Chapter 12 Tier 2 Intervention for Students with Internalizing Symptoms Minglee Yong and Boon Ooi Lee Abstract Students in secondary schools face increased vulnerability for devel- oping internalizing symptoms such as feelings of anxiety, sadness, and hopeless- ness, as well as social withdrawal and somatic complaints. These symptoms are associated with reduced engagement in school, interpersonal problems, and possibly other serious mental health issues. To support students with internalizing symptoms, schools can play an important role in early identification and intervention. The multi- tier system of support is described as the recommended framework for providing a continuum of services for students with internalizing symptoms. At the Tier 1 level, schools can implement a universal social–emotional learning curriculum to equip all students with foundational skills in emotion regulation, perspective-taking, self- management, and problem-solving. At the Tier 2 level, intervention programmes can provide additional support for students screened to be at-risk of developing more serious internalizing symptoms. These programmes aim to alleviate symptoms and prevent further deterioration of functioning. Tier 2 interventions are currently less widespread. The goals of this chapter are to identify treatment components and features of effective school-based Tier 2 programs for students with internalizing symptoms and to provide specific recommendations for integrating programmes into multitier system of support in schools. The effective implementation of Tier 2 programmes will address diverse needs of students and help them achieve more positive social–emotional outcomes. Keywords Internalizing symptoms · Multitier system · Tier 2 · Social–emotional learning · School-based intervention · Depression · Anxiety · Mental health · Secondary prevention · Evidence-based · Models of intervention M. Yong (B ) · B. O. Lee National Institute of Education, Nanyang Technological University, Singapore, Singapore e-mail: minglee.yong@nie.edu.sg B. O. Lee e-mail: boonooi.lee@nie.edu.sg © Springer Nature Singapore Pte Ltd. 2020 C. Koh (ed.), Diversifying Learner Experience, https://doi.org/10.1007/978-981-15-9861-6_12 207