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2012 National PBIS Leadership Forum Hyatt Regency O’Hare RosemontIllinois Community/School Partnerships for Tier 3 Wraparound Implementation Session A12 | October 18, 2012 | 10:00am – 11:15am Lucille Eber, Illinois PBIS Network Carol Ewen, Missoula County Public Schools Conan Green, Children’s Mental Health Bureau
Context • At least twice as many youth need high levels of support for emotional/behavioral needs than currently identified as EBD. • Nationally, youth who are identified as EBD have experienced very poor outcomes. • Behavior support for students with emotional/behavioral challenges is not just a “Special Education” issue. • Prevention-based systems, with capacity to scale-up and provide effective interventions for those youth with or at-risk of EBD are being developed and implemented in schools. • Schools can’t do it alone…partnerships with communities are needed to ensure success.
We Know the Practices that Work… • Proactive, strength-based; “set kids up” to experience success • High rates of consistent, supported instruction; teach/practice/reinforce • Predictable and consistent environments • Know unique “why?” for each student/problem • Contextual fit: Strategic use of natural supports, and settings • Careful monitoring of data over time with ongoing revisions to guide incrementalimprovements in quality of life
We Know the System Features Needed to Support the Effective Practices… • A Team unique to each individual child & family • Blend the family/natural supports with the school representatives who know the child best • A defined Meeting Process • Meet frequently and use data • Develop, implement, review range of interventions • Facilitator Role • Bringing team together • Blending perspectives; guiding consensus • Systematic use of data (strengths and needs)
Tertiary Prevention: Specialized Individualized Systems for Students with High-Risk Behavior SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT ~5% Secondary Prevention: Specialized Group Systems for Students with At-Risk Behavior ~15% Primary Prevention: School-/Classroom- Wide Systems for All Students, Staff, & Settings ~80% of Students
Positive Behavior Interventions & Supports:A Response to Intervention (RtI) Model Tier 1/Universal School-Wide Assessment School-Wide Prevention Systems ODRs, Attendance, Tardies, Grades, DIBELS, etc. Tier 2/Secondary Tier 3/ Tertiary Check-in/ Check-out Intervention Assessment Social/Academic Instructional Groups Daily Progress Report (DPR)(Behavior and Academic Goals) Individualized Check-In/Check-Out, Groups & Mentoring (ex. CnC) Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc. Brief Functional Behavioral Assessment/ Behavior Intervention Planning (FBA/BIP) Illinois PBIS Network, Revised Aug.,2009 Adapted from T. Scott, 2004 Complex FBA/BIP SIMEO Tools: HSC-T, RD-T, EI-T Wraparound
History • 1982 Unclaimed Children (Jane Knitzer) • SOC needed to be seamless continuum, community-based and culturally relevant 1983 CASSP: Technical Assistance plan to develop SOC • 1986 System of Care (Stroul & Freidman) • Called for collaboration & community-based services • Resulted in increments of service development • (i.e. case mgmt, respite, day treatment, in-home supports) • But not a coordinated system or continuum • Did not indicate practices needed for a SOC
History (cont.) • 1989-1993 RWJ Projects • 27 states and local communities • introduced managed care • effected state systems in some places (i.e. KY, NC) • 1992-present Comprehensive Community Mental Health Services for Children & Their Families Program • 85 states local tribes & territories • Decrease use of restrictive placements while increasing • access, satisfaction, and youth/family outcomes • Systemic change across systems • Development of state & community structures
Wraparound: A SOC Tool • Emerged from practitioners struggling to implement SOC (grassroots) • Keep/bring youth home • Flexible, creative, non-categorical • Natural support networks • Community-based • Unconditional-Commit to “stay the course” • Let family voice guide service development • Non-traditional supports and services
What is Wraparound? Wraparound is a process for developing family-centered teams and plans that are strength and needs based • (not deficit based) • across multiple settings and life domains.
Implementing Wraparound: Key Elements Needed for Success • Engaging students, families & teachers • Team development & team ownership • Ensuring student/family/teacher voice • Getting to real (big) needs • Effective interventions • Serious use of strengths • Natural supports • Focus on needs vs. services • Monitoring progress & sustaining • System support buy-in
Features of Wraparound • individual students • built upon strengths • voice, priorities of youth and family • based on unique youth and family needs • culturally relevant teams and plans • plans include natural supports • traditional and non-traditional interventions • multiple life domains • unconditional
Unique Fit Wraparound plans should be uniquely designed to fit individual students needs as opposed to making a student fit into existing services or a prescribed program.
Life Domain Areas to Consider • Physical Needs/Living Situation • Family/Attachment • Safety • Socialization • Cultural/Spiritual • Emotional/ Psychological • Health • Educational/ Vocational • Legal
Value Base • Build on strengths to meet needs • One family-one plan • Increased parent choice • Increased family independence • Support for youth in context of families • Support for families in context of community • Unconditional: Never give up P. Miles, 2004
What’s New in Wraparound? • Skill set specificity • Focus on intervention design/effectiveness • Integration with school-wide PBS • Phases to guide implementation/supervision • Data-based decision-making • Integrity/fidelity assessment (WIT) • Tools to guide teams: • Home School Community • Education Information Tool
Wraparound Skill Sets • Identifying “big” needs (quality of life indicators) • “Student needs to feel others respect him” • Establish voice/ownership • Reframe blame • Recognize/prevent teams’ becoming immobilized by “setting events” • Getting to interventions that actually work • Integrate data-based decision-making into complex process (home-school-community)
Four Phases of Wraparound Implementation • Team Development • Get people ready to be a team • Complete strengths/needs chats (baseline data) • Initial Plan Development • Hold initial planning meetings (integrate data) • Develop a team “culture” (use data to establish voice) • Plan Implementation & Refinement • Hold team meetings to review plans (ongoing data collection and use) • Modify, adapt & adjust team plan (based on data) • Plan Completion & Transition • Define good enough (Data-based decision-making) • “Unwrap”
Data-Based Decision-Making and Wraparound Can wraparound teams use data-based decision-making to prioritize needs, design strategies, & monitor progress of the child/family team? • more efficient teams, meetings, and plans? • less reactive (emotion-based) actions? • more strategic actions? • more effective outcomes? • longer-term commitment to maintain success?
Jacob Poor school attendance Tardiness Refusal to participate in 2nd grade classroom activities. Did work independently in office/partial school days. Previous hospitalization (Bipolar Disorder?) Retention – currently repeating 2nd grade year Failing Grades
“Jacob”Home/School/Community ToolGetting to Strengths & Needs at Baseline
Integrating Wraparound in Montana 2012 Carol Ewen, M.A., MCPS RTI Coordinator Conan Green, MSW, State Wraparound Coordinator, CMHB National Consultants: Lucille Eber Dr. John VanDenBerg
Philosophical approach • Wraparound is, by definition, an integration process. It is defined by working in multiple community domains to support healthy development of children, adults and families. • Montana’s goal is to ensure that any family receiving wraparound support have only one integrated plan. • OPI and CMHB (Children’s Mental health Bureau) are working hand in hand to ensure that this goal is met.
How we Got Here… • High Fidelity Wraparound was introduced through the PRTF Waiver in 2008. • In (2009) CMHB implemented HF Wrap training to support the development of: • HF Wraparound Facilitators • Coaches • Peer to Peer Support • Wraparound Process Mentors
Being in the Right Place at the Right Time • In 2011 OPI Grant selected two school pilot sites to participate in Integrated Systems Framework (ISF)Project • ISF Project introduced school Wraparound for Tier 3 school interventions • OPI and CMHB recognized the need to integrate approaches and clarify
Putting it all together • State commissioned Eber and VanDenBerg to design a crosswalk and layout a foundation for integrated practice. • OPI contracted with school staff to present PBIS and School Wraparound at state HF Wraparound trainings • CMHB funded State HF Wraparound Coordinator to support school Wraparound implementation
Ingredients for Collaborative Work • Trusting Relationships between State Department staff • Vertical and Horizontal Communication Channels • Passionate Innovators • Open Minds • Child and Family Centered Approach
Activity • Identify your State/District Strengths and Needs for community school-collaboration
Integrating Practice In Missoula • HF Wraparound staff and school based PBIS staff initiated a process to ensure that crosswalk comes to fruition. • Let’s look at how this will be implemented.
Increasing Parent & Family Involvement • School based wraparound teams have access to and understand role of the Peer to Peer supports. • The Peer to Peer Coach works with pilot site staff to increase parent involvement. • School staff assist Peer to Peer Coach in identifying and involving parents • Supporting the development of Peer to Peers within the schools offers parents more opportunities to be involved in multiple domains within the Wraparound process.
BENFITS of Collaboration • Support for wraparound staff in schools on individualized interventions for children in need of wraparound. • Access to consultation and implementation of high fidelity wraparound process. • State Wraparound Coordinator available to MBI coaches for skill building and trouble-shooting • MBI coaches available to State Coordinator for skill building
Benefits… • Cross training community and school based wraparound coaches and staff • Ongoing assistance in development of Tier 3 wraparound interventions by a State HF Wraparound Coordinator (credentialed as a national wraparound mentor) • Consultation on planning, functional behavior assessments, and crisis planning from the high fidelity wraparound curriculum
Benefits… • An integrated agreement to blend the wraparound plan if receiving both community and school supports. • Flexibility and support to ensure consistent functional behavior assessments and crisis plans across domains. • Getting the best of both worlds (i.e. Strengths, Needs, and Culture Discoveries and Home School Community Tool).
Activity • What facilitator strengths do each training model foster? What are needs facilitators might have based on training model?