Framework for Developmental Translation of an Intervention: An Upward Adaptation of the Smarts Intervention Elementary to Middle School

Background and Purpose: Disagreement exists about the use of manualized treatments among researchers and clinicians, with debate about the effectiveness of adapting manual-based interventions from research to practice. Despite dispute, well-defined prevention and intervention manuals are favored for research funding and among the most well-researched treatments available. Treatment manuals perform multiple functions in practice and is a crucial component in conducting successful evaluation studies, including RCT’s, as it allows for treatment fidelity monitoring, and adherence to the intervention described in the original research protocol. Adapting existing empirically supported manualized treatments for new populations requires a systematic and thoughtful process. As population differences demand modifications to a manual-based intervention, additional research is necessary to maintain the treatment’s empirical integrity and value. Theoretical emphasis should guide targeted prevention and treatment development, however, the manual development process itself must be grounded in established methodologies.

Method: This paper reviews existing guidelines for manual development following steps for adapting intervention manuals for new target populations. This approach is grounded in Participatory Action Research (PAR) methodology, using input from key stakeholders (i.e., expert community members, individuals from target treatment populations, prospective treatment providers) throughout the manual development process, pilot studies, and randomized controlled trials (RCT). In addition to PAR methods used to identify the problem, precursors, methods of study, and practical solutions, a similar method of coproduction of interventions (CP) used by these researchers to work with personnel to design, refine, and finalize intervention procedures and materials. Using translational steps outlined by (Goldstein, et. al, 2012), this paper will discuss the process and how purposeful focus groups helped guide the development of the Self-Management and Regulation Training Strategies (SMARTS) Curriculum, materials, and self-monitoring app to promote self-regulation skills in middle school students.

Conclusion and Implications: The SMARTS intervention not only teaches students at risk for behavior disorders social emotional and goal setting skills but puts the learning into practice through self-monitoring and processing with school counselors using a combination of the three critical intervention phases to promote improvements in disruptive behavior, prosocial behaviors, and emotional regulation. By staying true to the original SMARTS intervention proven effective with elementary students, while also using PAR and CR techniques along with identified translational steps, the Self-Management and Regulation Training Strategies (SMARTS) Curriculum, materials, and self-monitoring app has been translated to be appropriate and acceptable for middle school students and school systems.