howard muscott, ed.d., eric mann, licsw and michelle lewis

Developing a Tier III System of Response to Intervention for Positive

Behavioral Interventions and Supports Day 1 of 2

March 14, 2011SERESC

Howard Muscott, Ed.D., Eric Mann, LICSW and Michelle LewisNH Center for Effective Behavioral Interventions & Supports at

SERESCwww.nhcebis.seresc.net

206-6891 [email protected]; 206-8820 [email protected]

http://www.nhcebis.seresc.net/

mailto:[email protected]

mailto:[email protected]

http://www.iod.unh.edu/

Support for NH RESPONDSis provided by

the NH Bureau of Special Education, NH Department of Education under a

grant from the US Department of Education, Office of Special Education

and Rehabilitation Services

NH RESPONDS Lead Partners NH Dept. of Education- Bureau of Special Education NH Center for Effective Behavioral Interventions and Supports

at SERESC Expertise in Positive Behavior Supports Expertise in integration of mental health and school supports

Institute on Disability at University of NH Expertise in Literacy within an RtI model Expertise in PBIS and Intensive Interventions (RENEW) for

Secondary Transition and Dropout Prevention Parent Information Center

Expertise in effective parent involvement and communications

Agenda for Day One

1. Preview the Training2. Readiness for Tier III3. Tier III Systems, Data & Practices4. Tier III Teams5. Responding to Escalating Student Behavior6. School to Community Mental Health

Protocols7. Tier III Checklist and Action Planning

Outcomes1. To be able to describe the features of a

tertiary system of supports2. To self-assess Tier III supports3. To identify the membership and roles of Tier

III teams4. To describe the conflict & escalating

behavior cycles5. To describe strategies for engaging families6. To describe a school to mental health

protocol

Responsiveness to Intervention (RtI)Batsche et al. (2006)

RtI is defined as “the practice of providing high-quality instruction and interventions matched to student need, monitoring progress frequently to make decisions about changes in instruction or goals, and applying child response data to important educational decisions.”

Guiding Principle: Social Behavior and Achievement are Linked

To improve the academic success of our children, we must also improve their social success.

Academic and social failures are reciprocally and inextricably related.

As a result, systems to support behavior and literacy should be integrated.

Systemic Process of RtILiteracy Behavior

Secondary Transition for high school

80%-90%

Universal Interventions

•All students•Core curriculum•Preventive, proactive

Intensive, Individual Interventions

•Individual students•Specifically tailored instruction•Progress monitoring

Targeted, Group Interventions

•Some students (at risk)•Additional instruction•Progress monitoring 5%-10%

1%-5%

Tier 1 – UniversalWhole School, All students, Screening and Early Identification

Literacy StandardsWord ID

Language ComprehensionPrint Processing

School CultureBehavior Expectations

Promotion of Positive Behavior (define, teach, recognize)

Response to problem behavior(define behaviors and response processes)

ToolsMatrix of expected behaviorsTeaching plan and practiceRecognition planProblem behavior definitionsResponse processReporting/Data collection

DataWeekly data reports of problem behavior; Attendance,Periodic self-assessments

ToolsExplicit instruction/modeling

Systematic instruction/skill-buildingAmple practice opportunities

Immediate corrective feedback Differentiated instructionContinuous assessment

DataDIBELSNWEAAIMSwebOther

Movement to Tier 2 supported by effective decision rules, goal-setting, progress monitoring, fidelity of implementation, use of evidence-based instruments and linkage to specific skill deficits

ToolsResearch-based literacy curriculumClassroom-wide and small group Benchmark assessmentData-driven instruction

Tier 2 – TargetedSmall Groups and Individual Supports Based on Similarities of Needs and Data

LiteracyAdditional group instruction time to address specific skill

needs

BehaviorTeacher Check, Connect, Expect

Targeted group interventions based on skills and function of behavior

ToolsTCCECheck-In, Check-OutPASS (Preparing and Supporting Self-Managers)And other group interventions

DataWeekly data reports of problem behavior or prosocial behaviorProgress monitoring of group interventionsPeriodic self-assessments

ToolsDiagnostic assessmentSmall groups based on specific skill needs(e.g., comprehension, sight word recognition, vocabulary)

DataDIBELSAIMSwebOther

Movement to Tier 3 or 1 supported by effective decision rules, goal-setting, progress monitoring, fidelity of implementation, use of evidence-based instruments and linkage to specific skill deficits

Parents as Partners?We know that parental involvement is a

fundamental pillar of effective programsWe understand that some see parents as the

problem while others see them as part of the solution

We believe that parents are important partners and we encourage programs to actively engage all types of parents in decision-making

Communicating with Families and Faculty

It is important to establish a culture that supports both family and faculty involvement, engagement, positive communication and collaborative decision-making

Establishing such a culture as expected practice helps promote stakeholder engagement as an outcome

Effective communication implies that there are regular and frequent opportunities to: Provide information Gather feedback to gain consensus and shared

ownership regarding the design, implementation and evaluation of the program.

Family Involvement

How have you communicated to families about Tier 1 and Tier 2?

How have families been part of the Tier 1 and Tier 2 planning and infrastructure building?

Tier 3 – IntensiveIndividual Assistance Focused on Needs and Data

LiteracyAdditional individual

instruction time to address specific skill needs

BehaviorIndividualized planning for

behavior supports

ToolsFunctional Behavioral AssessmentBehavior Support PlanPerson-Centered PlanningLife Space Crisis Intervention (LSCI)WraparoundRENEW School-to Career Planning (HS)Alternative Education Plans (HS)

DataWeekly data reports of problem behaviorProgress monitoring of studentPeriodic self-assessmentsStudent Progress Tracker (HS)

ToolsOne-on-one instructionExplicit instruction/modelingSystematic instruction/skill-buildingAmple practice opportunities Immediate corrective feedback Alternative Education Planning (HS)

DataDIBELSAIMSwebDiagnostic Assessment

Family &

Youth

Systems

School-Based Systems

Community-Based Systems

Intensive Systems

of Behavior Support

Muscott, Mann & Berk (2006)

MAST-NH

SYSTEMS

PRACTICES

DATA

SupportingAdults

SupportingDecisionMaking

SupportingStudents and Families

PBIS-NH Tertiary SupportsOUTCOMES

PBIS-NHSchool-Based

Tertiary SystemsMuscott & Mann

(2010)

4. Facilitated Referral Processes to Community-

Based Supports

Universal Primary Prevention

Targeted Secondary Prevention

1. Tier III Teams

SAU/District-wide

Administrative Team

3. De-escalation Response

Team

2. School-Based Activation Processes

PBIS-NHSchool-Based

Tertiary PracticesMuscott, Mann & Berk (2007)

6. Person-Centered Planning

4. EngagingFamilies

2. Escalating Behavior Cycle

1. Conflict Cycle

3. Life Space Crisis Intervention

5. Intensive FBA & Behavior

Support Plans

7. Wraparound

Building Relationships

8. RENEW for HS

PBIS-NHSchool-Based Tertiary DataMuscott, Mann & Berk (2007) 3. Implementation

with Fidelity

1. Data-Based Decision Making

4. Improvements in Youth and Family

Quality of Life

6. Consumer Satisfaction/Social

Validity2. Process Outcomes

5. Improvements in Staff

Quality of Life

PBIS-NHSchool-Based


(2010)



1. Tier III Teams

SAU/District-wide

Administrative Team

Shared leadership through the activities of a leadership team is an essential

element of successful implementation and sustainability of a variety of

innovative educational reforms and practices such as PBIS, RtI, urban school

reform, and inclusive education. Artiles, Kozleski, Dorn, & Christensen, 2006; Burns

&Ysseldyke, 2005; Jorgensen, Schuh, & Nisbet, 2006; Katzman, Gandhi, Harbour, & LaRock, 2005; Kozleski & Smith, 2005; Villa & Thousand, 2005; Warren et al., 2004

Composition of the School RTI Tier III Oversight Team by Role

Administrator(s) Curriculum/Assessment Director Guidance Counselor General Education Classroom Teachers Special Education Teachers Behavior Specialist/Guidance/Psychologist Reading/Literacy Specialist Title I Coordinator/ELL /ESOL/ Other Specialists Data People Family Member (i.e., infrastructure stage)

Tier III- Family Involvement

Participation and design of the Oversight Team (the infrastructure)

Engagement with the Tier 3 Implementation team

Two-way, meaningful communication (with all families) about the RtI System

Roles of the School RTI Tier III Oversight Team

1. Lead the Tier III system2. Meet regularly3. Access current Tier III interventions and

supports 4. Design and implement Tier III system with

interventions matched to student needs5. Train, coach, and support teachers in

academic and behavior interventions 6. Provide progress monitoring of interventions

Roles of the School RTI Tier III Oversight Team

7. Design, collect, analyze data and use data based decision making to inform Tier III process

8. Monitoring for fidelity of implementation and efficacy of interventions

9. Communicate with key stakeholders (Universal/targeted team, parents/ families/staff)

10. Refine and sustain Tier III system using current data

Types of RTI Tier III Implementation Teams

Personalized teams created for the individual student including family

Tier III oversight team may serve this purpose for some students as long as family involvement is included

The Tier III Team should work in coordination with an existing IEP team

Roles of RTI Tier III Implementation Teams

1. Develop effective and efficient Tier III services matched to student needs

2. Weekly progress monitoring3. Working collaboratively and

communicating with family to support student

4. Ongoing communication with Tier III oversight team & IEP team

RtI, Tier III, and Special Education

Memo from US Dept of Ed 1.21.11 re: RTI and evaluation for eligibility under IDEA “A multi-tiered instructional framework , often referred

to as RTI, is a school-wide approach that addresses the needs of all students, including struggling learners and students with disabilities….”

“OSEP supports implementation of RTI strategies to ensure that children who are struggling academically & behaviorally are identified early and provided needed interventions in a timely and effective manner.”

RtI, Tier III, and Special Education

Memo from US Dept of Ed 1.21.11 Cont. “The use of RTI strategies cannot be used to delay or

deny the provision of a full and individual evaluation, pursuant to 34 CFR §§300.304-300.311, to a child suspected of having a disability under 34 CFR §300.8.”

“It would be inconsistent with the evaluation provisions at 34 CFR §§300.301 through 300.111 for an LEA to reject a referral and delay provision of an initial evaluation on the basis that a child has not participated in an RTI framework.”

Effective Tier 3 Team Norms and Group Processes

Roles and responsibilities defined Meeting ground rules are

established Agendas are prepared Decision-making is formalized A strategic problem solving

approach is used Action plans with tasks, timelines

and accountability are developed Data is used for decision-making Conflicts are resolved

constructively and professionally

Tier III Team Activity

Who: Each school “group”What: Choose ONE activity

1. Identify members of the Tier III oversight team2. Discuss how the Tier III team would be activated if a

student needs more than Tier I & II 3. Discuss what additional information would be needed in

addition to what has been collected at Tiers I & II4. Discuss how Tier III team would work with an existing

IEP team

Time: 15 minutesPost or Report Out: Volunteers

PBIS-NHSchool-Based


(2010)



SAU/District-wide

Administrative Team

2. School-Based Activation Processes

What Makes an Effective School-Based Activation Process?

The process clearly identifies the sequence of activities. The process clearly identifies who is eligible. The process differentiates one type of service or support

from another. The process is written down on paper in either graphic

form (e.g., flowchart) and/or narrative form. The process includes the type of information needed to

make a referral. The process indicates where parents are notified and

informed.

Family Involvement

How would you involve families in the shared school/district vision statement for Tier III?

How would you communicate the difference between Tier 2 and Tier 3 to families?

What strategies would you use to engage families of students in need of Tier III supports who may be reluctant to engage?

Inventory of Formal School-Based Supports Available to Support Students with Intense and Chronic Needs

Muscott (2007)

What is the School-Based

Support?

Who is the Point of

Contact for the Support?

What Types of Student Issues are Addressed through this Method of Support?

Is there an Identified Written

Protocol for How to Make a

Referral?

What Forms

/Information is Necessary to Make a Referral?

Is there Evidence of Effectiveness?

Tier III Team Activity

Who: Each school “group”What: Choose one activity1.Identify your array of Tier II & III supports

using the chart.2.Address the family engagement questions

from the previous discussion.Time: 30 minutesPost or Report Out: Volunteers

PBIS-NHSchool-Based


1. Conflict Cycle


“Students in crisis seldom see connections among what they feel, how they behave and how others respond. Their responses to stress tend to be behaviors fueled by feelings, perpetuating conflict and crisis.”

“Not only are most students unable to recognize feelings, they are also not able to talk about them.”

“But unless a student is able to do these two things, it is difficult, if not impossible, for the student to make a lasting change from behavior driven by feelings to behavior regulated by rational processes.”

Long, Wood, Fescer, 2001 p. 39

CONFLICT CYCLENicholas J. Long

STUDENT’S SELF CONCEPTIRRATIONAL BELIEFS

1. A Thoughts

"People are disturbed not by things, but by the views which they take of them."

EPICTETUS,1st Century A.D.

21LSCI Institute

The Sequence of the Conflict CycleNicholas J. Long

1. Self-Concept as a Setting Event2. A Stressful Event Occurs3. The Event Activates Irrational Beliefs4. Negative Thoughts Trigger Feelings5. Negative Feelings Drive Inappropriate Behavior6. Behavior Incite Staff7. Staff Pick Up Student’s Negative Feelings and

Frequently Mirror Student Behavior8. Staff Behavior Increases Student Stress and

Escalates Cycle9. Student’s Self-Fulfilling Prophesy is Reinforced

StressfulIncident

Student’sFeelings

Student’sObservable

Behavior

Student’sThoughts

Student’s Self –Concept and Irrational Beliefs

Staff/PeerReactions

Conflict

4. Describe the student’s feelings

5. Describe the student’s behavior

6. Describe the staff/peer reaction

3. Describe the student’s thoughts

Conflict CycleWorksheet

WAREA 2004

2.Describe the stressful incident

1. Describe the student’s self concept & irrational beliefs

7. How did this effect the student’s self-concept & irrational beliefs?

LSCI Institute

FOUR REASONS WHY COMPETENT TEACHERS BECOME COUNTER-

AGGRESSIVELong, Fecser, Deming (2010)

1. Trapped in the Conflict Cycles of Aggressive Students (51%)

2. An Increase of Personal Life Stresses – Carry-In Reasons (17%)

3. Students Violate Cherished Beliefs (13%)

4. Students Expose Unresolved Developmental Issues – Tap-In Reasons (10%)

5. Other (9%)

A Prescription for Success

You’ll always have the counter feelings, but you can’t act on them or do what is comfortable

The challenge is to turn conflict cycle into a coping cycle

The Conflict Cycle occurs when both individuals react at the “low road” level.

Bridget Walker (2006)

Adults must remember to take the “high road” when faced with stressful situations

BUTStudents have to learn to take the “high road”

when faced with stressful situations

Bridget Walker (2006)

TWO DISTINCT BRAIN FUNCTIONSRATIONAL BRAIN

(NEW BRAIN)

IMPULSE CONTROL

SENSE OR REASON AND JUDGEMENT

EMOTIONAL BRAIN (OLD BRAIN)

FIGHT OR FLIGHT REASONING

BIOLOGICAL RESPONSE

Conflict Cycle Activity

Who: Each person What: Identify a student who you are

concerned about because their behavior escalates into power struggles with you. Identify which likely reason you might engage in counter-aggression

Timeframe: 5 minutes Report Out: Volunteer

PBIS-NHSchool-Based


2. Escalating Behavior Cycle


Conflict Cycle to Acting-Out Behavior Cycle

ActionAction

Action

ActionAction

Feeling

Thought

Stimulus

Stimulus

Action

StimulusStimulus

Stimulus

Stimulus

Thought

Thought

Thought

Feeling

Feeling

Feeling

Feeling

Feeling

Acting-Out Behavior Cycle

Period of Escalation

A time when the student calls upon

existing coping skills to resolve a problem presented

by a trigger

Period of De-escalation

This phase marks the beginning of the student’s

disengagement and reduction in severity of

behavior. Students are still not especially cooperative

or responsive to adult influence

Peak

This phase is characterized by serious disruption and behaviors that often represent a threat to the safety of others. Logical cognitive

processes are impaired and impulsive behavior rules

1. Calm 7. Recovery

2. Triggers

4. Acceleration

3. Agitation

Sources: Colvin (1992); Walker, Colvin, & Ramsey (1995)

6. De-escalation

5. Peak

Time

Phase 1: Calm Behaviors

1. Calm

Sources: Colvin (1992); Walker, Colvin, & Ramsey (1995)Time

1. Exhibits on-task behavior2. Follow rules and expectations

3. Is responsive to praise4. Initiates positive behavior

5. Is goal-oriented

Phase 2: Triggers


School-Based1. Conflicts

2. Changes in routines

3. Provocations4. Pressures5. Ineffective problem-solving6. Errors7. Corrections

Non-School-Based1. Ineffective

home environments

2. Health problems3. Nutritional

problems4. Sleep

deprivation5. Substance

abuse6. Gangs

2. Triggers

Phase 3: Agitation


Decreases in behavior:

1. Staring into space

2. Subdued language

3. Contained hands

4. Withdrawal from groups

Increases in behavior:1. Darting eyes2. Non-conversational language3. Busy hands4. Moving in and out of groups5. Off task, then on-task behavior

3. Agitation

Phase 4: Acceleration


1. Questioning and arguing2. Non compliance and defiance3. Off-task behavior4. Provocation of others5. Compliance with inappropriate behaviors6. Criterion problems

7. Whining and crying

8. Avoidance and escape

9. Threats and intimidation

10. Verbal abuse11. Destruction

of property12. Serious behavior in

general

4. Acceleration

Phase 5: Peak


1. Serious destruction of property2. Assault

3. Self-abuse4. Severe tantrums5. Hyperventilation

5. Peak

Phase 6: De-escalation


6. Is responsive to simple directions

7. Is responsive to manipulative or

mechanical tasks8. Tries to avoid

discussion except to blame

others

1. Is confused and/or disoriented2. Attempts to withdraw3. Makes attempts at reconciliation4. Engages in denial5. Tries to blame others

6. De-escalation

Phase 7: Recovery


1. An eagerness for independent

work or activity2. Subdued behavior in

group work3. Subdued behavior in class

discussions4. Defensive behavior

5. An avoidance of debriefing7. Recovery

Applying the Cycle to Your Student

1. Calm


Using a student you are currently working with who displays serious acting-out behavior,

describe the specific behaviors for each phase of the cycle

7. Recovery

6. De-escalation

5. Peak

4. Acceleration3. Agitation

2. Triggers

Escalating Behavior Activity

Who: Teams What: Complete the escalating

behavior chart for a student of concern.

Timeframe: 20 minutes Report Out: Volunteers

PBIS-NHSchool-Based

Tertiary PracticesMuscott, Mann & Berk (2007) 3. Life Space Crisis

Intervention


Life Space Crisis InterventionLong, Wood, Fecser (2001)

LSI is a therapeutic, verbal strategy designed to intervene with students in crisis

LSI focuses on the crisis that occurs when an incident escalates into a conflict between a student and others

The adult serves as a mediator between the stress the student’s actions, the reactions of others, and the private world of feelings that students seem unable to handle without help

Note: LSCI strategies can be used during any of the escalating behavior stages and the decision should be based on multiple factors.

6. Get Ready to Resume Activity

2. Create a Timeline

4. Develop Insight

3. Isolate Central Issue and Select

Intervention

5 .Address New Skills

Life Space Crisis InterventionLong, Wood, Fecser (2001)

1. Drain Off De-escalate

the Crisis

Reclaiming StagesDiagnostic Stages

Life Space Crisis Intervention StagesLong, Wood, Fecser (2001)

Stage 1: Drain Off and De-escalate the Crisis Focus on the Incident

Stage 2: Timeline -- Students in Crisis Need to TalkStage 3: Central Issue -- Select the Appropriate

Reclaiming InterventionStage 4: Insight – The Goal of the Reclaiming

InterventionStage 5: New Skills -- Plan for SuccessStage 6: Transfer of Learning -- Get Ready to

Resume the Activity

Stage 1:Drain Off and De-escalate the Crisis by Focusing on the Incident

Purpose: To convey support and understanding of the

student’s stress and to start the student talking about the incident.

To drain off emotional intensity in order to prepare to focus on the event

Content: The incident itself – the event that actually

brought about the need for the LSCI – is identified.

Staff Reactions Student Reactions

Perceiving DiverseMultidimensional

ConcreteOne Dimensional

Thinking LogicalCognitvely-Based

Illogical Omnipotent

Irrational Trap

Feeling Accepts and Controls

FloodedExplosive

BehavingAccepts

Responsibility for Behavior

Does Not Accept Responsibility for Behavior

The Difference in Psychological Worlds Between a Student in Stress

and a Helping Staff

LSCI Institute

Stage 2: Timeline -- Students in Crisis Need to Talk

Purpose: To encourage the student to relate in sufficient detail the

unique perception of the event and surrounding circumstances;

To decrease the student’s emotional intensity while increasing reliance on rational words and ideas

To discover the student’s unique perception of the event Content:

A sequence of events (timeline) is established to obtain details of the student’s view of the incident, the associated stress, and the personal involvement

THE 7 ESSENTIAL QUESTIONS

WHERE?WHEN? TARGET? DURATION? FREQUENCY? INTENSITY? CONTAGION?

LSCI Institute

Stage 3: Central Issue -- Select the Appropriate Reclaiming Intervention

Purpose: To explore the student’s perception of the incident and

associated feelings and anxieties until you have sufficient understanding to concisely state the central issue and decide which Reclaiming Intervention should be used.

To determine if the crisis represents the student’s pattern of self-defeating behavior or if it is an unusual or rare reaction for this student

Content: Determine the extent to which the student’s behavior is

driven by feelings and anxiety, the depth and spread of the conflict, the amount of rational control the student can exercise over these emotions, and what the long and short-term outcomes of the LSI should be

Stage 4: Insight – The Goal of the Reclaiming Intervention

1. To reframe the student’s perception of the event2. To enable the student to gain a new insight into

repetitive patterns of self-defeating behavior3. To help the student realize that change is possible4. For the student to use his or her new insight into

the previous pattern of behavior to develop a plan for change

5. If the student is unable to do this, the adult chooses a solution that establishes group values and reality consequences that will work in the student’s behalf

Stage 4: Insight – The Goal of the Reclaiming Intervention

Content: The adult decodes the student’s behavior using a range of

relationship and listening skills The intervention moves towards a specific goal The solution is selected from several alternatives,

representing the student’s own changing insights and beliefs about what constitutes a satisfactory solution, considering subsequent consequences.

When the student denies responsibility or cannot choose, the adult structures the solution for them around group values and social norms that are within the student’s capacity to use successfully

Stage 5: New Skills -- Plan for Success

Purpose: To teach prosocial skills – to consider what will

happen and anticipate the reactions and feelings of self and others when the chosen solution is put into action

Content: Selected behaviors are specifically practiced as

rehearsal for reacting and problem solving successfully when the student faces the consequences of the original incident & when a similar problem may happen in the future

Stage 6: Transfer of Learning -- Get Ready to Resume the Activity

Purpose:To plan for the student’s transition

back into the group’s ongoing activity

To close down private topics or feelings that may have surfaced during the talk

The Six Reclaiming Interventions of LSCI

1. Red Flag InterventionImported Problems

2. Reality Rub InterventionErrors in Perception

3. Symptom EstrangementJustifying Harmful Behavior

The Six Reclaiming Interventions of LSCI

4. Massaging Numb Values Intervention

Behavior Driven by Guilt5. New Tools Intervention

Poor Social Skills6. Manipulation of Body

BoundariesExploitation of Peers

The Red Flag Intervention: Identifying the Source of the Stress

“Everyone is against me! No one understands what’s going on with me and no one cares! I can’t take it anymore.”

For students who:1. Overreact to normal rules and procedures

with emotional outbursts2. Attempt to create a no win situation by

engaging staff in a power struggle which ultimately results in more rejection and feelings of alienation

PBIS-NHSchool-Based


(2010)



SAU/District-wide

Administrative Team

3. De-escalation Response

Team

How Would Your School Respond?

John is in class and begins to get frustrated over a writing task. Before you know it, he begins to throw his books and papers on the floor, tips over chairs and makes loud threatening statements when you ask him to stop. He refuses to stop.

De-escalation Response TeamMuscott (2007)

A de-escalation response team is a group of highly trained personnel who are available to respond quickly to an incident where one or more students are (a) exhibiting escalating behavior that is unsafe to themselves and/or others and (b) not responding to adult requests to desist and move to an alternative space in the school.

Building De-escalation CapacityConsiderations of Need

How many students?How dangerous are the behaviors? Is it likely that physical restraint would be

necessary?When are the escalations likely to take

place?How long do they take to de-escalate?Other?

Building De-escalation Capacity

1. Need2. Legal Considerations & Policies3. Space4. Trained Personnel/Team5. Contingency Planning6. Communication Systems

PBIS-NHSchool-Based


(2010)

4. Facilitated Referral Processes to Community-

Based Supports



SAU/District-wide

Administrative Team

Mental Health CentersModalities and Services

1. Individual Therapy: Pre-school, Latency, Adolescent

2. Group Therapy: Pre-school, Latency, Adolescent, Parents/Caregivers

3. Family Therapy4. Emergency Services/Crisis

Stabilization5. Psychological Testing6. Prescribe Medication7. Dispense Medication8. Administer Medication

9. Admission/Discharge10. Medical/Psychiatric

Screening11. Case Management/Mental

Illness Management Services

12. Adolescent Substance Abuse Services

13. Dialectical Behavioral Therapy Program for Adolescents

14. Respite Care15. Wraparound

What Makes an Effective Community-Based Referral Process?

The process clearly identifies the sequence of activities. The process clearly identifies who is eligible. The process differentiates one type of service or

support from another. The process is written down on paper in either graphic

form (e.g., flowchart) and/or narrative form. The process includes the type of information needed to

make a referral. The process indicates where parents are notified and

informed or whether they alone can make the referral.

Facilitated Referral Process for Accessing Mental Health Services from

a Community Mental Health Center

Inventory of Formal Community-Based Supports Available to Support Students with

Intense and Chronic Needs Muscott (2007)

What is the Community-

Based Support?

Who is the Point of

Contact for the Support?

What Types of Student Issues are Addressed through this Method of Support?

Is there an Identified Written

Protocol for How to Make a

Referral?

What Forms

/Information is Necessary to Make a Referral?

Is there Evidence of Effectiveness?

Community-Based Intensive Supports Referral Activity

Who: Each school “group”What: Choose one activity1.Complete the Inventory of Community-

Based Supports2.Review the facilitated referral material from

Rochester SD and Community Partners.Time: 30 minutesPost or Report Out: Volunteers

Intensive Tier III Checklist Activity

Who: Teams What: Review and complete the

checklist and create an action plan.

Timeframe: 30 minutes Report Out: None

Acknowledgements

Lucille EberGeorge SugaiRob HornerHill WalkerDoug CheneyKathleen LaneKevin MurphySteve LeClair

Julie PrescottBecky BerkValarie DumontDebra GrabillSantina ThibedeauAmy JenksMike HatfieldJanet Salisbury

ResourcesLong, N.J., Wood, M.M., & Fecser, F.

(2001). Life space crisis intervention: Talking with students in conflict (2nd ed.). Austin, TX: Pro-ed.

Walker, H.M., Colvin, G., & Ramsey, E. (1995). Antisocial behavior in school: Strategies and best practices. Pacific Grove, CA: Brookes Cole.

howard muscott, ed.d., eric mann, licsw and michelle lewis

Documents

social behavior

behavior cyclesto

nh department of education

nh bureau of special

office of special education

intensive interventions

tier iiitier

roles of tier