aligning community science and school based mental health: policy to practice paul d. flaspohler...
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ALIGNING COMMUNITY SCIENCE AND SCHOOL
BASED MENTAL HEALTH: POLICY TO PRACTICE
Paul D. FlaspohlerCarl E. Paternite
Noelle DuvallMelissa Maras
Abe Wandersman
June 11, 2005 - Champaign, ILJune 11, 2005 - Champaign, ILA Symposium at the10th Biennial Conference A Symposium at the10th Biennial Conference of the Society for Community Research & Actionof the Society for Community Research & Action
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A Strategy: Expanded School Based Mental Health
Student Well Being
And School Success
Enhanced Systems (Family, School, Community)
Policies
InfrastructuresResources
Practices
Primary and
Secondary Prevention
Assessment and
Early Intervention
Intensive
Treatment
Mental H
ealth
Promotion
Awareness of Need
Strategic Planning
Training (Pre- and In-
Service)
Collaboration
Effective Practice
Evaluation
Quality Assessment And Improvement
Common Language
Coordination
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Best Practice Principles of ESBMH (Weist et. al., 2005)
• All youth and families are able to access appropriate care regardless of their ability to pay.
• Programs are implemented to address needs and strengthen assets for students, families, schools, and communities.
• Programs and services focus on reducing barriers to development and learning, are student and family friendly, and are based on evidence of positive impact.
• Students, families, teachers and other important groups are actively involved in the program's development, oversight, evaluation, and continuous improvement.
• Quality assessment and improvement activities continually guide and provide feedback to the program.
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Principles of ESBMH (cont’d)
• A continuum of care is provided, including school-wide mental health promotion, early intervention, and treatment.
• Staff hold to high ethical standards, are committed to children, adolescents, and families, and display an energetic, flexible, responsive, and proactive style in delivering services.
• Staff are respectful of and competently address developmental, cultural, and personal differences among students, families, and staff.
• Staff build and maintain strong relationships with other mental health and health providers and educators in the school, and a theme of interdisciplinary collaboration characterizes all efforts.
• Mental health programs in the school are coordinated with related programs in other community settings.
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Ohio’s Efforts
• Strengthening Policy: the Shared Agenda• Bridging Policy and Practice: The Ohio
Mental Health Network for School Success• Providing Prevention Support – The Ohio
Community Collaboration Model for School Success
• Providing Prevention Support - University-Community Partnerships
• Pre- and In-Service Training: The Mental-Health Education Integration Consortium
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Strengthening Policy: Development and
Implementation of Ohio’s Shared Agenda
Carl E. PaterniteCenter for School-Based
Mental Health Programs (Miami University)and
Ohio Mental Health Network for School Success
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Legislative Forum On Mental Health and School SuccessCreating A Shared Agenda In Ohio
Kristin’s TestimonyOctober 9, 2003
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Guiding Principles for a Mental Health,Schools,
Families Shared Agenda
• Mental health is crucial to school success
• There are shared opportunities for mental health, schools, students and families to work together more effectively address the well-being and school success of youth
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Infrastructure for Ohio’s SharedAgenda Initiative
Hearing on Mental Health and School Success (February 8, 2001)
Presided over by Ohio’s First Lady Hope Taft and convened by:Ohio Department of Mental Health (ODMH)
Center for Learning ExcellenceOhio Department of Education (ODE)
Governor’s Office
Publication of Mental Health and SchoolSuccess: Hearing Summary and Resource
Guide (Spring, 2001)
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Infrastructure for Ohio’s SharedAgenda Initiative
Formation in 2001 of the Ohio Mental Health Network for School Success
(OMHNSS)
Action Networks spearheaded by affiliate
organizations in six regions of the State
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Ohio’s Positive Behavior Support Initiative
Collaborative efforts of: Special Education Regional Resource Centers The Ohio Association of Elementary School Administrators The Ohio Association of Secondary School Administrators
There currently are over 700 building teams and 10,000 educational staff trained in Positive
Behavior Supports
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Policymaker Partnership (now the IDEA Partnership) at the National Association of State Directors of Special Education (NASDSE) and the National
Association of State Mental Health Program Directors (NASMHPD)
Concept Paper:Mental Health, Schools and Families Working
Together for All Children and Youth:Toward A Shared Agenda (2002)
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Purpose of the Concept Paper
“Encourage state and local family and youth organizations, mental health organizations, education entities and schools across the nation to enter new relationships to achieve positive social, emotional and educational outcomes for every child.”
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Missouri, Ohio, Oregon,South Carolina, Texas, and Vermont
With Ongoing Across-State NetworkingFacilitated by IDEA Partnership/NASDSE
Shared Agenda Seed Grant Awards to:
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Additional Funding for Ohio’s Shared Agenda Initiative
Ohio Department of Mental HealthOhio Department of Education
Ohio Department of Healthand
Numerous Additional State-level and Regional Organizations
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Ohio’s Mental Health, Schools, and Families Shared Agenda Initiative
http://www.units.muohio.edu/csbmhp/sharedagenda.html
Phase 1—Statewide forum for leaders of mental health, education, and family policymaking organizations and child-serving systems(March 3, 2003)
Phase 2—Six regional forums for policy implementers and consumer stakeholders (April-May, 2003)
Phase 3—Legislative forum involving key leadership of relevant house and senate committees (October 9, 2003)
Phase 4—Ongoing policy/funding advocacy and technical assistance to promote attention to the crucial links between mental health and school success
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Approximately 725 participants
Keynote presentations by national and state experts
Promising work in Ohio showcased
Youth and parent testimony
Cross-stakeholder panel discussions
Facilitated discussion structured to create a collective vision, build a sense of mutual responsibility for reaching the vision, instill hope that systemic change is possible, and problem-solve regarding implementation issues
Strategies and Features of Phase 1 and 2 Shared Agenda Forums
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Materials compiled and developed to inform the Fall, 2003 Shared Agenda Legislative Forum
Through Legislative Forum raise public awareness and build advocacy for policy and fiscal support for better alignment for education and mental health in the next biennial budget process
Website created to track and publicize Ohio’s Shared Agenda initiative (http://www.units.muohio.edu/csbmhp/sharedagenda.html)
Following Phases 1 and 2
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Development of format for forum, and selection of date
Commitment of participation from ODMH and ODE leadership
Identification and preparation of legislative co-chairs
Invitation to additional legislative panelists
Invitation to stakeholders throughout the state
Legislative Forum PreparationOctober 9, 2003
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Promotional work
Selection of students for written and oral testimony and identification of facilitator
Selection of adults (parents, educators, and mental health providers) for written and oral testimony and identification of facilitator
Development of written materials for the legislators
Plan for pre-forum events with student and adult participants
More Legislative Forum PreparationOctober 9, 2003
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Legislative Forum On Mental Health and School SuccessCreating A Shared Agenda In Ohio
October 9, 2003
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Legislative Forum On Mental Health and School SuccessCreating A Shared Agenda In Ohio
October 9, 2003
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Comments from Legislators Following the Adult Testimony
From Representative Joyce Beatty (Member House Education Committee)In a question/challenge to fellow legislative panelists:
“Is there legislation that we should be looking at?”
From Representative Arlene Setzer (Chair, House Education Committee)In response to Representative Beatty:
“During this whole process I was also taking notes and marking because, as you indicated there have been some specifics provided to us which we truly need many
times when looking at legislation. And, as most of you know currently the house and the senate are working on Senate Bill 2 House Bill 2 which is for the teacher success and
identifying highly qualified teachers. And within that realm…..I am going to guide that discussion around some of things that I have heard today about the idea that teachers
need to understand regardless of what their teaching assignment might be…”
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Phase 4 Steps for Ohio’s Shared Agenda Initiative
ODMH and ODE jointly formed an ad hoc workgroup to address action steps related to the Shared Agenda Recommendations
Public Awareness and Advocacy Professional Development/Training and Service Delivery Policy and Funding
Final report with recommended goals and objectives released, Summer 2004 (see handout)
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Phase 4: An Immediate Legislative Outcome
(signed into law, June 2004)
Senate Bill 2Standards for Educator Professional Development
Section 3319.61, specifying what the new educator standards board is charged to do: Item E (lines 2912-2915) —
“The standards for educator professional development developed under division (A) (3) of this section shall
include standards that address the crucial link between academic achievement and mental health issues.”
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Building A Bridge Between Policy and Practice: The
Ohio Mental Health Network for School Success
Noelle Duvall
Children’s Resource Center
Bowling Green, OH
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Funding:
Ohio Department of Mental HealthOhio Department of Education
Co-Leadership:
Center for School-Based Mental Health Programs (Miami University)
Center for Learning Excellence(Ohio State University)
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To help Ohio’s school districts, community-based agencies, and families work together to achieve improved educational and developmental outcomes for all children — especially those at emotional or behavioral risk and those with mental health problems.
Mission
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The Ohio Mental Health Network forSchool Success
Action Agenda
Create awareness about the gap between children’s mental health needs and “treatment” resources, and encourage improved and expanded services (including new anti-stigma campaign).
Partner with regional action networks to enhance within-region implementation of the action agenda, actively soliciting student and family input. Also, contribute to statewide efforts (e.g., training institutes, workshops, research, etc.).
Conduct surveys of mental health agencies, families, and school districts to better define the mental health needs of children and to gather information about promising practices.
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Phase 4 Steps for Ohio’s Shared Agenda Initiative
Ohio’s SAMHSA-sponsored 3-year Elimination of Barriers Initiative (EBI), focusing on the school age population. Contact strategies include:
Youth speaker panel/bureau
School resource materials
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The Ohio Mental Health Network forSchool Success
Action Agenda (continued)
Provide training and technical assistance to mental health agencies and school districts, to support adoption of evidence-based and promising practices, including improvement and expansion of school-based mental health services.
Develop a guide for education and mental health professionals and families, for the development of productive partnerships.
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The Ohio Mental Health Network forSchool Success
Action Agenda (continued)
Assist in identification of sources of financial support for school-based mental health initiatives.
Assist university-based professional preparation programs in psychology, social work, public health, and education, in developing inter-professional strategies and practices for addressing the mental health needs of school-age children.
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Examples of OMHNSS Special Projects (2003-2005)
• Southwest: University-Community Partnership in Effective Implementation of the Olweus Bullying Prevention Program
• Northwest: Wood County Cross Training Initiative; Olweus Program Implementation
• Northeast: Intensive Positive Behavior and Support Training and TA
• Central: Development and Use of an Intensive School District Survey
• Southeast: Expansion of Youth Experiencing Success in Schools (Y.E.S.S.) Program
• North Central: See Me Hear My Feelings and related youth experience initiative; SBMH needs surveys in schools
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Partnership Characteristics and Capacities
Local and State Level Actions and
Activities
Immediate
Mental Health Delivery OutcomesOutputs
Process and Activity Immediate
Training, Technical Assistance, and
Consultation Outcomes
Long-Term
Outcomes and Impacts
Contextual Conditions at
Local, County, and State Levels
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Promoting School Success and Student Well-being Through
Effective Community Collaboration
Paul FlaspohlerAngie LedgerwoodMiami University
Dawn Anderson-Butcher Ohio State University
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For Some of Our Kids Getting the Conditions Right is Difficult
Smart & Bored
Abused
Poor Health
Hungry
Depressed
Parents Did Not Do Well
in School Alcoholic Mother
Isolated
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ODE Logic Model
Students receive high quality instruction
aligned with academic content standards
HIGHER ACHIEVEMENT
FOR ALL STUDENTSStudents have the right
conditions and motivation for learning
ODE’s Logic Model (Fall, 2004)
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Student Achievement
Conditions & Resource Assessment
Youth Development
Parent/Family Engagement
& Support
Health & Social
Services
Community Partnerships
Evaluation &
Feedback
Collaborative Leadership & Sustainability
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ODE’s new and expanded version for school improvement...
Getting the Conditions Right!!!!
AcademicOutcomes
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Why an expanded model
• Builds upon traditional walled-in school reform strategies
• Addresses conditions underlying learning (i.e., non-academic barriers)
• Mobilizes community and school resources in support of school improvement
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Bridging Research and Practice
• Implementation guide• Tools and resources • OCCM liaisons providing on-site technical
assistance• Professional development and training
opportunities• Cross-site networking and sharing
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OCCMSI Pilots
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Initial Lessons Learned @ Implementation
• School-driven from continuous improvement planning process
• Strategic, sustainable partnership • Attention to process and relationships• Connection of needs/outcomes to
effort/activities• Priority for systems change• Need for new roles and responsibilities • Local context matters
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• Sustainable, capacity-building• Development of experts who share
their knowledge and experiences• Mutual learning about connections of
research and practice • Role of change agent and tendencies
to become part of system• Questions about who is prepared to do
this work• Implications for pre- and in-service
training
Initial Lessons Learned @ Technical Assistance and Training
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Next Directions
• Future pilot project in 6+ districts across Ohio
• Embedded training within Regional School Improvement Teams
• EPIC• Connections of local level to content
expertise • Implications for policy
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Keeping Our Eye on the Prize - Making School Improvement
Happen One Student at a Time Student Strengths and
Needs •Academic•Developmental•Social and Emotional•Physical and Behavioral Health
The Student
School and Community Services and Supports
Attributes•Individualized•Accessible•Timely•Best Practice Based•Competent
Types (Examples)•Academic Enrichment•Health Services•Social Services•Recreation Opportunities•Counseling Services•After-school Programs•Mental Health Services
The System
The Goal - To have a school-parent-community system in place that supports teachers by responding quickly and competently to student needs
Teachers in the Classroom
A Home Environment that Encourages and
Supports Learning Parents and Family
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Prevention Support through University-Community Partnerships
Melissa Maras, Chris Reiger, Rochelle Rokusek, Kathy Conoway, Jim Mosher, Marc McLaughlin, & Angie
Ledgerwood
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A Developing Philosophy
• School is the most appropriate setting for the provision of mental health intervention, prevention and promotion services (expanded school-based mental health)
• The effectiveness of these services hinges on successful collaboration between stakeholders
• Pre-service training is essential for stakeholders to build the skills necessary for doing expanded school-based mental health
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Community Psychology in a Clinical Program?
Traditional Clinical Program
Individual/ FamilyPsychotherapy in School
Setting
Individual/ FamilyPsychotherapy in Clinic
Setting
Individual/ FamilyPsychotherapy in School
Setting
Prevention and Health Promotion in School Setting
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Center for School-Based Mental Health Programs
ClassroomsCommunities
Schools/ Programs
Children and Families
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Schools, Communities, Families & Children
• Opportunities– Access to diverse services– Support– Great resources at an excellent value
• Obstacles– State-mandated proficiency requirements– Resistance to expanded school-based mental health– Amount of services v. Collaboration between service-providers
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Graduate Students
• Opportunities– Training
• Collaboration with MH stakeholders
– Research/ Practice Integration– Flexibility
• Obstacles– Constraints of Role Expectations
• The “expert” and “fix-it” syndrome• Frequent turnover
– Training Students for Multiple Roles• The tension between community and clinical psychology
– Accountability
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Lessons Learned
• Better preparation• Join the community• Transparency• Modeling
• Accountability• Engaging families• Building bridges
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Promoting Mental Health and School Success: Workforce Issues
The Mental Health—Education IntegrationConsortium (MHEDIC)
Bringing to together national experts in education and mental health fields to address:
pre-service workforce preparation issues
development of effective in-service training curricula and strategies
Administered through CSBMHP (Miami U.) and working in conjunction with the Center for School Mental Health Assistance (U. of Maryland), IDEA Partnership, and School Mental Health Alliance
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In Addition to Parents, Teachers are On the Mental Health “Front Line”
• Yet, teachers/educators are very poorly trained in problem recognition and mental health promotion
• Significant need to enhance teacher/educator training based on analysis of issues confronted in the classroom/school
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What Teachers/Educators Need
Basic Current Knowledge About:
Role of stress in students’ lives and impacts on learning
Signs and symptoms of mental illness diagnoses (e.g., depression, ADHD, anxiety disorders, conduct disorders…)
Risk factors and warning signs for suicide
Protective factors that promote resilience in students
Effective, culturally-informed treatments and supports for students with mental health problems
Medications and effects (intended and side effects) on learning and behavior
How to access community support and referral
Impacts of stigma
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What Teachers/Educators Need
Effective Strategies and Skills for:
Promoting mental health (well-being) and academic achievement through instructional techniques and curriculum
Creating a positive classroom climate that offers a healthy learning environment and promotes academic, social, and emotional development for all students
Creating a positive, inclusive and safe school culture and climate
Working with students displaying typical emotional and behavior problems
Interacting with parents in empowering and affirming ways
Listening to students
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EPE Content Review and
Revision
EPE Process Review and
Revision
Effective Practice
Integration Council
Content EPE /
U-C Partner
Process EPE /
U-C Partner
Stakeholder
Credibility Check
OCCMSI Shared AgendaABCFCF Councils
Effective Practice Network: Development and Implementation of Enhanced Content, Tools and Processes for SBMHDRAFT
Building and County /
District Engagement
Building and County /
District Engagement
OMHNSS
Enhanced SBMH Content
SBMH Sample Tools
Enhanced SMBH
Process
Products of the EPIC –
Synthesized and Translated Tools , Processes , and
Content to promote
successful implementation of effective practices in
Expanded School -Based Mental Health .
Piloting with PfS Academy
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OCCMSI District Pilots
IDEA
PartnershipCASEL CSMHA MHEDIC
Partner
States
Department
of Education
Department
of Mental Health
Department
of Youth Services
National Partnerships State Partnerships
EPIC
Effective and Culturally Competent
Practice Synthesis and Translation
OMHNSS
Statewide
Effective Practice
Dissemination
RSITS
Statewide School
Improvement mechanisms
OCCM Liaisons
School Building School
Improvement Mechanism
PriorityNeeds
Lessons
Learned
Content ,
Tools , and processes for
Effective Practice
Models and
Mechanisms for Training
and Technical Assistance
OCCM Management
School Building
Planning , Implementation &
Evaluation
Collaborative
Structures
Linkage
Protocols
Ohio Schools
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PreventionResearch System
Synthesis and
Translation
CDC Prevention Support
National Prevention Support Organizations
Org.Capacity
InnovationSpecificCapacityBuilding
GeneralCapacityBuilding
State Prevention Support System
Org.Capacity
InnovationSpecificCapacityBuilding
GeneralCapacityBuilding
Intermediary Prevention Support System
Org.Capacity
InnovationSpecificCapacityBuilding
GeneralCapacityBuilding
Local Prevention Delivery System
General and Innovation Specific
Capacity
Innovations (Principles ,
Processes , &
Programs )
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Mental Health and School Success Websites
National:National Association of State Directors of Special Education
(www.nasdse.org)
Center for School Mental Health Assistance (CSMHA, http://csmha.umaryland.edu)
Center for Mental Health in Schools(http://smhp.psych.ucla.edu)
Ohio:Center for School-Based Mental Health Programs
(http://www.units.muohio.edu/csbmhp)
Center for Learning Excellence, Alternative Education and Mental Health Projects(http://altedmh.osu.edu/omhn/omhn.htm)
Ohio’s Shared Agenda Initiative(http://www.units.muohio.edu/csbmhp/sharedagenda.html)
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This PowerPoint Presentation is posted on the Center for School-Based Mental Health Programs website
http://www.units.muohio.edu/csbmhp/