ROLE OF CLINICIANS IN MTSS

BUILDING CAPACITY FOR CHANGE AT THE DISTRICT LEVEL

National PBIS Leadership Forum October 22-23, 2015

Ali Hearn, LCSW

Midwest PBIS Network

Russ Uhing & Brenda Leggiadro

Lincoln Public School District

Session Description

Explore how districts can build the capacity of their staff by positioning clinicians as social/emotional leaders in the building(s).

Exemplar clinician leaders will guide participants through considerations of resources data systems Practices

Ultimately building the capacity of the district to effectively meet the social/emotional needs of ALL

youth.

Maximizing Your Session Participation

When Working In Your Team

Consider 4 questions:

– Where are we in our implementation?

– What do I hope to learn?– What did I learn?– What will I do with what I learned?

Where are you in the implementation process?

Adapted from Fixsen & Blase, 2005

• We think we know what we need so we are planning to move forward (evidence-based)

Exploration & Adoption

• Let’s make sure we’re ready to implement (capacity infrastructure)

Installation

• Let’s give it a try & evaluate (demonstration)

Initial Implementation

• That worked, let’s do it for real and implement all tiers across all schools (investment)

• Let’s make it our way of doing business & sustain implementation (institutionalized use)

Full Implementation

Leadership Team Action Planning Worksheets: Steps

Self-Assessment: Accomplishments & Priorities

Leadership Team Action Planning Worksheet

Session Assignments & Notes: High Priorities

Team Member Note-Taking Worksheet

Action Planning: Enhancements & Improvements

Leadership Team Action Planning Worksheet

Session Objectives

Describe how a clinician can effectively fit into an MTSS model of support

Learn how to utilize clinicians as social emotional leaders, helping build the capacity of district/building

Identify potential district/building-level systems that may need consideration in the process

Review different ways to gather data for district/building-level decision making and progress monitoring

What we know…Jane Meredith Adams, EdSource

“Definitions of social and emotional learning vary…”

“Interest in social and emotional learning is growing, fueled by a desire to create positive school environments and prevent bullying, disconnection, and academic underachievement.”

“Many educators are still unclear about what social and emotional learning is and how they can incorporate it into the classroom.”

“We sometimes receive push back from teachers, who say ‘right now, my top priority is Common Core’.”(Libia-Gil, vice president at the Collaborative for Academic, Social, and Emotional Learning (CASEL))

Adams, Jane M. "Social and Emotional Learning Gaining New Focus under Common Core." EdSource Today. N.p., 15 May 2013.

The “Old” System (pre-MTSS) Examples

Send a student with any social/emotional concern to the clinician at any time

Subjective decision-making vs. Data Driven decision-making to determine which social/emotional supports a youth receives

Ask the clinician during an IEP/update meeting “how does George do with you in your office” as a means to assess success- his ability to generalize his behaviors to other settings

Ask the clinician to cover the jobs of multiple otherroles in the building (i.e. admin, discipline, etc.)

Over-servicing students with low level needsAND

Under-servicing students with high level needs

Understanding some of the System(s) Challenges…

Video(IEP Cartoon)

A Shift in PracticeWhere/How is time currently being spent?

A shift in our thinking…

Coaching/Consultation

Coaching/Coordination

Coaching/Facilitation

The Role of the School-Based/Community-Based

Clinician at All Three Tiers

Coordinator vs. Facilitator

Coordinator• Organizes and/or

oversees the specific interventions such as CICO, S/AIG & Group with Individual Features

• Roles may include: scheduling meetings, reviewing & collecting data to share during team meetings, curriculum development, training, mentoring, etc…

Facilitator• Directly provides

intervention support services to youth/families

• Roles include: meeting with students for CICO, running groups, etc.

Coaching/Consultation

• Teams

• System

s

• Data

• All-Staff

• Familie

s

Tier 1

Coaching/Coordination   

Consultation

• Systems

• Interventions

• Training/

support for

Facilitators

Tier 2

Coaching/Facilitation

Consultation

Coordination

• Individual

student

teams

• Direct

services

Tier 3

Where do school/community-based clinicians fit in?(example of how a clinician can travel through the Tiers as they are being developed)

Universal Team• Universal Team Member• All-school data analysis• Consultation with team

Secondary Team• Tier 2 Coach

• Coordinate Tier 2 Intervention(s)

Tertiary Team• Tier 3 Coach

• Coordinate Tier 3 Intervention(s)

• Tier 3 Facilitator

Moving from being the only response to identified social emotional needs, to being

social emotional leaders of the building.

TO

Helping to build the capacity of the rest of the

staff

General Education & Special Education

Tier 1/Universal School-Wide Assessment / School-Wide Prevention Systems

Check-In-Check-Out

Check-In-Check-Outwith Individualized

Features

Social/Academic Instructional Groups

Mentoring

Brief Function-Based Problem Solving

Individualized Team Development:Complex Function-Based Problem Solving

Person-Centered Planning

How do we design this filter to prevent too many

students from going through to receive Tier 2 support,

AND also ensure that enough youth receive it?

Who will receive clinician support?

Home School Community

There is a place for a clinician to be

involved in supporting youth and families atALL 3 Tiers

Areas of involvement can be

broken down by Tier (level of need)

and Domain (home, school,

community)

Common Trends

Moving from reactive to preventative Time efficient and least restrictive Moving from Tier 1 to leading/coordinating Tier

2/3 Facilitating Tier 3 Interventions and teams Serving students in a purposeful/intentional

way Systems approach

(Consider looking at buildings as clients and not just individual youth/families)

Interventions first vs. Referral to Professional or IEP

How easy would it be to engage others in this dialogue?

Easy

Moderately Easy

Neutral

Moderately Challenging

Challenging

Guiding QuestionsExamples from Admin & Clinician Dialogue

How would administrators, staff and clinicians in your district describe the role of the clinician? Are these descriptions the same or different?

How are decisions made about when to give youth more social/emotional support? How to gain access to time with the clinician(s)?

How are clinicians able to report on whether or not the work they are doing with students is effective?

Change sometimes takes having (potentially) Difficult Conversations…

Other clinicians in the district Staff Administration Director(s) of Special Education Superintendent Board of Education Parents/Families

…and (potentially) dare to

step one foot into someone

else's…

Know your

sandbox…

• Russ UhingDirector of Student Services

• Brenda Leggiadro Coordinator for Counselors and School Social Workers

Lincoln Public Schools

PBIS Implementation Plan

Three year timeline for implementation of PBIS

School Transformation Grant – mental health, social-emotional learning, increasing staff capacity around behavior/mental health

Regular education and special education together – changes the traditional roles of some clinicians

The District’s Plan for Clinicians

56 school buildings

PD was scheduled for ALL clinicians together at the same time (for the first time in this district). 125+ clinicians in the same room hearing

the same messages and collaborating with one another including: Social Workers Psychologists School Counselors Psychotherapists

The District’s Plan for Clinicians

3 events were scheduled throughout the year with the intended outcomes of: Consistent and clear understanding

of MTSS for behavior Analysis of where we are and where

we are going Increased collaboration

The District’s Plan for Clinicians

First 2 sessions were with clinicians - getting on the same page

Last session included administratorsAdministrators and clinicians engaged in systems level conversations about data, systems and practices at all 3 tiers

The District’s Plan for Clinicians

Within the district: Definition of roles to guide clinicians

and administrators in buildings Skillstreaming & Second Step training Trauma training for all school staff School mental health teams Conference attendance to build

capacity in team members CBITS – coming in summer 2016

The District’s Plan for Clinicians

With the community: Better use of existing resources

(Expedited SCIP process; Hospital triage)

Mental Health Response Team PBIS Trainings attended by HSF

members Human Services Federation Resource

Fair Mental Health Interns from a local

college

The District’s Plan for Clinicians

5 District exemplar sites have been identified to shift systems effectively and efficiently, create outcomes for youth, and ultimately lead the way for this work to continue

Next stop: Clinicians will learn the process of FBA/BIP within a PBIS framework, with Psychologists as the leadership/coaching team, to help the district move forward through the tiers of support

Continuing to educate ALL staff on Clinicians being social emotional leaders

The District’s Plan for Clinicians

Systems District-level conversations- paradigm shift Cross-talk between clinical departments Ongoing dialogue with community agency partners

about partnering opportunities

Practices Embedding Second Step into Tier 1 as Universal Curriculum (aligned

with expectations and using data for delivery) starting with grades k-1 Shifting clinicians from Tier 1 Facilitation to Tier 2/3

Coordination/Facilitation as much as possible Considerations for community partners on PBIS teams

and facilitating practices

Data Using the TFI Using student outcomes Tracking outcomes from exemplar sites

Benefits and Challenges

Benefits: Increased cooperation between

regular ed and special ed Collaboration of clinicians Less duplication of services Better use of mental health experts Building capacity of all staff

Benefits and Challenges

Challenges: Data System Shift in roles is challenging

Ways to identify students for interventions

Planning the intervention Who provides the intervention

Resources and practices in buildings vary

Working with community agencies effectively

What will be the greatest barriers to making this work, work?

CONTACT INFORMATION:

• Ali Hearn- ali.hearn@midwestpbis.org

• Russ Uhing- duhing@lps.org • Brenda Leggiadro- bleggia@lps.org

Other Questions/Comments?

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