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Connecting the Dots: How to Integrate Mental Health Initiatives within Existing Behavior Support
Structures
UFGainesville
May 30, 2017
Lucille Eber Ed.DMidwest PBIS Network and
National PBIS TA Center [email protected]
Alignment
MentalHealth
PBIS
ISF
Practicalstrategies
Resources(Free)
Agenda for Today:
Freeofcharge
Freeparking(?)
FREELunch
Researchsharing(brief)
Noondeparture
1. UnderstandneedforaligningrelatedinitiativesattheDistrictLevel.
1. Identifyaprocess/toolsforaligning.
2. UnderstandneedforinterconnectingMTSS-B/PBISandMentalHealth.
3. Identifyprocess,structures,toolsforstrengtheningfoundationsofMTSofPBISwhileintegratingmentalhealthandothercommunitypartners.
1. Identify1or2“takebacktoteam(s)”strategies/examples/toolstoinformactionstepsforstrengtheningyourcurrentsystemstoexpediteoutcomesformostvulnerablepopulations.
PossibleLearningObjectivesforToday
Describe how interventions for students with significant mental health challenges can be efficiently delivered within a school-widesystem of Positive Behavior Supports.
Share examples of how individualized interventions, can be layered up from an effective school-wide PBS curriculum.
Level 2 BIG Ideas for Today:
YourOpportunitiestoRespond
1. ABIGIdeaI“get”andcanmaybeshare?
1. ABigIdeaIamstill“circling”?
1. ABIGIDEAIcantakebackandwecanDO?
WhyInvestinAlignment?
• Unaligned efforts are ineffective and inefficient
• Doing many things, but none of them well• Initiative fatigue (Project 1= Monday, Project 2 =Wed, Project 3
=Thurs)• Assumption that New is better… .More is better• Political value of “touching” many efforts (“we have XXX in our school”)• Assumption that if we train individuals in many things THEY will do the
alignment and integration on their own.
Alignment• New emphasis on “sustainability” and “efficiency” have heightened
attention on the need for effective systems of alignment.
• McIntosh– One of the major variables to sustained implementation of effective
practices is the introduction of new initiatives that either (a) compete with resources needed for sustained implementation or (b) contradict existing initiatives.
• We know more about how to conduct small-scale “demonstrations” than how to take effective demonstrations and make the highly efficient “standard operation procedures.”
Definealignment
SourcesofFrustration
• The “Shotgun” approach
• The Parallel Play Approach
• Initiative Conflict
• Monogamy (one way)
• Serial Monogamy
FeaturesofEffectiveAlignment• Begin by defining the “unit” of impact (school, district, community)• Define WHO will own the goal of establishing alignment
– Need a leadership team who operates at the point where budgets for all initiatives converge• Define the “problem” with precision
– What is the difference between what we have and what we want?– Define a goal (or goals)
• Commit to using “evidence-based practices” that are appropriately “fit” with the culture of the setting
– Build an agreement to only adopt new initiatives (programs) if they meet standards for being evidence-based, logistically practical, culturally fit, better than what you already have
– Require any new initiative to have a Measure of Fidelity and a Measure of Impact• Conduct resource mapping to define what you already are doing
– Most context are already doing many initiatives as the plan to adopt something new• Organize “practices” around core features that achieve your goal
– Get content experts to help define practices and core features
ProcessofAlignment
• Define team with authority to guide alignment• Define common outcome measure based on “goal”• Define common fidelity measure based on “core feature” and content
practices• Conduct a “practices audit”
– Don’t try to combine… rather build• Design Professional Development Plan
– Build foundation practices– Then include “value added” elements
• Start with Alignment of Practices but always build common SYSTEMS – Team structure and function– Data systems for fidelity and impact– Training and Coaching of operational units (teams) not individuals– Continuous improvement system to adapt to local community
EffectiveAlignmentofInitiatives:PBIS,RestorativePractices,SecondStep
RestorativePractices
SecondStep PBIS
OrganizationalUnit
FidelityandOutcomeMeasures
CoreFeatureSummaryforeachInitiative
SingleProfDevelPlan
(withcoaching,policy,datasystems)
UseDistrict-LevelLeadershipTeamforcoordinationandimplementation.
UseRestorativePracticesfortheclassroomandadministrator“consequencesystem”…supplemented withdistrictpolicyandprocedures forsafety.
UseSecondStepmaterialsandprocedurestoteachschool-wideexpectations.
UsePBISframeworkforteamdevelopment, rewardsystem,familyengagement,bullyprevention, classroommanagementprotocols,datasystem,andTierII,TierIIIsupports.
UsePBISfidelitymeasures(TFI)andSISEPDistrictCapacityAssessment(DCA)toassessdevelopmentoforganizational capacity.
UsePBISstudentoutcomemeasures(OfficeDisciplineReferrals,Attendance,Suspension,Expulsion) Add…juvenile justicecontacts/arrests.
LogicModelsMatter:ResolveLogicConflictattheHighestLevel
• Consider not only what is being recommended but the assumptions about WHY recommendations should work.– Remember nearly all initiatives have a useful contribution
• Initiatives with conflicting logic models are more difficult to align.– Discovery Learning vs. Explicit Instruction– Teach emotions to guide behavior vs. Teach the Behaviors you Want.– Rewards damage intrinsic motivation vs. Rewards build intrinsic
motivation– Facilitated Communication
• It is worth taking time to find common ground.– Restorative justice
Wisconsin DPI
Why use the PBIS framework for trauma-sensitive schools?
The fundamental purpose of PBIS is to make schools more effective & equitable learning environments.
Rob Horner, Co-Director of the OSEP Technical Assistance Center for PBIS
Predictable
Consistent
Positive
Safe
WIDepartmentofPublic Instruction Trauma-SensitiveSchoolsResourceshttp://sspw.dpi.wi.gov/sspw_mhtrauma
Teaching Matrix
INCORPORATE Trauma Informed Strategies
All Settings Halls Playgrounds Classroom
Library/Computer Lab
Assembly Bus
Respectful
Be on task.Give your best effort.
Be prepared.
Walk. Have a plan.Study, read,
compute.
Sit in one spot.
Watch for your stop.
SafeBe kind.
Hands/feet to self.
Help/share with others.
Use normal voice
volume.Walk to right.
Share equipment.
Include others. Whisper.Return books.
Listen/watch.
Use appropriate applause.
Use a quiet voice.Stay in
your seat.
ResponsibleRecycle.Clean up after self.
Pick up litter.
Maintain physical space.
Use equipment properly.
Put litter in garbage can.
Push in chairs.Treat books
carefully.
Pick up.Treat chairs
carefully.
Wipe your feet.
Expe
ctations
Self CheckUse Calming
Strategy
UseyourwordsUsesafehands
Ask for helpConnect with Safe Person
Alignment:Defined
• Alignment:– “To be in precise adjustment or correct relative position”
– “The proper positioning of parts in relation to each other.
• Organizational Alignment– The simultaneous implementation of multiple initiatives with
efficiency and effectiveness.
16
WhyAlignmentisImportant
• New emphasis on “sustainability” and “efficiency” have heightened attention on the need for effective systems of alignment.
• “One of the major variables affecting sustained implementation of effective practices is the introduction of new initiatives that either (a) compete with resources needed for sustained implementation or (b) contradict existing initiatives.”
McIntosh (2015)
17
YourExamples
• Initiatives to improve early literacy
• Initiatives to improve social behavior
• Initiatives to reduce drop out
• Initiatives to enhance mental health
NPR
TheSilentEpidemic:TheMentalHealthCrisisinourSchools
publishedon-lineSeptember7,2016
NPRStoryConclusion:
In Schools, Mental Health should be
EVERYONE’s Job
Partnershipsareneeded:
• Onein5youthhaveaMH“condition”
• About80% ofthosegetnotreatment• Schoolis“defacto”MHprovider• JuvenileJusticesystemisnextlevelofsystemdefault• Suicideis2ndleadingcauseofdeathamongyoungadults• Factorsthatimpactmentalhealthoccur‘roundtheclock’• Itischallengingforeducatorstoaddressthefactorsbeyond
school• Itischallengingforcommunityproviderstoaddressthe
factorsinschool
Confusionaboutwhatconstituteseffectivesupport?
• Exclusion(orplacements)seenas“intervention”• Confuselabelas“intervention”• Confusepaperworkwithintervention• Confusepeoplewithinterventions• Notsogreatinterventions• Notsogreatfidelity• Resourcesnotallocatedcommensuratewithneeds
DidHenry“need”arestrictiveplacement?
QuickStudentExample#1:Studentw/EBDmovestonewDistrict
0
20
40
60
80
100
9/3 9/10 9/17 9/24 10/1 10/8
% o
f Goa
l Ach
ieve
d
%of Daily Total CICO Points
Henry’sDailyPointDataforBehavioralGoals
DidHenry“need”arestrictiveplacement?
Oreffectiveinterventions?
FailedInterventionsareNotNeutral
• Theyleavearesidualeffect…
WeKnowthePracticesthatWorkforStudentswithsignificantsocial/emotional/behavioralneeds…
• Proactive,strength-based;“setkidsup”toexperiencesuccess
• Highratesofconsistent,supportedinstruction;teach/practice/reinforce
• Predictableandconsistentenvironments• Knowunique“why?”foreachstudent/problem• Contextualfit:Strategicuseofnaturalsupports,and
settings• Carefulmonitoringofdataovertimewithongoing
revisionstoguideincrementalimprovementsinqualityoflife
• Behaviorsupportistheredesignofenvironments,nottheredesignofindividuals.
• Positivebehaviorsupportplansdefinechangesinthebehaviorofthosewhowillimplementtheplan.Abehaviorsupportplandescribeswhatwe willdodifferently.
Do ALL staff understand the context for effective behavior interventions?
CoreFeaturesofMTSS:
• Teambasedleadershipandcoordination• Evaluationofimplementationfidelity• Continuumofevidence-basedpractices• Continuousdata-basedprogressmonitoringanddecision-making
• Comprehensiveuniversalscreening• On-goingprofessionaldevelopmentincludingcoachingwithlocalcontentexpertise
AdvantagesofPBISFramework
• Promoteseffectivedecisionmaking• Improvesclimate&learningenvironment• Changesadultbehavior• Reducespunitiveapproaches• ReducesOSSandODRs• Improvesstudentacademicperformance
ExperimentalResearchonSWPBIS
Bradshaw,C.P.,Koth,C.W.,Thornton,L.A.,&Leaf,P.J.(2009).Alteringschoolclimatethroughschool-widePositiveBehavioralInterventionsandSupports:Findingsfromagroup-randomizedeffectivenesstrial. PreventionScience,10(2),100-115
Bradshaw,C.P.,Koth,C.W.,Bevans,K.B.,Ialongo,N.,&Leaf,P.J. (2008).Theimpactofschool-widePositiveBehavioralInterventionsandSupports(PBIS)ontheorganizationalhealthofelementaryschools. SchoolPsychologyQuarterly,23(4),462-473.
Bradshaw,C.P.,Mitchell,M.M.,&Leaf,P.J.(2010).ExaminingtheeffectsofSchool-WidePositiveBehavioralInterventionsandSupportsonstudentoutcomes:Resultsfromarandomizedcontrolledeffectivenesstrialinelementaryschools. JournalofPositiveBehaviorInterventions,12, 133-148.
Bradshaw,C.P.,Reinke,W.M.,Brown,L.D.,Bevans,K.B.,&Leaf,P.J. (2008).Implementationofschool-widePositiveBehavioralInterventionsandSupports(PBIS)inelementaryschools:Observationsfromarandomizedtrial. Education&TreatmentofChildren,31, 1-26.
Bradshaw,C.,Waasdorp,T.,Leaf.P., (2012)EffectsofSchool-widepositivebehavioralinterventionsandsupportsonchildbehaviorproblemsandadjustment.Pediatrics,130(5)1136-1145.
Horner,R.,Sugai,G.,Smolkowski,K.,Eber,L.,Nakasato,J.,Todd,A.,&Esperanza,J.,(2009).Arandomized,wait-listcontrolledeffectivenesstrialassessingschool-widepositivebehavior supportinelementaryschools.JournalofPositiveBehaviorInterventions,11, 133-145.
Horner,R.H.,Sugai,G.,&Anderson,C.M.(2010).Examiningtheevidencebaseforschool-widepositivebehavior support.FocusonExceptionality,42(8),1-14.
Ross,S.W.,Endrulat,N.R.,&Horner,R.H. (2012).Adultoutcomesofschool-widepositivebehavior support.JournalofPositiveBehavioralInterventions.14(2)118-128.
Waasdorp,T.,Bradshaw,C.,&Leaf,P.,(2012)TheImpactofSchoolwide PositiveBehavioralInterventionsandSupportsonBullyingandPeerRejection:ARandomizedControlledEffectivenessTrial.ArchiveofPediatricAdolescentMedicine. 2012;166(2):149-156
Bradshaw,C.P.,Pas,E.T.,Goldweber,A.,Rosenberg,M.,&Leaf,P. (2012).Integratingschoolwide PositiveBehavioralInterventionsandSupportswithtier2coachingtostudentsupport teams:ThePBISplus Model.AdvancesinSchoolMentalHealthPromotion,5(3),177-193.doi:10.1080/1754730x.2012.707429
Freeman,J.,Simonsen,B.,McCoach D.B.,Sugai,G.,Lombardi,A.,&Horner, (submitted)ImplementationEffectsofSchool-widePositiveBehaviorInterventionsandSupportsonAcademic,Attendance,andBehaviorOutcomesinHighSchools.
AdvancingEducation
Effectiveness:InterconnectingSchoolMentalHealthandSchool-Wide
PositiveBehaviorSupport
Editors:SusanBarrett,LucilleEber andMarkWeist
pbis.orgcsmh.umaryland
IDEAPartnershipNASDSE
ISFNationalLeadershipTeam
• SusanBarrett,Director,[email protected]
• LucilleEber,Director,[email protected]
• BobPutnam, ExecutiveVicePresidentofPBISandConsultation,[email protected]
• KellyPerales,DirectorofTrainingandTechnicalAssistancePBIS/MHIntegration,[email protected]
• MarkWeist,Professor,Clinical-CommunityandSchoolPsychology,USouth [email protected]
• SharonStephan, Co-Director,[email protected]
• NancyLever, Co-Director,[email protected]
• ElizabethConnors,AssistantProfessor,DirectorPerformanceMeasurement,[email protected]
• JoniSplett,AssistantProfessor,[email protected]
• AshleyQuell,[email protected]
DevelopmentofISF• 2002-2007:SiteDevelopmentwithPBISExpansion(informaland
independent)• 2005:CoP focusonintegrationofPBISandSMH• 2008:ISFWhitePaper:formalpartnershipbetweenPBISandSMH• 2009- 2013Monthlycallswithimplementationsites,national
presentations(fromsessionstostrands)• 2009-2011GrantSubmissions• June2012- September2013ISFMonograph• MonographAdvisorygroup• 2015:ISFLearningCommunity,SOCWebinarSeries• 2016:RCTGrantawarded• 2016:TargetedWorkGroupWebinars(8)• 2017:TargetedWorkGroupWebinarscontinuing
The Interconnected Systems Framework (ISF)
How Multi-Tiered Systems of Support (MTSS) can enhance mental health in schools
Installing MH through MTSS in Schools– Systems– Data– Practices
ItTakesaSystem…
…..thatbuildssystemcapacityforadvancedtiers
SupportingStaff Behavior
SupportingDecisionMaking
SupportingStudent Behavior
PositiveBehaviorSupport
PRACTICES
OUTCOMES
Social Competence &Academic Achievement ٭
Adapted from “What is a systems Approach in school-wide PBS?”OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.Pbis.org/schoolwide.htm
Where do specific “MH” Interventions Fit?That depends on the data of
the school & community
Examples of Expanded View of Data
Child welfare contacts Violence ratesIncarceration ratesDeployed families Homeless families Unemployment spikes
Trauma-sensitive schoolsTrauma-sensitive schools
recognize the prevalence & impact of traumatic occurrence in students’ lives &
create a flexible framework that provides universal supports, is sensitive to the unique needs of students & is mindful of avoiding re-traumatization.
WIDepartmentofPublicInstructionTrauma-SensitiveSchoolsResourceshttp://sspw.dpi.wi.gov/sspw_mhtraumaAdapted from Helping Traumatized Children Learn
WIDepartmentofPublicInstructionTrauma-Sensitive Schools Resourceshttp://sspw.dpi.wi.gov/sspw_mhtrauma
KeyMessages
1.SingleSystemofDelivery
3.MentalHealthisforALL
4.MTSSessentialtoinstallSMH
An Interconnected Systems Framework
1.SingleSystemofDelivery• Onecommittedandfunctionalteamwithauthorityguides
thework,usingdataatthreetiersofintervention• MHparticipatesacrossALLTiers• EvidenceBasedPractices/Programsintegratedateachtier• Symmetry(ofprocess)atDistrictandBuildinglevel
• DistricthasaplantointegrateMHatallbuildings• Planisbasedoncommunityandschooldata
• Plantobuild“socialemotional”capacityacrossstaff• TrainingandCoachinginplaceforALLstaff(communityand
schoolemployed)• Staffarecompetentandconfidentinidentifying,intervening
and/orreferring
Traditional
MHcounselor“sees”studentatappointments
Cliniciansonlydo“mentalhealth”
Casemanagementnotes
AnInterconnectedSystemsFramework
MHpersononteamsatalltiers.Interventionsaredefined(corefeatures,dosage.Frequency,
outcomes)
MHiseveryone’sjob.Clinicianscontributetointegratedplan
FidelityANDoutcomedatadeterminedbeforedelivery;
datamonitoredcontinuouslybyteams
Individualization and Intensity ofInterventions Increases
A Few Students
>5%
ALL Students
100%
Some Students
>15%
Tier1Interventions&Supports- StructuredBehaviorInterventions forallstudents• PRIDEExpectationMatrix,
• PRIDEClassroomExpectations&PRIDEClassroomLessons• GuidanceServices,
• HomeroomGuidance• ContinuumofDisciplineResponses
• Student/ParentConferences,• Before&AfterSchoolProgram• ProjectSuccess(SubstanceUse)
Tier2:BehavioralInterventions&Supports- Supports forsomestudentswhostrugglewithmeetingtheexpectations
• SimpleBehaviorSupportPlans• SimpleFunctionalBehavioralAssessments(FBA)
• TargetedCounseling,• CopingCAT
• AcademicSeminar• Check In/CheckOut,
• Mentoring
Tier3:Individualized Supports -Structured Interventions forthefewstudentswiththegreatestneed
• ComplexFunctionalBehavioralAssessment(FBA)andBehaviorSupport• 3R(Respectful,Relevant,Realistic)Plan(s)
• IndividualizedFamilyandYouth-DrivenPlanningandSupport• CommunitySupports (WRAP,DCYF,MentalHealth,andChildandFamilyServices)
• EnhancedAcademicSeminar
MSPyramidofInterventions
2.AccessisNOTenoughAllworkisfocusedonensuringpositiveoutcomesforALLchildrenandyouthandtheirfamilies.
• Interventionsmatchedtopresentingproblemusingdata,monitoredforfidelityandoutcome
• Teamsandstaffareexplicitabouttypesofinterventionsstudentsandyouthreceive(e.g.from“studentreceivescounseling”to“studentreceives4copingskillsgroupsessions)
• SkillsacquiredduringsessionsaresupportedbyALLstaff(e.g.staffareawarethatstudentisworkingondevelopingcopingskillsandprovidesprompts,pre-corrects,acknowledgesacrossschoolday)
Pre/PostCopingCatStudentsReportontheSCARED
(n=18)
35
36
37
38
39
40
41
42
43
44
45
PreCopingCat PostcopingCat
AverageNumberofAbsencesperStudent(FullDays)
Pre(7weeksprior togroup); During (8schoolweeksofintervention);Post(7weeksaftergroup)
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
Pre-CopingCat DuringCopingCat PostCopingCat
AverageNumberofVisitstotheNurse(perweek)
Pre(7weeksprior togroup); During (8schoolweeksofintervention);Post(7weeksaftergroup)
0
1
2
3
4
5
6
7
8
9
Pre-CopingCat DuringCopingCat PostCopingCat
CaseExample#18th GradeFemaleStudent
0
10
20
30
40
50
60
70
80
SCAREDPre SCAREDPost AttendancePre
AttendanceDuring
AttendancePost
NuresPre NurseDuring Nursepost
3.MentalHealthisforALL• Positiveschoolclimateandcultureservesasprotectivefactor.
• Social/emotional/behavioralhealthaddressedwithsamelevelof
attentionandconcernasisourchildren’sacademicand
cognitiveachievement.
• SocialbehaviorskillstaughtandreinforcedbyALLstaffacross
ALLsettings,andembedded inALLcurriculum
• Behaviorexamplesusedtoexplicitlyteachwhatbehaviorslook
likeandsoundlikeacrossschoolsettings.
EBP=TeachingSkills(sameforsocial/emotionalasforacademics)
Define simply
Model/demonstratew/rangeofexamples
Practice inrangeofnaturalsettings
Monitor&providepositivefeedback&reinforcement
Basedondata,adjustinstruction&reteach
Teaching Matrix
INCORPORATE Coping Strategies for Managing Stress
All Settings Halls Playgrounds Lunch
Library/Computer Lab
Assembly Bus
Respectful
Be on task.Give your best effort.
Be prepared.
Walk. Have a plan.Study, read,
compute.
Sit in one spot.
Watch for your stop.
Achieving&
Organized
Be kind.Hands/feet
to self.Help/share with others.
Use normal voice
volume.Walk to right.
Share equipment.
Include others. Whisper.Return books.
Listen/watch.
Use appropriate applause.
Use a quiet voice.Stay in
your seat.
ResponsibleRecycle.Clean up after self.
Pick up litter.
Maintain physical space.
Use equipment properly.
Put litter in garbage can.
Push in chairs.Treat books
carefully.
Pick up.Treat chairs
carefully.
Wipe your feet.
Expe
ctations
Have a lunch plan and choose quiet or social
lunch area
Invite friends to join me
Invite those sitting alone to
join in
Use my breathing technique
Listen to my signals
4.InstalledandalignedwithcorefeaturesofMTSSframework.
«Teams«Data-basedDecision- making«ContinuumoflinkedEBP’s«Screening«Progressmonitoring«OngoingPD/coaching
Are these features in place (or partially/in progress) in your district?
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
ConsiderFeaturesofSWPBISw/regardstoyouthwithEBD
Module1:PBISTeamModule2:FacultyCommitmentModule3:ExpectationsandRulesModule4:LessonPlansModule5:AcknowledgementModule6:DisciplineProceduresModule7:DataEntryandAnalysisModule8:ClassroomBehaviorSystemsModule9:EvaluationModule10:ImplementationPlan
CommonLanguageExpectations 3-5overarchingschool-wide
expectations
Behaviors/Rules specifictasksstudentsaretodotoachievetheschool-wideexpectations
Routines/Procedures methodsorprocessforhowthingsaredoneinnon-classroomsettingsandeachclassroom
Howwillweteachbehavior?Whenwillweteachbehavior?
Kick-offevents– Teachingstaff,studentsandfamiliestheexpectationsandrules
On-goingdirectinstruction– Data-drivenandscheduleddesignedlessons– Pre-correction– Re-teachingimmediatelyafterbehavioralerrors
EmbeddingintocurriculumBoostertrainings
– Scheduledanddata-driven
Continuedvisibility– VisualDisplays– posters,agendacovers– Dailyannouncements– Newsletters
Guidelines• School-widereinforcementsareforevery student• Acknowledgethebehavior• Includethestudents inidentifyingpossiblerecognitions
• Recognizestudentsotherthanyourownincommonareas
• Recognitioncloselyfollowsthedesiredbehavior• Keepitnovel
Tier 1/UniversalSchool-Wide Assessment
School-Wide Prevention Systems
SIMEO Tools: HSC-T, RD-T, EI-T
Check-in Check-out (CICO)
Group Intervention with Individualized Feature (e.g., Check and Connect - CnC and Mentoring)
Brief Functional Behavior Assessment/Behavior Intervention Planning (FBA/BIP)
Complex or Multiple-domain FBA/BIP
Wraparound
ODRs,Credits, Attendance,
Tardies, Grades, DIBELS, etc.
Daily Progress Report (DPR)
(Behavior and Academic Goals)
Competing Behavior Pathway, Functional Assessment Interview,
Scatter Plots, etc.
Social/Academic InstructionalGroups (SAIG)
PositiveBehaviorInterventions&Supports:AResponsetoIntervention(RtI)Model
Tier 2/Secondary
Tier 3/Tertiary
Individual StudentInformation System (ISIS)
USDOE-OSEP Tertiary Demo Project
#H326M0060010
MoreStudentsAccessTier2/3InterventionsWhenTier1/UniversalisinPlace
7.94%
4.95%
0%2%4%6%8%
10%
Partially Implementing(n=26)
Fully Implementing(n=125)
% s
tud
en
ts
FY09SchoolProfileToolStudentsAccessingTier2/Tier3Interventions
Reflection:AccesstoTier1/2
Thinkof2 studentswhoyouthinkneed(oralreadyaccessing)intensivelevelsupports.
- WhatistheircurrentaccesstoTier1looklike?Tier2?
- HowisorhowcouldTier1be‘tweaked”toensurettheyexperiencemoresuccess?
Tier2/Tier3…..ChangingExistingSystems
• Harderthanstartingfromscratch• Schoolsthinktheyare“alreadydoingit”…–Needto“deconstruct” someexistingteamingapproachesandpractices
–Datanotbeingusedexcepttojustifyplacements
TIER2/3:InterventionExamples,Decision-RulesandTools
Reflection:InterventionsatyourSchools?
1. Identify a Tier 2/3 intervention example you are installing or implementing in your school(s).
1.How is it connected down to Tier 1?
1.How does it provide a foundation for building a Tier 3 intervention?
FailedInterventionsareNotNeutral
• Theyleavearesidualeffect…
ExamplesofIneffectiveSecondary/TertiaryStructures
• ReferralstoSp.Ed.seenasthe“intervention”
• FBAseenasrequired“paperwork” vs.aneededpartofdesigninganintervention
• Interventionsthesystemisfamiliarwithvs.oneslikelytoproduceaneffect– (ex:studentsentforinsightbasedcounselingatpointofmisbehavior)
ExampleofChangethatmaybeNeeded
• “Groups” thatarenotevidence-based• Clinicians“seeing” studentsw/oclarityofinterventionanddatatodetermineeffectiveness
• Re-installFBA/BIPprocesswithfocusoneffectivenessvscompliance
3-Tiered System of Support
Necessary Conversations (Teams)
Check-In Check-Out
Skills Groups
Group w. individual
feature
ComplexFBA/BIP
Problem Solving Team Meeting
Tertiary Systems Team Meeting
Brief
FBA/BIP
Brief FBA/BIP
Wraparound
Secondary Systems Team
Meeting
Plans schoolwide &
classroom supports
Uses process data; determines overall
intervention effectiveness
Standing team; uses FBA/BIP process for one student at a time
Uses process data; determines overall
intervention effectiveness
UniversalTeam
Meeting
Universal Support
USDOE-OSEP Tertiary Demo Project
#H326M0060010
Coordinatorvs.FacilitatorCoordinator
• Organizesand/oroverseesthespecificinterventionssuchasCICO,S/AIG&GroupwithIndividualFeatures
• Rolesinclude:schedulingmeetings,review&collectdatatoshareduringteammeetings,etc…
Facilitator• Directlyprovidesinterventionsupportservicestoyouth/families
• Rolesinclude:meetingwithstudentsforCICO,runninggroups
USDOE-OSEP Tertiary Demo Project
#H326M0060010
USDOE-OSEP Tertiary Demo Project
#H326M0060010
Tier 2/Tier 3 Tracking Tool
http://tinyurl.com/hzr9ufy
Check-in-Check-out(CICO)
• Merely an extension of Tier 1• Some get high frequency scheduled positive
contact with adults• Youth solicit the positive contact/feedback• Low effort for teacher if built on Tier 1• Need to have 7-12% accessing if it is to come
to be a routine in your school(s)• If you only have 1-2% on CICO, those are
likely to be kids who need more….
Whydoyouwant7-12%onCICO?
1. Kidswhohere-to-forwouldhavegottennothing(‘tilthey‘gotworse”)nowgetapositiveboostofsupport(seaofineligibility)
2. Allteacherswillexpectthateverydaytheywillhavekidscrosstheirthresholdwhoneedhigherrateofpositivecontact
3. Quicker/easiertosupportkidswhoneedTier3
4. StructuretobuildtransferenceandgeneralizingfromSocialSkillsinstructionalgroupsandfunction-basedbehaviorplans
Social/AcademicInstructionalGroups
• Selectionintogroupsshouldbebasedonyouths’ reactiontolifecircumstancenotexistenceoflifecircumstances(ex.fightingwithpeers,notfamilydivorce)
• Goalsforimprovementshouldbecommon acrossyouthinsamegroup(ex.useyourwords)
• DatashouldmeasureifskillsarebeingUSED innaturalsettings,notincounselingsessions(transferenceofskillstoclassroom,caféetc.)
• Stakeholders (teachers,familyetc.)shouldhaveinputintosuccessofintervention(ex.DailyProgressReport)
DailyProgressReport(DPR)SampleNAME:______________________ DATE:__________________
Teacherspleaseindicate YES(2),SO-SO(1),orNO(0)regardingthestudent’sachievementinrelation tothefollowingsetsofexpectations/behaviors.
EXPECTATIONS1 st block 2 nd block 3 rd block 4 th block
Be Safe 2 1 0 2 1 0 2 1 0 2 1 0
Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0
Be Responsible 2 1 0 2 1 0 2 1 0 2 1 0
Total Points
Teacher Initials
AdaptedfromGrantMiddleSchool STARCLUB
RespondingtoProblemBehaviorinSchools:TheBehaviorEducationProgram byCrone,Horner,andHawken
DailyProgressReport(DPR)SampleNAME:______________________ DATE:__________________
Teacherspleaseindicate YES(2),SO-SO(1),orNO(0)regardingthestudent’sachievementinrelation tothefollowingsetsofexpectations/behaviors.
EXPECTATIONS1 st block 2 nd block 3 rd block 4 th block
Be Safe 2 1 0 2 1 0 2 1 0 2 1 0
Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0
Be Responsible 2 1 0 2 1 0 2 1 0 2 1 0
Total Points
Teacher Initials
AdaptedfromGrantMiddleSchool STARCLUB
RespondingtoProblemBehaviorinSchools:TheBehaviorEducationProgram byCrone,Horner,andHawken
“Social & Academic
Instructional Groups”
Walk to classKeep hands to self
Use appropriate language
Raise hand to speak
Bring materials Fill out assignment
notebook
Daily Progress Report (DPR) SampleNAME:______________________ DATE:__________________
EXPECTATIONS1st block 2nd block 3rd block 4th block 5th block 6th block 7th block
Be Safe 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0
Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0
Be Responsible 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0
Total Points
Teacher Initials
“Social & Academic Instructional
Groups”(sample coping skills group)
Label feelingUse deep breathing
Use calm words with peers
Let teacher know feeling temperature if
above yellow
DailyProgressReport(DPR)SampleNAME:______________________ DATE:__________________
Teacherspleaseindicate YES(2),SO-SO(1),orNO(0)regardingthestudent’sachievementinrelation tothefollowingsetsofexpectations/behaviors.
EXPECTATIONS1 st block 2 nd block 3 rd block 4 th block
Be Safe 2 1 0 2 1 0 2 1 0 2 1 0
Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0
Be Responsible 2 1 0 2 1 0 2 1 0 2 1 0
Total Points
Teacher Initials
AdaptedfromGrantMiddleSchool STARCLUB
RespondingtoProblemBehaviorinSchools:TheBehaviorEducationProgram byCrone,Horner,andHawken
Trauma-InformedTier 2 Group
Self-CheckUse calming strategy
Use your wordsUse safe hands
Ask for helpConnect with safe
person
DailyProgressReport(DPR)SampleNAME:______________________ DATE:__________________
Teacherspleaseindicate YES(2),SO-SO(1),orNO(0)regardingthestudent’sachievementinrelation tothefollowingsetsofexpectations/behaviors.
EXPECTATIONS1 st block 2 nd block 3 rd block 4 th block
Be Safe 2 1 0 2 1 0 2 1 0 2 1 0
Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0
Be Responsible 2 1 0 2 1 0 2 1 0 2 1 0
Total Points
Teacher Initials
AdaptedfromGrantMiddleSchool STARCLUB
RespondingtoProblemBehaviorinSchools:TheBehaviorEducationProgram byCrone,Horner,andHawken
“Tier 3 Plan with Trauma-Informed
Strategy”
SOS (slow down, orient, self-check)Use mindfulness
Distract & Self-Soothe
Let ‘M Go
Make A LinkMake Meaning
DailyProgressReport(DPR)SampleNAME:______________________ DATE:__________________
Teacherspleaseindicate YES(2),SO-SO(1),orNO(0)regardingthestudent’sachievementinrelation tothefollowingsetsofexpectations/behaviors.
EXPECTATIONS1 st block 2 nd block 3 rd block 4 th block
Be Safe 2 1 0 2 1 0 2 1 0 2 1 0
Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0
Be Responsible 2 1 0 2 1 0 2 1 0 2 1 0
Total Points
Teacher Initials
AdaptedfromGrantMiddleSchool STARCLUB
RespondingtoProblemBehaviorinSchools:TheBehaviorEducationProgram byCrone,Horner,andHawken
Use your wordsUse deep breathing
Keep arm’s distance
Use #2 voice level when upset
Ask for breaksSelf-monitor with
DPR
Individualized Student Card
(FBA/BIP)
ExampleSpring2014:IdentifiedNeed
• Asmall (15)groupofstudentswhowereaskingtogototheofficeonadailybasisorwerefrequentlyabsent– Mostbehaviorswereinternalizing:anxiety,withdrawal,avoidanceof
others– Thesewerestudentswhoperformedacademically,notspecialeducation
eligible• Schoolpsychologistresearchedsmallgroupinterventionsforthesestudents• FoundCopingCat
Coping CAT is a Cognitive Behavioral Intervention that helps students recognize & analyze feeling related to stress & develop strategies to cope with stress provoking situations. It is an 8 week, group intervention that meets on a weekly basis for 45 minutes.
ModifiedCopingCatCopingCatsmallgroups(6students)areco-facilitatedbyaCommunityMentalHealthCounselorandaschoolcounselor.Studentresponsibilities includeparticipating inweeklygroupsessions, completinghomeworkassignments(usingcopingstrategies)&self-monitoringprogress.
Teacherresponsibilities includepromptingstudentstousetheircopingstrategies&awillingnesstoparticipateinprofessionaldevelopmentregardingstressmanagement&/oranxiety.CopingCatinstructorresponsibilities includeimplementing theCopingCatcurriculumwithfidelity&monitoringstudentprogress(OfficeVisitRequestsandAttendanceRate)withstudents&teachers.
Pre-postmeasure:ScreenforChildAnxietyRelatedDisorders(SCARED).Birmaher,Khetarpal,Cully,Brent,&McKenzie,1995.
Resource: Recorded webinarInstalling ISF-Local Experiences Integrating SOC & EducationA review of the core components of the ISF and experiences from SOC/Education efforts in New Hampshire. https://theinstitute.adobeconnect.com/p5sh4fur2al/
MethuenPublicSchoolsMethuen,MAJohnCrocker
SessionE8NationalPBISLeadershipForumOctober
28,2016
John Crocker
Comprehensive School Mental Health System National Quality Initiative Summit
April 26, 2016
Example– ScreeningforInternalizingProblems
• TwolargescalescreeningsatMethuenHighSchool– GAD-7anxietyscreener(January)– PHQ-9depressionscreener(April)
• ElectronicscreeningusingGoogleforms• Parentnotificationandopt-outprocessinadvance• 100%ofstudentswhorequiredfollow-upreceiveditwithin7
daysofthescreening
MethuenHS,cont.• Thetwoscreeningsyieldedthefollowingdata:
– GAD-7(January)• 840responses(approx.45%ofthehighschoolpop.)• 85studentsscoredinthesevererange(10.1%ofrespondents)• 104studentsscoredinthemoderaterange(12.4%ofrespondents)
– PHQ-9(April)• 853responses(approx.45%ofthehighschoolpop.)• 69studentsscoredinthesevererange(8.1%ofrespondents)• 102studentsscoredinthemoderaterange(12.0%ofrespondents)
– 8.1%ofstudentsscoredinthemoderateorsevererangeonbothscreeners
– 2.3%ofstudentsscoredinthesevererangeonbothscreeners
IntegrationofPositiveFamilySupportintoPBIS&RTI (TomDishonandKevinMoore)
Indicated
Selected
Universal
•FamilyCheck-Up•ParentingSupportSessions•ParentManagementTraining•CommunityReferrals
•ParentIntegrationCICO•Attendance&HomeworkSupport•Home-SchoolBeh ChangePlans•EmailandTextmessages
•FamilyResourceCenter•ParentingMaterials
(Brochures/Videos/Handouts)•PositiveFamilyOutreach•Student NeedsParentScreening
•IndividualizedSupports•FunctionalBehavioralAssessments
•SpecializedSupports•Check-In/Check-Out
• SchoolRules&Expectations
•PositiveReinforcement•Student NeedsScreening
(http://fcu.cfc.uoregon.edu/)
Check-In:YourOpportunitiestoRespond
1. ABIGIdeaI“get”andcanmaybeshare?
1. ABigIdeaIamstill“circling”?
1. ABIGIDEAIcantakebackandwecanDO?
WeKnowthePracticesthatWork…• Proactive,strength-based;“setkidsup” toexperience
success• Highratesofconsistent,supportedinstruction;
teach/practice/reinforce• Predictableandconsistentenvironments• Knowunique“why?” foreachstudent/problem• Contextualfit:Strategicuseofnaturalsupports,and
settings• Carefulmonitoringofdataovertimewithongoing
revisionstoguideincrementalimprovementsinqualityoflife
WeKnowtheSystemFeaturesNeededtoSupporttheEffectivePractices…
• ATeam uniquetoeachindividualchild&family– Blendthefamily/naturalsupportswiththeschoolrepresentativeswhoknowthechildbest
• AdefinedMeeting Process– Meetfrequentlyandusedata– Develop,implement,reviewrangeofinterventions
• FacilitatorRole– Bringingteamtogether– Blendingperspectives;guidingconsensus– Systematicuseofdata(strengthsandneeds)
Thepersonwhoissupposedtoimplementthestrategyneedstobeactivelyinvolvedindesigningit;oritprobablywon’twork!
Ownership&Voice:AKeytoInterventionDesign
Interventions…
Tier3Interventions
• Person-Centered(voiceandchoice)• Highlyindividualized(uniqueteamperstudent)• MultipleDataSources(addTier3data- Perceptiondata)
• Complexfunction-basedbehaviorplans• Wraparound/RENEW/FamilyFocusedPlans
DoAllStaffUnderstandtheContextforPBIS?
• Behaviorsupportistheredesignofenvironments,nottheredesignofindividuals.
• Positivebehaviorsupportplansdefinechangesinthebehaviorofthosewhowillimplementtheplan.Abehaviorsupportplandescribeswhatwe willdodifferently.
Problem Solving Steps
Step 1: Problem Identification
Step 2: Problem Analysis
Step 3: Intervention Design
Step 4: Response to Intervention Why is it occurring?
What’s the problem?
What are we going to do about it?
Is it working?
Setting Event Strategies
Antecedent Strategies
Teaching/ Instructional Strategies
Consequence Strategies
CompetingBehaviorPathwayBehaviorInterventionPlan
Neutralize/eliminate
settingevents
Add relevant & remove irrelevanttriggers
Teach alternativethat is more
efficient
Add effective & & removeineffectivereinforcers
BehavioralPathwaySettingEvent
DayswithGym
ProblemBehavior
Negativecommentsaboutactivityandtopeersleadingtophysicalcontact
Consequence
SentoutofP.E.class
Function
Toescapesetting
BriefFunction-basedInterventions
•SettingEventStrategies•Addcheck-inbeforegym
TeachingStrategies•Teachsocialskills(gettingalongwithothers,friendship,problemsolving,sportsmanship)
•Teachhowtoapproachgymteachertoaskforadrinkofwatertoleavesetting.
•Teachstudenthowtore-enterandcontinuewithactivity
ConsequenceStrategiesAcknowledging/rewardingstudentwhenusesnewskills(askingforadrinkofwatertoleave,usingrespectfullanguagewithpeers,beingagoodsport,etc..)
AntecedentStrategies•BehaviorLessonsforallstudentsaboutusingrespectfullanguagewithselfandothersandhowtobeagoodsport
•.Morefrequentactivitieswithlessfocusoncompetition(parachute,4-square,etc...)
•Pre-correct
TertiaryLevel“Coaches”HavetoHelpEstablishCapacity(Fidelity)forWraparound:
• Commitmentoftime• Commitmentto“stayattable”• Willingnesstoregroupandbesolution-focused
• Nojudgingorblaming• Timeforlisteningtostories• Timeforventing,validating
• Establishingconsensus• Voiceofstudent/familyinprioritizing• Establishingownership
TertiaryInterventionsPhasesofTier3Coaching
«Phase1:Modeling- Coachmodelsthedesiredskillsandcompetencies
«Phase2:SupportandFeedback- Coachprovidessupportandfeedback
«Phase3:Monitoring– Coachmonitorstoensurefidelity
WHAT DOES THIS LOOK LIKE AT A SCHOOL SITE?
MTSSMentalWellness
IdentificationofNeeds
Interventions/Programs
Sample High School: PBIS(Within Placer County CA)
«Third year of PBIS implementation– Tiers I and II are solid – Partially implementing Tier III (School
based Wraparound)
«50% reduction in office referrals
Sample High School: PBISSystems(SupportingAdultBehavior)¡ DistrictLeadershipTeam(guidedbyDCA)
¡ 2districtPBIScoachessupport18schoolsacrossthedistrict
¡ TierITeam&InterventionTeam¡ TeamcompletesTieredFidelityInventorytwotimesperyear(TierI=84%,TierII=75%,TierIII=34%)
Sample High School: PBIS
TierIII: Wraparound
TierII: CheckinCheckOutPeerMentoring
TierI: 4Pos.Rules(SOAR)RulesDefined/Taught-VideoAcknowledgmentSystemConsistentConsequencesUseofDataFamilyEngagement
Sample High School: School Mental Wellness (SMW)
• Current needs: Sample High School is a high performing school with a diverse student body of 2,000 students.
• Recent data indicates that Sample High School’s students reflect national trends with approximately 20% (400 students) reporting mental health concerns that are significant enough to cause impairment.
• California Healthy Kids Survey/school counselors report high number of students are leaving class and high levels of suicidal ideation.
MHprogramstoEnhanceTheirPBIS
TierIII:ASIST
TierII:MentalHealthFirstAid
ReconnectingYouth
TierI:EliminatingBarriersto
Learning(EBL)
Universal System to Identify Students with Possible Mental Health Needs
Five ModulesEliminatingBarriersforLearning:TheFoundation
Social-emotionaldevelopment,stigma,anddiscrimination
Social-Emotional Development,MentalHealth,andLearningOverviewofdisorders,effectsonlearning,riskfactors,andclassroomstrategies
MakingHelpAccessibletoStudentsandFamiliesFormulateaplantohelpstudentswithmentalhealthneeds
StrategiesToPromoteaPositiveClassroomClimateCreateaclimatethatpromoteslearningandmentalwellnessCreateaformalactionplanforpromotingmentalwellness
InfusingCulturalCompetenceintoMentalWellnessInitiativesPracticalconsiderationsfortheclassroomandcampus
MentalHealthFirstAid• 8-hour course that teaches you how to help
someone who is developing a mental health problem or experiencing a mental health crisis
• Helps you identify, understand, and respond to signs of mental illnesses and substance use disorders– A ssess for risk of suicide or harm– L isten nonjudgmentally– G ive reassurance and information– E ncourage appropriate professional help– E ncourage self-help and other support strategies
For more information about Youth Mental Health First Aid training, Visit: http://www.wishschools.org/resources/YMHFA.cfm
AppliedSuicideInterventionSkillsTraining(ASSIST)
• For caregivers who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide
• Two-day, highly interactive and practice-oriented workshop (15 hours)
• Develop skills – Learn how to communicate with a suicidal
individual – Recognize and review risk – Intervene to prevent the immediate risk of suicide– Understand resources available
• Peerclubsledbyanadvisorthatbringmentalhealthawarenesstocampus
• Clubsopentoallstudents,regardlessofmentalhealthstatus
• Clubspromotementalhealthactivitiesoncampus
• Strivetocreateasafeandstigmaanddiscrimination-freeenvironmentoncampus
• Createslife-longmentalhealthadvocates
Activitiesinclude:
• ParticipateintheDirectingChange
videocontest
• ParticipateinMentalIllnessAwarenessWeek
• Moviescreenings
• Hosteventsfeaturingspeakerswithlivedexperience
• Learningtheaccuratefactsaboutmentalillness
• Discussionsonhowtosupportfriends
• Identificationofon-andoff-campusresourcesandservices
• Advocatingfordistrictadministrationtocreatenewpoliciesoractionplansformentalhealthawareness,educationandpre/post–visionplans
Signs of Suicide ¡ Secondaryschool-basedsuicideprevention
programthatincludesscreeningandeducation¡ Studentsatriskreferredforprofessionalsupport
¡ Videoteachesstudentstorecognizesignsofdepressionandsuicideinthemselvesandothers
¡ Guidedclassroomdiscussionsaboutsuicideanddepression
- Acknowledge- Care- Tell
For more information about Suicide Prevention trainings, Visit: http://www.wishschools.org/resources/index.cfmOr https://dpi.wi.gov/sspw/mental-health/youth-suicide-prevention/training
Eliminating Barriers to Learning in Action
« Anna has been struggling to complete her assignment for the past few months and often appears worried in class. Her attendance has been poor, her grades recently declined and Ms. Dennis suspects that Anna may be abusing alcohol or drugs. Ms. Dennis responds by:
« Providing immediate support and « Referring Anna to Sample High School’s Intervention
Team
The Intervention Team at Sample High School
• The Intervention Team at Sample High School meets and after reviewing the progress on the effectiveness of their Tier II interventions and review progress monitoring data on specific students that have been placed into these interventions, the team begins reviewing new referrals.
• Ms. Dennis had completed a Request for Assistance Form for Anna and the team begins by reviewing this form.
• Specific concerns included: possible anxiety, possible drug use, frequent absences, withdrawal, and poor work completion
• The team decides to place Anna into a Tier II Intervention
ReconnectingYouth
75lessonsintheRYcurriculum.Itistypicallyofferedasasemester-long,for-creditclassbyateacher/facilitator–RYprogramgoals:¡ Increasedschoolperformance¡ Decreaseddruginvolvement¡ DecreasedemotionaldistressActivitiesFocusOn¡ Self-esteemEnhancement¡ DecisionMaking¡ PersonalControl¡ InterpersonalCommunication
CheckinCheckout
• The intervention Team Selects Check in Check out for Anna, below is her response to this intervention:– The concerns about Anna’s drug abuse
has grown since the Intervention team last met. Her attendance has improved but she continues to struggle behaviorally (see chart below)
Intervention Team Meeting
¡ Afterseveralweeks,theInterventionTeamreconvenedanddiscussedAnna’sprogresstodate.Annacontinuedtohavesignificantneeds,substanceusecontinuesandthereappearstobecomplexfamilyneeds.
Theyquicklyruledoutfadingsupportsanddecidedtoeither
¡ KeepAnnainherexistingTierIIinterventionor
¡ PlaceherintoSchoolBasedWraparound
SchoolBasedWraparound
• Holistic method of engaging with individuals with complex needs
• Focus on home, school and community• Process aims to achieve positive outcomes by
providing a structured, creative and individualized team planning process
• Focus on strength and needs• Development of family and students
resources • Begins from the principle of “voice and
choice”
Anna’s Wraparound Team¡ Team Members: Anna, Science Teacher, School
Counselor, Pastor, Neighbor and Family Friend/Previous Girl Scout Leader
¡ Second Meeting: ¡ Anna does not show up for the meeting¡ Ms. Irvin, the family friend, reports that Anna had
told her that she does not want to participate because she “does not plan on being around for next semester.”
¡ Ms. Brown, the school counselor, identifies this as a possible warning sign and establishes time to meet with Anna to conduct an ASIST intervention
Anna’s ASIST Intervention
¡Ms.BrownmeetswithAnna,engagesandconnectsAnna’swarningsigns/invitationsandasksdirectlyandclearlyifAnnaishavingthoughtsofsuicide.
¡ Annareportsthatyesshehasrecentlybeenthinkingaboutendingherlifebutdoesnotyethaveasuicideplan.
¡Ms.Brownfollowstheschool’sprotocolandnotifiesAnna’sparents.Ms.BrownprovidesconnectionstoformalsupportsinthecommunityandisanongoingsupportcontactforAnnaatschool.
Wraparound¡ Anna’s Wrap around team continues to meet and after several
months, they reevaluate her progress. ¡ Anna is no longer having thoughts of suicide and is not using drugs¡ Anna attendance has improved but could still be better¡ Anna has not had a behavioral referral in 6 weeks and she is passing
her classes ¡ Below is pre and post data from wrap
Measure Pre Post
GPA 1.22 2.40
SchoolAttendance 60% 75%
BERS,Teacherratingofstudent 86 111
BERS,Parentratingof student 76 94
BERS,Student ratingofself 69 100
Discipline Violations, Averagepermonth 4 1
TechnicalGuideforAlignmentofInitiatives,Programs,Practices
inSchoolDistricts
NationalTechnicalAssistanceCenteronPositiveBehaviorInterventionsandSupport.(2017).
Eugene,OR:Retrievedfromwww.pbis.org
TheAlignmentProcess
• SectionI.AssessmentofCurrentInitiatives• Coordinateandleadalignmentprocesswithanexecutivelevelteam.• Definethevaluedoutcome(s)tobeachieved.• Developaninventoryoftherelatedinitiativesthatarecurrently
implementedacrossthedistrict.• Hastheteamidentifiedthecoresystemfeaturesforinitiatives
targetedforalignment?• Analyzeandmakedecisionsforalignmentofinitiatives• Designtheplanforeffectivealignmentincludingimplementation,
evaluationandprofessionaldevelopment.• SectionII.Teamadoptsaformalprocessforaddingnewinitiatives• Foranynewinitiativesbeingconsidered,determinetheir“fit”,
includingevidence-baseamongotherinitiatives.• Ifteamdeterminesnewpractice/initiativeistobeadopted,team
determineshowthenewpractice/initiativecanbealignedwithintheexistingframeworkforrelatedinitiatives.
HowDidyouDo?
1. ABIGIdeaI“get”andcanmaybeshare?
1. ABigIdeaIamstill“circling”?
1. ABIGIDEAIcantakebackandwecanDO?
• MakeitworkforTeachers,KidsandFamilies
• MakeMentalHealthInterventionsTransparent
• MakesureAdultsFeelCompetentandConfidentatallTiers
Context Matters
ISFrecordedwebinarsoftheISFTargetedWorkGroup
ToolsPublications
etc
www.midwestpbis.org“content’“ISF”
*neweBookavailableatwww.pbis.org
AligningandIntegratingFamilyEngagementinPositiveBehavioral InterventionsandSupports(PBIS):ConceptsandStrategiesforFamiliesand
SchoolsinKeyContexts
Editors:MarkD.Weist,S.AndrewGarbacz,KathleenLane,andDonKincaid
PBISNationalLeadershipForum
September28– 29Hilton,DowntownChicago
“PBIS:Starting,Scaling,andSustaining”
• 75differentbreakoutsessions– includingastrandonmentalhealthintegration
• NationalTrainersandExemplars• 19Roundtable/Discussions• NetworkingPosterSession
ACE Study:
The Relationship of Adverse Childhood Experiences and Adult Health
Source: Adverse Childhood Experiences (ACE) Study. Information available at http://www.cdc.gov/ace/index.htm
NationalChildTraumaticStressNetworkEmpiricallySupportedTreatments&PromisingPracticesList
http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices
– Clinical&anecdotalevidence– ResearchEvidence– Outcomes
http://naswil.org/news/chapter-news/featured/for-school-social-workers-sparcs-sparks-interest-among-adolescents-in-champaign-county/
http://sparcstraining.com/index.php
• ovc.gov forvideo—clickonLibraryandMultimediathenvideosthenChild&YouthVictimization
• www.depts.washington.edu/hcsats/resources.html,clickonResourcesthenTherapyResources
• NationalChildTraumaticStressNetworkSchoolsCommittee.(October2008).ChildTraumaToolkitforEducators.LosAngeles,CA&Durham,NC:NationalCenterforChildTraumaticStress.
• nctsn.org,clickonResourcesthenAudiencesthenResourcesforSchoolPersonnel
• ovc.gov forvideo—clickonLibraryandMultimediathenvideosthenChild&YouthVictimization
• www.depts.washington.edu/hcsats/resources.html,clickonResourcesthenTherapyResources
Resources
• https://dpi.wi.gov/sspw/mental-health/trauma/modules