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An Educational Model for Mental Health: Serving Children in Schools
Jessica Anderson, PsyS, NCSP & Kelly Arrington, MSW, LICSW
An Educational Model for Mental Health: Serving Children in Schools - - PowerPoint PPT Presentation
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:
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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
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- Dr. Anne Gearity, PhD, LICSW,
Therapist, Consultant, U of MN Faculty
- Dr. Bruce Perry
- Dr. Dan Siegel
Our Action Research Projects
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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
- f distress.
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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
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Key Components
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 schools in supporting mental health.
3. Teacher efforts:
a. Understanding the specific role of educators in supporting mental health. 4.
School Psychologist role:
a. Understanding the role of of school psychologists on a continuum of mental health.
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Key Component 1:
Understanding how to identify distress and respond appropriately in order to support student needs.
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What Schools Must Understand.
In order to effectively support students, we must recognize how children carry their fear and reactivity to school. We must gain awareness around:
- The process of development
- Stress
- Factors that exacerbate stress
in order to know how to identify distress and respond appropriately.
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Development
Development is innate, based on experience, and supports new learning. All of our experiences are wired into our body.
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Development
The brain develops from the bottom up and from the inside out.
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Where in the brain is the child?
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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.
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Stress and Distress
Stress is both experience shared with others (objective reality) but also perceptions experienced within the child's body and mind (subjective reality). Distress describes the child's internal state of dysregulation and often, disorganization: what is happening to me right now is dangerous.
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When stress is matched with children’s developmental resources and mediated with kind and reliable adult help, children can cope effectively with distress and regain wellbeing. When stress is not matched with children’s developmental resources, persists and becomes unmanageable, and/or when there is insufficient adult help, children become overwhelmed. Stress shifts from tolerable and useful to intolerable and endangering.
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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?
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Neocortex Limbic Diencephalon Brainstem
85% 90% 10%
Regulated: External Focus (Calm and Alert)
Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org
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Neocortex Limbic Diencephalon Brainstem
10% 60% 60%
Dysregulated: (Flock/Freeze)
Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org
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Neocortex Limbic Diencephalon Brainstem
5% 30% 85%
Highly Dysregulated: (Flight/Fight)
Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org
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Where in the brain is the child?
Bruce D. Perry, M.D., Ph.D. www.ChildhoodTrauma.org
Reason Relate Regulate
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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.
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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.
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Key Component 2:
Understanding the specific roles of schools in supporting mental health.
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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.
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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.
b.
Making social-emotional learning different from academic learning denies the realities
- f the child’s brain.
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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
- rganization 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).
b.
This helps the child manage stress without staying distressed.
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Key Component 3:
Understanding the specific roles of educators in supporting mental health.
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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.
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Key Component 4:
Understanding specific roles school psychologists have in supporting a continuum of mental health support.
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School Psychologists and the Continuum of Mental Health: Tier 1-ish 1. Increase our consultation effectiveness. 2. Build reflective capacities. 3. Be brave.
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Continuum of Behavioral and Mental Health Services at Jenny Lind Elementary
Teacher Behavior Dean
School Social Worker School Psych SEL Social Worker Co-Loc. Therapist
- Supports
classrooms upon request.
- Give breaks to
kids that need them.
- Helps mediate
conflicts when they occur
- Partner with
SSW if patterns persist.
- Facilitate IEPs and
DP needs
- Manage
transportation
- Manage and
support HHM
- Complete bully
investigations and asses/support mental health crisis
- Partner with
teachers to facilitate student plans
- Lead student
groups
- Interventions in
classroom supported by MTSS Team
- Reviewed in
MTSS
- Can be both
academic and behavioral
- Facilitate MTSS
- Complete SPED evals.
- Complete informal
fBAs
- Guide/consult with
teachers through behavioral and academic interventions
- Assist/Respond to
crisis and crisis recovery
- Lead Tier 2 SEL
Groups
- Support teachers with
SEL implementation in the classroom.
- See students on
an individual basis
- Students seen
with and without insurance
- Meet with
14-18 students at a time
- Services last
9-12 months
- See students
weekly.
- Have limited
conversations with teachers and families.
- Support SSWs
- Lead SEL PD
- Directly train
teachers on mental health patterns and needs.
- Work with teachers
to create ongoing classroom accommodations
- Complete crisis
assessments
- Facilitate mental
health groups/
- Individual work with
students
- Partner with parents
for ongoing mental health needs
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Classroom Cohesion
If you are an observer entering a classroom, reflect on these questions:
- What do you notice about the cohesiveness (or lack thereof) in the room…
- What do relationships look like between those in the room?
- Are the expectations equitable and equitably applied?
- How are students grouped/categorized/labeled?
- Do students feel connected so that all feel they belong?
- What happens during disruptions?
If there is no group cohesion - STOP! - and focus on building it. It takes a lot of front end loading, but will always pay off.
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Classroom Cohesion
Acknowledge, accept, and appreciate the culture that is - use as a guide to develop a new classroom culture and sense of cohesion. When the group stops working, step back and determine the obstacles that are interfering with the work of the group. Reflect: 1. What do we want students to learn? 2. How are we going to redefine the work of the group? When a student is struggling, try focusing on the group and how the group can pull the student in back to learning. E.g. “Ari is having a hard time right now. What are some ideas you can share to help Ari get back on track with our group?”
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The “What are you going to do about this student?” question.
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The “How am I supposed to find time to help this one student when I have 30
- ther kids in my class?”
question.
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The “He needs social skills. Don’t you have a social skills group?” question.
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“I appreciate all of those questions. I can see that we are both concerned about this student. Let’s make a plan to help him feel good about school and learning.”
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Five Finger Model
1. 2. 3. 4. 5.
1 2 3 4 5
What are the stressors in/out of school? Who are the relationship anchors? How is the student learning?
- What is the student learning and what
learning is possible right now.
What would the child, family, teacher say about the problem?
- What is this like for the student?
Ideas? What are we going to do?
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Self-Reflection and Building Your Self-Reflective Capacity
We are tasked with building our self-reflective capacity in order to facilitate the reflective capabilities of others. Going into conversations we need to: 1. Courageously identify our own biases, triggers, and stressors a. Stay personal, local, and immediate 2. Do a quick self-check/assessment a. Are you grounded? Are you neutralized? 3. Consciously remind ourselves and the group to focus the energy a. Student-focused, strengths-based problem solving
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Facilitating Adult Reflective Capacity
We need to model and engage in high self-reflective capacity in order to facilitate the self-reflection of others. How do you invite teachers into reflection as their partner: 1. Listen, really listen
a. Listen attentively, especially in the first five minutes. These will lead you to asking questions to get to the root of the real issue…. The why.
2. Normalize 3. Join with 4. Use reflective statements to move the conversation and intervention forward. Example 1: “Isn’t that sad, that must be really difficult. I wonder if ________ is because
- f _______.”
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But what do I say…
- “How interesting…?” … and then pause.
- Recap and ask, “What do you think that means?”
- “I’m observing that we seem to be stuck/not moving forward.”
- When bringing additional staff “I brought in additional staff/support to help
brainstorm ideas.”
- “Thank you for sharing that. How do you think that will help him/her in this
class?”
- “I think it would be a helpful component. What else can we do? What else can we
try in the classroom?”
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When you encounter ‘crusting’
The: “I’ve done this, this, this….. And nothing worked!” Normalize and move forward: “You’ve tried a lot. Let’s look as to how those were done.” Oftentimes, these small tactics were tried without the student knowing what was happening, they were done randomly and without sufficient explanation, and done without having the student engaged. Reframe the tactic into an intervention that includes the student. Example: Setting up a reading intervention: “This is to help you read. If you stay with me, I am here to help you read.”
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Finding Time
When availability and scheduling impacts the team (i.e. “I just don’t have time”)
- Acknowledge and move forward:
- “I know - it is very hard to find time together. We know that something is not working right now for
this student. Let’s make sure when we meet we are really effective with our time together to make a plan.”
- Use brave statements/questions: “Oh, I hear you don’t have time. What do you want to do/What do
you want to do about ______?)
- (Let the space and awkward pause)
- Be upfront, honest, and realistic (with yourself and others)
- Formally schedule for follow-up when necessary
- Reframe how we consult to match time available
- One-legged interview or standing meetings
- Shared documents (*remember to abide by confidentiality regulations)
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Be brave!
1. Become comfortable not knowing/not having the answers/being the solution.
a. You don’t have to have or be the solution. b. Use caution around “expert” language.
2. Use consultation as a means of coaching and increasing understanding.
a. Responding to the “We have to do these interventions and then we get to evaluate.”
3. Balance empathy with hard questions.
a. We can say hard things in a kind way.
4. When there are big feelings, name them and move forward:
a. “I can see I am not giving you the answer you want right now.”
5. Become comfortable with awkwardness.
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Things to ground you and your work...
- We are doing the best we can
with the resources we have.
- We lead with our defenses.
- Develop a mantra/s to help move
you forward.
○ “Your crisis is not my crisis.” ○ “That is not mine to hold”
- Build your allies.
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What questions or comments are there?
Jessica Anderson, PsyS, NCSP Kelly Arrington, MSW, LICSW
JessicaA.Anderson@mpls.k12.mn.us Kelly.Arrington@mpls.k12.mn.us
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Five Finger Model
Charlie and The Chocolate Factory 1. What are the stressors in/out of school? 2. Who are the relationship anchors? 3. How is the student learning?
a. What is the student learning and what learning is possible right now?
4. What would the child, family, teacher say about the problem?
a. What is this like for the student?
5. Ideas? What are we going to do?