STRONG Development

STRONG was co-developed with the newcomer community and reviewed by several experts in the fields of education and mental health, with specific expertise in school mental health, adversity and trauma, refugee mental health, and resilience.

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STRONG was co-developed and reviewed by members of the newcomer community and several experts in the fields of education and mental health, with specific expertise in school mental health, adversity and trauma, refugee mental health, and resilience.

 

STRONG development was initiated by School Mental Health Ontario (SMH-ON), formerly School Mental Health ASSIST (SMH ASSIST), a provincial implementation support team, funded by the Ontario Ministry of Education, and housed within the Hamilton-Wentworth District School Board (HWDSB).  SMH ON provides leadership, resources, and implementation coaching to all school boards in Ontario, in English and French.  The team works closely with the Ministry of Education and has a role within the wider system of care, linking with the Ministry of Health and Long-Term Care and the Ministry of Children and Youth Services. 

 

A core pillar within SMH-ON Strategic Directions involves offering unique and differentiated supports for students within a focus on Equity and Specific Populations.  Immigrant, Refugee, Ethnocultural, and Racialized (IRER) mental health practices are a key part of this pillar.  In 2016-2017, SMH ON engaged in regular “newcomer mental health rounds” with Ontario school boards to determine priority areas for resource development.  At that time, the need for a tier two/three intervention to serve students from refugee backgrounds experiencing the impacts of trauma was identified.  For this purpose, SMH-ON partnered with the local newcomer community and international leaders in school mental health, refugee mental health, trauma, and resilience to develop a school-based intervention. The intervention, Supporting Transition Resilience of Newcomer Groups (STRONG), was piloted in two school boards in Ontario between March-June 2018, and then again between February-June 2019. Evaluation of STRONG, conducted by Dr. Claire Crooks, Director of the Centre for School Mental Health at Western University, and her team demonstrated acceptability, feasibility and positive impact of STRONG. Evaluation findings informed intervention refinement, including further developmental attunement of intervention components, resulting in the current STRONG intervention.

 

STRONG content and structure was informed by the experiences of the development team with other school-based interventions, most prominently Cognitive Behavioral Intervention for Trauma in Schools (CBITS, www.cbitsprogram.org, originally developed by Lisa Jaycox, 2003, second edition released in 2019 authored by Jaycox, Langley and Hoover) and Bounce Back (www.bouncebackprogram.org,  developed by Audra Langley and Lisa Jaycox, 2015). CBITS is a 10-session, group-based cognitive behavioral intervention designed to treat post-traumatic stress in schools. It has been widely implemented across several nations with a strong evidence for its positive impact on psychosocial and academic functioning. CBITS revolutionized the way childhood trauma is identified and treated. For example, following the devastation of Hurricanes Katrina and Rita in New Orleans in 2005, researchers established that over 90% of children completed CBITS when offered in schools compared to approximately 15% of children completing evidence-based trauma treatment offered in traditional community mental health settings (Jaycox et al., 2010). CBITS provided groundbreaking support that students can effectively be  treated for mental health problems, including trauma, in schools. Bounce Back, an adaptation of CBITS for younger students (Kindergarten to 5th grade), provided support that young children could be successfully treated for post-traumatic stress in school settings.