social and emotional learning for students with internalizing behaviors paul caldarella, leslie...
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Social and Emotional Learning for Students with Internalizing Behaviors
Paul Caldarella, Leslie Gunter, Thomas J. Kramer, Luke A. Marvin
BYU - Positive Behavior Support Initiative
Presented at the TECBD ConferenceTempe, AZ
October 25, 2013
Acknowledgements
Dr. Ken Merrell
November 24, 1957 to August 19, 2011
Overview
I. Mental health problems in schools
II. Internalizing behaviors
III. Prevention
IV. Screening
V. Social-Emotional Learning
VI. Strong Kids
VII.Evaluation results
Mental Health Needs in Schools
~20% students in need of services • Only ~20% receive services
Demands on educators• Insufficient resources, overworked• Limited time, academic requirements
Ineffective Programs• Not evidence based (e.g., “fads”)• Reactive “get tough” approaches• Address problems too late, less responsive to treatment
Internalizing Behaviors• Expression of distress inwards• Anxiety, depression, social withdrawal,
somatic complaints• Can be difficult to detect through
observation• Associated with negative academic and
social outcomes• Prevalence: higher in girls & adolescents
Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. By: Hankin, Benjamin L., Abramson, Lyn Y., Moffitt, Terrie E., Silva, Phil A., McGee, Rob, Angell, Kathryn E., Journal of Abnormal Psychology, 0021843X, 1998, Vol. 107, Issue 1
Anxiety Disorders
Source: http://emedicine.medscape.com/article/286227-overview#aw2aab6b2b8 based in part on Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry. Feb 1996;53(2):159-68.
Internalizing Behaviors
• Attempts to regulate internal emotional and cognitive states in a manner that is maladaptive
• May be elicited by the way youth:– think about their experiences – behaviorally cope with unpleasant events
Learning social and emotional skills and altering maladaptive thought and behavior patterns may help prevent and reduce internalizing symptoms.
Three Pronged Prevention Approach
Affective: emotional education
Behavioral: social skills training
Cognitive: change thinking
Behavior
Cognition
Affect
Prevention of Internalizing Disorders
– Look at the “big picture”– Consider the needs of all students– Move some resources and effort towards
those not experiencing severe difficulties– Address problems before they become severe
Merrell, K. W., Parisi, D. M., & Whitcomb, S. A. (2007). Strong Start grades K-2: A social and emotional learning curriculum. Baltimore, MD: Paul H Brookes Publishing.
Primary Prevention:Universal
Interventions
Secondary Prevention: Specialized interventions
Tertiary Prevention:Intensive interventions
~80% of Students
~15% ~15%
~5% 1) Build Relationships
2) Establish Expectations
3) Teach Academic and Social-Emotional Skills
4) Reinforce Appropriate Behavior
5) Use Interventions Based on Data decisions
BYU-PBSI Foundations
Identifying Needs
• Systematic Screening for Behavior Disorders (SSBD) (Walker & Severson 1992)
– Screens All Students– Internalizing & Externalizing
• Teacher ratings• Multi-gated• Suggests risk level
School-University Collaboration
• Screening• Review of results• Discussion of PBS interventions• Social and emotional learning
Social and Emotional Learning (SEL)
• Promotes resilience by teaching the skills to: – Recognize and manage emotions– Develop care and concern for others– Make responsible decisions– Form positive relationships– Handle challenging situations effectively
Strong Start (ages 5-8)
Strong Kids (ages 8-12)
Strong Kids (ages 12-14)
Strong Teens (ages 14-18)
Strong Kids Series – SEL Curricula
Strong Start Pre-K (ages 3-5)
Objectives of Strong Kids
• Prevent internalizing disorders • Understand emotions • Learn to:
• monitor and regulate emotions, thoughts, feelings• handle challenges• solve interpersonal problems• set goals
• Based on:• Principles of effective instruction• Premise that social-emotional skills must be specifically
taught, learned, and practiced just like academic skills
• Semi-scripted developmentally appropriate lessons
• School to home practice application• Home bulletin (Strong Start Pre-K/K-2)• Home work (Strong Kids/Teens)
• Practical and easy to use• Wide range of appropriate settings, purposes, leaders
About Strong Kids
How Strong Kids differs from other SEL programs?
• Emphasis on internalizing behaviors• Brief: 10-12 lessons, 25-50 minutes each• Empirically-based• SEL skills taught directly• Three-pronged instructional focus
– Affective: emotional education– Behavioral: social skills training– Cognitive: change thinking
Strengths
Low-cost, low-tech Semi-structured Covers specific
objectives and goals Feasible and easy to
implement Highly flexible across
school settings and student populations
Limitations
o Not a comprehensive program
o May not meet needs of all students
Teaching Strong Kids• Direct Instruction
– Use scripts to directly teach concepts and skills
• Discussion– Ask students to volunteer to share and discuss experiences
• Activities– Conduct small groups, model examples, and role-plays– Read children’s literature– Create drawings/posters– Practice relaxation exercises
• Application– Precorrect, remind, and reinforce
Required Materials• Projector or transparencies• Handouts• Chalk or marker board• Stuffed animal mascot and children's literature
for Strong Start
• Overview of Lessons
Lesson Summaries
Lesson 1: About Strong Kids– Critical terms defined (e.g., self-esteem,
depression, anxiety)– Overview of upcoming lessons– Behavioral expectations outlined– Pre-assessment of knowledge and symptoms
(optional)
Sample – Symptom Checklist Items
Lessons 2 and 3: Understanding Your Feelings
• Improve emotional awareness and vocabulary• Identify and distinguish feelings as comfortable or
uncomfortable• Recognize situations that cause particular feelings• Learn appropriate vs. inappropriate ways to express
feelings
• This activity will help you learn to identify comfortable and uncomfortable feelings…put a plus (+) mark next to any words that you think describe comfortable feelings, and put a minus (-) mark next to any words that you think describe uncomfortable feelings.
• Comfortable feelings: make people feel good, can help you have fun and enjoy life
• Uncomfortable feelings: make people feel bad, can also help people grow and change for the better
• Feeling Listhappy lonely scared boredangry sad upset surprisedstrong proud afraid gladshy worried tired love
Feelings Identification Activity
Lesson 4: Dealing with Anger
• Describe anger, causes, and function • Anger model • Distinguish between anger and aggression• Steps for delaying impulsive anger reactions• Appropriate ways to express anger
Anger Model
Trigger Any situation that results in you feeling angry.
Interpretation The process of thinking about what has happened to you and deciding what it means.
Emotional Reaction (Anger) What you feel after interpreting a situation or trigger.
Decision Making a choice about the action you will take.
Behavior Acting out the decision that you made.
Consequence The direct results of your behavior.
Sample - Anger Management Strategy
Lessons 5: Understanding Other People’s Feelings
• Empathy training• Identify feelings and perspectives of other people• Consider body language, facial expression• Role play scenarios
Sample - Empathy Assignment
Think of two times when you could tell how someone else was feeling. _________________________________________________
How could you tell? (What were the clues that you noticed?) _________________________________________________
What did you do, or what could you do to help that person? _________________________________________________
Lessons 6 and 7: Clear Thinking
• Positive vs. negative thought patterns• Thoughts influence mood, choices, actions• Determining the level of the emotion• Common thinking errors• Dispelling negative thoughts
Binocular vision: looking at things in a way that makes them seem bigger or smaller than they really are.
Black-and-white thinking: looking at things in only extreme or opposite ways. For example, thinking of things as being good or bad, never or always, all or none.
Dark glasses: thinking about only the negative parts of things.
Fortune-telling: making predictions about what will happen in the future without enough evidence.
Making it personal: blaming yourself for things that are not your fault.
Blame game: blaming others for things you should take responsibility for.
Sample – Common Thinking Errors
HIGH
MEDIUM
LOW
Supplement 6.1 (Overhead Transparency)Feelings Thermometer
Lesson 8: The Power of Positive Thinking
• Learn to redirect pessimistic feelings• Foster optimistic thinking• Do not attribute negative events to oneself• Change negative thoughts
Example of Using the ABCDE Model (Positive Thinking)
A: Adversity (Any problem): Michelle answers a question wrong in Math class.
B: Belief (Bad thoughts): Michelle believes the teacher is angry and the whole class thinks she is stupid.
C: Consequence (Crummy feelings): Michelle feels depressed and thinks "I wish I could run out of this classroom and never have to come back here again.“
D: Disputation or Decide (Decide not to accept thoughts): Michelle thinks "Okay, I answered the question wrong but that doesn't mean the teacher is mad. We are just learning these equations and she can't expect that all the students will always answer the questions right. The other kids in the class probably don't think I'm stupid because they get questions wrong too sometimes.“
E: Energization (Enjoy): Michelle thinks "I'm still a little embarrassed about getting the question wrong but I don't think the teacher is mad and the kids think I am stupid anymore. I no longer wish that I could run out of the classroom."
Lesson 9: Solving People Problems
• How to resolve conflict– Identify problem– Brainstorm solutions– Choose one– Make an agreement
• Strategies– Deal making– Compromising– Discussing– Brainstorming
Sample – Solving People Problems
Lesson 10: Letting Go of Stress
• Self-awareness of stress level– physical & cognitive symptoms
• Relaxation techniques– Slow breathing– Muscle relaxation
• Cognitive techniques for dealing with stress– Talking to friends– Facing your fears
Lesson 11: Behavior Change - Setting Goals and Staying Active
• How to set and attain goals• Increase engagement in positive activities• Personal values as a critical component• Connection between activity and mood
Lesson 12: Finishing Up!• Review and re-teach where needed• Post assessment (optional, but recommended)
Booster Lessons• Reminds students of main ideas• Provide more opportunities to practice
General Evaluation Results
• Empirically evaluated in ~ 20 separate studies • Treatment fidelity• Emotion knowledge and social-emotional
competence• Negative behavioral and emotional symptoms• Primarily at Tier 1 and Tier 2• Student and teacher satisfaction (social validity)
http://strongkids.uoregon.edu/
SSBS Peer Relations Subscale
38
44
50
56
Pretest Posttest
Mea
n Ra
w S
core
s
Treatment
Control
SSRS Internalizing Subscale
6
10
14
18
Pretest Posttest
Mea
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aw S
core
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Treatment
Control
Strong Start effects on teacher ratings of 26 second grade students internalizing symptoms & peer-related social skills
Caldarella, P., Christensen, L., Kramer, T. J., & Kronmiller, K. (2009). The effects of Strong Start on second grade students’ emotional and social competence. Early Childhood Education Journal, 37, 51 – 56.
Strong Kids effects on teacher ratings of 22 at-risk elementary school students internalizing symptoms
13
10
45
32
4
9
14
0
2
4
6
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10
12
14
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Pre-test Post-test Follow-up
Num
ber o
f Stu
dent
s
Clinical
Borderline
Normal
Marchant, M., Brown, M., Caldarella, P., & Young, E. (2010). Effects of Strong Kids curriculum on students at risk for internalizing disorders: A pilot study. Journal of Empirically Based Practices in Schools, 11(2), 123-143.
Strong Start Pre-K effects on teacher ratings of 52 preschool school students
Gunter, L., Caldarella, P., Korth, B.B., Young, K. R. (2012). Promoting social and emotional learning in preschool students: A study of Strong Start Pre-K. Early Childhood Education Journal, 40 (3), 151-159.
Pretest Posttest101520253035404550556065
STRS Relationship Conflict Score Over Time
Treatment
Treatment + Boosters
ControlPretest Posttest Follow-up
60
70
80
90
100
110
120
130
PKBS-2 Internalizing Behavior Scores Over Time
Strong Start/Kids effects on teacher ratings of internalizing symptoms & social skills at treatment school (n = 348) vs. control school (n = 266)
Kramer, T. (2013). Evaluating the effects of a social and emotional learning curriculum, Strong Kids, administered school-wide (Unpublished doctoral dissertation). Brigham Young University, Provo, Utah.
Pretest Posttest0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
At-risk vs not-at-risk Internalizing
At-risk
Not-at-risk
SS
RS
-I m
ean
sco
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Pretest Posttest30
35
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At-risk vs not-at-risk, Peer relations
At-risk
not-at-risk
SS
BS
pee
r re
lati
on
s m
ean
sco
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Strong Start/Kids effects on teacher ratings of at-risk (n = 48) and non-at-risk students (n = 300) internalizing symptoms & social skills
Kramer, T. (2013). Evaluating the effects of a social and emotional learning curriculum, Strong Kids, administered school-wide (Unpublished doctoral dissertation). Brigham Young University, Provo, Utah.
Treatment Fidelity & Social Validity
• Teachers have been able to implement Strong Kids with fidelity– Most common areas missed: review of
previous week’s lesson and wrap-ups
• Teachers, students, parents valued goals, procedures, and outcomes– Lesson length a bit long for younger students– More supplementary materials needed,
particularly for Strong Start
Positive Teacher Comments“The strength of the curriculum was in providing students a way to talk about their issues using a common language”
“Students seem to be doing better at inviting other people to play and joining in activities”
“SEL is definitely necessary, since often the kids are coming to us in pieces, and they can’t focus.”
“I had one boy . . .and he was really at risk and had behavior issues, but he really just thrived during the lessons and he was totally engaged in them. We would read a book and he would say, “I need that book. That’s me in that book!”
“…we spend a lot of time teaching the students academics but we know for our students at this school the most helpful thing for them is emotional help…when you help them emotionally you’re empowering them for the rest of their lives. And seeing them use the things we have taught is very rewarding.”
Critical Teacher Comments
“I would want more supplemental material. I would love to have photographs of people showing the emotions. The book had black and white pictures that were real, but they were small.”
“More games and activities (in the manual) for the students, since this is supposed to be something that we don’t have to plan for very much.”
“If there was a packet that came with it that had supplements with things to do I would be more inclined to go through the section.
“(The lessons) were a little too long.”
“I thought the (students’) attention span was the hardest thing. . . I think once I became more familiar with the format of it I got a little more comfortable shortening it to their attention span.”
Study in Residential Treatment Center
• Evaluate effectiveness of Strong Teens with adolescent girls• One previous study in RTC (Isava, 2006) with mixed results
• omitted two of the lessons• taught over the course of 5-weeks instead of 12• small sample
• In current study, Strong Teens administered to approximately 50 adolescent girls during weekly group therapy• Wait-list control group design• Data-analysis underway
Study in EBD classroom• One study of Strong Kids implemented in a special
education self-contained classroom
• 21 third thru fifth graders with EBD
• Results showed improvements in students’ emotional knowledge and self report, but no significant effects on teacher ratings
• Teachers planned to continue using Strong Kids
• More research with this population is needed
Nakayama, N. J. (2008). An investigation of the impact of the Strong Kids curriculum on social-emotional knowledge and symptoms of elementary aged students in a self-contained special education setting. Unpublished doctoral dissertation, University of Oregon, Eugene.
Using Strong Kids: Getting Started
• Materials ready (paper, posters, transparencies, overhead projector)
• Familiarize yourself with the lesson, prepare for transitions and lesson length
• Incorporate classroom rules
• Reinforce appropriate participation
• Consider seating arrangements (desks, tables, etc.)
Additional Suggestions
• Consider a team approach to leading a Strong Kids group or for school-wide implementation: teachers, counselors, psychologists, etc.
• Use pre-post tests (knowledge & symptoms) to document effectiveness (with parent consent)
• Review Tips for Transfer Training at end of each lesson, for maintenance and generalization
Recommendations at Tier 3
• Frequent reinforcement• Consider small groups for activities• Immediate feedback on written activities• Incorporate school-wide behavior supports• Allow opportunities to practice skills• Break up lessons• Use relevant, realistic examples specific to group• Supplement and reinforce lessons throughout week• Allow students to “show off” skills learned• Shorten scripts when lengthy
