PBIS and SAP

Making the Connection and Achieving the Best Outcomes for

Our Students

May 29, 2014

TODAYS WORKSHOP

Explore currently used models for substance abuse prevention and mental health promotion.

Outline the four phases of the SAP model and mechanisms for improving SAP practice.

Describe mechanisms for improving communication and collaboration between PBIS and SAP.

Detail the variety of interventions made possible through coordinated efforts of SAP and PBIS.

Questions

1. What Grade levels do you work with? a) K-5 b) K-8 c) Middle school d )High school

2. Has your school implemented PBIS at Tier 1 a) Yes b) No

Questions

3) Are you implementing tier 2/3 supports? a) Yes b) No

4) Do you currently serve on a SAP team? a) Yes b) No 

Small Group Activity

5) How are SAP and PBIS collaborating in your school? 6) What do you want to take away today from this sessions? 7) What barriers to collaboration do you see between SAP and PBIS.

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Five Approaches for Addressing Youth Mental Health Issues

1. Institute of Medicine Classifications 2. Coordinated School Health Programs3. Systems of Care 4. Public Health Approach 5. Individual Intervention Approach

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1. Institute of Medicine Classifications

Interventions can occur in schools, homes, community centers, or other community-based settings Promote emotional and social competence through activities that teach emotional regulation and problem solving skillsUsed by the National Registry of Effective Programs and Practices NREPPwww.nrepp.gov

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2. Coordinated School Health Programs

3. Systems of CareD&A

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4. Public Health Approach

Works across systems to forge connections that promote child and adolescent mental health in many types of sites (e.g., schools, communities, workplace, and hospitals)

Organizes youth mental health concerns into three levels of prevention interventions

Primary (Universal) Secondary (Indicated) Tertiary (Targeted)

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Public Health Levels of Intervention

Primary Prevention Purpose is to prevent future cases

of a problem behavior/disorder Population—whole population all

youth in a school community)

Tertiary Prevention Prevent future cases of a

disorder; promote wellness and prevent problems; slow progression of disorder and minimize complications; reduce intensity of problem behaviors

Secondary Prevention Prevent future

cases of a disorder—identify disorder early, reduce symptoms, cure disorder, and/or limit disability, reduce frequency of problem behaviors

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5. Individual Intervention Approach

The individual mental health concerns and problems intervention process approach is concerned with addressing the mental health and problems of individual children and adolescents, one at a time, within the larger population of youth at a site (i.e., school community program, camp).

By definition, it is intense and time consuming to focus on attending to a single child or adolescent and his or her family and caregivers.

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Individual Intervention Approach

A continuum of activities linking students to necessary programs and services.

The Center for Mental Health in Schools at UCLA include as key elements of the activity continuum

initial problem identification clarifying need consultation with child and family management of care ongoing monitoring

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Individual Intervention Approach

Modeled after student assistance program that uses four phases to link students and their families to the care system in the school community referral planning intervention and recommendations follow-up and support

(Fertman, 2004;

Fertman, Fichter, Schlesinger, Tarasevich, Wald, Zhang, 2001)

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Benefits of the Approaches

Helps in discerning program outcomesSpecifies programs and services for addressing concernsIdentifies the timing for interventionsHelps in choosing the right mix of strategiesEnhances communication between professionalsPromotes critical thinking and creative problem solvingReduces replication of activities & improves resource

managementImproves program efficiency and effectiveness

Child and adolescent mental health socio-ecological approach

Team Effectiveness

Depends on: level of administrative support availability of needed resources, including sufficient

time the leadership of the team and the focus, commitment, and motivation of team

membersTeam composition, size, membership,

communication, and support from stakeholder groups (e.g., school and agency staff, community members, parents) also contribute.

Seven Qualities of Effective Teams

Outcomes orientedHighly skilled

membersCommitment to vision

and outcomesHigh standards of

excellence

LeadershipSufficient internal

and external resources

Use experience and feedback to learn

A Partnership…

is “an undertaking to do something together…, a relationship that

consists of shared and/or compatible objectives and an acknowledged distribution of specific roles and responsibilities among the participants which

can be formal, contractual, or voluntary, between two or more parties”

(Partnership Resource Kit, 1995).

Collaborations

Work on change, and practices and policies across region, state, or states.

Generally state level or multi-state formal inter-organizational relationships involving shared authority and responsibility for planning, implementation, and evaluation of a joint effort (Hord, 1986).

Authority is the power and right of a collaboration to take action to accomplish agreed-upon goals.

Effective Partnerships & Collaborations Call on Six Issues

Clear goals and realistic expectations

Roles

Balance

Equality

Trust

Coordination

1:1 Assessment

with SAP LiaisonService

Coordination

1:1 School CounselorTruancy Elimination

Safety – Coping

Plan

Multiple 1:1

Connections

Check In Check Out

Skill

Development Groups

Conflict

resolution

Character Ed

Peer Leadership

Coping Cat (anxiety)

Teach Be Safe, Be Responsible, Be Respectful rules all areas

Organizational skills

Study skills

Emotional Regulation

Skills

Handwriting without Tears

PATHS OLWEUS

Universal Level PBIS

Check and Connect

.

Parents: Focus on Anchor Points• Consistent

Bedtime• Consistent

Mealtime• Exercise –

Martial Arts, Yoga

• Freedom within expressed limits

The Four Phases of SAP

Referral

Team Planning

Intervention

Follow-Up &

Support

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Resolved: No Further

Action Needed

7.12 Copyright Addiction Medicine Services of WPIC-UPMC c 2012

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SAP Referral Process FLOWCHART

REFERRAL: ALL REFERRALS ARE CONFIDENTIAL SAP Referral/STUDENT INFORMATION FORM (S.I.F) completed by referring source.

Referral reviewed by SAP Coordinator, Administrator, & SAP Team (if possible). What has teacher done?:

Should have at least one parent contact Appropriate classroom interventions attempted

Inappropriate SAP Referral: No parent contact Classroom

intervention inappropriate or none attempted

CRISIS-ACT IMMEDIATELY!

Appropriate ESAP Referral: Made parent

contact Appropriate

classroom intervention(s) have failed

Return referral & provide feedback (contact parent, etc.)

TEAM PLANNING & DATA COLLECTION 1. Data collection that DOES NOT REQUIRE

PARENTAL PERMISSION S.I.F. (at least 2 others) S.I.F. Counselor (if applicable) S.I.F. Nurse Grades Attendance Standardized Tests Discipline Records

2. SAP Coordinator, administrator, & SAP team review data.

3. Assign Case Manager (CM). CM contacts parents to discuss SAP Referral.

4. Send home: SAP Cover Letter Parental Consent Form FERPA Notification Parent Checklist

INTERVENTIONS & RECOMMENDATIONS 1. Obtained parental consent to enroll in SAP 2. Ask student to complete the checklist 3. Add referral to the agenda of next scheduled SAP meeting 4. Present student data: WHOLE CHILD SUMMARY FORM 5. Brainstorm interventions & strategies 6. Set Goal/Plan: GOAL & SKILL DEVELOPMENT FORM

Brainstorm solutions: examples 1. In-school/team intervention 2. Refer to school counselor 3. Peer helper 4. Teacher as Mentor 5. Refer for Mental Health

Screening (HIGH SCHOOL) 6. Refer for D & A Screening

(HIGH SCHOOL) 7. Refer to health care

provider 8. Refer for Developmental

assessment 9. Refer for district evaluation 10. Refer to CYF

SUPPORT & FOLLOW-UP: 1. Case manager continues to monitor & update team as needed 2. Revise goal/plan as needed to continue removing barriers to

learning 3. Follow-up

OBTAINED Parent Consent

DID NOT OBTAIN Parent Consent

Respect parent’s decision Document refusal Continue to monitor

student Provide agency contacts

with information Continue to update

parents as needed Follow school policy for

D/A violation or threats to self/others

LEAVE THE DOOR OPEN

SAP & PBIS Collaboration Toolkit

Communication and Collaboration Between PBIS and SAP

Know and understand what the roles and functions of each are within the framework.

Explore working together smartly

Teams Purpose Outcome Target Group Staff Involved Action Planning

           

           

           

           

           

           

Questions to Ask

Before you decide to combine or not - What is the “big picture” ?

- District philosophy- Administrative commitment- Time - Internal supports - External linkages

Identify Internal Supports

Are there enough staff for each team?

Are team roles and responsibilities clearly defined?

How are parents engaged early in the process?

How are students engaged in their own planning?

What are the strengths & challenges of Tier 1 supports?

What Tier 2 interventions are available?

What Tier 3 interventions are available?

Identify External Linkages

What resources & existing linkages are available within the school?

At the community/ county level, what kind of resources are available?

How can the school link with new resources?

How is student voice considered in identifying needs, supports and external linkages

To Combine or Not to Combine?

Isn't that the question?

To ‘combine’ or not to ‘combine.’ Isn't that the question?

Questions to Help with Decision-Making

How to utilize systems – practices – outcomes with SAP?

Who are the members of the Universal Tier 1; Tier 2 Problem Solving and/or Data Committee?

Who provides and monitors Tier 3 services? Who monitors agreements with service

providers to make certain school – family –community partnerships are strong?

Who helps students transition? How?

Questions When Combining Teams

What are the tasks and requirements of both processes?

How do we handle written parental permission?What information is shared with a student’s

teachers?What about confidential information?What information is shared between community

service providers and the school?How is disciplinary data included and analyzed? How are referred students continuously

monitored?

Questions When NOT Combining Teams

How will a Communication System be developed between teams?

What referrals go to which team, when, and what is the process for triaging referrals to make sure they are correctly addressed?

What do staff need to know?

Develop your community partnerships

Who are the key contacts in community MH/ ID/D&A offices

Who is the community provider of in school mental health services/ therapy? Can they share information with the school? Yes, they can!

Who in the community do you need to partner with to develop your in school supports

Visit community clubs and businesses … such as Lions Club, Business Support Partnership

Improving SAP Process

Components and Indicators Checklist

Flow Chart

State Map

Remember to ask for help

SAP Regional Coordinators & Commonwealth Approved SAP Trainers

SWPBS Facilitators

PaTTAN Staff

Presenters

Dr. Susan Tarasevich - tarasl@upmc.edu

Donna Kean – donna.kean@stvincent.edu

Marie Bozwellllli c-mbozelli@pa.gov

Websites

SAP: www.sap.state.pa

PAPBS : www.papbs.org