2012 National PBIS Leadership

Forum

Hyatt

Regency O’Hare

RosemontIllinois

Community/School

Partnerships for

Tier 3 Wraparound

Implementation

Session A12 | October 18, 2012 | 10:00am – 11:15am

Lucille Eber, Illinois PBIS NetworkCarol Ewen, Missoula County Public

SchoolsConan Green, Children’s Mental

Health Bureau

Context• At least twice as many youth need high levels of support

for emotional/behavioral needs than currently identified as EBD.

• Nationally, youth who are identified as EBD have experienced very poor outcomes.

• Behavior support for students with emotional/behavioral challenges is not just a “Special Education” issue.

• Prevention-based systems, with capacity to scale-up and provide effective interventions for those youth with or at-risk of EBD are being developed and implemented in schools.

• Schools can’t do it alone…partnerships with communities are needed to ensure success.

We Know the Practices that Work…

• Proactive, strength-based; “set kids up” to experience success

• High rates of consistent, supported instruction; teach/practice/reinforce

• Predictable and consistent environments

• Know unique “why?” for each student/problem

• Contextual fit: Strategic use of natural supports, and settings

• Careful monitoring of data over time with ongoing revisions to guide incrementalimprovements in quality of life

We Know the System Features Needed

to Support the Effective Practices…• A Team unique to each individual child &

family– Blend the family/natural supports with the

school representatives who know the child best

• A defined Meeting Process– Meet frequently and use data– Develop, implement, review range of

interventions

• Facilitator Role– Bringing team together– Blending perspectives; guiding consensus – Systematic use of data (strengths and needs)

Primary Prevention:School-/Classroom-Wide Systems for

All Students,Staff, & Settings

Secondary Prevention:Specialized Group

Systems for Students with At-Risk Behavior

Tertiary Prevention:Specialized

IndividualizedSystems for Students

with High-Risk Behavior

~80% of Students

~15%

~5%

SCHOOL-WIDE POSITIVE BEHAVIOR

SUPPORT

Tier 1/Universal School-Wide Assessment

School-Wide Prevention Systems

SIMEO Tools: HSC-T, RD-T, EI-T

Check-in/ Check-out

Individualized Check-In/Check-Out, Groups & Mentoring (ex. CnC)

Brief Functional Behavioral Assessment/Behavior Intervention Planning (FBA/BIP)

Complex FBA/BIP

Wraparound

ODRs, Attendance, Tardies, Grades, DIBELS, etc.

Daily Progress Report (DPR) (Behavior and Academic Goals)

Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc.

Social/Academic Instructional Groups

Positive Behavior Interventions & Supports:A Response to Intervention (RtI) Model

Illinois PBIS Network, Revised Aug.,2009Adapted from T. Scott, 2004

Tier 2/Secondary

Tier 3/Tertiary

Inte

rven

tio

nAssessm

en

t

1982 Unclaimed Children (Jane Knitzer)• SOC needed to be seamless continuum,

community-based and culturally relevant

1983 CASSP: Technical Assistance plan to develop SOC

1986 System of Care (Stroul & Freidman)

History

• Called for collaboration & community-based services• Resulted in increments of service development

• (i.e. case mgmt, respite, day treatment, in-home supports)

• But not a coordinated system or continuum• Did not indicate practices needed for a SOC

1989-1993 RWJ Projects• 27 states and local communities• introduced managed care• effected state systems in some places (i.e. KY, NC)

History (cont.)

1992-present Comprehensive Community Mental Health Services for Children & Their Families Program

• 85 states local tribes & territories• Decrease use of restrictive placements while increasing access, satisfaction, and youth/family outcomes• Systemic change across systems• Development of state & community structures

Wraparound: A SOC Tool

• Emerged from practitioners struggling to implement SOC (grassroots)

• Keep/bring youth home• Flexible, creative, non-categorical• Natural support networks• Community-based• Unconditional-Commit to “stay the course”• Let family voice guide service development• Non-traditional supports and services

What is Wraparound? Wraparound is a process for developing family-centered teams and plans that are strength and needs based

– (not deficit based)

– across multiple settings and life domains.

Implementing Wraparound:

Key Elements Needed for Success• Engaging students, families & teachers• Team development & team ownership• Ensuring student/family/teacher voice

– Getting to real (big) needs

• Effective interventions– Serious use of strengths– Natural supports– Focus on needs vs. services

• Monitoring progress & sustaining• System support buy-in

• individual students

• built upon strengths

• voice, priorities of youth and family

• based on unique youth and family needs

• culturally relevant teams and plans

• plans include natural supports

• traditional and non-traditional interventions

• multiple life domains

• unconditional

Features of Wraparound

Unique FitWraparound plans should be uniquely designed to fit individual students needs as opposed to making a student fit into existing services or a prescribed program.

Life Domain Areas to Consider

• Physical Needs/Living Situation

• Family/Attachment• Safety• Socialization• Cultural/Spiritual

• Emotional/ Psychological

• Health• Educational/

Vocational• Legal

Value Base• Build on strengths to meet needs

• One family-one plan

• Increased parent choice

• Increased family independence

• Support for youth in context of families

• Support for families in context of community

• Unconditional: Never give upP. Miles, 2004

What’s New in Wraparound?

• Skill set specificity

• Focus on intervention design/effectiveness

• Integration with school-wide PBS

• Phases to guide implementation/supervision

• Data-based decision-making

• Integrity/fidelity assessment (WIT)

• Tools to guide teams:

– Home School Community

– Education Information Tool

Wraparound Skill Sets

1. Identifying “big” needs (quality of life indicators)

• “Student needs to feel others respect him”

2. Establish voice/ownership

3. Reframe blame

4. Recognize/prevent teams’ becoming immobilized by “setting events”

5. Getting to interventions that actually work

6. Integrate data-based decision-making into complex process (home-school-community)

Four Phases of Wraparound

ImplementationI. Team Development

• Get people ready to be a team• Complete strengths/needs chats (baseline data)

II. Initial Plan Development• Hold initial planning meetings (integrate data)

• Develop a team “culture” (use data to establish voice)

III.Plan Implementation & Refinement• Hold team meetings to review plans (ongoing data

collection and use)• Modify, adapt & adjust team plan (based on data)

IV. Plan Completion & Transition• Define good enough (Data-based decision-making)

• “Unwrap”

Can wraparound teams use data-based decision-making to prioritize needs, design strategies, & monitor progress of the child/family team?

Data-Based Decision-Making

and Wraparound

• more efficient teams, meetings, and plans?

• less reactive (emotion-based) actions?

• more strategic actions?

• more effective outcomes?

• longer-term commitment to maintain success?

Jacob• Poor school attendance

• Tardiness

• Refusal to participate in 2nd grade classroom activities. Did work independently in office/partial school days.

• Previous hospitalization (Bipolar Disorder?)

• Retention – currently repeating 2nd grade year

• Failing Grades

“Jacob”Home/School/Community Tool

Getting to Strengths & Needs at Baseline

Integrating Wraparound in Montana 2012

Carol Ewen, M.A., MCPS RTI Coordinator

Conan Green, MSW, State Wraparound Coordinator, CMHBNational Consultants:Lucille EberDr. John VanDenBerg

Philosophical approach

• Wraparound is, by definition, an integration process. It is defined by working in multiple community domains to support healthy development of children, adults and families.

• Montana’s goal is to ensure that any family receiving wraparound support have only one integrated plan.

• OPI and CMHB (Children’s Mental health Bureau) are working hand in hand to ensure that this goal is met.

How we Got Here…• High Fidelity Wraparound was

introduced through the PRTF Waiver in 2008.

• In (2009) CMHB implemented HF Wrap training to support the development of:– HF Wraparound Facilitators– Coaches– Peer to Peer Support– Wraparound Process Mentors

Being in the Right Place at the Right Time

• In 2011 OPI Grant selected two school pilot sites to participate in Integrated Systems Framework (ISF)Project

• ISF Project introduced school Wraparound for Tier 3 school interventions

• OPI and CMHB recognized the need to integrate approaches and clarify

Putting it all together

• State commissioned Eber and VanDenBerg

to design a crosswalk and layout a foundation for integrated practice.

• OPI contracted with school staff to present PBIS and School Wraparound at state HF Wraparound trainings

• CMHB funded State HF Wraparound Coordinator to support school Wraparound implementation

Creating a Unified Approach

CMHB

OPI

Ingredients for Collaborative Work

• Trusting Relationships between State Department staff• Vertical and Horizontal

Communication Channels• Passionate Innovators• Open Minds• Child and Family Centered Approach

State Departments…CM

HB

and

OPI Agree to

blend the practice of mental health and education services.

CMH

B an

d O

PI Train employees to ensure both agencies are trained in MBI and High Fidelity wraparound.

CMH

B an

d O

PI Agree to share materials, process and progress measurement tools and resources

Activity• Identify your State/District

Strengths and Needs for community school-collaboration

Integrating Practice In Missoula

• HF Wraparound staff and school based PBIS staff initiated a process to ensure that crosswalk comes to fruition.

• Let’s look at how this will be implemented.

Creating Common Commitments in Missoula

CMHB OPI/Pilot SiteFree HF Wrap 101 trainings for school staff -texts and workbooks along with support in credentialing

Free PBIS/Wrap presentation in HF Wrap 101

Monthly Facilitator Coaching for both school and community staff

Free PBIS training for Peer to Peer Coach and HF Wrap facilitators

“Hands on” site specific training in cross walk implementation

Develop HF/School Wraparound model through crosswalk (paper work, process)

Access to CMHB Peer to Peer Coach Develop referral process for Peer to Peer Coaches and parents in need of support

Creating Sustainable Coordinated Practices

State support for HF Wrap

and PBIS

Ongoing training for new staff

Ongoing coaching for existing staff

School/Community referral and

collaboration

Blending funding and

resources

Increasing Parent & Family Involvement

• School based wraparound teams have access to and understand role of the Peer to Peer supports.

• The Peer to Peer Coach works with pilot site staff to increase parent involvement.

• School staff assist Peer to Peer Coach in identifying and involving parents– Supporting the development of Peer to Peers

within the schools offers parents more opportunities to be involved in multiple domains within the Wraparound process.

BENFITS of Collaboration

• Support for wraparound staff in schools on individualized interventions for children in need of wraparound.

• Access to consultation and implementation of high fidelity wraparound process.

• State Wraparound Coordinator available to MBI coaches for skill building and trouble-shooting

• MBI coaches available to State Coordinator for skill building

Benefits…• Cross training community and school

based wraparound coaches and staff• Ongoing assistance in development of Tier

3 wraparound interventions by a State HF Wraparound Coordinator (credentialed as a national wraparound mentor)

• Consultation on planning, functional behavior assessments, and crisis planning from the high fidelity wraparound curriculum

Benefits…• An integrated agreement to blend the

wraparound plan if receiving both community and school supports.

• Flexibility and support to ensure consistent functional behavior assessments and crisis plans across domains.

• Getting the best of both worlds (i.e. Strengths, Needs, and Culture Discoveries and Home School Community Tool).

School Wrap HF Wrap

Community resources

Fidelity

Family Engagement

Data based Decision making

Academic Engagement

Access to Tier 1 and 2 interventions

Program Strengths…

Activity• What facilitator strengths do each

training model foster? What are needs facilitators might have based on training model?

Thank you!