A3: Integrating Mental Health Supports Within a School-Wide ...

A3: Integrating Mental Health Supports Within a School-Wide ...

Building Capacity of School Staff to Train Trauma Informed Practices within a PBIS Framework Susan Barrett Implementer Partner, Center on PBIS [email protected] Appreciation for. Melissa Nantais National TA Center on PBIS Interconnected Systems Framework Leadership Team Lucille Eber, Mark Weist, Kelly Perales, Katie Pohlman, Joni Splett Handouts available pbis.org Afternoon Session Objectives: Learn how to set up conditions to support youth impacted by trauma through an Interconnected Systems Framework Learn about sites /examples that developed a system to support building the social and emotional capacity for all staff to use traumainformed approachesinformed approaches Identify actions to increase skills of schoolinformed approachesbased team members and staff in order to use traumainformed approachesinformed practices Key Rationale PBIS and SMH systems are operating separately

Results in ad hoc, disorganized delivery of SMH and contributes to lack of depth in programs at Tiers 2 and 3 for PBIS By joining together synergies are unleashed and the likelihood of achieving depth and quality in programs at all three tiers is greatly enhanced Requires re-positioning staff Requires District Level Actions Starts with Equal Priority Academic Rigor Social Emotional Health/ Mental Wellness/Physical Health Socially Significant Outcomes Adapted from Fixsen and Blase 2013, 2013 Organizational Health:

Workforce MH+ PBIS= ISF Interconnected Systems Framework Where Weve Been: 2002-2007: Site Development with PBIS Expansion (informal and independent) 2005: CoP focus on integration of PBIS and SMH 2008: ISF White Paper: formal partnership between PBIS and SMH 2009- 2013 Monthly calls with implementation sites, national presentations (from sessions to strands) 2009-2011 Grant Submissions June 2012- September 2013 ISF Monograph Monograph Advisory group

2015: ISF Learning Community, SOC Webinar Series 2016: RCT Grant awarded 2016: Targeted Work Group Webinars (8) 2017: Targeted Work Group Webinars continuing, knowledge development sites across country Interconnected Systems Framework Advancing Education Effectiveness: Interconnecting School Mental Health and School-Wide Positive Behavior Support Editors: Susan Barrett, Lucille Eber and Mark Weist pbis.org csmh.umaryland IDEA Partnership NASDSE An Interconnected Systems Framework (ISF) A Structure and process for education and mental health systems to interact in most effective and efficient way. guided by key stakeholders in education and mental health/community systems

who have the authority to reallocate resources, change role and function of staff, and change policy. Context One in 5 youth have a MH condition At least 50%, perhaps 80%, of those get no treatment School is defacto MH provider Juvenile Justice system is next level of system default Suicide is 2nd leading cause of death among young adults Factors that impact mental health occur round the clock It is challenging for educators to address the factors beyond school It is challenging for community providers to address the factors in school Additional Context 33% increase in teens reporting symptoms of depression

46% of children in the US have experienced at least one Adverse Childhood Experience (ACE) US has highest rate of opioid use in the world The CDC reports electronic aggression as an emerging public health problem Any type of harassment or bullying that occurs through email, a chat room, instant messaging, a website or text messaging What we know Increased prevalence rates (proportion), increased incidence rates (new cases) Priority and budgets primarily dedicated to academic supports Separate, siloed systems Discipline often is confused with punishing, shaming, blaming and excluding youth. Not enough staff trained in evidence best practices and implementation science Too many initiatives Need for Alignment Need for Alignment through one MTSS Trauma Informed Practices Mental Health interventions SEL curriculum v. SEB competencies

What Will Be Different in an Interconnected System: Traditional An Interconnected Systems Framework MH Professional sees student at appointments MH person(s) on teams at all tiers. Interventions are defined (core features, dosage, frequency, outcomes) Experts only do mental health (e.g. test, place, refer, serve) MH is everyones job. Clinicians contribute to integrated plan Case management notes Manage at an individual level

Fidelity AND outcome data determined before delivery; data monitored continuously by teams 1. Single System of Delivery is s s e c c A . 2 gh u o n e T NO

Key Messages 4. MTSS essential to install SMH 3. Mental Health is for ALL 1. Single System of Delivery One set of teams Community and School MH staff serve on leadership team and make decisions as a TEAM Symmetry of Process State County District School A seamless system for accessing interventions Both school and community based supports

What Does it Look Like? Invest in one set of school behavioral health teams organized around tiers. Flexibility of funding to allow community employed staff to serve on teams and assist serving ALL students. Role and function of staff are explicitly stated in MOU. ALL Requests for Assistance managed within one set of teams. ALL school and community employed staff take part in teaching Social/Emotional/Behavioral (SEB) necessary to navigate social situations, school, family and work environments. 2. Access is NOT Enough Success is defined by student impact Interventions are evidenced based and matched to presenting problem using data - Interventions are progress monitored for fidelity and impact Teams are explicit about

intervention description (what, when, how long) Skills taught in Tier 2/3 interventions are assessed across all tiers by ALL Staff across ALL settings linked to Tier 1 Social Emotional Behavioral (SEB) instruction What Does it Look Like? The District and School team includes community providers, families, students and persons who have authority to make structural changes within their organizations. Teams works collaboratively with leaders to continuously assess student needs, implement programs, and eliminate, adjust, replace programs at all tiers to increase their impact on students. Ineffective programs or practices are eliminated. 3. Mental Health is FOR ALL From Few to ALL

Integrate SEB competencies into PBIS Matrix Vast majority of students will benefit from safe, predictable, positive nurturing environment, mentoring and academic support. What Does it Look Like? ALL staff are trained and supported through PD plan/coaching process. MOU defines roles of all staff working in schools. Universal Screening to identify ALL possible MH/Behavioral needs (externalizers and internalizers) Clinicians role includes support of systems and support of ALL adults as well as delivery of some interventions with students. Need MH experts to triage and identify students with positive screen to determine next steps. However, not all interventions require clinical expertise

Teachers provide social emotional behavior (SEB) instruction along with academic content. - District Leadership prioritizes Staff Wellness 4. Use MTSS Framework Need implementation science to guide the work Data-based decision making is used at all tiers with type of data matched to specifics and complexity of interventions. A formal process for selecting and implementing evidence-based practices is established. Comprehensive screening allows for early access to interventions. What Does it Look Like? The system models a Public Health

Approach All initiatives/programs are aligned and installed with core features of MTSS Progress monitoring for both fidelity and effectiveness; Skills taught in Tier 2/3 interventions are supported by ALL Staff across ALL settings linked to Tier 1 SEB instruction Ongoing professional development and coaching to ensure fluency and to guide refinement of implementation. - The continuum of evidence-based interventions are linked across tiers, with dosage and specificity of interventions increasing from lowest to highest tiers. U.S. Public Health:

Tiered Logic Model A few Some All Cancer treatment; nursing homes; dentures; organ transplants Medication; medical treatment; fill cavities; vision correction Check-ups; diet; exercise; vaccinations; fluoride; seatbelts, handwashing Walker et al. (1996). Integrated approaches to preventing antisocial behavior patterns among school-age children and youth. JEBD, 4, 194 209. Public Health Implementation Framework Social Emotional and Behavioral Health We organize our resources Multi-Tier Mapping, Gap Analysis So kids get help early

Actions based on outcomes (data!), not procedures We do stuff thats likely to work Evidence-Based interventions We provide supports to staff to do it right Fidelity: Tiered Fidelity Inventory (TFI) Training, Coaching And make sure theyre successful Progress monitoring and performance feedback Problem-Solving process Increasing levels of intensity Installing a Trauma Approach within the Framework of PBIS Step 1: What does the data say? (Community factors, behavior patterns, climate surveys, fidelity checks) How many students are impacted? How many staff are impacted? Step 4:

How do we teach staff the necessary skills? How do we support staff to implement with fidelity? Professional Learning Communities used to support one another in development of practices. How do we use data to monitor progress toward our goal and inform each other? How do we improve ? SYSTEMS Support Staff Behavior Step 3: What will we do to support student behavior and provide necessary coping skills? What curriculum will we use? (e.g. SEL, Coping Cat, SPARKS) Match to need Promote predictable, positive, safe, and consistent environments by: -Develop caring connections (e.g. morning meetings) -Teach expectations, replacement skills -Develop acknowledgement system Layered Daily Progress Report with additional time for

acquiring coping skills PRACTICES Support Student Behavior DATA Supports Decision Making Step 2: What is the SMART (specific, measureable, attainable, realistic, time-bound) goal? What is your role? Job description match what you do?

Does the system promote efficiency? Are you meeting needs of your children? What are the opportunities? What would you change? What supports do you need? Experimental Research on SWPBIS 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. Bradshaw, C., Waasdorp, T., Leaf. P., (2012 )Effects of School-wide positive behavioral interventions and supports on child behavior problems and adjustment. Pediatrics, 130(5) 1136-1145. 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. Ross, S. W., Endrulat, N. R., & Horner, R. H. (2012). Adult outcomes of school-wide positive behavior support. Journal of Positive Behavioral Interventions. 14(2) 118-128.

Waasdorp, T., Bradshaw, C., & Leaf , P., (2012) The Impact of Schoolwide Positive Behavioral Interventions and Supports on Bullying and Peer Rejection: A Randomized Controlled Effectiveness Trial. Archive of Pediatric Adolescent Medicine. 2012;166(2):149-156 Bradshaw, C. P., Pas, E. T., Goldweber, A., Rosenberg, M., & Leaf, P. (2012). Integrating schoolwide Positive Behavioral Interventions and Supports with tier 2 coaching to student support teams: The PBISplus Model. Advances in School Mental Health Promotion, 5(3), 177-193. doi:10.1080/1754730x.2012.707429 Freeman, J., Simonsen, B., McCoach D.B., Sugai, G., Lombardi, A., & Horner, ( submitted) Implementation Effects of School-wide Positive Behavior Interventions and Supports on Academic, Attendance, and Behavior Outcomes in High Schools. SWPBIS Exp erimentally Related to: 1. Reductio n in problem behavior 2. Increase d academic performance 3. Increase d attendanc e 4. Impro e v d perceptio n of safet 5. Reductio

y n in bullying behaviors 6. Improv ed organizatio nal efficienc 7. Reductio y n in staff tu r n over 8. Increase d perception of teacher 9. Improve efficacy d Social Em otional com petence How SW-PBS is Trauma Informed How Classroom Practices Are Trauma Informed? Example

WE are all ambassadors of Mental Health and Wellness Moving from being the only response to identified social emotional needs, to being social emotional leaders of the building. TO Helping to build the capacity of the rest of the staff All 3 Tiers Social Emotional Leaders for the building Facilitate (coaching) Coordinate (coaching)

Consult (Coaching) Helping to build the capacity of the entire building to support social/emoti onal needs Building a Utopian Society Trauma Informed Lens Brain development Observing behavior patterns with Fight, Flight or Freeze Trauma Informed Practices Create safe, predictable, & consistent environments Building community and relationships Teaches new skills (specifically coping skills) Support regulation Content Expert and Systems Coaching

Content Area: Trauma- Build Capacity for Experts Systems Coach Use of MTSS Action Plan for Success Leadership Team has protocol for Data Review to identify need, select EBP Secure Buy in and Readiness (District, Building Admin, Staff, students, families) Know how to build content for staff through Professional Development days Format, delivery, time Facilitate teams to use Data for decision-making plan ( track fidelity and impact) Level of support across staff Build as part of Tier 1 SEB curriculum Visibility and Marketing Showcasing Results Support Leadership and communicate to district around TA Trainer of Trainers Model Big change happens at the organizational level Change can be put into place using data, systems and practices A belief all educators need to understand the impacts of trauma Recognition ownership is stronger when staff teach/present to their own staff

***What if ? School Employed and Community Employed Staff use community and school data to assess the needs of young people in their school community and, together as an integrated team, select evidence based practices that match specific needs. What if you were on this team and could review population level data, provide input, deploy resources differently? Teams Which building teams will need a trauma informed lens? Tier 1 team Building Leadership Team Tier 2 team Individual student teams Problem solving teams

How does trauma lens change the conversation? Tier 1: Consider how school-wide and classroom practices are supporting all students. Is there need for more support for all students? Tier 2: How are tier 2 interventions supporting students impacted by trauma? Do we need to add trauma based interventions? Tier 3: How are we assessing impact trauma may have on student? School Data Community Data Student and System level Academic (Benchmark, GPA, Credit accrual etc) Discipline Attendance Climate/Perception Visits to Nurse,

Social Worker, Counselor, etc Screening from one view Community Demographics Food Pantry Visits Poverty Rate Drug Addiction Rates Calls to crisis centers, hospital visits Screening at multiple views Other Datasets Using Census (income, family structure, population) Positive Assets Parks & Playgrounds Hospitals Community Centers Recreation Centers Libraries Religious Buildings

Potential Risk Factors Alcohol Outlets Crime Vacant Housing Fast food outlets Lottery/Gambling Outlets Wraparound Function-based Support School Mental Health Classroom Management Restorative Practices Wellness & Self-Regulation Cognitive Behavior Counseling Literacy Instruction Check In Check Out Social Emotional Learning Threat Assessment Dropout Prevention Check & Connect Bullying Prevention School Climate Safety Cultural Responsiveness

Data Review and Needs Assessment and Readiness Trauma Informed Strategies Discipline Handbook/ Code of Conduct Foundation: Establish team operating procedures Establishing, Teaching and Acknowledging SW expectations and Social Skills Curriculum Establishing an Equitable Discipline System Using Data to Guide Decisions (Academic, Behavior, Climate, Attendance) Screening Classroom Systems: 8 components Student, Family, Community Support Evaluation: Fidelity and Impact

Additional Professional Development on Specific Topics/Matched to Need Track 1: Trauma Informed Track 2: Equity Track 3: Literacy ***What if ? We. focused on are specific ways that everyone teaches social emotional skills across ALL settings and content areas everyday!! and we use our data to prioritize the skills we teach And you led that charge with the assistance of district, admin, team and staff support? What does our curriculum look like? Expectations

Teaching Matrix SETTING All Settings Hallways s n o ti a t c xpe 1. E Walk. Respect Ourselves Be on task. Give your best effort.

Be prepared. Respect Others Be kind. Hands/feet to self. Help/share with others. Respect Property Recycle. Clean up after self. Playground s Use normal voice volume.

Walk to right. Cafeteria Have a plan. Eat all your food. Select healthy foods. Play safe. Include others. Share equipment. Practice good table manners c fi i

c e p S r o s trays es Use iorReplace Pick up litter.ul equipment R properly. v & utensils. Maintain a . h 3 physical Clean up e litter in eating Put Bgarbage space. area. can. Library/

Computer Lab Assembly Bus 2. NA Study, read, TU Sit in one Watch for compute. spot. your stop. (Lo RAL ca CO tio N ns TE XT ) Whisper. Return books. Listen/watch.

Use appropriate applause. Use a quiet voice. Stay in your seat. Push in chairs. Treat books carefully. Pick up. Treat chairs appropriately. Wipe your feet. Sit appropriately. Specific Behaviors + Social-Emotional Skills Expectation

Specific Behavior AND Social Emotional Skill Keep hands and feet to self Be Safe Be Respectful I tell an adult when I am worried about a friend. Use the signal to ask a public or private question. Make sure everyone gets a turn. Turn in all work on time Be Responsible Check in with my feelings during the day Specific Behaviors + Pro-Social Skills Specific Behaviors Throw paper in the waste can Use the right side of the stairway Bring all materials to class

Keep hands, feet, and other objects to yourself Pro-Social Skills Choose kindness over being right; pick up trash even if it isnt yours Encourage others; tell peer they did a good job Pro-Social Skills on Matrix Teaching Matrix Respectful INCORPORATE Coping Strategies for Managing Stress All Settings Expectations & Organized

Playgrounds s n o ti a t c e p x E Be on task. Give your best effort. Be prepared. Walk. Be kind. Hands/feet to self.

Help/share with others. Use normal voice volume. Walk to right. 1. Achieving Halls Have a plan. Share equipment. Include others. Recycle. Clean up after self. Invite those

sitting alone to join in Study, read, compute. Sit in one spot. Watch for your stop. Whisper. Return books. Listen/ watch. Use appropriate applause. Use a quiet voice.

Stay in your seat. Push in chairs. Treat books carefully. Pick up. Treat chairs carefully. Wipe your feet. Have a lunch plan and choose quiet or social lunch area Invite friends to join me c fi i

c e Responsibl p S r e o s s e r l o u i 3. R Behav Pick up litter. Maintain physical space. Lunch Library/

Comput er Lab Use equipment properly. Put litter in garbage can. Use my breathing technique Listen to my signals Assembly Bus CO 2. NT NA EX TU T ( RA Lo ca L tio ns Teaching

Matrix Respectful INCORPORATE BULLY PREVENTION / INTERVENTION All Settings Expectations Achieving & Organized Playgrounds s n o ti a t c e p

x E Be on task. Give your best effort. Be prepared. 1. Halls Be kind. Hands/feet to self. Help/share with others. Walk. Use normal voice volume. Walk to

right. Have a plan. Share equipment. Include others. Invite those who are alone to join in. c fi i c e Responsibl p S r e o s s

e r l o u i 3. R Behav Recycle. Clean up after self. Pick up litter. Maintain physical space. Use equipment properly. Put litter in garbage can. If you see Disrespect Library/

Comput er Lab STOP: Interrupt CO 2. NT NA EX TU T ( RA Lo ca L tio ns ) & model respect, rather than watch or join in WALK: Invite people who are being disrepected to to join you and move away.

Stop: Interrupt, Say thats not ok. Walk: Walk away Dont be an audience Talk: REPORT to an adult Assembly Bus Study, read, compute. Sit in one spot. Watch for your stop. Whisper. Return books.

Listen/ watch. Use appropriate applause. Use a quiet voice. Stay in your seat. Push in chairs. Treat books carefully. Pick up. Treat chairs carefully. Wipe your feet.

***Now, imagine if we Use that same logic at home and in our communities And you worked with Family Leaders to MAKE IT HAPPEN? PBIS Matrix for Home I am respectful Listen to my parents Be truthful to my parents Play cooperatively Speak nicely to others I am responsible Put away my toys, bike, and equipment Help with jobs at home Follow my parents directions Share Thursday folder with parents I am safe Play safely with others Stay in designated areas

Stay away from strangers Wear bike helmet and equipment I am prepared Finish homework and share with parent . Pack backpack at night for school the next day Go to bed on time Get up and get ready for school when called Getting up in the morning Getting to school Clean-up time Time to relax

Homewor k time Mealtime Getting ready for bed R Y D A Y H HELP OUT O OWN YOUR BEHAVIOR

M MANNERS COUNT E V E At HOME Expectation Be Safe Be Respectful At SCHOOL it looks like Keep hands and feet to self Tell an adult if there is a

problem Treat others how you want to be treated Include others Listen to adults Do my own work Be Responsible Personal best Follow directions Clean up messes it looks like For MYSELF, this looks like

In my NEIGHBORHOOD it looks like Expectation Be Safe Be Respectful At SCHOOL it looks like At HOME it looks like Keep hands and feet to self Protect your friends and family Tell an adult if there is a

problem Dont talk back Treat others how you want to be treated Do exactly what adults tell you to do Include others Dont stand out Listen to adults Dont bring shame Do my own work Personal best Be Responsible

Follow directions Clean up Help your family out first Own your mistakes Share credit In my NEIGHBORHOOD it looks like Stick up for your friends Dont back down Look the other way Text back within 30 seconds Be nice to friends parents

Share food Have each others backs Own your mistakes Check in about what to do posters Sustaining PBIS Implementation Communitywide External Coach from the community setting Monthly Community-wide Leadership Team mtgs. Monthly Community-wide Coaches meetings Annual assessment of implementation Family/Community Forum/s On-going training (new summer staff at pool/park etc.) Picnic and other community events *** What if. We looked at attendance, tardiness, behavior referrals, suspensions, grades, visits to nurses office and loitering in hallway as an indication that our students and youth more social emotional supports? and exclusionary responses will make it worse? AndYou had time to review link data to need and

provided reports during faculty meetings, grade level meetings that showed connection? Broaden Use of Data: Focus on Internalizing Issues ***What if We screened every student just like we provide vision and hearing screenings? District and School Leadership provided time supports to MAKING It HAPPEN!! UCLA to offer free mental health screening, treatment to all incoming students 10,000 incoming freshmen and transfer students will receive the first invitations to join the effort in the next few weeks. The voluntary screening will then be opened up to the campus community, including the health system, with the goal of incorporating 100,000 people in the research study, making it the largest and most comprehensive depression study ever undertaken. The results will help inform research on depression and mental health and those who are found to be at risk for depression or who have depression will be offered a free, eight-week cognitive behavioral treatment program with the option of receiving additional support based on the severity of their symptoms.

Ask the Families! Parent Screener for ALL students transitioning to Middle school Missoula, MT Adapted from Dishion et al https://reachinstitute.asu.edu/ PBS I ***What if We decreased the time between identifying a student need and providing additional supports? Label, diagnosis, insurance plan should never be a factor when someone needs help! Request for Assistance Process I need help! Love, me Designated team responded within 24 hours Student started Check in/Check Out within 72 hours Using CICO as the Organizer

Intervention Screening Tool Data Collection progress monitoring fidelity Teacher Support Formal Documentation Social & Daily Academic Instructional Groups (sample coping skills group) EXPECTATIONS Be Safe Progress Report (DPR) Sample NAME:______________________ DATE:__________________ 1st block 2

1 0 2nd block 3rd block 4th block 5th block 6th block 7th block 2 1 0 2 1

0 2 1 0 2 1 0 2 1 0 2 1 0 Label feeling Use deep breathing

Be Respectful 2 1 0 2 1 0 2 1 0 2 1 0 2 1

0 2 1 0 2 1 0 Be Responsible 2 1 0 2 1 0 2

1 0 2 1 0 2 1 0 2 1 0 2 1 0 Use calm words with peers

Let teacher know feeling temperature if above yellow Total Points Teacher Initials Understanding Types of Groups REMEMBER to Consider: structure, skills taught, staff skills, location, and frequency EBP or kernels matched to student need with instructional focus, skilled staff (i.e. group dynamics, content, behavior science, clinical) EXAMPLE Social Behavior Core Curriculum taught by teacher

daily to all students Small group taught inside classroom weekly by teacher or support teacher Self-management cards for some Pro-Social Skills-Core SE curriculum Taught by range of staff with teaching background Outside of Classroom 2/week

Coping Skillspulled from SE curriculum Add emotional regulation feature Taught by staff with technical skills Complex Basic Monitor Data, Select Practice, Install Systems

Specific Curriculum (I.e. Coping Power Taught by Staff with advanced technical skills Location varies Daily When do we Kick it Up a Notch? Does everyone know that? Student has ? consecutive minor classroom reports Student has 2-5 ODRs Student has 1Suspension Student experiences more than ? minutes out of instruction Student misses more than ? days unexcused absences Student- incomplete classwork/homework Tardies Other indicators: ***What if Our teachers had more time to foster care and connections with ALL of their students and felt more competent and confident to handle the

complex needs of our young people? Lets add SNI. It will fix everything! www.safetycenter.navy. Hexagon Tool DATA PRACTICES NEED EVIDENCE RESOURCES Do we have data that supports the need? Is there research to support its use?

Have we considered parent and community support? Is there research to support its use with a particular population? Will this EBP support a school improvement or continuous improvement goal? Is the effect size sufficient? Is there data specific to the EBP that can serve as a component of progress monitoring?

Is it cost-effective or is there something less expensive that yields similar results? Can the data be communicated to students (feedback) and parents? Is there a system in place to evaluate the data to determine outcomes? t u p sFIT t Le

x e H a SYSTEMS n o Is there a fidelity checklist or tool? ! ! t s r ti fi Is there time and money for adequate training?

Is the technology department able to support the EBP if needed? Is there time and money for adequate coaching? READINESS Does the leadership team support the EBP? Did the leadership team obtain buy-in? Have committed staff members to been selected to implement? Are there competing initiatives?

Is there clarity about where the initiative fits in the tiered system? CAPACITY Is there sufficient time in the schedule for the EBP? Has the coach or expert on the EBP been identified as a primary assistant and communicator? Is the EPB easily replicated ? o

Does the District support the EBP? o Can families be shown how to support the EBP? Vermont Joint House/Senate Resolution ( J.R.H 6) 2013 Whereas, following the mass shootings at the Sandy Hook Elementary School in Newtown, Connecticut, we, as a nation, have had time to reflect collectively on who we are and how best to respond to the slaughter of the innocents, and Whereas, the General Assembly rejects the singular response of meeting force with force, and Whereas, alternatively, the General Assembly embraces a Vermont commitment that the mental, physical, and nutritional health of our students and their caregivers is addressed with the same level of attention and concern as is our students academic and cognitive achievement, and Whereas, Vermont schools must offer a learning environment that encourages all students to attain mastery of academic content, to practice generosity, to

experience belonging, and to realize independence in their daily lives, now therefore be it Resolved by the Senate and House of Representatives: That the tears of Sandy Hook and our nation will not fall on fallow ground but will give rise to a rededication to our goal of maintaining safe and healthy schools, and be it further Resolved: That the General Assembly declares Vermont to be a state in which equity, caring, and safety, both emotional and physical, are evident in all of our schools practices. How? An Instructional Process for Academics DEFINE (TELL) ADJUST (RETEAC H) For efficienc y Simplify MODEL (SHOW) BE CONSISTENT

MONITO R PRACTIC E In setting How?... The Same Process for Social Emotional Behavior DEFINE (TELL) ADJUST (RETEAC H) For efficienc y Simplify MODEL (SHOW) BE CONSISTENT

MONITO R PRACTIC E In setting Mental Health Skills are just like other skills and we use Instructional Process for skill acquisition Academic Enablers -Organizational Skills -Study Skills -Group Process -Time Management Social/Emotiona l -Communication Skills -Healthy

Relationships -Managing Stress Academic Content -Academic Standards -Graduation Requirements Andif we ask employers What are the skills you are looking for in a potential employee? So what are the skills required to succeed in college, career and life? Support staff considering the cafeteria as a place to embed services in the natural context Teaching how to socialize in the cafeteria Teaching healthy eating habits Team approach that involves admin, teachers, caf supervisors, food service personnel, students and families How will we teach SEB skills? When will we teach SEB skills? Kick-off events

Teaching staff, students and families the expectations and rules On-going Direct Instruction Data-driven and scheduled designed lessons Pre-correction Re-teaching immediately after behavioral errors Embedding into curriculum Booster trainings Scheduled and data-driven Continued visibility Visual Displays posters, agenda covers Daily announcements Newsletters ***What if Our State, County and District and our Child Serving Agencies ALL invested in a common way of work that helped school communities

become more efficient and effective? State and District Community Teams Guiding Principles Effective leadership teams that include school and community mental health providers ALL Professional Development is delivered to teams with leadership support coaching support and data Data-based decision making that include school level data and community dataTeam Initiated Problem Solving used across all levels of teaming (State, District/ Community and School) Formal processes for the selection & implementation of evidence-based practices (EBP) across tiers with team decision-making. State and District Community invests in formal routine and as a team determine the what based on children, youth, families specific needs Early access through use of comprehensive screening, which includes internalizing and externalizing needs- This includes family screening (Dishion) Rigorous progress-monitoring for both fidelity & effectiveness of all

interventions regardless of who delivers Ongoing coaching at both the systems & practices level for both school and community employed professionals- Culture of Coaching existed across cascade that involves professional learning networks Stakeholder Support Funding Policy & Systems Alignment Workforce Capacity Executive Functions LEADERSHIP TEAMING Implementation Functions Training Coaching

Evaluation & Performance Feedback Local Implementation Demonstrations Behavioral Expertise Change is Hard Adopting an integrated framework is a process that will challenge the assumptions and traditional practices of most school faculty, and mental health systems. This typically requires the difficult process of abandoning long held patterns of doing business and creating new models based on the strengths of the schools/district/community, and the changing needs of students and families. PASS NIJ Comprehensive School Safety Initiative Interconnecting PBIS and School Mental Health to Improve School Safety: A Randomized Trial 2016-2019, National Institute of Justice (#2015-CK-BX-0018)

PI Mark Weist, Co-PI Joni Splett, Co-I Colleen HallidayBoykins, Lead Research Manager Elaine Miller Study Aims: Evaluate impact of the ISF on school discipline rates, teacher and student perceptions of school climate and safety and social, emotional, behavioral and academic functioning of students Evaluate the impact of the ISF on the functioning of teams, student access to services, and quality and cost-effectiveness PASS Goals and Objectives: Improved implementation of screening and follow-up on screening findings Improved coordination and communication between school and mental health staff Improved proportion of children with mental health problems who receive treatment interventions Enhanced connection of students to school mental health interventions for full range of mental health needs Enhanced connection of students to school mental health interventions for full range of mental health needs PASS Goals and Objectives: Intervention Receipt Forms (IRF) to track the number of students over time who are connected to ISF interventions School and community mental health professionals on teams to review data, select EBPs, progress monitor, etc.

Universal mental health screening conducted twice annually Intervention continuum array to include Early intervention access via CICO Expanded array at Tiers 2 and 3 for internalizing needs, trauma, protective factors, family engagement Preliminary Access Outcomes Students with emerging emotional and behavioral risk were Identified (Splett et al., 2018) Connected to more services in the ISF condition than control conditions Especially true for African American students PASS Goals and Objectives: Intervention Service Delivery Enhanced provision of school-wide mental health promotion and prevention programs Decreased amount of time between problem identification and effective intervention delivery Improved selection and implementation of evidence-based services across tiers Students and families received greater dose of effective interventions Intervention Service Delivery

Implementation Use of ISF Implementation Inventory and Integrated Action Planning MH partners providing PD for school staff and consultation on MH issues Enhancing continuum of interventions in both sites with attention to existing resources (i.e., behavior intervention protocol) Professional Development on behavior intervention protocol and team process Professional development for school and community MH professionals on MATCH-ADTC Use of MATCH-ADTC in both small group and individual intervention Themes from Implementation Inventory Report Card Nearly all schools improved in each tier with each administration Many items were indicated as fully in place Several schools improved Tier 1 and some Tier 3 core features of ISF

Family engagement consistently identified as needing improvement Pass Goal: Improved Student Outcomes Social/emotional/behavioral functioning School and academic functioning School climate and student safety Other Successes School district coaches PBIS fidelity Presentation at SBH conference X2 Commitment of districts to continue and expand Need More? TA Brief for Alignment RDQ Brief as example with Mental Health Integration Technical Guide for Alignment of Initiatives, Programs and Practices in School Districts (OSEP Technical Assistance Center on PBIS, 2017) http://www.pbis.org/blueprintbriefstools Roundtable Dialogue: Aligning and Integrating Mental Health and PBIS to Build Priority for Wellness

http://www.pbis.org/presentations/chicago-forum-17 Current Work and New Resources Teaching Social-Emotional Competencies within a PBIS Framework https ://www.pbis.org/Common/Cms/files/pbisresources/ TeachingSocialEmotionalCompetenciesWithinAPBISFramework.pdf Improving Multi-tiered Systems of Support for Students with Internalizing Emotional/Behavioral Problems http://www.midwestpbis.org/interconnected-systems-framework/publications Leadership Installation Guide Available as handout Follow Us On Social Media PBIS: Celebrating Positive & Safe Learning Environme nts

This two-day forum for school, state, district, and regional Leadership Teams and other professionals has been designed to increase the effectiveness of PBIS implementation. Sessions are organized by strands that support initial through advanced implementation in a full range of education settings, and assist state level planning to improve school quality and student success. Featuring sessions specific to Juvenile Justice, Alternative Educational Settings, Mental Health, and Family partnerships. Hilton Chicago 720 S. Michigan Avenue Registration opens April 3rd. For more information, visit the Upcoming Events page at www.pbis.org in March. October 4-5,

2018 OSEP Technical Assistance Center on PBIS | 2018 PBIS Leadership Forum | Chicago, IL Wrap Up and Action Steps What questions do you still have? Take a few minutes to think about next steps or action plan. What you are going to do when you return to your building/district tomorrow, next week, next month? Complete Your Action Plan WHAT NEEDS TO BE COMPLETED? A. Use slides from Susans ppt to talk to others in my community

about MH needs of our students B. Look up my community demographic data to find impact of MH in my community. C. Find out if my school district has MOU with community providers and we track use of EBP. RESOURC ES NEEDED? WHO? WHEN?

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