ORIGINAL PAPER Do School-Based Clinicians’ Knowledge and Use of Common Elements Correlate with Better Treatment Quality? Sharon Stephan • Anna Westin • Nancy Lever • Deborah Medoff • Eric Youngstrom • Mark Weist Published online: 16 June 2012 Ó Springer Science + Business Media, LLC 2012 Abstract Increasingly, research is focusing on strategies to make evidence-based practice more achievable in school mental health. A significant theme is training and imple- mentation of ‘‘common elements’’ or specific therapeutic skills associated with positive clinical outcomes for chil- dren and youth, as compared to ‘‘manualized’’ interven- tions, which can be difficult to implement, especially in the school setting. As part of a larger study on quality assessment and improvement and evidence-based practice in school mental health (SMH) in three US states, this study analyzed 29 SMH clinicians’ knowledge and use of common elements and the relation of knowledge and use to independent ratings of therapy quality. There was high variability in knowledge and use of the common elements and strong associations between knowledge and use and ratings of treatment quality/effectiveness. Results are dis- cussed in relation to advancing research and clinical practice on achievable evidence-based practice in SMH. Keywords Common elements Á Evidence-based practices Á Implementation Á Depression Á Quality assurance Introduction Given the unmet need for children’s mental health services (Essau, 2005; Merikangas et al., 2010), along with the barriers (e.g., waiting lists, transportation, child care, and financial) to accessing traditional hospital and community- based mental health care, increasing attention has been given to treating children in their natural settings, such as their school (Weist & Ghuman, 2002). School mental health (SMH) services have the potential to increase access to services (Flaherty & Weist, 1999; Jennings et al., 2000; Weist et al., 1999), decrease stigma (Nabors & Reynolds, 2000), expand prevention services (Elias, 1997; Weare, 2000), and improve generalization of treatment gains (Evans, 1999). Schools are also a particularly promising setting for reaching underserved populations (Weist et al., 1999) and hold unique opportunities for engaging both parents and teachers in treatment (Weist, Evans, & Lever, 2003). While only 16 % of all children receive mental health services, of those receiving care, about 75 % receive that care in the school setting (Rones & Hoagwood, 2000). S. Stephan (&) Á N. Lever Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA e-mail: sstephan@psych.umaryland.edu URL: http//csmh.umaryland.edu N. Lever e-mail: nlever@psych.umaryland.edu A. Westin Human Services Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA e-mail: aw10@umbc.edu D. Medoff Division of Services Research, Department of Psychiatry, University of Maryland School of Medicine, 737 W. Lombard Street, Room 518, Baltimore, MD 21201, USA e-mail: dmedoff@psych.umaryland.edu E. Youngstrom Psychology Department, University of North Carolina at Chapel Hill, 348 Davie Hall, Chapel Hill, NC 27599-3270, USA e-mail: eay@unc.edu M. Weist Department of Psychology, University of South Carolina, Barnwell, Room 407, Columbia, SC 29208, USA e-mail: weist@mailbox.sc.edu 123 School Mental Health (2012) 4:170–180 DOI 10.1007/s12310-012-9079-8