three with 2,001 to 2,500 students, three with 2,501 to 3,000 students, and two with more than 3,000 students. On average, 31.66% of the population across schools was minority, primarily African Americans (SD = 28.64%, range = 1.56%–93.42% per school), and a mean of 38.54% (SD = 19.51%) was low socioeconomic status (SES; range = 7%–75%). Schools were fairly evenly distributed across community location (as defined by Department of Education), with 21 (39%) suburban, 20 (37%) rural, and 13 (24%) urban.
After recruitment, schools were randomly assigned to an intervention (n = 27) or wellness (comparison, n = 27) condition. Students in the intervention condition received a comprehensive, assessment-based intervention package. Although most intervention components (i.e., classroom supports, mental health interventions) were provided only when indicated through assessment or the presence of risk factors (see Kern et al., 2015), all students received C&C and an Interpersonal Skills Group. For students in the wellness condition, monthly newsletters were sent to their parents/guardians, teachers, and mental health providers with information and tips about problems that adolescents frequently encounter (e.g., drug use, gangs).
Participants
Students
Based on school staff referral, 857 families/students agreed to be screened for participation in the RCT based on the following inclusion criteria: (a) absence of autism spectrum disorder (ASD) or intellectual disability (ID), (b) displayed impairments in social/emotional/behavioral and school functioning, and (c) had a parent/guardian who could speak English fluently. The rationale for excluding students with ASD and ID was that some interventions (e.g., cognitive-behavioral therapy) required a particular level of social and/or cognitive skills. Impairment in social/emotional/behavioral functioning was determined by a cutoff T-score on one of three standardized measures: (a) 60 or above on either the internalizing or externalizing composites of the Behavior Assessment System for Children–Teacher or Parent Version (BASC), indicating “at risk” status; (b) 60 or above on the Multidimensional Anxiety Scale for Children (MASC), which is one standard deviation above the mean; or (c) 50 or above on the Reynolds Adolescent Depression Scale–2 (RADS-2), which is one standard deviation above the mean. Impairment in school functioning was defined as exhibiting any two of the following indicators: (a) four or more office disciplinary referrals during the semester prior to enrollment, or 5 or more times during the current semester; (b) five or more non-illness-related absences or tardiness to class during any month of the current or previous semester; (c) two or more in-school or out-of-school suspensions in the current academic year; or (d) one or more Fs, or two or more Ds in any core academic subject in one of two most recent grading periods.
A total of 647 students met admission criteria and consented to participate. Schools were randomly assigned to the intervention or wellness condition, with 341 students apportioned to the intervention group and 306 to the control group. Data used in the current study were from the intervention group only. Among participants, the majority were 9th and 10th graders (38.3% and 35.9%, respectively), aged 14 (25.4%) or 15 years old (29.4%). Of them, 66.5% were male, and the major ethnicity was White/Caucasian (52.1%) followed by African American (38.6%), Hispanic/Latino (5.3%), and Other (4%). Furthermore, 48.5% of the students had a special education classification, with 21.6% of the total sample identified as having learning disabilities (LD), 9.9% as having emotional disturbance (ED), 8.5% as having other health impairments (OHI), and 8% as other (e.g., traumatic brain injury) or unknown.
Mentors
There were 234 C&C mentors: 153 in Year 1, 156 in Year 2, and 75 in both years. Mentors were recruited with the following characteristics: (a) willingness to persist with students for 1 or more years; (b) belief in students’ strengths and abilities; (c) willingness to collaborate and cooperate with families and grant staff; and (d) good skills in advocacy, organization, and case management. Seventy-six percent of the mentors were teachers (20% also served as case managers), 4.26% were counselors/school psychologists, 2.65% were social workers, 2.12% were administrators, and 10.58% were other school-based professionals, such as coaches or school security officers, with the remaining 4.39% unknown.
Variables and Measures
Variables investigated in this study included students’ treatment acceptability of C&C, behavior severity, C&C dosage received, mentors’ years of experience, students’ special education label, and change in mentor. Students’ acceptability of C&C at Year 2 was the dependent variable for Research Questions 1 and 2. Students’ acceptability of C&C at Year 1, C&C dosage across 2 years, and change in mentors were the predictors for Research Question 1, while behavior severity, special education label, and C&C dosage at Year 2 were the predictors for Research Question 2. The measures used for each variable are described below.
Students’ treatment acceptability of C&C
Students’ acceptability was measured by the total scores of the Student School Intervention Rating Form (Student SIRF). Student SIRF is a six-item survey with responses on a 7-point Likert-type scale (e.g., 1 = did not like; 4 = like some; 7 = like a lot) that assesses students’ treatment acceptability for C&C pertaining to understanding, like, helpfulness, and side effects. The SIRF was adapted from the Treatment Acceptability Rating Form–Revised (TARF-R; Reimers & Wacker, 1988) by modifying wording slightly to reflect a school setting and student respondent. For example, “How much discomfort is your learner likely to experience as a result of these procedures?” was changed to “Did anything about the intervention make you feel uncomfortable?” Possible scores range from four as the lowest (because no score is assigned to two questions when an N/A is indicated), 23 as middlemost, to 42 as the highest. A higher score indicates the intervention was viewed as more acceptable. The internal consistency coefficients of Student SIRF, assessed on the current sample, were .77 and .80 in Years 1 and 2, respectively.
Behavior severity
Student behavior severity was measured using T-scores of Externalizing and Internalizing Problems from the Teacher Rating Scale (TRS) of the Behavior Assessment System for Children, Second Edition (BASC-2; Reynolds & Kamphaus, 2004) at Year 2 of the RCT. The BASC-2 is a norm-referenced, standardized behavior rating scale for children and youth aged from 2 to 25. The TRS contains 139 items that represent five composites: Externalizing Problems, Internalizing Problems, School Problems, Behavioral Symptoms Index, and Adaptive Skills. A teacher who knew the student well, but was not a mentor, rated a student’s behavior on a 4-point Likert-type scale (i.e., 1 = never to 4 = almost always). The BASC-2 has moderate to good validity and reliability (Tan, 2007).
Students’ C&C dosage
Because mentors were encouraged to meet with students weekly, the dosage of C&C that a student received was measured by total number of weekly sessions divided by the total possible sessions (e.g., 36 weeks for an academic year). For example, if a student had 20 sessions with a mentor in Year 2, the dosage for the student would be 20 out of 36 weeks in the school year, or 56%. Dosage data were collected from the C&C monitoring sheet. Each monitoring sheet allowed for weekly data entry across a 1-month time period. Mentors and mentees were required to sign the monitoring sheet after each weekly meeting. In addition, when mentors did not meet with their mentee, they were asked to code the reason. The monitoring sheet was collected at the end of each month and served as permanent product data to assess dosage.
Mentors’ years of experience
Mentors’ years of experience was measured by the total years they held in their school-based position. These data were obtained through their report on a demographic form.
Change in mentors
Students’ change in mentors across the 2 years of the RCT was coded as change or no change by comparing mentors’ ID numbers relative to each participating student.
Students’ special education label
Students’ special education label was coded as with special education label or no label(s). The data were obtained from a school record review.
C&C Procedures and Training
Consistent with the C&C guidelines, mentors agreed to meet weekly for 10 to 15 min with their mentees. Mentors utilized a C&C monitoring sheet to document students’ risk indicators (e.g., behavioral infractions, class grades, school/class attendance, missing assignments) and provide feedback to students. When weekly monitoring indicated a student was at risk, mentors coached the student through the following five-step problem-solving process: (a) Stop! Think about the problem, (b) What are some choices? (c) Choose one, (d) Do it, and (e) How did it work? In addition, more intensive interventions were simultaneously implemented (Kern, Harrison, Custer, & Mehta, 2019).
Grant staff employed a coaching model to train mentors to implement C&C. During an initial 15- to 20-min meeting, grant staff first explained the rationale for and the format of C&C, provided examples and non-examples via videotape illustrating how to conduct mentoring sessions, modeled and role-played with mentors, then answered questions.
To ensure consistent implementation, grant staff assessed mentors’ treatment integrity each week for 3 weeks within the first month of implementation through direct observation and permanent product (i.e., evaluated completion of monitoring sheet). Once mentors met 80% accurate implementation during the third check, grant staff faded integrity checks to once a month. When mentors’ implementation fell below 80%, grant staff and mentors problem-solved implementation lapses and retraining was provided.
Data Analyses
Simultaneous and hierarchical regression with multiple imputations (MIs) was conducted for both research questions. The rationale for such a hierarchy was first to control for the variability of dosage that students received and then to examine the impact of student and mentor characteristics. Prior to regression, missing data, power analysis, and statistical assumptions were examined. Percentage of missing data in each variable was 1.2% for special education label, 48% for behavior severity, 42.8% for Year 1 Student SIRF, 47.8% for Year 2 Student SIRF, 46.3% for Year 2 Mentor SIRF, 41.6% for Year 2 treatment integrity, 45.1% for change in mentor, 28.5% for Year 1 dosage, 37.5% for Year 2 dosage, and 62.2% for mentors’ years of experience. Much of the missing data can be attributed to student attrition, both prior to beginning the study and throughout the course of the 2-year RCT. Little’s missing completely at random (MCAR; Little, 1988) test was further conducted on SPSS 23 to examine the missing mechanism. The MCAR test revealed significance, χ2(250) = 408.08, p < .001, suggesting that the missing pattern was not missing completely at random and warranted MI. Despite missing data, statistical power was sufficient at 0.8 and alpha level of .05, and normality and absence of multicollinearity were fulfilled.
Given the MCAR test was significant, MI was conducted to address missing data. Specifically, the fully conditional specification (FCS) with the predictive mean matching (PMM) was used to generate 40 data sets (m = 40) on SAS 9.4. The imputation model included all predictors and the dependent variable (Allison, 2001). Due to complete missing values for two cases, each imputed data set only contained 339 cases.
Once data sets were imputed, multiple regression proceeded. For Research Question 1, the predictors (i.e., the Student SIRF in Year 1, dosage, and change in mentors) were simultaneously entered to the regression model to predict the Student SIRF in Year 2, whereas for Research Question 2, the predictors were entered to the hierarchical regression model in a three-step fashion: first dosage followed by behavior severity and special education label, and finally mentors’ years of experience. Only pooled results are reported.
Results
Table 1 displays pooled, descriptive statistics for the variables investigated. For behavior characteristics, at the start of Year 2, students in the intervention group with a special education label exhibited significantly more problem behavior than those without a special education label, t(13533) = −19.74, p < .001, r = .17, t(13558) = −32.38, p < .001, r = .27, for externalizing and internalizing problem behaviors, respectively. Students who stayed with the same mentors also showed significantly more problem behaviors than those who had a change in mentors, t(11176) = 10.70, p < .001, r = .10, t(10317) = 7.60, p < .001, r = .07, for externalizing and internalizing problem behaviors, respectively.
Pooled, Descriptive Statistics for Each Variable (N = 339).
Note. EPC = externalizing problem composite score; IPC = internalizing problem composite score; SIRF = School Intervention Rating Form; mean difference between with and without special education label across variables is significant, p < .01; mean difference between same and change in mentor was significant, p < .01.
For Student SIRF, overall, students rated C&C above the total midpoint score of the scale (i.e., 4 as the lowest, 24 as the midmost, and 42 as the highest) over 2 years. Furthermore, students with a special education label had significantly lower SIRF scores than those without a special education label: t(13427) = 6.37, p < .001, r = .05 for Year 1; t(13354) = 7.9, p < .001, r = .07 for Year 2. Students who stayed with the same mentors had significantly higher SIRF scores than those who experienced change in their mentor: t(12259) = 2.61, p < .001, r = .02 for Year 1; t(12225) = 5.73, p < .001, r = .05 for Year 2.
The findings from Research Question 1 are reported in Table 2. Results of simultaneous multiple regression with MI indicated that Year 1 SIRF was significantly correlated with Year 2 SIRF. Students’ Year 1 SIRF, 2-year dosage, and change in mentors significantly explained 15% of the variance in students’ Year 2 SIRF, F(3, 343.64) = 8.00, p < .001. However, further examination of each variable indicated that only Year 1 SIRF made a significant contribution to the model, t(59.23) = 4.25, p < .001. The b weights of each predictor are also presented in Table 2.
Pooled, Correlation Matrix and Simultaneous Multiple Regression Analysis Summary for Students’ Year 2 SIRF and Its Predictors (N = 339).
Note. R2 = .15. SIRF = School Intervention Rating Form.
p < .001.
The results from Research Question 2 are shown in Tables 3 and 4. As shown in Table 3, none of the predictors significantly correlated with students’ Year 2 SIRF. In Table 4, results of the hierarchical multiple regression with MI indicated that when first entered to the regression model, Year 2 dosage did not significantly predict students’ Year 2 SIRF and only explained 2% of the variance, F(1, 103.17) = 1.94, p = .17. Adding students’ behavior severity and special education diagnostic label did not significantly explain the variance in students’ Year 2 SIRF, R2 = .03, F(3, 566.15) = 0.60, p = .61, and the change in variance was small (1%). Likewise, further adding mentors’ years of teaching experience did not significantly increase the amount of variance in students’ Year 2 SIRF, R2 = .04, F(1, 89.32) = 0.01, p = .93, and the change in the variance remained small (1%). The b weights of each variable stayed the same with the inclusion of new variable(s) in each regression step.
Pooled, Correlation Matrix for Students’ Year 2 SIRF and Its Predictors (N = 339).
Note. SIRF = School Intervention Rating Form.
p < .05. **p < .001.
Pooled, Hierarchical Multiple Regression Analysis Summary for Students’ Year 2 SIRF and Its Predictors (N = 339).
Note. SIRF = School Intervention Rating Form.
Discussion
C&C is a promising mentoring program to address students’ disengagement in school. Despite the empirical evidence, however, treatment acceptability from the perspective of students is unknown. This broadly reflects the limited studies on students’ perspectives in the treatment acceptability literature. The current study addressed gaps in the treatment acceptability literature as it pertained to C&C and examined (a) whether students’ treatment acceptability of C&C was consistent over 2 years; and (b) whether the variables investigated in analogue studies, dosage of C&C and change in mentor, affected students’ treatment acceptability. Overall, students perceived C&C as an acceptable intervention. Further analyses showed that students’ Year 1 SIRF, dosage received over 2 years, and change in mentor as a whole significantly predicted their Year 2 SIRF, although the effect was small in magnitude. However, when examining the relation between students’ Year 2 SIRF and each predictor separately, only students’ Year 1 SIRF significantly predicted their Year 2 SIRF. Moreover, after controlling for Year 2 dosage, students’ behavior severity, special education label, and mentors’ years of experience failed to predict students’ Year 2 SIRF.
With respect to assessing the sustainability of treatment acceptability recommended by Kern and Manz (2004), the most important finding from this study was that students’ treatment acceptability ratings in Year 1 predicted their ratings in Year 2. The finding suggests that students’ prior perception of the intervention may have impact on their later perception. Therefore, helping students perceive the intervention positively at the onset could be vital for sustaining their positive perception over time.
Surprisingly, dosage and change in mentor did not predict students’ acceptability ratings in Year 2. The absence of predictive relations for dosage and change in mentor on students’ acceptability in Year 2 may suggest that frequency of student meetings with mentors or the switch of mentors did not matter for acceptability as long as students perceived there was someone who cared about them. C&C guidelines require a 2-year commitment from mentors; however, we could not find any research that supports this assertion.
With regard to student and teacher characteristics, this study revealed that students’ behavior severity, special education label, and mentors’ years of experience had no predictive effects on their Year 2 acceptability. The lack of predictive relations suggests these variables may not be influential factors for treatment acceptability. These outcomes diverge from previous research that indicated behavior severity played a role in ratings of treatment acceptability (e.g., Elliott et al., 1986). The current study, however, differs in two important ways. First, Elliott, Witt, Galvin, and Moe (1986) evaluated student perceptions based on analogue situations. Second, the nature of C&C differs from interventions evaluating student perceptions in previous research. C&C is a preventive and relationship-based intervention, rather than one that is applied only as a consequence for problem behaviors.
Limitations
The results should be interpreted with caution due to several limitations. First is the relatively high percentage of missing data across some variables. Because data were collected in the second year of the RCT, attrition coupled with other common issues among this population (e.g., student absences) hindered our ability to obtain data for all variables. In fact, recruitment took place over approximately 9 months due mainly to difficulty meeting with parents to obtain consent. At the start of the RCT, students had already left the study because of school dropout, movement to more restrictive settings, incarceration, and other events commonly experienced by this population. Second, dosage was calculated based on whether or not weekly meetings were held. Although mentors were asked to meet with students once per week at least for 10 min, the actual length of each meeting was not recorded. In addition, mentees were free to meet with their mentors more frequently than weekly, and indeed mentees sometimes sought contact or advice from their mentors between scheduled weekly sessions. Consequently, the measure of dosage used in this study represents an estimate. Measuring the exact frequency of meetings and time spent in each meeting would provide a more exact measure of dosage. In addition, some students experienced a change in mentors more than twice, but this variable was quantified categorically only as one mentor or more than one.
Also to answer the research questions, dosage was calculated by averaging the percentage of sessions attended across 2 years, which may mask the consistency of meetings across time. For example, although two students could have had an average of 50% dosage, one student may have 50% of dosage (18 meetings in 36 weeks) in Year 1 and 50% of dosage (18 meetings in 36 weeks) in Year 2, while the other student may have 75% of dosage (27 meetings in 36 weeks) in Year 1 and 25% of dosage (nine meetings in 36 weeks) in Year 2.
Future Research
Several directions for future research are recommended. Most importantly, replications with different data sets and interventions are needed to validate findings from the current study. In particular, the relations among students’ acceptability and students’ behavior severity should be further studied, particularly given that the findings in the current study diverge from previous research. Also, variables might be measured differently. For example, measuring the length of mentors’ prior experience in mentoring process may be more relevant than measuring the years in their positions, and measuring the actual time that students spent with their mentors may be a better reflection of true intervention dosage.
In addition, future research should assess treatment acceptability of interventions periodically and perhaps more frequently. In the current study, treatment acceptability was assessed at the end of each school year. It is unclear whether similar findings would emerge, particularly the prediction between Year 1 and Year 2, across more frequent assessments.
Future research might also explore other variables that potentially influence treatment acceptability. For example, matching mentors and students is commonly used in mentoring-based interventions; however, the research is mixed on whether this improves mentoring outcomes (Kern et al., 2019). Future research might explore whether matching based on students’ preferred interaction styles or allowing students to self-select their mentor influences treatment acceptability.
Implications for Practice
The findings suggest several implications for practice. First, favorable student acceptability ratings indicate C&C is a socially valid intervention for high school students with emotional and behavioral problems (e.g., Kern et al., 2019). When selecting interventions, practitioners may consider C&C as a possible option.
Second, as students’ previous acceptability ratings of C&C affect their later acceptability ratings, it may be important to help students buy into the intervention early on, both for their own benefit and the probability of continuing the intervention. Possible strategies may include (a) presenting the intervention to high school students with problem behavior in a non-stigmatizing way, (b) clarifying students’ misconceptions of the mentoring process, (c) matching students with mentors who have certain interaction styles or personalities that students prefer, (d) pairing students with adults with whom they already have established trusting relationships, or (e) training mentors to interact with students in their preferred ways. These strategies should be viewed as speculative, however, given the absence of research to support their role with respect to treatment acceptability. In addition, given the predictive relation of students’ acceptability between the two time points, practitioners or researchers may consider utilizing students’ acceptability data to detect any dissatisfaction that may lead to dropping out of the program and subsequently address areas of concern for students and mentors.
Third, the absence of predictive effects of dosage and change in mentors on students’ acceptability suggest that frequency of meetings and a 2-year commitment may not be critical, at least when considering students’ perception of the intervention. This has significant implications for practice as it may ease the requirements needed to implement the program with fidelity. Student acceptability data, however, need to be considered in conjunction with program effectiveness data.
In sum, this study provides a glimpse of students’ authentic perspectives toward C&C through a longitudinal data set. In general, C&C appears to be a socially valid intervention, based on the perspectives of high school students. The fact that frequency of student meetings with mentors and change in mentors did not affect their acceptability warrants further research and has implications for practice. In addition, students perceived C&C positively regardless of their behavior severity, special education label, and mentors’ years of experience. These and other variables should be further examined in future treatment acceptability research.
Footnotes
Declaration of Conflicting Interests
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Institute of Education Sciences, U.S. Department of Education, through Grant R324C080006 awarded to Lehigh University.