School-based Mental Health and Positive Behavioral Interventions and Supports and High Schools

Maryland Safe and Supportive Schools Initiative

A Collaborative Effort of the MSDE, Sheppard Pratt Health System, and Johns Hopkins University

Susan Barrett Director, PBIS Regional TTAC Sheppard Pratt Health System, Implementer Partner Center on PBIS [email protected]

Interconnected Systems Framework for School Mental Health Tier I: Universal/Prevention for All

Coordinated 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

MDS3 Initiative

• • • • • Funding: U.S. Department of Education ’ s Office of Safe and Healthy Students (OSHS) Number of awards: 11 states (of 33 applicants): Arizona, California, Iowa, Kansas, Louisiana, Maryland, Michigan, South Carolina, Tennessee, West Virginia and Wisconsin are S3 Grantees in the first cohort Amount: 13M Length: 4 years (October 2010-2014) Partners: MSDE, Sheppard Pratt Health System, Johns Hopkins University

MDS3 Goals 1) Assess school climate, student engagement, and the school environment, 2) Implement evidence-based programs (EBPs) to meet student needs, based on survey 3) Improve conditions for learning, 4) Reduce school violence and substance use, and improve student engagement and the school environment to support student learning.

Keys to 10 Year Success

• • • • • • Commitment of leadership at state, district and school levels Private, public, & university partnership Standards and Protocols developed and implemented INFRASTRUCTURE developed to support state and regional training capacity State-wide impact: – 877 schools in all 24 systems trained • 740 implementing Tier 1/Universal PBIS with fidelity PBIS Maryland WEBSITE and DATABASE, WIKI ( www.pbismaryland.org

)

Keys to 10 Year Success (cont)

• • • • • • Ongoing Technical Assistance-Coaching Capacity (400 trained) Ongoing Evaluation/Progress Monitoring Evaluation Tools Ongoing Data Collection for Decision Making • IPI (Implementation Phases Inventory), SETs, SWIS, BOQ Ongoing expansion of Local School System infrastructure as numbers of schools increase—staff designation, coaches for schools, and funding Federal Grants to support Rigorous Randomized Evaluation Activity through JHU

Trained Schools by Cohort

1000 900 800 700 600 500 400 300 200 100 0 805 877 714 617 519 414 301 144 216 91 5 19 46 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 NOTE: If a school has been retrained only the most recent training year is included above.

500 450 400 350 300 250 200 150 100 50 0 429 209 24

Trained by School Type

8 2 126 26 12 34 4 1 8

USDOE

’

s S3 School Climate Model

School Climate Engagement Relationships Respect for Diversity School Participation Safety Emotional Safety Physical Safety Substance Use Environment Physical Environment Academic Environment Wellness Disciplinary Environment

Using Lessons Learned to Build Next Phase

• • • • • Training must be ongoing and connected to previous and upcoming activities.

High schools require additional supports to successfully launch PBIS and implement it with fidelity.

– Adolescent students with unmet social and emotional needs create challenges – High schools are often unprepared to implement Tier 2 and Tier 3 interventions or to address mental health needs and resources at the local and – state level have been ??

Relatively few developmentally appropriate EBPs (Greenberg et al., 2001). Coaching is NECESSARY and supported by evidence (NIRN) School Liaisons need to have a small school to staff person ratio (PBIS Plus-6:1; MDS3 3:1) Need to make the Focus School condition worthwhile for those schools.

Maryland Safe and Supportive Schools (MDS3)

Implementation

“

develop capacity in schools to improve

”

Research and evaluation

“

sustainable system to measure

”

Administration

“

disseminate outcomes to stakeholders

”

Methodology

• •

Participating Schools

– 52 high schools across the state of Maryland • 10 districts: Anne Arundel, Baltimore County, Charles, Caroline, Dorchester, Somerset, Washington, Wicomico, Worcester, and Queen Anne ’ s – Second cohort of up to 8 additional schools possible for spring 2012, for a total of 60 schools

Design

– 3 years (spring 2011 through summer 2014) – All 52 schools participated in the data collection activities • 29 “ implementation schools” who are implementing the • MDS3 Initiative 23 schools are in the “ focus ” or control group – Schools were randomly assigned to these groups 3/11/2012 13

Design of MDS3 Observational Study

• • • • Funded by William T. Grant Foundation 4 data points, over 3 years – 2 data collectors (1 ASSIST and 1 SAfETy) – 25 classrooms per school (≈1500 per time point) – 30+ non-classroom locations Using handheld devices to collect data Instruments –

Assessing School Settings: Interactions of Students & Teachers (ASSIST):

Rusby et al. (2001); Cash & Debnam • Praise, opportunities to respond, punishing statements, transitions, supervision, positive interactions, engagement, aggressive behavior etc.

• Both event based and global ratings – School Assessment for Environmental Typology (SAfETy): Bradshaw, Lindstrom Johnson, Milam, & Furr-Holden • Features of the school environment that encourage access control, surveillance, territoriality, physical maintenance, and behavioral management (e.g., disorder, substance use, broken windows)

Menu of Evidence-Based Programs

• • • • • •

Positive Behavioral Interventions and Supports

– (PBIS; Sugai & Horner, 2006) – 3 tiered prevention model, focused on climate and behavior management

Olweus Bullying Prevention Program

– (Olweus, 2007) – Bullying and school climate

Botvin

’

s Life Skills program

– (Botvin et al., 2006) – Substance abuse prevention

Check-in/Check-Out

– (Hawken & Horner, 2003) – Mentoring and behavior management

Check & Connect

– (Anderson et al., 2004) – Mentoring and truancy prevention

Cognitive Behavioral Intervention for Trauma in Schools

– (Kataoka et al., 2003) – Focused on mental health issues (e.g., anxiety, depression)

Center for School Based Mental Health Nancy Lever and Sharon Stephan • • • • • • •

Link to EBP resources specific to HS Mobilize student, family, community CBITS Community Resource Mapping Manual Cross train Common Calendar Increase ISF awareness, visibility

MDS3 School Climate Model: % Time Spent on

“

Valued Outcomes

” School Climate

Engagement 42%

Check and Connect Culturally Responsive Teaching Safety 9% Olweus Bully Prevention Botvin Life Skills Relationships Respect for Diversity School Participation Emotional Safety Physical Safety Substance Use

Environment 47%

Check in Check Out + Academic Support CBITS & Mental Health Awareness Physical Environment Academic Environment Wellness Disciplinary Environment

Evidence-Based Programs Implemented 2010-2011

18 16 2 0 6 4 14 12 10 8 PBIS CICO CnC Life Skills Olweus CBITS 2010-2011

Year 1: Foundation: Applying the Tiered Logic • • • • • • •

Continuum of EBP Fidelity of Implementation Teaming Structure Data System Universal Screening and Decision Rules for Access Data Base Decision Making Team Problem Solving Continuous Progress Monitoring

10 5 20 15 25 Evidence-Based Programs Implemented 2010-2011 and 2011-2012 0 PBIS CICO CnC Life Skills Olweus CBITS 2010-2011 2011-2012

Evidence-Based Programs Anticipated Implementation for Year Two 20 15 30 25 10 5 0 PBIS CICO CnC Life Skills Olweus CBITS 2010-2011 2011-2012 2012-2013

MDS3 Data Sources

•

Data for Decision-making:

• Web-based school climate survey (students, school staff, parents) • Site visits - Health and safety of school environment • School-level records: referrals, suspensions, attendance, nurse and counselor log, academics • School-wide Evaluation Tool (SET), Individual Student Systems Evaluation Tool (ISSET)

Spring 2011 MSD3 Student Climate Survey Results

•

Safety

– ___% feel safe at school – ___% reported being bullied during the school year – ___% reported that other students try to stop bullying – ___% often or very often feel sad – ___% reported that substance abuse is a problem at their school

Spring 2011 MSD3 Student Climate Survey Results

•

Safety

– 83.0% feel safe at school – 25.0% reported being bullied during the school year – 31.7% reported that other students try to stop bullying – 20.2% often or very often feel sad – 64.9% reported that substance abuse is a problem at their school

Spring 2011 MSD3 Student Climate Survey Results

•

Engagement

– ___% feel they belong at school – ___% feel their teachers encourage them to work hard – ___% feel their parents are informed when they do well – ___% feel students of all races are treated equally

Spring 2011 MSD3 Student Climate Survey Results

•

Engagement

– 67.5% feel they belong at school – 81.2% feel their teachers encourage them to work hard – 43.9% feel their parents are informed when they do well – 57.9% feel students of all races are treated equally

Spring 2011 MSD3 Student Climate Survey Results

•

Environment

– ___% report that disruptions in the classroom get in the way of their learning – ___% report the school building is clean and well-maintained – ___% report that students who need help with their problems are able to get it at school

Spring 2011 MSD3 Student Climate Survey Results

•

Environment

– 60.5% report that disruptions in the classroom get in the way of their learning – 49.4% report the school building is clean and well-maintained – 63.6% report that students who need help with their problems are able to get it at school

Stages of Implementation

Fixsen

Focus Stage Description

Should we do it Exploration/ Adoption Decision regarding commitment to adopting the program/practices and supporting successful implementation.

Getting it right Making it better Installation Initial Implementation Elaboration Continuous Improvement/Re generation Set up infrastructure so that successful implementation can take place and be supported. Establish team and data systems, conduct audit, develop plan.

Try out the practices, work out details, learn and improve before expanding to other contexts.

Expand the program/practices to other locations, individuals, times- adjust from learning in initial implementation.

Make it easier, more efficient. Embed within current practices.

Funding

Expanding the SWPBS Implementation Blueprint www.pbis.org

Visibility Training Systems Coaching Coach Political Support Policy Evaluation Expertise

31

Policy: Shapes Adult Behavior

• • •

Equal priority to Social Emotional Health and Wellbeing Academic Achievement Academic Behaviors – Organizational Skills – Team Problem Solving – Study Skills

Training

Activity Based Training • WIIFM • • • Resource/Continuum Mapping Inventory current interventions, practices Service Delivery Teams- Who?

• organization, role and function, communication • from case management to systems planning • assess skills, competencies across staff • Data: Student List, Early Warning Systems, ODR as screening tool • Implementation Snapshots and Practice Profiles

WIIFM? Why Am I Here?

•

How can I use this training to benefit the work I do everyday?

– Prioritize which topics align with your district ’ s mission – With your schools goals – Share your thoughts at your table

Before you add one more thing….

www.safetycenter.navy.mil

Resource Mapping • Taking Inventory • Linking to Outcome/Strategic Plan • How do we support adults?

• How do we make sure we invest in what works with our students/youth?

• What data will help keep us on track?

Triangle Activity:

Applying the Three-Tiered Logic to Your School

,

District or State

Tier 3

Practices, Initiatives, Programs for a FEW

Tier 2

Practices, Initiatives, Programs for SOME

Tier 1

Practices, Initiatives, Programs for ALL

38

Screening & Feedback

• •

Essential to developing effective systems – Effective systems allow for high fidelity of implementation Often overlooked

Activity: Student List

Name

Jana Blake Toby Carlos Yvonne Lin Maria Doug Tyrone Sam Paul Tia

Grade Level GPA last year

9 11 10 10 9 11 12 9 9 10 9 9 2.2

1.3

2.8

.7

2.7

2.3

1.9

3.1

2.9

2.4

3.4

3.7

Behavior Referrals

4 ref 0 16 ref 1 S 22 S 3 S 2 ref 0 16 ref 2 S 2 ref 10 ref 13 ref 1 ref 0

Core Grades

1 D 1 F 3F 2D 1 F 4 F 2 D 1 F 1 F 4 D 1 F 1 F 2 D 2D 1 F 1 D 2 C

Attendance Credits

82% 88% 84% 62% 86% 90% 74% 81% 89% 87% 86% 60% On Track -3 -2 -4 -1 -2 -4 On Track On Track -2 On Track On Track

Who gets access to an intervention that integrates academic/behavioral support ? Choose 6 students.

Activity: Student List

• • • • • • • • • Do you have rules for access? Do you need to lower the threshold?

Are there other sources of data available?

Can you get access to a data dash board? What else should we know about the students? Do any staff in building have relationship with the student?

What are some possible political implications of choosing the students you chose? Leads to the integration Reflect on the team dynamics

Decision Rules for Access to Advanced Tiers (and decision rules for prevention-if we can predict the trajectories , then we can prevent it from happening)

• • • • • • • • • • • • Youth has 2 Major ODRs Youth has 1 Suspension Youth experiences more than ? minutes out of instruction Youth misses more than ? days unexcused absences Youth drops GPA by more than ??

Youth – benchmark testing McIntosh Youth- incomplete class work/homework Attendance (look at predictors for drop-out and school completion) Admin Referral Teacher/Staff Referral Family Referral Other:

Screening: Early Warning Systems

• Research is clear that ninth grade is a “make or break” year. More students fail ninth grade than any other grade in high school, and a disproportionate number of students who are held back in ninth grade subsequently drop out (Herlihy, 2007). • The most powerful predictors of whether a student will complete high school include

course performance

and

attendance

during the first year of high school (Allensworth & Easton, 2005; 2007). • Therefore, systematic collection of student attendance and course performance data can be used to develop an effective early warning system that can also be tailored to local contexts. http://betterhighschools.org/ews.asp#EWS1

Early Warning Indicators

Course Performance in Core Subjects GPA Credits FCAT/ Concordance Scores Attendance Office Discipline Referrals Additional Factors On-Track At-Risk for Off Track Off-Track Highly Off Track Extremely Off-Track

Meeting all graduation requirements Cs or better in all areas Lacking 1 graduation requirement 2.5 or more 2.0 to 2.49

Meeting credit graduation requirement for grad plan year Behind 1 Credits Level 3 or Above or concordant scores within the same school year Level 2 on FCAT 4% or less absences per quarter or semester 5% or more absences per quarter or semester Lacking 2 graduation requirements Failing 1-3 classes Lacking 2 or more graduation requirements Currently failing 3 or more classes Meeting no graduation requirements 2-3 Years Behind Less than 2.0 Less than or equal to 1.5

Less than or equal to 1.0

Behind 3 credits Not passed both sections of 10 th grade FCAT or retakes Behind 4 or more credits No concordant scores Not passed 10 th grade FCAT or retakes No concordant scores 10% absences per quarter or semester 15% or more absences per quarter or semester Not meeting cohort graduation plan Not passed 10 retakes scores th grade FCAT or No concordant 20% or more absences per quarter or semester 3 or less Level I and/or minor referrals 4 or less Level I and/or minor referrals Level II ODRs per semester 5 or more Level I and/or Level II ODRs per semester 5 or more Level II ODRs for fighting/ profanity/ disruption per semester Established pattern of severe behavior Level II & III ODRs Disengagement No extra curricular involvement Substance Abuse High Mobility Depression Anxiety Free/Reduced lunch Foster/group home Transient/Homeles s Parent unemployment Student employment Changes in behavior/ appearance More recent traumatic event Missed guidance appointments No show for yearbook picture

Critical Features for Implementing Advanced Tiers of Support:

• • Establish decision rules for access to the intervention Explore data and “look” for students in need • • • •

**Refrain from grouping students with similar life circumstance (divorce/bully etc)

–

Group based on demonstrated need- response to the life circumstance and the coping skills required

Interventions are linked directly to the SW expectations and/or academic goals Interventions are always available to students Monitor progress of student- (outcome with data in and data out) Staff are trained, receive ongoing support, and are provided feedback.

Types of Coaching: Selection and Recruitment for the “Right Fit”

•

Coaching for Individual Change

: • focus on skill development, support and performance feedback (content specific: academic, behavior)

Coaching for Team/Group Change:

focus on collaboration and facilitation, group dynamics •

Coaching for Systems Change:

focus on organizational change

Systems Coach

Support to Leadership Systems Change Coach (Facilitator/ Communicator) Skill Coach for Practitioners

Organizational/Systems Change OR The Development of Effective, Productive, Collaborative Systems that create optimal Conditions for Learning

Support To Leadership 1. Listen, model 2. Advocate for School-Wide Support through data 3. Broker Resources to Include EBPs 4.

Be a “New Pair of Eyes” 5. Provide an Objective View of a Situation 6. Lead in the Direction of Sustainability

Skill/Coach for Practitioners 1. Provide Direct Training, recruit next trainer 2. Serve as the System Level Interventionist 3.

Promote Common Language That’s Productive 4. Provide Scaffolding 5. Model Active Listening

Facilitator/Communicator 1. Develop Effective Communication Systems 2. Facilitate Sharing Different Views and Perspectives 3. Guide Through: a. Self-Assessment of Efficiency b. Evaluation c. Needs Assessment d. Use of Data e. Critical Features of Systems and Programs

User: patti Ch an g e Passwo r d Ti m esh eet Ho m e

MDS3 Online Visit Log Database:

Cl i m at e Sp eci al i st s Sch o o l s An d Sco r es Li st / Ed i t Vi si t s Ad d a Vi si t Up d at e

Edit the following visit and task information as necessary:

Visit Log ID: Visit Date: (YYYY-MM-DD) Duration of Visit (hours): School: Climate Specialist: Intervention: Work linked to SIP (Y/N): Work linked to SW expectations (Y/N): Comments (65K char max): Visit Information 1 2 0 1 1 - 1 0 - 3 1 2 Di st r i ct CCPS : No r t h Po i n t Hi g h Sch o o l Pat t i , Her sh f el d t Ti er I - Fo u n d at i o n al Wo r k Yes Yes Ad d Task

List of Tasks: Number of tasks: 0 : Sum of task percentages: 0 %

Task Category Dat a Task Subcategory TA f o r el em en t s o f Dat a- Based Deci si o n Mak i n g Coaching Type Teach i n g / Tr an sf er o f n ew sk i l l set (optional) Individual Role: Group Coached Wh o l e Facu l t y Percentage Of Time 5 0 % (optional) Type of Group:

Coaching: % Of Time Spent w/ Each Group

Coaching: % Of Time Spent On Each Type Of Coaching

Percentage Of Time Spent On…

Top Small Group Hours

Challenges

What is a School Climate Specialist? School leadership opposition Staff buy-in Lack of systems structure “B.D.T.R.B. Syndrome”

Been Down This Road Before

Involvement of whole staff

School Climate Specialists’ School Visits

90 80 70 60 50 40 30 20 10 0

54 66 50

scs1 scs2 scs3

Visits by SCS as of 03/01/2012 87

scs4

31

scs4

63 41

scs6 scs7

60

scs8

58

scs9

23

scs10

Lessons Learned in the School Climate Specialist Role 1.

Support May Look Different From School-to-School 1.

Expect Successes and Challenges 1.

Healthy Debriefing Among Colleagues is Good Practice 1.

Pushback from Schools is not Personal 1.

Flexibility is Key in Maintaining Healthy Relationships with School Teams 1.

Three Schools Seem to Be the Limit for Successful Implementation of EBPs 1.

Serve as a Guide, Facilitate not Direct 1.

1.

Celebrate Even the Smallest of Successes Remember… You are a Guest in the School

Lessons Learned About Evidence-Based Programs 1.

2.

3.

4.

5.

6.

7.

Let Schools Work Within their Own Timeline For Some Interventions (e.g., Tier 2 and Tier 3), It Is Okay to Start Small and Work the Kinks Out Utilize Data To Make Decisions about Evidence-Based Programs Celebrate Even the Smallest Successes Realize that Program Implementation Will Not Take Place the Day After Training Work With What’s Already in Place To Formalize or Document EBPs Don’t just do “IT” to say “we do IT.”

Lessons Learned about Stakeholders

1. Administrator Buy-In is Critical for Success 2. Make Sure Team is Representative of Staff 3. Know Who Has the Power in the School and Work Through Them 4. Gather Student Feedback and Participation 5. For Sustainability, Business/Community Support is Imperative 6. Expect Changes in Team Composition Over Time 7. Recognize school readiness signals in order to advance to next steps

Lessons Learned in Implementation Steps

1. Each school is in a different phase-make sure you are also in that phase.

2. Each stakeholder on the team has a different agenda and perspective about needs.

3.

Each member of the team will have the “aha” moment at different times.

4. Implementing step 2 before step 1 will sometimes help you have a stronger team. It is okay to go back.

5. Staff may need training in the program before they can commit and commitment is never assured.

Year 2

• • •

State Integration Team District and Community Team Community Resource Mapping – GIS (geographic information system) mapping of the locations of the schools in relation to community-based resources (e.g., libraries, churches, hospitals, community centers) and risks (e.g., alcohol outlets, crime). We are also linking the schools with community level census data (e.g., income of surrounding zip codes). – This will allow us to examine some macro-level factors related to the survey data and school-based observational data collected in the project. – Data will enrich the information available to the schools, as well as the research on community-level correlates of school climate.

Year 2: Capacity

• • • • •

RENEW CBITS School based team expansion Implementation Briefs ISF Facilitation Guides – Funding, Tools, Team – Readiness Checklist for Integration – ISF Consumer Guide

Share Your Thoughts…Questions?

Acknowledgements “The Elite Eleven” Beth Chatfield, Kim Crawford, Lacey Hentz, Wayne Hickman, Christina Jordan, Christina Knepper, Mike Muempfer, Rebecca Piermattei, Rebecca Philbrick, Morgen Piper, Brian Tureck Patti Hershfeldt, Jerry Bloom, Aniket Joshi, Muriel Smoot Catherine Bradshaw, Katrina Debnam Martha Essenmacher, Mike Ford, Andrea Alexander

“No significant learning occurs without a significant relationship." Dr. James Comer