Addressing School Bullying with a Multi-tiered System of Support Approach

Janet Njelesani, Kristen Attard, Amanda Duimstra, Naomi Zenderman

Research output: Contribution to journalArticlepeer-review


School bullying undermines students’ participation and functioning and is within the scope of practice for school-based occupational therapists to address. The Multi-Tiered System of Support (MTSS) approach has the potential to guide the work occupational therapists do in addressing bullying. However, to date, how occupational therapists are addressing school bullying with an MTSS approach is unknown. We, therefore, conducted an exploratory qualitative interpretive study to gain an understanding of how occupational therapists are addressing school bullying with an MTSS approach. The methods we used included semi-structured one-on-one interviews with eight occupational therapists (seven women, one man) working in public schools in New York City. We used the qualitative data management tool Taguette and thematic analysis for data analysis. Themes illuminate occupational therapists’ minimal involvement and uncertainty with bullying prevention and intervention efforts being implemented through MTSS in their schools. They attributed their minimal involvement to not having sufficient experience and a lack of recognition from school staff on occupational therapy’s mental health expertise and distinct contribution that could be brought to anti-bullying efforts. In conclusion, this study emphasizes the need for occupational therapists to have access to occupation-based anti-bullying interventions, appropriate mentorship, workload support, recognition from school staff, and professional development to be part of an interprofessional team in schools that addresses bullying. For this to occur, a systematic process of capacity building, advocacy, and planning across system levels (i.e., entry-level education programs, individual school sites, state occupational therapy associations, professional association) is needed.


  • Qualitative research
  • bullying
  • mental health services
  • occupational therapy

ASJC Scopus subject areas

  • Social Psychology
  • Education
  • Occupational Therapy


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