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Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

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Page 1: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Colorado Framework for School Behavioral Health Services:  Lessons

Learned From the FieldApril 24, 2015

Page 2: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

WHY SCHOOL BEHAVIORAL HEALTH SERVICES?

Page 3: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Academic Link

• Academic link: A growing body of literature highlights the strong connection between social, emotional, and behavioral health and academic achievement.

– “A study estimating the relative influence of 30 different categories of educational, psychological, and social variables on learning revealed that social and emotional variables exerted the most powerful influence on academic performance” (CASEL, 2003, p. 7).

– A meta-analysis of school-based social and emotional learning programs involving more than 270,000 students in grades K-12 revealed that students who participated in these programs improved in grades and standardized test scores by 11 percentile points compared to control groups (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011).

Sources: CASEL. (2003). Safe and sound an educational leader’s guide to evidence-based social and emotional learning (sel) programs. Retrieved from http://casel.org/publications/safe-and-sound-an-educational-leaders-guide-to-evidence-based-sel-programs/

Charvat, J. (2012). Research on the relationship between mental health and academic achievement. National Association of School Psychologists. Retrieved from http://www.nasponline.org/advocacy/Academic-MentalHealthLinks.pdf

Page 4: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Access to Services and Prevention

• The majority of youth who receive services do so in a school setting (Slade, 2002).

• Proactive versus reactive behavior management• Traditional, artificial separation of the cognitive domain and

affective domains of learning• Trauma and intergenerational trauma

Slade, E. P. (2002). Effects of school-based mental health programs on mental health service use by adolescents at school and in the community. Mental Health Services Research, 4(3), 151- 166.

Page 5: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

COLORADO FRAMEWORK FOR SCHOOL BEHAVIORAL HEALTH SERVICES

Page 6: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

The Context - Colorado Framework for School Behavioral Health Services

• A systems-level Framework to help districts and schools create or enhance their layered-continuums of social, emotional, and behavioral health supports to improve student outcomes

• Leadership Advisory Committee guided the work• Investigated the scalability of Building Bridges for Children’s Mental

Health• Research

– 57 people interviewed or participated in a focus group– Over 75 academic articles and policy documents reviewed– National scan of districts/schools implementing these systems– Gaps and barriers analysis = 14 school-related plus 6 overall

gaps and barriers

Page 7: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

The Framework Model

Learn more at: http://www.Coloradoedinitiative.org/resources/schoolbehavioralhealth

Page 8: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Lessons Learned from Implementing the Framework

Embed in an existing team

What existing data can you use?

Do you include SEL in school policies?

Transforming School Climate Toolkit

Is SEL embedded across classes and across curriculum?

What capacity do you currently have to screen or identify?

Is the referral process clearly communicated and acted upon between staff?

What gaps do you have in your crisis response plan?

Example of re-entry plans

How effective is your group/individual therapy?

Systems of Care

How do you identify for Tier 2 supports? How do you match the Tier 2 supports to the identified need? How do the Tier 2 interventions supplement the Tier 1 SEL instruction/curriculum?

Assess Needs!

How do you reduce mental health stigma in a school setting? What PD is offered around students’ social, emotional, and mental health needs?

Page 9: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

SOCIAL EMOTIONAL COMPETENCIES

Page 10: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Social and emotional competencies must be taught in order for children to learn them

“When you plant lettuce, if it does not grow well, you don’t blame the lettuce. You look into the reasons it is not doing well. It may need fertilizer, or more water, or less sun. You never blame the lettuce.”

-Thich Nhat Hanh

Page 11: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

What are the competencies?

• https://www.youtube.com/watch?v=DqNn9qWoO1M

Page 12: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Why teach these competencies in schools?

Social skills and academic performance….

• They are positively related (e.g., Caprara et al, 2000; Valiente et al,

2008)…

• Children with strong social and emotional skills demonstrate self-control, pay attention and persist in completing tasks (e.g., Coolahan et al., 2000; Normandeau and Guay, 1998; Wentzel, 993)

Page 13: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Two Approaches to Helping Students Become Socially and Emotionally Competent

• The school and community based services approach: Aurora Public Schools with Aurora Mental Health Center

• The school based services approach: Mesa Valley Public Schools

Page 14: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

HEALTHY ENVIRONMENTS AND RESPONSE TO TRAUMA IN SCHOOLS (HEARTS)

Aurora Mental Health Center

Page 15: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Development of Aurora Mental Health Center HEARTS Model

• HEARTS was created in San Francisco by Joyce Dorado at UCSF in collaboration with SF Unified School District– Students who were being seen by therapists in the school

would go back to class only to be re-traumatized– Three tiered approach was developed to support schools

and children exposed to trauma

• Brought to Aurora, CO in 2013– Thank you to our funders: The Denver Foundation,

Kaiser/CEI, The Giving Trust– Thank you to Aurora Public Schools, our partners of over

30 years.

Page 16: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

HEARTS: Trauma in the schools

• Learning, Behavior, and Relationships– All are significantly impacted by trauma

• School to Prison Pipeline – Children of color, especially boys, are at high risk of

entering the School to Prison Pipeline – trauma is a factor

• Trauma System– How do the systems around you – family, school,

community – respond after a trauma?

• Helping traumatized children learn– The goal is to spend more time teaching and less time on

classroom management and discipline

Page 17: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

HEARTS: Three-tiered Approach to Addressing Stress and Trauma in Schools

• Intensive/Tertiary Intervention (5%): Trauma-informed psychotherapy with students + consultation with teachers, IEP consultation

• Early/Secondary Intervention (15%): Participation in Team Meetings for at-risk students and school-wide issues, Trauma-informed discipline policies, Teacher wellness groups, Parenting support groups

• Primary Prevention (80%): Capacity building with school staff, Training for staff on effects of complex trauma in schools and trauma-sensitive practices, Promote staff wellness and address stress, burnout, & vicarious trauma, Offering stress and trauma lens to augment universal supports , Positive Behavioral Interventions and Supports (PBIS), Health education on coping with stress, Safe and supportive school climate, Social Emotional Learning (SEL) curricula, Restorative Practices / Restorative Justice

Page 18: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Complex Trauma Domains of Impairment

• Attachment/Relationships • Biology/Brain Development • Affect Regulation • Dissociation• Behavioral Control • Cognition/Academic Functioning• Self-Concept

(NCTSN, 2003)

Page 19: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

J. Dorado & L. Dolce (2013) UCSF HEARTS

Trauma “Wears a Groove” in the Developing Brain

When the brain is in a chronic state of fear-related activation, brain more easily triggered into the “fear” track (survival brain)

Page 20: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Learning Brain vs. Survival BrainLearning Brain (and body)

Engaged in explorationacquiring new knowledge, language processingforming neuronal/synaptic connections

Driven by search for optimal balance between familiarity and novelty

Survival Brain (and body)Fight, flight, freeze, or clingSeeks to anticipate, prevent, or protect against

potential or actual dangersLanguage goes “off-line” and primitive brain

takes over( Ford, 2009)

Page 21: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Common Childhood Triggers

• Unpredictability or sudden change• Transition• Loss of control• Feeling vulnerable or rejected• Loneliness• Sensory overload• Confrontation• Praise, intimacy, and positive attention

(from ARC, Kinniburgh & Blaustein, 2005)

Page 22: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Survival Brain

• What does this look like in the classroom?• In the halls? • On the playground?

Page 23: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Data

• After Year 1 teacher training in Aurora Public Schools:

• 91% of respondents reported implementing trauma-sensitive practices in the classroom.

• 78% of respondents reported assessing for personal burnout

• 87% having a changed perspective of students’ behavior as a result of the training.

• 65% reported participation in new self-care activities

Page 24: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Next Steps

• Student-level data evaluation– No changes in suspension/expulsion rates thus far

• Seeking Year 3 funding to meet APS requests for growth

• Increasing and strengthening links between other programs such as Restorative Practices/Justice and Mindfulness for Teachers

• Improving our work with feedback from trainees, schools, students, parents, etc.

Page 25: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: History of Social/Emotional Learning

• 2009-2011 CDE chose D51 as a demonstration site for the Building Bridges to Children’s Mental Health grant designed to produce systems and products that could be replicated in other districts.

• Team included counselors, psychologists, behavior specialists, Mind Springs Health, Probation, parent coalition, teachers

Page 26: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: History of Social/Emotional Learning

• District 51 was chosen based on the history of successful implementation of PBIS and RtI

• We were addressing behavior and academics, but not mental health or social emotional learning

• Which means, we weren’t really addressing behavior or academics!

• We knew this conceptually, but not in practice.

Page 27: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: Goal

Our goal was to develop tools for teachers and counselors that could be used to support mentally healthy classrooms and practices and implement them within our universal systems of support for all students and families, as well as to have tools to use for screening, identification, action planning and support.

Page 28: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: Action

• Based on this thinking, we sought to include mental health systems within our PBIS/RtI Systems of Support. We created:• New RtI Flow Chart to include MH• Parent Engagement Flip Charts• School Tip Sheets (CDE) • New, streamlined Mental Health referral form• SEL Rubrics

Page 29: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: SEL Rubrics Development

• Research of States (Illinois/Maryland)and organizations (CASEL) promoting Social/Emotional Learning

• Integration of ASCA (American School Counselor Association) Standards

• Knowledge, experience and expertise of team to develop behavioral indicators

Page 30: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: Criteria for SEL Standards Rubric

• Be clear and meaningful to educators, students, parents and the community

• Include appropriate combination of knowledge and skills• Be specific enough to convey what students should know

and be able to do, but broad enough to allow for a variety of approaches to teaching and aligning curriculum

• Be specific enough to allow for classroom assessments to measure student progress

• Model a tool with which we are familiar

Page 31: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: Where the work is now

Training occurred for all counselors, psychologists and administrators

Tools were distributed to schools through psychologists

The plan was to train in coordination with PBIS training

The bottom fell out

Support through CEI for training

Page 32: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: Where the work is now

• Training in December to introduce continuums• Follow up in April to deepen understanding and

explore uses• Staff identified some next steps

Page 33: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

D51: Next Steps

Systems level:

All admin trained and embedded into expectations

video training

exposure to all staff

Classroom/Team level:

PLC’s- implementation? Training needs? Uses?

MTSS teams- embedded through PBIS and individual support through RtI

Counselors with individual teachers and students

Page 34: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Question & Answer

Questions for us?

Contact information:

Finessa Ferrell, CEI, [email protected]

Gianna Cassetta, SEL consultant, [email protected]

Laura McArthur, Aurora Mental Health Center, [email protected]

Cathy Haller, District 51, [email protected]

Page 35: Colorado Framework for School Behavioral Health Services: Lessons Learned From the Field April 24, 2015

Thank you!

Please fill out your evaluation form and leave it on your table.

For more resources and information, visit www.coloradoedinitiative.org.