Pennsylvania’s Integration of Mental Health and Positive Behavior Interventions and Supports (PBIS)
Creating and Sustaining Effective Mental Health Services and Supports in the Educational Setting
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Transcript of Creating and Sustaining Effective Mental Health Services and Supports in the Educational Setting
Creating and Sustaining Effective Mental Health Services and Supports in the Educational
Setting
Newport-Mesa Unified School District Team
Melissa Hurd: Psychological Services Coordinator
Joy Cleary: LCSW, PPS
Tucker Cannon: LCSW, PPS
Michelle Lepak: Ed.S., NCSP, School Psychologist, Program Specialist, Behavior Specialist
Eby Kent: MS, School Psychologist, Licensed Educational Psychologist, Behavior Specialist, BCBA
Yuba City Unified School District Team
Elizabeth Engelken: Director of Student Support; Credentialed School Psychologist, PPS; Advanced Nurtured Heart Trainer
Veronica Coates: Psychological Services Specialist; Credentialed School Psychologist, PPS; Advanced Nurtured Heart Trainer
Ivona Mikesell: Credentialed School Psychologist, PPS; ERMHS Behaviorist; Advanced Nurtured Heart Trainer
Presentation Outline1. History: How did we get “from there to here”?
(Newport-Mesa/Yuba City)2. Program Development and Rationale (Yuba City)3. RtI: A Three Tiered Approach (Newport-Mesa)4. Foundation and Methodology (Yuba City)5. Assessment Process (Newport-Mesa)6. ERMH Services (Yuba City)7. Next Steps (Newport-Mesa/Yuba City)
History of Mental Health Supports in California Schools
In 1984, Assembly Bill 3632 outlined and required a partnership between school districts and county mental health agencies to deliver mental health services to students with individualized education programs (IEPs). A subsequent Assembly Bill, 26.5, updated the mandate for students with disabilities.
History of Mental Health Supports as a Related Service
In 2011, the California Legislature passed Assembly Bill 114, which repealed the state mandate on special education and county mental health agencies. This action gave school districts the sole ability to decide how mental health services were delivered. Many districts continue to contract with county mental health or other mental health agencies. The term Educationally Related Mental Health Services (ERMHS) refers to those services related to a students educational plan, and developed to address social, emotional and behavioral areas of significant need.
A Journey toward ERMHS Legal Consortiums Consultation with SELPA leadership and
other major stakeholders Research and observation of model
programs Develop Program Design; Hire Exceptional
Staff Developing a Three Tiered approach to
intervention
Foundational Approach
Providing a continuum of services which is effective with special populations
Services which are effective with intense students and families
Acknowledging the common underlying belief that we have tried many methodologies with very limited and poor results
Utilizing a strengths based approach as a foundation for all services delivered
Strengths Based Approach 100% of staff trained in the Nurtured Heart Approach
(NHA), utilizing the strategies from classroom to therapy setting
Program Development ERMH staff is composed of specialists within the
field of mental health; psychologists, licensed clinicians, clinical aides and behavior specialists
ERMH clinicians and behaviorists become collaborative and integrated members of IEP teams
Creation of a program which serves students across the special education continuum; from prevention to intense intervention
Continuum of ServicesERMH Services are Designated
Instructional Services for students with disabilities
ERMH Services fall along the continuum of service – different levels of ERMH intervention are delivered, based on student needs
Continuum of Services Continuum of School Based Behavioral & Mental Health Services
Prevention Teachers, Counselors, Admin, Probation
Site Based Services District Counselors and School Psychologists
Site Based Educationally Related Mental Health Services
District School Psychologists and Counselors
Regionalized Educationally Related Mental Health Services
Clinicians, Behaviorists, Clinical Aide, Psychological Services Specialist
Least Restrictive
County Operated Program + Site Based ERMHS
Clinicians, Psychological Services Specialist, Clinical Aide, Behaviorists, County School
Psychologist
County Operated Program Regional ERMHS
Clinicians, Psychological Services Specialist, Clinical Aide, Behaviorists
NPS Day School Psychological Services Specialist, Clinician,
Behaviorists, NPS Staff
NPS Residential Psychological Services Specialist, Clinician,
Behaviorists, Residential Staff
Most Restrictive
Psychological Support Services
Universal Intervention
Early Intervention
Intensive Interventions and Support
Response to Intervention: A Three Tiered Approach
Site level School-Wide Positive Behavior Interventions and Support
School Psychologists implement research-based curriculum for identified at-risk studentso Push-in whole classroom interventiono Targeted group intervention
o Curriculum-Based (Second Step, Steps to Respect)o Expressive Therapy
Progress Monitoringo Data collection, progress reports, teacher input, attendance, work completion, grades, etc.
Student Study Teams
Tier I Counseling Referral Please refer to form in folder
Parent Education Training
Tier I: Universal Intervention
A need for counseling is suspected for a student receiving special education services.o IEP is held to document a referral for School-Based Counseling
o Please refer to Tier I or Tier II Counseling form in foldero Case Carrier completes Counseling Referral and submits to the School Psychologist
School Psychologist reviews referral and determines if additional strategies can be implemented or if Counseling Assessment is warranted.o IEP is held to document School Psych’s recommendationso If Counseling Assessment is recommended, Assessment Plan is presented and consent
obtained.
School Psychologist completes ERMHS Counseling Assessment to determine if there is an area of need
IEP is held to document Counseling Assessment results/recommendationso Goals proposed in areas of needo Service recommendation provided
o Individual Counseling, Group Counseling (includes Social Skills), Parent Education Training
o Minimum of 12 weeks offered (individual and group services)
Tier II: Early Intervention
Tier II: Early Intervention
Progress Monitoring Counseling goals are monitored weekly
IEP team reconvenes after 12 weeks and determines continued need/level of Counseling Services based on progress monitoringo Data collection, rating scales (objective and research-based),
attendance, work completion, grades, compliance, and team input
IEP team could determine: Student met Counseling goals and service is discontinued Student is progressing towards goals and would benefit from
continued School-Based Counseling sessions Student is not making progress and a Clinic-Based Counseling
Referral is recommended
Clinic-Based Serviceso Individual Counselingo Group Counseling
Targeted Parent Education Counseling and Training Collateral Family sessions – Push in home support
Non-Public School Placement
Residential Placement• In-State• Out-of-State
Tier III: Intensive Interventions and Support
Length of Intense Services
Initial referrals for assessment and those exiting service are a fluid process
Average length of service is 12-18 months
Referral Process
After exhausting site based services, IEP team recommends an ERMHS referral
Preventive mental health services are required prior to referral
Referral Requirements Parent Approval at IEP to make referral Site based School Psychologist and Case
Manager compile a packet of data to present to Psychological Services Specialist
Psychological Services Specialist analyzes referral with Director of Student Support and ERMH team, assigning a clinician or behaviorist to the student
Once referral is approved, assessment plan is presented to parent
Assessment Process Yuba City Assessments ERMH Clinician provides assessments to student,
parents, and school staff including, but not limited to: Standardized Assessments Observations Consultation Collaborates with School Psychologist and site
based team
Assessment Process
Newport-Mesa Assessments Educationally-Related Mental Health Services
(ERMHS) AssessmentsConducted by School Psychologists
Residential Assessments Conducted by a Multi-Disciplinary team of
mental health professionals
Eligibility
A direct link between social-emotional and/or behavioral functioning and a lack of educational progress must be present
Preventive mental health services must have been provided
Goals Drive Service
Example of Annual Goal: By (date) Student will utilize at least three
appropriate coping strategies (i.e. positive self-talk, reframing negative thoughts, taking pride in his inner wealth etc.) to increase positive self-perception in counseling and/or school settings, in 4 out of 5 times as measured by observations and interviews.
Goals Drive ServiceExample continued with short term objectives:1. By (date), when prompted by a Clinician, Student will identify 5
strengths he sees in himself. 4 out of 5 of these strengths must be statements about his inner wealth, not related to academic or intellectual.
2. By (date) when prompted by a Clinician, Student will identify at least 3 positive strategies on how he is utilizing his strengths of inner wealth (journaling, verbal positive affirmations, visual positive affirmations, positive self-talk, re-framing negative thoughts, resetting)
3. By (date) Student will be able to identify 10 positive attributes about himself without prompting, as well as identify how he utilizes these strengths to reset back to inner wealth rather than become trapped in misperceptions of how others feel about him, withdrawal, or negative self talk.
Services Individual CounselingGroup CounselingParent CounselingSocial Work ServicesPsychological ServicesBehavior Intervention Services
Individual Counseling
Counseling in a 1:1 setting with an ERMH clinician or other qualified individual
No other students are present Clinician working directly on students
individual goals and objectives
Group CounselingStudent participates in a group led by
an ERMH clinician. A group of students working on similar
social skillsA group centered around 1or 2 students
with neurotypical peersGroups are led by clinicians and often
co-facilitated by a school counselor, school psychologist or clinical aide
Social Work Services Consulting/Training staff and/or parents on
specific interventions (i.e. Nurtured Heart Approach)
Training 1:1 aides on specific behavioral and social emotional interventions
Infusing/Modeling strengths based approaches within general and special education classrooms
Assisting teams on Behavior and Social Emotional Care Plans
Psychoeducation groups not related to IEP goals but rather to develop a more positive classroom environment
Parent CounselingProviding parent support in a 1:1 or
group settingModeling Strengths Based
communication to parents Providing support before and after IEP
meetingsPsychoeducation
Psychological ServicesServices Delivered by the
Psychological Services SpecialistConsultation with site based teamsAssessmentParent supportCounseling In class InterventionsLiaison to Nonpublic and Residential
schools
Behavioral Intervention Services
Refinement of current Behavioral Support Plan
Data Collection In Class modeling of interventions in
conjunction with Clinical Aide1:1 Aide and Teacher trainingConsultation to site based teams
Other Services Offered to SELPA and Community
Support provided to sites during crisis or emergency situations (threat assessments, crisis management, grief counseling)
Staff Development Presentations for teachers, administrators and support staff (NHA, Anxiety and Trauma, Selective Mutism, Self-Harming Behaviors, Developing BSP’s, Prevention and Early Intervention)
Sustaining Effective Services and Positive Results
Identify new staff to train; keep cycle of training fresh
Develop specialists; classroom support providers, clinical staff for therapy, parenting class and support staff, bilingual staff, training teams
Ongoing Learning Lab Maintain foundational approach as a district and
SELPA wide initiative so that it is embedded in board accepted and approved goals
Future Goals for Newport-Mesa Develop a needs assessment to determine priorities and
future professional development Leadership Training
Eliminating Barriers to Learning through the Early Identification of Student Mental Health Issues
District-Wide collaboration in addressing barriers to learning High-Touch Impact on students district-wide
Build upon current Parent Training component Parent Academy
Refine school reintegration procedures for students placed on psychiatric holds
Therapeutic placement between SDC ED/ NPS & RTC Explore Day School options
Next Steps & Future Goals for Yuba City
Continue honing the whole child/strengths based model with a continuum of services
Continue providing trainings SELPA wide (parents, families and staff)
Provide ongoing psychoeducation in classroom settings
Focus on ERMH’s contribution to preventive mental health
Q & A
Burning Questions