2014-15 Mental Health Professional Development Unit

1. 2014-15Mental HealthProfessional Development Unit By: Lily Kellogg Greenwood Academy:

2. Personal learning focus: • I took this course in order to expand my ability to understand and work with students demonstrating mental health challenges • SO THAT I can help the student be a more effective member of the community, learn more successfully in the social and academic areas • AND THAT I can help teachers be more effective in working with and supporting this student.

3. What new instructional strategies did I implement in my classroom/practice during the course of the PDU? I think using Motivational Interviewing was a new tool for me. Working with this particularly student, it became clear that traditional behavior change approaches did not work, so I had to settle into a supportive, encouraging role, and more or less invite the client to change, holding out optimism and specific support as needed. Another strategy that had not occurred to me is to take relevant parts of the student’s BASC result and use them for progress monitoring. I also started exploring Mindfulness Training and the use of distress tolerance thermometer, but have not fully developed this use yet. We have only recently gotten to a place in support that the student is open to learning more about himself and the way he functions in the world.

4. How did I apply the PDU strategies in my classroom? (examples) How did I collaborate with my team about implementing the PDU strategies? In course of exploration, it became clear that a huge piece of the work had to include building self-efficacy. As we had small or large successes, I shared his successes with the relevant members of our team – teachers and supportive staff. As far as other team members and aspects of the PDU went, I shared relevant insights as we went along discussing various students. I work closely with my social work and special education colleagues as well as the teachers and everything we do we have to do together through conversation and comparing notes.

5. CASE STUDY • &th Grade Student • History of scattered emotional outbursts, but decent academic progress • Poor EF skills (problem solving , planning, very, very weak self-advocacy skills, etc.) • 6th saw a nose dive, esp an math and 7th grade worse • SRR done in spring of 2014 – parental response revealed history of depression in family and reluctance/refusal to seek outside treatment • SPED referral in fall 2014 and SED qualification • BASC scores…… 1st generation immigrant family, different understanding of mental health issues and how to treat them

6. Almost no homework done • Minimal classwork done, typically student has had head on desk or reads a book or stares at desk • Seemingly average or perhaps above intelligence, good verbal skills, comprehension, above reading ability. • 6th grade no math support was given, student faced with frequent shaming by unresponsive teacher who was convinced student was “lazy”

7. Interventions • Standard interventions such as point sheets failed • “talk therapy” of minimal value, when down, student was basically unresponsive • Bibliotherapy – Huebner book, minimal value • Evaluations revealed poor coordination combined with poor visual memory (4%ile – WRAML2) • However, student responded to combination of movement/rhythm therapy combined with problem solving which lead to some CBT self-efficacy work • Movement and CBT techniques (specifically self-efficacy therapy) used

8. Hypothesis • Hypothesis: Student who has poor executive functions and poor coordination, emotionally sensitive with high sensitivity to self-criticism/strong avoidance of failure/poor self-esteem and poor self-advocacy skills may respond to problem solving & self-efficacy therapy • Movement work increased coordination which involved setting and achieving simple goals • Tutoring “therapy” – student was voluntarily placed with a second grade student with struggles in math and reading • Teachers encouraged to assign “kickboard” points when possible

9. Interventions cont’d • Problem solving continued along with frequent encouragement to use positive self-talk, exercise, stimulants such as coffee as appropriate • Math classroom and homework was switched to more student friendly materials in areas of weakness so that success could be achieved on a daily basis • It was clarified that any assignment requiring personal reflection or self-evaluation was abhorrent to this student, so teachers were encouraged to find alternative assignments

10. Outcomes • Student joined adventure club, almost able to attend winter snow tubing trip, except for resistance of parents related to liability waiver (would have been first time doing such an activity) • Student started achieving successes remarked upon by teachers • Journal entries were written • Success in use of logic in a classroom debate improved teacher approval and self-approval • Student became interested in exploring “logic” so Sudoku, etc were introduced.

11. What three strategies did I implement from the study section of the PDU? What strategy worked best? Why? • I started the process with using our typical behavior change tools – point sheets, etc. which had minimal value. Probably the best way to describe my approach from there is a combination of Problem-Solving “Therapy,” Motivational Interviewing, with with some RET techniques and an overarching goal of improving self-efficacy (concept from Cognitive Behavioral). This student’s depressive aspect made any kind of talk-therapy useless when he was in his “I don’t know” phase. At this point I used biofeedback program that typically brought him to a better mood, with more willingness to engage. From there, as [possible, we worked on identifying problems that we could begin to solve, though I had to take more of the lead. Gradually, he took on challenges of interest to him, which was great for self-efficacy. The sticking point at this time is homework and we are in a sort of motivational interviewing process of developing some interest, or at least willingness to create a new habit around doing homework. • Why did it work? Because it worked….

12. What did I learn to do differently as a result of the PDU and strategy implementation in my classroom? • ? Perhaps the idea of using the BASC as a therapeutic tool, not only for assessment. • I also had to keep thinking outside the box for this student and the PDU gave me permission to draw from a wide variety of sources for ideas and strategies.

13. Why is this PDU action research process important to my students learning and to my growth as a professional? • There is nothing besides action research in this job! Every student is so different, every situation is so different that one needs to have a wide variety of strategies at hand to adapt to ever-changing circumstances.

14. PDU Data AnalysisReflecting on the data you have collected, how did this experience impact instruction, progress monitoring, student performance, and your own practice? • It remains challenging to measure social-emotional growth and change. The measures I expected to help me are not yet showing up as seeing progress (kickboard, grades)(some BASC items), but the fact that this student is going camping for the first time in his life and presented a monologue in front of an entire class where he is too anxious to order his own food at a restaurant is unmeasurable…However, I have plenty of teacher reports that he is showing up for extra help sessions, is contributing in their lessons, and occasionally does some very good work.

15. How will I apply my new learning in the future to further my practice? What are my next steps? • One thing is that I will use the BASC results more actively or find a survey that I can use as a working document instead of just a test… I also want to come up with a better system for targeting areas of need besides the daily intuition of what is going wrong or going right for this student. Most of my students fall in the “poor executive function” camp which means that they are typically in trouble with someone for something or have a problem to be solved. Most of them do not have a diagnosis that can be related to something in a book (even if it seems SO clear that they are ADHD…) so I continue to look for ways to educate students about themselves in a systematic fashion. At any given moment they may seem to have a mental health challenge, but it is usually related to their poor EF skills. That is to say, I will use tools from this PDU to work with the anxiety when it arises, or the depression, or the distorted thinking. I think the key may be to work more with self-monitoring and mood/attention thermometers, etc.

16. PDU Artifact #1 • Kickboard – not so useful • Homework, slow progress, point sheet and working for rewards, limited motivator • After school – Adventure Club!!!!! • First time snow tubing (required signed forms, etc) First time camping, requires getting parents involved

17. PDU Artifact #2 • I cover up my work when the teachers walks by (True) False • I never quite reach my goal (True) Often I feel sick in my stomach (True) • often have headaches (True) I never seem to get anything right (True) False •  I get sick more than others (True) I used to be happier (True) • I give up easily (True) False Things go wrong for me, even when I try hard (True) • Even when I try hard I fail (Often) SometimesI quit easily (Often) Sometimes • People act as if they don’t hear me (Often) I am left out of things (Often) • Other people find things wrong with me (Often) • I feel out of place around people (Often) Sometimes • I forget things (Often) ** I get blamed for things I can’t help (Often) Almost Always I get nervous I can’t breathe (Often) Never I feel guilty about things (Often) Sometimes • I get nervous (Often) • I worry about what is going to happen (Often) • I have trouble paying attention to what I am doing  (Almost Always) • Other children don’t like to be with me   (Almost Always) Sometimes • ***My parents expect too much from me (Often)  Almost Always

18. PDU Artifact #3 • (i.e. Data Charts, Pre/Post Student Work, Lesson Plans, Reflection Logs, Discussion Questions, etc.) David had been going to do his monologue in front of the teacher alone, but spontaneously (!!!) did it front of the whole class and they were all blown away Art class has been problematic, but recently David did a drawing that the teacher was amazed by.

19. Exit Ticket • How can we support your professional growth in future PDUs? • I’m struggling with practical ideas on how to make measurable/graphable goals and can never get too much help in this area… • 2 things that you took away from the PDU this year • Permission to use play therapy techniques • More understanding of conduct vs mood disorders • 1 piece of constructive criticism • I would like to have explored the issues of the mood issues of sensory disordered children…