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The Primary Project (formerly the Primary Mental Health Project, or PMHP) is a school-based early intervention and prevention program that addresses the social and emotional needs of children in kindergarten through third grade who have social or emotional school-adjustment difficulties (but not serious dysfunction). It is based on the principle that traditional school-based mental health efforts are insufficient to meet the needs of children who could benefit from additional help. Implementing Primary Project involves a reorganization of the school-based mental health delivery system to include paraprofessional “child associates” who work more intensively with students.
The program uses early screening tools with all children to identify those in need of additional supports early in their school career. Typical candidates include children who are acting out, display mild aggression, are anxious or withdrawn, or have learning problems that interfere with progress in school. The teachers, parents, and school counselors of each student collaborate to develop an intervention plan that establishes goals for the student’s treatment. The core of the intervention is the creation of a strong relationship with the child associate, who meets with the student for one-on-one counseling sessions one 25- to 45-minute session a week during 20–25 weeks a year. The child associate meets with the student in a structured playroom environment in expressive play sessions intended to reinforce and build on the child’s strengths. Progress is assessed during regular meetings between the child associate and school mental health professionals and midintervention progress reviews.
Program materials include a variety of informational booklets and manuals such as
A recent evaluation of a Primary Project site in Hennepin County, Minn., compared baseline data from program participants with their combined data from the 2001–02 and 2002–03 school years. Data was collected from teachers at baseline and program completion using the T–CRS (Teacher–Child Rating Scale) 2.1, a tool that measures student competencies and problem behaviors through scaled questions that address four competency areas (task orientation, behavior control, assertiveness, and peer social skills). The sample size at base and other years is not stated; however, the sample consisted of 54 percent males and 46 percent females, 61 percent whites, 18 percent African-Americans, 6 percent Hispanics, 6 percent Asian-Americans, 2 percent Native Americans, and 7 percent other ethnicities. Sixty percent of the children in the sample came from two-parent homes. Fifty-three percent of the children lived in middle-income homes, 31 percent in lower income homes, 11 percent in poverty-level homes, and 5 percent in upper income homes. Forty-six percent of the children in the sample were in prekindergarten or kindergarten, 26 percent were in first grade, 21 percent in second grade, and 7 percent in third grade.
Another study assessed program impacts in Jefferson County, Ky. The sample for this study consisted of 610 students participating in the program in 12 schools in the Jefferson County Public School District. Of these, 299 took both pretests and posttests. The sample was made up of roughly equal proportions of students in kindergarten, first grade, second grade, and third grade. Forty-seven percent were female. The ethnic breakdown was 55 percent African-American, 38 percent white, and 6 percent other. Analysis was based on data collected using the T–CRS.
In the Hennepin study, the comparison of pretest and posttest T–CRS results showed statistically significant changes as a result of the program in all four competence areas across the county. Program students made significant improvements in task orientation, specifically in working more independently and completing tasks faster. In behavior control, program students showed increased coping skills and lower levels of aggressiveness and produced fewer disruptions. In assertiveness, students had improved participation in activities, were better at expressing ideas, and showed increased leadership and decreased shyness. Improvements in peer sociability included increases in the quality of peer relationships and improved social skills. Jefferson County study researchers found similar improvements from pretest to posttest in all competence areas at both the State and district level.
Several other evaluations of the Primary Project present evidence of improved school adjustment and decreases in problem behaviors for treatment children. One control group study, with 600 children from 18 school sites randomly assigned into immediate intervention and delayed treatment groups, showed statistically significant decreases in adjustment problems for children receiving program services compared with children waiting for services. Another wait control group design, which employed a 3-month follow-up measure, demonstrated for the treatment group a decline in teacher ratings of learning problems and shy/anxious behaviors and an increase in task orientation and peer social skills. One of the matched comparison group evaluations showed a decrease in adjustment problems and an increase in adaptive competencies after 1 school year in favor of the treatment group. Long-term effects were found in a follow-up study of fourth through sixth graders 2 to 5 years after the intervention. Posttest-only results showed treatment children to be better adjusted than a demographically comparable group of current problem children, based on teacher identifications and ratings, in a statistically significant finding.
Cowen, Emory L. 2001. “Primary Mental Health Project.” Prevention and Treatment 4(1).
Demanchick, Stephen, and Deborah B. Johnson. 2004. Primary Project: Hennepin County, Minnesota. Report to Alliance for Families and Children in Hennepin County. Children’s Institute Technical Report T04–005.
Deborah B. Johnson
Children’s Institute
274 North Goodman Street, Suite D103
Rochester, NY 14607
Phone: (585) 295-1000
Fax: (585) 295-1090
E-mail: djohnson@childrensinstitute.net
Web site: http://www.childrensinstitute.net
Deborah B. Johnson
Children’s Institute
274 North Goodman Street, Suite D103
Rochester, NY
Phone: (877) 888-7647
Fax: (585) 295-1090
E-mail: djohnson@childrensinstitute.net
Web site: http://www.childrensinstitute.net/programs/primaryProject/
