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NASP Practice Model

Examples From the Field

By Eric Rossen

The Model for Comprehensive and Integrated School Psychological Services, also known as the Practice Model, outlines 10 general domains of school psychological practices. This article is one in a series entitled, "NASP Practice Model: Examples From the Field," which highlights various domains within the Practice Model and, through interviews with practicing school psychologists, illustrates how the domains are effectively applied in everyday professional activities.

Domain 6

Preventive and Responsive Services

Anyone who has ever gone to a beach likely recognizes the risks associated with sun exposure, including painful sunburn, blisters, sunstroke, premature signs of aging, and possibly even skin cancer. Nevertheless, you will often find different methods of how people deal with this issue that fall neatly into the three levels of prevention:

  • Primary: applies sunscreen before getting to the beach, and reapplies regularly throughout the day
  • Secondary: applies sunscreen when someone notices redness in the shoulders or on the face, or if the sun appears particularly hot that day
  • Tertiary: does not apply sunscreen and realizes the mistake after having an incredibly painful shower that evening, followed by days of peeling and using aloe to alleviate pain, and possibly a visit to a physician to make sure symptoms do not worsen

Regardless of the availability and potential success of primary prevention (in this case, sunscreen), it is rarely 100% effective for everyone for one reason or another. Perhaps some underestimate the power of UV rays, or don’t anticipate being in the sun for very long, or do not apply it properly. Therefore, while sunscreen remains a critical aspect of addressing sun exposure, knowing how to respond appropriately once sunburn occurs is also important. Similarly, we must strive to be prepared for and maintain an understanding of a multitiered approach to help prevent, and if necessary, respond to problems that arise in the school setting.

While a day at school is far different than a day at the beach, they are similar in that various problems or concerns occurring in schools can be considered within this paradigm. Prevention efforts aimed at entire school populations may help in reducing global issues such as dropout rates, bullying, obesity, or substance abuse; however, even the best primary prevention programs may not reach all students. Therefore, multitiered prevention efforts in schools can be effective in supporting all students’ mental health, school functioning, and overall well-being, particularly when primary prevention efforts are unsuccessful for certain students.

Prevention and responsive services using a multitiered approach can often improve many aspects of the school beyond a particular targeted area. For example, prevention programs aimed at improving graduation rates may result in increased family involvement, safer learning environments, the development of early literacy programs and reduced future special education referrals, improved community collaboration, and increased availability of after-school programs. By attempting to prevent school dropout through these programs, schools end up improving an array of factors related to school success for all students. Unfortunately, as with the beach example above, such efforts will not completely eradicate dropout problems, in which case additional individualized approaches should be considered for selected students.

Multitiered prevention requires a great deal from school psychologists, including: recognition of risk and protective factors, knowledge of the school system, skills and understanding regarding a variety of prevention and responsive intervention methods, identification of students that may require more individualized support, and the ability to access resources and collaborate with others. Furthermore, many school psychologists feel they do not have the time or ability to support primary prevention efforts and instead focus only on tertiary prevention and intervention, which often means that school psychologists mostly or exclusively serve special education students. In this regard, preventive and responsive services are sometimes overlooked or undermined as falling outside the realm of school psychological practice or providing little value to the school as a whole.

Given the increasing pressure on administrators to produce achievement benchmarks, mental health needs and initiatives are sometimes marginalized. Furthermore, the role and skill set of school psychologists are often misunderstood. As a result, school psychologists may rarely be asked to support or develop a multitiered prevention and response program, leaving a large responsibility on school psychologists to take the initiative. Mary Clare Hayes from Burlington Public Schools in Massachusetts offers a great example of how she responded to new bullying legislation by initiating and developing a preventive and responsive framework within her school district.

Interview

Mary Clare Hayes, NCSP, a school psychologist in Burlington Public Schools in Massachusetts talks about how she is applying Domain 6 standards in her district.

Describe the preventive and responsive services you implemented in your schools in response to the new bullying legislation in Massachusetts.

With the passing of Massachusetts’ antibullying law (http://www.malegislature.gov/Laws/SessionLaws/Acts/2010/Chapter92) in May 2010, schools are now required to have very clear procedures for preventing and managing cases of reported bullying and retaliation. As part of the law, every district in the state must create a bullying prevention and intervention plan (BPIP) and submit it to the Department of Elementary and Secondary Education (DESE). Given my experiences as a PREPaRE trainer and disaster response mental health counselor, I was encouraged by my supervisors to learn the new law, determine how it would impact our district, and help create the BPIP. In collaboration with another school psychologist, we first reviewed the model plan provided by the DESE and developed suggestions on how to best implement the requirements in our district. Next, we helped create a district-wide multidisciplinary committee consisting of teachers, administrators, parents, and community stakeholders. This group, referred to as the Student Empowerment Committee, discusses issues pertaining to the new law, including methods of educating all students about bullying as part of a district-wide preventive measure.

A universal intervention that I created was a school-wide assembly for juniors and seniors emphasizing the role of bystanders in bullying. Students this age have heard these messages before, so I focused on getting them to think for themselves about how they can make an impact on their communities both now and when they graduate. This was an interactive assembly where students could text in their replies and see instant results on a screen, which made the students highly engaged in the learning process.

I then developed a social skills class aimed at helping students who are identified as potential targets of bullying and harassment. I now teach the class daily to selected students in my high school and it has become a safe place for them to discuss any issues that have come up in their school day that they need help navigating. I also offer short-term solution-focused counseling for any high school student who needs help with problems that don’t require more intensive therapy.

A next step our district took was developing a bullying/harassment reporting form, which includes a section where the students can be referred to the school psychologist as part of the procedure. When any student, parent, or teacher witnesses any act that could be deemed as bullying, this form can be used to document the incident as well as the results of the administrators’ investigation. I help to determine the type and intensity of intervention needed on a case-by-case scenario, ranging from mediation to referrals within the community.

What were some of the initial barriers you faced?

One of the requirements of the new law states that:

Whenever the evaluation of the Individualized Education Program team indicates that the child has a disability that affects social skills development or that the child is vulnerable to bullying, harassment, or teasing because of the child’s disability, the Individualized Education Program shall address the skills and proficiencies needed to avoid and respond to bullying, harassment, or teasing.

This presented challenges in identifying which students this affected as well as what services qualified as directly addressing those skills and proficiencies. To address these barriers, I began identifying students by starting with disability type, including students with autism, ADHD, neurological disorders, and other emotional/behavioral disabilities. Next, I spoke with guidance counselors and teachers about each of these students to confirm any particular concerns that matched the law’s language. We recognized the drawbacks and limitations of this approach, although we agreed this was the best way to begin the identification process. I then created a class that meets every day for 45 minutes and is available to any student identified as needing consistent, direct instruction in social skills development. I brought our speech therapist on board to coteach with me twice each week.

Another barrier we faced was establishing a consensus on which situations required reporting and remediation, and reconciling differences of opinion on how to best handle each case among members of our school team. Perhaps the most difficult aspect of this issue lies in the distinction between bullying versus typical social conflict. This has been a particularly challenging aspect of implementing the law because it requires all adults to examine their own beliefs and styles of communicating. Despite the massive amount of literature on bullying, much of it still disagrees on what constitutes bullying or harassment, and on how to best intervene with adolescent social conflicts.

An unfortunate consequence of the new law is that many educators sometimes act out of fear of litigation. To address these concerns, I have stressed to my team the importance of properly documenting all concerns and bringing them first to the administrators who filter issues to me if the situation requires a school psychologist to be involved. This process ensures compliance with the law.

How has this activity benefited students, families, the school, and your district?

The intention has been to establish consistency in how our district handles incidents of bullying and harassment. This will ultimately serve our families well if they know that we support their children and strive to make them feel safe and supported at school. Our new reporting forms and methods have encouraged our team to meet regularly to discuss at-risk students and to track cases that have been reported, which leads to more dialogue and collaboration. Furthermore, as our collaborative problem-solving increases, the students can recognize a consistent approach to bullying from the entire school faculty.

The social skills class has also benefited students as a direct service to help them develop skills to reduce their victimization from teasing and harassment, or to reduce the physical and emotional impact of bullying. Many of these students are learning stronger self-advocacy and assertiveness skills that will be helpful throughout their lifetime.

How has this experience impacted your interest in providing similar services in the future?

The Student Empowerment Committee is only one means by which our district is implementing the requirements of the new law. It has been an excellent start to a new mandate, but there is certainly room for growth. I want to be sure that the purpose of the committee does not become a venue for staff to talk negatively about deficits in our district’s methods or its social–emotional curriculum and training. Instead, I want the group to prove its efficacy by developing solutions to the issues we discuss despite limited time and resources. I plan to continue working with the committee and my school team on developing effective communication outlets and a consistent, steady approach to addressing bullying and harassment.

We are planning to ask students to partake in a survey on bullying behavior in the coming months and we will use the data to inform decisions on the scope and type of interventions required. Regularly collecting data will also help us determine how effective our efforts have been and if additional changes need to be made.

Prior to the end of the school year, I plan to identify students who should participate in the social skills class for the following school year, following a thorough review of records and consultation with teachers and support staff. In doing so, we can build the class into their schedules ahead of time. I am working to get these students credit just as they would for any other class. (Read more about Mary Clare Hayes’ work by visiting http://www.boston.com/news/local/massachusetts/articles/2010/12/19/burlington_school_leaders_confront_bullying_head_on/?camp=misc:on:share:article.)

Domain 4

Interventions and Mental Health Services to Develop Social and Life Skills

Supporting mental health remains a critical aspect of a school psychologist’s role. It has been estimated that only 20% to 25% of school-age students receive the mental health support they need (Kataoka, Zhang, & Wells, 2002; RAND, 2001). This is likely due to the various barriers that may preclude parents from seeking mental health support outside of schools, including cost, lack of transportation, stigma, or lack of awareness of a need for help. Combined with the known relationship between mental health and learning, schools (and school psychologists in particular) bear an increasing responsibility to offer mental health interventions and services. After all, students are substantially more likely to seek help when school-based mental health services are available (Slade, 2002), and schools are second only to families in their potential to affect the mental health of children and adolescents (National Research Council and Institute of Medicine, 2009).

Importantly, such interventions and mental health services should not be designated solely for students with severe mental health concerns. All students can benefit from opportunities to develop social, emotional, behavioral, and life skills that help them navigate the world as they continue to mature. Specifically, skills such as healthy decision-making, planning/organization, empathy, gratitude, humility, and respect can be modeled and taught to all students. This is another paramount and often marginalized role of all educators.

Services of this nature can be provided at the individual, small group, classroom, school, and district-wide levels. Erica Dorfmeister-Chandler, a school psychologist in Prince George’s County Public Schools in Maryland, offers a great example of how to utilize a school-wide intervention program developed by NASP called Gratitude Works (see http://www.nasponline.org/communications/spawareness/2010_gratitudeworks.aspx) to teach students the value and importance of gratitude, improve teacher morale, and develop a sense of community within the school building.

Interview

Erica Dorfmeister-Chandler, NCSP, a school psychologist with Prince George’s County Public Schools in Maryland, talks about how she is applying Domain 4 standards in her district.

Describe the intervention you implemented in your schools to help students develop social and life skills.

This last October, I found myself, along with many of the staff at my middle school, needing a pick-me-up after having a very difficult start to the new school year. Morale had been particularly low this year due to a variety of different factors. I went back to my office, looked over at my bulletin board with notes of appreciation from students, families, and staff that I received and saved over the years, and realized that those notes have helped get me through many difficult days. Within moments, I made a choice to implement "Gratitude Week" at James Madison Middle School with the resources provided by NASP based on the National Gratitude Works program. While I had previously felt too busy to entertain any suggested activities for School Psychology Awareness Week offered through the NASP website, developing this important life skill (gratitude) among students while restoring morale and motivation seemed just as important as my typical duties, and possibly even more important.

With the support of my principal, Courtney King, and the efforts of my intern, Chavaughn Brown, November 8–12, 2010 became an amazing week at James Madison Middle School for students, staff, and families. Students in Grades 7 and 8 (838 in all), and more than 40 staff members, wrote letters of gratitude. An outstanding 94% of students participated.

Letters were addressed to family members, coaches, bus drivers, current and previous teachers, cafeteria workers, custodians, administrators, members of the military, and even President Obama. Letters were sorted and delivered to recipients throughout the week. In addition to the letters, staff and students were asked to sign a banner created by a group of students acknowledging parents and family members. Parents were greeted with the banner upon entering James Madison Middle School on November 12 for parent–teacher conference day. With permission from selected students, several letters were acknowledged and read during the morning announcements. Many of the "unsung" heroes of the James Madison Middle School community, including cafeteria workers, custodians, and substitute teachers, received special recognition.

What were some of the initial barriers you faced in implementing Gratitude Week?

Working as a school psychologist in the 16th largest school system in the United States consisting of approximately 127,000 students would challenge any professional’s ability to provide comprehensive and integrated school psychological services. Being assigned to multiple schools, including a middle school with more than 900 students, certainly does not make my job any easier. As a result, the biggest challenge I regularly face is having limited time to deal with a multitude of responsibilities. The school system is faced with severe budget cuts and dwindling resources, all while the emotional and educational needs of our students grow greater each year. Many of us simply do not have the time to provide the full range of psychological and mental health services that we would like without feeling overwhelmed or frustrated.

In making the decision to implement Gratitude Works for the entire community, I risked falling behind with my other responsibilities or being perceived as having nothing else to do; however, I spent over 35 hours outside of school to make this work, worked 11-hour days during the week of implementation, spent my own money to purchase bookmarks and other materials, and I had an intern to assist me.

How has this activity benefited students, families, the school, and your district?

I found myself overwhelmed with emotion throughout the week as I realized the impact of my efforts. As an educator in my building said to me during the week, "What an honor for you to have the trusted seat of being able to view the thoughts and feelings of many hearts." I felt honored, inspired, and grateful beyond words. Students were talking to one another about it in the hallways, staff members were in tears as they read the letters, parents and families felt appreciated and connected with the school, and the entire James Madison MS community felt uplifted and renewed. The full impact extended beyond the walls of the school as several letters were mailed to students’ former elementary school teachers, women and men serving in our military, and other community members.

How has this experience impacted your interest in providing similar services in the future?

Implementing Gratitude Week as part of School Psychology Awareness Week was a choice I made, and I believe it was well worth the effort and sacrifice. I know that, unfortunately, there will be times when I will pass on doing something extra for my students and schools, because there is simply no time. For now, I will reflect on the hundreds of gratitude letters completed at James Madison Middle School, be grateful for the opportunity, and continue my best efforts at providing comprehensive and integrated services to those in need as outlined by NASP’s Model for Comprehensive and Integrated School Psychological Services.

References

Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.

National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press.

RAND Corporation. (2001). Research highlights: Mental health care for youth: Who gets it? How much does it cost? Who pays? Where does the money go? Santa Monica, CA: Author.

Slade, E. P. (2002). Effects of school-based mental health programs on mental health service use by adolescents at school and in the community. Mental Health Service Research, 4, 151–166.


Eric Rossen, PhD, NCSP, is the NASP Director of Professional Development and Standards.