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Educator Roles in Promoting Mental Health and School Success for PreK-12 Students. Carl E. Paternite, Ph.D. Center for School-Based Mental Health Programs Department of Psychology Miami University (Ohio) http://www.units.muohio.edu/csbmhp

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Educator Roles in Promoting Mental Health and School Success for

PreK-12 Students

Carl E. Paternite, Ph.D.

Center for School-Based Mental Health Programs

Department of Psychology

Miami University (Ohio)

http://www.units.muohio.edu/csbmhp

Presented at Mental Health Services and Schools Creating a Shared Vision Ellicottville, NY

August 19th, 2003


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Educator Roles in Promoting Mental Health and School Success for PreK-12 Students

  • Instructional Objectives For Presentation:

    • Increase participant awareness of the importance of

      educators in school-based mental health programming.

    • Increase participant knowledge of effective approaches to

      enhance educator – mental health professional collaboration.

    • Increase knowledge of ways to infuse "mental health

      education" into the school milieu.


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Educator Roles in Promoting Mental Health and School Success for PreK-12 Students

  • Themes Addressed in Presentation:

    • Program development.

    • Interdisciplinary collaboration and partnership.

    • Prevention.

    • Research, training and education.


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Mental Health Needs of Youth and Available Services for PreK-12 Students

  • About 20% of children/adolescents (15 million), ages 9-17, have diagnosable mental health disorders (and many more are at risk or could benefit from help).

  • Less than one-third of youth with diagnosable disorders receive any service, and, of those who do, less than half receive adequate treatment (even fewer at risk receive help).

  • For the small percentage of youth who do receive service, most actually receive it within a school setting.

  • These realities raise questions about the mental health field’s over-reliance on clinic-based treatment, and have reinforced the importance of alternative models for mental health service — especially expanded school-based programs.


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Leading Causes of Death in 15-19 Year Olds in the United States in 2000— U N I T E D S T A T E S, 2000 —

1631

CAUSE # OF DEATHS

Accidents 6573

Homicide 1861

Suicide 1574

Cancer/Leukemia 759

Heart Disease 372

Congenital Anomalies 213

Lung Disease 151

Stroke 60

Diabetes 40

Blood Poisoning 36

HIV 36

From Weist & Adelsheim, 2003


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Report of President’s New Freedom Commission on Mental Healthhttp://www.mentalhealthcommission.gov

“…the mental health delivery system is fragmented and in disarray…leading to unnecessary and costly disability, homelessness, school failure and incarceration.”

Unmet needs and barriers to care include (among

others):

  • Fragmentation and gaps in care for children.

  • Lack of national priority for mental health and suicide prevention.

    July, 2003


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Report of President’s New Freedom Commission on Mental Health: Six Goals for a Transformed System

  • Americans understand that mental health is essential to overall health.

  • Mental health care is consumer and family driven.

  • Disparities in mental health services are eliminated.

  • Early mental health screening, assessment, and referral to services are common practice.

  • Excellent mental health care is delivered and research is accelerated.

  • Technology is used to access mental health care and information.

    July, 2003


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Four Recommendations Supporting Goal 4: Early Mental Health Screening, Assessment, and Referral to Services are Common Practice

Promote the mental health of young children.

Improve and expand school mental health programs.

Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies.

Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and supports.

July, 2003


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Expanded School-Based Screening, Assessment, and Referral to Services are Common Practice Mental Health Programs

  • National movement to place effective mental health programs in schools, serving youth in general and special ed.

  • To promote the academic, behavioral, social, emotional, and contextual/systems well-being of youth, and to reduce “mental health” barriers to school success.

  • Programs incorporate primary prevention and mental health promotion, secondary prevention, and intensive intervention,joining staff and resources from education and other community systems.

  • Intent is to contribute to building capacity for a comprehensive, multifaceted, and integrated system of support and care.


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University of Maryland Screening, Assessment, and Referral to Services are Common Practice

Center for School Mental Health Assistance

Mark Weist

(http://csmha.umaryland.edu)

ESBMH


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UCLA Screening, Assessment, and Referral to Services are Common Practice

Center for Mental Health Assistance

Howard Adelman & Linda Taylor

(http://smhp.psych.ucla.edu)

“Barriers to Learning”

(see handout)


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Interconnected Systems for Meeting the Needs of All Students Screening, Assessment, and Referral to Services are Common Practice

CONTINUUM OF SCHOOL AND COMMUNITY PROGRAMS AND SERVICES

(From Adelman & Taylor, http://smhp.psych.ucla.edu)


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Potential of Schools as Key Points of Engagement Screening, Assessment, and Referral to Services are Common Practice

  • Opportunities to engage youth where they are.

  • Unique opportunities for intensive, multifaceted approaches and are essential contexts for prevention and research activity.


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Schools: The Most Screening, Assessment, and Referral to Services are Common PracticeUniversal Natural Setting

  • Over 52 million youth attend 114,000 schools

  • Over 6 million adults work in schools

  • Combining students and staff, one-fifth of the U.S. population can be found in schools

    From Weist, 2003


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  • Overarching Goals

  • Build collaborative university-school district relationships to

    address the mental health needs of children and adolescents

    through multifaceted programming.

  • Promote mental health and school success for youth through:

    • Primary prevention and mental health education

    • Early direct intervention for identified at-risk children

      and adolescents, and treatment for thosewithsevere/

      chronic mental health problems

    • Action research, training, and consultation


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    Center for School-Based Mental Health Programs (at Miami University)

    • Ohio Mental Health Network for School Success

      • Six affiliate organizations working together in regional and state-wide activities (including “Shared Agenda” initiative)

    • Butler County School-Based Mental Health Program

      • School-based mental health promotion, prevention, intervention, and applied research activities.

    • Addressing Barriers to Learning Program

      • Annual conferences to initiate and sustain local, school-based projects that reduce mental health barriers to learning and enhance the development of healthy school communities.


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    Center for School-Based Mental Health Programs (at Miami University)

    • Behavioral Health Advisor

      • Mental health newsletter for elementary and secondary school educators, focusing on issues related to child mental health and school success.

    • Evaluation of Alternative Education/ Discipline Programs

      • Ongoing formative evaluation of 11 alternative programs in Butler County,OH.

    • Mental Health for School Success

      • Special project with Ohio Department of Education to promote mental health — education integration.


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    Center for School-Based Mental Health Programs (at Miami University)Funding History (current in bold)

    • Butler County Mental Health Board

    • The Health Foundation of Greater Cincinnati

    • Ohio Department of Mental Health

    • The Center for Learning Excellence

    • Butler County Family and Children First Council

    • Talawanda and New Miami School Districts

    • Ohio Department of Education

    • Miami University cost sharing


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    School-Based Mental Health Partnerships University)

    Many individuals have been instrumental to our school-based mental health partnerships since 1998. To name just a few:

    University-Based (3 universities, 5 academic divisions, 6 departments)

    Faculty/Staff: Carl E. Paternite, Karen Schilling, Julie Rubin, Denise Fox-Barber, Amy Wilms, Betty Yung, David Andrews, Al Neff, Diana Leigh, Alex Thomas, Randy Flora, Doris Bergen, Valerie A. Ubbes, Raymond Witte, Joan Fopma-Loy …

    Psychology interns and graduate assistants: Lynne Knobloch, Becky Hutchison, Sally Phillips, Leslie Baer, Linda Gal, Derek Oliver, Mike Imhoff, Julie Cathey, Liz Morey, Chris Dyszelski, Chris Mauro, Nancy Pike, Jessica Donn, Sandra Kirchner, LaTasha Mack, Ann-Marie Bixler, Jari Santana-Wynn, Jeanene Robinson, Gloria Oliver, Francesca Dalumpines, Jamie Williamson, Jill Thomas, Jennifer Malinosky, Jason Kibby, Julia Pemberton, Ann Marie Lundberg, Marc McLaughlin, Robin Graff-Reed, Melissa Maras, Chris Reiger, Julie Swanson …

    Community-Based

    John Staup, Kay Rietz, Saundra Jenkins, Barbara Perez, Susan Smith, Valerie Robinson, Jolynn Hurwitz, Kate Keller, Terri Johnston, Charlie Johnston, Kathy Oberlin, Ellen Anderson, Noelle Duval, Linda Maxwell, Greg Foster, Teresa Jullian-Goebel, Suzanne Robinson, Terre Garner, Bryan Brown, Greg Rausch, Carolyn Jones, David Turner …

    School-Based

    Teacher consultants: Sherie Davis, Marilyn Elzey, Tom Orlow, Teresa Abrams, Sarah Buck, Jim Carter, Julie Churchman, Amy Gibson, Joy Boyle, Chris Carroll, Mary Hessling, Joan Parks, Joanne Williamson, Jaimie Pribble, Pam Termeer, Pat Stephens, Patricia Scholl, Martha Slamer, David Wood, Susan Meyer, Monna Even, Ginny Paternite, Connie Short, Terri Hoffmann, Karen Shearer …

    Guidance counselors, school psychologists, school nurses, and administrators: Marianne Marconi, Sandy Greenberg, Tom O’Reilly, Roberta Perlin, Betsy Esber, MaryBeth Bergeron, Greg Rausch, Ann Schmitt, Alice Bonar, Stephanie Johnson, Marcia Schlichter, Susan Cobb, Phil Cagwin, Bob Bierly, Martha Angello, Bill Miller, Bob Phelps, Dan Milz, Dave Isaacs, Mark Mortine, Rhonda Bohannon, Clint Moore, Cathy Keener, Mary Jane Roberts, Jean Eagle, Alice Eby, Kathy Jonas, David Greenburg, Candice McIntosh, Sharon Lytle, Terri Fitton, Steve Swankhaus, Melissa Kessler, Mary Jacobs ..

    Action-Project Teams: Fourteen 2-4 person teams from ten schools in five school districts, each with a university faculty/graduate student liaison.


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    The Ohio Mental Health Network for School Success University)

    Mission

    To help Ohio’s school districts, community-based agencies, and families work together to achieve improved educational and developmental outcomes for all children — especially those at emotional or behavioral risk and those with mental health problems, including pupils participating in alternative education programs.


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    The Ohio Mental Health Network for School Success University)

    Action Agenda

    • Create awareness about the gap between children’s mental health needs and “treatment” resources, and encourage improved and expanded services (including new anti-stigma campaign).

    • Encourage mental health agencies and school districts to adopt mission statements that address the importance of partnerships.

    • Conduct surveys of mental health agencies and school districts to better define the mental health needs of children and to gather information about promising practices.


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    The Ohio Mental Health Network for School Success University)

    Action Agenda (continued)

    • Provide technical assistance to mental health agencies and school districts, to support adoption of evidence-based and promising practices, including improvement and expansion of school-based mental health services.

    • Develop a guide for education and mental health professionals and families, for the development of productive partnerships.

    • Assist in identification of sources of financial support for school-based mental health initiatives.

    • Assist university-based professional preparation programs in psychology, social work, public health, and education, in developing inter-professional strategies and practices for addressing the mental health needs of school-age children.


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    Policy Maker Partnership (PMP) at the National Association of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    Concept Paper

    Mental Health, Schools and Families Working Together for All Children and Youth:

    Toward A Shared Agenda (2002)


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    “Encourage state and local family and youth organizations, mental health organizations, education entities and schools across the nation to enter new relationships to achieve positive social, emotional and educational outcomes for every child.”

    Purpose of the Concept Paper


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    The concept paper is available online at: mental health organizations, education entities and schools across the nation to enter new relationships to achieve positive social, emotional and educational outcomes for every child.”www.nasdse.org/sharedagenda.pdfwww.ideapolicy.org/sharedagenda.pdfwww.nasmhpd.org


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    Policy Maker Partnership (PMP) at the National Association of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    Shared Agenda Seed Grant Awards to Six States:

    Missouri, Ohio, Oregon,

    South Carolina, Texas, and Vermont


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    Additional Funding for Ohio’s Shared Agenda Initiative of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    Ohio Department of Mental Health

    Ohio Department of Education

    Ohio Department of Health

    and

    Numerous Additional State-level and Regional Organizations


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    Infrastructure for Ohio’s Shared of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    Agenda Initiative

    The Shared Agenda seed grant is being implemented in Ohio within the collaborative infrastructure of the Mental Health Network


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    Three Phases of Ohio’s Shared of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    Agenda Initiative

    Phase 1—Statewide forum for leaders of mental health, education, and family policymaking organizations and child-serving systems (March 3, 2003)

    Phase 2—Six regional forums for policy implementers and consumer stakeholders (April-May, 2003)

    Phase 3—Legislative forum involving key leadership of relevant house and senate committees (October, 2003)


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    Phase 1 and Phase 2 of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)Shared Agenda Forums

    Logo Here

    Columbus, OH — Statewide Forum, March 3, 2002

    Athens, OH—Southeast Wooster, OH—North Central

    April 15, 2003 April 28, 2003

    Columbus, OH—Central Bowling Green, OH—Northwest

    April 29, 2003 April 29, 2003

    Cleveland, OH—Northeast Hamilton, OH—Southwest

    May 5, 2003 May 5, 2003


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    Strategies and Features of Various Shared Agenda Forums of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    • Keynote presentations by national and state experts:

      • Mark Weist, Center for School MH Assistance, U. of Maryland

      • Steve Adelsheim, New Mexico School MH Initiative

      • Howard Adelman & Linda Taylor, UCLA School MH Project

      • Kimberly Hoagwood, Columbia University

      • Howie Knoff, Project Achieve

      • Joseph Johnson, Ohio Department of Education

      • Eric Fingerhut, Ohio State Senator


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    Strategies and Features of Various Shared Agenda Forums of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)

    • Promising work in Ohio showcased

    • Youth and parent testimony

    • Cross-stakeholder panel discussions

    • Facilitated discussion structured to create a collective

      vision, build a sense of mutual responsibility for reaching

      the vision, instill hope that systemic change is possible,

      and problem-solve regarding implementation issues

    • Appreciative Inquiry model for promotion of systems-level change and transformation informed the process


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    Outcomes and Recommendations of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)from Phases 1 and 2 of Ohio’s Shared Agenda Initiative

    • Approximately 725 participants

    • Report being compiled that will inform the Fall, 2003 Shared Agenda Legislative Forum

    • Through Legislative Forum raise public awareness and build advocacy for policy and fiscal support for better alignment for education and mental health in the next biennial budget process

    • Website created to track and publicize Ohio’s Shared Agenda initiative (http://www.units.muohio.edu/csbmhp/sharedagenda.html)


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    Ten Emerging Recommendations of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD)from Phases 1 and 2 of Ohio’s Shared Agenda Initiative

    Logo Here

    1. Promote EFFECTIVE mental health and educational practices in schools

    2. Increase family and community involvement in school mental health and educational programs

    3. Actively solicit and appreciate student input in program planning and operation

    4. Reduce stigma for children who need mental health

    services


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    Ten Emerging Recommendations from Phases 1 and 2 of Ohio’s Shared Agenda Initiative (cont’d)

    Logo Here

    5. Maintain focus on all children, not just students in special education

    6. Promote a better understanding of children’s mental health needs in schools

    7. Expand cross-discipline training (preservice and inservice) for mental health/family-serving providers, educators and parents


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    Ten Emerging Recommendations from Phases 1 and 2 of Ohio’s Shared Agenda Initiative (cont’d)

    Logo Here

    8. Work more effectively to reduce “turf issues” that interfere with children’s mental health service delivery and with mental health-education collaboration

    9. Coordinate more effectively between state-level and regional/local efforts in the area of school mental health and in promotion of mental health and school success

    10. Develop organizational structures (e.g., 501C3) that will promote strong coalitions and facilitate funding


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    Creating and Maintaining Ongoing, Empowering Dialogue with Educators

    • Multi-level, formal and informal dialogue with policy makers, formulators, enforcers, and implementers.

    • Programs for school board members and administrators.

    • Newsletter for teachers.

    • Website resources.

    • Extensive “contact time” with educators in their school buildings.

    • “Joining” the school community.

    • Key opinion leaders.


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    Assessing and Responding To EducatorsEducator-Identified Needs and Concerns

    • Careful, detailed, local needs assessments from the perspective of educators, and a commitment to be responsive to identified needs.

    • Results used in advocacy efforts and as guideposts for ongoing work.


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    Perceived Problems Educators

    And

    Teamwork Exercises


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    Teacher Consultants Educators

    • Teacher consultants develop and implement special projects

      related to school-based mental health enhancement.

    • Teacher consultants serve as liaisons to the schools in efforts to promote school-based mental health programming.

    • Teacher consultants serve as informal advisers/mentors to

      school staff on matters related to social-emotional adjustment and learning needs of children and school/climate issues.


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    Incentives For Teacher Consultants Educators

    Leadership opportunity

    Training opportunity

    Academic credit

    Stipends (“supplemental contracts”)

    Empowerment

    Demystification


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    • Addressing Barriers to Learning: Annual Conference and Action Projects Program

    • Goal

      • Conduct annual conferences, to help initiate planned

        local public school-based projects that reduce mental

        health-related barriers to learning and enhance the

        development of healthy school communities.


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  • Demonstrate, produce and assess school-based mental

    health practices (classroom-based, classroom-linked)

    that address barriers to desired academic outcomes

    and personal and social skill development.

  • Put into continuing practice that which participants learn

    in conference activities and projects.

  • Increase the effectiveness of school district

    collaboration and system support for school-based

    mental health practices.

  • Disseminate findings.


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  • Researchers and practitioners whose work on the

    conference theme evidences quality and the potential for

    successful application locally.

  • Web-site support.

  • Resource packets.

  • Small grants to support action projects.

  • Ongoing consultation with action teams with graduate

    students/faculty.


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  • 2000 — Nonviolent Schools: Building Programs That Work

    Consultants: Betty Yung and Jeremy Shapiro

  • 2001 — School, Family, and Community Partnerships

    Consultants: Marc Atkins and Scott Rankin

  • 2002 — School, Family, and Community Partnerships

    Consultants: Program faculty


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  • School-wide project focused on increasing students’ positive social skills, using monthly

    themes and activities (open house nights, assemblies, community speakers). Parent

    involvement in planning and implementation is emphasized.

  • School-wide project focused on “trait of the month” themes (e.g., responsibility, caring)

  • and activities (community service projects, fund raising for needy families, school-based

  • counseling groups, after school activities, peer mediation program).

  • School-wide attendance enhancement program, through improved monitoring, enhanced

  • parental involvement with an after school/evening tutoring program linked to family

  • dinner/activity events, and an attendance reward program.

  • School-wide outreach program to families (“The Road Show”) taking school informational

  • meetings into neighborhoods and communities, to overcome obstacle of the

  • geographically large catchment area and to increase family sense of engagement with the

  • school.

  • School-wide project focused on positive social skills, with emphasis on recess

    programming.


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  • A violence reduction program, focused on development of resource materials and use of

    psychoeducational training in coping skills and strategies for at risk students.

  • School-wide family engagement project emphasizing literacy, through school-based

    reading night dinner programs with storytellers and opportunities for families to read

    together.

  • School-wide parent involvement and support program focused on attention to needs of

  • families, efforts to increase positive attitudes toward learning, and enhancement of social

  • skills of students, using community picnics and “Parents on Board” parenting classes.

  • School-wide program focused on understanding and appreciating difference, tolerance,

    and conflict resolution skills, using curricula from the Center for Peace Education.


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  • Mentoring program focused on academic and personal success

    of students, including a strong community service component.

  • Alternative high school service learning program incorporating

    intensive involvement with a senior citizens center and tutoring in

    an elementary school.


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  • Determine goals and objectives.

  • Determine data needed to measure desired outcomes.

  • Select measurement methods.

  • Outline data collection plan.

  • Collect data.

  • Compile, analyze, interpret, and report results.

  • Refine project based on findings.

  • Note: Dr. Doris Bergen (Miami University Center for Human Development, Learning, and

  • Teaching) has provided ongoing technical assistance on the evaluation process.


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  • Evaluation expected on two or more of the four levels:

  • Level 1 -- Records on planned activities.

  • Level 2 -- Self-report data from participant groups on knowledge,

  • attitudes, behaviors.

  • Level 3 -- Outcome data on student effects (attendance, office

  • referrals, grades…).

  • Level 4 -- Systematic observational data on behavior change

  • related to objectives of project.

  • Note: Dr. Doris Bergen (Miami University Center for Human Development, Learning, and

  • Teaching) has provided ongoing technical assistance on the evaluation process.


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  • “The Road Show”

  • Objectives:

    • Increase family involvement with school

    • Increase student attendance

    • Decrease discipline referrals

  • Evaluation Plan:

    • Number of positive/negative calls to school

    • “Road show” attendance rates and parent survey

    • Attendance at parent conferences

    • Student attendance rates

    • Student discipline referrals


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    Educators as Key Members of the Mental Health Team to Evaluation

    • Schools should not be held responsible for meeting every need of every student.

    • However, schools must meet the challenge when the need directly affects learning and school success. (Carnegie Council Task Force on Education of Young Adolescents, 1989)

    • There is clear and compelling evidence that there are strong positive associations between mental health and school success.


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    Educators as Key Members of the Mental Health Team to Evaluation

    • “Children whose emotional, behavioral, or social difficulties are not addressed have a diminished capacity to learn and benefit from the school environment. In addition, children who develop disruptive behavior patterns can have a negative influence on the social and academic environment for other children.” (Rones & Hoagwood, 2000, p.236)

    • Contemporary school reform—and the associated high-stakes testing (including federal legislation signed in 2002)—has not incorporated the Carnegie Council imperative. That is, recent reform has not adequately incorporated a focus on addressing barriers to development, learning, and teaching.


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    Educators as Key Members of the Mental Health Team to Evaluation

    An Exercise:

    How much time do you spend addressing the emotional,behavioral, and/or social difficulties of your students (minutes per hour)?


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    Context Examples to Evaluation

    Senior high school with 880 students reported over 5,100 office discipline referrals in one academic year.


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    What does this mean? to Evaluation

    • 5100 referrals @ 10 minutes each =

      • 51,000 minutes or

      • 850 hours or

      • 141 6 hour days!


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    Context Examples to Evaluation

    Middle school principal reports he must teach classes when teachers are absent, because substitute teachers refuse to work in a school that is unsafe and lacks discipline.


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    Context Examples to Evaluation

    Middle school counselor spends nearly 15% of day “counseling” staff who feel helpless & defenseless in their classrooms because of lack of discipline & support.


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    Context Examples to Evaluation

    Elementary school principal found that over 45% of their behavioral incident reports were coming from the playground.


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    Context Examples to Evaluation

    Three rival gangs are competing for “four corners.” Teachers actively avoid the area. Because of daily conflicts, vice principal has moved her desk to four corners to regain control.


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    Context Examples to Evaluation

    Bus transportation company is threatening to w/draw their contract if students don’t improve their behavior. Recently, security guards were hired to ride buses.


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    Context Examples to Evaluation

    Elementary school principal reports that over 100% of her office discipline referrals came from 8.7% of her total school enrollment, & 2.9% had 3 or more.


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    Who’s problem is it? to Evaluation

    • In one school year, Jason received 87 office discipline referrals.

    • In one school year, a teacher processed 273 behavior incident reports.


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    Something to Think About to Evaluation

    • “Any student who is giving it bad to an educator is getting it at least as bad or worse from some important source in his life.”

      (Mendler, 1997)


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    Insubordination, noncompliance, defiance, late to class, nonattendance, truancy, fighting, aggression, inappropriate language, social withdrawal, excessive crying, stealing, vandalism, property destruction, tobacco, drugs, alcohol, unresponsive, not following directions, inappropriate use of school materials, weapons, harassment, unprepared to learn, parking lot violation, irresponsible, trespassing, disrespectful, disrupting teaching, uncooperative, violent behavior, disruptive, verbal abuse, physical abuse, dress code, other, etc., etc., etc.

    Exist in every school

    Vary in intensity

    Are associated w/ variety of contributing variables

    Are concern in every community

    Problem Behaviors


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    Prioritizing Promotion of Healthy Development and Problem Prevention

    • School-based models should capitalize on schools’ unique opportunities to provide mental health-promoting activities.

    • For example, recommended strategies for drop-out and violence prevention, including those for which the central role of educators is evident, can be promoted actively within an expanded school-based mental health program.


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    Prioritizing Promotion of Healthy Development and Problem Prevention

    For drop-out prevention, these include:

    • Early intervention.

    • Mentoring and tutoring.

    • Service learning.

    • Conflict resolution and violence prevention curricula and training for students/staff.

    • Alternative schooling.


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    Some of What We Know About Youth Violence Prevention From the Surgeon General (2001), U.S. Secret Service (2000),CDC (2002), Mulvey & Cauffman (2001)

    • Violence is a serious public health problem.

    • Violence is most often expressive/interpersonal, rather than primarily instrumental or psychopathological.

    • About 30 to 40 percent of male and 15 to 30 percent of female youth report having committed a serious violent offense by age 17.

    • About 10 to15 percent of high school seniors report that they have committed an assault with injury in the past year — a rate that has been rising since 1980.

    • By self-report, about 30 percent of high school seniors have committed a violent act in the past year — hit instructor or supervisor; serious fight at school or work; in group fight; assault with injury; used weapon (knife/gun/club) to get something from a person.

    • Violent acts are committed much more frequently by male than by female youth. (see Miedzian, 1991)


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    Some of What We Know About Youth Violence Prevention (continued)

    • 43% of male and 24% of female high school students report that they had been in a physical fight during the past school year. (CDC, 2002)

    • No differences are evident by race for self-report of violent behavior.

    • At school, highest victimization rates are among male students.

    • Violent behavior seldom results from a single cause.

    • School continues to be one of the safest places for our nation’s children.

    • Serious acts of violence (e.g., shootings) at school are very rare.

    • Targeted violence at school is not a new phenomenon.

    • Most school shooters had a history of gun use and had access to them.

    • In over 2/3 of school shooting cases, having been bullied played a role in the attack.


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    “For every complex Prevention

    problem there is a

    simple solution that

    is wrong.”

    H.L. Mencken


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    A QUESTION: Prevention

    WHAT ARE THE CAUSES OF VIOLENCE, OTHER PROBLEM BEHAVIOR, AND DISCIPLINE PROBLEMS?


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    Causes of Violence, Other Problem Behavior, and Discipline Problems

    • Out-of-School

      • Society

      • Media

      • More children living in poverty

      • Deterioration of family

      • Difficult temperaments

      • Less able to listen effectively and process verbal material, compared to children 20 – 30 years ago


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    Violent Behavior Problems(Resnick et al., 1997)

    • Behaviors modeled by sports and television heroes desensitize students to violence and antisocial behaviors

    • Strongest protective factors from antisocial behavior…

      • Strong emotional attachments to parents and teachers


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    Aggressive and Rejected Children Problems

    • Thinking errors

      • Attribute hostile intentions to accidental or ambiguous behavior

      • Misinterpret important social cues

      • Tease others but respond incompetently when provoked


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    Educators Problems

    • Thinking errors

      • If punishment is severe enough, children will cease negative behavior

      • Punishment is in the best interest of the child

      • Well controlled classrooms must be quiet classrooms

      • Control is like a behavioral ointment:

        • no control at home = slather it on in school

      • Prescribed discipline programs provide security for staff


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    Model: Influences on Violent versus Problems

    Non-Violent Behavior

    (From Shapiro, 1999, Applewood Centers, Inc., Cleveland, OH)


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    Some of What We Know About ProblemsYouth Violence PreventionFrom the Surgeon General (2001), U.S. Secret Service (2000),CDC (2002), Mulvey & Cauffman (2001)

    • Promoting healthy relationships and environments is more effective for reducing school violence than instituting punitive penalties.

    • The best predictor of adolescent well-being is a feeling of connection to school. Students who feel close to others, fairly treated, and vested in school are less likely to engage in risky behaviors.

    • A critical component of any effective school violence program is a school environment in which ongoing activities and problems of students are discussed, rather than tallied. Such an environment promotes ongoing risk management, which depends on the support and involvement of those closest to the indicators of trouble — peers and teachers.


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    Violence Prevention: ProblemsWhat Doesn’t WorkFrom the Surgeon General (2001) and others

    • Scare tactics. (e.g., Scared Straight)

    • Deterrence programs — shock incarceration, boot camps.

    • Efforts focusing exclusively on providing education/information about drugs/violence and resistance. (DARE)

    • Efforts focusing solely on self-esteem enhancement.

    • Vocational counseling.

    • Residential treatment.

    • Traditional casework and clinic-based counseling.


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    Promoting Nonviolence: An Problems

    Example of a Heuristic

    School-Based Framework

    • Deutsch (1993) — Educating for a peaceful world

    • Four Key Components Including:

      • Cooperative Learning.

      • Conflict Resolution Training.

      • Use of Constructive Controversy in Teaching Subject

        Matters.

      • Mediation in the Schools.


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    Prioritizing Promotion of Healthy Development and Violence Prevention:Best and Promising Practices

    Including:

    • Structured social skill development programs.

    • Mentoring. (see Big Brothers/Sisters; Garbarino, 1999)

    • Employment.

    • Programs that foster school engagement, participation, and bonding.

    • Promotion of developmental assets. (see Search Institute)

    • A variety of approaches that engage parents and families. (e.g., parent

      training, MST, functional FT)

    • Early childhood home visitation programs.

    • Multi-faceted programs that combine several of the above.

    • For good examples see “Blueprint Programs.”


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    Developmental Assets and Violence Prevention:(1997 data, www.search-institute.org)

    Approximately 100,000 6th-12th graders.

    Definition of violence—three or more acts of fighting, hitting, injuring a person, carrying a weapon, or threatening physical harm in the past 12 months.

    • 61% of youth with fewer than 11 of 40 developmental assets were violent.

    • 6% of youth with 31 or more of 40 developmental assets were violent.


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    Positive Behavior Support Prevention:(see www.pbis.org)

    • PBS is a broad range of systemic & individualized strategies for achieving important social & learning outcomes while preventing problem behavior with all students.


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    Terminology Prevention:

    • Positive Behavior….

      • Includes all skills that increase success in home, school and community settings.

    • Supports….

      • Methods to teach, strengthen, and expand positive behaviors.

      • System change.


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    Discipline Defined Prevention:

    • “The steps or actions, teachers, administrators, parents, and students follow to enhance student academic and social behavior success.”

    • “Effective discipline is described as teaching students self-control.”


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    Reactive Vs. Proactive Prevention:

    • Traditional approaches. (including aversive interventions)

      • Address problem behaviors reactively

      • Crisis driven

    • PBS emphasizes proactive interventions.


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    Goals Prevention:

    • Improved quality of life for all relevant stakeholders. (the individual, family members, teachers, friends, employers, etc.)

    • Problem behaviors become irrelevant, inefficient, and ineffective and are replaced by efficient and effective alternatives.


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    PBS Interventions Prevention:

    • Context driven.

    • Addressing the functionality of the behavior problem.

    • Acceptable to the individual, family and community.


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    PBS is a Problem-Solving Process Prevention:

    • Decisions are based upon functional behavioral assessment. (FBA)

    • FBA directs intervention design.

      • FBA establishes instructional targets for alternative skills

      • FBA designates supports and context revisions required for maintenance of positive changes


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    Systems Change Prevention:

    ****DEFINING FEATURE OF PBS****

    • Efforts focused on fixing problem contexts, not problem behavior.

    • Successful outcomes can not depend solely on identifying ONE key critical intervention to “fix” the problem.


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    Components of School-Wide Systems Prevention:

    • Common philosophy.

    • Positively stated rules. (3 or 4)

    • Behavior expectations defined by context.

    • Teaching behavior expectations in context.

    • Reinforcement of expectations.

    • Discouragement of violations.

    • Monitor and evaluate effects.


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    Two Distinct Discipline Models Prevention:

    • Obedience Model

    • Responsibility Model

      From Johnston (2003)


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    Obedience Prevention:

    • MAIN GOAL:

      • Student follows orders

    • PRINCIPLE:

      • Do what the teacher wants

    • INTERVENTION: PUNISHMENT

      • External locus of control

      • Done to the student

    • STUDENT LEARNS:

      • Don’t get caught

      • It’s not my responsibility

        From Johnston (2003)


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    Responsibility Prevention:

    • MAIN GOAL:

      • To teach students to make good choices

    • PRINCIPLE:

      • Learn from the outcomes of decisions

    • INTERVENTION: CONSEQUENCES

      • Internal locus of control

      • Natural or logical

      • Done by the student

    • STUDENT LEARNS:

      • I have more than one alternative

      • I have power to choose

      • I cause my own outcomes

      • From Johnston (2003)


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    Science of behavior has taught us that students…. Prevention:

    • Are NOT born with “bad behaviors”

    • Do NOT learn when presented contingent aversive consequences

    • Do learn better ways of behaving by being taught directly & receiving positive feedback

      From Johnston (2003)


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    Teacher Behaviors That Contribute to Discipline Problems Prevention:

    • Sitting at the desk most of the time, not moving or mingling with the students

    • Using a low, unenthusiastic or uniteresting voice tone

    • Becoming easily sidetracked by one student’s irrelevant question

      From Johnston (2003)


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    Teacher Behaviors That Contribute to Discipline Problems Prevention:

    • Ignoring students’ interests and tying instruction solely to the textbook

    • Repeating student’s answers too frequently

    • Leaving concepts before they have been clarified and/or expecting independent work before understanding has been checked

    • Not being prepared and leaving “down time” for students to fill

      From Johnston (2003)


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    Teacher Behaviors That Contribute to Discipline Problems Prevention:

    • Poorly worded questions that cloud discussion or understanding

    • Having questions/answers be directed solely between teacher and student

    • Neglecting to tie content or learning to prior knowledge of students

    • Using too much time to teach the lesson and not focusing on what is being learned

      From Johnston (2003)


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    Teacher Behaviors That Contribute to Reduction of Discipline Problems

    • Remove conditions that trigger & maintain undesirable practices

    • Increase conditions that trigger & maintain desirable practices

    • Remove aversives that inhibit desirable practices

    • Establish environments & routines that support continuum of PBS

      From Johnston (2003)


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    Promoting Nonviolence Problems: An Example of a Promising Secondary Violence Prevention Program

    • Positive Adolescent Choices Training (PACT)

    • Developed by

    • Betty R. Yung & W. Rodney Hammond

    • Components

      I. Violence-Risk Education

      II. Anger Management

    • III. Social Skills


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    PACT Components I and II Problems

    • Violence Risk Education:

      • Increase awareness of circumstances, risk factors, and consequences of violence.

    • Anger Management:

      • Understand and normalize feelings of anger, recognize anger triggers, and manage anger constructively.


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    PACT Components III: Social Skills Problems

    • Givin’ It:

      • Expressing criticism, disappointment, anger, or displeasure calmly and ventilating strong

        emotions constructively.

    • Takin’ It:

      • Listening, understanding, and reacting appropriately to others’ criticism and anger.

        Workin’ It Out:

      • Listening, identifying problems and potential

        solutions, proposing alternatives when

        disagreements persist, and learning to

        compromise.


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    Closing Observations Problems

    • Clearly, intellectual, social, and emotional education go hand-in-hand, and all are linked to creating safe schools, building healthy character, and achieving academic success:

      The proper aim of education is to promote significant learning. Significant learning entails development. Development means successively asking broader and deeper questions of the relationship between oneself and the world. This is as true for first graders as it is for graduate students, for fledgling artists as graying accountants.

      A good education ought to help people become more perceptive to and more discriminating about the world: seeing, feeling, and understanding more, yet sorting the pertinent from the peripheral with ever finer touch, increasingly able to integrate what they see and to make meaning of it in ways that enhance their ability to go on growing. To imagine otherwise, to act as though learning were simply a matter of stacking facts on top of one another, makes as much sense as thinking one can learn a language by memorizing a dictionary. Ideas only come to life when they root in the mind of a learner. (Daloz, 1999, p. 243)


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    Closing Observations Problems

    • The need for increased attention to mental health promotion on behalf of youth, is quite clear:

      We have a burgeoning field of developmental psychopathology but have a more diffuse body of research on the pathways whereby children and adolescents become motivated, directed, socially competent, compassionate, and psychologically vigorous adults. Corresponding to that, we have numerous research-based programs for youth aimed at curbing drug use, violence, suicide, teen pregnancy, and other problem behaviors, but lack a rigorous applied psychology of how to promote youth development.

      The place for such a field is apparent to anyone who has had contact with a cross section of American adolescents. (Larson, 2000, p. 170)


    Closing observations114 l.jpg
    Closing Observations Problems

    • Certainly, educators are key partners in efforts to intervene with children in need and to promote development.

    • In fact, through their day-to-day interactions with students, educators are the linchpins of school-based efforts to encourage healthy psychological development of youth.


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    This PowerPoint Presentation, with a reference list for cited work, will be posted on the CSBMHP website

    http://www.units.muohio.edu/csbmhp


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    Common Messages Across Initiatives cited work, will be posted on the CSBMHP website

    • It is important to build on the common goals of expanded school-based mental health programs and existing community and school initiatives. For example, in Ohio:

      • “Shared Agenda Initiative”

      • “Partnerships for Success”

      • “Alternative Education Challenge Grant Program”

    • All share a common core focus on barriers to development, learning, and teaching.

    • Identification of the common message across initiatives is extremely important for reducing the chances that what is being introduced by any one initiative will be marginalized by proponents of narrowly-focused school reform.


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    Strategies and Features of Various Shared Agenda Forums cited work, will be posted on the CSBMHP website

    • Keynote presentations by national and state experts:

      • Mark Weist, Center for School MH Assistance, U. of Maryland

      • Steve Adelsheim, New Mexico School MH Initiative

      • Howard Adelman & Linda Taylor, UCLA School MH Project

      • Kimberly Hoagwood, Columbia University

      • Howie Knoff, Project Achieve

      • Joseph Johnson, Ohio Department of Education

      • Eric Fingerhut, Ohio State Senator


    Strategies and features of various shared agenda forums118 l.jpg
    Strategies and Features of Various Shared Agenda Forums cited work, will be posted on the CSBMHP website

    • Promising work in Ohio showcased

    • Youth and parent testimony

    • Cross-stakeholder panel discussions

    • Facilitated discussion structured to create a collective

      vision, build a sense of mutual responsibility for reaching

      the vision, instill hope that systemic change is possible,

      and problem-solve regarding implementation issues

    • Appreciative Inquiry model for promotion of systems-level change and transformation informed the process


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    Proven, Successful Treatments Exist for Most Disorders cited work, will be posted on the CSBMHP website

    Treatment success rates:

    • 80% for major depression

    • 65% for bipolar disorder

    • 60% for schizophrenia

    • 45% for heart disease

    From Weist & Adelsheim, 2003


    Characteristics of children living in poverty ruby payne 1998 l.jpg
    Characteristics of Children Living in Poverty cited work, will be posted on the CSBMHP website(Ruby Payne, 1998)

    • Laughs when disciplined; or is disrespectful to the teacher

    • Argues loudly with the teacher

    • Responds angrily

    • Uses inappropriate or vulgar comments

    • Fights to survive or uses verbal abuse with other students


    Characteristics of children living in poverty ruby payne 1998121 l.jpg
    Characteristics of Children Living in Poverty cited work, will be posted on the CSBMHP website(Ruby Payne, 1998)

    • Hands are always on someone else

    • Can’t follow directions

    • Is extremely disorganized

    • Talks incessantly

    • Cheats or steal


    Characteristics of children living in poverty ruby payne 1998122 l.jpg
    Characteristics of Children Living in Poverty cited work, will be posted on the CSBMHP website(Ruby Payne, 1998)

    • If one out of every four children under the age of 18 in the USA was living in poverty in 1996, 25% or more of our students may exhibit these behaviors in the classroom.


    Students can t learn when fearful of l.jpg
    Students can’t learn when fearful of... cited work, will be posted on the CSBMHP website

    • Physical assault

    • Assault to self-esteem

    • Damages to personal property


    And teachers can t teach l.jpg
    …and teachers can’t teach! cited work, will be posted on the CSBMHP website


    Carly and aidan l.jpg
    Carly and Aidan cited work, will be posted on the CSBMHP website

    in their vehicles


    Carly elmo and aidan l.jpg
    Carly, Elmo and Aidan cited work, will be posted on the CSBMHP website


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