Mistrust to Trust NY If we can do

Mistrust to Trust: NY, If we can do it here you can do it anywhere.

THE PRESENTERS

Cindy Bautista-Thomas, LCSW Associate Director of Field Education Columbia University School of Social Work Ph. D Student, The Graduate Center, City University of New York, Urban Education Program

Linda Salazar, LCSW-R Social Work Coordinator Bronx School for Law, Government and Justice

Cole Hooley, LCSW Director of Social Work and Counseling Harlem Village Academies

THE OBJECTIVES

1. You will be able to articulate ways to develop a social work team staffed by graduate school interns by collaborating with non-profit organizations, school staff, families and universities. 2. You will be able to describe ways to work with social work interns in schools on all levels to develop social work skills. 3. You will be able to describe ways to work collaboratively with school staff and document the effectiveness in increasing academic outcomes. 4. You will be able to describe an evidenceinformed clinical model being implemented in an urban school setting.

THE CHALLENGE

Prevalence 25 Out of students experience mental health challenges leading to severe impairment and/or distress 5 (Merikangas, et al. , 2010).

Prevalence 14 y/o 50% of all lifetime cases of mental start by age 14. illness (Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2005)

Impact Mental health difficulties impact: • Academic success (De. Socio & Hootman, 2004; Esch, et al. , 2014; Puskar & Bernardo, 2007; Repie, 2005) • Attendance (Gall, et al. , 2004) • Concentration (Humensky, et al. , 2010) • Academic confidence (Masi, et al. , 2001)

Lack of Services • Most children with diagnosable mental illnesses don’t receive treatment (CSMH, 2013) • Estimates of children who need but don’t receive services vary: – 70% (Greenberg et al. , 2003) – 63. 8% (Merikangas et al. , 2011) – 45. 3% (Green et al. , 2013)

Lack of Services Youth from minority or disadvantaged groups are less likely to have access to mental health care and receive quality care if they have access (Garland, Lau, Yeh, et al. , 2005).

Estimate of NYC Youth 2010 456, 172 16, 811 3. 7% Received Services Need Services

THE OPPORTUNITY

Access • School mental health programs increase access. (CSMH, 2013) • Most youth who receive mental health services gain access from a school setting. (Rones & Hoagwood, 2000)

School-Based Services Help • Effective interventions are associated with academic gains (CHHCS, 2014) – 28 studies between 2001 -2013 – Peer-reviewed journal or reputable resource – Experimental or quasi-experimental design – N>100

THE RESULTS

Our Results 107% 3. 7% NYC 73% HVA 82% BSLGJ

OUR PROGRAMS

1. Relationships 2. Interventions 3. Feedback

Relationships Demonstrably effective (Cooper, 2004; Norcross, 2002) 1. Therapeutic alliance a) Agreement on therapeutic goals b) Consensus on tasks that make-up therapy c) The bond between client & therapist

Relationships Demonstrably effective (Cooper, 2004; Norcross, 2002) 2. Goal consensus and collaboration a) Agreement on therapy goals and expectations b) Mutually working together in helping relationship 3. Empathy

Relationships Probably effective (Cooper, 2004; Norcross, 2002) 1. Positive regard 2. Congruence/genuineness 3. Providing feedback 4. Repairing alliance ruptures 5. Self-disclosure 6. Relational interpretations 7. Manage counter-transference

Relationships Rogerian Business-like

Interventions Manual Modular Non. Directive

Interventions Manual Anxiety Coping Cat Trauma TF-CBT Depression TADS Anger SAMHSA

Interventions Modular

Interventions Non-Directive • Psychodynamic – Relational – Object Relations – Attachment – Non-directive play therapy

Feedback • Regular, systematic feedback from clients improves outcomes. (Cooper, et al. , 2013; Duncan 2010; Duncan, 2011; Lambert, 2010; Miller, et al. , 2006) Assessment Tool Area of Concern PCOMS-CORS General PCOMS-CSRS Alliance SCARED Anxiety GAD-7 Anxiety PHQ-A Depression CES-DC Depression

Developing Future School Social Work Leaders • • School social work Culturally relevant practices Setting the stage Student/field instructor match

Field Instruction in School Social Work • Supervision • Appropriate assignments • Partnerships with schools of social work

QUESTIONS

References • • Center for School Mental Health (2013). The impact of school mental health: Educational, social, emotional and behavioral outcomes. Maryland: Author. Cohen, J. A. , Mannarino, A. P. , & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford Press. Cooper, M. (2004). Towards a relationally-oriented approach to therapy: Empirical support and analysis. British Journal of Guidance and Counseling, 32(4), pp. 451 -460. Cooper, M. , Stewart, D. , Sparks, J. , & Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23(4), 474 -488). Curry, J. F. , et al. (2000). Treatment for adolescents with depression study (TADS): Cognitive behavior therapy manual. Durham, NC: Duke University. De. Socio, J. , & Hootman, J. (2004). Children’s mental health and school success. The Journal of School Nursing 20(4): 189 -196. Duncan, B. L. (2011). The partners for change outcome management system (PCOMS): Administration, scoring, and interpretation manual update for the outcome and session rating scales.

References • • Duncan, B. L. (2010). On becoming a better therapist. Psychotherapy in Austrailia, 16(4), 4251. Esch, P. , Bocquet, V. , Pull, C. , Couffignan, S. , Lehnert, T. , Fond-Harmant, L. , & Ansseau, M. (2014). The downward spiral of mental disorders and educational attainment: A systematic review on early school leaving. BMC Pscyhiatry, 14 (237). Gall, G. , et al. (2000). Utility of psychosocial screening at a school-based health center. The Journal of School Health 70(7): 292 -298. Garland, A. F. , Lau, A. S. , Yeh, M. , Mc. Cabe, K. M. , Hough, R. L. , & Landsverk, J. A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162, 1336 -1343. Green, J. G. , Mc. Laughlin, K. A. , Alegría, M. , Costello, E. J. , Gruber, M. J. , Hoagwood, K. , . . . & Kessler, R. C. (2013). School mental health resources and adolescent mental health service use. Journal of the American Academy of Child & Adolescent Psychiatry. Greenberg, M. T. , Domitrovich, C. E. , Graczyk, P. A. , & Zins, J. E. (2005). The study of implementation in school-based preventive interventions: Theory, research, and practice. Promotion of Mental Health and Prevention of Mental and Behavioral Disorders. (3). Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Humensky, J. et al. (2010). Adolescents with depressive symptoms and their challenges with learning in school. The Journal of School Nursing 26(5): 377 -392.

References • • • Kendall, P. C. , & Hedtke, K. A. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual (3 rd ed. ). Ardmore, PA: Workbook Publishing. Kessler, R. C. ; Berglund, P. ; Demler, O. ; Jin, R. ; Walters, E. E. 2005. Life-time Prevalence and Age-of-onset Distribution of DSM-IV Disorders in the National Co-morbidity Survey Replication. Archives of General Psychiatry 62: 593 -602 Lambert, M. (2010). Yes, it is time for clinicians to routinely monitor treatment outcome. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds). The heart and soul of change: Delivering what works (2 nd ed. , pp. 239 -268). Washington DC: American Psychological Association. Masi, G. et al. (2001). Depressive symptoms and academic self-image in adolescence. Psychopathology 34: 57 -61. Merikangas, K. R. et al. (2010). Lifetime prevalence of mental disorders in U. S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry 49(10): 980 -9. Merikangas, K. R. , He, J. P. , Burstein, M. , Swendsen, J. , Avenevoli, S. , Case, B. , . . . & Olfson, M. (2011). Service utilization for lifetime mental disorders in US adolescents: Results of the National Comorbidity Survey–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 50(1), 32 -45.

References • • Midgley, N. , & Kennedy, E. (2011). Psychodynamic psychotherapy for children and adolescents: A critical review of the evidence base. Journal of Child Psychotherapy, 37(3). Miller, S. D. , Buncan, B. L. , Brown, J. , Sorrell, R. , & Chalk, M. B. (2006). Using formal client feedback to improve retention and outcome: Making ongoing, real-time assessment feasible. Journal of Brief Therapy, 5(1), 5 -22. National Research Council and Institute of Medicine (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. M. E. O’Connell, T. Boat, & K. E. Warner (Eds. ), Board of Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington DC: The National Academies Press. Norcross, J. C. (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. Oxford: Oxford University Press. Office of Mental Health (2014). Mental health service use for 2011. Retrieved from http: //bi. omh. ny. gov/cmhp/dashboard#tab 2 Palmer, R. , Nascimento, L. N. , & Fonagy, P. (2013). The state of the evidence base for psychodynamic psychotherapy for children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 22 (2), 149 -214. Puskar, K. R. , & Bernardo, L. M. (2007). Mental health and academic achievement: Role of school nurses. Journal for Specialists in Pediatric Nursing, 12, 215 -223

References • • • Reilly, P. M, & Shopshire, M. S. (2002). Anger management for substance abuse and mental health clients: A cognitive behavioral therapy manual. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration. Repie, M. S. (2005). A school mental health issues survey from the perspective of regular and special education teachers, school counselors, and school psychologists. Education and Treatment of Children, 28, 279 -298 Rones, M. , & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology, 3(4), 223 -241. The Center for Health and Health Care in Schools (2014). The impact of school-connected behavioral and emotional health interventions on student academic performance. Washington, DC: Author. United States Census (2010). United States census 2010. Retrieved from http: //quickfacts. census. gov/qfd/states/36/3651000. html