Uncovering the Moment-to-Moment Processes and Strategies of Staff in School-Based Day Treatment for Children with Social, Emotional and Behavioural Difficulties

The school-based day treatment program at the Child Development Institute (CDI) provides intensive mental health services for children in kindergarten and grade 1 with social, emotional and behavioural difficulties who are unable to manage in mainstream classrooms. Despite services such as this having been offered in Canada for several decades, research on day treatment is scarce with no standard models for program delivery. Using stimulated recall interviews with classroom staff, this study aimed to describe the moment-to-moment processes and strategies of classroom staff in the day treatment program at CDI and incorporate them into a preliminary program model. Several processes and strategies used by staff members emerged from thematic analysis of the interviews. These included a process of tailored intervention, characterized by a continual and cyclical process of attunement, responsiveness, assessment and evaluation, using a team-based approach, noticing positives about children, a climate of positive relationships, staff regulating their own emotions, being flexible while also being firm and consistent, and seeing children from a developmental perspective. More specific strategies used by staff members (e.g., token economy) also emerged from the interviews. School readiness was identified as being the major developmental goal for children in the day treatment program. Ultimately, the program was conceived as a milieu therapy. Implications for future research and preservice teacher training are discussed.