School-Based Mental Health Programming: Concentric Collaborative Conversations School-Based Mental Health Programming: Concentric Collaborative Conversations

School-Based Mental Health School-Based Mental Health Programming: Concentric Programming: Concentric

Collaborative ConversationsCollaborative ConversationsCollaborative and Dialogic Practices in Therapy

and Social Change April 24, 2010, Cancun, Mexico

Jeff Chang, PhD, R.Psych.

Athabasca University

and

The Family Psychology Centre

School-Based Mental Health Programming: School-Based Mental Health Programming: Concentric Collaborative ConversationsConcentric Collaborative Conversations

Acknowledgements:Alberta Health Services (program funder)Independent Schools Advisory Committee,

Calgary, AB (organizational sponsor)Almadina Charter Language Academy and

Calgary Islamic SchoolAthabasca University:

Academic/Professional Development Fund Research Incentive Grant


In this workshop I will describe the development and operation of a school-

based mental health service, operating in two schools of choice serving Muslim students.

Program consultation, program development, staff supervision, consultation to school staff, and service delivery to children and families, were executed using collaborative practices based on solution-focused therapy, narrative

therapy, and appreciative inquiry, with attention to the discourses in which education and school based mental health services are

embedded, and attending to the interface between Muslim and mainstream culture.


What attracted you to this workshop? Fast forward: The Project as it currently operates Situating the work:

Calgary and Alberta Me The discursive nexus

Project Description: Development and Operation Local wisdom

Fast Forward: The Project as it currently Fast Forward: The Project as it currently operatesoperatesThe “Wellness Empowerment Program” –

name eventually selected by the schoolsFunded by Alberta Health Services One of 30+ school-based “mental health

capacity building projects” in Alberta.All others were creations of specific

individual school boards; the nature of our organizations led to some very different organizational practices

Two schools:

Fast Forward: The Project as it currently Fast Forward: The Project as it currently operatesoperates

A publicly funded, ESL charter school Elementary and Middle School Campus with

about 650 students


Calgary Islamic School: Private religious school K-12 on one campus (650 kids)


Eventual service configuration: 4 FTE bachelors level School Support

Counsellors .6 FTE mental health OT 1 Masters level Project Coordinator

Services Universal Group oriented Contextual/consultative Family Individual

Situating the work: Calgary, Alberta, Situating the work: Calgary, Alberta, CanadaCanada 1 million people, 70,000 Muslims

Successive waves of immigration started in late 1960s/ 1970s

Oil capital of Canada: “Boom and bust” mentality Somewhat resistant to recession:

Conservative banking regulation Balanced budgets We’ve got oil!

Politically conservative Low tax, low regulation, socially conservative Surprisingly unpopulist and intolerant

Situating the work: Calgary, Alberta, Situating the work: Calgary, Alberta, CanadaCanada

Situating the work: MeSituating the work: Me Influenced by postmodern ideas (mainly

solution-focused and narrative therapies), and appreciative inquiry

Counselling psychologist Youth and family mental health programs and

private practice, now in a faculty position Commitment to developing others through:

Clinical supervision Teaching and curriculum development Creating collaborative workplaces by obtaining

large service delivery contracts Qualitative research (new paper in JST on

hermeneutic inquiry for postmodern therapists)

Situating the work: The Discursive NexusSituating the work: The Discursive Nexus

Intersecting discourses:“Diversity and inclusion” and “cross-

cultural counselling”“Mental health”

“Community mental health” “Capacity building and resilience” “Partnerships”

“Islam and the world”

““Diversity and inclusion” and “cross-Diversity and inclusion” and “cross-cultural counselling”cultural counselling”“Diversity and inclusion”Government-speak and policy-speak for well-

meaning efforts to study and address inequityAcknowledgement of real power inequities,

and differential access to resources and opportunity, based on differences in class, gender, race, linguistic fluency, sexual orientation, and physical ability

Little appreciation of privilege on the part of policy-makers and funders

Pragmatism/cynicism about this amongst funding recipients

““Diversity and inclusion” and “cross-Diversity and inclusion” and “cross-cultural counselling”cultural counselling”“Cross-cultural counselling”Initial attempts to articulate cross-cultural

counselling approaches were conceptualized from the perspective of dominant culture counsellors relating to “the culturally different” and being “culturally sensitive”

At the conference of a national counselling association last year, several participants commented that the field still largely approaches this from the standpoint of the dominant culture

““Diversity and inclusion” and “cross-Diversity and inclusion” and “cross-cultural counselling”cultural counselling”“Cross-cultural counselling”“Office practice” is seen as the model, and

we extrapolate to figure out what to do in community based settings

Although we are of the dominant culture, we are guests in the schools where we work.

The metaphors from which we operate (anthropologist, missionary, traveler, tourist) are not quite fitting

““Mental health”Mental health”Originally an individualistic, modernist

discourse that underemphasized or ignored context, community, and collectivism

“Community Mental Health”Oriented to keeping people struggling with

chronic mental health problems out of institutions.

“Mental Health Capacity Building”:From the description of this project “The thirty-one sites address the capacity

building and risk reduction service components in selected at-risk communities (italics mine).

““Mental health”Mental health”

“Resiliency” (and its cousins “Strength-Based,” “Positive Psychology,” and “Character Education”):

A step in the right direction to focus on what’s going right.

Reifies “resiliency factors,” “strengths,” “positive character traits,” etc.

As a function of logical type, we must therefore reify pathologies

If “character strengths” reside within persons, as opposed to being a function of relational patterns and linguistic constructions, so must pathologies and deficits

Islam and the WorldIslam and the World

Take five minutes and chat with your neighbor about reaction to the phrase “Islam and the world.”

Islam is not monolithic: In our schools, 30+ countries of origin of

studentsArabic, sub-Saharan African, south Asian,

Asian, CaucasianArabic, Urdu, Somali, Persian/Farsi are

predominant languages


Islam is much misunderstood, exoticized in a negative way, and pathologized

This cartoon appeared in the Montreal Gazette after an article reported that a women was asked to leave a publicly funded French language class because she would not remove her niqab.


A cultural/discursive context exists for the maintenance of stereotypes and the perpetuation of polarization that overwhelms conversations with the potential to construct new understandings


Accordingly, thin descriptors like: “terrorist” “radical” “enemy” “subjugating of women” “separatistic” “I know one. He’s normal…”… crowd out alternative understandings, like:


spiritualrespectful of women feministfamily orientedinclusiveadvocating for social justiceembracing Canada as fully participating

citizens

Project DescriptionProject Description

Possible pilot project funding afforded us the opportunity to develop a program for a high needs school population

Because we (service providers and Independent Schools Association) already had a relationship with both schools, we initiated a conversation with them about seeking this funding

Parameters of FundingParameters of Funding

Salamon, Grevelius, & Andersson, 1993: The AGS Commission Model: Presented commission > hypothetical

commission Primary commission vs. secondary commission

Appreciative InquiryAppreciative Inquiry

Using Appreciative Inquiry, the following assumptions guided our development process

In every human situation, something works What we focus on becomes our reality Reality is created in the moment and there are

multiple realities The language we use shapes our reality The act of asking questions influences the

outcome in some way


People have more confidence going into the future (unknown) when they carry forward parts of the present (known)

If we carry parts of the past into the future, they should be what are best about the past

It is important to value differences


The “4-D Cycle” Dream: “What might be?”

Envisioning Results Design: “What should be - the ideal?”

Co-constructing Deliver: “How to empower, learn, and

adjust/improvise?” Sustaining

Discover: “What gives life?” Appreciating

Dream: “What might be?” Design: “What should be - the ideal?”

Eight consultation meetings with parents, schools’ boards, mental health professionals familiar with the community:

Parents:Parents: Someone to help our kids transition

to new schools Help to figure out how to get kids to

be successful in Canada – and to be faithful Muslims

Dream: “What might be?” Success in the Canadian school

system Dealing with worries and troubles How to work together to keep our

kids safe. How to get kids to listen Someone to help us with family

stress Someone to talk to about family

problems who is not part of the community

How to get help for kids A more caring school community

Dream: “What might be?”

ProfessionalsProfessionals Prevent young men being

radicalized Support for our grads in high school

– they get labeled as “gangs,” “A-Rabs,” “towel heads,” “jihadis.”

Early school readiness. Our kids are behind the 8-ball in Kindergarten. How can we improve this?

Test anxiety – provincial achievement tests and other tests. They need to learn how to handle this

Dream: “What might be?” Connections with community

resources Organizational skills – some kids

need help badly. A safer school -- not every kid feels

safe. Help for bullies and the victims. A school where everyone feels safe

Our religion is very important – how can we work together with you to support families? Sometimes I don’t know what to do

They know the services are there in high school, but are afraid to go. If someone would support them to use what’s there, that would be great.

Dream: “What might be?” Isolated women and men who abuse

their wives – how can we help them? If you are part of the school, and the

parents see you all the time, they’ll trust you

Parents have to know that they just can’t pull their kids out for months at a time.

Dream: “What might be?”

Themes/categories:Community connectionsSchool readiness and academic

supportA safe and caring schoolGenerational connections

(includes faith)Dealing with transitions

Design: “What should be - the ideal?”Design: “What should be - the ideal?”

Not clinical therapy or assessmentNext to no “therapy” has been done

Embedded in the school, positioning ourselves as:CollaborativeRespectful guestsThose who ‘serve’ rather than those who

‘help’

Deliver: “How to empower, learn, and Deliver: “How to empower, learn, and adjust/improvise?”adjust/improvise?”

Sustaining Solution-focused supervision AI informed staff meetings and meetings with

the schools AI-informed problem-solving processes – not

everything has been hunky-dory Staff problems Leadership vacuum and changes Conflicts about access to information Lines of accountability and communication

Discover: “What gives life?”

Appreciating Quarterly meetings with schools Triennial meeting with funder

Classroom PresentationsClassroom Presentations

o Alongside individual and small group work, we’ve also offered many classroom presentations for ECS-Grade 10

o Over 35 different topics in areas of peer relationships, safety, academic skills, personal development, problem-solving and many more!

“I never knew what cyber bullying was until your presentation. It has been going on

for 1 year now and I need help.”

- Grade 6 student

Weekly Lunchtime Skill-Building GroupsWeekly Lunchtime Skill-Building Groups

“ This group really helped me a lot and gave me lots of ideas and tips…” - Student

Small-Group Skill BuildingSmall-Group Skill Building

About 130 students per year have participated in weekly lunch-time skill building groups

“I liked how group is not taught in a text book-ish way - it's done in a fun way.”

-Student

ECS- Leadership Program at AlmadinaECS- Leadership Program at Almadina

o Grades 6, 7 and 9 students volunteer for 6 week blocks to provide leadership activities for ECS students during recess. o October 2008: 4 leaderso September 2009 to January 2010: 64 leaders

o Teachers report that playground problems have decreased

o Positive relationships between ECS and Junior High students

o Leaders demonstrate increased maturity and responsibility outside of volunteering time

Environmental/Leadership ProgramEnvironmental/Leadership Program

Nineteen Grade 9 and 10 students:o Green initiativeso Service at school eventso First aid and CPR trainingo Outdoor pursuitso Peer conflict resolutiono Encouraged by Imam

School Bus ProgramSchool Bus Program

• Initial driver comments: “This program will never work, nothing will change.”• Now…. “I have some of the best kids

on the bus!”

“Lots of changes…

“Getting better!”

• Significant improvement in driver retention

o Requested by schools at start of projecto Supporting student transitions...

Into ECS ECS to Grade 1 Grade 5 to Grade 6 Grade 9 to High School

Student Transition ActivitiesStudent Transition Activities

Grade 6 orientation…Grade 6 orientation…

“I wish we had this when I was going into Grade 6. We were just thrown into junior

high and figured it out ourselves!” –Student

“This is so cool! I’m so glad I know how to open my lock and read my timetable

before I get to the junior high. It’s not that scary anymore.”

-Student

Parent SupportParent Support

“Thank you for helping me with [pediatrician] appointments. It’s good to know that this

type of support is in the school.” -Parent

We hired a van-taxi and sent a staff member to take a mother and four children to the

public health nurse’s office for treatment of head lice.

She spoke: Treatment of Selective Mutism:She spoke: Treatment of Selective Mutism: 8 year old Grade 3 student, who was not speaking

in class Had not spoken in school since K The school was concerned, but was not sure what

to do. We facilitated a referral to a service at Alberta

Children’s Hospital. This meant: Accompanying the child and mother for sessions with

the clinical psychologist Implementing a behavioral shaping program in school SSC interacted with the child 83 times over the school

year

She spoke: Treatment of Selective Mutism:She spoke: Treatment of Selective Mutism:

E-Mail from School Support Counsellor to clinical psychologist:

Hi Annette,

I am pleased to announce.....THERE HAS BEEN PROGRESS. I am so happy for YZ over the past two sessions.

My first session she shut down and wouldn't speak and covered her face with a binder. Ever since then, she has responded very well.

She spoke: Treatment of Selective Mutism:She spoke: Treatment of Selective Mutism:

Last session she was noticeably louder when speaking in class (so that I didn't need to strain to hear her) and she seems to be more engaged and interested in the points for some reason. We are doing it so that YZ and [mother] need to work together to get points and the points will work towards some sort of party of their choice at the end of the school year.

During today's session, I was able to get her to speak to the teacher and do a "mini" presentation on a recycled picture her and [mother] made together (with her classmates present in the room). The teacher was also able to ask her a question or two in which she verbally responded…. This upcoming Monday, I am going to try a session without her mother in the classroom. Hopefully it goes really well!

The Re-Connect Booth

One Grade 5 class: many demands on home room teacher or the School Support Counsellor to have their disagreements, miscommunication and misunderstanding “solved”

To teach the students how to use the booth, which was set up in a corner of the classroom, the School Support Counsellor delivered a presentation to the class on basic communications skills: The acronym is C.A.R.E.

The Problem-Solving Booth

C=Conflict is happening, address it! A= Active Listening . Students meet together at the

booth and practice active listening skills R = Reflect and Make a Plan. Brainstorm 3 possible

solutions to the problem, and agree on which solution they would like to try first).

E = Evaluate. 2-3 days later

Children have been actively using the booth as a location to deal with day to day social difficulties

Formerly skeptical VP now wants them in all Grade 5 classes

Local WisdomLocal Wisdom In the real world, delivering services is messy Collaboration breeds collaboration and creativity A focus on what works trumps models and

approaches to therapy Relationships and connections with others are

enhancing – whether we conceptualize this from “attachment theory,” “family systems theory,” or “solution focused therapy” matters little

Service delivery and knowledge creation can co-exist: inductive, participatory action research

Transcultural competence is mutual and recursive

Local WisdomLocal Wisdom Required attributes for staff are: flexibility, “can-

do” spirit, and boundaries We did not design a program based on a theory.

We serve based on the strengths and talents of our staff. adventure therapy, play-based approaches, instructional

approaches to family support Relational positioning is more important than

model, technique or method Macro-application of working alliance All (children of all ages, parents, teachers) are

capable of helping if resources are called forth

Documents

School-Based Mental Health Programming: Concentric Collaborative Conversations School-Based Mental Health Programming: Concentric Collaborative Conversations