Transcript Mistrust to Trust: - American Council For School Social Work

Mistrust to Trust:
NY, If we can do it here you
can do it anywhere.
THE PRESENTERS
Cindy Bautista-Thomas, LCSW
Associate Director of Field Education
Columbia University School of Social Work
PhD Student, The Graduate Center, City University of New York,
Urban Education Program
Linda Salazar, LCSW-R
Social Work Coordinator
Bronx School for Law, Government and Justice
Cole Hooley, LCSW
Director of Social Work and Counseling
Harlem Village Academies
THE OBJECTIVES
1. You will be able to articulate ways to
develop a social work team staffed by
graduate school interns by collaborating
with non-profit organizations, school
staff, families and universities.
2. You will be able to describe ways to
work with social work interns in schools
on all levels to develop social work skills.
3. You will be able to describe ways to
work collaboratively with school staff
and document the effectiveness in
increasing academic outcomes.
4. You will be able to describe an
evidence-informed clinical model being
implemented in an urban school setting.
THE CHALLENGE
Prevalence
Out of
25 students
5 experience
mental health
challenges leading
to severe
impairment and/or
distress
(Merikangas, et al., 2010).
Prevalence
14 y/o
50% of all lifetime cases of mental illness
start by age 14.
(Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2005)
Impact
Mental health difficulties impact:
• Academic success (DeSocio & Hootman, 2004;
Esch, et al., 2014; Puskar & Bernardo, 2007; Repie, 2005)
• Attendance (Gall, et al., 2004)
• Concentration (Humensky, et al., 2010)
• Academic confidence (Masi, et al., 2001)
Lack of Services
• Most children with diagnosable mental
illnesses don’t receive treatment
(CSMH, 2013)
• Estimates of children who need but
don’t receive services vary:
– 70% (Greenberg et al., 2003)
– 63.8% (Merikangas et al., 2011)
– 45.3% (Green et al., 2013)
Lack of Services
Youth from minority or
disadvantaged groups are less
likely to have access to mental
health care and receive quality
care if they have access
(Garland, Lau, Yeh, et al., 2005).
Estimate of NYC Youth 2010
456,172
16,811
3.7%
Received Services
Need Services
THE OPPORTUNITY
Access
• School mental health programs
increase access.
(CSMH, 2013)
• Most youth who receive mental health
services gain access from a school
setting.
(Rones & Hoagwood, 2000)
School-Based Services Help
• Effective interventions are associated
with academic gains (CHHCS, 2014)
– 28 studies between 2001-2013
– Peer-reviewed journal or reputable
resource
– Experimental or quasi-experimental
design
– N>100
THE RESULTS
Our Results
107%
3.7%
NYC
73%
HVA
82%
BSLGJ
OUR PROGRAMS
1. Relationships
2. Interventions
3. Feedback
Relationships
Demonstrably effective (Cooper, 2004; Norcross,
2002)
1. Therapeutic alliance
a) Agreement on therapeutic goals
b) Consensus on tasks that make-up
therapy
c) The bond between client & therapist
Relationships
Demonstrably effective (Cooper, 2004; Norcross,
2002)
2. Goal consensus and collaboration
a) Agreement on therapy goals and
expectations
b) Mutually working together in helping
relationship
3. Empathy
Relationships
Probably effective (Cooper, 2004; Norcross, 2002)
1. Positive regard
2. Congruence/genuineness
3. Providing feedback
4. Repairing alliance ruptures
5. Self-disclosure
6. Relational interpretations
7. Manage counter-transference
Relationships
Rogerian
Business-like
Interventions
Manual
Modular
NonDirective
Interventions
Manual
Anxiety
Trauma
Coping
Cat
TF-CBT
Depression
TADS
Anger
SAMHSA
Interventions
Modular
Interventions
Non-Directive
• Psychodynamic
– Relational
– Object Relations
– Attachment
– Non-directive play therapy
Feedback
• Regular, systematic feedback from
clients improves outcomes.
(Cooper, et al., 2013; Duncan 2010; Duncan, 2011; Lambert,
2010; Miller, et al., 2006)
Assessment Tool
Area of Concern
PCOMS-CORS
General
PCOMS-CSRS
Alliance
SCARED
Anxiety
GAD-7
Anxiety
PHQ-A
Depression
CES-DC
Depression
Developing Future
School Social Work Leaders
•
•
•
•
School social work
Culturally relevant practices
Setting the stage
Student/field instructor match
Field Instruction in
School Social Work
• Supervision
• Appropriate assignments
• Partnerships with schools of
social work
QUESTIONS
References
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Center for School Mental Health (2013). The impact of school mental health: Educational,
social, emotional and behavioral outcomes. Maryland: Author.
Center for School Mental Health (2013). The impact of school mental health: Educational,
social, emotional and behavioral outcomes. Maryland: Author.
Cohen, J.A., Mannarino, A.P., & Deblinger, E. (2006). Treating trauma and traumatic grief
in children and adolescents. New York: Guilford Press.
Cooper, M. (2004). Towards a relationally-oriented approach to therapy: Empirical
support and analysis. British Journal of Guidance and Counseling, 32(4), pp. 451-460.
Cooper, M., Stewart, D., Sparks, J., & Bunting, L. (2013). School-based counseling using
systematic feedback: A cohort study evaluating outcomes and predictors of change.
Psychotherapy Research, 23(4), 474-488).
Curry, J.F., et al. (2000). Treatment for adolescents with depression study (TADS): Cognitive
behavior therapy manual. Durham, NC: Duke University.
DeSocio, J., & Hootman, J. (2004). Children’s mental health and school success. The
Journal of School Nursing 20(4):189-196.
Duncan, B. L. (2011). The partners for change outcome management system (PCOMS):
Administration, scoring, and interpretation manual update for the outcome and session
rating scales.
References
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Duncan, B.L. (2010). On becoming a better therapist. Psychotherapy in Austrailia, 16(4),
42-51.
Esch, P., Bocquet, V., Pull, C., Couffignan, S., Lehnert, T., Fond-Harmant, L., & Ansseau, M.
(2014). The downward spiral of mental disorders and educational attainment: A
systematic review on early school leaving. BMC Pscyhiatry, 14 (237).
Gall, G., et al. (2000). Utility of psychosocial screening at a school-based health center.
The Journal of School Health 70(7):292-298.
Garland, A.F., Lau, A.S., Yeh, M., McCabe, K.M., Hough, R. L., & Landsverk, J.A. (2005).
Racial and ethnic differences in utilization of mental health services among high-risk
youths. American Journal of Psychiatry, 162, 1336-1343.
Green, J. G., McLaughlin, K. A., Alegría, M., Costello, E. J., Gruber, M. J., Hoagwood, K., ...
& Kessler, R. C. (2013). School mental health resources and adolescent mental health
service use. Journal of the American Academy of Child & Adolescent Psychiatry.
Greenberg, M. T., Domitrovich, C. E., Graczyk, P. A., & Zins, J. E. (2005). The study of
implementation in school-based preventive interventions: Theory, research, and practice.
Promotion of Mental Health and Prevention of Mental and Behavioral Disorders. (3).
Center for Mental Health Services, Substance Abuse and Mental Health Services
Administration.
Humensky, J. et al. (2010). Adolescents with depressive symptoms and their challenges
with learning in school. The Journal of School Nursing 26(5):377-392.
References
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Kendall, P.C., & Hedtke, K.A. (2006). Cognitive-behavioral therapy for anxious children:
Therapist manual (3rd ed.). Ardmore, PA: Workbook Publishing.
Kessler, R. C.; Berglund, P.; Demler, O.; Jin, R.; Walters, E. E. 2005. Life-time Prevalence and
Age-of-onset Distribution of DSM-IV Disorders in the National Co-morbidity Survey
Replication. Archives of General Psychiatry 62: 593-602
Lambert, M. (2010). Yes, it is time for clinicians to routinely monitor treatment outcome. In
B.L. Duncan, S.D. Miller, B.E. Wampold, & M. A. Hubble (Eds). The heart and soul of
change: Delivering what works (2nd ed., pp. 239-268). Washington DC: American
Psychological Association.
Masi, G. et al. (2001). Depressive symptoms and academic self-image in adolescence.
Psychopathology 34:57-61.
Merikangas, K. R. et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents:
Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of
the American Academy of Child and Adolescent Psychiatry 49(10):980-9.
Merikangas, K. R., He, J. P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., ... & Olfson,
M. (2011). Service utilization for lifetime mental disorders in US adolescents: Results of the
National Comorbidity Survey–Adolescent Supplement (NCS-A). Journal of the American
Academy of Child & Adolescent Psychiatry, 50(1), 32-45.
References
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Midgley, N., & Kennedy, E. (2011). Psychodynamic psychotherapy for children and
adolescents: A critical review of the evidence base. Journal of Child Psychotherapy,
37(3).
Miller, S. D., Buncan, B.L., Brown, J., Sorrell, R., & Chalk, M.B. (2006). Using formal client
feedback to improve retention and outcome: Making ongoing, real-time assessment
feasible. Journal of Brief Therapy, 5(1), 5-22.
National Research Council and Institute of Medicine (2009). Preventing mental,
emotional, and behavioral disorders among young people: Progress and possibilities. M.E.
O’Connell, T. Boat, & K.E. Warner (Eds.), Board of Children, Youth, and Families, Division of
Behavioral and Social Sciences and Education. Washington DC: The National Academies
Press.
Norcross, J.C. (2002). Psychotherapy relationships that work: Therapist contributions and
responsiveness to patients. Oxford: Oxford University Press.
Office of Mental Health (2014). Mental health service use for 2011. Retrieved from
http://bi.omh.ny.gov/cmhp/dashboard#tab2
Palmer, R., Nascimento, L.N., & Fonagy, P. (2013). The state of the evidence base for
psychodynamic psychotherapy for children and adolescents. Child and Adolescent
Psychiatric Clinics of North America, 22 (2), 149-214.
Puskar, K. R., & Bernardo, L. M. (2007). Mental health and academic achievement: Role
of school nurses. Journal for Specialists in Pediatric Nursing, 12, 215-223
References
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Reilly, P.M, & Shopshire, M.S. (2002). Anger management for substance abuse and mental
health clients: A cognitive behavioral therapy manual. Rockville, MD: Center for
Substance Abuse Treatment, Substance Abuse and Mental Health Services
Administration.
Repie, M. S. (2005). A school mental health issues survey from the perspective of regular
and special education teachers, school counselors, and school psychologists. Education
and Treatment of Children, 28, 279-298
Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research
review. Clinical Child and Family Psychology, 3(4), 223-241.
The Center for Health and Health Care in Schools (2014). The impact of schoolconnected behavioral and emotional health interventions on student academic
performance. Washington, DC: Author.
United States Census (2010). United States census 2010. Retrieved from
http://quickfacts.census.gov/qfd/states/36/3651000.html