233 The Professional Counselor | Volume 13, Issue 3 recognize the value of collaborating with training programs and utilizing CITs to meet students’ mental health needs, particularly given high school counselor-to-student ratios. Utilizing additional personnel, such as CITs, can bolster the number of services offered and students served. Kennedy and Farley (2018) have noted the importance of tailoring treatment approaches to best meet high-achieving students’ needs by acknowledging a students’ giftedness as a part of their identity. Further, it is important to consider how high-achieving students’ abilities may interact with other high achievement factors, such as perfection. The literature on perfectionism demonstrates a strong association with dichotomous thinking patterns, underachievement, and anxiety (Kennedy & Farley, 2018). The modified CBT-P small group intervention (Shafran et al, 2002) specifically addressed these associations and underlying concerns through various treatment strategies. This study verified the importance of understanding contextual factors (such as accelerated curricula) and underlying concerns (such as perfectionism) in high-achieving students when formulating theories and designing and implementing targeted therapeutic support. Therefore, future studies should consider and assess other factors of high achievement when delivering tailored interventions to high-achieving students in early college programs. Future research should also explore the impacts of universal classroom-based CBT-P interventions, both as stand-alone programs and in conjunction with small-group counseling interventions. A classroom approach has the potential to reach even more high-achieving students, specifically those who are more prone not to seek help or self-disclose mental health concerns (Flett & Hewitt, 2014; Leone & Wade, 2018). Further, research should continue to explore the impact of delivery modality (i.e., in-person or online) of the modified CBT-P small group intervention (Shafran et al., 2002) on early college high school students. Despite the efficacy of online therapy being well established in the treatment of mental health concerns, some studies suggest that students would prefer face-to-face support over online therapy (Horgan & Sweeney, 2010; Sweeney et al., 2019). Although some students prefer in-person groups, because of COVID-19 and IRB barriers, attending an in-person group was not an option for this study. Limitations As with any study, this one had limitations. For one, the generalizability of the findings are limited, as the study only included one early college high school in the Southeastern United States. Second, a nonequivalent comparison group design was used because randomization was not possible within the school setting. So future studies might consider a true random assignment of students to the group conditions to control for confounding variables and increase internal validity. Third, the study was also limited to half a school year for both rounds and did not examine the impact of the modified CBT-P intervention over time. Future studies should explore the impact of CBT-P over time with a larger sample size. Another limitation of the study was the small sample size (N = 41). The original sample size in the study (N = 46) was above the adequate sample size (N = 42) according to the a priori G-power analysis calculation. However, barriers with recruitment and retention existed, resulting in a final total sample size of N = 41. Missing data can make it more challenging to carry out a true intention-to-treat analysis. Attrition most notably occurred within the treatment group after attending at least one CBT-P small group. Pfeiffer (2021) identified two necessary components that are critical for therapy success for the high achieving: (a) establishing and maintaining a strong therapeutic relationship; and (b) a deep understanding of working with gifted children. Certified school counselors may have more knowledge and training and be better equipped than CITs to develop strong therapeutic relationships within this student population. Therefore, using certified school counselors who are already embedded within the school and have the necessary training could improve participant recruitment and retention.
RkJQdWJsaXNoZXIy NDU5MTM1