An Educational Model for Mental Health: Serving Children in Schools - PowerPoint PPT Presentation

An Educational Model for Mental Health: Serving Children in Schools Jessica Anderson, PsyS, NCSP & Kelly Arrington, MSW, LICSW

For too long, schools have operated on a contingency punishment model. The problem with contingency punishment: it is predicated on misunderstandings of behavior and assumptions of the effectiveness of punitive consequences. We get caught in a cycle of reaction and response.

Need for a coherent plan for change. ● Change always comes with some trepidation and uncertainty. It can be easier to do things the old ways...even when outcomes remain limited at best. ● Our challenge: to re-conceptualize SEB interventions and support for all children “A paradigm shift is always hard... Asking people to change is like asking fish to jump out of water.” - Dr. Gearity

Dr. Anne Gearity, PhD, LICSW, Therapist, Consultant, U of MN Faculty Our Action Research Projects Dr. Bruce Perry Dr. Dan Siegel

Developmental Repair Developmental repair describes a state of mind, as well as a program model: It is the intentional and practiced stance that allows adults to remain active regulating partners for children who are unable to sustain adequate self-regulation and self- organization in the face of distress.

EMMH: What is it? Dr. Gearity’s Educational Model for Mental Health is a paradigm for thinking about schools and mental health. This model includes: - Addressing the needs of distressed children at school; - Supports learning; - Increases teacher effectiveness; and - Supplements other mental health services students may receive **It is NOT a specific strategy/ies that define exactly how and/or what to do. Dr. Anne Gearity, PhD, LICSW, Therapist, Consultant, U of MN Faculty

1. Student needs: a. Understanding how to identify distress and respond appropriately in order to support student needs. 2. School procedures: a. Understanding the specific role of Key Components schools in supporting mental health. 3. Teacher efforts: a. Understanding the specific role of educators in supporting mental health. School Psychologist role: 4. a. Understanding the role of of school psychologists on a continuum of mental health.

Key Component 1: Understanding how to identify distress and respond appropriately in order to support student needs.

In order to effectively support students, we must recognize how children carry their fear and reactivity to school. What Schools Must We must gain awareness around: Understand. - The process of development - Stress - Factors that exacerbate stress in order to know how to identify distress and respond appropriately.

Development Development is innate, based on experience, and supports new learning. All of our experiences are wired into our body.

Development The brain develops from the bottom up and from the inside out.

Where in the brain is the child?

Stress Biology Stress is normal, and bodies are organized to manage reasonable stress. Stress hormones cause the body to rev up and be active, and then calm down and recover. Stress is tolerable with adult mediation; the body recovers. Toxic stress occurs when stress exceeds the child’s resources, and is too much, too long, with too little help. Toxic stress can disrupt development.

Stress and Distress Stress is both experience Distress describes the child's shared with others (objective internal state of dysregulation reality) but also perceptions and often, disorganization: experienced within the child's what is happening to me body and mind (subjective right now is dangerous. reality).

When stress is not matched with When stress is matched with children’s developmental children’s developmental resources, persists and becomes resources and mediated with unmanageable, and/or when kind and reliable adult help, there is insufficient adult help, children can cope effectively children become overwhelmed. with distress and regain wellbeing. Stress shifts from tolerable and useful to intolerable and endangering.

Now our work begins... Self-regulation: the biological and psychological capacity to get my balance back when I am thrown. Our ability to stay regulated is at the core of our functioning. When we can stay interested in our children instead of angry when they are struggling, then we are working on repair. Where in the brain is the child and what do I do?

85% Neocortex Regulated: Limbic External Focus 90% ( Calm and Alert ) Diencephalon 10% Brainstem Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org

10% Neocortex Dysregulated: Limbic ( Flock/Freeze ) 60% Diencephalon 60% Brainstem Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org

5% Neocortex Highly Limbic Dysregulated: 30% ( Flight/Fight ) Diencephalon 85% Brainstem Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org

Reason Where in the brain is the child? Relate Regulate Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org

Examine Student-Based Practices that Exacerbate Stress - Placing demands on a student while assuming a child’s developmental level is the same as their chronological age. Extreme stress interferes with development. As a - result, many children try to solve problems with resources that are no longer matched with age expectations. - Being removed from or estranged from a peer group. - E.g., seclusion/exclusion practices, TAB outs, suspensions, etc.

Factors that Exacerbate Stress - Assuming the child has done what you are asking before or knows your expectation. - For stressed children, learning must start with shared experiences. - E.g., A child who has never felt calm must experience the feeling of calm with people at school before they do this independently. - Assuming you will be helpful and the child will respond to you because you are the adult. - When very stressed children have not experienced adequate mediation in dangerous situations, they do not expect adults to be helpful. - Very stressed children need to learn that adults at school can and will help to manage their stress before they can do this for themselves.

Key Component 2: Understanding the specific roles of schools in supporting mental health.

How schools support mental health Schools hold a universal promise: When distressed, learning can help children feel better. Adult instruction and support that is positive, encouraging, instructive, and patient helps children stay engaged in things other than difficult events. When learning is compromised because children lack pre-learning abilities (e.g. regulation, organization, attention, social monitoring, etc.) schools must repair these prerequisites for complex learning and remedite age-appropriate coping skills.

Integrating care in schools We integrate care throughout the school by operating from these premises: 1. We must change the sense of ownership from imposed and enforced to engaged and collaborative learning communities where everyone has an investment. 2. All children belong in school and are accepted as learners. a. All learning must be recognized as equal and integrated. Making social-emotional learning different from academic learning denies the realities b. of the child’s brain.

Integrating care in schools (continued) 3. A predictable, reliable, and consistently safe school climate fosters security and group cohesion. a. Safe schools are created by adults at the school providing sufficient structure and organization so that all children can feel safe. They are not created by banishing the children who initiate danger. 4. Experiential learning that happens in-the-moment or close to the experience of distress is crucial. a. Join the child’s perception in order to look beneath behavior (symptom) and better understand their distress (cause - NOT to be confused with function). This helps the child manage stress without staying distressed. b.

Key Component 3: Understanding the specific roles of educators in supporting mental health.

How educators support mental health 1. All educational staff must have the capacity and willingness to acquire skills for experiential remediation and repair. a. Learning can help you feel better organizes the child; I can help you learn is the teaching imperative. b. We may have good intent, but the system is hard. 2. Teachers need effective support systems and availability of competent professionals with mental health training in the school community. a. School psychologists, school social workers, school counselors, nurses, etc. 3. Adult reflective capacity. a. Being interested and concerned about what is going on inside the children. b. Educators must understand how they can join children who are dysregulated.

Key Component 4: Understanding specific roles school psychologists have in supporting a continuum of mental health support.

School Psychologists and the Continuum of Mental Health: Tier 1-ish 1. Increase our consultation effectiveness. 2. Build reflective capacities. 3. Be brave.