When Worlds Collide: Implementing PBS across Multidisciplinary Residential Settings

C. Michael Nelson, Ed.D.National Technical Assistance Center for PBISKristine Jolivette, Ph.D.Georgia State University

Advanced OrganizerOverview: History and Rationale√ Definition of multidisciplinary residential settingsCharacteristics & needs of institutionalized youth

√ Review of national PBS outcome research√ Rationale for using PBS in residential settingsImplementation Fidelity in Residential Settings√ Procedures√ Adaptations for residential settingsExemplar in residential setting

Definition of Multidisciplinary Residential Setting

• Any 24/7 facility• Facilities with multiple systems

• Education• Security• Mental health/counseling• Vocation• Recreation

• Facilities with transient youth• Public/private residential facilities• Juvenile justice facilities (short- and

long-term)

Youth in Juvenile Corrections

• Characteristics that relate to behavior:– Special education classification– Mental disorders– Drug and alcohol abuse– History of abuse, neglect, and

witnessing violence

J. Gagnon, 2008

QuestionsWhy do these troubled and disabled youth end up in the juvenile justice system?When do their problems first emerge?What role do social institutions (family services, early childhood programs, schools, juvenile delinquency programs) play in either addressing or exacerbating these problems?

Outcomes of PBS• Reductions in:

– discipline referral rates by 50% to 60% (Horner, Sugai, & Todd, 2001);

– office discipline referrals (Lane & Menzies, 2003);– fighting (McCurdy, Mannella, & Eldridge, 2003);– in-school suspension (Scott, 2001);– classroom disruption (Lohrmann & Talerico, 2004;

Newcomer & Lewis, 2004); and– negative student-adult interactions (Clarke,

Worcester, Dunlap, Murray, & Bradely-Klug, 2002)• Increases in:

– academic achievement (Luiselli, Putnam, Handler, & Feinberg, 2005; Horner et al., 2009) and

– perceived school safety (Horner et al., 2009)

How Juvenile Justice “Works”

Incarceration PLUS punishmentSuccessful completion of “treatment” plans require high levels of literacy skillsRelease is contingent upon progress through the treatment planEducation is an add-on

Covariate adjusted mean recidivism effect sizes for

intervention philosophies (Lipsey, 2009)

Intervention Philosophy

Recidivism Rate

% Difference from Control Group (M=.50)

Counseling .43 -13%

Multiple Services .44 -12%

Skill Building .44 -12%

Restorative .45 -10%

Surveillance .47 -6%

Deterrence .51 +2%

Discipline .54 +8%

Why PBS in Secure Facilities?

Effective and efficient alternative to harsh, inconsistent, and ineffective disciplinary methods in public schoolsDiscipline in many secure facilities is often harsh and harmful

punishment mentality inconsistency among staff

Decisions about discipline not linked to data on youth behavior

PBS – Links to These Settings

• Two youth development principles– Appropriate Structure

• Predictable routines, rules, and expectations• Consistent implementation of supports by staff linked to

positive expectations– Positive Social Norms

• Teaching and modeling of appropriate, expected behaviors• Reinforcement for displaying these behaviors

» National Council on Disability (2003)

• Incorporation of evidence-based interventions– Comprehensive -Durable– Relevant - Positive

K. Jolivette, 2009

Call for Action• National Council on Disability (2003) call for PBS in

JJ• Researchers call for PBS extension to AE, Residential,

and JJ settings • (Houchins, Jolivette, Wessendorf, McGlynn, & Nelson, 2005; Nelson, Sugai, & Smith, 2005;

Scott, Nelson, Liaupsin, Jolivette, Christle, & Riney, 2001)

• Limited experimental studies implementing PBS in AE, residential, or JJ settings– Unknown application in residential settings– NM & NC implementing PBS in all JJ educational settings– TX passed legislation for state-wide implementation– AL, ID, MA, VT considering PBS for JJ– CA, IA, IL, OR, WA—PBS in at least one JJ facility– KY beginning pilot in one facility

• (National Center on the Education of Children who are Neglected, Delinquent, or At-Risk, 2007)

Obstacles and Opportunities

Belief that incarceration shouldn’t be “positive”Use of complex, multi-level “treatment” curriculaFailure to systematically collect or use behavior data for decision-makingLack of staff communication across disciplines--no mandate or precedent

Obstacles and Opportunities (cont.)

Staff turnover•Youth turnoverLack of time for training, collaborationNo history of or interest in collaborationDisproportionate number of youth with disabilities, lacking literacy skills, significant mental health problemsOthers?

Non-classr

oom

Setting Systems

ClassroomSetting Systems

Individual Student

Systems

School-wideSystems

School-wide PositiveBehavior Support

Systems

Education Program

Housing Units

Other Programs

Facility-wide Systems

PositiveBehavior Support

Systems in Residential Facilities

Individual Youth

Primary Prevention:1 or 0 discipline reports per

month

Secondary Prevention:2-5 discipline reports per

month

Tertiary Prevention:Multiple discipline reports

per month

~80% of Youth

~15%

~5%

CONTINUUM OFPROGRAM-WIDE

POSITIVE BEHAVIORSUPPORT

    32%

   

Iowa Juvenile Home

Continuum of School-Wide

Positive BehaviorSupports

~ 23%Secondary

Prevention

~53% TertiaryPrevention

~24%Primary Prevention

Current StatusResidential Schools/Facilities

24-hour monitoring of social, emotional, educational needs; involuntary enrollment (Gagnon & Leone, 2005)13% enrollment increase among students with EBD in past 10 years½ to ¾ total population receive special education services under EBDProgram philosophy: Behavioral (53%), Psychoeducational (28%) (Gagnon & Leone, 2005)Students: high prevalence of mental health diagnoses, minorities, anti-social behaviors

The Team Needs to …Look at global considerationsLook at possible systems, data, and practice issues

Considerations for the Facility

Level of SupportHow much? (initial training plus follow-up)How configured? (all staff at one time or by individual systems)By whom? (university/local personnel, different based on staff)

Staff IssuesFusing of different philosophies and educational backgroundsAttitude (negativity, “catching youth being bad”)Securing buy-in (how so across all staff)

LogisticsTime (release time, reconfiguration of duties)Staffing (will it look different, impact on facility)Resources (SWIS, research articles, behavioral strategies)

FinancialTraining costs (substitute teachers, more security)Reinforcement (youth versus staff)

Systems IssuesWho would constitute a leadership team

Facility and non-facility participants

Disconnect between residential systems and staff

Educational, Housing unit, Security, Mental health, Recreation

Competing prioritiesSafety first everything else second

Hierarchies and politics within and across systems

Power, History, Resource allocation

Data IssuesDifferent types of and reporting mechanisms for data collected

Anecdotal, frequency, duration, daily, weekly, monthly, semester reports

Limited sharing of dataAcross staff within and outside of systems

“Big Picture” of what is going on often missingDisconnect between 24/7 events (morning, school, lunch, after-school, afternoon, evening, nighttime)

Practice Issues“Saboteurs”

Lack of “buy-in” by ALL staff across systems

Use of non-scientific strategies, interventions, and curricula

Lack of “knowing” or time to investigate/staying with current practices

Differential & low expectations of youthLack of administrative and staff consensus on strategies/interventionsExpectations change dependent on the environment, staff, time of day, etc.Trying to catch youth being “bad” (punishment focus)

Residential Facility Demographics

Residential SchoolFor students with severe EBD referred by schools, mental health agencies, and the courts1 – 12 grades½ Year 1 = 75 students; Year 2 = 75 students11 teachers and 1 staff person per class

Residential Units8 units; 2-3 staff per shiftStudents on-site 24 hours, 7 days a weekStudents eat lunch on the units

But you HAVE to for Residential settings!!!!!

!

As a Team – you …

Residential School/Unit-wide Expectations

Be a STARShow respectTake responsibilityAccept adult directionsRespond appropriately

School

Hallway Bathroom Entrance Library Computer Lab

Transitions to and from

SchoolStairwell

SShow Respect

* Use inside voice* Maintain boundaries* Stay to the right side of the hall

* Clean up after yourself

* Use inside voice* Walk to class* Hold door for those behind you

* Use inside voice* Keep library clean and organized* Stay within the library room

* Use inside voice* Be kind to the computers* Keep computer area neat

* Walk* Stay on sidewalk* Use appropriate language

*Walk on the right side*Hold door for those behind you*Maintain your boundaries

TTake

Responsibility

* Keep hands and feet to yourself* Go directly to class

* Wash your hands* Use time wisely

* Go directly to class* Be on time

* Return books on time* Put books back in correct place

* Keep current computer settings* Print only with permission

* Go directly to school or unit

*Go directly to class*Walk safely*Stay in student area*Keep stairwell clean

AAccept Adult

Directions

* Listen to staff

* Exit when requested by staff

* Stay with staff* Act on first prompt

* Stay with staff

* Wait for teacher direction* Stay with staff

* Stay with staff

* Stay within staff’s sight*Listen to staff/teachers

RRespond

Appropriately

* Walk* Use appropriate language* Report problems to staff immediately

* Answer the knock* Report problems to staff immediately

* Report problems to staff immediately

* Wait your turn to check out books* Report problems to staff immediately

* Keep reward in mind* Report problems to staff immediately

* Speak only with those around you* Report problems to staff immediately

*Report problems to staff immediately*Address others respectfully

Sample School Student Rft.o 5-10 S.T.A.R.s Pens or pencil; One night

homework passo 11-12 S.T.A.R.s 30 minutes of computer access;

Word search book puzzle o 21-30 S.T.A.R.s Leisure books; Teacher helper;

Library helper; Kidz Club accesso 31-40 S.T.A.R.s Blockbuster gift certificate; S.T.A.R

store helper; On-campus lunch with staff of your choice

o 41-50 S.T.A.R.s Movie pass; Bike ride with staff; Garden time with staff

o 51+ S.T.A.R.s Off-campus movie with staff; Off-campus lunch with staff; Picnic in the park with staff

Unit

Entrance HallwayUnit

Activity Living AreaKitchen Dining Area

Privilege Room

Bedrooms Bathroom

SShow Respect

*Enter calmly and quietly.*Wait for those ahead of you to enter before you do.

*Use inside voice.*Enter your room only.*Stay to the right side of the hallway.

*Use appropriate language.*Maintain boundaries.

*Use inside voice.*Keep area clean and organized.

*Keep area neat and clean.*Use only as much as you need.*Wait for peers to exit before entering.

*Use inside voice.*Stay in only for your allotted time.*Keep area clean.

*Enter and exit room quietly.*Keep your belongings on your side of the room.*Ask before touching another’s belongings.

*Knock before entering.*Flush the toilet.*Wash your hands.*Clean up after yourself.

TTake

Responsibility

*Go directly to designated area.*Take a seat and wait for instructions.

*Maintain boundaries.*Go straight to your room.

*Stay in designated area.

*Maintain boundaries.*Put items back where they belong.*Make agreements on seats and tv.

*Clean up after yourself.*Wash your hands.*Do your chores properly.

*Maintain boundaries.*Clean up after yourself.*Use appropriate language.

*Keep your room clean.*Keep only appropriate items in your room.*Keep track of your belongings.

*Use your time wisely.*Report problems before closing the door.

AAccept Adult

Directions

*Enter unit only when staff are present.*Follow directions the first time.

*Follow staff directions the first time.

*Follow directions the first time.

*Move when directed.*Stay within staff’s sight.*Follow staff directions the first time.

*Wait for staff directions before entering.*Stay within staff’s sight.

*Leave when asked to do so.*Clean up when directed.

*Remain in your room when directed.*Exit room when directed.

*Exit upon request.*Clean up when directed.

RRespond

Appropriately

*Use manners.*Report problems to staff immediately.

*Use appropriate language.*Walk quietly.*Report problems to staff immediately.

*Express yourself calmly and in an appropriate manner.

*Take out toys only with permission.*Use your manners.*Report problems immediately.

*Use your manners.*Report problems to staff immediately.

*Use appropriate language.*Follow directions the first time. *Report problems to staff.

*Be polite to roommate and staff.*Follow directions the first time.*Report problems to staff.

*Answer politely when someone knocks.*Report problems to staff immediately.

Sample Housing Student Rft.1-5 S.T.A.R.s Pens or pencils, General school supplies, Candy

6-10 S.T.A.R.s 15 minutes of computer access, Journals, Crayons11-20 S.T.A.R.s Blockbuster gift certificate, On-campus lunch with staff

21-30 S.T.A.R.s Mr. Bill’s helper, Art project with art teacher, Picnic in the park with staff

ResultsSchool – Year 1 - 2 38% decrease in ODRsSchool – Year 1 – 3 42% decrease in ODRSHousing – Baseline – Year 1 30% decrease in behavioral incidentsHousing – Baseline – Year 2 35% decrease in behavioral incidentsCurrently, lower numbers of ODRs and incidents

SET – for the school setting continues to be above minimum 80/80

Focus Groups Staff (teachers and unit supervisors) themes

Promotes positive behavior managementIncentives help with motivationImproved short- and long-term behaviorImplementation suggestions (materials, STAR store, consistency

Student themesFosters transition to less restrictive level of careImprovement in daily livesImproved motivation

* S.T.A.R.S program* Evidence-based interventions implemented with fidelity

* Check in/Check out* Choice-making* Focused positive praise* Intensive academic supports* Targeted group therapy

* Individual functional behavior assessments and intervention plans* 1:1 therapeutic interventions* Medical or mental health crises

Lessons LearnedFacility systems not interested at same time

School first then unitsDisconnected data sources

No baseline school data available, units used own system

24/7 concept a challengeStaff turnover

Training, buy-in, implementation, fidelity

Secondary and tertiary interventions a challenge

For the units

Want to implement?“Leadership team to actively coordinate implementation efforts

An organizational umbrella composed of adequate funding, broad visibility, and consistent political support,

A foundation for sustained and broad scale implementation - those who can coach implementation and train on specific practices,

A system of ongoing evaluation and provision of performance-based feedback to implementers, and

Small group of sites that demonstrate viability”Nelson, Sprague, Jolivette, Smith, & Tobin, 2009, p. 488

Words from the FieldStart small

Obtain endorsement & support at the state level

Link to an ongoing statewide PBS or related initiative

Adapt a data collection & decision model

Incorporate PBS into an existing treatment or discipline model, if compatible

Nelson, Sprague, Jolivette, Smith, & Tobin, 2009

Contact:

C. Michael Nelson, Ed.D.cpdmiken@email.uky.edu

Kristine Jolivette, Ph.D.kjolivette@gsu.edu