Tag Archives: School Counseling

School Counseling

The case for universal mental health screening in schools

By Emily Goodman-Scott, Peg Donohue and Jennifer Betters-Bubon September 5, 2019

When I (Emily) was in elementary school, I vividly remember being screened for scoliosis. One day, all the students in my fifth-grade class marched down to the school library, and one by one, we were each briefly and privately evaluated by the school nurse. This was a form of universal screening: systematically screening every student for given criteria.

Universal screening continues to be commonplace today in our pre-K-12 schools. In education, we screen all students for academics: Are they reading on grade level? We screen all students for key health-related factors: Could their hearing or vision be impeding their academics? We provide universal screening for a variety of factors that can affect students’ school success … but what about screening for mental health?

Mental health concerns are prevalent in society, with approximately 80% of chronic mental health disorders beginning in childhood. The National Academy of Sciences estimates that 14% to 20% of youths each year are diagnosed with mental, emotional or behavioral mental health disorders. In addition, we are seeing substantial stress in childhood and adolescence. According to Dr. Sandra Hassink, a former president of the American Academy of Pediatrics, approximately one-third of children display signs of stress, while more than half of college students report overwhelming anxiety. Hassink categorizes stress as the “top health problem facing kids today.”

In addition to stress and anxiety, we remain concerned about the rates of suicide, self-harm, depression and school violence among pre-K-12 students. Despite the prevalence of mental health concerns, only 45% of youths with a diagnosis receive treatment. And less than 25% of those youths receive any form of treatment in the schools, despite the overwhelming evidence supporting early prevention and intervention.

In schools, it is often easier to identify externalizing behaviors such as aggression and rule breaking rather than internalizing behaviors such as depression, anxiety, isolation, suicidal ideation and so forth. In fact, in a 2008 study, Catherine Bradshaw, Jacquelyn Buckley and Nicholas Ialongo found that students with internalizing behaviors were substantially underserved in pre-K-12 schools compared with their peers with externalizing behaviors. This suggests that students with internalizing behaviors may fly under the radar of school staff, making them less likely to be identified and, thus, less likely to receive services.

Given the prevalence of mental health and behavioral concerns in students and the gaps in adequately identifying and serving students with elevated needs, there has been a call for change in pre-K-12 schools. After the devastating school violence and loss of life at Sandy Hook Elementary School in 2012, the Connecticut Office of the Child Advocate conducted a thorough investigation and made recommendations, the first of which was screening every student in a particular class, grade, school or district for criteria related to mental health or social/emotional indicators. Universal screening, also known as universal mental health screening (UMHS), has been recommended by a plethora of organizations, including the 2002 President’s Commission on Excellence in Special Education, the National Association of School Psychologists, the Institute of Medicine, the American Academy of Pediatrics, and A Framework for Safe and Successful Schools, which was authored or co-signed by a wealth of educational and mental health organizations.

Furthermore, burgeoning research supports the implementation of school-based UMHS, suggesting that it can increase the likelihood of identifying students with internalizing behaviors. Many of the schools we have talked to have echoed this sentiment, saying that after implementing UMHS, they identified students struggling with internalizing concerns who previously had not been identified by either the school or the family and thus were not receiving services. UMHS can help pinpoint student needs that are beyond the awareness of school staff and parents or guardians, thus ensuring that fewer students fall through the proverbial cracks.

Schools and school districts nationwide are considering UMHS, with more and more schools beginning implementation. At the same time, successfully facilitating this practice requires significant planning and time initially and having a system of resources readily available to serve the students, once identified. In 2018, the National Center for School Mental Health at the University of Maryland created a guide for operationalizing the steps to UMHS. We’ll describe those steps. 

Operationalizing UMHS

Step one: Create a multidisciplinary team and secure buy-in from key stakeholders. The UMHS team is responsible for designing and coordinating UMHS implementation. Because of the systemic nature of the process and the plethora of responsibilities, implementation should truly be a team effort rather than falling on one or two staff members. Team members could include school-based mental health providers such as school counselors and licensed mental health counselors, as well as school psychologists and school social workers. It is also important to include school-based and district-level administrators on the team, both for their expertise in school leadership and resource availability and to gain their buy-in. Some teams might have other stakeholders such as family members, school nurses, teachers, resource officers, and related community partners join the team to offer their unique perspectives. It might be helpful to develop district-level teams to discuss districtwide protocol and resources.

Once the team is assembled, it should collaborate with key stakeholders to gain momentum, support and resources. This buy-in can be developed by educating key stakeholders on the purpose and research behind UMHS and how UMHS can meet the specific needs of the school or district. The team can analyze the current concerns of the school or district by gathering corresponding data: Are students’ mental health needs being adequately identified and met? What are the most pressing issues in the school or district? For instance, has there been an increase in student suicide attempts or drug-related suspensions and use in the school and community? Is the team interested in prevention efforts to better identify students with internalizing concerns such as anxiety or depression?

Many of the schools and districts with which we have corresponded have reported that UMHS was supported and even driven by influential district-level stakeholders, such as a superintendent. It is important for counselors to understand that gaining buy-in for UMHS can take years and that it requires purposeful advocacy and education. When attempting to gain stakeholder buy-in, team members may find it fruitful to present UMHS as a tool to meet existing district priorities such as improving students’ social/emotional learning, enhancing college and career readiness, and removing barriers to learning.

Also, rather than presenting UMHS as “one more initiative,” team members can ask how this practice might tie into other programs that already exist in the school or district. UMHS is often implemented as part of multitiered systems of support (MTSS) such as response to intervention and positive behavioral interventions and supports. MTSS is widely implemented in all states nationwide, and its tiered focus on prevention for all students and identification and intervention for those with elevated needs is a natural fit with UMHS. Thus, teams could discuss UMHS within their school’s or district’s existing MTSS practices. Furthermore, in an effort to work smarter, not harder, consider whether an existing student support team is in place that could oversee UMHS, rather than creating a new team to do this.

This first step of garnering key stakeholder support may take some time. We’ve seen that using data to highlight school needs and connecting UMHS to district priorities and current programs generally assist with stakeholder buy-in.

Step two: Clarify the goals and purpose. Once the UMHS team is developed and has gained buy-in from instrumental stakeholders, the next step is confirming the goals and purpose of UMHS. During this step, the team can work with key stakeholders to continue reviewing school/district data and confirming the goals for UMHS. What is important to the stakeholders and the district? What are the most pressing needs for the school or district? It may take some time to reach consensus on the greatest need in the school or district.

Step three: Discuss resources and logistics. UMHS takes considerable planning as the team maps out its processes and procedures. Thus, much of the work for UMHS is done on the front end. Each school or district has unique needs and resources, so there is no one-size-fits-all approach for implementing UMHS. One question the team might ask during this step is which students are currently being screened or should be screened moving forward. We’ve seen some schools that screen for suicide and depression in high school health classes across all students, whereas other schools screen more broadly for strengths and difficulties at multiple grade levels, such as third, seventh and 10th grades. Still other schools may have the resources and desire to screen across every grade K-12. The answer to which students to screen may be based on a school’s or district’s resources and its driving purpose behind implementing UMHS.

Another consideration is garnering the support and consent of parents and guardians. First, the team might consider the overall readiness of parents and guardians for UMHS. Some schools recommend holding educational sessions for parents and guardians in which de-identified school-level data on student needs is provided, along with the rationale for using UMHS to meet those student needs. This may be a helpful time for the team to normalize mental health and UMHS by making comparisons to other school-based screenings for reading level, hearing, vision and so forth.

We also recommend demystifying UMHS by describing the procedures and perhaps showing examples of successful UMHS processes in other schools or districts. These information sessions can also describe how parents and guardians will be notified of their child’s results, especially for children identified with elevated needs. We have witnessed that parents and guardians are often supportive of UMHS when provided with ample and appropriate education and awareness, and when consideration is given to the unique culture of each school community.

Once schools have gained buy-in from parents and guardians, UMHS teams should engage in the consent process. Many schools have found success with a passive consent, notifying parents and guardians about UMHS through several means (email, automated phone calls, letters home, social media, etc.) and communicating that students will be included in the UMHS process unless the parent or guardian completes an opt-out form by a specified date.

When it comes to discussing resources and logistics for UMHS, two questions usually take precedence: How much will UMHS cost, and how much time will UMHS require? The UMHS team should work hand-in-hand with stakeholders, especially administrators who oversee the school or district budget and schedule, to address these concerns. School staff with whom we’ve spoken have reported that UMHS does take time and can have associated costs, especially in the beginning. However, these staff members have also expressed that the cost and time were absolutely worth it.

One cost associated with UMHS is the assessment or screener being used (we will discuss this in greater depth later in the article). Regarding time, the UMHS team should discuss how the school staff will be involved and the training required for their involvement. For example, who will administer and score the assessments/screeners? Who will communicate the results? Who will notify parents and guardians of elevated scores?

When considering time and costs, the UMHS team should also evaluate available resources for providing services to students identified with elevated needs. What school-based services will be offered? What referrals will be made for outside services? Teams typically map out the existing resources available within the school or district, as well as current and possible external partnerships. In anticipation of an increase in identified students and, thus, needed services, these partnerships and referral sources should be explored and confirmed prior to screening. In addition, teams need to create a plan for services based on student need and the level of immediacy (e.g., same-day supports for immediate/critical needs versus same-week supports for moderate needs). Relatedly, some schools secure grants and Medicaid funding to finance provision of services in the schools by community-based mental health professionals.

Other questions that come up frequently center on the issue of liability. For example, schools often ask us:

  • “What if we identify students with elevated needs, such as suicidal ideation, and the parents or guardians refuse services?”
  • “What if we have more students eligible than we have available services?”
  • “Legally, how do we document these results?”
  • “Regarding confidentiality: which school staff members should be aware of the results?”
  • “Do the results become part of a student’s permanent file?”

These are important questions to consider and talk through with the UMHS team, especially administrators and the school district’s legal experts. By establishing clear district policies and defining protocols proactively, the UMHS team can get ahead of many of these concerns. Furthermore, small-scale pilot screening can help teams predict schoolwide prevalence of students who will need intervention. Collecting and sharing de-identified screening data can also be an essential step in advocating for additional services and resources. 

Another important logistic to consider is time. As mentioned, teams usually spend considerable time planning for UMHS implementation, including designing a timeline. Within this timeline, teams often consider conducting a pilot screening, testing UMHS with a small sample of the school, such as a class in each participating grade. After this pilot, schools can collect feedback on the screening to guide changes to the process and procedures before rolling out UMHS throughout the school or district.

The team might also consider the time of year, week and day that UMHS will be implemented. It is often recommended to begin UMHS toward the start of the school year but to allow enough time for students to settle into their new routines and for students and teachers to have built rapport. This also provides time for follow-up screening to occur after the initial baseline. In addition, screening could take place early in the day, such as during an advisory or home room period, and early in the week. This allows time for immediate follow-up, particularly for students identified as having high needs. It also allows time to reach out to the student, parents or guardians, and school-based and community-based resources. In fact, some schools align their UMHS schedules with the availability of internal and external referral sources to ensure that mental health providers are on standby to assist immediately if needed.

Step four: Select a screening tool. Selecting an appropriate screening tool is a crucial aspect of UMHS. Because no two schools are alike, each team should consider its school’s specific needs, culture and resources. The National Center for School Mental Health recommends asking the following questions when considering screening tools:

  • Is the tool reliable, valid and evidence-based? In other words, has the tool been empirically tested and backed by research? Similarly, was this tool normed on a population that is similar to the school or district population? We want a tool that is culturally appropriate, valid and reliable, and, thus, as accurate as possible.
  • Is the tool free, or can it be purchased for a reasonable cost? Tools have a range of costs, which is important to consider based on the school’s or district’s budget and the number of students completing the tool.
  • How long will it take to administer and score the tool? Time is a precious commodity in education. Thus, the UMHS team should investigate the possible options for administering and scoring tools. Although paper-and-pencil tools exist, schools often prefer administering screening tools through online means (e.g., Google forms) or Scantrons. Electronic administering and scoring can lead to fewer errors and faster results.
  • Does the tool come with ready access to training and technological support for staff? As mentioned earlier, staff need to be trained on UMHS procedures, including administering and scoring screening tools. Furthermore, most tools have educational requirements, such as a master’s degree in specific fields, associated with administering and scoring them. Hence, some schools and districts have determined that school psychologists or school counselors are responsible for administering and scoring the tools because of their training and expertise.
  • Does the tool screen for what the school or district wants to know (e.g., type of mental health or behavioral concern)? Specifically, do the goals and purpose of the UMHS process align with the aim of the screening tool? If a school’s goal is to screen for internalizing mental health concerns (e.g., depression, anxiety, self-harm, suicidal ideation), does the selected tool actually screen for those concerns?

It is important to note that the developmental age of students should be considered when selecting a screening tool, as should the type of administration. Some tools are self-reports completed by the students, whereas other tools are completed by teachers or parents and guardians (this is especially the case when screening younger students). It is also important to discuss the meaning of specific scores for each tool in advance of data collection and analysis. For instance, what score constitutes a high risk in need of immediate follow-up? What score constitutes a moderate risk, and when should follow-up occur? What score constitutes little or no risk?

The following list includes common UMHS tools:

  • Systematic Screening for Behavior Disorders: Screens for internalizing and externalizing concerns (K-9)
  • Student Risk Screening Scale: Screens for seven externalizing behavioral criteria (lies, cheats, sneaks; steals; behavior problems; peer rejection; low academic achievement; negative attitude; and aggressive behavior) three times per year (K-12)
  • Behavior Assessment System for Children, Third Edition: Behavioral and Emotional Screening System: Identifies students with needs in both academic and social domains, including internalizing problems, externalizing problems, school problems and adaptive skills (pre-K-12)
  • Strengths and Difficulties Questionnaire: Screens broad behavioral domains, including emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior (K-12)
  • Resiliency Scales for Children and Adolescents: Profiles personal strengths and vulnerability (ages 9-18)

Step five: Collect data, analyze and follow up. After implementation of the screening tool, UMHS teams will engage in data collection, analysis and follow-up according to their individualized plans. Follow-up may include further evaluation and services for students with elevated needs. It may also include monitoring students with elevated needs and providing additional screening at different points during the school year and subsequent school years. As emphasized by the National Center for School Mental Health, it is imperative that students with high risk to themselves or others receive follow-up the same day.

UMHS and counselors

Both school counselors and licensed mental health counselors (LMHCs) can play active roles in UMHS in several ways. First, school counselors run comprehensive school counseling programs that provide a range of student services, including direct counseling services. School counselors also provide consultation and collaborate as members of student support teams and schoolwide leadership teams. Thus, school counselors should be active members of their respective UMHS multidisciplinary teams, helping to design and implement the screening process, and sharing their expertise on mental health, equity, data-driven practices and culturally responsive systemic change. As part of a UMHS team, school counselors may also assist with analyzing the screening data, referring students to mental health services, and engaging in progress monitoring and continued evaluation. School counselors may also provide counseling services, although their counseling should be short term and time bound.

LMHCs can also be involved in UMHS screening in a variety of ways. School-based or community-based LMHCs may be invited to be members of a UMHS team because they can provide expertise on mental health needs and the services available in the school and community. In addition to consulting and collaborating on screening procedures and data analysis, LMHCs can provide further evaluation and long-term and crisis counseling to those students identified with elevated needs.

Again, we emphasize that counselors’ roles, and the corresponding procedures and services, may be different based on each school’s or district’s culture, resources and needs.

Challenges and benefits

There are both challenges and benefits to implementing UMHS. Among the challenges, there is no denying that screening takes time, resources, stakeholder support and substantial planning. The stigma surrounding mental health issues can also test stakeholders’ willingness to implement UMHS in schools. In addition, some educators and legislators have voiced concerns that UMHS could lead to the overdiagnosis and unnecessary stigmatizing of students, giving them labels that could last a lifetime.

School leaders are often hesitant to initiate a UMHS program if they lack the resources to meet identified needs without collaborating with outside agencies. Some school administrators in rural areas indicate that school-based mental health services are the only such services available for most families. Teams working to implement UMHS must be prepared to address resistance to universal screening in their communities as part of the implementation process. Hence the importance of seeking early education and buy-in.

At the same time, UMHS is associated with a wealth of benefits, including:

  • Prevention and early identification and treatment of mental health and behavioral concerns
  • The use of data to guide mental health interventions
  • A comprehensive approach that encourages systemic thinking and breaks down school/community/family silos
  • Collaboration across school-based mental health providers and between school-based and community-based mental health providers
  • Greater normalization and awareness of mental health issues within the schools

Schools and school districts have told us that implementing UMHS is worth the associated challenges. Many school-age youths struggle with mental health and behavioral concerns, yet their struggles are not always identified or treated, leading to larger long-term concerns. Because of the climbing rates of school violence, anxiety, depression, self-harm and suicide among our youths, we need a better system. We need a system in which fewer youths fall through the cracks. We need a system in which more youths are identified earlier and more accurately. We need a system that is comprehensive and that works. 

****

For more information, we suggest the following resources:

  • The School Counselor’s Guide to Multi-tiered Systems of Support edited by Emily Goodman-Scott, Jennifer Betters-Bubon and Peg Donohue (2019, Routledge). This book discusses aligning comprehensive school counseling with MTSS, devoting a chapter to UMHS.
  • The SHAPE System (theshapesystem.com): The School Health Assessment and Performance Evaluation System is a free, private, web-based portal that offers a virtual workspace for school mental health teams to document, track and advance quality and sustainability improvement goals and to assess trauma responsiveness.
  • National Center for School Mental Health (csmh.umaryland.edu): The center is committed to enhancing understanding and supporting implementation of comprehensive school mental health policies and programs that are innovative, effective, and culturally and linguistically competent across the developmental spectrum (preschool to postsecondary) and three tiers of mental health programming (promotion, prevention, intervention).
  • Systematic Screenings of Behavior to Support Instruction: From Preschool to High School by Kathleen Lane, Holly Menzies, Wendy Oakes & Jemma Kalberg (2012): The authors show how systematic screenings of behavior, used in conjunction with academic data, can enhance teachers’ ability to teach and support all students within a response-to-intervention framework.
  • School-Wide Universal Screening for Behavioral and Mental Health Issues: Implementation Guidance (tinyurl.com/OhioPBISGuide): This document provides a general overview of considerations in implementing UMHS for behavioral and mental health issues.

 

****

 

Emily Goodman-Scott is an associate professor, graduate program director and school counseling coordinator in the counseling program at Old Dominion University in Virginia. Prior to that, she was a school counselor and special education teacher. She is passionate about advocating for lower caseloads and greater resources for school counselors and schools. Her research interests include a range of school counseling topics such as multitiered systems of support (MTSS), counselor education, and counseling exceptional students. Contact her at egscott@odu.edu or on Twitter: @e_goodmanscott.

Jennifer Betters-Bubon is an associate professor of counselor education at the University of Wisconsin-Whitewater. Previously, she was an elementary school counselor for 11 years and a special education teacher. In addition to teaching future counselors, her work focuses on data-driven practice, advocacy and leadership in transforming the role of the school counselor within culturally responsive MTSS. Contact her at bettersj@uww.edu.

Peg Donohue is an assistant professor of counseling at Central Connecticut State University (CCSU) in the Department of Counseling and Family Therapy. Before joining the CCSU faculty, she spent 16 years working as a school counselor in Connecticut and California. Her primary research interests include fostering social and emotional learning, aligning school counselor preparation with MTSS, and universal screening for mental health concerns in schools. Contact her at peg.donohue@ccsu.edu.

 

For more resources and conversations on UMHS, follow the authors on Twitter:
@SchCouns4MTSS and Facebook: School Counselors for MTSS.

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

One school counselor per 455 students: Nationwide average improves

By Bethany Bray May 10, 2019

Although America’s average student-to-school counselor ratio is improving, it is still higher than what is recommended by the American School Counselor Association (ASCA) and some states lag far behind the national mean.

Across the U.S., there is an average of one school counselor for every 455 public K-12 students. This is an improvement over last year’s average of 464-to-1 and the narrowest margin the ratio has been in three decades, according to ASCA.

However, the nationwide average remains far above ASCA’s recommended ratio of 250 students per school counselor. Individual state ratios also vary widely, ranging from 202-to-1 in Vermont to 905-to-1 in Arizona.

“Given the prevalence of school shootings, increasingly intensified natural disasters and rising suicide rates among youth, there has never been a more critical time to ensure that students have access to school counselors,” says American Counseling Association President Simone Lambert. “Our children deserve the opportunity to reach their academic potential to prepare for future careers, while attending to mental health concerns. School counselors play a vital role in supporting students who have mental health concerns, which challenge students’ daily life functioning and school success.”

ASCA compiles a report each year on student-to-school counselor ratios based on data from the federal government. The Virginia-based nonprofit’s latest report, released this week, included data from the 2016-2017 school year, which is the most recent information available.

 

According to the report:

  • States and territories with the lowest student-to-school counselor ratios include Vermont (202-to-1), U.S. Virgin Islands (213-to-1), New Hampshire (220-to-1), Hawaii (286-to-1), North Dakota (304-to-1), Montana (308-to-1), Maine (321-to-1) and Tennessee (335-to-1).

 

  • States and territories with the highest student-to-school counselor ratios include Arizona (905-to-1), Michigan (741-to-1), Illinois (686-to-1), California (663-to-1), Minnesota (659-to-1), Utah (648-to-1), Puerto Rico (571-to-1), Idaho (538-to-1), the District of Columbia (511-to-1), Washington (499-to-1), Oregon (498-to-1) and Indiana (497-to-1).

 

  • Alabama was the most improved state, adding 269 new school counselors and decreasing the student-to-school-counselor ratio 15% (to 417-to-1).

 

  • Wyoming lost more than 100 school counselors (76 secondary-level counselors and nearly 70 at the elementary level). As a result, the state’s student-to-school counselor ratio increased 52% from ASCA’s last report, from 225-to-1 to 343-to-1.

 

****

 

Access the full report with a state-by-state breakdown on the ASCA website: schoolcounselor.org

 

 

The American Counseling Association’s School Counselor Connection page: counseling.org/knowledge-center/school-counselor-connection

 

From the Counseling Today archives in 2017: “U.S. student-to-school counselor ratio shows slight improvement

 

Statistics on mental health and American youth:

 

 

Bethany Bray is a senior writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at facebook.com/CounselingToday.

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Behind the Book: Critical Incidents in School Counseling

Compiled by Bethany Bray April 22, 2019

“There is no amount of preparation that fully prepares you for what happens in the classroom or on the job,” writes Heather J. Fye, co-editor of the third edition of Critical Incidents in School Counseling, in the opening chapter of the book.

A school counselor’s graduate degree and academic training serve only as a base for the continuous learning that happens on the job — in classrooms, via interactions with students, via collaboration with colleagues, and through professional development. Teachable moments, Fye writes, can happen both spontaneously and as planned elements of time spent with students.

As much as school counselors grow, learn and evolve on the job, the discipline itself continues to change. With this in mind, co-editors Tarrell Awe Agahe Portman, Chris Wood and Fye recently updated Critical Incidents in School Counseling to reflect an ever-changing landscape that now includes challenges such as cyberbullying. The American Counseling Association published a third edition of the book in December 2018.

Portman is dean of the College of Education at Winona State University; Wood is an associate professor in the counselor education program at the University of Nevada, Las Vegas; and Fye is an assistant professor at the University of Alabama.

CT Online sent the trio some questions, via email, to learn more.

 

Q+A: Critical Incidents in School Counseling

Note: Responses co-written by Portman, Wood and Fye.

 

In providing case studies, one of the goals of the book is to bridge the gap between the academic learning that school counselors receive in graduate school and in-the-moment practical experience. Besides using your book, what else do you suggest to help school counselors bring themselves up to speed?

School counselors need to be lifelong learners, continually reading professional literature and attending professional development [opportunities] such as workshops and conferences. One of the added features of the new edition of the book is that a list of resources is included by the authors [of each chapter] in response to the critical incidents. These resources include additional reading on the topic, websites with tools and information on the specific topics, and resources from professional organizations such as ACA and the American School Counselor Association.

Small steps are important. It is important for school counselors to find supports within the counseling community. If school counselors are unfamiliar with other school counseling professionals in their school district or surrounding areas, it may be helpful to reach out to them.

It may be helpful for school counselors to attend a local, regional or national conference or take part in volunteer activities, as time permits, from a counseling organization. If national involvement does not seem possible, start with the local or state chapters [of professional organizations]. State school counseling organizations or chapters often have excellent websites, newsletters and resources available.

Lastly, networking with school counselor educators at the university level may provide engaging and collaborative opportunities between counseling professionals.

 

Fill in the blank: I wish I had known ________ when I was in my first year as a school counselor. What would you want to share with new or soon-to-be school counselors who might be reading this?

Chris Wood: How much I still had to learn.

Much of this is not because of inadequate training. It is just due to the incredible demands on professional school counselors and that the unique and ever-changing needs of students and schools make any new school counselor face a challenging learning curve. So, I would want new school counselors to recognize the importance of constantly improving their knowledge, awareness and skills through professional development.

Heather Fye: How I fit in to making a difference in the lives of students.

Do not just accept the status quo. Change takes time. Remember why you became a school counselor and try to do something — even five minutes each day — that aligns with your passion. You know yourself best.

Tarrell Awe Agahe Portman: More about policies, procedures and standards which directly impacted student success.

I would want new school counselors to feel reassured of their purpose and influence on the lives of generations to come. This can be overwhelming but is really just a part of the circle of life.

 

School counselors might be the only counselor in their building, working with educators and helping professionals who have different licensure and training. What advice would you give to school counselors about remaining true to their counselor identity?

Professional school counselors should draw their identity from their training and certification/licensure, not from how others in the building may perceive them. Certainly, there are many threats to the identity of professional school counselors that could push them into tasks or actions that are inconsistent with their training or even their ethical standards. An obvious example is the fact that school principals may want school counselors to engage in activities that help fulfill some school need but ultimately inhibit the professional school counselor’s effective functioning.

Staying connected to the profession, reading the professional literature — including research — and regularly attending professional development that is specifically targeted toward school counselors can help buffer the negative effects of those who don’t understand a professional school counselor’s role.

Professional school counselors should remember to reflect upon why they wanted to become a school counselor, stay aware of positive changes in schools from their school counselor program, and stay true to their training and self as a professional.

School counselors gain many techniques throughout their graduate training that can help them build professional relationships. Finding supports, staying connected with others who want to make a positive impact in the school setting, and [engaging in] continuous learning through professional development can be integral to self-care as well as professional identity.

 

The last edition of this book was released in 2000. What prompted a new edition? Why is it relevant and needed now?

Societal changes and new demands on school counselors created the demand for the new third edition of the critical incidents text. It was 27 years between the first edition and almost 20 years between the second edition and this newer third edition. So, one of the reasons for a new edition is a need to provide incidents that are more contemporary, embedded in the current school climate, and [which] address incidents based on the current generation of students.

Just the advances in technology since the last book highlight the different world that students live in today. When the second edition of the text came out there, was no Facebook or Myspace — these came several years later — and the word cyberbullying wasn’t a common concept. By 2006, there was some research to suggest that cyberbullying was affecting almost half of all American teens. So, obviously, the rapidly changing world of students in schools warrants a book that can help school counselors respond to critical incidents.

The original rationale for the first two editions is still relevant: to assist school counselors and school counselors-in-training with knowledge, critical thinking and related resources in order to respond to the many critical incidents that they face in their career.

Importantly, in this newest edition, we focused on having school counselors author the incidents and used experts with actual school counseling experience to author the responses. We felt that this would help lend the book toward offering more pragmatic learning and direct application to professional practice.

 

What do you hope readers will take away from the book?

Hopefully, readers will be able to relate their own professional practice to many of the critical incidents in the book and leave with two takeaways.

1) We hope the readers will feel validated in what they are experiencing on the job and benefit from multiple perspectives in addressing professional challenges.

2) We hope the readers will feel greater confidence in relying on their own knowledge [and] awareness and put their skills into direct action that benefits students. Reading the incidents and responses is intended to help school counselors improve their ability to problem-solve situations, advocate for themselves and their profession, build a foundation in peer consultation, and engage in ongoing professional development.

 

The landscape of school counseling is ever-changing. Do you feel graduate programs across the U.S. are keeping up?

Yes, in the case of graduate programs that maintain the highest levels of accreditation, train their students in the most current models of evidence-based practice, and teach students to apply their learning in innovative ways. Such programs are equipping their students to face changes and challenges that we can’t even name yet.

In general, there is a progressive movement happening in graduate programs across the U.S. However, there continues to be a disconnect between schools and universities — counselor or educator. School counselors have many demands, and this is true for university faculty as well. So, there may always be a need to produce books and other resources that can help bridge the knowing-doing gap between what school counselors learn in graduate programs and the practical application of such learning in an ever-changing landscape.

 

****

 

Critical Incidents in School Counseling is available both in print and as an e-book from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-347-6647 ext. 222.

 

 

****

 

Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

 

Follow Counseling Today on Twitter @ACA_CTonline and Facebook at facebook.com/CounselingToday.

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

Promoting LGBTQ students’ well-being in schools

By Roberto L. Abreu, Adriana G. McEachern, Jennifer Geddes Hall and Maureen C. Kenny October 2, 2018

Research shows that LGBTQ youth are disproportionately bullied (whether in person or via cyberbullying), verbally and physically harassed, and assaulted in schools by peers and staff. Such hostility has been correlated to lower school performance and psychological and emotional distress, including suicidal ideation and attempt, depression and anxiety.

In the 2015 GLSEN (formerly Gay, Lesbian & Straight Education Network) National School Climate Survey, LGB students reported higher levels of verbal, physical and sexual violence and bullying than did their heterosexual counterparts. Specifically, 98.1 percent of LGB students heard the word “gay” used in a derogatory manner, 85.2 percent reported verbal harassment, and 34.7 percent reported being physically harassed in the past year. In addition, a 2017 meta-analysis (conducted by co-authors Roberto L. Abreu and Maureen C. Kenny) of 27 empirical studies on the effects of cyberbullying on LGBTQ youth revealed that compared with their heterosexual and cisgender counterparts, these students are disproportionately harassed online and through other technology-based means. Such harassment has been correlated to a range of behavioral and emotional difficulties, including suicidal ideation (with some studies suggesting rates as high as 40 percent among LGBTQ youth) and suicide attempts (with rates as high as 30 percent).

Many LGBTQ students identify school counselors as the one school staff member to whom they are most likely to disclose concerns related to their sexual and gender identity. Given this reality, school counselors are uniquely positioned to address myths about LGBTQ youth, to advocate for these students and to effect change.

Dispelling myths

Let’s begin by examining five myths that can have an impact on the identity, safety and well-being of LGBTQ youth. We’ll also look at specific strategies and interventions that counselors can use to address these myths and increase the safety of LGBTQ students.

Myth #1: Parents must be informed of their child’s sexual and gender identity. A 10th-grader discloses to her high school counselor that she identifies as a lesbian. Most of her friends know, but she has yet to tell her parents. She fears their reaction because she has heard them make derogatory remarks toward LGBTQ individuals in the past. Must the school counselor inform the student’s parents?

The American School Counselor Association (ASCA) National Model (2012) stresses the importance of parent and family involvement and its influence on the well-being of students. Although parent engagement is critical when working with LGBTQ youth, school counselors should consider several factors before disclosing to parents a student’s sexual or gender identity. Many LGBTQ students believe they lack parental support, and they may fear rejection, abuse and an unsafe home environment if their parents discover their sexual or gender identity.

Therefore, the counselor in this scenario should first discuss with the student her feelings about informing her parents and assess how they may react to this information. It would be important for the counselor to prepare the student for potential negative parental responses. Role-playing the conversation could be helpful for the student. It would be best to have the minor client make the disclosure to her parents with the counselor present to provide support. It is also important to have a plan in place to provide the client with a safe place to stay should the parents totally reject her and need time to adjust to the situation.

In certain instances, school counselors may have to break confidentiality. For example, what if the student also disclosed to the counselor that she was distraught over the situation and was having suicidal thoughts and feelings of hopelessness because she feared that her parents would never understand or accept her sexual and gender identity? In that situation, there would be potential harm and danger to the minor client. Therefore, the counselor would need to conduct a thorough suicide assessment, then inform the client of the legal and ethical reasons that confidentiality must be breached.

It is important for counselors to check their schools’ policies and procedures in relation to dealing with crisis situations such as suicide. School counselors can work with parents individually or in groups to foster awareness and acceptance of LGBTQ students and to promote understanding of their needs and the challenges these students face every day.

Myth #2: Gender-neutral facilities are a threat to school safety. A school district policy does not allow transgender students to use the restroom that corresponds to their gender identity. A transgender student has brought this to the attention of the school counselor, inquiring about what to do. The student says he often goes the entire school day without going to the restroom.

School counselors should use their role as staff and educators to speak to the school administration about this issue. In talking to school administrators, counselors can present research related to transgender students experiencing a lack of safety in schools and make the argument that forcing these students to use a bathroom that does not align with their gender identity only contributes to this presenting concern.

Some states have passed laws precluding gender-neutral facilities, imposing on the rights of transgender individuals to use the restroom that corresponds to their gender identity rather than their sex at birth. Some of these laws have been incorporated into school policy. The rationale given for these laws has been to protect public privacy and safety. However, there is no research evidence to support this claim.

In 2015, Media Matters for America conducted a survey of 17 school districts in 12 states encompassing approximately 600,000 students. The survey asked about cases of harassment or inappropriate behavior after transgender-inclusive policies had been passed in those districts. The survey results concluded that no incidents of sexual harassment or inappropriate behavior had been reported in those schools, debunking the myth that gender-neutral facilities are a threat to school safety.

Counselors, as social justice agents, must involve themselves in policy. This can be done at school meetings, where counselors can advocate for gender-neutral policies in schools and school districts. Counselors can inform school administrators of their interest in participating in these meetings and being involved in the decision-making process. They can volunteer to conduct information sessions for meeting participants about the academic, personal and career needs of LGBTQ youth. Counselors should actively seek to advocate for transgender youth so that these students can use the bathroom that best aligns with their gender.

Myth #3: School policies and laws protect all students. School policies and laws have focused mainly on reducing bullying but not necessarily on protecting LGBTQ youth and keeping them safe. The 2015 GLSEN report that investigated anti-bullying policies in the nation’s school districts revealed that out of the 13,181 school districts surveyed, 70 percent had anti-bullying policies. However, only 20 percent of these school districts had LGB-inclusive policies, and only 10 percent had LGBT-inclusive anti-bullying policies.

Although anti-bullying policies may be in place, LGBTQ students continue to report higher incidents of bullying and harassment than do other students. Often, these policies are not widely distributed to students and staff, and although most students and staff may be aware of district anti-bullying policies, they are not necessarily aware of LGBT-inclusive anti-bullying policies. 

Furthermore, policies and laws are often influenced by politics and societal opinions. Laws referred to as “no promo homo” involve efforts to prevent national LGBT education, mandate that administrators take a neutral stance on gender identity and prohibit providing specific services to these students. Although seven states (Alabama, Arizona, Louisiana, Mississippi, Oklahoma, South Carolina and Texas) had “no promo homo” laws as of January 2018, many states are working to develop LGBT-inclusive laws and policies that do not discriminate against these youth. For example, many states have developed LGBT anti-discrimination laws. These laws also permit transgender students to participate in sports congruent with their gender identity.

School counselors need to be proactive and work with school administrators to develop LGBT-inclusive policies. Counselors can assist in disseminating and discussing these policies regularly with students, parents and staff. Counselors should educate school administrators on bullying and “no promo homo” laws so they will better understand the detrimental effects of systemic oppression on LGBT youth.

In addition, school counselors should empower LGBTQ students to share with school staff their experiences with bullying and harassment within the school. This will open the door for school personnel to make a personal connection with these students and will help them learn more about the physical and mental health consequences of LGBTQ bullying and lack of representation.

Myth #4: LGBTQ students are safe around all school personnel. Many LGBTQ students do not feel safe at school — around either other students or school personnel. The GLSEN survey from 2015 reported that more than 50 percent of LGBTQ students heard homophobic comments from teachers and school staff. Many of these students believed that reporting harassment or assaults to school personnel would worsen the situation and that no action would be taken. Among those who did disclose bullying, harassment or assault to school staff, 63.5 percent indicated that their reports were ignored. In addition, when these incidents were reported, LGBTQ students faced harsher discipline than did their heterosexual and cisgender peers and were often blamed for the incidents (see research from Shannon Snapp, Jennifer Hoenig, Amanda Fields and Stephen Russell). This lack of support from school personnel places LGBTQ students at greater risk of being victimized.

In 2017, students in California’s San Luis Obispo High School published an edition of the student paper, Expressions, featuring LGBTQ issues. In response, a special education teacher at the school wrote a letter quoting the Bible and stating that those committing homosexual acts “deserve to die.” The school administration chose not to discipline the teacher for the action, stating that teachers as well as students “do not shed their First Amendment rights” at school. Although the teacher resigned soon after the incident, his statement remains a testament to the harassment and discrimination leveled against some LGBTQ students by school personnel.

School counselors need to advocate for and support LGBTQ students in the face of such victimization. Providing training to all students, parents and school staff is critical to reducing incidents of bullying and harassment and increasing awareness and sensitivity to the issues LGBTQ students confront in schools. A middle school in South Florida developed a monthlong program that focused on bullying prevention, including sexual and gender identity sensitivity training at various levels. At the high school level, counselors are forming LGBTQ support groups to provide outlets for these students to discuss specific issues and concerns. These groups provide one way to let these students know that they are valued and that their voices are important.

Myth #5: Sex education is inclusive of all students. Sex education that is LGBTQ inclusive is very limited or nonexistent in our nation’s schools. Often, this lack of inclusion is due to discomfort and lack of knowledge about LGBTQ sexuality on the part of school personnel, students and parents. Many teachers do not feel competent to teach on the topic.

Traditionally, sex education in U.S. schools centered on an abstinence-only curriculum. This ideology changed somewhat in the 1980s because of the AIDS epidemic, the increase in sexually transmitted diseases and teen pregnancy. The curriculum during this time focused on prevention and contraception, but no content was included on LGBTQ sexuality. In the 1990s, there was an effort to develop national guidelines for comprehensive sex education by the Sexuality Information and Education Council of the United States, a task force composed of educators and health professionals. However, these guidelines also lacked specific and clear directives on how to address the needs of LGBTQ students in schools.

Health care reform legislation in 2010 provided states with funding to draft comprehensive sex education in schools. One of the programs created from this initiative was the Personal Responsibility Education Program for young adults. Once again, however, this program
failed to offer educational content or policy language that was inclusive of LGBTQ students.

Given this reality, school counselors can take leadership roles in advocating to administrators and teachers on the importance of including educational information and materials about LGBTQ sexuality in the sex education curriculum. Counselors may need to ensure that the programs being used to teach sexuality are inclusive. Counselors can assist health educators by providing appropriate materials (see hrc.org/resources/a-call-to-action-lgbtq-youth-need-inclusive-sex-education for more information on LGBTQ-inclusive sex education). Counselors can also conduct psychoeducational workshops to dispel myths and misconceptions regarding LGBTQ students with all stakeholders, including students, school staff and parents.

 

A call to action

Clearly, the perpetuation of these myths indicates that something more needs to be done to better support LGBTQ students within school systems. School counselors, as outlined by ASCA, have an ethical obligation to support underserved and oppressed populations. Additionally, school counselor training programs emphasize the role of school counselors as agents of change within the school system and professional leaders who must act as allies and advocates for all students.

This role includes:

  • Being aware of the challenges that LGBTQ students face within the school system
  • Designing a developmental, comprehensive school counseling program to support the LGBTQ student population
  • Advocating for policies and practices that address inequities regarding academic, career and social/emotional domains for LGBTQ students 

Therefore, supporting LGBTQ students and promoting social justice initiatives should be done through large-scale, small-scale and individual interventions in an effort to create a positive school climate for everyone.

Readiness assessment

The first step is to conduct a needs and readiness assessment. This assessment should focus on gauging the school’s current climate related to LGBTQ students and the willingness of staff to make needed changes. Assessments should target students, faculty, staff and parents. Their openness toward acceptance and making changes, as well as the amount of education and training they have received related to LGBTQ populations, is important to assess.

Parents and school personnel may be reluctant to support LGBTQ youth in part because they do not feel prepared to respond to the unique needs of these students. School counselors will need to collaborate and discuss concerns with all stakeholders to comprehensively make appropriate systemic changes. These conversations also allow school counselors to gain awareness of current school policies and procedures related to the treatment of LGBTQ students.

Additionally, before changes can begin, school counselors should collect data that may be reflective of disparities and issues that LGBTQ students face within the school. Such data may include behavioral referrals, truancy rates and negative changes in grades and attitudes/behaviors. Behavioral referrals should be more specific and include incidents of verbal and physical harassment that LGBTQ students have endured as well as LGBTQ students who might be “acting out” in class in reaction to bullying or oppressive interactions.

LGBTQ students who are lacking support and involved with negative interactions often are truant, report somatic complaints and disengage from the learning process. It is therefore important that school counselors collect and examine data concerning absenteeism, visits to the school nurse, incidents of skipping class and dropping grades. This data should be saved and used as well during the measurement of formative and summative program success. This information will help inform what needs exist and how the school can best support LGBTQ students in dealing with their struggles.

It is important to note here that when collecting and analyzing data, counselors should look for patterns and then meet with students individually, regardless of their sexual or gender identity. At the time of this meeting, if the student discloses that their struggles are indeed related to their LGBTQ identity (for example, they are being bullied because of their gender expression), then counselors should move forward with interventions while making sure to protect the student’s confidentiality.

Intervention formulation

After school counselors have conducted a thorough assessment of their schools’ climate and needs, they can begin to formulate interventions and adjust policies to better support LGBTQ students. School counselors should include LGBTQ community members on their advisory boards to assist with inclusivity when promoting change and programming. Change and programming should include interventions at the schoolwide, small group and individual levels. 

Schoolwide interventions addressing bullying and diversity have been deemed most effective in promoting a more positive school environment for all students. These interventions should include procedures and programming specific to the LGBTQ population, such as staff training on LGBTQ issues, multicultural awareness and response procedures regarding victimization of LGBTQ students. Schoolwide strategies and policies to address LGBTQ-specific bullying and harassment must also be outlined.

Schools are also encouraged to provide educational workshops for parents that address issues related to sexual and gender identity, ways of talking at home about bullying (with both victims and perpetrators), and ways to discuss diversity and acceptance beyond the school setting. These conversations should include information that is pertinent and specific to LGBTQ students.

As a universal approach, teachers should be encouraged to incorporate LGBTQ-affirming curricula into their existing core areas of focus at the elementary, middle and high school levels as developmentally appropriate. School counselors also need to include examples of LGBTQ populations and the issues they face in classroom guidance lessons and when promoting positive behavior intervention and character education programs at their schools. Positive recognition of LGBTQ students, parents, staff and community members can also help to promote a more accepting environment overall. Additionally, it is beneficial to foster support from those involved in athletics and other extracurricular activities. This includes recruiting the active assistance and endorsement of coaches and athletes regarding LGBTQ students.

In addition to schoolwide interventions, schools can better support LGBTQ students by providing small group and individual services designed specifically for them. Safe zones/diversity rooms can be designated to serve as a resource for LGBTQ student needs or concerns. These spaces should be run by the school counselor or other trained staff and must respect the confidentiality of the students who use them. These spaces can serve as a safe, supportive environment for LGBTQ and other students to discuss issues they are facing. In addition, they can serve as resource rooms stocked with helpful books, flyers and other materials.

School counselors can also facilitate support groups specifically for LGBTQ students, allowing them to openly discuss their experiences, process their thoughts and feelings, and develop coping strategies. Group topics could include local and national resources available for LGBTQ individuals, LGBTQ role models, family relationships, intimate relationships, coming out, personal and professional issues that LGBTQ individuals encounter, and information about higher education institutions that are affirming of LGBTQ individuals.

Support groups for parents of LGBTQ students should also be offered. These groups would address ways for these parents to support their children. The groups would also provide a forum for parents to share their experiences and concerns with each other and with the school. In addition, many schools now offer a Gay-Straight Alliance (GSA), a student-led organization with a faculty adviser that typically meets to learn about issues that LGBTQ students are facing. GSA is meant to be a group that promotes acceptance, social justice and advocacy. 

School counselors also make themselves available to all students for individual counseling. In many cases, they may be the only mental health professional that students have easy access to for support. It is therefore imperative that school counselors demonstrate cultural competency and provide a safe, affirming environment that includes acceptance and respect for all students.

School counselors need to be aware that LGBTQ students may not present with problems related to their sexuality or gender identity. School counselors also need to consider other contextual factors such as family dynamics when counseling LGBTQ students. In addition to providing leadership toward systemic change, counselors need to have an understanding of issues that specifically affect LGBTQ students on an individual basis. This understanding is achieved through an ongoing process that includes communicating with the local LGBTQ community, participating in continuing education opportunities about LGBTQ students, reading the latest research related to this population and familiarizing themselves with the legal and ethical mandates surrounding LGBTQ students. Most important, school counselors must engage in ongoing self-examination of their own biases, stereotypes and blind spots concerning all students.

The role of school counselors in advocating for LGBTQ students in school is critical. It is school counselors’ professional and ethical responsibility to ensure a safe and harassment-free learning environment for all youth. Connecting with parents and educating them on the continuum of gender and sexual identity can also be an important part of the process. Given counselors’ expertise and skills in supporting diversity and communicating difficult topics, they can play a central role in helping staff, administrators and students create schools that empower LGBTQ youth.

 

****

Recommended resources from the authors

  • A Queer Endeavor (aqueerendeavor.org): This site provides educators, school staff, families and students with resources (videos, lesson plans, curriculum development best practices, textbook recommendations) to help support and create an inclusive school environment for sexual minority and gender-expansive students.
  • GLSEN Educator Resources (glsen.org/educate/resources): GLSEN is one of the nation’s largest advocacy groups focused on providing resources that promote the well-being of sexual minority and gender-expansive students in grades K-12. This site provides tools for schoolwide advocacy programming and lesson plans that are LGBTQ inclusive.
  • It’s Pronounced Metrosexual (itspronouncedmetrosexual.com): This site provides online resources (worksheets, videos, articles, books) about privilege and oppression overall, with an emphasis on educating society about topics related to sexual and gender identity. The site serves as a source of information for social justice advocates, researchers and clinicians.
  • American Psychological Association (APA) Safe and Supportive Schools Project (apa.org/pi/lgbt/programs/safe-supportive/default.aspx): APA’s Safe and Supportive Schools Project partners with five professional organizations, including the American Counseling Association and ASCA, to provide training and educational resources. The goal is to help school personnel, leaders of community organizations, parents and students to build positive, supportive and healthy environments that promote acceptance, allowing LGBTQ youth to thrive as their authentic selves.

 

****

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Roberto L. Abreu is an assistant professor of counseling psychology at Tennessee State University. His research agenda focuses on the well-being of LGBTQ people of color, with specific attention to parental, school and community acceptance of Latinx LGBTQ youth. Contact him at rabreu@tnstate.edu.

Adriana G. McEachern is a professor emerita, a visiting associate professor and the program director for counselor education in the Department of Leadership and Professional Studies at Florida International University. She is a national certified counselor, certified rehabilitation counselor and licensed mental health counselor in Florida.

Jennifer Geddes Hall is a clinical assistant professor at Clemson University and a licensed professional counselor. She has more than 15 years’ experience working with children and teenagers as a school counselor and clinical mental health counselor in various community settings.

Maureen C. Kenny is a professor of counseling at Florida International University and director of the university’s clinical mental health counseling program.

 

Letters to the editor: ct@counseling.org

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Five strategies to develop mental health models in schools

By Dakota L. King-White March 12, 2018

Over the past 13 years, I have dedicated my career to developing mental health services and models within the academic setting as a school counselor, mental health therapist and now as an assistant professor in counselor education, where I engage in community action research to develop mental health models in schools from pre-K through 12th grade. From my research and experiences, I have observed that students’ ability to learn is significantly affected by their mental health.

Many of our nation’s students have been exposed to traumatic events and regular life stressors that act as barriers to their success. Exposure to violence and other traumatic experiences can have a lifelong effect on academic achievement. Within the school setting, this can be manifested in a number of ways, including trouble concentrating, low grades, a decline in test scores and students avoiding school or dropping out of school entirely.

Making an investment in prevention and intervention services can help to address students’ overall development and thus enhance their ability to succeed socially, emotionally and academically. The school setting is an ideal place to provide mental health support to students. However, it is extremely important for schools to align mental health support with academic achievement goals. This calls for greater collaboration among mental health professionals, teachers, administrators, parents, students, staff and other stakeholders in school settings.

Based on the work I have done in developing mental health models in schools, as well as guidance from the American School Counselor Association (ASCA) National Model, I believe that the following five components are key to effectively supporting both the mental health needs and academic achievement of our students.

1) Create mental health programming based on data-driven decisions.

2) Collaborate to address the mental health needs of students.

3) Provide a tiered system of mental health support.

4) Evaluate mental health services to ensure they are addressing the academic achievement gaps.

5) Communicate the outcomes to key stakeholders.

Make data-driven decisions

Developing mental health models in schools is a preventive measure by which mental health professionals analyze data ahead of time and design programming based on need. This approach allows stakeholders to assess the needs and develop services that truly address the academic, social and emotional gaps. Schools have an obligation to create programming based on their students’ needs.

When developing mental health models in schools, it is imperative to analyze data from several sources. One key component involves looking at data that focus on academic achievement. Report cards, test scores and other instruments that measure academic achievement must be considered. The main priority when addressing mental health issues in schools is to identify barriers that are affecting students’ academic achievement.

Once the needs have been identified, the next step is to create measurable goals to address the gaps. This step involves a collaborative approach that should include school counselors, mental health therapists, parents, teachers, administrators and students. Measurable goals provide a means for stakeholders to evaluate programming and help to ensure that it is supporting academic achievement.

Collaborate to address student needs

In a 2010 article for the Journal of Interprofessional Care, Elizabeth Mellin and colleagues identified collaboration among colleagues as being imperative when developing mental health models in schools. School counselors, mental health therapists, school psychologists and school nurses are the professionals most often tasked with delivering mental health services to students in schools.

School counselors are an excellent resource to support mental health models in schools. Quite often, however, school counselors are still labeled as “guidance counselors” in educational settings and are not always considered when schools are developing mental health services and models. Administrators and other stakeholders must be informed that the practice of school counseling has evolved, with “guidance” being only one component of the services that school counselors provide. According to the ASCA Ethical Standards for School Counselors, the school counselor’s role is to address all students’ “academic, career and social/emotional development needs.” School counselors must actively engage and advocate to inform stakeholders of their titles and responsibilities, which are based on their skill set and training. Their skill set and training include addressing many of the social and emotional barriers that affect the ability of students to succeed academically.

Mental health therapists are another valuable resource. When licensed as a clinical counselor or social worker, these professionals are able to diagnose mental health disorders and provide treatment to students. Another invaluable component of their skill set that often goes untapped is an ability to provide consultation to staff, teachers, parents and administrators. It is also important that mental health therapists collaborate with teachers, administrators, other staff members and families to demonstrate the correlation between mental health and academic achievement.

School psychologists are integral to the collaboration process when developing mental health models in schools. According to the National Association of School Psychologists, the school psychologist’s role includes providing assessments, providing interventions to address mental health concerns and working with teachers, staff, administrators and other stakeholders to create programming to address gaps. As noted by Joni Williams Splett and Melissa Maras in their 2011 Psychology in the Schools journal article, school psychologists who are trained as research practitioners offer a unique skill set that contributes to bridging the gap of research and actual practice of services to support academic achievement.

School nurses can also play a central role in developing mental health models in schools. Quite often, school nurses have mental and physical health records provided by school personnel, parents and outside health care providers. Because of the time these professionals spend with students addressing other health concerns, they are frequently able to screen for mental health concerns. This relationship provides school nurses opportunities to develop rapport with students. It is during these interactions that school nurses can detect changes in a student’s physical or mental health. School nurses can also provide insight to their colleagues about the mental health concerns they have observed within the school setting.

Teachers and administrators are additional important contributors to the development of mental health models in schools and must be equipped to identify mental health concerns in the school setting. In an effort to ensure that all school stakeholders are collaborating and properly equipped, regular meetings are essential. The more collaboration that takes place among the mental health team, teachers, parents, students and administrators, the more likely it is that students will succeed.

Provide a tiered system of support

Kelly Vaillancourt and colleagues described the benefits of a tiered system of mental health support in their 2013 article for the National Association of School Psychologists and the National Association of School Nurses. A tiered system of support for delivering mental health services also provides different levels of care to support students to succeed academically. Keep in mind that schools must use evidence-based strategies. This ensures that the most effective, empirically supported practices available are being used to help students succeed.

Tier one is the universal level of support in which all students have access to mental health services in a school setting. Within tier one, trauma-informed classroom methods are introduced to teachers, administrators and staff. Tier one includes implementation of a social/emotional curriculum for all students that is preventive in nature and that supports academic achievement by addressing social and emotional barriers. It is also imperative to use a strengths-based approach that looks at the positive attributes of the students and builds upon those attributes to provide services for the students. To further support students, families should be made aware of the services and information being taught at school.

Tier two is where targeted interventions are identified for students who need additional mental health support to eliminate barriers that are affecting them academically. Selective interventions are provided to students who exhibit behaviors that are hindering them. Mental health and other services provided at the tier-two level consist of small groups, classroom behavior management strategies for teachers and staff, individual counseling and additional professional development for stakeholders related to social and emotional barriers to academic achievement. Collaboration among the team is extremely important.

The third tier is the most personalized, with intensive strategies provided based on the student’s needs. Typically, this is done through a comprehensive process in which key stakeholders gather to collaborate and strategize about the needs of the student. The team should consist of the mental health team members, the student, the student’s parents or guardians, teachers, administrators and outside agencies that work with the student and family. As highlighted by Kenneth Messina and colleagues’ 2015 article in The Family Journal, family buy-in is crucial at this level because of the importance of collaboration between home and school to support the student’s academic achievement and to identify the student’s strengths. Mental health and related services at this level include, but are not limited to, individual counseling provided by a mental health therapist, crisis intervention, outside counseling services, small group counseling, behavior plans and additional professional development for stakeholders.

Evaluate and communicate

In an effort to improve academic achievement, mental health services provided in the schools must be based on data-driven decisions and evaluated to ensure that progress is being made to address the needs. Vaillancourt and colleagues noted that an effective mental health model includes consistent monitoring of student and program outcomes. This includes reviewing outcome data and analyzing the data to measure gaps, successes and areas of limitation. Evaluation of services is a continuous process.

Once programming or services are provided, it is critical to analyze the data and review the goals that were established for the student. It is imperative to have an outside reviewer provide feedback on the data and assess the outcomes of programming. The outside reviewer could be a mental health professional, teacher, curriculum director, administrator, local college professional or another professional within the district who has experience analyzing data.

Once the data are analyzed, it is vital to communicate the results to the stakeholders. Communicating the results to stakeholders has been found to build rapport and transparency among the team. Communication also allows for stakeholders to understand the impact and correlation between mental health and academic achievement.

Conclusion

There is a need to develop effective mental health models in schools because of the mental health challenges that affect students academically, socially and emotionally. Students will continue to be faced with these challenges, but it is important that schools address the barriers that affect students’ academic achievement. Mental health professionals, teachers, parents, students, administrators and school staff play a vital and collaborative role in the development, implementation and evaluation of mental health services aimed at maximizing students’ academic success. Through the five strategies discussed in this article, I believe that school districts will realize the success of mental health models being implemented within schools to support academic achievement.

 

****

 

Dakota L. King-White is an assistant professor in counselor education at Cleveland State University in Ohio. She is a licensed school counselor and licensed professional counselor. Her areas of research include the development of mental health models in schools, children of incarcerated parents and 21st-century school counseling. Contact her at d.l.king19@csuohio.edu.

 

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.