Students with Emotional Disturbance require an array of support at schools, including but not limited to proactive classroom management techniques, specialized academic instruction, motivation systems, frequent goal setting and monitoring, mentor- based supports, school-home collaborative efforts, and psychotherapeutic services. While research has highlighted the importance of these components, many programs serving students with Emotional Disturbance do not consistently implement these evidence-based practices. The present study is an exploratory analysis of the implementation and outcomes of Tiers of Intensive Educationally Responsive Services (TIERS), a comprehensive program consisting of several evidence-based practices to promote social-emotional growth in students with Emotional and/or Behavioral Disturbance (EBD).

The purpose of the study was to examine 1) whether the TIERS package of interventions resulted in significant increases in student transitions to the least restrictive environment from baseline, and whether significant differences existed between programs on this basis of implementation fidelity, 2) the impact of TIERS interventions on the severity of problem behaviors in students in three selected high school classrooms, 3) the impact of the TIERS model on the teacher ratings of treatment acceptability, and 4) whether or not a significant correlation exists between teacher treatment acceptability and the degree of implementation fidelity.

The results of the study suggested that 1) there was a significant increase in the number of student transitions from baseline, though significant differences were not found on the basis of implementation fidelity, 2) single-case data demonstrated significant positive behavior growth among 24 high school students, 3) teachers' attitudes toward implementation were significantly improved from baseline, and 4) there was a statistically significant moderate positive correlation between treatment acceptability and implementation fidelity. Implications for future research in the areas of school-based programming for students with emotional disturbance and implementation science are discussed.