EDUCATORS’ PERSPECTIVES OF YOUTH-LED IMPLEMENTATION OF THE FRIENDS FOR LIFE PROGRAM: A CRITICAL INCIDENT STUDY by NATHAN BARTZ A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES GRADUATE COUNSELLING PSYCHOLOGY PROGRAM We accept this thesis as conforming to the required standard .................................................................................. Robert Lees, Ed.D., Thesis Co-Supervisor ................................................................................... Marvin McDonald, Ph.D., Thesis Co-Supervisor ……………………………………………………… Annette Vogt, MA, External Examiner TRINITY WESTERN UNIVERSITY March, 2018 © Nathan Bartz EDUCATOR PERSPECTIVES ii ABSTRACT This study examined the viability of a newly piloted implementation model of the FRIENDS for Life anxiety prevention program. The FRIENDS program is the only empirically validated universal anxiety prevention program recognized by the WHO and continues to build research support for efficacy in reducing anxiety symptoms. In Chilliwack, British Columbia, a collaborative community initiative piloted an implementation model of the FRIENDS for Life program, which involved the inclusion of high school students as chief implementers of the FRIENDS program to local elementary school populations. In conjunction with staff at the Ministry of Children and Family Development in Chilliwack, this study utilized the Enhanced Critical Incident Technique to explore the professional observations and insights from educators involved in this new implementation. The purpose of the study was to answer the question of what helps and hinders the implementation of FRIENDS when high school students are the implementers. Semi-structured interviews were conducted with five educators who were asked about their experiences with the FRIENDS program, what helpful and hindering incidents they observed, and to provide a wish list for future improvements. A total of 128 incidents were extracted, 51 of which were helping, 38 hindering, and 39 wish list items. From these incidents, 9 helping, 11 hindering, and 9 wish list categories were formulated with participation rates ranging from 20% to 100%. Results suggest that a youth-led FRIENDS implementation model is a viable model of program delivery and worth consideration for future development and refinement. The educators reported that high school students are highly capable of forming important emotional bonds with the elementary school students, and together with supportive mentors, contribute to a pro social EDUCATOR PERSPECTIVES iii and viable model of FRIENDS program implementation. The educators also provided a list of recommendations for improving the viability of the youth-led model of implementation. This study’s findings offer a promising outlook on a youth-led implementation model of the FRIENDS for Life program with possibilities of fostering pro social outcomes in elementary and high school youth, and also increased community benefit from community collaboration and partnership. Keywords: FRIENDS; peer-led implementation; anxiety; educators; youth mental health programs EDUCATOR PERSPECTIVES iv TABLE OF CONTENTS ABSTRACT .................................................................................................................................... ii TABLE OF CONTENTS ............................................................................................................... iv ACKNOWLEDGEMENTS .......................................................................................................... vii CHAPTER 1: INTRODUCTION ................................................................................................... 1 Childhood and Adolescent Anxiety ............................................................................................ 1 The FRIENDS Program .............................................................................................................. 4 FRIENDS implementation in Chilliwack. .............................................................................. 5 Piloted FRIENDS implementation strategy. ........................................................................... 7 CHAPTER 2: LITERATURE REVIEW ........................................................................................ 9 The Effectiveness of FRIENDS .................................................................................................. 9 Variations of FRIENDS Implementations ................................................................................ 15 Peer-Led program delivery models ........................................................................................... 18 Youth as educators. ............................................................................................................... 20 Educator perspectives. .......................................................................................................... 23 Rationale for The Current Research ......................................................................................... 24 CHAPTER 3: METHOD .............................................................................................................. 26 Design of the Research Project ................................................................................................. 26 Paradigmatic assumptions. .................................................................................................... 26 Pragmatism and the critical incident technique .................................................................... 27 Research goal and the enhanced critical incident technique. ................................................ 30 Youth led model ........................................................................................................................ 32 Participants ................................................................................................................................ 33 Recruitment. .......................................................................................................................... 35 Stakeholders. ......................................................................................................................... 35 Data Collection ......................................................................................................................... 37 Researcher self-description. .................................................................................................. 37 Research interview protocol. ................................................................................................ 38 Recording and storing the information. ................................................................................ 39 Data Analysis ............................................................................................................................ 40 Rigour and Validation ............................................................................................................... 42 Summary ................................................................................................................................... 47 CHAPTER 4: RESULTS .............................................................................................................. 49 Overview of Helpful Incidents.................................................................................................. 50 Helpful categories. ................................................................................................................ 52 EDUCATOR PERSPECTIVES v Overview of Hindering Incidents.............................................................................................. 54 Hindering categories. ............................................................................................................ 57 Overview of Wish List Items .................................................................................................... 59 Wish list categories. .............................................................................................................. 61 Summary ................................................................................................................................... 63 CHAPTER 5: DISCUSSION ........................................................................................................ 66 High School Student Capability ............................................................................................... 67 Connection with elementary students. .................................................................................. 68 Classroom management abilities. ......................................................................................... 69 High school students as inspirations. .................................................................................... 70 Self-esteem and confidence. ................................................................................................. 72 Supporting Roles ....................................................................................................................... 73 Hindering Category Themes ..................................................................................................... 75 Administrative challenges. .................................................................................................... 75 Confusion with supporting roles. .......................................................................................... 77 Missed implementation opportunities. .................................................................................. 78 Recommendations for Improved Viability of Youth-led FRIENDS Model ............................. 80 Limitations & Future Research ................................................................................................. 82 Conclusion ................................................................................................................................ 85 REFERENCES ............................................................................................................................. 87 APPENDIX A: INFORMED CONSENT FORM ........................................................................ 98 APPENDIX B: INTERVIEW PROTOCOL ............................................................................... 100 APPENDIX C: DEBRIEFING SCRIPT ..................................................................................... 102 EDUCATOR PERSPECTIVES vi Table 1: Helpful Categories.......................................................................................................50 Table 2: Hindering Categories...................................................................................................55 Table 3: Wish List Categories....................................................................................................60 EDUCATOR PERSPECTIVES vii ACKNOWLEDGEMENTS The process of completing this thesis project was certainly not possible without the support of many by my side. I wish to express my deepest gratitude to the many individuals who helped this project become a reality. Thanks to Dr. Marvin Mcdonald for your wisdom in guiding me through the process and teaching me how to think deeper. Thank you, Dr. Rob Lees, for introducing me to this opportunity and for your insight and encouragement throughout the various stages of the project. I especially want to thank my wife, Rianna, for your unending support, love, and encouragement. In many ways, this is as much yours as it is mine. Your patience is ever appreciated. Lastly, I want to thank the participants who devoted their time, knowledge, and expertise to make this project a realty. Thank you. EDUCATOR PERSPECTIVES 1 CHAPTER 1: INTRODUCTION Anxiety is clinically understood as a disorder involving the interaction of cognitive, emotional, and physiological responses to a future threat (DSM-5; American Psychiatric Association, 2013). Anxiety is different from fear: where fear is associated with thoughts of imminent threat, produces sympathetic arousal, and is associated with an escape response, anxiety involves thoughts of future threat, and produces muscle tension and avoidance behaviours (Craske et al., 2009). Common symptoms for anxiety include: increased heart rate and breathing, excessive sweating, nausea, dizziness or light-headedness, tight chest, numbness or tingling sensations, bright vision or feelings of unreality (AnxietyBC, 2014). Anxiety is the most common of mental disorders experienced within the general population (Public Health Agency of Canada, 2011). A report on mental illnesses in Canada revealed that approximately 12% to 18% of the Canadian population is affected by anxiety disorders at any one time (Public Health Agency of Canada, 2011). This figure from The Human Face of Mental Health in Canada 2006 (https://www.canada.ca/en/public-health/services/reports-publications/humanface-mental-health-mental-illness-canada-2006/anxiiety-disorders-2016.html) refers to the cluster of anxiety disorders, including generalized anxiety disorder (GAD), phobias, social anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, and agoraphobia. Childhood and Adolescent Anxiety Anxiety is not just experienced by adults. It is also the most common disorder experienced by children and adolescents (Kashani & Orvaschel, 1990). Symptoms of the various subtypes of anxiety disorders are increasingly being recognized in child and adolescent populations. According to Costello, Mustillo, Erkanli, Keeler, and Angold (2003), within any given year, approximately 1% of adolescents between the ages of 13 and 18 will struggle with EDUCATOR PERSPECTIVES 2 GAD, 4% of this group will develop PTSD, and approximately 7% will develop social anxiety. The prevalence of disorders varies, as social anxiety, panic disorder, depression, and substance use increase in prevalence as children mature, while separation anxiety and attentiondeficit/hyperactivity disorder decrease. The preexistence of anxiety in adolescence is also found to mediate the development of alcohol and drug dependence (DeWit, MacDonald, & Offord, 1999), and is also considered highly co-morbid with depression (Farrell & Barrett, 2007). There are numerous effects that anxiety has which are unique to children and adolescents. General effects of anxiety include an interference with normal daily functioning and lost productivity (Boyd, Johnson, & Bee, 2012). Interference with normal daily functioning may be evidenced by less participation than children without anxiety in social, athletic, or recreational clubs, and difficulty making friends (Anxiety BC, 2014). Anxiety has also been associated with increased school refusal. Moreover, anxiety in school children can also go unnoticed because they still reluctantly attend school while experiencing a myriad of debilitating somatic, social, and emotional problems related to anxiety (Jones & Suveg, 2015). Since the debilitating effects of anxiety disorders have lasting negative impacts well into adulthood, it is important for interventions to work as efficiently and effectively as possible. According to a recent report from the British Columbia Ministry of Child and Family Development (MCFD) focusing on child and youth mental disorders (Waddell, Shepherd, Schwartz, & Barican, 2014), approximately 13% of children and youth aged 4-17 in BC (about 84,000) experience clinically significant mental disorders at any one time. Collectively, the different subtypes of anxiety disorders show a prevalence rate of approximately 4%, or 25,000 children with a diagnosis of any anxiety disorder. Further estimates expect the national prevalence rate to be close to 206,000. Within BC, it is also estimated that, of the 84,000 EDUCATOR PERSPECTIVES 3 children who are experiencing some type of mental health disorder, only 31% are receiving specialized mental health treatment. This presents a clear need to reach these children who are not getting the necessary care and treatment. As a means of addressing the need for more affordable and accessible treatment, the FRIENDS program has been offered in BC schools since 2004. Under the guidance and direction of the MFCD, in conjunction with the BC Ministry of Education, FRIENDS is made available to the staff of any school who wish to implement it in their classrooms. Researchers suggest that, despite the prevalence of anxiety in child and adolescent populations, there is a lack in treatment access (Fisak, Richard, & Mann, 2011; Public Health Agency of Canada, Chapter 5 Anxiety Disorders, 2011). This lack of treatment access exists for various reasons such as minimal access to appropriate services, low awareness by the individuals or parents, long wait lists, and competing time commitments (Creswell, Waite, & Cooper, 2014). One response to the issue of treatment access is the use of universal interventions (Anticich, Barrett, Gillies, & Silverman, 2012; Dadds et al., 1999; Farrell & Barrett, 2007). Universal interventions are typically conducted by an individual trained to deliver the program to whole classrooms or groups in organizational settings, regardless of whether the children have a specific diagnosis of anxiety or not. Research indicates that universal programs are often effective in accomplishing their objectives to reduce anxiety in child populations (Anticich et al., 2012; Bennett et al., 2013; Corrieri et al., 2014; Dadds et al., 1999; Farrell & Barrett, 2007; Fisak et al., 2011). One program specifically has garnered considerable empirical support for its effectiveness in reducing child anxiety. EDUCATOR PERSPECTIVES 4 The FRIENDS Program The FRIENDS anxiety management program is a universal anxiety intervention developed by Dr. Paula Barrett in Australia and implemented in school classrooms around the world. The title of ‘FRIENDS’ is an acronym with each of the letters representing the seven steps or skills learned through the program: F-Feelings, R-Remember to relax, I-I can do it, EExplore solutions, N-Now reward yourself, D-Don’t forget to practice, S-Smile. FRIENDS is a social and emotional learning program targeting children and adolescents between the ages of 416 as both a prevention and intervention for children suffering with, or at risk of developing, anxiety (Barrett, Lowry-Webster, & Turner, 2000a; Barrett, Lowry-Webster, & Turner, 2000b). The content of FRIENDS is based on CBT principles for the purpose of building and encouraging resiliency, self-esteem, problem solving skills, healthy self-expression, and healthy relationships with adults and peers. Built within the program are skills such as understanding and recognizing feelings of self and others, learning how to face challenges, learning relaxation and self-regulation, recognizing helpful and unhelpful thoughts, learning from role models, building support teams, and learning to effectively solve problems. FRIENDS has also received the endorsement of the World Health Organization as an effective intervention for child and adolescent anxiety (WHO, 2004). Traditionally, mental health professionals or classroom teachers, who will have received a one-day certification course, deliver the program. The program takes a minimum of ten sessions to complete. Three levels of the program have been developed targeting different age groups. The Fun FRIENDS program is mostly experiential and tailored for kindergarten and grade 1. The FRIENDS for Life program is tailored for grades 4 and 5, and the My FRIENDS Youth program for grades 6 and 7. EDUCATOR PERSPECTIVES 5 FRIENDS implementation in Chilliwack. Specifically, within BC, the MCFD has focused research on the use and implementation of FRIENDS in classrooms. Despite the FRIENDS program’s popular support (WHO, 2004), MCFD in Chilliwack has found implementation challenges concerning treatment fidelity and sparse use of the program among schools (Sawyer, 2011). Some themes emerging from Sawyer’s qualitative study suggest there are challenges with consistency of implementation. Sawyer suggests that, despite FRIENDS having a user-friendly design that can be easily integrated with an existing teaching curriculum, there are still resourcing challenges with regards to teachers having the time to consistently implement FRIENDS in their classrooms. In Sawyer’s critical incident study, which focused on educators’ perspectives of what helps and hinders the implementation of FRIENDS in Chilliwack schools, one of the emerging themes related to the time commitment necessary to implement FRIENDS. Specifically, the teachers found a scarcity of time to commit to implementing FRIENDS in their classrooms. The need to attend the FRIENDS training program was also found to be a hindrance for teachers who already believed that they had competency from their teaching experience to teach the FRIENDS curriculum. These primary hindrances, along with others, contribute to an overall lack in implementation of the FRIENDS program in Chilliwack schools. Another possible hindrance and barrier to implementation, and specifically the implementation of the proposed youth-led model, is the impact that this model might have on the teachers’ classroom and whether it will be perceived as saving time in comparison to the teacher implementing the program. It is a valid possibility that an inefficient system of delivery of the youth-led model would not actually save teachers time and therefore not be deemed a worthy educational investment in their classroom. However, the FRIENDS program, when viably and properly implemented, works to enhance social emotional learning and reduce anxiety EDUCATOR PERSPECTIVES 6 symptoms. In the classroom context, this can increase the general mental health literacy of the students, give the students a language to begin learning to cope with stressors, and thereby enhance the efficiency of their learning. Moreover, recent changes to the BC teaching curriculum (2018) highlights how one of the core competencies are to achieve personal and social growth in students. Specifically, the competency of personal awareness and responsibility fits with the curriculum of FRIENDS. This means that, for teachers to receive the youth-led model of FRIENDS, they will not have to sacrifice otherwise valuable time to ensure the core competencies are addressed in the classroom. Instead the youth-led model, when facilitated efficiently and effectively, can provide the necessary learning points to address this curricular competency. These challenges are important to consider for the purpose of this study because a primary goal of many MCFD staff, and other community stakeholders in Chilliwack, is to see increased implementation of FRIENDS in schools. Therefore, the challenges of implementation are important to address. One possible solution to the dilemma of increasing implementation of FRIENDS in school classrooms is to diversify the personnel involved in implementing FRIENDS. A pilot project of FRIENDS was conducted in the Chilliwack school district, where local high school students received the FRIENDS training and conducted the FRIENDS program instead of the teachers. It is proposed by the MCFD in Chilliwack that having high school students implement the FRIENDS program can be a potential solution to the aforementioned challenges to implementation. First, by having high school youth deliver FRIENDS, the hindrance of time commitment can be alleviated. Secondly, in addition to having the elementary school children learn about FRIENDS, the high school students delivering the program also will receive education and training in mental health, which can have positive health benefits in their own EDUCATOR PERSPECTIVES 7 personal development, as similar effects were found in other studies involving youth peer-led programs and interventions (Haski-Leventhal, Ronel, York, & Ben-David, 2008; Jennings, Howard, & Perotte, 2014; Ohlmann, 2012; Wyman et al., 2010). Piloted FRIENDS implementation strategy. Currently, there is very little research on implementing the FRIENDS program using high school aged youth. Additionally, for the purposes of improving the implementation feasibility of FRIENDS in Chilliwack schools, there is a need to examine the perceptions of educators as they observe the new-piloted strategy within their schools in order to inform future decisions regarding the use of high school students for implementation. In this study, the perspectives of the educators were explored, as they were both conveniently and strategically situated to observe the entire process—from program coordination to in-class implementation— and provide insight as to how the high school students implement the FRIENDS program. The educators had a strategic vantage point to observe what benefits or challenges surfaced during the process of implementation. A variety of educators associated with the program delivery both within and outside the schools were sought after, including teachers, educational assistants, school administrators, and group facilitators. Specifically, the question of what helps and hinders the implementation of FRIENDS when high school youth deliver the program was explored, including the educators’ opinions of what they would like to see implemented differently. Educators’ perspectives are critical to obtain for a number of reasons. The educators in Chilliwack provide valuable information for this study as to whether a model of youth implemented FRIENDS is worth inviting into their classrooms. These perspectives were gathered via the Critical Incident Technique (CIT), and since the teachers were present during the teaching of FRIENDS, they were poised to assess various critical incidents of implementation, providing useful information regarding the helping and hindering aspects of EDUCATOR PERSPECTIVES 8 youth led FRIENDS. This study is specifically not meant to be a quantitative evaluation of the effects of the new pilot strategy. The focus is to gain critical qualitative information about the dynamics of the youth-led implementation for the purpose of addressing the current challenges to FRIENDS implementation in Chilliwack schools (Sawyer, 2011). It is in the interest of the MCFD in Chilliwack to see increased delivery of the FRIENDS program in Chilliwack schools, and ultimately, in BC schools. Since one of the key identified challenges of implementation is time commitment (Sawyer, 2011), the inclusion of high school youth to deliver FRIENDS is a promising alternative to teacher-led FRIENDS. Furthermore, since principals and teachers are the stakeholders who decide whether to introduce FRIENDS into their schools and classrooms, it is important to consider their perspectives regarding the implementation of FRIENDS. Educators are the deciding factor of whether FRIENDS is introduced within their respective schools and classrooms. Because FRIENDS is not a provincially mandated program, it is essential to understand the challenges of implementation in order to increase the program’s appeal to educators within schools. The purpose of this study is to discover, via the Enhanced Critical Incident Technique ECIT method, the educators’ perspectives of youth implemented FRIENDS, in order to better understand how to address existing challenges of implementation. EDUCATOR PERSPECTIVES 9 CHAPTER 2: LITERATURE REVIEW This chapter will discuss the literature relevant to the aforementioned pilot project of FRIENDS in Chilliwack, BC. Specific sections of the review will highlight the established effectiveness of FRIENDS as an evidence-based program, modifications to FRIENDS, and the rationale behind the current pilot project. The Effectiveness of FRIENDS Since its development, the FRIENDS program continues to garner considerable research attention. Within Australia, the country of origin, FRIENDS has been established as an effective universal anxiety management program (Barrett, Farrell, Ollendick, & Dadds, 2006; Lock & Barrett, 2003; Lowry-Webster, Barrett, & Lock, 2003). The authors who conducted these studies found favourable longitudinal effects of the FRIENDS program on reducing anxiety symptoms in the sample participants. Prevention effects and symptom reduction were sustained at 36 months (Barrett et al., 2006). Also, there is a greater effectiveness of the interventions on younger primary-aged children than children aged 14-16 (Barrett, Lock, & Farrell, 2005; Lock & Barrett, 2003), suggesting the importance of a preventative focus on primary children. In another study, 85% of children who scored above the clinical cut-off for anxiety or depression and were given the FRIENDS intervention were diagnosis free after the intervention compared to 31% in the control (Lowry-Webster et al., 2003). Despite the numerous studies supporting the effectiveness of FRIENDS, there have been some less positive results. A recent meta-analytic evaluation was conducted examining the FRIENDS program’s effectiveness for preventing anxiety in student populations (Maggin & Johnson, 2014). According to Maggin and Johnson (2014), the meta-analytic findings showed mixed results. The authors reported three main methodological limitations: the failure to use EDUCATOR PERSPECTIVES 10 appropriate units of analysis, an extensive overreliance upon self-reports to assess treatment outcomes, and the pervasive use of waitlist-controls. With regard to the overall effectiveness of the program, Maggin and Johnson found that the FRIENDS program offered a slight reduction in the anxiety of low-risk students immediately following program completion. However, the effects of the intervention were not maintained at follow-ups after 12 months, which suggest that the effects of the program on measures of anxiety fade over time for low-risk students. With regards to high-risk students, there were no effect differences found between treatment and control classrooms at immediate posttests. Follow-up data collected within 12 months also showed no differences between these groups. Maggin and Johnson concluded that most of the current research on the effectiveness of the FRIENDS program lacks the appropriate rigour to label it as evidence based. A response to Maggin and Johnson from Barrett, Cooper, Stallard, Zeggio, and GallegosGuajardo (2017) was recently published, critically addressing the assertions made by Maggin and Johnson regarding the effectiveness of the FRIENDS program. Barrett et al. point to conceptual flaws, methodological concerns, and flaws in interpretations that challenge the validity of Maggin and Johnson’s findings. Concerning methodology, Barrett et al. argue that the true effectiveness of FRIENDS is misrepresented in Maggin and Johnson’s meta-analysis because there were almost as many published studies which met their selection criteria that were omitted from analysis as there were included. Moreover, they failed to highlight any potential risk of bias through the study selection process. Barrett et al. (2017) further argue that Maggin and Johnson failed to consider a more holistic view of intervention effects. By contrast, Maggin and Johnson’s emphasis for effectiveness was symptom reduction and therefore does not account for multiple aspects of intervention effectiveness. Consideration of this critique highlights the EDUCATOR PERSPECTIVES 11 importance of recognizing both the ongoing development and evolution of the FRIENDS program, which Maggin and Johnson (2014) highlight, while maintaining the confidence in the established empirical evidence of the effectiveness of FRIENDS, as highlighted by Barrett et al. (2017). In Canada, a study was conducted on the effectiveness of FRIENDS with culturally enriched material to appeal to aboriginal populations (Miller, Laye-Gindhu, Bennett, et al., 2011). The authors examined the effectiveness of using teachers as program deliverers, applying FRIENDS universally within school classrooms, and enriching the program with relevant Aboriginal content in hopes of increasing effectiveness of the intervention with Aboriginal students. A total of 533 students participated in a randomized control study, with 192 students having an Aboriginal background. The effect that the culturally enriched FRIENDS program had on reducing anxiety was analyzed via multilevel models three times over the course of a year. The authors found that all students, regardless of intervention condition, ethnic status, or gender, reported consistent decreases in anxiety over 6 months, and that anxiety symptom reduction could not be directly attributable to the enriched FRIENDS protocol. Similar results were found in another Canadian study involving children in grade 4 (Rose, Miller, & Martinez, 2009a). However, FRIENDS was shown to be effective in reducing sub clinical and clinical anxiety in students in Regina, Saskatchewan, with effect sizes of .32 and .35 for anxiety and depression respectively (St. Onge, Stephenson, & Kumar, 2016). An examination of the effectiveness of both targeted and universal applications of FRIENDS was conducted (Miller, Laye-Gindhu, Liu, et al., 2011). The authors utilized a randomized attention control design over a period of 17 months. The targeted study (study 1) yielded a sample size of 191 students with 48% female. The universal study (study 2) yielded a EDUCATOR PERSPECTIVES 12 sample size of 253 students with 54 % being female. The authors matched schools by socioeconomic status and randomly assigned them to the intervention or control groups. Results indicated that all studies reduced anxiety regardless of the intervention and found no intervention effects between the intervention and control groups. Despite study strengths that included a heterogeneous and generalizable sample size, random assignment, and the inclusion of an attention control, Miller, Laye-Gindhu, Liu, et al.’s findings are inconsistent with most other research findings of the effectiveness of the FRIENDS program (Barrett, Cooper, & Guajardo, 2014; Barrett & Ollendick, 2004; Fisak et al., 2011; Rodgers & Dunsmuir, 2015). An important note that Miller et al. makes is the difficulties with low reporting of program adherence. It may be possible that those who implemented the FRIENDS program lacked the necessary understanding and skills required to administer a CBT intervention with the fidelity necessary to make it effective. This may also contribute to the lack of significant differences between the attention control group and intervention group. Although these recent studies suggest different results concerning the effectiveness of the FRIENDS program, there continues to be research that affirms FRIENDS as an effective evidence-based anxiety prevention program in schools. One meta-analysis examined the most efficacious components of anxiety prevention programs (Fisak et al., 2011). Fisak et al. included studies with children or adolescents under the age of 18, and also studies that were both published and unpublished in order to account for possible publication bias. Studies focusing on other mental health issues like depression, and studies with children or adolescents with previously developed anxiety prior to the intervention were excluded. The authors suggested it is unlikely that there is a significant effect of publication bias on the overall effect size. They further assert that the FRIENDS program specifically, is a well-established and effective EDUCATOR PERSPECTIVES 13 program for preventing general anxiety symptoms. Moreover, Fisak et al., (2011) argue that studies using FRIENDS as the intervention, compared to other interventions, were more effective in reducing anxiety. The results of Fisak et al. are consistent with Corrieri et al., (2014), whose systematic review found that most school-based interventions are effective in either reducing or preventing mental disorders in adolescents, albeit with small effect sizes. The FRIENDS program has also shown to be effective in various countries (DeSousa et al., 2016; Martinsen, Aalberg, Gere, & Neumer, 2010; Pereira, Marques, Russo, Barros, & Barrett, 2014; Siu, 2007; Stallard, Simpson, Anderson, & Goddard, 2008). Researchers in Mexico saw positive changes in multiple aspects of wellness in addition to changes in anxiety (Gallegos, Rodríguez, Gómez, Rabelo, & Gutiérrez, 2012). The study focused on a sample of ten girls aged 9 to 10 years, who were from a low socio-economic background and were living at an orphanage. The mean age of the girls was 9.8 years. The authors found that the optimism and positive self-concept of Mexican girls living in an orphanage were increased, and they also reported decreases in worry, physiological symptoms of anxiety, and negative mood. Social validity assessments, which measured how much the participants enjoyed participating in the FRIENDS program, indicated that participants found the program both enjoyable and useful. In a sample of 339 Dutch children aged 8-13 years, FRIENDS contributed to lasting reductions in anxiety and depression when implemented daily (Kösters, Chinapaw, Zwaanswijk, van der Wal, & Koot, 2015). Researchers in Scotland and Ireland suggest FRIENDS has positive impacts on children’s self-esteem and social skills (Liddle & Macmillan, 2010; Ruttledge et al., 2016), and on the reduction of overall anxiety scores, even beyond a 4-month follow-up (Rodgers & Dunsmuir, 2015). Long term effects of reduced anxiety at 4 and 6 months EDUCATOR PERSPECTIVES 14 were also reported in South African children from low socio-economic backgrounds (Mostert & Loxton, 2008). One evaluation presents some of the key components of FRIENDS that are important to consider for this study (Briesch, Hagermoser Sanetti, & Briesch, 2010). The purpose of Briesch et al.’s evaluation was to examine the current research base for the FRIENDS for Life program, for evidence of its effectiveness. They generally concluded that the program shows promise for use in school-based settings, having showed both universal and targeted effectiveness in reducing anxiety within schools. Moreover, the authors suggest FRIENDS can also benefit all students through the teaching of coping skills, regardless of their status of anxiety. Some important points to consider in future implementations of the FRIENDS program include: who implements the program in classrooms, the level of intervention in which FRIENDS is delivered, and the exploration of such issues as cost, feasibility and flexibility. With regard to who implements the program, Briesch et al. point out that, despite the non-significant differences found between psychologist led and teacher led FRIENDS (Barrett & Turner, 2001), their analysis reveals that mean effect sizes noticeably drop from those of clinically trained providers (Mean ES = 0.56) to a smaller effect size (Mean ES = 0.22) for teacher trained implementers (Briesch et al., 2010). While FRIENDS shows promise in benefitting all students, Briesch et al. also report that it may generally be more effective to consider the use of FRIENDS in non-universal settings, citing mean effect sizes for the general population being small (ES = 0.24) compared to at-risk (ES = 0.44) and anxiety diagnosed (ES = 0.84) individuals. The authors suggested that local decision-making consider the costs and benefits of universal implementation in light of these findings. This presents the need for further EDUCATOR PERSPECTIVES 15 research into the feasibility of the FRIENDS program to maximize the benefit it provides for school student populations at the least cost to community and school stakeholders. Despite the presented concerns related to the effectiveness of FRIENDS (Maggin & Johnson, 2014; Miller, Laye-Ginhu, Bennett et al., 2011; Rose, Miller, & Martinez, 2009b), there continues to be research (Barrett et al., 2014; Rodgers & Dunsmuir, 2015; Skryabina et al., 2016; Stallard et al., 2014), that supports the existing endorsements of FRIENDS as a valuable and beneficial evidence based program (WHO, 2004) for treating anxiety. However, in consideration of the presented concerns, for future implementation of FRIENDS, it is necessary to consider ways to further improve the program and address some of the current effectiveness concerns presented above. The current pilot study, discussed earlier, can provide a potential solution to the questions of cost and resourcing in implementing the FRIENDS program at local and provincial levels. The new pilot modification of training high school youth implementers, instead of clinical professionals or teachers, can satisfy many of the concerns regarding costs in finances, time, and personnel, that currently hinder the widespread implementation of FRIENDS. Variations of FRIENDS Implementations Recent researchers examined some different piloted variations of implementing the FRIENDS program. They assessed a combined intervention to promote social and emotional skills in Grade 6 and 7 students from low socioeconomic areas (Iizuka, Barrett, Gillies, Cook, & Marinovic, 2014). The variation piloted in this study was the teachers receiving training for both teaching the social and emotional skills for students and also receiving an adult resilience program for themselves. The authors hypothesized that focusing on the teachers’ own development would have a greater effect on their influence on the students’ development than if EDUCATOR PERSPECTIVES 16 the teachers only delivered the FRIENDS program on its own. In this way, an improvement would be made to the delivery of FRIENDS that could potentially address some of the contextual challenges of implementing the program in low socioeconomic populations. The authors found that the combined intervention was effective in decreasing the students’ anxiety levels when delivered universally. Students in the ‘low difficulty’ group initially showed increased scores with generalized anxiety at post-test. This result significantly decreased by the 3-month followup and was sustained at 6-month follow-up. Additionally, the authors used the FRIENDS Social Acceptability Measure to assess the students’ acceptance of the program on a 5-point Likert scale. On average, the program was found to be socially acceptable by the students. A study conducted in the UK (Stallard et al., 2014) utilized a randomized trial comparing the implementation of the FRIENDS program between teachers and mental health professionals. A total of 40 schools participated, of which 14 were randomly assigned to the teacher-led FRIENDS group, 14 to the health professional-led FRIENDS group, and 12 to the usual school provision group. The program delivery was compared between implementation groups at 12 months. The authors found that, as a cognitive behavioural anxiety prevention program, FRIENDS is effective in reducing anxiety in children. However, the program leader is important to consider since the delivery of FRIENDS was more effective when led by health professionals rather than teachers. The authors conclude that FRIENDS is an effective universal prevention program but recommend that it be led by mental health professionals, in everyday school settings, to ensure effectiveness. Stallard et al.’s (2014) study is currently the only research focusing on comparisons of implementation between teachers and mental health professionals. This current study purposes to examine the implementation of FRIENDS by trained high-school students rather than EDUCATOR PERSPECTIVES 17 teachers. While some research suggests that non-mental health professionals are not as effective at implementing FRIENDS (Miller et al., 2011; Stallard et al., 2014), teacher-implemented FRIENDS was still found to be effective, but with smaller effect sizes (Iizuka et al., 2014). This finding is important when considering the use of high-school students in delivering FRIENDS, because the findings suggest that effective implementation is still possible by non-mental health professionals. Also, considering the success found in other youth-led programs (Jennings et al., 2014; Ohlmann, 2012; Wyman et al., 2010), using high-school students as implementers of FRIENDS is arguably a promising modification to the program to meet the implementation needs within Chilliwack schools. The use of high school students can provide the necessary resources to both encourage and ensure increased and consistent implementation of FRIENDS. A study by Kösters et al. (2017) examined the implementation characteristics and childrens’ appraisal of the FRIENDS for Life program in a naturalistic setting. In their study, the prevention workers used the appropriate therapeutic skills but did not completely adhere to the program protocol. The authors found that a lower protocol adherence did not negatively affect program outcomes, and that the children’s participation and appraisal of the program was good. This is an important finding to acknowledge when considering the use of high school students as FRIENDS implementers. It is reasonable to expect that high school students may not have the equivalent skill development and training as professionals who implement the program, and thus may not be able to rigidly adhere to treatment protocols. As Kösters et al. (2017) point out, though, a lower adherence to delivery protocol does not render the successful application of FRIENDS principles void, and it can thus be expected that high school students will bring value to the elementary school classroom regardless of implementation protocol adherence. EDUCATOR PERSPECTIVES 18 Peer-Led program delivery models Mellanby, Rees, and Tripp (2000) conducted a review of published studies on the effects of peer-led deliveries of school-based health education program. Their findings suggest that students of slightly older or similar age who are delivering an educational curriculum were at least as effective, if not more effective than adult-led interventions. The youth-led implementation of a School HIV/AIDS Education Program (SHEP) in Zambia was evaluated by Denison et al. (2012) for the effects on students’ HIV and reproductive health knowledge as well as attitudes and behaviours. The authors found that the youth-led model resulted in an increase of HIV and reproductive health knowledge, greater self-efficacy, lower levels of risky sexual behaviours, and lower stigma associated with sexual health (2012). Another study had youth trained to communicate positive health message regarding smoking to their peers (Audrey, Holliday, & Campbell, 2006). The authors found that the peer educators were active in their educational roles and that a model of informal peer support showed promise in effectively disseminating mental health education among peers. One program involving a youth-led delivery to address mental health stigma was explored by Bulanda et al. (2014). Bulanda et al. evaluated the S.P.E.A.K. program, which is designed to address mental health stigma, and was implemented by high school students. The high school students were involved in both planning and delivering the program activities. The authors found significant changes in knowledge and social distance scales, suggesting the capability of youth capability educating about mental health stigma (2014). These findings are important to consider in light of this current research project which seeks to explore a local youth-led implementation of the FRIENDS program. EDUCATOR PERSPECTIVES 19 Some of the important questions to consider regarding the implementation of prevention programs by youth relate to the adherence of program fidelity. In any program, fidelity is ensured by an adherence to the specified protocol of the program when delivering its contents. Since the FRIENDS program was originally designed to be implemented by either mental health professionals or teachers, the question of fidelity is pertinent to the proposition of a youth-led delivery model. Some of the concerns relate to whether the effectiveness of the program will be compromised by the possibility of variable levels of implementation fidelity. Although, Byrnes, Miller, Aalborg, Plasencia, and Keagy (2010) highlight that adherence to program fidelity, under certain circumstances, can have different effects. They suggest that moderate levels of fidelity may actually be ideal in comparison to low or high levels because low levels of fidelity indicate a lack of the core components of the program, while high levels of fidelity may produce a less flexibility to adapt to client needs. In this regard, it is possible that lower levels of fidelity in a youth-led FRIENDS delivery may not necessarily compromise the overall psychosocial impact that the peer-led program might have. Of course, the degree to which fidelity is compromised must ideally be minimized. With regards to considering how the effectiveness of a program may be impacted by fidelity adherence, it may be valuable to consider Harden, Oakley, and Weston’s (1999) Review of the Effectiveness and Appropriateness of Peer Delivered Health Promotion Interventions for Young People. In their review, the authors report that programs delivered by peer leaders were not found to be less effective than teachers, and in some instances, they were more effective. However, competence in facilitating group processes such as facilitating dialogue and guiding rather than dominating were a main factor contributing to the success of the programs (1999). This may pose challenges with the notion of adolescents teaching younger children if the youth EDUCATOR PERSPECTIVES 20 leaders lack the necessary group facilitation skills and are not able to grasp the necessary concepts of the program material in to deliver its contents to adequate fidelity. Youth as educators. Though there has not yet been a FRIENDS program that has been delivered by youth, there have been other prevention studies that demonstrate the benefits of having youth involved as leaders of prevention programs. One of the clearly established benefits of having youth involved in prevention program delivery is the personal benefit gained by the youth. One study examined the key components of a youth community service program (Lakin & Mahoney, 2006). The authors assessed whether the program was experienced as intended, and what outcomes were produced. Results showed that the program was experienced as empowering for the youth involved and promoted a sense of community. The youth who delivered the program also reported having greater self-empathy and an increased motivation to be involved in future community action. This is consistent with Wilson & Musick (1999), who argue that the practice of volunteering can be self-validating, foster intimacy and trust between people, and encourage the volunteer to anticipate reciprocal help when needed—all of which contribute to positive mental health benefits. Volunteering encourages social connection and engagement. The importance of social connection is seen in research which found that adolescents who had stronger connection in family and community contexts, were predicted to have a greater likelihood to be involved in voting, community volunteer service, social group involvement, education groups, and endorsement of civic trust and engagement in young adulthood. (Duke, Skay, Pettingell, & Borowsky, 2009). Another study conducted in drop-in centers for at-risk youth in Israel compared youth and adult volunteers with regards to motivations, benefits, and commitment of youth volunteers (Haski-Leventhal et al., 2008). The authors found that, compared to adults, the youth volunteers were more relationship oriented, EDUCATOR PERSPECTIVES 21 whereas adults were more service oriented. The at-risk youth clientele also perceived the youth volunteers as helpful, explaining that having volunteers their age helped change their perspectives and increase feelings of empowerment to volunteer themselves. These findings suggest that youth have a different, special impact on their peers compared to adults. It may be that youth are perceived differently from adults—less as authority figures, and more as inspirational role models. This change in perception could positively enhance the effects of the FRIENDS program when it is delivered by youth. Youth volunteerism and involvement in prevention programs also enhances protective factors for the youth. An outcome evaluation was conducted on the effectiveness of the Sources for Strength program in enhancing protective factors in the youth leaders who conducted the program in their schools (Wyman et al., 2010). The study included 18 high schools, which were randomly assigned to either the intervention or control group. A total of 453 peer leaders were given surveys at baseline and at 4-month follow-up. Results indicated that having received the training, the peer leaders showed improved adaptive norms with suicide such as the increased perception that adults in their school can provide adequate help for suicidal students, and the acceptability of seeking help from adults. They also had better connectedness with adults, increased school engagement, and increased perceptions of adult support for suicidal youths and the appropriateness of seeking help. Peer leaders were also four times more likely to refer a suicidal friend to an adult than non-trained peers. Wyman et al.’s results suggest that, through participation as peer leaders, the youth are effective agents of change, and their own personal protective factors are enhanced. The results from a qualitative analysis in a British Columbia high school (Ohlmann, 2012) richly supports Wyman et al.’s findings of the benefits of participation as peer leaders of a suicide prevention program. Ohlmann utilized a Listening EDUCATOR PERSPECTIVES 22 Guide to explore the experiences of high school students between the ages of 15 and 18, as they created and performed presentations of suicide prevention to peers and students at other schools. The focus of the Listening Guide was to explore the impact of the program on the participants’ resiliency. Ohlmann found that, through the Alive group that the participants were involved in, they increasingly started developing a sense of knowing, connection, altruism, and protection. The participants gained a greater knowing and understanding of themselves and others. From this increased personal knowing, they began to show more desire to help others and positively impact others with their own learning experiences. Through greater connections with themselves, the youth participants became more passionate about engaging others with what they knew to be important. The narratives of these experiences were gained from their involvement in the experience of the Alive group and delivering the suicide program to others. Similar results were found in another study focusing on the impact of peer-led sexuality education program (Jennings, 2014). A group of 96 high school students were trained as peer leaders of the Teen Prevention Education Program (PEP), with 61 in the comparison group. The students who participated as peer leaders reported significantly greater opportunities to practice sexual risk reduction skills, greater willingness to talk with friends, parents, and sex partners about sex and birth control, greater intentions to set boundaries with sex partners and ask partners to be tested for sexually transmitted infections. Compared to the control group, the peer leaders also showed significantly higher scores on knowledge of sexual health issues and ability to refuse risky sexual situations. These two studies strongly demonstrate that youth who participate in specialized training to deliver an awareness and prevention program stand to gain a great deal of personal knowledge, self-confidence, and personal agency. EDUCATOR PERSPECTIVES 23 Educator perspectives. With regard to increasing the implementation of the FRIENDS program, another important consideration is the social validity of the program. This is important to note because the dissemination of the FRIENDS program to more schools in British Columbia will likely not be consistent or adequate if the program is not perceived as socially valid (Skryabina et al., 2016). In their study in the UK, Skryabina et al. conducted a qualitative evaluation of the views that children, parents, and school staff have of the FRIENDS program. The authors utilized semi-structured individual interviews or focus groups with the threedifferent participant groups and analyzed the data via thematic analysis. They found that overall, the program was perceived as a positive experience and the children understood the concepts of CBT that the program taught. However, the teachers had some reservations including an overlapping of the program with the current curriculum and the extra time required to teach it, and close to half the teachers reported being unable to identify tangible changes in the children’s behaviour. These views show that the social validity of the program was largely supported, but the teachers’ concerns pose a challenge to the sustainability of the program. This finding points to the importance of the teacher’s perspectives of various components of the FRIENDS program, particularly when considering this study. Since the educators are the ones who decide whether or not to implement FRIENDS in their classrooms, their perspectives are critical when it comes to making improvements to the implementation of FRIENDS—such as using high school students to deliver the program. Furthermore, most of the current research on the effectiveness of FRIENDS does not incorporate the perspectives of those who have consistent face time and relationship with the students who receive the intervention. For this reason, a qualitative study focusing on their perspectives is a necessary addition to the existing body of research on the effectiveness of FRIENDS. EDUCATOR PERSPECTIVES 24 Rationale for The Current Research The purpose of this study is to address some of the ongoing feasibility concerns of the consistent implementation of FRIENDS within Chilliwack schools (Sawyer, 2011), and to add needed qualitative data to the growing body of quantitative research on the FRIENDS program (Briesch et al., 2010). As discussed in this literature review, FRIENDS is an empirically established universal anxiety prevention program (Barrett et al., 2014, 2017; Rodgers & Dunsmuir, 2015; Skryabina et al., 2016; Stallard et al., 2014). However, despite demonstrating effectiveness in accomplishing its goals, the FRIENDS program still faces barriers to implementation within Chilliwack schools, such as time commitment and competency issues (R. Lees, personal communication, June 20, 2016; Sawyer, 2011). One possible solution to the barrier of time commitment is to utilize local high school students from the Human Services Career Enrichment Program (HSCEP) at Chilliwack Senior Secondary (CSS) as the implementers of FRIENDS. This study will utilize the Enhanced Critical Incident Technique (ECIT) to examine educator perspectives of the CSS youth-led FRIENDS. Most studies on the effectiveness of FRIENDS provide evidence from self-report measures given to the students who receive the program. Since school educators are important stakeholders with regard to the implementation of the FRIENDS program, it is important that their voices also be represented in the body of literature focusing on the FRIENDS program. With the ECIT, this study will explore what the educators observe helps and hinders the implementation of FRIENDS as a universal anxiety program by the CSS students. Since educators are at the front line of the FRIENDS program delivery, they are strategically poised to provide a unique qualitative evaluation of whether utilizing youth as implementers of FRIENDS is a positive direction to take the program. Understanding the educators’ perspectives concerning EDUCATOR PERSPECTIVES 25 the viable delivery of FRIENDS by youth can provide essential information for the future improvement of the FRIENDS program in BC. Refining the viability of a youth-led FRIENDS implementation model may address some of the ongoing resourcing concerns that keep FRIENDS from being consistently implemented. The primary goals of this study are to explore the observations of educators regarding what helps and hinders the youth-led implementation of FRIENDS, and to elicit the educators’ suggestions as to what could be added to improve the viability of a youth-led FRIENDS implementation model. EDUCATOR PERSPECTIVES 26 CHAPTER 3: METHOD This chapter of the thesis will detail the relevant methodology of the proposed study. As mentioned in the literature review, this study sought to answer the question of what educators observe is helpful or hindering when involving high school students with implementation of the FRIENDS program in school classrooms. The proposed qualitative method for this study is the Enhanced Critical Incident Technique (ECIT). This chapter details the study design including discussion of paradigmatic assumptions, a rationale for the use of ECIT, relevant stakeholders, participants involved in the study, recruitment procedures, data collection and proposed analysis procedures, and lastly, rigour and quality assurance. Design of the Research Project Paradigmatic assumptions. Understanding the foundational paradigm underlying a qualitative study is important for knowing the rationale behind the method of inquiry selected for the particular study. Research paradigms are a set of value-laden assumptions which guide the processes a researcher takes when conducting the study (Mertens, 2015). Specifically, these assumptions are drawn from a philosophy of science including axiological understanding (the role of values in research), epistemological assumptions (how knowledge is acquired and how the researcher relates to it), and ontological considerations, which deal with the nature of being and reality (Ponterotto, 2005). Paradigms also inform and determine the methodological process of research. Understanding the paradigmatic assumptions behind research studies builds coherence within the methodological process and fosters relevance of the study within the existing body of related literature. According to Ponterotto (2005), the main research paradigms include positivism, postpositivism, constructive-interpretivism, and critical-ideologicalism. Mertens (2015) also supports the additional paradigm of pragmatism. It is generally understood EDUCATOR PERSPECTIVES 27 that pragmatic research is largely concerned with what works to answer the proposed research question (Mertens, 2015). However, the use of pragmatism as a paradigm has deeper philosophical roots that inform the process of inquiry in a different way than the traditional paradigmatic assumptions of axiology, epistemology, and ontology (Morgan, 2014). From a philosophical standpoint, Morgan draws from the works of John Dewey, citing that knowledge is obtained in a process of inquiry based on the cyclical reflection of beliefs and action. The knowledge process involves making choices by asking and answering questions. These questions are concerned with the likely outcomes of applying current beliefs to future action. Dewey’s model of experiences supposes a cyclical pattern of reflecting on actions to choose beliefs, leading to a reflection on beliefs to choose actions, and so on. Moreover, the boundary between everyday life and research is grey, with the caveat that research is practiced more carefully and consciously. Morgan (2014) outlines the approach to pragmatic inquiry as beginning with: (a) recognizing a situation as problematic, (b) considering the differences between defining the problem one way or another, (c) developing a possible line of action in response to the problem, (d) evaluating the likely consequences of the possible lines of action, (e) taking action that will likely address the problem. Pragmatism and the critical incident technique. As a method of inquiry, the critical incident technique (CIT) fits well with a pragmatic paradigm of research. A summary of the CIT method suggests it is a flexible method that can fit with either postpositive or constructivist approaches (Butterfield, 2005). The CIT was developed as a practical scientific tool designed to uncover existing realities for the purpose of measurement and prediction. The CIT was originally designed to collect direct observations of human behaviour to solve practical problems and develop psychological principles (Flanagan, 1954). As was reflective of the era in which it EDUCATOR PERSPECTIVES 28 was designed, the CIT was originally utilized from a postpositive perspective for quantitative purposes. It was not until later that the CIT was adapted for more qualitative settings and constructivist leanings (Butterfield, Borgen, Maglio, & Amundson, 2009). Indeed, one study utilized the CIT method to gain perspective on what helps and hinders workers’ ability to manage change within their workplace environments (Butterfield, Borgen, Amundson, & Erlebach, 2010). From a pragmatic perspective, CIT has an inherent design that aligns with the pragmatic notion of experience as being a continual interaction of beliefs and action (Morgan, 2014). Indeed, the distinctive features of the CIT are the focus on critical events, incidents, or factors that either help or hinder the effective performance of an activity. The CIT primarily gathers data from interviews, and analyzes data within a specific frame of reference, resulting in category formation in narrative form with self-descriptive titles (Butterfield et al., 2009). These features collectively inform the basis of the pragmatic notion of belief. When used for the purpose of informing and improving the effectiveness of an activity or experience, the data from a CIT study pragmatically informs future action of the intended activity with adjustments from the gathered beliefs about the previous actions of the activity. The critical incidents gleaned from the data provide a basis upon which effective suggestions and inferences can be made regarding the necessary characteristics for future success and effectiveness of an activity. This is how the CIT is unique in its flexibility to function both quantitatively and qualitatively as a method, and also unique in its ability to fit within different paradigms. Ontology. Since this study will be conducted from a pragmatic paradigm, it is important to note how the metaphysical assumptions of pragmatism are different from the traditional paradigms, and how pragmatism informs this research project. With regards to ontology—the nature of reality—philosophical pragmatism differs from the traditionally polar modes of EDUCATOR PERSPECTIVES 29 scientific inquiry that are postpositivism and constructivism. According to Morgan (2014), where postpositivism asserts that the world exists apart from our understanding of it, and where constructivism holds that the world is constructed in real-time by our subjective perceptions, pragmatism respects both ontological notions as equally important claims of human nature. Since the CIT is a flexible method that can fit in either camp (Butterfield, 2005), it is therefore appropriately aligned with the pragmatic approach to research. Epistemology. The paradigmatic assumption of epistemology, which relates to the philosophy of knowledge, has a different focus within pragmatism. Instead of focusing on which kinds of knowledge are possible within the given ontological parameters of either postpositivism or constructivism, the pragmatic philosophy of knowledge is more concerned with experience as the continual interaction of beliefs with action. Morgan (2014) suggests this leads to more practical questions pertaining to the difference it makes in choosing to obtain one form of knowledge over the other, and for what purposes. Pragmatism supposes that knowledge is a reciprocal inquiry process between belief and action rather than existing in an abstract relationship between the researcher and what is known (Morgan, 2014). Axiology. The axiological component of a paradigm is concerned with the researcher’s values associated with the research process (Ponterotto, 2005). Mertens (2015) suggests that, at the roots of pragmatism, Dewey emphasized an ethic of care in research and highlighted the need to gain various different perspectives of other constituencies. Though this historical ethical standard is considered the ideal, there also exist some contemporary notions of pragmatism that pursue more of a “whatever works” approach to accomplishing the research goals (Mertens, 2015). This pragmatic axiological ethic of care, and intentional perspective taking, is at the base of the pragmatic paradigm driving this current research project. The selected method of ECIT EDUCATOR PERSPECTIVES 30 along with the researcher’s own motivations, which will be discussed later, are consistent with the aforementioned pragmatic philosophical ethic of research. Methodology. As a paradigm, pragmatism is compatible with both quantitative and qualitative research methods (Mertens, 2015). The ontological and epistemological assumptions of pragmatism discussed above lend the flexibility for the researcher to choose a variety of method combinations that work best for answering the proposed research questions. Mertens suggests that the pragmatic researcher choose whatever method is most appropriate considering the community reference group of the researcher. Consistent with this pragmatic methodological philosophy, the ECIT has been chosen as the appropriate method of inquiry for the proposed study. Research goal and the enhanced critical incident technique. According to Flanagan (1954), the main applications of the CIT include: measuring typical performance criteria, measuring proficiency, examining training purposes, selection and classification, job design and purification, clarifying operating procedures, equipment design, evaluating motivation and leadership attitudes, and counselling psychotherapy. The CIT is not simply a method of obtaining opinions, but it gathers records of behaviour from individuals in optimal positions to make the required observations. These foci make the ECIT an appropriate method for answering this project’s research purpose: discovering the perspectives of the educators as they observe the FRIENDS program being implemented by high school youth. More recently, the original CIT has been modified into the enhanced critical incident technique (Butterfield, 2005; Butterfield et al., 2009) which includes a wish list along with the traditional critical incidents from Flanagan (1954). This study involves numerous stakeholders; one of the primary ones is the Ministry of Child and Family Development (MFCD) in Chilliwack, BC. The significance of each EDUCATOR PERSPECTIVES 31 stakeholder will be discussed later, but it is important to acknowledge that ECIT has been determined by correspondents at MCFD as the most appropriate method for exploring educator perspectives of the piloted FRIENDS implementation for the purpose of program improvement and increased implementation (R. Lees, personal communication, June 30, 2016). As was discussed in the literature review, the FRIENDS program is effective as a universal program in reducing anxiety and building self-esteem in school populations (Barrett et al., 2014; Barrett & Ollendick, 2004). There are also benefits in having high school students receive training to run social programs (Jennings et al., 2014; Ohlmann, 2012; Wyman et al., 2010). One benefit of using the ECIT is that it can provide the structure to gain valuable information, which can be used to assess the merit of having high school youth implement FRIENDS in elementary school classrooms. This method has applications for foundational and exploratory work, provides qualitative understanding on factual happenings in a real-world environment, and provides the critical incidents that help discern differences or turning points in the program delivery (Woolsey, 1986). The ECIT is an appropriate method for evaluative purposes and has been used in previous studies and theses (Mclean, 2012; Mercer, 2009; Westwood, McLean, Cave, Borgen, & Slakov, 2010). In the case of this study, the ECIT provided critical incidents and a wish list from the educators as they observed the implementation of FRIENDS by high school students. The critical incidents were analyzed from a rich narrative account from the educators, were analyzed to form relevant categories of incidents bringing coherence to the educators’ observations of what helps and hinders a youth implementation model of FRIENDS. This data will help inform future direction concerning the implementation of the FRIENDS program in Chilliwack schools. Because the ECIT is an action- EDUCATOR PERSPECTIVES 32 oriented method, focusing on the solving of practical problems (Flanagan, 1954), it adequately meets the needs of the stakeholders involved in the program which the ECIT is investigating. Youth led model The youth-led model of FRIENDS implementation is multidimensional and incorporates multiple stakeholders involved. The program is designed to be implemented over a ten-week span for one hour per week. Specifically, the youth involved in the model come from CSS. These youths are involved in the HSCEP. In their involvement with this educational path, they take a psychology 10 course through which their involvement with the teacher facilitates their involvement in the FRIENDS training. Training in the FRIENDS program is facilitated by MCFD and provided for the high school students as part of their HSCEP program requirements. Communication between staff on the Child and Youth Mental Health (CYMH) team and schools interested in receiving the FRIENDS program, within the Chilliwack School District, arranges for the youth-led teams to have a block of one hour within the respective classrooms to deliver the program. This happens in conjunction with agreement of the school administrator and classroom teacher of the receiving school program. Staff from the CYMH team also arrange for group facilitators to provide leadership and guidance of the high school youth before, during, and after the implementation of the program. The role of these group facilitators is to confirm transportation of the high school students to and from schools, to ensure that proper permission forms are collected, ensure the high school students are prepared with their lessons for the day from the program manual, and facilitate debriefings with the high school students after sessions are delivered. The role of the classroom teacher is flexible in this model of implementation. While the high school students are primarily responsible for simultaneous classroom management and EDUCATOR PERSPECTIVES 33 delivery of the FRIENDS material, the teacher has the flexibility to function in a supportive role with classroom management and transition facilitation. Additionally, the teachers can help with coaching and mentoring the high school students regarding presentation techniques and group management skills. The teachers also have to coordinate times with the group facilitators to ensure that a block of time is established for the high school students to deliver the program material. The role of the youth in this model is to first receive training in the FRIENDS program and to deliver the program material as specified within the program structure to the elementary students. Participants The participants for this research study were recruited from two schools involved in the piloted implementation. They are within the Chilliwack School District. Participants included full time registered educators within the District. The term ‘educators’ is meant to include any of the following: teachers, administrators, educational assistants, and community-based volunteers with Masters level training in counselling psychology. This term was specifically selected because it is meant to encompass both the traditional educational roles of teachers, administrators, and educational assistants, but also to acknowledge the educational role that the group facilitators provided for the high school youth. In the context of this model of implementation, all of these participants play an educational role for both the high school students, and elementary students either directly or indirectly. A total of 6 educators participated in the study. Four of the educators were female, and 2 males. One of the participants was an elementary school principal, one an elementary classroom teacher, one a certified educational assistant, one a high school psychology instructor, one a Masters in counselling psychology student intern, and one a community businessman with a Masters in Counselling Psychology. It EDUCATOR PERSPECTIVES 34 is important to note that the nature of this explorative study lends to the methodological challenge of having a selective pool of participants to draw from. Initially, the intention of this piloted project was to include 2 elementary schools with multiple classrooms, which would have yielded an ideal potential participant pool of 8-10 teachers, educational assistants, and school administrators for this research study. Only one elementary school participated, and within this particular school, participants from only one classrooms implementation met the criteria to be included. This therefore necessitated a broadening of the participant base to include the group facilitators as well in order to satisfy the basic necessity for an ECIT study. This limitation is further acknowledged in the limitations section. These participants were selected because they were either directly or indirectly involved with the piloted implementation of the FRIENDS program by youth. The elementary classroom teacher was FRIENDS trained and had previously delivered the FRIENDS program in her classroom and was therefore interested in participating in this piloted implementation. Some of the participants have potentially biasing roles that is noteworthy for this study. One educator, the secondary school psychology teacher, is involved in the HSCEP at CSS, as his students are the ones involved in this piloted program implementation. The participant who was one of the group facilitators was an intern counsellor at the Chilliwack CYMH location, which was associated with the HSCEP stakeholders in collaborating to have the FRIENDS program delivered in the elementary school. The FRIENDS program is not mandatory, and therefore implementation is a discretionary choice of first, the school administration, and second, the teachers themselves, who typically receive the training and implement it in their classrooms. Participant involvement with this implementation of the FRIENDS program ranged from direct observation of the program delivery to administratively orchestrating the program via coordination and mediation roles between schools. The two EDUCATOR PERSPECTIVES 35 community volunteer facilitators helped lead the groups of high school students to and from the two schools and maintained a supportive presence in the classroom during implementation. Since coordination is an integral part of the implementation of FRIENDS, administrators’ perspectives were invaluable for the improvement of FRIENDS. Recruitment. Since an ECIT method was employed to inquire about educator perspectives of what helps or hinders youth implementation of FRIENDS, a criterion sampling method was chosen. Criterion sampling involves an establishment of specific criteria required for the purpose of the study (Mertens, 2015). This study required narrow participant criteria: the participants were educators as defined above, they needed to be employed at the schools involved in the study and were either directly or indirectly involved with the piloted FRIENDS implementation. Utilizing a heterogeneous sample of participants, including teachers, administrators, an EA, and community volunteers, provided the necessary data from the various procedural components of FRIENDS program implementation for the purposes of this analysis. Exclusion criteria excluded any educators not directly involved with the FRIENDS program in their respective classrooms. Though the participant sample size was small, the ECIT method is not dependent upon participant size, but critical incident size (Butterfield, 2005). This means that the small number of educators involved in this project were a satisfactory number of participants so long as the appropriate number of critical incidents is gathered for analysis. Stakeholders. While the methodological focus of the study is a qualitative application of the ECIT, the study is also situated as an evaluative component within the broader context of the Human Services Career Enrichment Program (HSCEP) in Chilliwack. Because this project is also a component of program evaluation within the HSCEP, it is necessary to outline the relevant stakeholders associated with the focus of the study. The stakeholders associated with this EDUCATOR PERSPECTIVES 36 research project are: Dr. Robert Lees with the MCFD, the HSCEP, which functions out of Chilliwack Senior Secondary (CSS), Big Brothers Big Sisters of Chilliwack, and the involved elementary school. Dr. Rob Lees is a registered community psychologist with the MCFD in Chilliwack. He has previously served as supervisor to studies both utilizing the ECIT method and focusing on the involvement of youth in program implementation and research (Chou, 2013; Ohlmann, 2012; Sawyer, 2011). He is currently providing guidance and instruction on this project and serves as a communicative liaison between the MCFD and Big Brothers Big Sisters, and the schools involved in the program. Dr. Lees has a vested interest in improving the community of Chilliwack via program coordination within the schools to encourage the development and wellbeing of children and youth. The HSCEP is a multi-faceted applied learning initiative developed with CSS (HSCEP, 2015). This program functions in partnership with MCFD, the University of Fraser Valley, and other Chilliwack social services, particularly Big Brothers Big Sisters. The focus of the program is to give high school students the opportunity to experience academic programming focused on human services subject matter. The HSCEP endeavors to increase school connectedness and engagement and facilitate participation between Chilliwack youth and their community. Since MCFD is the licensee of the FRIENDS program in BC, the HSCEP is partnered with the MCFD, allowing the cohort of high school youth involved in the HSCEP to receive training to deliver the FRIENDS program in local elementary schools in Chilliwack. If the youth-led model of FRIENDS implementation is seen as mutually beneficial by the HSCEP and elementary schools, then multiple needs can be met. The HSCEP can have a consistently viable medium for providing high school students with practical human services educational opportunities; and the elementary schools receiving the FRIENDS program can have human resources via the HSCEP EDUCATOR PERSPECTIVES 37 high school students, thus aiding increased access to mental health interventions via the viably consistent delivery of the FRIENDS program. The Big Brothers and Big Sisters of Chilliwack and University of the Fraser Valley are two other organizational stakeholders. Their role with the HSCEP is that they provide mentorship to the high school students in the HSCEP as the high school students receive the FRIENDS training and other human services related experience. Data Collection Researcher self-description. I served as the principal investigator of this research project. I am a 30-year-old Caucasian Canadian male and currently enrolled in a Master’s of Arts in Counselling Psychology at Trinity Western University in Langley, British Columbia. My interest and commitment to this project stems from my previous volunteer work experiences with youth, and interest in the effects of anxiety on the child and youth population. Additionally, when in my teenage years myself, I had experience in youth groups with older peer mentors whom I not only looked up to, but they also had a strong positive impact in my life. I have experienced firsthand the value of peer mentoring and role modeling relationships. I worked as a volunteer in a church youth group and also with the Big Brothers Big Sisters, running afterschool programs for boys. In addition, my wife is an elementary school teacher, and has inspired me with first hand unique perspectives of child mental health from an educator’s vantage point. I have a Christian worldview, which motivates my passion to see healthy functioning communities and individuals, and also informs my belief in the capability and empowerment of youth to make a difference in their community and contribute to the mental health of their younger peers. The extent of my involvement in this model of implementation was attendance of the same FRIENDS training session the youth attended. Otherwise, my involvement was the conducting of this research project. EDUCATOR PERSPECTIVES 38 Research interview protocol. The primary means of collecting data in this ECIT study was via one to one semi-structured interviews (Butterfield et al., 2009). In the beginning of the interview, the goal was to establish rapport with the participant, obtain the participant’s informed consent (Appendix A), and answer any potential initial questions the participants had about the process. Butterfield et al., (2009) highlights an important objective of ECIT interviewing: to maintain consistency in exploring the same content areas to the same degree of detail for all participants. In the case of this study the content of focus for exploration, via the ECIT, was the factors that educators think is either helpful or hindering when high school students are the implementers of the FRIENDS program, and what factors the educators recommend for change. Prior to the interviewing stage, the recommended steps to prepare for the data collection (Flanagan, 1954) were utilized in this study. The study used the steps originally recommended by Flanagan in a form updated by Butterfield (2005). Over the course of the entire study, the steps were as follows: (a) determining the general aims of the activity being studied; (b) making plans and setting specifications; (c) collecting the data; (d) analyzing the data; and (e) interpreting the data and reporting the results. Prior to the commencement of the FRIENDS intervention, the participants were informed of the first two steps, the first being the general aim of the study, which was to determine from the educators’ perspectives what helped and hindered the implementation of FRIENDS by the high school youth. This is an example statement of the general aim: “The purpose of this research project is to discover what factors, themes, or events, are both helpful and hindering of the implementation of the FRIENDS program by high school youth.” Participants were also provided with precise and specific instructions about observation (Butterfield, 2005), for the purpose of ensuring consistency across observations. These first two steps adequately prepared the participants for the interviewing stage of data collection to obtain EDUCATOR PERSPECTIVES 39 the data relevant to the research question. The context explored in the interview included the entire range of the process required to have the youth implement FRIENDS. The process ranged from scheduling and coordination between CSS and the elementary school, through the process of implementation of FRIENDS in the respective classrooms by the high school students, to observations of the impact of the program post-implementation in the elementary schools. The specific interviews were conducted via a series of open-ended questions designed to have the participants describe their personal experiences and observations of the program implementation. Though one of the important objectives was to maintain consistency of the content areas, the process of exploration varied from asking simple interview questions and allowing the participant to tell a story, to using more direct strategies of probing, asking for clarity, additional details, or examples (Butterfield et al., 2009). The questions provided for the interview protocol can be viewed in the appendices (Appendix B). Prior to the commencement of the interview, the participants were given a statement for their informed consent that explained the details of the study and interview process, along with the approximate interview time of 30 minutes to one hour. After the interview was finished, participants were provided with a short debrief (Appendix C) and the interview was completed. Recording and storing the information. Interviews were audio-recorded using a laptop computer, with the data being stored on the principal investigator’s password protected laptop computer and password protected USB drive. Audio recordings were stored separately from identifying information to ensure confidentiality and anonymity. Copies of the transcripts are being held within the Counselling Psychology department at Trinity Western University (TWU) and will be kept in a locked cabinet. As per the TWU Counselling Psychology data retention policy: for transcribed interviews, the original audio recordings will be destroyed after successful EDUCATOR PERSPECTIVES 40 defense of the thesis. However, the transcripts will be archived with identifying information replaced by pseudonyms or code identifiers. Data Analysis According to Flanagan (1954), the purpose of the data analysis stage is to summarize and describe the data efficiently and effectively to be used for practical purposes. The ECIT method has a specified process of data analysis involving three steps: first, determining the frame of reference; second, formulating the categories derived from grouping similar incidents; and third, determining the level of specificity or generality to be used when reporting the data (Butterfield et al., 2005, 2009; Flanagan, 1954). The principal researcher conducted the study according to these three steps. Credibility checks were also administered to ensure proper rigour and validity (Butterfield et al., 2005). The principal researcher and research assistants conducted transcription verbatim by transferring the audio recordings onto computer with each participant having a coded number. The frame of reference was determined by how the results will be used. In this study, the results are intended to inform the process of implementing the FRIENDS program by youth. The features that are expected to emerge from the data will help to show what aspects of youth implementation of FRIENDS should further be encouraged; this will be evidenced by what “helps.” The aspects that should be changed or removed are evidenced by what “hinders.” Lastly, the aspects that could be introduced to improve the implementation of FRIENDS by youth are represented by the “wish list.” Upon determining the frame of reference, the data was then assessed for incident extraction. The second component of data analysis with the ECIT was the formulation of categories from the extracted incidents. Categories are formed by sorting incidents into clusters of EDUCATOR PERSPECTIVES 41 similarity (Woolsey, 1986). It should be noted that the categorization of themes is unavoidably subjective in nature, with variability in researchers' approaches. Forming categories also requires insight, experience, and judgment (Flanagan, 1954). For this reason, the principal researcher gained these necessary skills for category formation by reviewing the audio recording and transcripts thoroughly to ensure a competent foundation: category formation is based on thematic and adequate grouping of incidents. Flanagan (1954) instructs that there are no simple rules for categorization with the exception of submitting the tentative categories to others for review. The principal investigator adhered to these rules via performing the required credibility checks discussed below. The last component of the data analysis involves determining the level of specificitygenerality (Butterfield et al., 2009; Flanagan, 1954). This process involves deciding whether it is more beneficial to present a greater number of specified categories versus a smaller number of simpler generalized categories. There are several considerations proposed by Flanagan (1954) that guide this process: (a) headings should have an easily discernible and logical organization; (b) titles should not require a detailed definition or explanation to convey meaning; (c) the list of statements should be homogeneous, for example, the headings should parallel the content; (d) the headings should be of the same magnitude or importance and not reflect bias towards certain incidents; (e) headings used for reporting data should have easy applicability; and (f) the list of headings should be comprehensive and cover all the incidents of significant frequencies. In light of the intended purposes of this study—to inform the implementation of FRIENDS by youth— the principal researcher maintained a higher degree of specificity in the categories to provide the best possible information for the improvement of future implementation of FRIENDS by youth. EDUCATOR PERSPECTIVES 42 Rigour and Validation The ECIT has nine specified validity checks built into the methodological process which ensure the rigour of the method (Butterfield et al., 2005; 2009). The credibility checks do not necessarily have to be conducted in sequential order. One of the checks necessary to establish the credibility of the extracted incidents by the researcher from the transcripts is the independent extraction method. For this study, the researcher recruited an independent assistant to examine approximately 25% of the interview transcripts and extract incidents for the purpose of assessing concordance with the incidents that the researcher extracted. Butterfield (2005) asserts this check is meant to determine the level of agreement between what the researcher thinks is a critical incident and what an independent coder thinks is a critical incident. It is suggested that a high concordance rate between the independent extractor and the researcher strengthens the validity and credibility of the incidents extracted by the researcher. Two and a half transcripts were given to Curtis Dueck, a Masters of Arts in Counselling Psychology student, for independent extraction. The determined concordance rate between the independently extracted incidents and the researcher's incidents was 77%. The second credibility check involves crosschecking the interview data. Butterfield et al., (2005) suggest conducting a second interview with the participants in order to give the participants a chance to confirm that the categories fit well with their experience. After each of the interviews was conducted, the transcripts were analyzed for critical incidents and the tentative categories formed. The participants were then contacted for a second interview. They were provided with their own copy of incidents from their interview, along with a copy of the formulated categories with the descriptions and placement of their incidents. The participants EDUCATOR PERSPECTIVES 43 were asked to review the incidents and categories and report whether they represented their experience, whether anything was missing, and what they might want to add. All of the participants took part in the second interview, and all agreed with the established categories and incident placements. Participants made a few minor corrections and additional suggestions for clarity of incident language and category description. The third credibility check involves an independent judge placing 25% of the total number of incidents into the tentative categories created by the researcher to measure the level of concordance between this investigator and the researcher. The independent judge invited to place the incidents into categories was Ms. Jerlyn Chan, a Master of Arts in Counselling Psychology student from Trinity Western University. A total of 36 incidents, including helpful, hindering, and wish list items, were randomly chosen and given to Ms. Chan to place into the categories, along with the descriptions of the categories. Her placements were compared with the principal researcher’s original placements, and an overall concordance rate of 84% was achieved. Higher concordance rates strengthen the credibility of the placement of the incidents into appropriate categories (Butterfield et al., 2005). This concordance rate is considered appropriate by standards suggested by Andersson and Nilsson (1964). The fourth credibility check in the CIT method is tracking the exhaustiveness of the categories. Exhaustiveness is defined as the point at which new categories no longer emerge from the transcript data (Butterfield, 2005). Typically, in an ECIT study, there might be hundreds of CIs represented from 10 or more interviews. This specific study, however, sought participants from a specific niche perspective. Consequently, the participant pool available to provide the required insight to examine the research question was limited to the small number EDUCATOR PERSPECTIVES 44 who took part in this study. This means that the concept of exhaustiveness necessarily must be adjusted to fit the size of this study’s participant pool. In the case of this study, exhaustiveness was reached via the completion of analysis of all transcripts for incident extraction and category formation. New category formation was continued even through the final transcript analyzed from the participant data set. In addition to the effect of the number of participants on exhaustiveness, the nature of the participants’ involvement in observing the FRIENDS implementation also impacts the degree of exhaustiveness achieved by the final transcript. The participants provided incidents from the different perspectives of being either teachers, educational assistants, administrators, or community volunteers; these various participants naturally provided some overlapping incidents, but also some unique differentiated incidents that also fitted in unique stand-alone categories and therefore delayed the emergence of exhaustiveness as typically described in CIT studies. The fifth check requires a submission of the tentative categories gleaned from the data to two or more experts in the field (Butterfield et al., 2005). Consultation with experts in the field being studied improves the credibility of the categories selected by the researcher. Two experts were consulted for this rigour check. The first was Joseph Ogmundson, an expert in working with youth and in education environments. Mr. Ogmundson found the presented categories useful and was unsurprised by what he saw. He gave some reflections regarding some wordings of category descriptions and requested greater clarification of certain concepts such as “intrinsic qualities” of high school students, “connections” between students, “collaboration” between professionals, and “relevance” of high school student life experiences. Mr. Ogmundson’s reflections and insights were considered and applied to the refinement of category definitions. The existing categories reflect of his feedback. EDUCATOR PERSPECTIVES 45 The second expert was Kafui Sawyer, who possesses expertise in the FRIENDS program, FRIENDS implementation research, and experience with youth. Ms. Sawyer provided suggestions regarding definitions of certain categories, and more appropriate wording for some category titles. All of Ms. Sawyer’s suggestions were applied to the refinement of the categories. Overall, both experts agreed with the presented categories, and were not surprised by any. Their suggestions brought greater refinement and understanding of the categories. The sixth credibility check is calculation of the participation rates. It is customary in the CIT method for the categories to be assessed for their representation among the varying participants. The participation rate is calculated by counting the number of participants who endorse a CI in each respective category and dividing that number by the total number of participants (Butterfield, Borgen, Maglio, & Amundson, 2009). As a benchmark, it is suggested that participation rates be at minimum of 25% for a category to be considered valid and useful for analysis (Butterfield, 2005). However, this particular research project has some important nuances to consider when establishing an appropriate participation rate. The first consideration is the pool of participants selected to answer the research question. For this study, the research team was only able to recruit six total participants, who were represented in five total interviews. One interview included two participants in a joint interview, and for the purposes of data analysis, the research team decided to treat the interview as a single participant since there was no clear distinction of participant voices between the two in the interview when extracting incidents. In addition, some of the participants also provided unique observations of the youth implementation of FRIENDS from different perspectives relative to their vocational position or involvement with the high school youth. EDUCATOR PERSPECTIVES 46 In consultation with the supervisor of the research team, I decided that even an endorsement by one participant is important to acknowledge in the data set because each respective viewpoint is valuable information for discovering the nuanced helping and hindering incidents of youth-implemented FRIENDS. Therefore, it was decided the minimum participation rate of 20% was acceptable, which reflects one participant's endorsing a category. A table of the categories and their respective participation rates is presented in the next chapter in Tables 1 through 3. The seventh check involves descriptive validity. It is important in an ECIT study to demonstrate the descriptive validity of the material gathered from the participant interviews. This is to maintain as much accuracy of the participant accounts of their observation as possible (Butterfield, 2005). Descriptive validity was maintained in this study by adhering to the recommendations of audio recording the participant interviews and completing content transcriptions of the interviews. The data used to create the incidents and categories was extracted from the written transcripts. In addition to the use of transcripts, the participant crosscheck was also used to confirm the categories and incidents, further ensuring the descriptive validity of the data. The eighth check refers to interview fidelity (Butterfield et al., 2005). This credibility check requires an expert in CIT research to listen to samples of interview tapes in order to ensure interview fidelity by the researcher. This check ensures that consistency is maintained, and that the researcher does not use any leading questions. This ensures maintenance of rigour in the study. An audio copy of the third interview was submitted to Dr. Rob Lees for analysis of interview fidelity, and he concluded that the interview was conducted with fidelity to the CIT method. EDUCATOR PERSPECTIVES 47 The credibility check of ensuring theoretical validity is accomplished in two ways: by making explicit the underlying assumptions of the proposed research and scrutinizing them in light of current literature and comparing the newly formed categories to the literature to see where there is support (Butterfield, 2005). Butterfield makes an important point in noting that a lack of supportive literature of the categories does not necessarily delegitimize them, since the very nature of the ECIT is to explore new realities not yet uncovered. The first step of establishing theoretical validity will be discussed here, and the second step will be covered in depth in the Discussion, Chapter 5. In relationship to the existing literature presented in Chapter 2, some of the key assumptions of this study include: a) The FRIENDS program is an empirically validated universal anxiety prevention and intervention program for elementary classrooms; and b) high school aged youth have demonstrated a capability in implementing other peer-led groups in school settings with favourable outcomes. Chapter 5 will further explore how the emergent categories fit with the existing literature. Summary The ECIT was used as the methodological framework for conducting this research project. The focus of the research question was to gather the perspectives of educators who witnessed the youth led implementation of FRIENDS. The framework of the ECIT purposes to ask the question of what was helpful and hindering with the youth-led implementation model, and a wish list was also elicited from the participants. The research strategies built into the ECIT ensure that the data gathered for the purpose of answering the research question can be treated as valid and high quality. Specifically, the credibility checks are designed to ensure the quality and validity of the data extracted from the transcripts. The credibility check dealing with EDUCATOR PERSPECTIVES 48 independent extraction of incidents is designed to establish the validity of the principal researcher’s interpretations of what constitute incidents in the transcript. The interview fidelity check ensures that the principal researcher conducted the semi-structured interviews according to the CIT protocol and maintained proper fidelity. Producing verbatim transcripts of the participant interviews in order to ensure that what they said was accurately represented in the data satisfied the descriptive validity check. The check requiring an independent judge to place incidents in categories was designed to increase the validity of the principal researcher’s choice of categories for them. The participant crosscheck improves the overall validity of the categories and incidents since the participants both check over what the principal researcher has extracted from the transcripts and have the final approval of whether the categories are representative of their experience. This gives confidence that the resulting categories are not just the researcher’s opinion. The expert check also strengthens confidence in the selection and description of the categories because the experts provide a broader perspective of the data from a more objective standpoint than the researcher's. EDUCATOR PERSPECTIVES 49 CHAPTER 4: RESULTS Interviews were conducted with six educators who fit the necessary requirements for the purposes of exploring the research question of this project. The interviews focused on gaining the perspectives of the participants as they observed the high school youth-led implementation of the FRIENDS program in the elementary school. Participants each provided unique perspectives due to their respective jobs, therefore giving unique accounts related to their specific vocational perspective of the FRIENDS implementation. The participants were guided through a semistructured interview and encouraged to share their previous experiences with the FRIENDS program. They were also asked to share about what they observed as helpful and hindering aspects of the youth led implementation, as well as what they would like to see that might help improve or change concerning the implementation (wish list items). After creating transcripts from the audio recordings of the interviews, critical incident (CI) extraction of the interviews yielded a total of 128 CIs. Of this total, 51 incidents were found to be helpful, 37 hindering, and 38 were wish list items. All of the 128 incidents were sorted into a total of 10 helping categories, 12 hindering categories, and 9 wish list categories. The categories were each given names describing the collection of incidents related to each other. To help explain the categories, paraphrases and clarifications from the participant transcripts will be used for capturing the essence of what the educators said to describe the categories and incidents. The categories from each of the helping, hindering, and wish list components of the ECIT method are presented in table format below, along with the incident rate and participation rates. The categories are listed in descending order from those represented by the largest incident rates and participation rates. Incident frequency was calculated by dividing the incidents represented in the particular category by the total number of incidents within the respective helpful, EDUCATOR PERSPECTIVES 50 hindering, or wish list domains. The participation rate was calculated by dividing the number of participants represented in the category by the total number of participants interviewed in the study. It is important to note that, even though there are differing incident and participation rates between the categories, each category is equally important in providing beneficial information regarding youth led implementation of FRIENDS. Overview of Helpful Incidents From the participant interviews, a total of 51 helping incidents were extracted and grouped into nine categories. Table 1 below shows the helpful categories along with the incident and participation rates. Table 1 Helpful Categories Category Name Incident Participant Frequency Rate Examples High School Student Intrinsic Qualities 31% 80% “I’ve read reports...saying that they were good, they were attentive, they listened, they were respectful, they heard the elementary students, they got down and presented themselves, they were open, they were available, like all those things that you really want” “...They showed a competence to be able to adapt what was given to them and adjust in order to not only teach but keep the kids in control and that they showed they were able to do that.” Classroom Management 14% 60% “But I soon realized that they were on top of it, they knew their materials, they had already divided roles. There was no confusion of who was doing what or how.... And then if they were starting the next activity, they would make sure that all eyes were on them and use classroom strategies...they managed the transitions well.” EDUCATOR PERSPECTIVES 51 Perception of the High School Students as Leaders 14% 60% Connection with Kids 14% 60% Program Nature 8% 60% Relevance 6% 40% Educators and Community Partnership 6% 40% High School Student Self Esteem and Confidence 6% 20% Role Models 2% 20% “But they are like rock stars coming into our building, so when we look at having older students come in as role models with our kids, it’s invaluable, like that alone stands aside from anything they’re even teaching; but even their presence here and being here is an absolute huge positive.” “So, I think that’s a really big part of it is that I as an adult, or teachers as adults can teach this stuff but students seem to have that connection with the kids a little more than the teacher does.” “What’s unique about FRIENDS, though, is that it’s probably the only program I’m aware of that we actually implement directly with kids...this is now teaching the kids, so that’s what I find valuable and sets it aside from many of the other things that we also try to bring in here.” “It’s not only personal information but it’s experiences of those that they’ve seen as well, because they [high school students] talk. So, when they go into an elementary classroom, they’re not just taking the training. They are taking the training bolstered by a whole bunch of life experience, first hand to them.” “Having [the facilitator] there was helpful just in case that I needed to ask a question and the high school students didn’t know. It was nice having someone representing them as well and it also helped make them feel a little more comfortable.” “They are pumped. They come back, eyes are big, saying “this happened today” and “that happened today”, and I’m so amazed that the kids listened and engaged...” “...because some were wondering ‘when do we get to do this?’ It gave them something to look forward to when they got to an older age, which was helpful.” EDUCATOR PERSPECTIVES 52 Helpful categories. High school student intrinsic qualities. Among the helping categories, this has the highest incident frequency with 16 CIs and the highest participation rate of 80%. This category is evidenced by positive characteristics and traits that the high school students inherently possessed that helped them to be able to grow, manage, and adapt to their constantly new experiences of implementing the FRIENDS program, and understanding the importance of what they are contributing. These intrinsic qualities are indicative of positive traits that help them lead the program and bond with the elementary students. Such intrinsic qualities are internally possessed, but also externally observed, such as listening skills, empathy, student emotional perceptiveness, personal reflection capabilities, assertiveness, demonstrations of growth, and adaptability, among others. Classroom management. Classroom management is represented by 60% of the participants and 7 CIs. Participants’ experience of classroom management was the way in which the elementary students were handled to help them stay focused and to help create a conducive environment for teaching the FRIENDS program and helping the students to learn it. Both the high school students and adults present in the classroom demonstrated classroom management. Examples of classroom management include demonstrations of organizational skills, transition management, adult and authority presence in the classroom, and numbers of high school students present. Perception of the high school students as leaders. Participants reported 7 CIs and contributed a 60% participation rate for this category, which discusses how the elementary school students view the high school students as leaders of the FRIENDS program, and the effect that has on the success of the program implementation. This perspective is a one-way EDUCATOR PERSPECTIVES 53 interaction, as the high school students are looked up to by the elementary school children and are seen as different from teachers and other adults, and therefore more relatable. Connection with kids. This category yields a participation rate of 60% and is represented by 7 CIs. The high school students were able to form a bond with the elementary students, evidenced by trust, value, and care, which was also reciprocal. This was a connection that both sets of students mutually shared and was evidenced as bi-directional. This connection facilitated positive interactions with the elementary students, such as questions asked of the elementary students to give them an opportunity to share about their lives, and to experience recognition, attention, and a safe space to share. Program nature. Program accessibility yields a 60% participation rate and 4 CIs. The participants shared that the FRIENDS program is easily accessible for the high school students to implement, and also for the elementary students to receive. The program's intrinsic organization, uniqueness, and generalizability increase its accessibility and reception. Relevance. Two fifths of participants endorsed this category with 3 CIs. The participants observed that the life experiences of the high school students, and the immediacy of implementing FRIENDS with real students, played an important role with helping the high school students in their implementation of FRIENDS and connection with the elementary students. Their personal life experiences helped them integrate and incorporate their learning practically into the group sessions. Educators and community partnership. A total of 40% of participants noted that a collaborative effort by numerous different professionals working together in coordinated efforts was helpful with the program implementation. The specific professionals involved include teachers, administrators, and facilitators. This category only makes reference to collaboration EDUCATOR PERSPECTIVES 54 between adults and does not involve the high school students. However, these periphery collaborative supports aided in the high school students’ success of implementation of FRIENDS via the provisions of supervision, classroom management assistance, and scheduling coordination. High school student self-esteem and confidence. One participant who reported 3 CIs represents this category. This participant noticed that the high school students displayed positive attitudes that showed they were confident in themselves and excited about their work. In response to their experiences learning and implementing FRIENDS, the high school students both chose and responded to their experiences with a positive attitude. Role models. One participant saw the helpfulness in the way the elementary school students look forward to being able to do the same things the high school students are doing when they get older. Though similar to the category of “Perception of the High School Students,” this is distinct in that, regardless of the origin of their inspiration, the elementary students expressed a forward-thinking desire to emulate what they were experiencing, thereby strengthening the positivity of the implementation of FRIENDS. Overview of Hindering Incidents A total of 38 hindering incidents were extracted and grouped into 11 categories. Table 2 below shows the hindering categories along with the incident and participation rates. EDUCATOR PERSPECTIVES 55 Table 2 Hindering Categories Category Name Conflicting School Schedules Incident Frequency Participation Rate 22% 100% Examples “The original plan was so that we could then leave that class and not have 7 teachers who needed permission forms to leave 7 classes or whatever it was. Um, we only managed to get 6 of the 12 in one block...and that creates another logistic because now one person has to leave socials, one music, one jazz, one this, one that.” “It turns out that some schools have the Pro-D days on the days that FRIENDS was planned. And some schools and teachers already had activities planned in their classrooms right before the holidays.” EDUCATOR PERSPECTIVES Administrative Barriers 26% 56 60% “The problem is now that [some] upper admin is somewhat disconnected with [the program] ....it maybe takes a lot slower identifying issues that are wrong and then doing something about it to fix those issues.” “And I think the other piece, and I don’t know, this is a logistical thing, just the logistics of setting it up, it was massive...and the secondary school requires all these field trip forms...which presented challenges because if you change a day all of the sudden, and the school is pretty sticky about it, and all of the sudden ‘you can’t go today, because you don’t have a field trip form for today’.” Role Confusion Due to Miscommunication 11% 60% “Like I said, I didn’t necessarily know my role. I didn’t know how much to step in and how much not to.” “Yeah, or they would say they would be here at a certain time and I would have them ready and the class doesn’t sit very well for long periods of time and they would be set off because they were late, but I think just communication was a little bit difficult because I didn’t know who to contact.” Lack of Importance 11% 40% “One of the things you are identifying is that people who are the gate keepers aren’t as bought into the vision as those who are on the ground trying to get it done.” EDUCATOR PERSPECTIVES 57 Ineffective Delivery of the Program 11% 20% High School Student Inexperience 8% 40% Numbers 3% 20% Program Content 3% 20% Transportation 3% 20% Training 3% 20% “Just the maturity and lack of desire to, because there were a couple of boys that again are a little bit younger in their thought process and they connected to it, where I think the other boys were like ‘I don’t need to know this’.” “So, the high school students understand the activities and they have fun with them, and they understand what’s going on and they understand the outcomes. But they don’t understand the psychological stuff that’s going on.” “The number of students we wanted to send out was far greater than what we ended up being allowed or able to facilitate...” “.... FRIENDS is a pretty big program, making it challenging to grasp all of the concepts necessary to be effectively implemented” “They have blocks to walk, and there’s a small amount of time to get from their school to the one they need to go to. Transportation is not good.” “So, they were trained last year, then we had a review session for Saturday, at that time they knew they were going to go become trainers themselves. But it was a review, they didn’t have time to really go into depth.” Hindering categories. Conflicting school schedules. This category is endorsed by 100% of participants, with 8 CIs. There were conflicting schedules between the elementary and high schools and also internally within the high school scheduling blocks. Examples include the high school students’ needing to come from different class blocks in order to meet to implement FRIENDS, and also EDUCATOR PERSPECTIVES 58 aligning the high school schedules with the elementary classroom schedules. One participant reported 3 CIs that numerous various schedule days in the school calendar such as holidays, professional development days, or high school exams, brought challenges to consistent implementation. Administrative barriers. Administrative barriers are the category with the most CIs, with 10 and a participation rate of 60%. The participants highlighted various administrative processes in the high school, and between schools, such as paperwork requirements, decisions, and the participation challenges from school administration individuals. Certain administrative considerations included paperwork, filling out appropriate forms, and slow school system response. Role confusion due to miscommunication. Three fifths of participants reported 4 CI’s concerning a confusion of roles and expectations. This involves clear expectations to support collaboration between teachers, program facilitators, and other personnel who help support the high school student implementation of FRIENDS. Clear communication is required regarding roles in the group process, funding, and necessary paperwork processing: for example, at the timely beginning of a group session, clarifying roles of high school students, teachers, facilitators, and any TOCs involved before the sessions, and also providing opportunities for ongoing clarification via debriefing moments after the group session. Lack of importance. This category is represented by 40% of participants and 4 CIs. Participants observed either internal school culture priorities that block FRIENDS implementation time, or other teachers and administrators, who do not share the vision for the HSCEP. EDUCATOR PERSPECTIVES 59 Ineffective delivery of the program. One participant provided 4 CIs reporting that there were elementary school students who demonstrated a general emotional and intellectual disengagement with the implemented FRIENDS program. In particular, the boys in the class did not seem to engage with the delivery of the program. High school student inexperience. This category has 3 CIs and a participation rate of 40%. Participants observed that the high school students demonstrated a lack of deeper awareness or understanding of the complexities of the FRIENDS program as it was designed to affect psychological coping and learning mechanisms in the elementary school students. Numbers. One participant noted there was a lower number of high school students deployed to implement FRIENDS than was originally desired, therefore hindering the hoped-for successful implementation of FRIENDS. Program content. One participant observed that the large size of the FRIENDS program created challenges for the high school students to adequately learn all of it when receiving the training. Transportation. This category is represented by one participant and CI. This participant noticed challenges with being able to transport the high school students from the high school to the elementary school. Training. One participant reported that the FRIENDS training the high school students received was not as effective as it could have been. Overview of Wish List Items A total of 39 wish list items were extracted and grouped into nine categories. Table 3 shows the wish list categories along with the incident and participation rates. Table 3 EDUCATOR PERSPECTIVES 60 Wish List Categories Incident Rate Participation Rate Modified Activities in the Program 21% 60% “I think a lot more hands on or acting out or involvement getting them up and moving, doing a little bit of sketching...a little bit more movement would do instead of just writing.” Scheduling 18% 100% “This whole human services piece, I think just in the fall or late spring when we’re looking ahead at timetables next year is having us meet with the high school. Because that’s our end of things is the scheduling pieces.... Yeah like we should be doing it after spring break, now we should be doing it.” Training 18% 60% “The high school students would be the spark or the inspiration and build a connection and facilitate the learning, the teachers would be the ones to generalize it to the school culture.” Category Name Examples “I would say maybe a more in-depth teaching of the program; yeah so teach it a little more with a little more in depth.” Generalization to Broader Influences 13% 60% “Ideally, I’d love to see kids come into our building learning this, and then having it again so when we look at spiraling information to kids at different stages in their learning and understanding and development, I think that’s really critical.” EDUCATOR PERSPECTIVES 61 “And even maybe staying until the end of the day and having a chat with the teacher, myself, whoever is there even just for us to say ‘yeah this little guy this little...” “I still think it would have been better suited if someone in the school had been doing all the facilitating, there probably would have been less bureaucracy and less red tape.” Communication 10% 40% Personnel 10% 40% Need for Administration to Promote Mental Health 8% 20% “It’s about follow through. We need somebody who can take it [FRIENDS program admin requirements] off the edge of the desk and put it in the middle of the desk, and let’s give this thing a shot.” Transportation 3% 20% Collaboration and Community Partnerships 3% 20% “We should get a shuttle bus to efficiently pick up and drop off the high school students so they don’t have to walk.” “There are community groups interested in helping us out. What we need is to start engaging with them and figuring out a way to utilize that expressed help” Wish list categories. Modified activities in the program. Modified Activities in the Program is the most significant wish list category, with a 60% participation rate and 8 items. The participants suggested items in this category such as adjusting the in-class implementation of FRIENDS to include specific activities, actions, or strategies that involve more activity, movement, and creative expression and processing. Also, in broad general terms of implementation, there is a need for the intention of sustainability of implementing FRIENDS rather than a one-off trial run. EDUCATOR PERSPECTIVES 62 Scheduling. Next to program implementation, scheduling has the second most items represented (seven) but has a 100% participation rate. The participants talked about the organizational aspects of scheduling related to the fundamental running of FRIENDS. This includes scheduling more consistent implementation blocks, pre-emptive scheduling for the next year to avoid future challenges, adjusting the implementation to a different day of the week, and the scheduling of relevant administrative meetings for planning the implementation. Training. Training is the third wish list item, with three fifths of participants endorsing it and seven suggestions. This category involves strategically adjusting the training of both the high school students and teachers to include more extensive training and preparation for high school students, the inclusion of teachers with the training, and also training for the facilitators. Generalizing to broader influences. This category has a participation rate of 60% and five items. Participants suggested planning for a broader generalization of strategic implementation of the FRIENDS program to generalize to the school culture, different ages, the teaching curriculum, and to consider ways to improve the current format of implementation. Communication. Forty percent of participants suggested items related to communication. Specifically, the items involve promoting clearer and more consistent communication between teachers, facilitators, and the high school students, for the purposes of clarifying roles, holding debriefing sessions, and coordinating dates. Communication also needs to be improved with district administration and proponents of the HSCEP program. Personnel. Two out of five participants contributed to this category with four items suggesting adding more or having different high school students and facilitators implement FRIENDS, such as more males, or an in-house facilitator. Additionally, it was suggested that the specific people involved in the implementation of FRIENDS should change since these two EDUCATOR PERSPECTIVES 63 educators felt that teachers rather than high school students best deliver the curriculum of FRIENDS. Need for administration to promote mental health. One participant provided three wish list items related to engaging more proactively with the high school administration to encourage more active participation such as presence in meetings and finishing the necessary paperwork to move the program forward. Transportation. One participant endorsed one item for improving the identified problem of transporting the high school students to the elementary schools – specifically, getting a shuttle bus to pick up and drop off the students to aid in ease of transporting them to and from the schools. Collaboration and community partnerships. The last wish list category is represented by one participant, suggesting the importance of local FRIENDS organizers showing a greater intentionality for different involved parties and community members and organizations to collaborate with each other for increased ease and success of implementation. Interested groups include three local Rotary clubs who expressed willingness to assist. Summary A total of five interviews were conducted, resulting in the extraction of 128 total incidents, 51 of which were helping, 38 hindering, and 39 wish list items. A total of 29 categories were formed from the incidents: 9 helping, 11 hindering, and 9 categories for wish list. Participation rates ranged from 20% to 100% across all categories. The helpful category with the highest incident rate was High School Student Intrinsic Qualities; the hindering category with the highest incident rate was Administrative Barriers. The wish list category with the highest incident rate is Program Implementation. EDUCATOR PERSPECTIVES 64 From the helping categories that emerged, it is apparent that high school students possess important qualities for implementing FRIENDS such as empathy, emotional perceptiveness, assertiveness, and adaptability, among others. This category was observed across 4 out of 5 participants and highlights how the high school students possess the emotional and developmental competence to handle the relational demands of implementing the FRIENDS program in the elementary school classroom. The second highest helping category is classroom management, being endorsed by 3 out of 5 participants. The educators highlighted the importance of the elementary school students being effectively managed and kept orderly in order to facilitate implementation of the FRIENDS program. In the instance of this category, both the high school students and the adults present in the classroom such as the teacher, EA, or facilitator practiced classroom management. The highest hindering categories in descending order include Conflicting School Schedules and Administrative Barriers. These first two categories highlight the most prevalent challenges facing this piloted youth led implementation of the FRIENDS program. Specific administrative barriers include paperwork requirements, slow school system responses to scheduling demands, and inconsistent participation by key administrative officials. Calendar schedules refer to the scheduling conflicts between the elementary and high schools, and also internally within the high school concerning the students’ class blocks. Taken together, these administrative barriers of the youth led implementation of FRIENDS are one of the primary challenges to address. Lastly, the wish list categories that emerged highlight the educators’ recommendations for improving this current format of FRIENDS implementation. Some of the categories are direct responses to some of the reported hindering categories, such as Scheduling, and Need for EDUCATOR PERSPECTIVES 65 Administration to Promote Mental Health. The most endorsed wish list category, with 60% of participants, is Modified Activities in the Program. The educators gave suggestions for ways to improve the implementation of FRIENDS by the high school students on the ground in the classroom. They suggested such things as more movement and activity instead of bookwork and activities that will engage the elementary students more. Some broad themes that have emerged from these categories include the emerging competence of the high school students to effectively engage with the elementary school students and present a basic level of the FRIENDS curriculum in the classroom. Key challenges include administrative and scheduling barriers that hinder the smooth and effective functioning of the FRIENDS implementation. These themes, along with other findings from the interviews will be discussed in greater detail in the following Discussion chapter. EDUCATOR PERSPECTIVES 66 CHAPTER 5: DISCUSSION The purpose of this research project was to explore the perspectives of educators in the Chilliwack School District who were involved with a piloted implementation of the FRIENDS for Life program. A number of community stakeholders in Chilliwack, BC, including MCFD, Chilliwack Senior Secondary, and a local elementary school partnered together to provide training in the FRIENDS program to high school youth from CSS. These high school students then implemented the FRIENDS program in a grade 4 classroom in Chilliwack with the assistance and supervision of group facilitators and the elementary school classroom teacher. To date, this is the only known attempt to implement the FRIENDS program using trained high school students to deliver the program, therefore necessitating research into the viability of this format of implementation. FRIENDS was the program of choice to be used within the Chilliwack classroom due to its empirical status as an effective universal anxiety prevention and intervention program in schools. Educators’ perspectives of the implementation of the FRIENDS program by high school youth were the focus. Specifically, they were asked what was helpful and hindering in implementing the program. The educators also offered recommendations for what could be done differently to improve future youth led implementation of the FRIENDS program in elementary classrooms. A number of themes emerged capturing the viability of youth-led implementation of FRIENDS. These themes describe notions of high school student capabilities in being chief implementers as well as primary challenges that affect the viability of this format of implementation. Connections among themes and how they relate to current understanding of FRIENDS programs are examined in this discussion for the purpose of unpacking the viability of EDUCATOR PERSPECTIVES 67 a youth led FRIENDS implementation model. For example, while a prominent helping theme of high school student capability was found, there were also some sentiments reflecting views that the high school students were lacking in certain areas of competency. The viability of the youth led FRIENDS program in Chilliwack is demonstrated by the capability of the high school students in implementing the program, despite challenges with logistics and some incompleteness of ways the youth implemented the program. This viability becomes especially clear when we consider the recommendations that the educator experts offer for future implementations of youth led FRIENDS programs. High School Student Capability The previous chapter highlighted the specific ECIT categories that emerged from the data of the interviews. Many of the helping categories highlighted the capability of the high school students to function as competent facilitators of the FRIENDS program in many of the ways the program requires. The FRIENDS program is a universal anxiety prevention and intervention program designed for implementation in elementary school classrooms. The FRIENDS program was designed by a psychologist and traditionally implemented by mental health professionals (Barrett et al., 2005). FRIENDS is also implemented by teachers in their own respective classrooms (e.g., Iizuka et al., 2014). In the case of this research, what makes the use of high school students as facilitators of the FRIENDS program so noteworthy is that it challenges the notions of the need for stereotypical “professionals” in order to promote mental health literacy in the community. The overarching question to consider along with these results is the extent to which high school students are capable of functioning in a classroom to implement the FRIENDS program the same as the traditional professionals in previous program deliveries. As EDUCATOR PERSPECTIVES 68 seen in the results, there are many ways the high school students demonstrated capability in implementing the FRIENDS program as per its typical requirements for facilitators. Connection with elementary students. A prominent theme that emerged from the results is that high school students make a positive impact and connection with the elementary school students. The FRIENDS program, by its intrinsic nature, is a therapeutic intervention. Like any therapeutic process, it is important that the FRIENDS facilitator be able to successfully make a personal connection, or therapeutic alliance, with the “clients,” in this case the elementary school students. This is foundational for the rest of the implementation. There were a number of categories that support this theme. The top four categories that emerged had the focus on the high school students and the way they were able to foster connection with the elementary students. The category most strongly demonstrating high school student capability to form therapeutic alliance was the High School Student Intrinsic Qualities category. As shared by the participants, these are qualities involving emotional intelligence, integrity, and work ethic. These were qualities that the high school students either were observed to possess prior to implementing FRIENDS or showed the capability of growing and nurturing them as they continued implementing the program. One participant interview noted: “they showed a competence to be able to adapt what was given to them and adjust in order to not only teach but keep the kids in control . . . and they showed they were able to do that.” Though the high school students’ intrinsic qualities were observed by the participants to be already present at the time of implementation, it is understood that these qualities can be taught or nurtured in the high school students through the process of being involved in the HSCEP. However, an important point to consider is that the students demonstrated the capability of both developing and maintaining these qualities, and that the existence of these qualities is a positive and helpful component of EDUCATOR PERSPECTIVES 69 such students' implementing the FRIENDS program to elementary students. At a foundational level, these qualities are necessary to help elementary students connect with the content of the FRIENDS program during implementation and therefore provide a basis for successful facilitation of the FRIENDS program. Classroom management abilities. Since the FRIENDS program is delivered to elementary school classrooms, there will inevitably be a requirement of the program facilitator to be able to effectively manage the dynamic of the class and ensure that the elementary students are engaging with the material, with limited behavioural distractions. As was highlighted in the category of Classroom Management, the high school implementers, together with the help of adult supports, demonstrated capability of managing the classroom in a manner to facilitate successful program delivery. The high school students were observed to have been capable in their classroom management abilities; for example, one participant noted how they were able to manage effective transitions between activities, and were observed to have increasingly grown in their confidence with controlling any distracting behaviour by the elementary school students: “If they were starting the next activity, they would make sure that all eyes were on them, and use classroom strategies, managing their transitions well.” Being able to manage transitions is important for implicitly communicating that presenters are confident and in control of the room and their presentation (Collins, 2004). Concerning the viability of youth-led FRIENDS facilitation, managing the classroom effectively is a necessary component; and in this case, the high school students demonstrated capability in doing so along with the help of the participating educators. However, one participant observed some variation in management capabilities, as some of the high school students varied in their levels of confidence in presenting and managing the class; however, they were also observed to have grown in their confidence across the EDUCATOR PERSPECTIVES 70 multiple weeks that they were implementing the FRIENDS program. With regard to the category Classroom Management, it is also possible that the assistance from the supervising adults—particularly the classroom teacher— may also have mediated in the smooth functioning of the program delivery, and possibly influenced the high school students in the development of their abilities to manage the classroom, as the high school students may have taken their management cues from the teacher. This possibility highlights the importance of collaboration between professionals and the students for increased viability and effectiveness of the FRIENDS program delivery. The importance of this in-class collaboration between the high school students and educators for maintaining facilitation viability will be explored in the recommendations section, because the adults present during implementation also played a key role in helping with management. High school students as inspirations. Two categories that are equally represented with a 60% participation rate and 14% incident rate are Perception of High School Students as Leaders, and Connection with Kids. Participants noticed that there was a special attitude with which the elementary students viewed the high school presenters. One participant noted how it was an invaluable experience that the elementary students looked up to their high school peers as role models, and that the high school students’ very presence in the classroom was a positive part of the implementation, stating: “The elementary students almost have a different perspective of the FRIENDS program because it is being delivered by more of a hero than an actual adult.... So, I think that’s a really big part of it is that I as an adult, or teachers as adults can teach this stuff, but students seem to have that connection with the kids.” This matters for the purposes of the FRIENDS program facilitation because a perception of the high school students as role models enhances their credibility as teachers of mental health literacy to the elementary school students. EDUCATOR PERSPECTIVES 71 Historically, the FRIENDS program was designed and facilitated by mental health or education professionals—both of whom are arguably viewed more as authority figures by the elementary students than the peer facilitators are. The different perception of the high school students by the elementary school students presents a unique contribution to the viability of this model of implementation. The high school students’ ability to relate and the children's perception of them as role models, as evidenced by the Role Models category, contributes to their connection with the elementary students and positively enhances the viability of youth-led FRIENDS program delivery. Indeed, one participant noticed that the elementary school students were inspired by the high school student role models and commented on how they could see themselves in a facilitation role like that in the future. This is an important point to consider regarding the longterm viability of youth-led FRIENDS. The elementary school students view the high school students as positive inspirations, and this increases the likelihood of the elementary students having an interest in doing the same when they are older. One possible future implication of this dynamic is a cyclical feeding back into the HSCEP with more high school students in the future being willing to implement FRIENDS due to their own experience as elementary school students receiving the program themselves. The high school students’ ability to relate with the elementary students was captured in the category Connection with Kids. The high school students were observed to have a good connection with the elementary school students, which contributed to an overall positive atmosphere and experience of the FRIENDS program. Similar findings (Haski-Leventhal et al., 2008) support these results in that youth volunteers are more relationship-oriented than adults. Additionally, the authors found that the youth volunteers' closeness in age to their target client population was helpful in impacting the clients’ perspectives and fostering a sense of EDUCATOR PERSPECTIVES 72 empowerment for their own volunteerism. This same effect is seen in this study, with the participants observing how the elementary school students look up to the high school students as role models, and this contributes to the overall positive experience of the youth led FRIENDS implementation. Self-esteem and confidence. The capability of the high school students to viably facilitate the FRIENDS program is also supported by the evidence of their self-esteem and confidence in delivering the program, along with their ability to reflect on their own related life experiences and use that to aid them in connecting with the elementary students. The Relevance and High School Student Self Esteem categories describe their success in relating to the elementary students this way. One participant who provided observations of the high school students in the context of their preparation at the high school noted: “They are taking the training bolstered by a whole bunch of life experience. . .. They are well equipped based on their own history to be able to step in and offer empathy and understanding while they implement the program itself. So, their interactions with the kids are really personal.” This participant observed how the high school students were able to use their own personal life experiences to make emotional connections, and how they increasingly understood the relevance and importance of what they were doing via the FRIENDS program in helping the elementary students. The high school students’ exposure to the elementary students via FRIENDS implementation helped them gain a greater self-awareness into their own lives and developed their ability to relate it back to their teaching opportunity. This is consistent with Wilson & Musick (1999), who argue that youth volunteering can be self-validating and foster increased self-empathy, intimacy and trust between people. These categories capture these phenomena in the youth implementers of FRIENDS. As Wilson and Musick suggest that youth volunteering EDUCATOR PERSPECTIVES 73 helps build trust between people, this building of trust is an important component of establishing rapport with the recipients of the FRIENDS program, the elementary students; and the high school students demonstrated their capability in doing so. Since this aids in their connection with the elementary students, and consequently, increases the salience of the content of the FRIENDS program, the high school students’ ability to foster empathy and trust with the elementary students via self-awareness of how their own life experiences relate, strengthens the viability of a youth-led FRIENDS implementation model. In addition to the benefits of reflecting on their own life experiences, the high school students were also observed to have positive self-esteem and confidence in their abilities to deliver the FRIENDS material. For presentations in general, self-esteem and confidence of the presenters of educational content is important for being able to effectively communicate and teach the intended content (Collins, 2004). The FRIENDS program is no exception to this principle. It is expected that traditional facilitators of the FRIENDS program— teachers and mental health professionals— have both confidence and competence at presenting educational material. The high school students also demonstrated ability to do the same, albeit with varying degrees from student to student. This was seen to be helpful to their implementation. These results are consistent with the findings of Wyman et al. (2010), suggesting that youth program implementers can both competently deliver prevention programs, and also personally benefit from being mental health literacy educators. Supporting Roles To ensure the viability of the youth-led FRIENDS model, it is important to involve other adults in order to assist the high school students with in-class dynamics and help manage the logistic challenges necessary to ensure successful functioning of this model of implementation. EDUCATOR PERSPECTIVES 74 One of the unique aspects of using high school students to implement the FRIENDS program is the need for other supportive adults to make sure that the FRIENDS program can be implemented in a manner consistent with its original design. The categories of Classroom Management, Educators and Community Partnership, and Program Nature highlight these important periphery components of viable implementation. Supporting Roles includes the process of educators empowering the high school students to implement FRIENDS, whether through shared classroom management, administrative organization, or mentoring and supervision. Other categories related to Supporting Roles include Program Nature and Educators and Community Partnership. The design of the FRIENDS program is complete with a structure that lends to a smooth delivery over the course of 10 weeks and has various concepts and activities that allow for flexible implementation and accessibility for implementers to grasp its material and then teach it. This is why FRIENDS implementers are required to undergo a one-day training session to learn the material. The high school students also received the same FRIENDS training regimen as other facilitators would. Another question of viability that arises is the ability of the high school students to understand the training material and FRIENDS workbook in order to properly integrate the FRIENDS material into their classroom presentations. There were mixed reports regarding high school student comprehension and integration of the FRIENDS program material. On one hand, as was discussed above, the high school students were observed to be excellent in engaging and connecting with the elementary students, and also contributing to classroom management. Though not as academically in tune with the psychological basis, these aspects of implementation are also important components of presenting the content of FRIENDS. On the other hand, one participant noted that it did not seem as if the high school students were EDUCATOR PERSPECTIVES 75 able to fully grasp the deeper psychological constructs that are foundational to the FRIENDS teaching concepts. One participant observed that the nature of the FRIENDS program allows it to be both learned by the high school students for the purposes of implementation, and also receivable by the elementary school students. The category of Educators and Community Partnership involved collaboration between multiple people involved in the process of making the FRIENDS implementation happen. In addition to the high school students, there were also group facilitators from the community who assisted by coaching the high school students and taking them to and from the schools; the elementary teacher and EA also helped within the classroom to clarify roles and provide helpful classroom management to facilitate smoother implementation. Hindering Category Themes There was a total of 11 Hindering categories extracted from the five participant interviews, representing 38 hindering incidents. Two major themes that emerged from these categories include Administrative Challenges and Missed Implementation Opportunities. Categories contributing to the theme of Administrative Challenges include Conflicting School Schedules, Administrative Barriers, and Lack of Importance. These categories represent the majority of the hindering factors associated with the youth-led implementation of FRIENDS. When considering both the positive and negative aspects of the viability of the youth-led FRIENDS implementation model, these categories speak to the challenges of having a viable youth-led FRIENDS delivery. Administrative challenges. All of the participants endorsed incidents related to scheduling challenges within both schools that made it difficult to make this FRIENDS implementation run smoothly. Competing schedules in the school calendars, such as EDUCATOR PERSPECTIVES 76 professional development days or school holidays, are common challenges within an educational environment, and also provide challenges with implementing FRIENDS with a sense of continuity. Within the high school’s internal schedules, two participants noted how there were challenges coordinating with the high school students’ class block schedules. Because permission slips were required for the students to leave their classes, and there were different classes the students were required to leave, this created extra administrative lag time in trying to get the groups of students together at one time in order to go to the elementary school to implement the FRIENDS program. These administrative challenges increased the difficulty for those adults involved in planning and organizing the implementation of youth-led FRIENDS. It was briefly discussed earlier that the viability of a youth-led FRIENDS model is much more likely when other supportive professionals are involved in managing the high school students. The supportive professionals help facilitate the necessary groundwork to ensure the high school students are given the platform to teach the FRIENDS curriculum in the elementary schools. The emergent theme of Administrative Barriers highlights the increasing pressure put on the involved supporting adults to make sure the implementation happens. This is why the existence of these particular barriers detracts from the viability of this implementation model. The category of Administrative Barriers further addresses this challenge. These categories highlight the importance of FRIENDS being a priority, particularly within the high school system. As one participant observed, the lack of prioritization given to FRIENDS by administrative officials contributed to some of the lagging paperwork and slow school system response which hindered the delivery of the program. Regarding the viability of a youth-led implementation model, these particular challenges do not reflect the capability of the high school students to deliver FRIENDS. Instead, it is more to do with the administrative processes required for the EDUCATOR PERSPECTIVES 77 implementation of FRIENDS to happen. These administrative viability challenges are nothing new to FRIENDS program implementation in Chilliwack. Previous research by Sawyer (2011) also examined the implementation of the FRIENDS program in Chilliwack schools, exploring what helps or hinders educators’ decisions to implement the FRIENDS program in their classrooms. In Sawyer’s interviews, participants reported the importance of support from school administrators in order for implementation to happen. Sawyer argues that administrative support for the implementation of the FRIENDS program encourages expression of interest and influences educators to receive the necessary training to deliver the program. The same effect is seen in this study, where the largest proportion of critical incidents and categorical participation relate to administrative barriers, giving the perception of the lack of importance in administration's view of the FRIENDS program in general, and consequently, negatively contributing to the viability of this particular model of FRIENDS implementation. Confusion with supporting roles. This theme highlights the various non-high-school student personnel involved in making sure the implementation of FRIENDS happened. Categories emphasizing this theme include Role Confusion Due to Miscommunication, and Training. The emergence of this theme further highlights the importance of the supporting roles required to improve the viability of a youth-led FRIENDS model. In comparison to the traditional manner in which FRIENDS is delivered by either mental health workers or teachers, involving high school students as the chief implementers of FRIENDS inevitably brings more complication to the process of delivering the FRIENDS program. The category of Role Confusion brings out some of these challenges, as it demonstrates how some of the people in supportive roles were not given a clear vision of what a youth-led FRIENDS implementation would look like, and how they could be involved. Three participants represented the category of EDUCATOR PERSPECTIVES 78 Role Confusion. Each reported that there was a confusion regarding what roles each of them were supposed to function in. For example, the elementary school teacher reported that she “didn’t necessarily know my role or how much to step in and how much not to.” The degree to which the supportive adults were to engage with the process of implementing FRIENDS was unclear for the educators. The researchers came to understand that this lack of clarity came primarily from a lack of communication between those involved in the organization of the FRIENDS program. Additionally, communication between the high school students and the educators involved in supporting them, regarding their respective roles, was missing. This confusion highlights the need for increased unity of vision with the youth-led FRIENDS model. Having a strong sense of vision with the model of implementation, and a unity of efforts, will likely reduce the amount of confusion experienced by supporting partners. Of course, in a traditional model of FRIENDS implementation, it can be expected that there would be little role confusion since the implementers would be the classroom teachers themselves, or mental health professionals, both of whom typically carry more directive authority when they implement the program. The addition of high school students as the primary implementers of FRIENDS inherently adds the extra essentials of mentoring and supervision to support the high school students in their delivery. In the case of a youth-led model of FRIENDS implementation, confusion about roles and responsibilities hinders the viability of this model of implementation if the confusion is not addressed, leading to an impact on the manner in which FRIENDS is delivered and therefore affecting the high school students’ ability to deliver the program in the manner it was originally designed. Missed implementation opportunities. The previous section of the discussion explored the high school students’ capability of implementing the FRIENDS program, and all of the EDUCATOR PERSPECTIVES 79 participants provided observations and insight supporting this capability. While there were many positive unique qualities the high school students brought to the implementation of FRIENDS, some participants also observed some missed implementation opportunities as well. The category Ineffective Delivery of The Program highlighted how some of the elementary school students were not able to connect with the way the high school students presented the material. One participant noticed how, even though the high school students had made positive emotional connections with these disengaged students, that the delivery of the program material did not seem to connect with them. Flexibility and creativity with incorporating interaction into a presentation is an important skill for presenters (Collins, 2004). The FRIENDS program is intrinsically designed with various creative activities and different ways of presenting the learning material, which suggests that the disconnection is more likely the result of high school student inexperience, rather than an inherent flaw in the FRIENDS program. The category of High School Student Inexperience, with a 40% participation rate and three CIs, presents observations from participants' noticing how the high school students did not seem to fully grasp the deeper theoretical and conceptual content of the FRIENDS program. FRIENDS is theoretically based upon principles of cognitive behaviour therapy to teach and encourage relaxation skills, self-awareness and control, and skills in cognitive restructuring. One participant noted how the high school students did not seem to understand these deeper psychological constructs, which may have affected their ability to deliver the material in a way that the elementary students could positively respond to. Though this hindering component of the youth-led FRIENDS program may impede the delivery of the material, it does not necessarily negatively impact the viability of using youth as chief implementers, especially when considering that FRIENDS is intended as a peer learning program model (Farrell & Barrett, EDUCATOR PERSPECTIVES 80 2007). Moreover, as Kösters et al. (2017) suggests, a lower adherence to FRIENDS delivery protocol does not necessarily impede program outcomes. It was possible that the prevention workers attuned to the needs of the group by creatively changing the delivery of the material to fit the audience. The authors suggest that this does not necessarily mean the goal of the program was not achieved. Therefore, in this study, even though the high school students’ experience level may have emerged as a hindrance to program delivery, the results on program outcomes are arguably minimal and are still outweighed by the aforementioned benefits of having high school students as chief implementers of the FRIENDS program. The next section will discuss the recommendations for improving the viability of a youth-led FRIENDS model for future implementations. Recommendations for Improved Viability of Youth-led FRIENDS Model As seen in the results section, there are numerous categories reporting on the capability of high school students as primary implementers of the FRIENDS program, along with some of the challenges facing this model of implementation. FRIENDS has extensive empirical validation of its effectiveness in reducing anxiety symptoms and increasing pro-social outcomes in elementary school students (e.g. Fisak et al., 2011). The focus of this study was to examine educators’ perspectives and observations of a new-piloted implementation of the FRIENDS program using high school students as the implementers. The viability of this model was the focus of this discussion, with the intent of highlighting the recommendations made by the educators for ways to improve this model's viability and therefore increase the usage of a youth-led FRIENDS implementation model in the future. These educators possess the necessary expertise to have fully observed this implementation and provide poignant recommendations for the improved viability of this model of FRIENDS. EDUCATOR PERSPECTIVES 81 1. The educators suggest greater flexibility regarding modification of activities inside the classrooms by the high school students to fit the unique needs of the elementary school students. For example, it is important to use more activities with movement and expression. 2. Educators observed a need for more efficient scheduling to achieve regular implementation in the classrooms and prioritizing the scheduling of administrative meetings for future planning purposes and to ensure smooth running of the implementation. 3. Some of the educators suggest that training procedures be adjusted to provide a more extensive training for the high school students rather than a single day occurring months before the implementation. They also suggest that teachers and group facilitators be included in the training for greater coherence of roles. 4. Some educators suggest strategically generalizing the concepts of FRIENDS to the school culture, different ages, and the teaching curriculum. 5. The educators believe that improved consistent communication between supporting partners, and the communication of a clear vision of the FRIENDS implementation purposes to all involved partners, will improve implementation viability. Examples include debriefing sessions between high school students and teachers and coordination meetings among stakeholders. 6. Some educators endorse having an increased role in implementation with the high school students, resulting in greater integration between the classroom teacher and high school students presenting the FRIENDS material. EDUCATOR PERSPECTIVES 82 7. Another suggestion is increased involvement by administration to promote mental health and wellness within schools and to ensure that administrative processes do not lag the implementation of the FRIENDS program. 8. Another suggestion is scheduling a shuttle bus to aid in effectively transporting the high school students to and from the schools. 9. One educator suggested greater collaboration with community partnerships such as Rotary clubs. Limitations & Future Research There are a few important limitations to consider for this study. The first is the nature of the participants in the group of focus. In the case of this piloted FRIENDS implementation in Chilliwack, most of the educators interviewed for this project observed the high school students in one school and classroom, even though it was implemented in three separate classrooms. The participant who was the principal of the elementary school provided observations from the context of three classroom implementations, but the other participants provided observations from one classroom. One important question in learning from pilot studies is the degree of applicability of findings to other educational contexts and communities. Applicability is most clearly described in relation to similarities and differences in community make-up including social class, ethnicity, or other background factors that may influence the success of implementation in each local community. From the perspective of implementation viability, a developmental psychological understanding of peer influence supports the observation that high school students are capable implementers. The processes of peer influence observed here are thus likely to have an impact in other educational environments with different socioeconomic EDUCATOR PERSPECTIVES 83 and geographical contexts. These findings are thus likely to be useful and applicable to other schools and school districts as well. Another limitation of this study is the possibility of bias in participant reports of critical incidents. First, it is possible that the educator participants might have reported incidents from more recent memory to the exclusion of other important incidents that they might not have remembered as readily. The inclusion of the rigour and validity checks, inherent within the ECIT method, help address this possibility since they provide ample opportunity for participants’ stories to be checked for accuracy and consistency with their experiences. A second potential aspect of bias also arises from the participants’ involvement with the HSCEP program in Chilliwack. It is possible that some of the participants involved with the HSCEP may be predisposed to seeing the success of this program, and therefore might readily report more helpful critical incidents. However, the rigour and validity checks clearly maintain a focus on accuracy for hindering incidents as well as helpful incidents. While there were more helpful incidents reported than hindering, all participants still provided adequate observations of hindering incidents and wish list items, suggesting a balanced observation of the youth-led FRIENDS implementation. Another limitation regarding the participant pool is that the term ‘educators’ needed to be expanded to include more than just classroom teachers in order to meet the necessary criteria for ECIT data collection and analysis. However, the inclusion of other professionals as educators also provided a broader perspective within the data of what helps and hinders the implementation of this FRIENDS model. Lastly, it is important to further note the potential bias stemming from the various stakeholder involvement in this thesis project. As previously mentioned, it is in the interest of the MCFD in Chilliwack to see increased delivery of the FRIENDS program in Chilliwack schools, EDUCATOR PERSPECTIVES 84 and ultimately, in BC schools. Moreover, this thesis project was commissioned by a staff member on the CYMH team in Chilliwack, Dr. Rob Lees, who also served as a co-supervisor on the project. While these particular stake holders have a vested interest in the success of this implementation model, the manner in which Dr. Lees’ involvement in the project was attributed to an advisory role. The examiner for the thesis project also serves as an active member on the HSCEP advisory team. In an attempt to minimize the impact of these possible biases to the results of the project, the ECIT method was deemed an appropriate research method due to the inherent exploratory nature and the inclusion of hindering items in the data. This study explored the perspectives of educators as they observed the implementation of FRIENDS as piloted by high school students, rather than specifically examining the effectiveness of this delivery strategy. Future exploration into the effectiveness of a youth-led FRIENDS program is needed to connect with the strong international body of literature on the effectiveness of FRIENDS. In particular, a more robust study that utilizes a mixed method approach to both further assess the viability of the model with this study’s future recommendations applied, and a quantitative component to measure the anxiety levels of the elementary school students. Additionally, it is recommended that an ECIT study with the high school students as the participants is a natural next step to developing this implementation model. The high school students provide a valuable perspective concerning the implementation of FRIENDS and how they can be increasingly supported when implementing this model. These contributions would add to this study’s findings on the viability of a youth-led model. EDUCATOR PERSPECTIVES 85 Conclusion The focus of this study was to explore the perspectives of educators as they observed the newly piloted youth-led implementation of the FRIENDS program in an elementary school classroom. Utilizing the ECIT method, a total of 128 incidents, 51 of which were helping, 38 hindering, and 39 wish list items were extracted. From these incidents, 9 helping, 11 hindering, and 9 wish list categories were formulated with participation rates ranging from 20% to 100% across all categories. Results from the educator interviews suggest that a youth-led FRIENDS implementation model is a viable model of program delivery and is worth consideration for future development and refinement in order to improve the current version of implementation. In particular, it was found that high school students demonstrate capability to form important emotional connections with the elementary school students, yielding positive pro-social development among students from both the elementary and high schools. Challenges to the viability of this implementation model relate to barriers with administrative processes and a disjointed vision among key supportive players involved in ensuring the success of delivery by the high school students. To address these concerns, the educators provided key recommendations based on their observations of the youth-led implementation of FRIENDS, which are highlighted in the section The findings of this study corroborate previous research concerning peer-led school interventions—suggesting that both the inclusion and use of high school youth to implement the FRIENDS program in elementary school classrooms is a delivery model worth continued consideration and refinement. When implemented correctly, the FRIENDS program has proven an effective strategy in creating positive outcomes in addressing anxiety symptoms in children. With further refinement in the training of high school students to deliver FRIENDS, EDUCATOR PERSPECTIVES 86 improvements in unifying key stakeholders and supportive professionals regarding the vision behind a youth-led model, the model of a youth-led FRIENDS program can be further improved to increase implementation success. Better implementation success will ultimately increase the positive community impact that a peer-led FRIENDS implementation model has the potential to achieve. A viable youth-led FRIENDS program can promote engagement of high school youth in community initiatives, provide role models for younger elementary school children while teaching mental health literacy, and encourage community professionals to work together with a common vision to build positive pro-social outcomes in the community. EDUCATOR PERSPECTIVES 87 REFERENCES American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). 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EDUCATOR PERSPECTIVES 98 APPENDIX A: INFORMED CONSENT FORM REB Approval Date: Educators’ Perspectives of Youth-Led Implementation of the FRIENDS for Life Program: A Critical Incident Study Principal Researcher: Nathan Bartz, M.A. student in Counselling Psychology, Trinity Western University Research Supervisors: Dr. Rob Lees, R. Psych., Ministry of Child and Family Development, Chilliwack; Dr. Marvin McDonald., Graduate Department of Counselling Psychology, Trinity Western University. Contact Information: If you have any questions about the research procedures, you may contact Nathan Bartz by email at ____________or by phone at____________. Dr. Rob Lees can be reached at ______________or by phone at_____________. Dr. Marvin McDonald can be reached _________________ If you have any questions about ethical issues involved in this project, you may contact Sue Funk at the TWU Office of Research at _______________or by phone at______________. If you have any questions about any other aspect of this project, do not hesitate to contact the Principal Researcher or either of the supervisors at the above provided contact details. Dear Participants, Thank you for your interest in this study. You will be asked to take part in one interview with the principal researcher, lasting approximately 1 hour. Interviews will involve open-ended questions concerning your perspectives of helping and hindering factors in regards the implementation of the FRIENDS program by high school youth. Once you have articulated a helping or hindering incident, you will be asked to describe this incident in as full detail as possible. The interviews will be audio-recorded and analyzed for themes according to the general purpose of the study. The principal researcher will be interviewing both principals and teachers who are having the youth-implemented FRIENDS program in their school and classrooms respectively. Therefore, there is a possibility that other members involved in your school district may participate in the study. The researcher will not communicate any information you provide to other participants. All information that you provide in this interview will be held confidential and will not be shared with any other participants of this study. There is the potential that you may feel uncomfortable in discussing what you have experienced during the process of youth implementing the FRIENDS program as designed by the licensee. At any point during the interview, you may take a break. If any of the questions make you feel uncomfortable, you are free to not answer. Your participation is entirely voluntary, and at any point in the interview, you are free to discontinue without penalty. If the interview brings up emotional or difficult subjects, following the interview you will be encouraged to contact counselling services available through your extended health plan, or provided with assistance to connect you with alternative professional supports. Your participation in this study will help provide empirical evidence for what helps and hinders EDUCATOR PERSPECTIVES 99 the implementation of FRIENDS, and particularly by youth. It will also inform and shape educators' awareness of the impact of implementing the FRIENDS program as an anxiety management program and also will serve as a useful feedback for those implementing FRIENDS. This study will also be relevant to planning program policy for schools in British Columbia and also the Human Services Career Program at Chilliwack Senior Secondary, which aims to give high school youth practical human service training opportunities. Findings from this study will be reported in Nathan Bartz’ master’s thesis, which will be available in the Trinity Western University library. In addition to publication as a master’s thesis, findings may be disseminated within academic journals and professional conferences. If you choose to withdraw from the interview and do not wish to have information from your interview included in the study, the audio recording and demographic information will be destroyed. To compensate you for the time that you spend during the interviews, a $10 gift certificate for Starbucks will be given to you at the beginning of the interview. This gift certificate will be given regardless of how long you participate in the interview. Your decision of whether to participate in this study, and the resulting information provided will not influence or affect your current or future employment. Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permission or as required by law. Specifically, we will store all information and recordings in locked filing cabinets and password protected computer hard-drives; only the investigators will have access to the information. Transcripts (with names and other identifying information removed), and coded data will also be securely stored for potential future analysis. All data, including transcripts and demographic information will be erased or shredded seven years after the completion of this study. Your signature below indicates that your questions regarding this study have been answered, you have received a copy of this consent form for your own records, and that you consent to participate in this study and that your responses may be put in anonymous form and kept for further use after the completion of this study. ___________________________________________ Signature Date _______________________ EDUCATOR PERSPECTIVES 100 APPENDIX B: INTERVIEW PROTOCOL Introduction 1) Informed Consent – Before starting the interview, I will explain to participants that I need to obtain informed consent from them prior to starting. I will give them a copy of the form and read it aloud for the participants to follow along. Along with the explanation of informed consent are the following topics/issues: 2) General aim/purpose of study: “The aim of this study is to discover descriptive themes and facilitating events that help and hinder the implementation of the FRIENDS anxiety management program when delivered by youth.” 3) Explanation of participant selection: “Participants like yourself, who were either present in the classroom during the implementation of FRIENDS by youth or involved in the coordination between schools to receive the youth-led FRIENDS in your school, will be most able to provide helpful and hindering factors.” 4) Access to professional supports for parents: “After the interview, if you feel it is necessary because of something raised in the interview, you will be encouraged by the researcher to contact any already existing professional supports that you may have. This would include your family doctor or adult mental health worker. If you have neither of these, the researcher will connect you with a Child and Youth Mental Health psychologist, free of charge, who will provide immediate, short-term intervention. They will also encourage your connection with other professional supports.” Semi-structured interview questions: 1) Initial open-ended question: “Please tell me the story of your experience with the FRIENDS program.” Also, for those who may have not experienced FRIENDS, I will ask “Please tell me if you have ever heard of anything in relation to the FRIENDS program and if you have, can you please tell me your story of how you were informed? 2) Follow-up questions to the initial open-ended questions: a. “Please think of a time during the youth-led implementation of FRIENDS in which you felt the process was helped or hindered by any specific event, situation or behaviour.” For example, when you observed the youth interact with the classroom, or when you coordinated scheduling to have the program run in your school/class. b. “Please describe a particular incident in full detail that significantly helped or hindered in the youth-led implementation of FRIENDS as designed by the licensee.” For instance, when the high school student was facilitating the program to your students in class c. “How was this incident helpful or unhelpful?” d. “What led up to this incident (antecedents)?” e. “What were the surrounding circumstances that affected this event or situation?” f. “What was the overall outcome of this event or situation?” g. “What did this incident mean to you personally?” h. “How did this specific incident make you feel?” Check in Question Prior to proceeding to the termination of the interview, the researcher will ask: “________, how are you feeling after sharing these incidents and situations that were either helpful or not helpful in the implementation of the FRIENDS anxiety management program as designed by the licensee.” If the participant is emotionally or psychologically distressed, the researcher will EDUCATOR PERSPECTIVES 101 respond appropriately, either with a break from the interview, or with crisis management skills. Closing Questions: 1) Suggestions for future implementation of the FRIENDS program: “Based on your personal experience as an educator involved in teaching and also providing curricula that help improve the mental health well-being of your students, what would be your recommendation for future program managers and program developers in the youth-led implementation of the FRIENDS program? Anything else you would like to add? Name (Please print)___________________________________________ O Check this box if you give us permission to retain your audio-recordings for future data analysis, after the completion of this study. All audio-recordings will be erased five years after completion of this study. EDUCATOR PERSPECTIVES 102 APPENDIX C: DEBRIEFING SCRIPT At the end of the interview the principal investigator will review the interview process with the participant by summarizing what the participant has discussed. The participant will be given the opportunity to ask questions or make any further comments. The principal investigator will use the following debriefing script: "We have been engaging in semi-structured, open interviews in order to explore your perceptions and experiences of the youth-implemented FRIENDS program. The purpose of these interviews was two-fold: to provide information for a thesis project that will soon be defended and published, and to provide an opportunity for you to discuss your experiences of a youthimplemented FRIENDS program designed for the purpose of providing useful feedback regarding what helps and hinders high school youth in implementing mental health promotion programs such as FRIENDS. The results of this study will inform future youth-led implementations of the FRIENDS program. That information may then be made available to school administrators, policy makers, program developers, and mental health clinicians to improve upon their current FRIENDS implementation services to school children.” “If, following this interview, you feel emotionally upset by something raised in the interview, you are encouraged to contact either your family doctor or counsellor. If you have access to neither of these supports, and if you wish, you will be given prompt access to a Child and Youth Mental Health Psychologist who will provide immediate, short-term interventions with you. He/She will also provide you with rapid access to other professional supports, either a family doctor or an adult mental health worker.” “At this point, do you have any further questions about this study in general, this interview, or anything else?” “Thank you very much for your contributions to this study."