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Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn Krista Kutash George Sugai IL PBIS Network University of S. FL University of OR University of S. FL University of CT July 2011 OSEP Project Directors Meeting Washington D.C.
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Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Dec 22, 2015

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Page 1: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Promoting Positive Behavioral & Mental Health in Schools:

Promising Practices from Early Childhood through High Schools

Lucille Eber

LiseFox

Beth Harn

Krista Kutash

George Sugai

IL PBIS Network

University of S. FL

University of OR

University of S. FL

University of CT

July 2011 OSEP Project Directors MeetingWashington D.C.

Page 2: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from

Early Childhood through High Schools

Audience

PD, SPDG, GSEG, TA&D,

Researchers, Parent

Programs

Agenda (BH Moderator)

10:30 Conceptual Framework

& 10:40 Elementary

(GS)

10:55 Early Childhood

(LF)

11:15 High Schools

(LE)

11:35 Mental Health

Perspective & 11:55

Concluding Comments

(KK)

Page 3: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

School-based Mental Health

Challenges

School-family-community disconnect

Variable use of data-based decision

making

Variable use of evidence-based

practices

Poor implementation

fidelity

Reactive exclusionary consequences

Non-evidence-based practices

Special education v. mental health v.

general education

Page 4: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Increase working knowledge of importance, evidence-based practices, & supporting systems of coordinated multi-tiered approaches for promoting positive behavioral &mental health for all children, including children & youth w/ disabilities;

Identify & describe strategies & systems for improving implementation fidelity, durability, & scaling of multi-tiered approaches for promoting positive behavioral & mental health for all children; &

Identify & describe capacity-expanding strategies & systems that promote positive behavioral & mental health development in schools & educational programs.

ObjectivesEvidence-

basedPractices

& Systems

ImplementationFidelity

ImplementationSustainability

& Scaling

Page 5: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

VIOLENCE PREVENTION

Positive predictable school-wide

climate High rates academic &

social success

Formal social skills

instructionPositive active supervision & reinforcement

Positive adult role models

Multi-component, multi-year school-family-community effort VIOLENCE

PREVENTION

• Surgeon General’s Report on Youth Violence (2001)

• Coordinated Social Emotional & Learning (Greenberg et al., 2003)

• Center for Study & Prevention of Violence (2006)

• White House Conference on School Violence (2006)

Page 6: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Conceptual Logic!Successful individual student behavior & mental health support is linked to host environments or schools & communities that are effective, efficient, relevant, durable, scalable, & logical for all students(Zins & Ponti, 1990)

Effective Work

Efficient Doable

Relevant Cultural/contextual

Durable Lasting

Scalable Transferrable

Logical Conceptually sound

Page 7: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Positive Behavior & Mental Health

Framework for enhancing adoption & implementation of

Continuum of evidence-based interventions to achieve

Academically & behaviorally important outcomes for

All students

Page 8: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

IMPLEMENTATION W/ FIDELITY

CONTINUUM OF EVIDENCE-BASEDINTERVENTIONS

CONTENT EXPERTISE &

FLUENCY

TEAM-BASED IMPLEMENTATION

CONTINUOUSPROGRESS

MONITORING

UNIVERSAL SCREENING

DATA-BASEDDECISION MAKING

& PROBLEM SOLVING

RtI

Page 9: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Prevention Logic for AllBiglan, 1995; Mayer, 1995; Walker et al., 1996

Decrease development

of new problem

behaviors

Prevent worsening &

reduce intensity of

existing problem

behaviors

Eliminate triggers &

maintainers of problem

behaviors

Prompt, teach,

monitor, & acknowledge

prosocial behavior

Consideration of risk & protective factors in redesign of teaching environments…not students

Page 10: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Primary Prevention:School-/Classroom-Wide Systems for

All Students,Staff, & Settings

Secondary Prevention:Specialized Group

Systems for Students with At-Risk Behavior

Tertiary Prevention:Specialized

IndividualizedSystems for Students

with High-Risk Behavior

~80% of Students

~15%

~5%

CONTINUUM OFSCHOOL-WIDE

INSTRUCTIONAL & POSITIVE BEHAVIOR

SUPPORT

ALL

SOME

FEW

Page 11: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

“Early Triangle”

(p. 201)Walker, Knitzer,

Reid, et al., CDC

Page 12: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Universal

Targeted

Intensive

All

Some

FewContinuum of Support for

ALL

Dec 7, 2007

Page 13: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Universal

Targeted

IntensiveContinuum of

Support for ALL“Theora”

Dec 7, 2007

Science

Soc Studies

Reading

Math

Soc skills

Basketball

Spanish

Label behavior & practice…not people

Page 14: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Universal

Targeted

IntensiveContinuum of Support for

ALL:“Molcom”

Dec 7, 2007

Prob Sol.

Coop play

Adult rel.

Anger man.

Attend.

Peer interac

Ind. play

Self-assess

Label behavior & practice…not people

Page 15: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Detrich, Keyworth, & States (2007). J. Evid.-based Prac. in Sch.

Startw/

What Works

Focus on Fidelity

Page 16: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Enhancing Adult Behavior

1.

“Change is slow,

difficult, gradual process

for teachers

2.

“Teachers need to receive regular

feedback on student learning

outcomes”

3.

“Continued support & follow-up

are necessary after initial training”

Guskey, 1986, p. 59

Page 17: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

SYST

EMS

PRACTICES

DATASupportingStaff Behavior

SupportingStudent Behavior

OUTCOMES

Supporting Social Competence &Academic Achievement

SupportingDecisionMaking

IntegratedElements

Page 18: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Funding Visibility PolicyPoliticalSupport

Training CoachingBehavioral Expertise

Evaluation

LEADERSHIP TEAM(Coordination)

Local School/District Implementation Demonstrations

SWPBS Implementation

Blueprint

www.pbis.org

Page 19: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Where are you in implementation process?Adapted from Fixsen & Blase, 2005

• We think we know what we need, so we ordered 3 month free trial (evidence-based)

EXPLORATION & ADOPTION

• Let’s make sure we’re ready to implement (capacity infrastructure)

INSTALLATION

• Let’s give it a try & evaluate (demonstration)

INITIAL IMPLEMENTATION

• That worked, let’s do it for real (investment)

FULL IMPLEMENTATION

• Let’s make it our way of doing business (institutionalized use)

SUSTAINABILITY & CONTINUOUS

REGENERATION

Page 20: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Algozzine, B., Wang, C., & Violette, A. S. (2011). Reexamining the relationship between academic achievement and social behavior. Journal of Positive Behavioral Interventions, 13, 3-16.

Burke, M. D., Hagan-Burke, S., & Sugai, G. (2003). The efficacy of function-based interventions for students with learning disabilities who exhibit escape-maintained problem behavior: Preliminary results from a single case study. Learning Disabilities Quarterly, 26, 15-25.

McIntosh, K., Chard, D. J., Boland, J. B., & Horner, R. H. (2006). Demonstration of combined efforts in school-wide academic and behavioral systems and incidence of reading and behavior challenges in early elementary grades. Journal of Positive Behavioral Interventions, 8, 146-154.

McIntosh, K., Horner, R. H., Chard, D. J., Dickey, C. R., and Braun, D. H. (2008). Reading skills and function of problem behavior in typical school settings. Journal of Special Education, 42, 131-147.

Nelson, J. R., Johnson, A., & Marchand-Martella, N. (1996). Effects of direct instruction, cooperative learning, and independent learning practices on the classroom behavior of students with behavioral disorders: A comparative analysis. Journal of Emotional and Behavioral Disorders, 4, 53-62.

Wang, C., & Algozzine, B. (2011). Rethinking the relationship between reading and behavior in early elementary school. Journal of Educational Research, 104, 100-109.

Academic-Behavior Connection

“Viewed as outcomes, achievement and

behavior are related; viewed as causes of

each other, achievement and behavior are

unrelated. In this context, teaching behavior

as relentlessly as we teach reading or other

academic content is the ultimate act of

prevention, promise, and power underlying

PBS and other preventive interventions in

America’s schools.”

Algozzine, Wang, & Violette (2011), p. 16.

Page 21: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Bradshaw, C.P., Koth, C.W., Thornton, L.A., & Leaf, P.J. (2009). Altering school climate through school-wide Positive Behavioral Interventions and Supports: Findings from a group-randomized effectiveness trial. Prevention Science, 10(2), 100-115

Bradshaw, C.P., Koth, C.W., Bevans, K.B., Ialongo, N., & Leaf, P.J. (2008). The impact of school-wide Positive Behavioral Interventions and Supports (PBIS) on the organizational health of elementary schools. School Psychology Quarterly, 23(4), 462-473.

Bradshaw, C. P., Mitchell, M. M., & Leaf, P. J. (2010). Examining the effects of School-Wide Positive Behavioral Interventions and Supports on student outcomes: Results from a randomized controlled effectiveness trial in elementary schools. Journal of Positive Behavior Interventions, 12, 133-148.

Bradshaw, C.P., Reinke, W. M., Brown, L. D., Bevans, K.B., & Leaf, P.J. (2008). Implementation of school-wide Positive Behavioral Interventions and Supports (PBIS) in elementary schools: Observations from a randomized trial. Education & Treatment of Children, 31, 1-26.

Horner, R., Sugai, G., Smolkowski, K., Eber, L., Nakasato, J., Todd, A., & Esperanza, J., (2009). A randomized, wait-list controlled effectiveness trial assessing school-wide positive behavior support in elementary schools. Journal of Positive Behavior Interventions, 11, 133-145.

Horner, R. H., Sugai, G., & Anderson, C. M. (2010). Examining the evidence base for school-wide positive behavior support. Focus on Exceptionality, 42(8), 1-14.

RCT & Group Design PBIS Studies

• Reduced major disciplinary infractions

• Improvements in academic achievement

• Enhanced perception of organizational health

& safety• Improved school climate• Reductions in teacher reported bullying

behavior

Page 22: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

~80% of Students

~5%

ESTABLISHING CONTINUUM of SWPBS

SECONDARY PREVENTION• Check in/out• Targeted social skills

instruction• Peer-based supports• Social skills club•

TERTIARY PREVENTION• Function-based support• Wraparound• Person-centered planning• •

PRIMARY PREVENTION• Teach SW expectations• Proactive SW discipline• Positive reinforcement• Effective instruction• Parent engagement•

SECONDARY PREVENTION• • • • •

TERTIARY PREVENTION• • • • •

PRIMARY PREVENTION• • • • • •

~15%

Page 23: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Behavior Support Elements

Problem Behavior

Functional Assessment

Intervention & Support Plan

Fidelity of Implementation

Impact on Behavior & Lifestyle

*Response class*Routine analysis*Hypothesis statement *Alternative behaviors

*Competing behavior analysis *Contextual fit*Strengths, preferences, & lifestyle outcomes*Evidence-based interventions

*Implementation support*Data plan

*Continuous improvement*Sustainability plan

• Team-based• Behavior competence

Page 24: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

SW-PBIS “Current Efforts”

Cultural diversity & relevance

Bullying behavior

DisproportionalityHigh poverty, low achieving districts

High schools

Implementation fidelity, durability,

scaling

Page 25: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

vPromising Practices for Early

Childhood

Page 26: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

The ContextThe Context

Concerns about increases in children’s challenging behavior

Growing awareness of the relationship between social emotional development and school readiness

Myriad of approaches to address particular social emotional issues; lacking comprehensive models

Reliance on clinical approaches

Page 27: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Pyramid ModelPyramid Model

UniversalPromotion

SecondaryPrevention

TertiaryIntervention

Page 28: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

28

Nurturing and Responsive Relationships

Nurturing and Responsive Relationships

Foundation of the pyramidEssential to healthy social developmentIncludes relationships with children,

families and team members

Page 29: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

29

High Quality EnvironmentsHigh Quality Environments

Inclusive early care and education environments

Comprehensive system of curriculum, assessment, and program evaluation

Environmental design, instructional materials, scheduling, child guidance, and teacher interactions that meet high quality practices as described by NAEYC and DEC

Page 30: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

30

Supportive Home Environments

Supportive Home Environments

Supporting families and other caregivers to promote development within natural routines and environments

Providing families and other caregivers with information, support, and new skills

Page 31: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Targeted Social Emotional Supports

Targeted Social Emotional Supports

Self-regulation, expressing and understanding emotions, problem solving, developing social relationships

Explicit instructionIncreased opportunities for

instruction, practice, feedback

Family partnershipsProgress monitoring and

data-based decision-making

Page 32: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

32

Targeted Social Emotional Supports

Targeted Social Emotional Supports

The support and coaching of families to enhance their child’s social development within natural environments and activities

Self-regulation, expressing and understanding emotions, developing social relationships

Page 33: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

33

Individualized Intensive Interventions

Individualized Intensive Interventions

Team developed

Parents as partners

Comprehensive interventions (all environments)

Assessment-based (functional assessment)

Skill-building

Page 34: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

The Pyramid Model: Program-Wide Implementation

ALL Levels Require Administrative

Support

Data-Based Decision Makingincluding screening and progress monitoring

Program-Wide Commitment

Teacher Training and Technical

Assistance (coaching)

Well-Defined Procedures

Partnerships with Families

Page 35: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Mental HealthMental Health

Framework for the Early Childhood Mental Consultant to build capacity

Emphasis on prevention with intensive individualized intervention available

Embedded screening for efficient identification and support

Comprehensive interventions that focus children and families

See www.ecmhc.org for resources

Page 36: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

OutcomesOutcomes

Teacher and parent satisfaction

Continual growth in implementation fidelity (practitioners and programs)

Decreases in behavior incidents

Page 37: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Experimental Child Outcomes

Experimental Child Outcomes

Non-target children

Differences between social skills scores for children in intervention versus control classrooms (Cohen’s d = .46).

Lower mean scores for problem behavior

Target children

Higher mean social skills scores in intervention classrooms (Cohen’s d = .41).

Differences in problem behavior scores

Significant differences in frequency of positive social interactions

Page 38: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

The non-system of early childhoodThe non-system

of early childhood

“Early childhood policies and procedures are highly fragmented, with complex and confusing points of entry that are particularly problematic for underserved populations and those with special needs. This lack of an integrative early childhood infrastructure makes it difficult to advance prevention-oriented initiatives for all children and to coordinate services for those with complex problems.”

(Shonkoff & Phillips, 2000, p.11)

Page 39: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Partnership for Scaling UpPartnership for Scaling Up

Center on the Social and Emotional Foundations for Early Learningwww.vanderbilt.edu/csefel/

Page 40: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Primary Partner Associations

Primary Partner Associations

Division for Early Childhood of the Council for

Exceptional Children (DEC)

IDEA Infant and Toddler Coordinators Association (ITCA)

National Association for Bilingual Education

(NABE)

National Association of Child Care Resource & Referral Agencies (NACCRRA)

National Association for the Education of Young Children (NAEYC)

National Association of State Directors of Special Education

(NASDSE)

National Association of State Mental Health Program Directors (NASMHPD)

National Head Start Association (NHSA)

Parent Advocacy Coalition for Educational Rights (PACER)

IDEA 619 Consortium

Page 41: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

CommitmentCommitment

Unified messageEvidence-based practicesComprehensive approach for supporting/promoting the

social emotional competence of all childrenFocus on the enhancement of social competencies

rather than the remediation of problemsApplication to the full range of programs and service

settings Affordable, feasible, and acceptable to diverse

personnel, families and communities

Page 42: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Changing PracticeChanging Practice

Training alone is inadequateCoaching is necessary for translation of

training to classroom practiceFidelity of implementation focus of coachingAdministrative support and systems change

necessary for sustained adoptionData driven systems necessary for ensuring

targeted program, practitioner, and child outcomes

Page 43: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Capacity BuildingCapacity Building

State Cross Sector Leadership Team• Building a system for ongoing training and technical assistance

for scaling up the implementation of the model within programs across service systems

Master T/TA CadreExpertise in all aspects of model Will provide training (of additional trainers, coaches, and

practitioners), external coaching, guide program-wide implementation, support data collection

Demonstration SitesData System

System and procedures for measuring implementation fidelity, outcomes, and using data for decision-making

Page 44: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Promoting Positive Behavioral and

Mental Health in Schools:

Promising Practices from

Early Childhood Through High School

Lucille Eber, Statewide Director, IL PBIS Networkwww.pbisillinois.org

[email protected]

Supporting Youth at the Secondary Level

OSEP Project Director’s ConferenceWashington DCJuly 19, 2011

Page 45: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Big Ideas

• Challenges and Context• A multi-tiered Systemic Approach• Effect of PBIS on existing ‘clinical’ supports

in place in schools and a developing model in IL

• A developing national model: National SMH and National PBIS Center

Page 46: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Some “Big Picture” Challenges

• Low intensity, low fidelity interventions for behavior/emotional needs

• Habitual use of restrictive settings (and poor outcomes) for youth with disabilities

• High rate of undiagnosed MH problems (stigma, lack of knowledge, etc)

• Changing the routines of ineffective practices (systems) that are “familiar” to systems

Page 47: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Why We Need MH Partnerships

• One in 5 youth have a MH “condition”

• About 70% of those get no treatment• School is “defacto” MH provider• JJ system is next level of system

default• 1-2% identified by schools as EBD• Those identified have poor outcomes• Suicide is 4th leading cause of death

among young adults

Page 48: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

It Takes a System…

Page 49: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Tier 3/Tertiary Interventions 1-5%• Individual students• Assessment-based• High intensity

1-5% Tier 3/Tertiary Interventions• Individual students• Assessment-based• Intense, durable procedures

Tier 2/Secondary Interventions 5-15%• Some students (at-risk)• High efficiency• Rapid response• Small group interventions• Some individualizing

5-15% Tier 2/Secondary Interventions• Some students (at-risk)• High efficiency• Rapid response• Small group interventions• Some individualizing

Tier 1/Universal Interventions 80-90%• All students• Preventive, proactive

80-90% Tier 1/Universal Interventions• All settings, all students• Preventive, proactive

School-Wide Systems for Student Success:

A Response to Intervention (RtI) ModelAcademic Systems Behavioral Systems

Illinois PBIS Network, Revised May 15, 2008. Adapted from “What is school-wide PBS?” OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. Accessed at http://pbis.org/schoolwide.htm

Page 50: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Core Features of a Response to Intervention

(RtI) Approach• Investment in prevention• Universal Screening• Early intervention for students not at

“benchmark”• Multi-tiered, prevention-based intervention

approach• Progress monitoring• Use of problem-solving process at all 3-tiers• Active use of data for decision-making at all 3-

tiers• Research-based practices expected at all 3-tiers• Individualized interventions commensurate with

assessed level of need

Page 51: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Examples of Ineffective Secondary/Tertiary Structures

• Referrals to Sp. Ed. seen as the “intervention”

• FBA seen as required “paperwork” vs. a needed part of designing an intervention

• Interventions the system is familiar with vs. ones likely to produce an effect – (ex: student sent for insight based

counseling at point of misbehavior)

Page 52: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Tier 1/Universal School-Wide Assessment

School-Wide Prevention Systems

SIMEO Tools: HSC-T, RD-T, EI-T

Check-in/ Check-out

Individualized Check-In/Check-Out, Groups & Mentoring (ex. CnC)

Brief Functional Behavioral Assessment/Behavior Intervention Planning (FBA/BIP)

Complex FBA/BIP

Wraparound/RENEW

ODRs, Attendance, Tardies, Grades, DIBELS, etc.

Daily Progress Report (DPR) (Behavior and Academic Goals)

Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc.

Social/Academic Instructional Groups

Positive Behavior Interventions & Supports:A Response to Intervention (RtI) Model

Illinois PBIS Network, Revised April2011Adapted from T. Scott, 2004

Tier 2/Secondary

Tier 3/Tertiary

Inte

rven

tio

nAssessm

en

t

Page 53: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Interconnected Systems Framework paper

Examples from the Field

Provided by:

Colette Lueck, Managing Director, Illinois Children's Mental Health Partnership Lisa Betz, Mental Health and Schools Coordinator, IL Division of MH

The IL PBIS Network Team

Page 54: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Community Partners Roles in Teams

• Participate in all three levels of systems teaming: Universal, Secondary, and Tertiary

• Facilitate or co-facilitate tertiary teams around individual students

• Facilitate or co-facilitate small groups with youth who have been identified in need of additional supports

Page 55: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Tier I: Universal/Prevention for AllCoordinated Systems, Data, Practices for Promoting Healthy Social

and Emotional Development for ALL Students 

• School Improvement team gives priority to social and emotional health • Mental Health skill development for students, staff, families and communities• Social Emotional Learning curricula for all students• Safe & caring learning environments • Partnerships between school, home and the community• Decision making framework used to guide and implement best practices that

consider unique strengths and challenges of each school community  

Tier 2: Early Intervention for SomeCoordinated Systems for Early Detection, Identification,

and Response to Mental Health Concerns

• Systems Planning Team identified to coordinate referral process, decision rules and progress monitor impact of intervention

• Array of services available• Communication system for staff, families and community • Early identification of students who may be at risk for mental health concerns due to

specific risk factors• Skill-building at the individual and groups level as well as support groups • Staff and Family training to support skill development across settings

 Tier 3: Intensive Interventions for FewIndividual Student and Family Supports

 • Systems Planning team coordinates decision rules/referrals

for this level of service and progress monitors• Individual team developed to support each student • Individual plans may have array of interventions/services• Plans can range from one to multiple life domains• System in place for each team to monitor student progress

 Adapted from the ICMHP Interconnected Systems Model for School Mental Health, which was originally adapted from Minnesota Children ’s Mental Health Task Force, Minnesota Framework for a Coordinated System to Promote Mental Health in Minnesota; center for Mental Health in Schools, Interconnected Systems for Meeting the Needs of All Youngsters.

Interconnected Systems Framework for School Mental Health

Page 56: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Tier 1 - Universal• Interventions that target the entire population of a school to

promote and enhance wellness by increasing pro-social behaviors, emotional wellbeing, skill development, and mental health.

• This includes school-wide programs that foster safe and caring learning environments that, engage students, are culturally aware, promote social and emotional learning and develop a connection between school, home, and community.

• Data review should guide the design of Tier 1 strategies such that 80-90% of the students are expected to experience success, decreasing dependence on Tier II or III interventions.

• The content of Tier 1/Universal approaches should reflect the specific needs of the school population.

• For example, cognitive behavioral instruction on anger management techniques may be part of a school-wide strategy delivered to the whole population in one school, while it may be considered a Tier 2 intervention, only provided for some students, in another school.

Page 57: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Tier 2 - Secondary• Interventions at Tier 2 are scaled-up versions of Tier 1 supports

for particular targeted approaches to meet the needs of the roughly 10-15% of students who require more than Tier 1 supports.

• Typically, this would include interventions that occur early after the onset of an identified concern, as well as target individual students or subgroups of students whose risk of developing mental health concerns is higher than average.

• Risk factors do not necessarily indicate poor outcomes, but rather refer to statistical predictors that have a theoretical and empirical base, and may solidify a pathway that becomes increasingly difficult to shape towards positive outcomes.

• Examples include loss of a parent or loved one, or frequent moves resulting in multiple school placements or exposure to violence and trauma.

• Interventions are implemented through the use of a comprehensive developmental approach that is collaborative, culturally sensitive and geared towards skill development and/or increasing protective factors for students and their families.

Page 58: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Tier 3 - Tertiary• Interventions for the roughly 1-5% of individuals who are

identified as having the most severe, chronic, or pervasive concerns that may or may not meet diagnostic criteria.

• Interventions are implemented through the use of a highly individualized, comprehensive and developmental approach that uses a collaborative teaming process in the implementation of culturally aware interventions that reduce risk factors and increase the protective factors of students.

• Typical Tier 3 examples in schools include complex function-based behavior support plans that address problem behavior at home and school, evidence-based individual and family intervention, and comprehensive wraparound plans that include natural support persons and other community systems to address needs and promote enhanced functioning in multiple life domains of the student and family.

Page 59: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Old Approach New Approach• Each school works out

their own plan with Mental Health (MH) agency;

• A MH counselor is housed in a school building 1 day a week to “see” students;

• No data to decide on or monitor interventions;

• “Hoping” that interventions are working; but not sure.

• District has a plan for integrating MH at all buildings (based on community data as well as school data);

• MH person participates in teams at all 3 tiers;

• MH person leads small groups based on data;

• MH person co-facilitates FBA/BIP or wrap individual teams for students.

Example 1: A District-Level Re-Design

Page 60: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Example 2: Planning for Transference and Generalization

• Middle schools SWIS data indicated an increase in aggression/fighting between girls.

• Community agency had staff trained in the intervention Aggression Replacement Training (ART) and available to lead groups in school.

• This evidence-based intervention is designed to teach adolescents to understand and replace aggression and antisocial behavior with positive alternatives. The program's three-part approach includes training in Prosocial Skills, Anger Control, and Moral Reasoning.

• Agency staff worked for nine weeks with students for 6 hours a week; group leaders did not communicate with school staff during implementation.

Page 61: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

• SWIS Referrals for the girls dropped significantly during group.

• At close of group there was not a plan for transference of skills (i.e. notifying staff of what behavior to teach/prompt/reinforce).

• There was an increase in referrals following the group ending.

• Secondary Systems team reviewed data and regrouped by meeting with ART staff to learn more about what they could do to continue the work started with the intervention.

• To effect transference and generalization, the team pulled same students into groups lead by school staff with similar direct behavior instruction.

• Links back to Universal teaching of expectations (Tier 1) is now a component of all SS groups (Tier 2).

Example 2: Planning for Transference and Generalization (cont.)

Page 62: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Example #3: Community Clinicians Augment Strategies

• A school located near an Army base had a disproportionate number of students who had multiple school placements due to frequent moves, students living with one parent and students who were anxious about parents as soldiers stationed away from home.

• These students collectively received a higher rate of office discipline referrals than other students.

• The school partnered with mental health staff from the local Army installation, who had developed a program to provide teachers specific skills to address the particular needs students from military families.

• Teachers were able to generalize those skills to other at risk populations.

• As a result, office discipline referrals decreased most significantly for those students originally identified as at risk but also for the student body as a whole.

Page 63: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Example #5: Systems Collaboration and Cost Savings

• A local high school established a mental health team that included a board coalition of mental health providers from the community.

• Having a large provider pool increased the possibility of providers being able to address the specific needs that the team identified using data, particularly as those needs shifted over time.

• In one case, students involved with the Juvenile Justice System were mandated to attend an evidence-based aggression management intervention.

• The intervention was offered at school during lunch and the school could refer other students who were not mandated by the court system, saving both the school and the court system time and resources and assuring that a broader base of students were able to access a needed service.

• As a result of their efforts, the school mental heath team was able to re-integrate over ten students who were attending an off site school, at a cost savings of over $100,000.

Page 64: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Number of IL PBIS High Schoolsas of April 2011

Page 65: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

LRE Data Trends at the High School Level

– Significantly higher use of restrictive placements of students with disabilities in most restrictive settings• Over 20% in some high schools

– Drop out rates exacerbate the issue– Students with any behavioral/emotional

component to disability more likely to be placed and/or drop out

– ….and lots more NOT identified with a disability

Page 66: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

How High Schools Are Different

• Size• Expectations of staff• Staff is departmentalized• More groundwork is needed• Teams can become layered• Implementation comes more slowly

Page 67: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

They’re not as different as they think they are!

The concepts are the same but the practices may look different.

Page 68: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Building-level Team Development

Core Team

Teaching

Acknowledgement

Data

Communication

Page 69: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

SECONDARY• Check In Check out (CICO)

– Training with high school examples

– TA with only high schools

• Small Group Interventions (SA/IG)

• Check & Connect (C&C)– University of Minnesota

• Brief FBA/BIP

Page 70: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

TERTIARY

• Complex FBA/BIP• Wrap-Around applying RENEW

– Two day training– SIMEO training– Follow up phone TA– Follow up TA days

Page 71: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Rehabilitation, Empowerment, Natural Supports, Education and Work {RENEW}

J. Malloy and colleagues at UNH

• Developed in 1996 as the model for a 3-year RSA-funded employment model demonstration project for youth with “SED”

• Focus is on community-based, self-determined services and supports

• Promising results for youth who typically

have very poor post-school outcomes (Bullis & Cheney; Eber, Nelson & Miles, 1997; Cheney, Malloy & Hagner, 1998) 71

Page 72: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

RENEW Overview

• RENEW (Rehabilitation, Empowerment, Natural Supports, Education and Work) is an application of wraparound – Reflects key principles: person-centered,

community and strengths-based, natural supports

– Focused on student, versus parent engagement (e.g., student-centered teams, student-developed interests)

Page 73: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

RENEW Overview

• The RENEW framework and the practice of mapping are ideal for engaging older students – For example, a key element of transition

planning, especially for older students, is building in opportunities/activities that the student has identified as important to their personal development

Page 74: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Promoting Positive Behavioral and Mental Health in Schools: Promising Practices from Early Childhood through

High School

Office of Special Education Programs (OSEP) Annual ConferenceJuly 2011 – Washington DC

The Mental Health Perspective

Krista Kutash, Ph.D.Department of Child & Family Studies

University of South Florida

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Page 75: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Integrating Education and Mental Health Into

School-Based Mental Health

Historically, difficult to establish effective partnerships

For many reasons….

75

Page 76: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Contrasting Perspectives

Important Theoretical Influences

Education System

Behaviorism,

Social Learning Theory

Mental Health System

Behavior Theory,

Cognitive Theory,

Developmental Psychology,

Biological/Genetic Perspective,

Psychopharmacology

76

Page 77: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Contrasting Perspectives

Focus of Intervention

Education System Behavior Management,

Skill Development,

Academic Improvement

Mental Health SystemInsight,

Awareness,

Improved Emotional Functioning

77

Page 78: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Education / Mental Health System

Improving Social and Adaptive Functioning.

Importance of and Need to Increase Availability, Access, and Range of Services

Perspectives

Common Focus

78

Page 79: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

What about evidence based practices….???

79

Page 80: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Evidence Based Practices

• Last Count = 92 mental health and SEL programs across five sources

• 53% of the programs aimed at universal level and 47% aimed at the selective/indicated levels

• 58% of the programs are school-based, 26% community based and 16% both community and school based

• 61% have a family component and 47% have a teacher component.

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Page 81: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

• A 2007 examination of 2,000 studies of School-based Mental Health Programs revealed;– 3% used rigorous empirical designs– 37% examined school outcomes – 15 programs dually effective at

meeting both academic & behavioral needs of youth.

81

Evidence Based Practices

Page 82: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

82

Effect sizes for emotional functioning, functional impairment, & achievement.

Integrated 1Integrated 2

Pull-Out 1Pull-Out 2

-0.4

-0.2

0

0.2

0.4

0.6

0.8

Emotional Functioning Functional Impairment Reading Math

Effect Size

Program

Kutash, K., Duchnowski, A.J., Green, A.L. (in press). School-based mental health programs for students who have emotional disturbances: Academic and social-emotional outcomes. School Mental Health.

Page 83: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Refocus School-Based Mental Health Services On the Core Foundation of

Schools:To Promote Learning

83

Page 84: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

The Refocused Role of Mental Health Services

• Support Teachers: the Primary Change Agents

• Mental Health Providers Become: “Educational Enhancers”

• Serve the Core Function of Schools• Promoting Social/Emotional

Development, no Longer Tangential

84

Page 85: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Need to Involve Parents & Families

85

Page 86: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

86

Common Vision

Families (FAM)Mental Health (MH)Education (ED)

IntensiveStudents in

Special Ed due to Emotional Disturbances

ED – FBA / PBS

MH – Assessment

FAMEDMH

EDFAMMH

Cognitive Behavior Therapy and other EBPs

Team Monitors Progress

UniversalAll Students

ED – PBS

MH - Screening

FAMED MH

EBP’s (PATHS)

SelectiveAt-Risk Students

ED – FBA / PBS

MH – Assessment

FAMED MH

MHED

EDMHFAM

Group Interventions

Team Monitors Progress

RtI

Implementedin organizations

that support and facilitatecollaborative, integrated

systems of services.

Integrated Partnership

Page 87: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Some Program Models with Organizational

Potential for Success

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Page 88: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

“The earmark of a quality program or organization is that it has the capacity to get and use information for continuous improvement and accountability. No program, no matter what it does, is a good program unless it is getting and using data of a variety of sorts, from a variety of places, and in an ongoing way to see if there are ways it can do better.”

– Weiss, 2002

…unless it is getting and using

data…

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Page 89: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

89

Model of Implementation Complexity

FIT

Does the innovation fit within your

organization

Complement or Compete?

CLIMATE

Willing to remove

obstacles?

Are there rewards?

Leadership support?

Clarity of Goals?

IMPLEMENTATION EFFECTIVENESS

Can you implement the innovation with

accuracy and fidelity?

INNOVATION EFFECTIVENESS

Impact of innovation,

commitment, and satisfaction

VOLITION

Is there capacity and willingness to implement?

FIDELITY BELIEFS

Favorable attitudes toward practice Complexity of innovation

Page 90: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

System Integration Strategies: Systems of Care

Effective Service Systems Requires• A range of services with a community• Collaboration between service sectors, organizations, parents and professionals

• Attention to careful planning• Performance measurement• Continuous quality improvement• Comprehensive Financing Plan• Individualized, comprehensive and Culturally Competent services

• Transformative Leadership

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Page 91: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Recently Concluded Study – SOC-IS(Surveyed 225 Randomly Selected Counties

on Their Level of SOC Implementation)

91

Page 92: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

National Levels of Implementation of Systems of Care

•75% of the counties surveyed rated themselves as having adequate implementation on 6 or more of the 14 factors associated with Systems of Care

• 26% of counties surveyed rated them selves as having adequate levels of implementation on 11 of the 14 factors associated with Systems of Care

92

Page 93: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Implementing Systems of Care 6 Factors that had the highest levels of implementation nationally

• Systems management approach • Leadership • Services based a statement of values & principles • Family voice and choice • Individualized, comprehensive cultural competent treatment • A written theory of change for system improvement

2 Factors with the lowest levels of implementation

• An implementation plan for service system improvement• An adequate level of skilled provider network

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Page 94: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Systems of Care

Information on the Systems of Care slides based on:  

Kutash K., Greenbaum P., Wang W., Boothroyd R., Friedman R. (2011) Levels of system of care implementation: A national benchmarking study. Journal of Behavioral Health Services and Research, 2011; 38(3).

 

Boothroyd R.A., Greenbaum P.E., Wang W., Kutash K., Friedman R. (2011) Development of a measure to assess the implementation of children’s systems of care: The system of care implementation survey (SOCIS). Journal of Behavioral Health Services and Research, 2011; 38(3).

 

Greenbaum P.E., Wang W., Boothroyd R., Kutash K., Friedman R.M. Multilevel confirmatory factor analysis of the system of care implementation survey (SOCIS) (2011). Journal of Behavioral Health Services and Research, 2011; 38(3).

  

Lunn L.M., Heflinger C.A., Wang W., Greenbaum P.E., Kutash K., Boothroyd R.A., Friedman R.M. (2011). Community characteristics and implementation factors associated with effective systems of care. Journal of Behavioral Health Services and Research, 2011; 38(3).

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Page 95: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

95

Alice said to the Cheshire Cat: “Would you tell me please, which

way I ought to go from here?”

“That depends a good deal on where you want to get to,” said the Cat.

“I don’t much care where,” said Alice.

“Then it doesn’t matter which way you go,” said the Cat.

…it depends a good deal

on where you

want to get to…

Page 96: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Where do we go from here?

• Build on strengths of schools • Build on strengths of families • Focus on learning• Improve & build feedback

systems• Provide services & system

coaches • and of course ….

96

Page 97: Promoting Positive Behavioral & Mental Health in Schools: Promising Practices from Early Childhood through High Schools Lucille Eber Lise Fox Beth Harn.

Fund More Research

97

A written summary of many of the points made in this presentation can be found in the following materials:

Atkins, M., Hoagwood, K., Kutash, K., & Seidman, E. (2010) Toward the Integration of Education and Mental Health in Schools. Administration and Policy in Mental Health and Mental Health Services Research, 37, 40-47.

Reducing Behavior Problems in the Elementary School Classroom

This guide is intended to help elementary school educators as well as school and district administrators’ develop and implement effective prevention and intervention strategies that promote student behavior. The guide includes concert recommendations and indicates the quality of the evidence that supports them. Additionally, we have described some ways in which each recommendation could be carried out. For each recommendation, we also acknowledge roadblocks to implementation that may be encountered and suggest solutions that have the potential to circumvent the roadblocks. Finally, technical details about the studies that support the recommendations are provided in the Appendix. Download a free copy at: http://ies.ed.gov/pubsearch/pubsinfo.asp?pubid=WWC2008012

School-Based Mental Health: An Empirical Guide for Decision-MakersKrista Kutash, Ph.D., Albert J. Duchnowski, Ph.D., Nancy Lynn, M.S.P.H.

This monograph provides a discussion of barriers to school-based services with the intention of improving service effectiveness and capacity. Reviews the history of mental health services supplied in schools, implementation of services and provides an overview of the evidence base for school-based interventions. Includes recommendations for evidence-based mental health services that can be used in schools. Download a free copy at: http://rtckids.fmhi.usf.edu/rtcpubs/study04/Or purchase a printed copy for $5.95 at https://fmhi.pro-copy.com/