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Session B-5 PBIS National ForumOctober 11, 2007 Wraparound as a Tertiary Level Intervention in a School-wide System of Positive Behavior Support Lucille Eber, IL PBIS Network (www.pbisillinois.org) Mary Bechtel, PBIS Facilitator, Kalamazoo RESA Sandy Roethler, Parent & Executive Director of Advocacy Services for Kids , Kalamazoo, MI
IL PBIS Tertiary Team Leaders • Kimberli Breen • Jen Rose • Diane McDonald • Amy Lee • Jayne O’Brien • Sheri Luecking • Joane Scholefield
Challenges with regard to students with Emotional Behavioral Challenges: • Low fidelity or low dosage of implementation of interventions • Lack of data-based decision making • Fragmentation of efforts on behalf of youth • Lack of effective behavior practices in schools • School environments that are “toxic” for youth with MH challenges
Examples of Ineffective Secondary/Tertiary structures • Referrals to Sp.Ed. seen as the “intervention” • FBA seen as required “paperwork” vs. a needed part of designing an intervention • Interventions the system is familiar with vs. ones likely to produce an effect • (ex: student sent for insight based counseling at point of mis-behavior)
Key Questions: • Is positive behavior support being applied in needed dosage for ALL students? • How do we move from “expert driven”, one student at a time, reactive approaches to building capacity within schools to support the behavior of ALL students?
A Systemic Definition of Tertiary: If a uniquely designed team is required to get enough of an effect to improve quality of life of youth/family: • Complex FBA/BIP • Key “players” need to be engaged • Highly individualized plan across home, school, and community
Positive Behavior Interventions & SupportsA Response to Intervention (RtI) Model Universal School-Wide Assessment School-Wide Prevention Systems Secondary Tertiary SWIS & other School-wide data Small Group Interventions Intervention Assessment Group interventions with An individualized focus BEP & group Intervention data Simple FBA/BIP Functional assessment tools/ Observations/scatter plots etc. Multiple-domain FBA/BIP Wraparound Revised August, 2007 IL-PBIS Adapted from T. Scott, 2004 SIMEO tools: HSC-T, RD-T
Individualized Teams at the Tertiary Level • Are unique to the individual child & family • Blend the family’s supports with the school representatives who know the child best • Meeting Process • Meet frequently • Regularly develop & review interventions • Facilitator Role • Role of bringing team together • Role of blending perspectives
What is Wraparound? • Wraparound is a tool (e.g. a process) used to implement interagency systems of care in achieving better outcomes for youth and their families. • The wraparound process is similar to person-centered planning, the individualized Positive Behavior Support (PBS) planning process.
What is Wraparound?(cont’d) • 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. • Wraparound plans include natural supports, are culturally relevant, practical and realistic.
What is Wraparound?(cont’d) • Blending perspectives of team members results in a variety of traditional and non-traditional strategies that are directly linked to agreed upon outcomes. • The wraparound process creates a context for effective implementation of research-based behavioral, academic and clinical interventions.
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: • used with individual students • plans reflect voice, priorities of youth and family • based on unique youth and family needs • culturally relevant teams and plans • built upon youth, family and provider strengths • uses traditional and non-traditional interventions • encompasses multiple life domains
Features of Wraparound (cont.): • resources are blended; must be flexible • servicesare planned, implemented, and evaluated by a team • team supports youth, family and providers • unconditional - if the plan doesn’t work, change the plan
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 Preparation - 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”
First Phase of Wraparound: Team Development Facilitator • Meets with family & stakeholders • Gathers perspectives on strengths & needs • Assess for safety & rest • Provides or arranges stabilization response if safety is compromised • Explains the wraparound process • Identifies, invites & orients Child & Family Team members • Completes strengths summaries & inventories • Arranges initial wraparound planning meeting
Second Phase of Wraparound: Plan Development Facilitator: • Holds an initial (or 2) wraparound plan development meeting • Introduces process & team members • Presents strengths & distributes strength summary • Solicits additional strength information from gathered group • Leads team in creating a mission • Introduces needs statements & solicits additional perspectives on needs from team • Creates a way for team to prioritize needs • Leads the team in generating brainstormed methods to meet needs • Solicits or assigns volunteers • Documents & distributes the plan to team members
Mary Ellen 7th grade student Referred to the Student Assistant Team as a potential WRAP because she had formed a strong attachment to a teacher that interfered with her ability to transition between classes. The team determined that when Mary Ellen transitioned between classes her anxiety increased because she wanted attention from her teacher. Staff escorts were assigned to her between classes as a safety precaution and to alleviate anxiety of the student and teacher. A staff member was also assigned outside the classroom teachers’ room. The anxiety continued and the wraparound process was initiated.
Mary EllenWraparound Phase One The escort service was gradually faded and Mary Ellen’s anxiety began to decrease. Mary Ellen met with her counselor, D.D., to set goals (Universal level intervention). Mary Ellen set the goal: “to walk to class by herself”. The wrap team plans to meet to address social and recreational needs identified by the family and school via data and conversation. The team has also started to plan ways that Mary Ellen can interact with peers (Trivia game, safety presentation).
The Process of a Engaging a Family-Centered Team • Validating thoughts, feelings, perspectives • Changing the environment around the student/family so they will be successful • Empower the family; build skills they need to cope • Identifying roles, strengths, and needs, to guide the team • Getting needs/concerns/anxieties out in a proactive matter that will allow the team to move forward. • Continuously looking at data to make decisions/monitor results. • Understanding that wraparound is a process.
The process of wraparound can help engage the “disengaged” How? • Perspectives are valued • Strengths are the focus • Needs are prioritized by family/teacher • Addresses home/school/community • Practical and relevant information • Data represents their perspectives
Team Members Want… • To be heard • To be validated • To feel trusted/competent • To work w/in their individual strengths/comfort zone • To feel supported/assisted in their role with the child • To see behavioral change that is measurable • To feel that their time is valued • To discuss potential barriers/worries/fears
Coaches have to help establish capacity for: • Commitment of time • Commitment to “stay at table” • Willingness to regroup and be solution-focused • No judging or blaming • Time for listening to stories • Time for venting, validating • Establishing consensus • Voice of student/family in prioritizing • Establishing ownership
“Needs” Talk in Team Meetings When a team member disguises a service as a need • “He needs a special education placement” or • “The family needs counseling” Ask the team member: • What do you hope will be accomplished through this? • Why do you think this is important to the person? • How will you know when it’s been effective?
Big Needs & Individualized Planning • Focus on the “why” of a need not the “how” • Needs to feel competent with academic tasks rather than he needs to complete his assignments • Use descriptive terms • To learn, To know, To experience, To feel, To see, To have, To be • Deal with the “big” stuff • Families/youth deserve to know their teams are dealing with their larger challenges • More than one way to meet it • Unlike a goal (John will come to school every day) • Improves quality of life (as defined by family, youth) • Family would want to be on a team that works on stated big need(s) Adapted from P.Miles,2004
Examples of Needs Statements: • The student needs to feel adults and peers respect him. • The student needs to feel happy about being at school. • The parent needs to know her son is getting a fair shake at school. • The student needs to be reassured that he can complete the work.
Missed Opportunity for Positive Behavior Support….?? • Kindergartner; tantrums; hurts small animals • In principal’s office by noon daily • “Waiting” to be accepted for MH assessment • No FBA/BIP done • Although “transitions” were a known trigger • School became immobilized by the “setting events” (i.e. possible psychiatric disorder)
Functional Assessment Pathway Maintaining Consequence THE FUNCTION “Get something” “Get away from Something” Problem Behavior Setting Event Triggering Event or Antecedent
Using data can produce more efficient teams, meetings, and plans. Baseline SIMEO data: • Collected through conversations with team members prior to the initial wrap meeting; • Includes perspectives, about strengths/needs. • Are used at the first meeting to • blend perspectives, identify strengths/needs across life domains. • Used at the initial meeting produces a more efficient meeting. • Makes getting to an action plan more likely
Using data can ensure less reactive (emotion-based) actions and more strategic plans. • Data at wrap meetings allows team members to focus on “problem-solving” versus “admiring the problem”. • Data leads teams to action plans based on team consensus.
Data helps teams get to more effective outcomes and longer-term commitment to maintain success. Data is used throughout the wrap process and at all team meetings to • celebrate success, • monitor and revise the action plan, and • keep the team moving forward. Data is used for transition planning, and to follow-up after the team “unwraps”.
Teacher Engagement A teacher’s sense of personal teaching efficacy (PTE) is directly tied to their belief that they can successfully intervene with a student’s academic/behavioral problem Sources: Morin,2001
Teacher Engagement • Teachers who aren’t engaged need: • An opportunity to vent to another adult • Feel hopeful that there’s a solution to their problem • Be recognized for their efforts Source: Gonzalez, Nelson, Gutkin, Shwery, 2004
Family Engagement Child & family Teams allow us to build relationships with families who might have been difficult to connect with in the past.
Family Engagement The Obvious Challenges for a Family… Access to Transportation Access to Child care Time constraints Language Cultural Differences Family Issues (Divorce, custody, financial) Poverty – What is the family’s priority?
Family Engagement(cont.) The “not so obvious” challenges for a family: • Fear of…sharing family struggles, stigma, confidentiality, expectations to “fix the kid”, etc. • Prior system failures – System Frustration • Feelings of Hopelessness & Helplessness – • Stressors – Health, Mental Illness, Substance Abuse, Employment, etc.
Outcomes of Engaging Families • Time invested up front will save time later and produce better outcomes. • School staff will not be frequently reacting to “crisis”; practice is proactive and preventative. • An ongoing plan is in place; supports needs of the child & family as well as school staff.
The Essentials of Phase I • Strategize who is best to contact family 2. Value of parent/family conversation 3. Deciding who should be on team 4. Permission 5. Value conversation with staff 6. Prepare all team members
The Essentials of Phase I 3. Deciding who should be on team • Ask family who they would like to be on team. • You may use info from your chat to prompt discussion of potential team members. • Members can always be added at a later point. • Not all members will be present at every (or any in some cases) meeting.
The Initial Meeting • What to Bring • List/summary of child/family strengths and 2-3 “big needs” • Selected SIMEO items graphed • Collaborative Team Planning Tool • What to Do • Introductions by roles • Open meeting with Child & Family Team philosophy • Share strengths; • Draw family/teacher into strength summary • Facilitate discussion of Big Needs, ensuring consensus • Develop a team Mission Statement (the BIGGEST need) • Prioritize needs (family voice)
The Essentials of Phase II 1. Action planning • Guide team through brainstorming ways to meet big needs using strengths • Every strategy must be built upon strengths of the student (and family). • Use data to blend perspectives,
The Essentials of Phase III 1. Staying at the table 2. Ongoing use of data will 3. Ongoing need for engagement
The Essentials of Phase IV 1. Believe in family strengths, abilities, and tenacity • Natural supports are built-in to wrap plan: • School-wide PBS will provide natural opportunities to transition students from more intensive to less intensive supports (secondary interventions are a built-in natural support) • Most school-based supports will continue. The more natural they seem and enduring they are, the more effective they will be in producing longer-term positive outcomes. • Home and community supports may become embedded into the family’s routine (supports that family was lacking).
The Essentials of Phase IV – cont’d 2. Use of data to support transition • Team identifies both the opportunity for transition and what supports may be more long term.