Moving Toward a Primary Prevention Model In Schools - PowerPoint Presentation

Moving Toward a Primary Prevention Model In Schools Denisha L. Carter, PsyD & Megan Polanin, PhD Medstar Georgetown University Hospital, Center for Well-Being in School Environments (WISE)

Key Word Today: Prevention

What Does Prevention Mean to You?

Scenario: Thomas is a 5 yo male who experiences environmental stress due to his home life. Thomas is in the 1st grade and has not developed a positive relationship with his teacher Ms. Laskins. He feels unsafe and not acknowledged by his teacher. In 2nd grade he continues to feel a lack of comfort and relationships with his teacher. By the 3rd grade, he experiences difficulty maintaining attention and defiant behaviors. He is referred to the school based MHP who then refers him to a community based therapist. He is diagnosed with ADHD and ODD.

Background: Relationships and School Climate

What do children need in childhood?

Serve and Return Mirror neurons are essential for imitation, planning our actions, understanding intention behind actions, and empathizing Connectedness is our TOP PRIORITY FROM BIRTH

Internal Locus of Control

Attachment/Relational Theories We are preprogrammed for attachment, especially with one main caregiver (Bowlby) Based on early experiences, we develop attachment styles (Ainsworth) Relationship factors estimated to account for 30% of therapeutic change (Hubble et al., 1999)

Outcomes Associated with Positive School Climates 1 in 5 students report being bullied during a school year (Center for Education Statistics, 2018) Increased risk for depression, anxiety, sleep difficulties, lower academic achievement and dropping out of school (CDC, 2018) Developing a positive school climate is consistently associated with lower rates of bullying and cyberbullying (Hinduja & Patchin, 2016) Programs focused on anti-bullying effectively reduce school bullying behaviors by 10-20% ( Gaffney, Ttofi & Farrington, 2018)

Impact of Positive School Climates on Students Better school attendance and study habits Increased motivation and academic success Engaged in learning (cooperative learning) Obtain better grades, improved test scores and mastery of complex subjects

Scenarios

Scenario 1 A student frequently absconds from class. Upon meeting with school team, parent and MHPs teacher identifies that student frequently exits situations when student feels frustrated when he/she does not understand the material presented in class. Team develops success plan and teacher implements with MHP support plan in class. However behavior continues and student begins not showing up for class at all. Guess the Tier?

Scenario 2 A child is suffering from depression. Teacher feels ill equipped to support this student. Referred to MHP. MHP meets with teacher weekly to suggest strategies. Teacher utilizes these strategies in the classroom with the student. Teacher realizes that this strategy is also useful for other students. Guess the Tier? Teacher de-escalates a student Building a relationship with a student

Mindfulness Break

Tiered System

What Do You Think of When You Hear TIER 1?

Tiered Interventions Programs can be relegated to tiers, but children cannot Children shift between tiers

Comprehensive, Integrated Three-Tiered Model of Prevention

WISE Tier System VISUAL

Let’s brainstorm! What Tier 2 & 3 strategies can be used at a Tier 1 level? Identify at least 2 strategies.

Redefining and Expanding Tier 1

Redefining Tier 1: Prevention Ways of Doing Social & Emotional Learning Ways of Being Interactions Well-Being/Self-Care/Demeanor Perspectives/Biases

Expanding Tier 1 How can we shift Tier 2 & Tier 3 interventions to Tier 1? Everything is Serve and Return!

List of Potential Strategies Community meetings Reflective Listening Tone/demeanor Surveys Handshakes/greetings Identify students’ specific interest (i.e. use preference surveys)-Showing interest in students; acknowledgement Spotlight time Special signals NC touch points Designated jobs Check-in/Check-out Us Time Creative Writing Social Stories Modeling Mindfulness

Let’s Practice: Spotlight Time

Let’s Practice: Us Time

Let’s Practice: Reflective Listening

Collaboration is Key Assumption: The collective and focused energies of the whole team are more effective than siloed, fragmented efforts Truth: Collaborative work among school teams enhances buy-in and overall well-being of students

Significance of Relationship Building Tierless intervention Building Block Universality

Mindfulness Break

Delegating Responsibilities for Serve & Return Throughout the School Who can be involved? Expanding network of support for students

Redefining Success Students are successful when they feel: Safe Acknowledged Genuinely cared for Engaging in these acts can reduce incidents of Emotional dysregulation Depression Oppositional behavior Academic instability

Scenario: Thomas is a 5 yo male who experiences environmental stress due to his home life. Thomas is in the 1st grade and has not developed a positive relationship with his teacher Ms. Laskins. He feels unsafe and not acknowledged by his teacher. In 2nd grade he continues to feel a lack of comfort and relationships with his teacher. By the 3rd grade, he experiences difficulty maintaining attention and defiant behaviors. He is referred to the school based MHP who then refers him to a community based therapist. He is diagnosed with ADHD and ODD.

Take-Aways Redefining Tier 1 Ways of doing + ways of being Expanding Tier 1 Tiers 2 & 3 as preventive interventions in classroom Dynamic model Serve and return Collaborative model Relationship building is key

Contact Information Denisha L. Carter, PsyD denisha@medstarwise.org 202-499-0138 Megan Polanin, PhD meganp@medstarwise.org 202-578-5553

References