WhoWho’’s That Guy on the s That Guy on the Phone? Phone? A TeacherA Teacher’’s Guide to the s Guide to the Mysterious School Mysterious School CounselorCounselor

Brendan Keenan, MSW, SACWorcester Public Schools

Eagle Hill Professional Development Day, 2009Hardwick, MA

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“...mental health is inexorably linked with

general health, child care, and success in the

classroom and inversely related to involvement in

the juvenile justice system." (U.S. Department of Health and Human Services. Mental Health: A

Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental

Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of

Mental Health, 1999.)

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““A collaborative and A collaborative and coordinated effort is needed coordinated effort is needed among schools, families, and among schools, families, and communities to ensure that all communities to ensure that all children and adolescents children and adolescents achieve positive academic and achieve positive academic and behavioral outcomes.behavioral outcomes.””

(National Association of School Psychologists (2003), Position Statement on Mental Health Services in the Schools)

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Both the promotion of Both the promotion of mental health in children mental health in children and the treatment of and the treatment of mental disorders should be mental disorders should be major public health goals.major public health goals.

Report of the Surgeon General’s Conference on Children’s Mental Health, 2000

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NASP GPR/HCI

The extent, severity, and far-reaching consequences of mental health problems in children and

adolescents make it imperative that our nation adopt a comprehensive, systematic, public health approach

to improving the mental health status of children.

-The National Advisory Mental Health Council’s

Workgroup on Child and Adolescent Mental Health, 2003

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NASP GPR/HCI

All children face some mental health problems/issues, including:• Anxiety about school performance

• Problems dealing with parents & teachers

• Unhealthy peer pressure

• Common developmental, adjustment problems

• Fears about starting school

• School phobia

• Dealing with death or divorce

• Feeling depressed or overwhelmed

• Drug or alcohol use

• Suicidal ideation

• Facing tough decisions

• Considering dropping out of school

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Overview of Children’s Mental Health Needs

• Between 20% to 38% of youth in the U.S. have diagnosable mental health disorders

• Between 9% to 13% of youth have serious disturbances that impact their daily functioning

• Between one-sixth to one-third of youth with diagnosable disorders receive any treatment

• Schools provide a natural, universal setting for providing a full continuum of mental health care

(University of Maryland & Prince Georges County Public School System)

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• Although ASCA recommends a 250-to-1 ratio of students to school counselors,

• The national average is actually 475 (2006-2007 school year). This is nearly equal to the previous academic year, when the average was 476

• In 2006-2007, Massachusetts averaged 444 students per every 1 counselor

• The ratio is often higher in higher need, inner city school systems.

• Issues of “quantity over quality” often arise when ratios are stretched. (ASCA)

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Statistics

• Each person has the right to be respected, be treated with dignity and have access to a comprehensive school counseling program that advocates for and affirms all students from diverse populations regardless of ethnic/racial status, age, economic status, special needs, English as a second language or other language group, immigration status, sexual orientation, gender, gender identity/expression, family type, religious/spiritual identity and appearance.

• Each person has the right to receive the information and support needed to move toward self-direction and self-development and affirmation within one’s group identities, with special care being given to students who have historically not received adequate educational services: students of color, low socio-economic students, students with disabilities and students with nondominant language backgrounds. (ASCA)

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Code of Ethics

• Each person has the right to understand the full magnitude and meaning of his/her educational choices and how those choices will affect future opportunities.

• Each person has the right to privacy and thereby the right to expect the counselor-student relationship to comply with all laws, policies and ethical standards pertaining to confidentiality in the school setting.(ASCA)

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Code of Ethics

• Informs students of the purposes, goals, techniques and rules of procedure under which they may receive counseling at or before the time when the counseling relationship is entered. Disclosure notice includes the limits of confidentiality such as the possible necessity for consulting with other professionals, privileged communication, and legal or authoritative restraints. The meaning and limits of confidentiality are defined in developmentally appropriate terms to students.• Keeps information confidential unless disclosure is required to prevent clear and imminent danger to the student or others or when legal requirements demand that confidential information be revealed. Counselors will consult with appropriate professionals when in doubt as to the validity of an exception. (ASCA)

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Confidentiality

• Can sometimes cause tension between counselors and teachers• Teachers often want to know what was discussed in private family meetings/ counseling sessions• Parents are often only able to begin to trust the school when their privacy is protected.• Parents/guardians should be told mandated reporter obligations and the limitations of confidentiality (all school staff are mandated reporters) (ASCA)

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Confidentiality

• Schools are the logical point of entry to increase the efficacy of mental health services to children and adolescents.

• For nearly half of the children with serious emotional disturbances who receive mental health services at all, the school system has been the sole provider.

• Schools are already the primary providers of mental health services for all children.

• Offering services in the schools improves access to treatment. (Feinberg & Cash)

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Why choose schools?

Other Reasons to Choose Schools Mental health is directly linked to educational

outcomes.

Schools are the optimal place to develop psychological competence and to teach children about making informed and appropriate choices concerning their health and many other aspects of their lives because schools are the only organization in our society to which virtually all children and adolescents are consistently exposed for extended periods of time. Schools are vital and central community institutions. (Feinberg & Cash)

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Other Reasons to Choose Schools As multidisciplinary entities, schools are the

best places to integrate and to coordinate the efforts of teachers, families, mental health service providers, and administrators to foster the mental health of students.

Accessible, affordable mental health services are most easily and consistently provided in the educational setting. Problems of transportation, accessibility, and stigma are minimized when such services are provided in schools. (Feinberg & Cash)

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Maslow’s Hierarchy of Needs

Basic Beliefs

• Students must be safe and healthy to be successful in school. This is supported in NCLB, IDEA and the President’s New Freedom Commission report.

• Schools are primary care/public health settings.

• Every community has a school district.(Feinberg & Cash)

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Basic Beliefs…cont.

• Mental health services should be an available component for every child’s school experience.

• Schools offer easy access and familiarity to children & families.

• Children & teens in this country are in dire need of expanded mental health services according to a variety of reputable sources. (Feinberg & Cash)

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Why are Mental Health Services in Schools Imperative? • Accessing students and their families

who need mental health services is facilitated by contact through and at schools

• Addressing psychosocial and mental and physical health concerns is essential to the effective school performance of some students (Feinberg & Cash)

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Calm

Trigger

Agitation

Acceleration

Peak

De-escalation

Recovery

Acting Out Acting Out CycleCycle

Adapted from The Iris Center: http://iris.peabody.vanderbilt.edu

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Mental Health in Schools…

• Schools can enhance the nature and scope of mental health interventions, fill gaps, enhance effectiveness, address problems early, and reduce stigma.

• Schools can positively impact educational outcomes by ensuring that all students are mentally & physically health (Feinberg & Cash)

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Meeting the Imperative…

• Emphasize mental strengths as well as deficits.

• Relate mental health to real-life day-to-day issues.

• Enhance the important collaborative partnerships between schools, home & community to serve the educational & emotional needs of students (Feinberg & Cash)

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Meeting the Imperative…• Stress the role mental health in

schools can play in ensuring that all students have an equal opportunity to succeed at school.

• Seek solutions to the related problems of marginalization, fragmentation, and counterproductive competition for sparse resources.

• Address the challenges of evidence-based strategies and achieving results.(Feinberg & Cash)

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Meeting the Imperative…• Mental health in schools needs to be a

valued part of student support systems that enable students to learn and allow schools to achieve their educational mission.

• With a shared agenda, existing resources can be deployed and redeployed in ways that enhance equity with respect to availability, access, and effectiveness. (Feinberg & Cash)

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The Role of the School Counselor

• Collaborating with outside agencies (DCF, Court, outside agencies, community groups, etc)

• Providing behavioral support in school• Providing usually short-term counseling

services in school• Providing professional development to staff• Completing functional behavioral

assessments (FBA’s), home assessments, and other evaluations for special education TEAMs

• 504 Coordinators• Are usually the truancy officers.• Crisis intervention, evals, and planning

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What is the continuum of “School Mental Health” Services?• Universal prevention services provided to

all students that seek to promote positive mental health and educational success

• Targeted prevention and intervention services that seek to improve social-emotional skills and behaviors linked to positive mental health and educational success

• Intensive intervention services that seek to help students effectively cope with social-emotional and behavioral issues that impact positive mental health and educational success

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Roles & Functions• ASCA’s national standards serves as

the guide in providing the goals and competencies for school counseling programs.

•The national standards address three areas:▫Students’ Academic development▫Students’ Personal/Social

development, and ▫Students’ Career Development (Cunningham &

Rowland, Professional School Counseling)

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Five main roles and functions of the school counselor:•Counseling and

Coordination •Leadership•Teaming and Collaboration

•Advocacy•Assessment of Data (Cunningham &

Rowland, Professional School Counseling)

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Counseling and Coordination•Three different settings for school

counseling are:▫ large group guidance,▫Individual counseling, and▫small group counseling (Cunningham &

Rowland, Professional School Counseling)

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Counseling and Coordination•An elementary school counselor may

see a student individually for:▫Fears ▫Low self esteem ▫Physical concern ▫Peer relationship problems ▫Study skills ▫Learning problems (Cunningham &

Rowland, Professional School Counseling)

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Counseling and Coordination•The school counselor also assumes the

role of a facilitator of small groups• Group counseling refers to small

groups of no more than 8 members who meet usually once a week to address a specific topic.

•Topics might be remedial (study skills), supportive (changing families, children of alcoholics), developmental (peer relationships, identity development), or preventative (anger management, conflict resolution). (Cunningham & Rowland, Professional School Counseling)

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Counseling and Coordination•A middle school small group

counseling may deal with death and dying (grieving the death of a family member, a student, teacher, friend, etc.) (Cunningham & Rowland, Professional School Counseling)

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Leadership• In the leadership role the school

counselor influences others to create a shared commitment to a common purpose.

•School counselors are leaders in identifying and removing barriers to high academic achievement and increasing learning opportunities for all students.

•The school counselor serves as a leader by sponsoring student activities, such as peer mediation, or school-wide initiatives, such as character education (Cunningham & Rowland, Professional School Counseling)

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Teaming and Collaboration• When the school counselors and other

school personnel work together as a team, the school environment is a positive one that helps students succeed academically

• School counselors provide support for teachers by coordinating and implementing activities.

• Through enhancement of skills, collaboration about student behavior and supportive consultation with parents, the counselor works as an ally with teachers in order to handle the demands of the classroom (Cunningham & Rowland, Professional School Counseling)

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Advocacy•Advocacy is an action taken by the

counselor to facilitate the removal or external and institutional barriers to the students’ well-being.

•Counselors are the first line of defense against barriers to student success and achievement. Counselors empower students and families to make a difference in their own lives(Cunningham & Rowland, Professional School Counseling)

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Ways to Increase Communication•Work out a system / protocol for referrals

•Weekly meetings (or more frequently)

•Counselor presents briefly at staff meeting

•Parent newsletters•Teacher as gatekeeper, spreading the word to student’s families

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““Children are the Children are the messages we messages we send to a time send to a time

we will not see.we will not see.”

Neil Postman

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Questions or Comments?Questions or Comments?

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References• Feinberg, T. & Cash, R.E. “School Mental Health: From

Understanding to Action”• National Association of School Psychologists (2003),

“Position Statement on Mental Health Services in the Schools”

• The National Advisory Mental Health Council’s Workgroup on Child and Adolescent Mental Health, 2003

• Report of the Surgeon General’s Conference on Children’s Mental Health, 2000

• University of Maryland & Prince Georges County Public School System. Mental Health 101 for Non-Mental Health Providers

• U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.)

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