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Project One-to-WonSchool Based Mental Health in the Pocono Mountain School
DistrictPresented by: Dr. Mary Beth Gustafson, Deanna Moerer LSW, and Greg Llewellyn Ed.S
May 18, 2011
Behavioral Health is as important as physical
health to a child’s quality of life and directly impacts
his/her learning and development.
PDE Grant Opportunity
School-Based Behavioral/Mental Health Performance Grant:•Create a model program to address the behavioral/mental health needs of students in grades K-12•Partner with an outside mental health agency – (i.e. Youth Advocate Program (YAP)•Create a three tiered behavior support system•Grant funding for five years
PMSD Demographics
Total Enrollment - 10,689Free/Reduced Lunch - 49.1%Special Education - 22% (increase from 15% in 2008-09)Gifted Education - 2.6%Diversity of Student Body•White – 53.5%• African American – 23.8%•Hispanic – 21.3%English as a Second Language – 400 studentsHomeless – 82 students (increase from 9 in 2009-10)
Transfer Students with Special Needs
• July 1, 2010 to present- 328• Foster – 8• Partial Hospitalization – 4• Alternative Educational Placement – 26• Adjudication - 20
Project One- to- Won
School Based Behavioral Health Program
Mental health is not simply the absence of mental illness; it also
means having the skills necessary to cope
with the challenges of life.
Main Staff
• Behavioral Specialist Consultant• Drug and Alcohol Counselors• Guidance Counselors• Student Assistant Program (SAP)
Coordinator• Project One-to-Won
• Deanna Moerer – Program Coordinator• Lynette Rohan – Social Worker• Beth Fisher – Assistant Program
Coordinator
Goal and Objectives
•Increase attendance rate•Decrease Alternative Education Placements (AEP)•Decrease In-School Suspension/Out of School Suspension•Increase student achievement•Increase Least Restrictive Environment (LRE) percentage•Increase graduation rate•Increase school community involvement
Response to Intervention
5%
BEHAVIORAL SYSTEM
TERTIARY (6 or more discipline referrals)
Targeted Programs•Ind/group Therapy•Community Links Program•Family Check Up Program•Truancy Treatment Planning•Transition Treatment Planning
ACADEMIC SYSTEMS
Resiliency Theory
• Based upon the principle that all people have the ability to overcome adversity to succeed.
• A strengths based model with a focus on providing support and opportunities which promotes success in life.
• Based on research devoted to identifying the protective/risk factors and processes that might account for children’s successful outcomes (Wolin & Wolin, 1993; Glantz & Johnson, 1999; Mastine, 2001).
Risk Factors
IN THE CHILD IN THE FAMILY
Fetal drug/alcohol effects PovertyPremature birth or Large family of 4 or moreDifficult temperament Parent with mental illness Shy temperament Parent with substance abuseNeurological Impairment Parent with criminalityIQ <80 Chronic medical disorder Psychiatric disorder Repeated aggression Substance abuse Delinquency Academic failure
Risk Factors cont.
Family/Experiential
Poor infant attachment to motherLong term absence of caregiver in infancyWitness to extreme conflict and violenceSubstantiated neglectSeparation/divorce/single parentNegative parent-child relationshipSexual abusePhysical abuseRemoval from homeFrequent family movesTeen pregnancy
Protective Factors
Qualities of the Child Family Characteristics
Positive - easy temperament Lives at home Independence as a toddler Warm relationship with High hopes for the future with parentInternal locus of control as a teenagerInterpersonally engagingSense of humorEmpathy Perceived competencies IQ>100 Good reader Gets along with others Problem solving skills
Referral/Intake Process
• Student Assistance Referral (SAP) - students exhibiting emotional/behavioral concerns.
• BIO/PSYCHO/SOCIAL - An assessment of all the factors relevant to resiliency which allows treatment planning to address ongoing risk factors, identify existing strengths, and build on protective factors.
• Assessment Tools• CHILD BEHAVIOR CHECK LIST-DSMIV
Treatment Planning
Once all intake paperwork has been completed, the following components are available to all students.
Individual/Group TherapyFamily Check UpCommunity LinksTransition Treatment PlanningTruancy
Becca - A Case Study
2009-2010•Attendance 45%•GPA 78•1 ODR 7 OSS•1 close friend•Youth group
2010-2011•Attendance 91%•GPA 95•0 ODR•Drama Club•Talent Show•8 close friends, sleepovers, parties, movies, youth group, typical teenager activities
How did we do this?
Component 1: Intensive Individual Therapy
• Cognitive, Solution Focused, Reality Based Therapy
• Mentoring• Consulting• Crisis Planning
Component 2: Intensive Group Therapy
• Aggression Replacement Training • Full of Ourselves/Girl Talk• Keeping Your Cool • Cool Cat• Coping Cat• Taking Action for Depression• I Can Problem Solve• Second Step• Skillstreaming • Student Bodies (Eating Disorders)
Aggression Replacement Training
• Anger Control• Skillstreaming50 social skills
• Moral Reasoning
Aaron
Penti
COMPONENT 3: FAMILY CHECK-UP
• Enables the therapist to partner with parents on a daily, weekly, monthly basis in school and/or home on a continuous basis.
• Bridges any gaps, creates a positive relationship, increases a positive home/school connection, and engages the parents in the process of their child’s road to mental wellness.
• Identifies barriers interfering with the child’s education and helps parents create and implement behavior support plans in the home.
• Provides a vehicle to inform parents of the child’s progress in all areas.
COMPONENT 4: COMMUNITY LINKS
Links students with after-school activities or in the community to build on their strengths and interests.
Examples:
•Equilibrium
•Pocono Medical Center
Community Links cont.
•Mental Health and Mental Retardation (MHMR) •Provider 50 •Multisystemic Therapy•Psychiatric Outpatient •Family Outpatient Counseling •YMCA •Libraries•Salvation Army•Medical Assistance
Tino
Sean
Component 5: Transition Treatment Planning
Provide continuity of care:
•Transition student in/out of district in timely manner.•Aide in securing services to build a resilient child/family.•Transfer learned coping skills back to district/staff.
COMPONENT 6: TRUANCY PROGRAM
•School Refusal Assessment Scale (SRAS): an evidenced-based scale that identifies the function of a student’s behavior that causes truancy.
•Bio/psycho/social: identifies the barriers that are affecting the child’s ability to attend school.
A significant percentage of truancy occurs when there is an undiagnosed mental health concern such as anxiety (school phobias/panic disorders), depression, paranoia , etc.
School Refusal Assessment Scale
Negative Affectivity - bad feelings related to something at school.Social/Evaluative Situations - difficulties interacting with or performing before others.Attention - child refuses to attend school to spend time with parents/guardians.Tangible Rewards - child misses school to have more fun outside of school.
Truancy Treatment Planning
• Identify the mental health concern (if applicable).• Obtain psychiatric treatment (if applicable).• Teach coping strategies.• Go to the home each morning, work the child
through their challenges, drive them to school and continue to work with them in school until they are stable enough to continue on their own.
• Transfer skills to parent/child.• Include school staff in all stages of planning as
they are integral to achieving success.
Truant Students who received support and services through Project One-to-Won
• 2008-2009 - Attendance rates increased by 19% (based on 3 students).
• 2009-2010 - Attendance rates increased from a baseline of 41% to 85% (based on 5 students).
Component 7: Professional Development
Tier II• Check-In/Check-Out (CICO) • Second Step
Tier III• Looking Beyond the Behavior (Anxiety, Eating
Disorders, ADHD, Bipolar Disorder)• Self Injury: Cutting and Eating Disorders• Understanding Bipolar Disorder in Children• Understanding ADHD in the School Environment• Treating Anxiety Disorders in School
Project One-to-Won 2009-2010 (based on approx. 60 students)
• Office Discipline Referrals - Decreased by 56%
• In-School Suspension - Decreased by 10%
• Out of School Suspension - Decreased by 47%
• Grade Point Averages - Increased by 8%, 90% maintained grade point average, 2% had a lower average
Graduation Rates
• 9 out of 10 TIER III students have graduated.
Tier IIIBuilding the Framework
2006-2007 2007-2008 2008-2009 2009-2010 2010-2011TIER I Researched,
Designed, Planned, Hired Staff, Trained Staff and created Advisory and Steering Committees.
Implemented SWPBS at Clear Run Elementary and Swiftwater Elementary Centers
Tobyhanna & Coolbaugh Elementary Centers plan for SWPBS
Implemented SWPBS at Tobyhanna and Coolbaugh Elementary Centers
Clear Run Intermediate School planned for SWPBS
Implemented Second Step Program in Kindergarten at CREC and SEC
Implemented SWPBS at Clear Run Intermediate
Implemented First Tee in CREC and SEC
Barrett Elementary Center planned for SWPBS
Constructed District Leadership Team
TIER II Pilot Check-in/Check-out at CREC and SEC
Trained guidance counselors to implement Behavior Education Program (CI/CO) and Second Step Program
Implemented Check-in/Check-out at CREC, SEC, TEC & CEC
Implemented Full of Ourselves self-esteem program at Swiftwater Intermediate School (SIS)
Implemented Check-in/Check-out at Clear Run Intermediate School and Swiftwater Intermediate School
• Implemented Full of Ourselves self-esteem program at CRIS
TIER III Project One-to-Won (SOAR Room) 18 studentsIndividual/Group TherapyAggression Replacement TrainingI Can Problem SolveMentor ProgramFamily Check-up ProgramCommunity Links ProgramTruancy Prevention Program
40 StudentsIncreased number of groups for Aggression Replacement Training from one to threeAnalyzed Alt. Ed. PlacementsCreated Individualized Transition Plan template for all students in Out of District PlacementsImplemented Second Step in targeted group settings
60 studentsUtilized the Individualized Transition Plan template for all students in Alt. Ed. PlacementsIncreased number of students receiving individual and group therapies by hiring a Master Level clinician.Implemented Second Step in 4 emotional support classrooms
90 students•Created a Mental Health Core Team•Implemented Aggression Replacement Training, Full of Ourselves and Social Skills groups at CRIS and WHS•Increased Second Step to 2 emotional support classrooms at PEC
Tier I
2006-2007 2007-2008 2008-2009 2009-2010 2010-2011
Tier I Implemented SWPBS at:•CREC•SEC
Planning stages for SWPBS:•TEC•CEC
Implemented SWPBS at:•CREC•SEC•TEC•CEC
Planning stages for SWPBS•CRIS Implemented Second Step Program in one Kindergarten at SEC
Implemented SWPBS at:•CREC•SEC•TEC•CEC•CRIS
Implemented Second Step Program in all Kindergarten classrooms at CREC and SEC
Implemented First Tee at CREC and SEC.
Implemented SWPBS at:•CREC•SEC•TEC•CEC•CRISPlanning stages for SPWBS:•BEC Implemented Second Step Program in Kindergarten and First Grade at CREC and SEC
Implemented First Tee at CREC and SEC.Create District Leadership Team for SWPBS
2006-2007 2007-2008 2008-2009 2009-2010 2010-2011
Tier II Piloted Check-in/Check-out: • CREC• SEC
Trained guidance counselors to implement Behavior Education Program (CI/CO) and Second Step Program
Implemented Check-in/Check-out: • CREC• SEC• TEC • CEC
Implemented Full of Ourselves self-esteem program at: •Swiftwater Intermediate School (SIS)
Implemented Check-in/Check-out at:•CREC•SEC•TEC•CEC•CRIS•SIS
Implemented Full of Ourselves self-esteem program at:•Swiftwater Intermediate School (SIS)
Implemented Full of Ourselves self-esteem program at;•Clear Run Int. School (CRIS)
2006-07 2007-2008 2008-2009 2009-2010 2010-2011
Tier III ImplementedProject One-to-Won•Individual Therapy•Group therapy•Family Check-up Program•Community Links Program•Truancy Prevention Program•Mentor Program•Family Therapy•Parenting Classes
Aggression Replacement TrainingI Can Problem Solve
Serves 18 students
ImplementedProject One-to-Won•Individual Therapy•Group therapy•Family Check-up Program•Community Links Program•Truancy Prevention Program
Increased number of groups for Aggression Replacement Training from one to two. Second Step, I Can Problem Solve.
Analyzed Alt. Ed. PlacementsCreated Individualized Transition Plan Template for all students in Alt. Ed. Placements Serves 40 students
ImplementedProject One-to-Won•Ind. Therapy•Group therapy•Family Check-up Program•Community Links Program•Truancy Prevention Program Increased use of the Individualized Transition Plan Template for all students in Alt. Ed. Placements
Increased number of students receiving individual and group therapies by hiring a Master Level clinician. Serves 60 students
ImplementedProject One-to-Won•Ind. Therapy•Group therapy•Family Check-up Program•Community Links Program•Truancy Prevention ProgramIncreased number of students transitioning back to district from Alt. Ed. PlacementsIncreased number of students receiving ind./group therapies.
Created a District Mental Health Core Team
Serves 90 students
Program BenefitInstructional Minutes
CREC Office Discipline Referrals
Referrals 5min 20min 10min
ISS
OSS
5min
5min
6hrs 20min
6hrs 45min
Teacher Student Administrator
Referrals 10 hrs/1hr 39hr/4hr 19hrs/2hrs
ISS 8.5hrs/45min101days/9days 33.5hrs/3hrs
OSS 4.5hrs/15min 55days/3days 41hrs/2hrs
AdministratorStudentTeacher
2007-2008 Pilot Program (18 students)
Referrals 5min 20min 10min
ISS
OSS
5min
5min
6hrs 20min
6hrs 45min
Teacher Student Administrator
Referrals 3.5 hrs/55min 2days/3.6hrs 7hrs/1.8hrs
ISS 5.75hrs/15min69days/3days 3days/1hr
OSS 3.5hrs/2.9hr42days/35days 4 days/3.5days
AdministratorStudentTeacher
2009-2010 ART Group (6 students)
CICO DATA FOR CREC 2008-09
CICO DATA 3 YEARS
LRE Percentages STUDENTS INCLUDED MORE THAN 80% OF THEIR DAY
Increase in LRE for Alex
Increase in LRE for Christian
Increase in LRE for Josephine
Increase in LRE for Latifa
Increase in LRE for Alexis
Cost Benefit
Would you want that program?
If programs and services were provided to students for $7.43 per student per day within the district vs. $69.00 per student per day in an Alternative Educational Placement (AEP)…
Financial Impact
Sustainability and Continuous Improvement
Sustainability and Continuous Improvement
• Develop a District-Wide SWPBS team.• Develop a District-Wide SBBH to:
improve the referral process, communication, and delivery of services to ensure
improve efficiency and effectiveness of the referral process
decrease duplication of services. • Collect and analyze four years of district data • Determine the cost effectiveness of providing
SBBH services within the district.
Moving Forward for 2011-12
•Develop a Needs Assessment•Develop an Action Plan
Identify roles and responsibilitiesImprove the referral processDevelop new forms and formatsDevelop a staff surveyPlan Professional Development Activities for 2011-12 school year
•Develop a system to monitor progress
Sustainability and Continuous Improvement cont.
•Develop consistency of programming and supports among all schools implementing School-Wide SWPBS.•Provide support and resources to the staff and students implementing SWPBS. •Provide on-going communication between and among all schools implementing SWPBS. •Increase collaboration and improve communication with PaTTAN, PDE, and IU 20 in an effort to provide on-going professional development opportunities to the school community related to SBBH/SWPBS.
Resources
• Achenbach, T, Child Behavior Checklist. ASEBA University of Vermont, Burlington Vermont, www.aseba.org.
• Albano, Anne Marie & Kearney, Christopher (2007), When Children Refuse School, A Cognitive-Behavioral Therapy Approach. Oxford University Press: Oxford.
• Goldstein, A , Glick, B & Gibbs, J (1998), Aggression Replacement Training. Research Press: Illinois.
• Crone, Deanne, Hawken, Leanne & Horner, Robert (2004) Behavior Education Program. Guilford Press: New York.
• www.pattan.net
Mary Beth Gustafson, Ed. D. mgustafson@pmsd.orgGreg Llewellyn, Ed.S gllewellyn@pattan.netDeanna Moerer, LSW dmoerer@yapinc.org Beth Fisher, BS bafisher@yapinc.orgLynette Rohan, LSW lrohan@yapinc.org
PaTTAN , PDE, and the IU 20 for
your support.
Thank You!
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