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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
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School-based Mental Health and Positive Behavioral Interventions and Supports and High Schools Maryland Safe and Supportive Schools InitiativeA 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 sbarrett@pbismaryland.org
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
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
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 HealthNancy 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”
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
Evidence-Based ProgramsAnticipated Implementation for Year Two
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 Should we do it Getting it right Making it better
Expanding the SWPBS Implementation Blueprint www.pbis.org ISF Leadership Team ISF Implementation Team Systems Coach Content Family Community Implementation Demonstrations
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
Screening & Feedback • Essential to developing effective systems • Effective systems allow for high fidelity of implementation • Often overlooked
Activity: Student List 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: Services and Interventions are available as soon as the student demonstrates a need
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
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
Support To Leadership • Listen, model • Advocate for School-Wide Support through data • Broker Resources to Include EBPs • Be a “New Pair of Eyes” • Provide an Objective View of a Situation • Lead in the Direction of Sustainability
Skill/Coach for Practitioners • Provide Direct Training, recruit next trainer • Serve as the System Level Interventionist • Promote Common Language That’s Productive • Provide Scaffolding • Model Active Listening
Facilitator/Communicator • Develop Effective Communication Systems • Facilitate Sharing Different Views and Perspectives • Guide Through: • a. Self-Assessment of Efficiency • Evaluation • Needs Assessment • Use of Data • Critical Features of Systems and Programs