Brief Intervention for School Clinicians (BRISC)

Professionals working individually with middle and high school students experiencing emotional and behavioral stressors

The Brief Intervention for School Clinicians (BRISC) was designed to be responsive to the typical presenting problems of youth in grades 6-12, as well as their approach to help-seeking and their patterns of service participation.

BRISC provides a brief, flexible structure that can be used by a range of school-based practitioners, including licensed clinicians, school social workers, school counselors, school psychologists, or other professionals.

During the four-session BRISC sequence, the practitioner engages the student in a structured engagement and assessment process that results in priority treatment goals that are selected by the student and phrased in their own

words. The practitioner then rapidly engages the student in a collaborative problem-solving process that identifies and addresses difficulties that are causing distress and impacting academic performance and mental well-being. In addition to structured problem-solving, BRISC incorporates empirically supported skill-building strategies, such as psychoeducation, cognitive restructuring, stress and mood management strategies, and communication skills. Data-based progress monitoring guides clinical decisions within BRISC, including “post-BRISC” triage and decision support.

After four sessions, the practitioner evaluates progress with the student and chooses one of the following next steps:

• Complete treatment
• Complete treatment and continue with periodic check-ins
• Continue treatment
• Refer to school-based supports
• Refer to more intensive or specialized mental health services

Over 50% of students typically complete BRISC treatment after four sessions.

Manual Information

There is a manual that describes how to deliver this program.

Child Welfare Outcome: Child/Family Well-Being

• Bruns, E. J., Lee, K., Davis, C., Pullmann, M. D., Ludwig, K., Sander, M., Holm-Hansen, C., Hoover, S., & McCauley, E. M. (2023). Effectiveness of a brief engagement, problem-solving, and triage strategy for high school students: Results of a randomized study. Prevention Science, 24(4), 701–714. https://doi.org/10.1007/s11121-022-01463-4

  Type of Study: Randomized controlled trial

  Sample:

  Age — Not specified. Participants were in grades 9–12

  Participants: 457

  Race/Ethnicity — 38% White/Caucasian, 28% Black/African American, 13% Latinx, 13% Multiracial, 5% Asian, 2% Other, and 1% each

  Gender — 67% Female and 33% Male

  Status — Participants were high school students.

  Location/Institution: Maryland, Minnesota, and Washington, United States

  Summary:

  The purpose of the study was to evaluate the feasibility, acceptability, efficiency, and outcomes of the Brief Intervention for School Clinicians (BRISC), a four‑session assessment, engagement, problem‑solving, and triage model, by comparing it with services as usual. Participant high schools were randomized to either BRISC or services as usual (SAU). Measures utilized include the Service Assessment for Children and Adolescents (SACA), Multidimensional Adolescent Satisfaction Scale (MASS), Therapeutic Alliance Scale for Adolescents (TASA), Youth Top Problems Assessment (YTPA), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Scale (GAD), Brief Problem Checklist (BPC), BRISC External Coding Tool (BECT), and the Acceptability, Likely Effectiveness, Feasibility, and Appropriateness Questionnaire (ALFA-Q). Results indicate that BRISC-assigned school mental health practitioners (SMHPs) reported significantly greater treatment completion after four sessions compared to SAU. Students in the BRISC condition also reported significantly greater reduction in problem severity as evaluated by the Youth Top Problems Assessment. No differences were found for anxiety or depression symptoms or overall functioning. Limitations include attrition and potential bias from BRISC’s structured four‑session review, incomplete treatment‑pathway data, unadjusted familywise error, and unspecified length of controlled postintervention follow-up, given that over 30% of participants continued on with the intervention.

  Length of controlled postintervention follow-up: Unclear.

• Bruns, E. J., Pullmann, M. D., Nicodimos, S., Lyon, A. R., Ludwig, K., Namkung, N., & McCauley, E. (2019). Pilot test of an engagement, triage, and brief intervention strategy for school mental health. School Mental Health 11, 148–162. https://doi.org/10.1007/s12310-018-9277-0

• Lyon, A. R., Bruns, E. J., Ludwig, K., Vander Stoep, A., Pullmann, M. D., Dorsey, S., Eaton, J., Hendrix, E., & McCauley, E. (2015). The Brief Intervention for School Clinicians (BRISC): A mixed-methods evaluation of feasibility, acceptability, and contextual appropriateness. School Mental Health 7, 273–286. https://doi.org/10.1007/s12310-015-9153-0

• Lyon, A. R., Bruns, E. J., Weathers, E. S., Canvas, N., Ludwig, K., Vander Stoep, A., Cheney, D., & McCauley, E. (2014). Taking evidence-based practices to school: using expert opinion to develop a brief, evidence-informed school-based mental health intervention. Advances in School Mental Health Promotion, 7, 42–61. https://doi.org/10.1080/1754730X.2013.857903