This paper describes implementation (fidelity, perceived acceptability) and tier 1 and tier 2 outcomes of a school-wide positive behavior interventions and supports approach (PBIS) including mental health supports at tier 2 in two K-8 urban schools. Interventions for tier 2 consisted of three manualized group cognitive behavioral therapy (GCBT) protocols for externalizing behavior problems, depression and anxiety. tier 1 and tier 2 interventions were implemented with fidelity but program feasibility for tier 2 was in question because school personnel needed a great deal of external support in order to implement the interventions. tier 1 interventions were associated with a decrease in office discipline referrals. Students participating in GCBT showed a significant decrease in mental health diagnostic severity at post-treatment. A discussion of perceived and actual implementation barriers and how they were addressed is provided. Implications for practice in low-income urban schools are discussed.
Keywords: Group cognitive behavioral therapy; Positive behavior interventions and supports (PBIS); Under-resourced urban schools; tier 2.