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ROLE OF CLINICIANS IN MTSS
BUILDING CAPACITY FOR CHANGE AT THE DISTRICT LEVEL
National PBIS Leadership Forum October 22-23, 2015
Ali Hearn, LCSW
Midwest PBIS Network
Russ Uhing & Brenda Leggiadro
Lincoln Public School District
Session Description
Explore how districts can build the capacity of their staff by positioning clinicians as social/emotional leaders in the building(s).
Exemplar clinician leaders will guide participants through considerations of resources data systems Practices
Ultimately building the capacity of the district to effectively meet the social/emotional needs of ALL
youth.
Maximizing Your Session Participation
When Working In Your Team
Consider 4 questions:
– Where are we in our implementation?
– What do I hope to learn?– What did I learn?– What will I do with what I learned?
Where are you in the implementation process?
Adapted from Fixsen & Blase, 2005
• We think we know what we need so we are planning to move forward (evidence-based)
Exploration & Adoption
• Let’s make sure we’re ready to implement (capacity infrastructure)
Installation
• Let’s give it a try & evaluate (demonstration)
Initial Implementation
• That worked, let’s do it for real and implement all tiers across all schools (investment)
• Let’s make it our way of doing business & sustain implementation (institutionalized use)
Full Implementation
Leadership Team Action Planning Worksheets: Steps
Self-Assessment: Accomplishments & Priorities
Leadership Team Action Planning Worksheet
Session Assignments & Notes: High Priorities
Team Member Note-Taking Worksheet
Action Planning: Enhancements & Improvements
Leadership Team Action Planning Worksheet
Session Objectives
Describe how a clinician can effectively fit into an MTSS model of support
Learn how to utilize clinicians as social emotional leaders, helping build the capacity of district/building
Identify potential district/building-level systems that may need consideration in the process
Review different ways to gather data for district/building-level decision making and progress monitoring
What we know…Jane Meredith Adams, EdSource
“Definitions of social and emotional learning vary…”
“Interest in social and emotional learning is growing, fueled by a desire to create positive school environments and prevent bullying, disconnection, and academic underachievement.”
“Many educators are still unclear about what social and emotional learning is and how they can incorporate it into the classroom.”
“We sometimes receive push back from teachers, who say ‘right now, my top priority is Common Core’.”(Libia-Gil, vice president at the Collaborative for Academic, Social, and Emotional Learning (CASEL))
Adams, Jane M. "Social and Emotional Learning Gaining New Focus under Common Core." EdSource Today. N.p., 15 May 2013.
The “Old” System (pre-MTSS) Examples
Send a student with any social/emotional concern to the clinician at any time
Subjective decision-making vs. Data Driven decision-making to determine which social/emotional supports a youth receives
Ask the clinician during an IEP/update meeting “how does George do with you in your office” as a means to assess success- his ability to generalize his behaviors to other settings
Ask the clinician to cover the jobs of multiple otherroles in the building (i.e. admin, discipline, etc.)
Over-servicing students with low level needsAND
Under-servicing students with high level needs
Understanding some of the System(s) Challenges…
Video(IEP Cartoon)
A Shift in PracticeWhere/How is time currently being spent?
A shift in our thinking…
Coaching/Consultation
Coaching/Coordination
Coaching/Facilitation
The Role of the School-Based/Community-Based
Clinician at All Three Tiers
Coordinator vs. Facilitator
Coordinator• Organizes and/or
oversees the specific interventions such as CICO, S/AIG & Group with Individual Features
• Roles may include: scheduling meetings, reviewing & collecting data to share during team meetings, curriculum development, training, mentoring, etc…
Facilitator• Directly provides
intervention support services to youth/families
• Roles include: meeting with students for CICO, running groups, etc.
Coaching/Consultation
• Teams
• System
s
• Data
• All-Staff
• Familie
s
Tier 1
Coaching/Coordination
Consultation
• Systems
• Interventions
• Training/
support for
Facilitators
Tier 2
Coaching/Facilitation
Consultation
Coordination
• Individual
student
teams
• Direct
services
Tier 3
Where do school/community-based clinicians fit in?(example of how a clinician can travel through the Tiers as they are being developed)
Universal Team• Universal Team Member• All-school data analysis• Consultation with team
Secondary Team• Tier 2 Coach
• Coordinate Tier 2 Intervention(s)
Tertiary Team• Tier 3 Coach
• Coordinate Tier 3 Intervention(s)
• Tier 3 Facilitator
Moving from being the only response to identified social emotional needs, to being
social emotional leaders of the building.
TO
Helping to build the capacity of the rest of the
staff
General Education & Special Education
Tier 1/Universal School-Wide Assessment / School-Wide Prevention Systems
Check-In-Check-Out
Check-In-Check-Outwith Individualized
Features
Social/Academic Instructional Groups
Mentoring
Brief Function-Based Problem Solving
Individualized Team Development:Complex Function-Based Problem Solving
Person-Centered Planning
How do we design this filter to prevent too many
students from going through to receive Tier 2 support,
AND also ensure that enough youth receive it?
Who will receive clinician support?
Home School Community
There is a place for a clinician to be
involved in supporting youth and families atALL 3 Tiers
Areas of involvement can be
broken down by Tier (level of need)
and Domain (home, school,
community)
Common Trends
Moving from reactive to preventative Time efficient and least restrictive Moving from Tier 1 to leading/coordinating Tier
2/3 Facilitating Tier 3 Interventions and teams Serving students in a purposeful/intentional
way Systems approach
(Consider looking at buildings as clients and not just individual youth/families)
Interventions first vs. Referral to Professional or IEP
How easy would it be to engage others in this dialogue?
Easy
Moderately Easy
Neutral
Moderately Challenging
Challenging
Guiding QuestionsExamples from Admin & Clinician Dialogue
How would administrators, staff and clinicians in your district describe the role of the clinician? Are these descriptions the same or different?
How are decisions made about when to give youth more social/emotional support? How to gain access to time with the clinician(s)?
How are clinicians able to report on whether or not the work they are doing with students is effective?
Change sometimes takes having (potentially) Difficult Conversations…
Other clinicians in the district Staff Administration Director(s) of Special Education Superintendent Board of Education Parents/Families
…and (potentially) dare to
step one foot into someone
else's…
Know your
sandbox…
• Russ UhingDirector of Student Services
• Brenda Leggiadro Coordinator for Counselors and School Social Workers
Lincoln Public Schools
PBIS Implementation Plan
Three year timeline for implementation of PBIS
School Transformation Grant – mental health, social-emotional learning, increasing staff capacity around behavior/mental health
Regular education and special education together – changes the traditional roles of some clinicians
The District’s Plan for Clinicians
56 school buildings
PD was scheduled for ALL clinicians together at the same time (for the first time in this district). 125+ clinicians in the same room hearing
the same messages and collaborating with one another including: Social Workers Psychologists School Counselors Psychotherapists
The District’s Plan for Clinicians
3 events were scheduled throughout the year with the intended outcomes of: Consistent and clear understanding
of MTSS for behavior Analysis of where we are and where
we are going Increased collaboration
The District’s Plan for Clinicians
First 2 sessions were with clinicians - getting on the same page
Last session included administratorsAdministrators and clinicians engaged in systems level conversations about data, systems and practices at all 3 tiers
The District’s Plan for Clinicians
Within the district: Definition of roles to guide clinicians
and administrators in buildings Skillstreaming & Second Step training Trauma training for all school staff School mental health teams Conference attendance to build
capacity in team members CBITS – coming in summer 2016
The District’s Plan for Clinicians
With the community: Better use of existing resources
(Expedited SCIP process; Hospital triage)
Mental Health Response Team PBIS Trainings attended by HSF
members Human Services Federation Resource
Fair Mental Health Interns from a local
college
The District’s Plan for Clinicians
5 District exemplar sites have been identified to shift systems effectively and efficiently, create outcomes for youth, and ultimately lead the way for this work to continue
Next stop: Clinicians will learn the process of FBA/BIP within a PBIS framework, with Psychologists as the leadership/coaching team, to help the district move forward through the tiers of support
Continuing to educate ALL staff on Clinicians being social emotional leaders
The District’s Plan for Clinicians
Systems District-level conversations- paradigm shift Cross-talk between clinical departments Ongoing dialogue with community agency partners
about partnering opportunities
Practices Embedding Second Step into Tier 1 as Universal Curriculum (aligned
with expectations and using data for delivery) starting with grades k-1 Shifting clinicians from Tier 1 Facilitation to Tier 2/3
Coordination/Facilitation as much as possible Considerations for community partners on PBIS teams
and facilitating practices
Data Using the TFI Using student outcomes Tracking outcomes from exemplar sites
Benefits and Challenges
Benefits: Increased cooperation between
regular ed and special ed Collaboration of clinicians Less duplication of services Better use of mental health experts Building capacity of all staff
Benefits and Challenges
Challenges: Data System Shift in roles is challenging
Ways to identify students for interventions
Planning the intervention Who provides the intervention
Resources and practices in buildings vary
Working with community agencies effectively
What will be the greatest barriers to making this work, work?
CONTACT INFORMATION:
• Ali Hearn- [email protected]
• Russ Uhing- [email protected] • Brenda Leggiadro- [email protected]
Other Questions/Comments?
Before you leave the session...
Take a moment to reflect on the session Record your thoughts in the back of your
program booklet These notes will assist you in completing
the online evaluation after the conference
Your comments are valued and assist in developing future conference sessions
