About

Ricardo Eiraldi, PhD, is a Professor and Chair of Pediatrics (Developmental and Behavioral Pediatrics) at the University of Pennsylvania, based at the Children's Hospital of Philadelphia. His research centers on understanding barriers and facilitators of service utilization for ethnically diverse children and families, with a focus on addressing disparities in inner city and rural public schools. Over the past eight years, his work has primarily involved developing and implementing school-wide programs aimed at preventing and treating externalizing (disruptive behavior, aggression, conduct problems) and internalizing mental disorders (anxiety, depression) in school children. His clinical expertise includes the assessment and treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, particularly among low-income, ethnically diverse populations. Dr. Eiraldi has been awarded multiple grants from prominent institutions such as the National Institutes of Mental Health, the Centers for Disease Control and Prevention, and the National Institute of Child Health and Development, supporting his research on behavioral support programs and cognitive behavioral therapy protocols in urban school settings.

Research topics

• Psychology
• Clinical psychology
• Developmental psychology
• Medicine
• Medical education

Selected publications

• Toolkit to Support Teachers’ Use of Behavioral Classroom Interventions: Results from a Randomized Pilot Trial

  School Psychology Review · 2025-11-06

  article

  Teacher-delivered Tier 1 (i.e., whole class) and Tier 2 (i.e., targeted) behavioral classroom interventions are effective in improving student academic and behavioral functioning, but often not delivered as recommended. Implementation strategies, especially strategies that are both feasible and effective, could support teachers in the delivery of these interventions. This pilot randomized controlled trial evaluated the acceptability, feasibility, and preliminary evidence of effectiveness of the Positive Behavior Management Toolkit (PBMT) in supporting teacher implementation and student outcomes. The PBMT is a modular implementation resource package to support K-5 teachers in delivering Tier 1 and Tier 2 behavioral interventions. Twenty teachers were randomized to receive either the PBMT or implementation support as usual. Quantitative and qualitative results suggested that the PBMT was highly acceptable, feasible and contextually appropriate. We also collected data on teacher fidelity to behavioral interventions and student outcomes for enrolled focal students with symptoms of attention-deficit/hyperactivity disorder (ADHD) at baseline and post-intervention. Although the pilot study was underpowered to conduct significance testing, the results suggested the PMBT may be effective in supporting teacher implementation outcomes and were mixed regarding student outcomes.

  PublisherDOI

• Prioritizing Partnerships in School-Based Implementation Research and Practice: Applying the ACCESS Model

  Evidence-Based Practice in Child and Adolescent Mental Health · 2025-04-13

  articleOpen access

  Background: Schools are the primary context for mental health services for youth in the United States and a critical setting for increasing access to mental health care, especially for youth from low income and historically minoritized communities. However, numerous barriers to implementing evidence-based practices persist for chronically underserved youth in schools. Establishing strong collaborations with community partners is essential for successful implementation. Objective: This conceptual overview offers the ACCESS model as a resource for school-partnered training and consultation efforts, in contrast to previous applications that emphasized community mental health and inpatient contexts. Method: Drawing from our groups' collective decades of partnering with school and community members to deliver evidence-based practice training and consultation support in underserved schools and reflecting on our collaborations with community mental health agencies contracted to provide mental health services in schools, we outline a practical model for partners to provide training and implementation support in the school context. Specifically, we have described applications of the ACCESS model (Creed et al., 2014; Stirman et al., 2010) in training and consultation in partnership with leaders, service providers, and educators working in underserved school settings. The ACCESS model provides guidance for trainers and implementers to Assess and adapt training content, Convey the basics during initial training, provide Consultation to facilitate learning and behavior change, Evaluate work samples to assess EBP fidelity, Study outcomes, and foster Sustainment of practices over time. Conclusion: The ACCESS model offers a practical roadmap for school-partnered EBP implementation, outlining each step and providing concrete guidance for psychologists with applied examples from our work. This authorship team represents co-developers of the ACCESS model and three distinct research groups that have provided training and consultation in partnership with numerous public-school systems. Throughout, we emphasize how school-academic partnerships can support implementation in underserved schools.

  PublisherOA PDFDOI

• Preparation for implementation of evidence-based practices in urban schools: A shared process with implementing partners

  Implementation Research and Practice · 2024-01-01 · 2 citations

  articleOpen access1st authorCorresponding

  Background: Shifting organizational priorities can negatively affect the sustainment of innovations in community settings. Shifting priorities can present barriers to conducting clinical research in schools if a misalignment occurs between school district priorities and the aims of the study. Often this misalignment occurs due to a shift during the period between when the study is submitted for funding and when research activities begin. Participatory research approaches can be employed to restore alignment between study processes and school district priorities. The purpose of the study is to describe data from a shared process with district partners. The shared process resulted in modifications to the main study's implementation processes and strategies in order to restore alignment with evolving school priorities while remaining faithful to the aims of the study. Method: Data originated from qualitative interviews conducted with 20 school district and school personnel in a large urban school district. Qualitative themes were organized into categories based on a social-ecological school implementation framework. Data from team meetings, meetings with school district administrators, and emails served to supplement and verify findings from interview analyses. Results: Themes included barriers and facilitators at the macro-, school-, individual-, team-, and implementation quality levels. Adaptations were made to address barriers and facilitators and restore alignment with school district priorities. Most adaptations to study processes and implementation strategies focused on re-training and providing more information to school district coaches and school-based staff. New procedures were created, and resources were re-allocated for the larger study. Conclusions: Findings were discussed in relation to the implementation literature in schools. Recommendations for sustaining strong collaboration among researchers and school partners are provided.

  PublisherDOI

• Implementation fidelity, student outcomes, and cost-effectiveness of train-the-trainer strategies for Masters-level therapists in urban schools: results from a cluster randomized trial

  Implementation Science · 2024-01-25 · 12 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Little is known about the effectiveness and cost-effectiveness of train-the-trainer implementation strategies in supporting mental health evidence-based practices in schools, and about the optimal level of support needed for TT strategies. METHODS: The current study is part of a larger type 2 hybrid cluster randomized controlled trial. It compares two train-the-trainer strategies, Train-the-Trainer (TT) and Train-the-Trainer plus ongoing consultation for trainers (TT +) on the delivery of a group cognitive behavioral treatment protocol for anxiety disorders. Participants were 33 therapists, 29 supervisors, and 125 students who were at risk for anxiety disorders from 22 urban schools. Implementation outcomes were implementation fidelity and treatment dosage. Student outcomes were child- and parent-reported symptoms of anxiety, child-reported symptoms of depression, and teacher-reported academic engagement. We estimated the cost of implementing the intervention in each condition and examined the probability that a support strategy for supervisors (TT vs TT +) is a good value for varying values of willingness to pay. RESULTS: Therapists in the TT and TT + conditions obtained similarly high implementation fidelity and students in the conditions received similar treatment dosages. A mixed effects modeling approach for student outcomes revealed time effects for symptoms of anxiety and depression reported by students, and emotional disaffection reported by teachers. There were no condition or condition × times effects. For both conditions, the time effects indicated an improvement from pre-treatment to post-treatment in symptoms of anxiety and depression and academic emotional engagement. The average cost of therapist, supervisor, and consultant time required to implement the intervention in each condition was $1002 for TT and $1431 for TT + (p = 0.01). There was a greater than 80% chance that TT was a good value compared to TT + for all values of willingness to pay per one-point improvement in anxiety scores. CONCLUSIONS: A TT implementation approach consisting of a thorough initial training workshop for therapists and supervisors as well as ongoing supervision for therapists resulted in adequate levels of fidelity and student outcomes but at a lower cost, compared to the TT + condition that also included ongoing external expert consultation for supervisors. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02651402.

  PublisherOA PDFDOI

• Partnering with Schools to Adapt a Team Science Intervention: Processes and Challenges

  School Mental Health · 2024-05-02 · 4 citations

  articleOpen access

  Public schools are a major provider of mental health services for children in the US. Mental and behavioral health services range from universal programming to individualized clinical supports to address student needs. These services in schools are delivered by various professionals including non-teaching and teaching school personnel, school-employed clinicians, and/or contracted community mental health partners. Provision of mental health services requires complex coordination of providers across disciplines, although few professionals have training in multidisciplinary collaboration strategies. Attention to team processes, such as delineating team members' roles, improving communication, and identifying collaboration strategies, may impact the effectiveness of evidence-based mental health service provision in real world settings. One intervention, Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), has been used in healthcare with positive outcomes and has been adapted to educational settings. The current paper describes the community-partnered subsequent adaptation of TeamSTEPPS for schools. Needs assessment interviews identified challenges, successes, and goals for student mental health. Overarching themes extracted from interviews include limited resources at multiple levels (e.g., financial support, time, and personnel), communication challenges, and poor role clarity. A community advisory board provided guidance during the adaptation and implementation planning process. Adaptations to the intervention included tailoring the intervention to the school context and the development of flexible training plans. In addition, individualized implementation plans were developed with each school partner to mitigate foreseeable barriers to rolling-out TeamSTEPPS. Our team is currently piloting the adapted TeamSTEPPS intervention and implementation strategies in partnership with three school districts. Supplementary Information: The online version contains supplementary material available at 10.1007/s12310-024-09665-7.

  PublisherOA PDFDOI

• Implementation resources to support teachers’ use of behavioral classroom interventions: protocol of a randomized pilot trial

  Pilot and Feasibility Studies · 2023-08-25 · 7 citations

  articleOpen access

  BACKGROUND: Teacher-delivered behavioral classroom management interventions are effective for students with or at-risk for attention-deficit/hyperactivity disorder (ADHD) or other disruptive behavior challenges, but they can be difficult for teachers to use in the classroom. In this study, we will pilot test a package of implementation strategies to support teachers in using behavioral classroom interventions for students with ADHD symptoms. METHODS: We will use a 2-group, randomized controlled trial to compare outcomes for teachers who receive Positive Behavior Management Implementation Resources (PBMIR), a theory and data-driven implementation resource package designed to increase teacher implementation of behavioral classroom management interventions, with those who do not receive this additional implementation support. We will measure teacher implementation outcomes (e.g., observed fidelity to behavioral classroom interventions) and student clinical outcomes (e.g., ADHD-related impairment, ADHD symptoms, student-teacher relationship, academic performance) before and after an 8-week intervention period for both groups; we will also measure teacher-reported acceptability, appropriateness, and feasibility for the PBMIR group following the intervention period. DISCUSSION: If there is preliminary evidence of feasibility and effectiveness, this pilot study will provide the foundation for evaluation the PBMIR at a larger scale and the potential to improve outcomes for students with or at risk for ADHD. TRIAL REGISTRATION: This clinical trial was registered at ClinicalTrials.gov. ( https://clinicaltrials.gov/ ) on 8/5/2022 which was prior to the time of first participant enrollment. The registration number is: NCT05489081.

  PublisherOA PDFDOI

• Development of an Online Training Platform and Implementation Strategy for School-Based Mental Health Professionals in Rural Elementary Schools: A Mixed-Methods Study

  School Mental Health · 2023-04-03 · 4 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• A comparison of two group cognitive behavioral therapy protocols for anxiety in urban schools: appropriateness, child outcomes, and cost-effectiveness

  Frontiers in Psychiatry · 2023-06-23 · 8 citations

  articleOpen accessSenior author

  Background: Cognitive behavioral therapy (CBT) for pediatric anxiety is efficacious for reducing anxiety symptoms and improving functioning, but many children are unable to access CBT for anxiety in community settings. Schools are an important setting in which children access mental health care, including therapy for anxiety. In this setting, therapy is usually delivered by Masters-level therapists. Objectives: Friends for Life (FRIENDS), a 12-session, manualized, group CBT program for anxiety has demonstrated effectiveness when implemented in schools. However, prior research has also found challenges regarding feasibility and cultural fit when delivering FRIENDS in the urban school context. To address these challenges, we adapted FRIENDS for implementation in the school setting so that it might be more feasible and culturally appropriate for low-income, urban schools in the United States, while maintaining the core components of treatment. The current study uses a mixed-method approach to compare the effectiveness, cost-effectiveness, and perceived appropriateness of FRIENDS and CATS when delivered by Masters-level therapists with train-the-trainer support. Materials and methods: First, we compared change scores for student outcomes (i.e., child-report MASC-2 total score, parent-report MASC-2 total score, teacher-report Engagement and Disaffection subscale scores) from pre- to post- treatment between students receiving FRIENDS and students receiving CATS to assess whether the two conditions resulted in equivalent outcomes. Second, we compared the cost and cost-effectiveness between the groups. Finally, we used an applied thematic analysis to compare appropriateness of the interventions as perceived by therapists and supervisors. Results: The mean change score for the child-reported MASC-2 was 1.9 (SE = 1.72) points in the FRIENDS condition and 2.9 (SE = 1.73) points in the CATS condition; results indicated that the conditions were similar in their treatment effects, and symptom reductions were small in both groups. The modified protocol, CATS, was shown to cost significantly less to implement compared to FRIENDS and showed greater cost-effectiveness. Finally, compared to therapists and supervisors in the CATS condition, therapists and supervisors in the FRIENDS condition more strongly described aspects of the intervention that were not appropriate for their context and in need of more extensive adaptations. Conclusion: Relatively brief, group CBT for anxiety, with adaptations to improve cultural fit, is a promising approach to treat youth anxiety symptom when delivered by school-based therapists with train-the-trainer implementation support.

  PublisherOA PDFDOI

• Therapist and supervisor perspectives about two train-the-trainer implementation strategies in schools: A qualitative study

  Implementation Research and Practice · 2023-01-01 · 5 citations

  articleOpen accessSenior author

  Background: Train-the-trainer (TT) implementation strategies (in which designated clinicians are trained to then train others in an intervention) are promising approaches to support mental health clinician use of evidence-based interventions in school contexts. However, there is little evidence to date examining clinicians' perceptions of the acceptability and feasibility of TT strategies, or comparing clinicians' perceptions of different types of TT strategies. Methods: The current study was conducted as part of a larger hybrid effectiveness-implementation trial, in which school-based therapists and supervisors received one of two different types of implementation support to implement cognitive behavioral therapy (CBT) groups for anxiety: TT (i.e., initial training for therapists and supervisors) or enhanced TT (TT+; i.e., initial training for therapists and supervisors, and ongoing external consultation for supervisors). We used applied thematic analysis to compare qualitative interview transcripts from 28 therapist interviews and 33 supervisor interviews from therapists and supervisors who received TT or TT+ support and report themes that were similar and different across the two groups. Results: Most themes were similar across the TT and TT+ conditions: therapists and supervisors in both conditions perceived the group anxiety intervention as acceptable and viewed supervision as acceptable, helpful, and feasible. Therapists and supervisors in both conditions had mixed impressions of the contextual appropriateness of the group anxiety intervention, and some reported logistical challenges with weekly supervision. Some unique themes were identified among the TT+ condition, including supervisors experiencing professional growth, and therapists and supervisors perceiving supervision as critically important and enjoyable. Conclusions: These results suggest that TT implementation support, using a model in which an internal supervisor receives initial training and then provides ongoing supervision, is acceptable and feasible to support a group CBT intervention in schools. The results also highlight additional benefits that therapists and supervisors perceived when supervisors received ongoing consultation. Clinical Trial Registration Information: The clinical trial from which these data were derived was registered at ClinicalTrials.gov (https://clinicaltrials.gov/) prior to the time of first patient enrollment. The registration number is: NCT02651402.

  PublisherOA PDFDOI

• Integration of Mental Health Interventions Within PBIS: a Mixed-Methods Analysis

  Contemporary School Psychology · 2023-08-28 · 1 citations

  article1st authorCorresponding
  PublisherDOI

Recent grants

• Targeting School Climate and Children's Behavioral Health in Urban Schools

  NIH · $3.1M · 2013–2018

• NIH Grant K23MH064080

  NIH · $784k · 2009

• A Hybrid Effectiveness-Implementation Trial of Group CBT in Urban Schools

  NIH · $3.8M · 2016–2023

Frequent coauthors

• Thomas J. Power

  University of Pennsylvania

  76 shared

• Abbas F. Jawad

  Children's Hospital of Philadelphia

  40 shared

• Stephen S. Leff

  23 shared

• Jennifer A. Mautone

  University of Pennsylvania

  20 shared

• Muniya Khanna

  Center for Anxiety and Depression

  17 shared

• Barry L. McCurdy

  Philadelphia College of Osteopathic Medicine

  16 shared

• James L. Karustis

  15 shared

• Courtney Benjamin Wolk

  University of Pennsylvania

  15 shared

Labs

• Ricardo Eiraldi LabPI

Education

• PhD, Psychology

  Hahnemann University Hospital

  1995

Awards & honors

• K23 grant from the National Institutes of Mental Health (NIM…
• R18 grant from the Centers for Disease Control and Preventio…
• R01 grant from the National Institute of Child Health and De…
• R01 grant from the National Institute of Mental Health (NIMH…