Teachers as Partners in Effective School-Based Mental Health Programs Therese C. Johnston, Ph.D. Carl E. Paternite, Ph.D. Ohio Mental Health Network for.

Teachers as Partners in Teachers as Partners in Effective School-Based Mental Effective School-Based Mental

Health ProgramsHealth Programs

Teachers as Partners in Teachers as Partners in Effective School-Based Mental Effective School-Based Mental

Health ProgramsHealth ProgramsTherese C. Johnston, Ph.D.Therese C. Johnston, Ph.D.

Carl E. Paternite, Ph.D.Carl E. Paternite, Ph.D.Ohio Mental Health Network for School SuccessOhio Mental Health Network for School Success

Johnston & Paternite, OMHNSS 2

IntroductionsCarl Paternite, Ph.D.

Department of Psychology

Miami University

Oxford, Ohio 45056

[email protected]


Introductions

Terri Johnston, Ph.D.Educator Consultant

Behavior Consultant

[email protected]


Background and Context• Most youth in need of MH intervention

don’t receive it

• Of the small percentage that do the majority receive treatment within a school setting

(Rones & Hoagwood, 2000)


Background and Context• Service realities

– Reliance on primary care medical settings

– Community mental health clinics

– Private practitioners


Background and Context• Historically, school

services focused on special education population

• Emphasized individual assessment and intervention


Historical Relationship• Teachers seen as

information source• Teachers often

perceived as untrained and unreceptive to consultation from MH provider


Educators vs. Therapists• Sedlak (1997) discussed the uneasy

alliance between service providers and schools

• Mental health staff (e.g., social workers, psychologists, counselors, etc.) seen as “frills” not essential to the academic mission of schools


Educators vs. Therapists• MH Provider Goals

– Focused on the individual– Social/emotional goals considered to be

not related to academic success– Therapeutic interventions occur in private

“pull-out” sessions– Confidentiality sited as reasons not to

inform teachers of progress


Educators vs. Therapists• Teacher Goals

– Focused on the group rather than the individual

– Academic achievement mandated as primary concern

– Feel unprepared to face the emotional demands of ever-changing population


Cooperation vs. Integration

• Many so called school-based programs co-exist in the buildings

• Rarely are mental health staff and educators actually working together identifying and sharing– Values– Goals– Strategies


The Role of Schools• Can’t be responsible for meeting the all

the needs• Must meet then challenges when needs

directly affect learning and school success (Carnegie Council Task Force on Education of Young Adolescents, 1989; Elias, Zins, Graczyk, & Weissberg, 2003)


The Role of Schools• Compelling evidence

– Positive associations between mental health and academic success

– Emotional, social, and behavioral health problems are significant barriers to learning (Adelman & Taylor, 1999; Atkins, Frazzier, Adil & Talbott, 2003)


Partnership is Critical• Public schools’ mission is to educate all students• Students with challenges of SED have the highest rates

of school failure– 50% drop out compared to 30% for students with other

disabilities

• Mental health is essential to learning as well as social and emotional development

• The interplay between emotional health and school success indicates schools must be partnersPresident’s New Freedom Commission on Mental Health Achieving

the Promise: Transforming Mental Health Care in America (2003)


Essential Attitudes for Collaboration

• Providers should view educators as valued customers

• Focus should explicitly be on MH barriers to schools success


Essential Attitudes for Collaboration

• Educators should be viewed as…– valued colleagues– Essential members

of the mental health team


Cognitive Dissonance• “Equal standing”??????• Mental health hierarchies

– Expert vs. consultee


Teachers Lack Confidence• Feel ill prepared to

design or support interventions for students with psychiatric disorders even when primary disability is attributed to emotional or behavior problems (Maag, 2002)


Student Support• Educators rarely know anything about mental

health services students are receiving nor the nature or intensity of the services

• Teachers who are engaged with students day after day play central roles in facilitating social and emotional learning


Student Support• Important collaboration could include

– Assistance and consultation with social skill instruction IN THE CLASSROOM

– Development and monitoring of behavior intervention plans

– Consultation with parents to encourage consistent strategies and promotion of practice and reinforcement of alternative behaviors across contexts


Models Fully Engaging Educators

• Positive Behavior Support• Re-Education

Specialized Individual Interventions(Individual StudentSystem)

Continuum of Effective BehaviorSupport

Specialized GroupInterventions(At-Risk System)

Universal Interventions (School-Wide SystemClassroom System)

Studentswithout SeriousProblemBehaviors (80 -90%)

Students At-Risk for Problem Behavior(5-15%)

Students withChronic/IntenseProblem Behavior(1 - 7%)

Primary Prevention

Secondary Prevention

Tertiary Prevention

All Students in School


School-Wide PBS• Continuum of integrated activities

– Health promotion through intensive intervention– Dependent on effective multi-disciplinary teamwork and

engagement of families

• “Positive behavior” refers to all skills that increase a student’s success in the home, school and community setting

• “Support” refers to the methods used to teach, strengthen and expand positive behaviors

(Sugai et al., 2000)


PBS• Shows promise as an

effective preventative strategy

• Decreases antisocial and other behavior difficulties amongst a growing population of children and youth

Specialized Individual Interventions(Individual StudentSystem)

Continuum of Effective BehaviorSupport

Specialized GroupInterventions(At-Risk System)

Universal Interventions (School-Wide SystemClassroom System)

Studentswithout SeriousProblemBehaviors (80 -90%)

Students At-Risk for Problem Behavior(5-15%)

Students withChronic/IntenseProblem Behavior(1 - 7%)

Primary Prevention

Secondary Prevention

Tertiary Prevention

All Students in School


Project Re-ED• Re-ED

– Re-Education of Emotionally Disturbed Children– Based on the work of Dr. Nicholas Hobbs more than 40

years ago

• Observation of residential treatment programs in Western European countries

• Noted that programs dominated by an elaborate professional hierarchy were less effective than those relying on and valued the interpersonal rapport of “natural child care workers”


The Heart of Re-ED• Problems do not

reside within a child• Instead, the

interaction of contextual variables in the natural setting contributes to the discord


12 Principles of Re-ED• Life is to be lived now

• The group is important

• Trust is essential

• Competence makes a different

• Time is an ally

• Intelligence can be taught


12 Principles of Re-ED• The body is the armature of the self (i.e., the

physical self around which the psychological self is constructed

• Communities are important• Feelings should be nurtured• Self-control can be taught• Ceremony and ritual give order• A child should know some joy in each day


The Heart of Re-ED• Therapeutic focus is competence

enhancement rather than deficit reduction• Academic achievement is of particular

importance• School and school work is the business of

children, and successful living is healing (Valore, 2002)


Educators Supporting Mental Health

• Most children fail in school because the feel detached, alienated and isolated from the process, not due to the lack of cognitive skills

• “…the bond between the teacher and student creates the foundation upon which a sense of belonging can develop”

(Beck & Malley, 1998)


Resilient Youth• Several studies suggest factors present in

resilient youth include– Successful school experiences– Development of reading skills above the 3rd

grade– Associations with caring adults outside the family– Ability to maintain hope

(Gilliam & Scoot, 1998; McEvoy & Welker, 2000)


Conclusion• It is essential to

engage educators in collaborative partnerships in order to promote both mental health and school success for children and adolescents


Adopt Inclusive definition of the term “educator”• Policy makers, central office administrators,

building-level administrators, classroom and non-classroom staff (e.g., guidance counselors, school psychologists, nurses, etc.)

• Recognize the diversity of roles and the diversity of strategies these folks can support


Establish formal relationships with key opinion leaders among the educational staff

• Teacher-consultants model– Serve as program advisors and champions

for initiatives within school related mental health promotion

– Can become peer mentors and advocates for demystifying the concept of “mental health”


Become immersed in the school community• Be reliable about attendance and flexible in

program delivery• Attend school events, e.g., sports, concerts

award ceremonies, etc.• Don’t unwittingly transfer the tendency to

view what happens behind closed doors with a client as the essence of the providers work


Conduct detailed, local needs assessments • Survey the perspective of educators,

students and parents

• Include school climate assessments

• Understand the unique characteristics of school cultures


Prioritize mental health promotion and problem prevention initiatives• Recognize the difficulty in delivering a

full spectrum of services• Refuse to allow “drift” toward primarily

individual services for students with severe/chronic problems

• Focus on adapting programs to the needs and competencies of teachers


Promote EFFECTIVE practices• This involves more than selecting

“evidence-based” practice– Most have not bee examined for

effectiveness, palatability, durability, affordability, and sustainability in real-world school settings

– Remember to include academic and school success outcomes


“Heart Test”The story of Teddy.

QuickTime™ and aTIFF (Uncompressed) decompressor

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Teachers as Partners in Effective School-Based Mental Health Programs Therese C. Johnston, Ph.D. Carl E. Paternite, Ph.D. Ohio Mental Health Network for.

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