Enhancing School Mental Health Training: A Model of Recruitment and Ongoing Support for Graduate Trainees

1. Enhancing School Mental Health Training: A Model of Recruitment and Ongoing Support for Graduate Trainees 12th Annual Conference on Advancing School Mental Health University of Maryland School of Medicine Division of Child and Adolescent Psychiatry Center for School Mental Health (CSMH) University of Maryland School Mental Health Program (SMHP) David Agger, LCSW-C Tom Sloane, LCPC Ellen Rosen, LGSW October 26, 2007 Orlando, Florida

2. Agenda • History of University of Maryland SMHP • Baltimore City Public Schools (BCPSS) and School Mental Health Services • Growth of SMHP • Evolution of Graduate Intern/Extern Program • Lessons Learned • From Graduate Intern to SMHP Clinician: an interview with Ellen Rosen, LGSW

3. The University of Maryland School Mental Health Program (SMHP) Established in 1989 in four Baltimore City Public Schools. Gradually expanded to 25 schools. Primarily serving West, Southwest, and South Baltimore, with two schools in North Baltimore. 2007-2008 SMHP staff: 3 psychologists 10 social workers (LCSW-C and LGSW), 6 professional counselors (LCPC and LGPC) 6 psychiatrists (First and second year post-residency fellows) 2 doctoral interns 11 graduate social work interns from the UMB School of Social Work 11 psychology externs from a variety of psychology masters’ programs (Loyola College, Johns Hopkins University, University of Maryland, Baltimore County, University of Baltimore, Towson University, and Argosy University). School Mental Health Program University of Maryland

4. School Mental Health in the Baltimore City Public School System(BCPSS) • 180 years in existence • Currently, over 120 of the 195 schools in the BCPSS have licensed mental health clinicians. • A growing city-wide coalition of over 20 school mental health programs. • A commitment to meet the needs of the entire school with a focus on school climate, working relationships with teachers, and becoming a team player with BCPSS mental health providers.

7. 2006-2007 Clinical Services Provided by 13 Graduate Interns and Externs • Individual client caseload – 79 Monthly individual therapy contacts – 254 • Therapy groups – 5 Monthly group contacts – 15 • Prevention groups – 18 Monthly group contacts – 80 • Support groups – 2 Monthly group contacts - 9

8. 2006-2007 Clinical Services Provided by Graduate Interns and Externs (continued) • School Teams: Student Support Team (SST) School Improvement Team (SIT) School Climate Committee Family Involvement Committee SMHP Liaison with Guidance Office and Administrators • Other Projects/Activities: Tobacco Education Initiative – Towards No Tobacco Use (TNT) Grandparents Networking Group Guest Reading Program Fifth Grade Kindness Presentation Go-Girl-Go Assembly Winter Coat Drive Suicide Prevention Awareness Week Classroom Presentations on Bullying Prevention/Conflict Resolution Fifth Grade Orientation & Pen Pal Project Violence Prevention Projects Coordination of Intake/Assessment Process for Student Referrals

9. 2003 – 2005 Graduate Intern/Extern Professional Development Workshops • Evidence-based Practice • Teacher Consultation • Collaborating and Partnering with Community Organizations • School Interventions for ADHD • Cultural Competence • Solution-Focused Therapy with Children and Adolescents • Using Assessment Measures in Schools • Developmental Disabilities and School-Aged Children • Introduction to Child and Adolescent Psychotherapies • Violence Prevention • Art and Play Therapies • Staff Wellness • Resiliency in Urban Youth of Color • Using Assessment Measures in Schools • Effective Non-Pharmacological Treatments for ADHD in Children • Brief Solution-Focused Therapy for Children in Schools

10. Enhancing School Mental Health TrainingLessons Learned • Required attendance for group supervision • Confidence building (“I need more time.”) • Adjusting to the Baltimore City Public Schools • Peer support (group supervision) • Skill-based information (intervention strategies) • Practicing case presentations • Opportunities to address field supervision issues • Two semester training (full school year) with a minimum of 2 days per week in the school.

11. School Mental Health ProgramSocial Work Intern/Psychology Extern Orientation • Welcome to the SMHP: - Introductions and Icebreakers • Our School Mental Health Program - Mission - History • Tools to Assist You in your Field Placement - Reviewing the Orientation Packet • Taking a Look at SMHP Paperwork • A Day in the Life of a School-Based Mental Health Counselor • Sharing Questions, Thoughts, and Impressions

12. October Intern/Extern Training 8:30 – 11:30 • Re-Introductions • Pre-placement expectations • Barriers/Strategies to achieving expectations • Beginnings/Endings in the Therapeutic Process • Surprises about the “Counseling Relationship” • A Way of Orienting Yourself to the Client • Timing in the Context of our Setting • Developing Treatment Goals/Termination Issues • Reducing the Language Barriers Between Clinicians and • Educators • PLUSES and WISHES about your placement the • student/supervisor relationship

13. December Intern/Extern Training Agenda8:30 – 11:30 Case Presentations Introduce a client that has presented significant challenges and/or successes for themselves and for you as the clinician. Briefly include the following: Client demographics Clinical questions for the group The primary goal is to use the group to identify best practices in clinical work with children and adolescents in a school setting. A secondary goal is to experience the value in preparing and facilitating a case presentation to peers for the purpose of professional self reflection and the development of clinical strategies to maximize our effectiveness with clients. This activity will be limited to 15 minutes for each person: 5 minutes to introduce the client 5 minutes to discuss the clinical questions 5 minutes to summarize feedback received

14. February Intern/Extern Training Agenda 8:30 – 11:30 • When you and the client reach a clinical plateau (Part I) • Personal and Professional Growth Experience (Part A) • “Listening to Students” • Reflect and share about a client that you have a very difficult time listening • to and what you can learn about yourself from this experience • Personal and Professional Growth Experience (Part B) • “Developing Relationships with Teachers, Administrators, and Parents” • Reducing the Language Barriers between Clinicians and Educators” • Personal and Professional Growth Experience (Part C) • “The Challenges and Benefits of Working Within the Baltimore City public • School System” • Reflect and share ways in which your ability to provide “service” has expanded • Termination Strategies and Clinical Issues

15. April Intern/Extern Training Agenda • Case presentations • Highlight the strategies and support used during the termination • process with one of your clients. • The primary goal is to use the group to identify best practices in clinical • work with children and adolescents in a school setting. • A secondary goal is to experience the value in preparing and facilitating a • case presentation to peers for the purpose of professional self-reflection • and the development of clinical strategies to maximize our effectiveness • with clients. • This activity will be limited to 15 minutes • 5 minutes to introduce the client • 5 minutes to discuss the clinical questions for the group • 5 minutes summarize feedback received • Unfinished termination issues with clients, Field Instructors, and the SMHP • Recommendations for Next Year