Amy Lansing, PhD; Jana Cook, MD, PhD; Wendy Plante, BS

Alternative Accountability Policy Forum: November 16, 2015

Develop multiple metrics in support of self-

identified needs voiced by staff, students

and organization representatives.

Provide wraparound supports◦ Via workforce, community and post-secondary

supportive partnerships

Next up: ◦ Differentiate & individualize instruction (Readiness)

◦ Focus on individual student learning gains (metrics

for Readiness skills that have transferability)

Trauma talk mapped onto what they saw in their students

Professional development

Improved staff retention

Tools to better motivate students

Organization and school readiness metrics

Statewide Accredited Public Charter School

Multiple drop-in centers throughout the state

GOAL is a free public school dedicated to giving

students a robust yet flexible learning

environment, utilizing today's high-tech tools

GOAL delivers classes primarily via the internet

but frequently met with students one-on-one

for tutoring, life skills, career guidance, &

academic reinforcement.

4,200 students statewide (Colorado)

97% High Risk:◦ Expelled, truant, dropped-out of school

◦ Teen parent

◦ Personal or family involvement with substances and/or

alcohol

◦ Incarceration

◦ Mental health

◦ Child Welfare/CPS/DHS involvement….

Among Incarcerated Youth…

67-75% have a mental disorder

20% have severe mental disorders

>1/3 needing ongoing clinical Mental Health Service care. This is twice the rate of the general adolescent population

Context: Mental Health Service Needs in Risk-Immersed Youth

81.6% (205/251) of delinquent youth lost had someone important to them who had died◦ Compared to national estimates of ~5%

Youth’s average age was 11 y/o

This resulted in: ◦ 22.1% Moved homes/schools

◦ 62.7% Started to use drugs or increased use

◦ 39% Grades dropped or attendance worsened

◦ 40.1% Met criteria for Complicated Grief

Lansing, et al. (in preparation)

Prolonged, unresolved, or traumatic grief

“The current designation for a syndrome of prolongedand intense grief that is accompanied by complications that derail the progress of grief and is associated with substantial impairment in work, health, and social functioning”

(Zisook, 2010)

“There is no grief like the grief that does not speak”

–Henry Wadsworth Longfellow

35.6%

24.8%

17.8%

8.4%

5.9%

5.4%2.0%

Grandparent

Friend or

Significant Other

Aunt/Uncle

Parent

Cousin, Nephew,

Niece

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

0%10%20%30%40%50%60%70%80%

Male Female PTSD CG

0%

20%

40%

60%

80%

100%

LCPD Girls SS Girls Screened

Girls

Complex PTSD and

CG

Complex PTSD only

CG only

No Complex PTSD

or CG classification

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Controls (n = 20) Delinquents (n = 22)

Complex PTSD and CG

Complex PTSD Only

CG only

No Complex PTSD or

CG classification

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

0%

10%

20%

30%

40%

50%

60%

70%

80% Incarcerated

Boys

Incarcerated

Girls

SCHI

BPD

PM

NPM

• Focus groups with staff from different regions.◦ Identify organizational problems and successes◦ Gather recommendations to GOAL for improvement

Trauma presentation to coaches ◦ The relationship between trauma and education

Focus groups with students from different regions◦ Identify environmental barriers to education ◦ Identify organizational problems and successes◦ Gather recommendations to coaches and GOAL for

improvement

Provide workshops to coaches:

◦ How trauma is related to school performance.◦ Tools for coaches to provide trauma sensitive mentoring,

while NOT being a therapist. De-escalation

Motivational interviewing

Provide workshops to students:

◦ The importance of self-compassion◦ Identifying triggers◦ Practicing mindfulness

Promote coach/student relationships◦ Taught students &

coaches O.A.R.S./MI skills

◦ ‘Role-play’ Implement MI skills

Demonstration of O.A.R.S

with a coach

Demonstration of O.A.R.S.

with student assuming

coach role

Communicating information in a timely, consistent manner

◦ Varying rules and resources between sites

◦ Transporting students

Need more training and professional development

Poor role definitions and/or fit of those roles

Top two issues in public school: ◦ Bullying by teachers (uniformly reported by youth as biggest

issue)◦ Not fitting in with other students

Second tier:◦ Inadequate academic support◦ No positive reinforcement (in this order: teachers, school, school

counselors, family)◦ Excessive negative feedback from school, teachers and lastly,

peers (“you are dumb, lazy”, “just ignore your family….”)◦ Fall too far behind in their comprehension of material to it make

up and no one to support them.◦ No tools to deal with Math anxiety, test anxiety, sleeplessness

(which increases interest in substance use to self-medicate)◦ Family demands interfere with attendance, homework and

attention

• In general: strong identification and appreciated

• Grateful for the support provided by GOAL

- “GOAL saved my life.”

• Admiration for the coaches who go above &beyond everyday

• Better communication from GOAL (uniform agreement on this)

• Need more help from specialists

• Need for positive feedback from coaches/family.

- Sometimes expectations are too high and students feel dejected and unable to meet goals.

• Concern for the coaches

- Many students worry about coaches just as they do their family members, siblings etc.

WHAT CAN COACHES DO TO SUPPORT EACH OTHER?

“Connecting community with resources”

“Be available for brainstorming about what defines success for an individual student”

“Reassure positive aspects of Goal”

“Talking about solutions, not just complaining”

“Academic tutoring”

• “I procrastinate a lot. I think if I focus more and get stuff done I’d be a lot better.”

• “Talking and letting people know my feelings. I am scared to show my emotions.”

• “Keeping my mouth shut when it don’t need to be opened.”

• “Stress”

• “My low confidence holds me back a lot. It makes me sad a lot”

• “Math or public speaking. My anxiety makes public school difficult and my ocd makes math difficult.”

• “Being quiet sometimes.”

“I am very passionate about music and art. They are my escape from stress in life.”

“I am a people person. I’ll talk to anyone about anything.”

“[I’m] really calm and like to see others point of views”

“I am very outspoken when it comes to equality and talking to people about it. Feminist.”

“Writing and reading. I’m also very passionate about everything I love.”

“Honesty and caring”

Strengths

Weaknesses

“I would love to help people. Guide them in the right direction & make them feel good about themselves.”

“Singing” “Traveling and then opening my own business” “A psychologist” “Travell in time, macanic, welder” “Game warden - catch all poachers” “If I ever had the change to be able to do anything, I

would want to have my own Rock band and be the bassist.”

“Pro female auto mechanic! If men can do it so can I! Rocken architect/construction.”

“A horse trainer just mainly because I’ve always loved to be around them.”

“A cartoonist or graphic art design” “I would love to be a model and to be a spokes person

for gender equality, own my own all natural makeup line, and incourage body possitivity”

“I would love to be in politics. Strong women in politics are people I really admire and I would love to do that.”

“I would ask my family for their full support and positive feedback. Their love.”

“If I could get anything to help me from my family, the only thing that I would ask from them is support.”

“I would ask my family to keep up the fantastic support system they have provided.”

“All I could really ask for is support because I love doing things by myself.”

“All I want is them to push me to giving myself a future”

“More support on what I love, show me that they know I can do it”

“Nothing but unlimited support is what I would ask of my family”

“Family could be better at ask ‘how are you doing in school’”

“I would ask for their full support and positive feedback. Their love” “If I could get help from my coach, I would just ask for support.” “I would ask him to make a little more of an effort on

communication” “All I could really ask for is support because I’m very independent.” “For him to just keep doing what he is doing cause it is working for

me” “I would ask my couches to keep doing what they’re doing. I really

admire the way they work with me now” “My coach could help me with any thing I would need” “Nothing” “I wouldn’t ask my coach anything because she’s amazing already.” “They could help with a little bit more of there time.” “I would ask the coach to bring all her students in & help each

other.” “Be more involving.”

“I would ask my specialist for help mostly cause I really don’t interact with them.”

“I would ask my specialist for a little more help on certain classes.”

“For him to just keep doing what he is doing cause it is working for me”

“I would ask my specialist to be able to help me when I need it.” “Nothing I can think of” “I would ask the specialists to be more available.” “They could be involved instead of waiting for some1 to ask for

help.” “The specialist sometimes take a bit longer to respond if you

have a question.” “I wish the specialist would relate more to the students. Be better

with communication. Be more helpful, understand that maybe there is a reason for help. Help understand students. Be more social but still keep the professional attitude.”

“I would ask GOAL to make it as easy as possible for me to graduate and get what I need.”

“I would ask from GOAL to just help me follow my dreams and push me towards the future.”

“Next time there is any trips or important events make sire information about it is more widespread please”

“Goal has done so much for me and to just find opportunities for there would help.”

“I would just ask goal to remain my high school forever, because I love it and all of the support!”

“Goal could have more teachers. Goal could be a world wide school.”

“I would ask Goal to keep doing these trips. These trips has helped me do my school work and meet new amazing people. Goal is fantastic and the people there are wonderful. They work with you one on one.”

“I would ask Goal to treat the coaches better”

Students email teachers questions (even math)

◦ Relies on weak verbal & executive skills

◦ Requires teachers to explain concepts in writing (likely difficult) and students to parse sentences

Mindfulness: Grounding vs. meditation

Cognitive Bias

MI/O.A.R.S

5. Return

1. Stop

2. Observe

3. Let it go4. And

http://app.stopbreathethink.org/

Overall tracking, tracks mood & has a social media component

http://app.stopbreathethink.org/

https://www.headspace.com/how-it-works

No mood tracking, but has a timer, reminders, overall tracking, set programs & social media

http://smilingmind.com.au/

Timer, reminders, mood tracking, tracking overall, set program & social media. Broken into age groups (7-11, 12-15, 16-22, Adult)

Only 4% of the 700 apps actually provide mindfulness training and education.

Most were timers, reminders, or guided meditation apps. The best-rated 23 apps are in the chart from Mani et al. (2015) article, but focused on products compatible with apple OS.

Mani, M., Kavanagh, D. J., Hides, L., & Stoyanov, S. R. (2015). Review and Evaluation of Mindfulness-Based iPhone Apps. JMIR mHealth and uHealth, 3(3), e82.

Your focus is on administration, staff &academics….

Kids here to learn: why aren’t they learning?

Our implicit biases get in the way and compound their trauma and loss experiences.

Our “language” is filled with projected bias based on our goals for, & perceptions of, the youth we work with

Our brain is built for bias

Allows fast decisions

Once you acknowledge a bias, it’s easier to manage.

Observational statements, not judgments or inferences….

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.huffingtonpost.com/blake-fleetwood/scary-times-call-for-a-gr_b_5973236.html&ei=qqBfVYzIMdC3oQTGmoGQDA&bvm=bv.93990622,d.cGU&psig=AFQjCNEi_agFbFhUN_BtzThnsBqXriNyGw&ust=1432416809460708http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.huffingtonpost.com/blake-fleetwood/scary-times-call-for-a-gr_b_5973236.html&ei=qqBfVYzIMdC3oQTGmoGQDA&bvm=bv.93990622,d.cGU&psig=AFQjCNEi_agFbFhUN_BtzThnsBqXriNyGw&ust=1432416809460708

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.nbcnews.com/news/us-news/vaccineswork-hillary-clinton-wades-vaccinations-debate-n299031&ei=4KBfVZODGsnroATw8IAQ&bvm=bv.93990622,d.cGU&psig=AFQjCNEv8SctCWoOvSuPrSj7XF9-5jjUUQ&ust=1432416863317460http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.nbcnews.com/news/us-news/vaccineswork-hillary-clinton-wades-vaccinations-debate-n299031&ei=4KBfVZODGsnroATw8IAQ&bvm=bv.93990622,d.cGU&psig=AFQjCNEv8SctCWoOvSuPrSj7XF9-5jjUUQ&ust=1432416863317460

Spirit of Motivational Interviewing

Motivation as a state or stage…

not a fixed character trait

Spirit of Motivational Interviewing

Resistance Change Talk

Open-ended Questions

Affirmations

Reflective listening

Summaries

Selective eliciting questions

Selective affirming

Selective elaboration

Selective summarizing

Selective reflection

Simple◦Repeating◦Rephrasing

Paraphrasing Reflecting Feeling

Amplified Double-sided