Vision ProgramCreating Circles of Courage for Students and their Families

Marcia Engel: Bloomington Schools

Susan Dannen, LICSW: Headway Emotional Health Services

  1. History and Philosophy
  1. 1999: Bloomington created the Vision Program
  1. 5th and 6th grade level initially
  2. Expanded to middle school, high school and then elementary
  1. July, 2002: Headway Emotional Health Services began a new collaboration with Bloomington to provide mental health services for the Vision Program
  1. Preventative Program - Reduce need for out of district, Setting 4 settings.
  1. Educational and Emotional needs - students whose emotional needs interfered with their educational goals.
  1. Multi-Dimensional- Utilizes individual support, group and social skills interaction, in-home family support, and community resources.
  1. Develop strength-based interventions:
  1. Teaching model: explore and accommodate a variety of learning styles
  2. Social and coping skills: learn responsibility and self-control
  3. Families: increase understanding of child’s special needs and how to work with school and community resources to address them
  4. Behavior management issues: in the home, community and school.
  1. Classrooms
  1. Sites:
  1. 2 K-2 Classrooms
  2. 2 3-5 Classrooms
  3. 1 Middle School
  4. 1 High School
  1. Elementary: Internalizing and Externalizing Student Issues
  2. Middle & High School: Internalizing Student Issues – No Aggression
  3. Classroom Size: 6-8
  1. The Circle of Courage
  1. The story of Joshua
  1. Family Background
  2. In Vision program for since Kindergarten
  3. His Circle of Courage when he started:

Belonging: wanted to have friends and a family

Mastery: artistic, reading

Independence: likes to make his own decisions

Generosity: shows empathy when someone got hurt

  1. Circle of Courage – 4 Quadrants
  1. Belonging: A sense of strong ties and bonding with family and the larger community; a sharing of mutual acceptance and mutual concern.
  1. Working cooperatively
  2. Joining in discussions
  3. Sharing attention
  4. Showing sensitivity to others
  5. Talking with others
  6. Accepting loss or defeat
  1. Mastery: Competence; achievement; control over self and environment
  1. Completing tasks
  2. Resolving conflict
  3. Setting goals
  4. Self-monitoring and reflection
  5. Dealing with anger or failure
  6. Disagreeing appropriately
  7. Coping with change
  1. Independence: Autonomy combined with responsibility and self-control; self-reliance; empowerment and control over one’s self and one’s destiny.
  1. Resisting peer pressure
  2. Making a decision
  3. Solving a problem
  4. Identifying feelings
  5. Laughing at oneself
  6. Coping with teasing
  7. Saying “No”
  1. Generosity: Caring, empathy, and altruism; acceptance of responsibility for the welfare of others
  1. Giving compliments
  2. Expressing affection
  3. Communicating appreciation
  4. Articulating empathy
  5. Listening carefully
  6. Making an apology
  7. Using social graces
  1. The story of Joshua in Grade 3

-His Circle of Courage Today

Belonging: recognizes his family is with his grandparents; has a friend in his neighborhood

Mastery: at grade level in academics, safer with his body

Independence: has joined art in general education and will follow the teacher’s directions on tasks

Generosity: encourages others in classroom, helping at home when grandma hurt arm

  1. Funding & Staffing Model
  1. Funding Sources:
  1. District Contracted Services
  2. Third Party Billing through Headway – Ancillary Services
  1. Staffing
  1. One licensed EBD Teacher
  2. One Mental Health Specialist
  3. One - two paraprofessionals
  1. Hiring Process – both Headway and Bloomington Involved with Teachers and Therapeutic Staff
  1. Process to be in the Vision Program
  1. Currently receiving Setting 2 services in their home building and needing more intensive services.
  2. Majority of students EBD; also some ASD and OHD
  3. Referring school presents student to Vision Team
  4. Family visits program
  5. IEP meeting held and once IEP is signed student begins.

* At secondary level parent must agree to family component and complete initial meeting with therapist prior to starting.

Staff Roles and Responsibilities

  1. Bloomington Special Education Supervisor
  • Oversee Special Education “team” - Teachers and Paraprofessionals
  • Ensure educational compliance standards being met
  • Provide compliance information to “Clinical” supervisor to ensure that therapeutic staff understand District policies
  • Address “system” issues with the schools that “host” Vision
  • Provide training to educational staff
  • Provide consultation to teams
  1. Headway “Clinical” Supervisor
  • Oversee therapeutic “team” - Mental Health Professionals
  • Provide administrative and “clinical” supervision
  • Ensure that staff are complying with mental health and school standards
  • Provide mental health consultation to classroom
  • Provide crisis consultation to staff
  • Provide training to therapeutic staff
  1. Classroom Special Education Teacher
  • Provide both academic and social emotional curriculum
  • Varied grade levels; meeting standards
  • Provide adaptations/modification information to general education staff
  • Collaborate with general education staff
  • Case manager for Due Process
  • Primary responsibility for paraprofessional supervision
  • Crisis Intervention
  • Communication with Families
  1. Mental Health Specialist
  • Classroom therapeutic support
  • Individual therapeutic support and skills training
  • Group therapeutic support and social skills training
  • Consultation with school and community providers regarding mental health needs and family needs
  • Supportive home visits
  • Crisis intervention
  • Coordination of treatment planning around students/IEPs - incorporating mental health needs
  1. Classroom Special Education Paraprofessional
  1. Assist team in Vision classroom with educational and emotional strategies
  2. Support students in the general education setting as needed.
  3. Be a link between general education teachers and the Vision team
  4. Crisis Intervention
  5. Team with the mental health specialist & Vision teacher
  6. Daily/weekly meetings
  7. Monthly meetings (Para Grant)
  1. Building Administrator
  • Responsible for daily supervision of the program
  • Consults regularly with Supervisor
  1. Children’s Mental Health Targeted Case Managers
  • Adjunct Therapeutic Support Services
  • Services provided at no cost to families - regardless of income or insurance
  • Must qualify in County of residence as SED
  • Assess child and family’s needs and find community resources
  • Coordinate resources with child’s “team”
  • Assist family in evaluating services being provided
  • Assist with Crisis planning

Supervision Model:

“Team Approach” to Supervision with Focus on Circle of Courage across Disciplines

Team: Bloomington Special Education Supervisor, Headway “Clinical” Supervisor, Teacher, Paraprofessional, Mental Health Specialist

●Building meetings: Vision Classroom “Team”- Once a month for each classroom - Progress, Therapeutic Aspects, Classroom Issues, “System” Issues, Plan to address

●Vision Training Days: Supervisors, Teachers, Mental Health Professionals - Three a year - Coordination of services, Clarifying of roles/responsibilities of the team, Program issues, Improvement of program, Training/education of staff - rotate between meeting at the District and Headway Offices

●Para Training Days: Supervisors and Paraprofessionals - Three a year - Training for Paras

●Headway Vision Team Meetings and Consultation: Headway Mental Health Specialists and “Clinical” Supervisor - Once a month - Administrative supervision focusing on how systems impact mental health, documentation and compliance, programming, and agency issues

●Headway Vision Team Supervision: Headway Mental Health Specialists and Program Supervisor - Once a month - Clinical Group Supervision

●Headway Individual Supervision: Individual Headway Mental Health Specialists and Program Supervisor - Twice a Month - Individual clinical supervision and professional growth

  1. IEP
  • Group and individual sessions listed on service grid
  • IEP and Treatment Goals Connections:
  • Follow directions at school
  • Follow directions at home
  • Transition safely with one or less reminder
  1. Treatment Plans and Strategies

Treatment Plans

  • Based on Circle of Courage - Treatment Plan Goal for each Quadrant
  • Developed in conjunction with the family and child
  • Include the child’s strengths in relation to the goal
  • Incorporate Mental Health needs and diagnosis
  • Incorporate IEP Goals and input from school “team”
  1. Classroom Curriculum
  • SEL and Academic Standards
  • Focused Curriculum:
  • Voices
  • Mind Up
  • Aggression Replacement Training
  • YSS
  1. Treatment Plans and Strategies: Based on Circle of Courage
  • Individual Treatment Plans combine IEP, Circle of Courage, and Family Goals
  • Individual meetings
  • Group Social Skills
  • Group Therapeutic Circles - “Talking” stick, Check-ins
  • Emotional Regulation
  • Diagnostic Assessments
  • TF-CBT
  • Occupational Therapy

●Play Therapy

●Yoga Calm

●Art Therapy

●“Circus Arts” Therapy

●Family Meetings - Twice a month

  1. School and Mental Health Culture – Merging

Benefits Of Combining:“Two Cultures”

School Culture and Mental Health Culture

  • Holistic approach
  • Multiple services provided in one setting
  • School setting provides teachable “moments” for therapy and skills
  • On-site crisis intervention that incorporates mental health needs
  • Increased communication between therapeutic and school setting
  • Students and their Families receive consistent messages from school and mental health
  • Mental Health Specialist can recommend and make referrals to outside resources that aren't’ always available to the school staff

Obstacles Of Combining :“Two Cultures”

School Culture and Mental Health Culture

  • Balance between mental health and educational needs
  • “Language” Barriers - acronyms, EBD vs. DSM
  • Privacy concerns - HIPPA vs. FERPA
  • Crisis intervention and Discipline policies - school policies vs. mental health needs
  • Change from “teacher’s” classroom to “team” classroom
  • Respecting the “host” school and integrating Vision staff and students into the “host” school setting
  1. Outcomes

A. Main Goals

1. Improved or Maintained CASII score - 60%

2. Improved SDQ score -Parent or Teacher - 60%

3. Maintained or increased attendance at school - 60%

4. Remain in the same placement or move to a less restrictive placement - 60%

5. Positive Client/Parent Satisfaction Report - 80%

Results 2012-2013 - Based on Roughly 76 Students over the School Year

1. CASII - 75%

2. SDQ - 64%

3. Attendance - 93%

4. Placement - 96%

5. Satisfaction - 100% - 25 Parents responded by mail or to phone survey

B. Expectations:

1. Average 2 hours family meetings/week

2. Average 2 hours of group/week

3. Average 2 hours staff consults/week

4. Average 3 hours individual sessions/week

Spring 2013:

1. Family Contacts - 3.8 Hours/Week

2. Group - 2.8 Hours/Week

3. Staff Consults - 4 Hours/Week

4. Individual - 5.2 Hours/Week

Outcomes

School Year 2012-2013

Staff Contacts - 682.15 Hours

Student Contacts - 1107 Hours

Parent Contacts - 186.77 Hours

School Meetings - 150.75 Hours

Individual Meetings - 889.95 Hours

Family Meetings - 666 Hours

Group Meetings - 503.25 Hours

C. Family Survey:

What has been most helpful in Vision?

  • Daily relationship building with students, family in-home therapy, group for students, compassionate and steadfast teachers (and wise).
  • Learning and working together on my child’s behaviors.
  • It’s been very helpful for client to have access to her therapist throughout the school day. I also appreciate Mental Health Specialist’s willingness to go above and beyond her duty to help.
  • In-home support, open communication with Headway staff at school, program teacher, and creative approaches to solving issues I face.
  • They all three have the patience of a Saint. I couldn’t thank them enough for not giving up. He’s worth it!

Standing Alone - Poem

She doesn’t want to leave the world behind

but it seems that the world won’t follow her

She feels lost within herself

because people seem to lose her

She has strived for what she wants to be,

strive for what she needs

she has to promote that she exists,

that she is important,

that she is real.

Her heart beats fast,

the knot in her chest grows tighter

She feels tired yet she strives to reach that point

where she stands alone to take on the world

Circle of Courage

For more information on the Circle of Courage please see the book Reclaiming Youth at Risk: Our Hope for the Future by: Larry Brendtro and Martin Brokenleg.

“a vision inspires one to

renewed purpose and hope,

giving power and strength

to live out their vision.”

-Martin Brokenleg