"An Overview of the Interconnected Systems Framework (ISF):
Integrating School Mental Health and Positive Behavioral
Interventions & Supports Within a Multi-Tiered System of
Supports Framework”
Rebecca Harris, M.S. Ed
Insight Publications, Inc.
[email protected]
309-781-6113
Parts of this PP adapted from NITT-PA CARS TA
Center ISF Overview by Christina Pate, PhD and
Rebecca Harris, M.S. Ed - 2016
SAMHSA’s NITT PA & MT…
Christina Pate, PhD
Rebecca Harris, M.S. Ed
Technical Assistance Liaison (TAL)
via CARS TA Center
Consultant & Subject Matter
Expert via CARS TA Center
Email: [email protected]
Email: [email protected]
Phone: 562.799.5423
Phone: 309.781.6113
SAMHSA’S “NOW IS THE TIME” INITIATIVES
Making
schools
safer.
PRESIDENT’S
“NOW IS THE TIME”
PLAN
Increasing
access to
mental health
services.
SAMHSA’S
“NOW IS THE TIME”
INITIATIVES
PROJECT
AWARE
HEALTHY
TRANSITIONS
PROJECT
AWARE SEA
PROJECT
AWARE LEA
PROJECT
AWARE-C
PROJECT
AWARE SEA-LEA
(LOCAL LABS)
3
Through active participation, Agents will:
Increase their understanding of a Multi-Tiered System of Supports (MTSS) framework
Increase their understanding of the critical features and rationale behind the ISF
Increase their understanding of how installing ISF following the steps of implementation
science can cause their work serving children, families, and communities to be more effective
Apply ISF pilot sites examples to their own work serving children, families, and communities
Identify and select tools to assess and assist their capacity in developing and implementing the
ISF by merging PBIS (MBI) and SMH within a MTSS framework
Strategically plan their ISF efforts within their respective state teams
Before We Get Started…
To clarify:
 ISF is just ONE way to organize and frame your
multiple initiatives within a MTSS framework
 This training will help you break down the concepts
of ISF and apply it to your specific
districts/communities
 This is NOT a substitute for MBI or SMH training
 Due to the varying levels of knowledge and
implementation, this training provides an overview of
ISF
5
Field Agents inventory…
 0-1-2-3 for MBI implementation
 0-1-2-3 for SMH implementation
 0-1-2-3 for ISF implementation
6
Differentiated tasks for participants
sisep.fpg.unc.edu
Stage of
implementation
What it looks like
Task for today
EXPLORATION
Assessing needs, examining
intervention components, considering
implementation drivers, assessing fit
•
•
•
Exposure
Strengths/barriers
Determining if you need it
INSTALLATION
Acquiring resources, preparing
organization, preparing
implementation drivers, preparing
staff
•
Taking inventory of your
readiness
What do you have/still need?
Are all voices impacted at the
table?
Adjusting implementation drivers,
INITIAL
IMPLEMENTATION managing change, deploying data
•
•
•
•
systems, initiating improvement cycles
•
Monitoring and managing
FULL
IMPLEMENTATION implementation drivers, achieving
fidelity and outcome benchmarks,
further improving fidelity and
outcomes
•
•
•
Assessing launch to date
What’s going well/needs help
with your data, systems, &
practices?
What does your data say?
Has it become systemic?
Are you achieving your goals?
What other initiatives can be
incorporated into your system?
Implementation drivers =
1) Competency (coaching, training, selection)
2) Organization (systems interventions, facilitative administration, data system)
3) Leadership (technical, adaptive)
7
Code names…
• PBIS
– Positive Behavioral Interventions &
Supports (AKA MBI in MT!!!)
• MTSS
– Multi-Tiered System of Supports
• SMH
– School Mental Health
• SOC
– Systems of Care
• IS
– Implementation Science
8
ISF:
The What
& the Why
What is an Interconnected Systems
Framework & why do we need it?
Adapted from Ohio Project AWARE Brief No. 1: March 2015
• Represents the structure and process of the interconnection
between MTSS (like PBIS) and SMH
• Strategically aligns and streamlines the goals, processes,
and resources of PBIS & SMH
• Addresses gaps and limitations of both PBIS & SMH
• Improves student and systems functioning
PBIS + SMH
= ISF
10
Origin of the ISF (since 2008)
•
University of MD Center for School Mental
Health and OSEP National Technical
Assistance Center on PBIS worked to link
SMH & PBIS
•
Concept paper developed to stimulate
dialogue at national conferences, meetings
and across partners in 4 states
•
Collaborative is learning from schools
currently implementing ISF (10 districts
across 6 states)
•
Examples and pilot sites discussed
extensively in the Monograph
https://www.pbis.org/school/schoolmental-health/interconnected-systems
11
LIE DETECTOR TEST…
We have both MBI and SMH supports in my district.
We must have an ISF.
FALSE!!!
• Although both might exist, they may not be
integrated together.
• Both might exist throughout your district but not
both within every building in your district.
12
Why should we invest in using an
Interconnected Systems Framework?
• Leverages and integrates the individual strengths of both MBI & SMH
• Addresses gaps and limitations of both MBI & SMH when used independently
• Improves outcomes for students through earlier access to wider range of
evidence-based practices
• Increases systems functioning within school + community MH + families
• Allows for wide scope of outcomes to be analyzed:
• individual student
• grade levels
• building
• district
• community
• Cross-system training promotes increased understanding & communication
• Decreases stigma due to availability of services across settings – continuum of
care
Ohio Project AWARE Brief No. 1: March 2015
ISF Final Monograph: Barrett, S., Eber, L., & Weist, M. (Eds). (2013) Advancing Education Effectiveness: Interconnecting School Mental
Health and School-Wide Positive Behavior Support
13
LIE DETECTOR TEST…
Our district has someone that sits on various
interdisciplinary teams, committees, or workgroups to
help improve outcomes for students .
We must have an ISF.
FALSE!!!
• ISF = MBI + SMH
• MBI is an example of a MTSS (multi-tiered system of
supports)
• By having MBI in the above equation, it is assumed
that MBI and SMH are blended by utilizing MTSS
principles to form an ISF
(holy acronyms!)
14
MONTANA AGENTS:
HANG ONTO YOUR HATS &
FIND YOUR CANDY CONTACT.
15
What is a Multi-Tiered System of
can give me
Supports (MTSS)? Who
common MTSS
Background: Stems from the Public Health Model
Key Components:
examples in a school
setting?
What else could you
organize in a MTSS
framework?
•
Framework not a curriculum
•
Multi-tiered continuum of supports guided by qualifying decision
rules:
 Tier 1: On-going, proactive and preventative for entire population
 Tier 2: As needed, large and small groups, some individualization for some of the
population
 Tier 3: Highly individualized for increased duration, intensity, frequency
•
Core + more
•
Use of evidence-based practices
•
Data used to assess, progress monitor, problem-solve
•
Stakeholder engagement
•
Culturally relevant and appropriate
16
Let’s investigate this…
ISF =
MBI (example
SMH:
•
WHO: All
students
•
WHAT: Continuum
of MTSS):
•
WHO: All
•
WHAT: Continuum
school
•
WHERE: In
needed
•
WHEN: As
•
HOW: School-based
supports
•
WHERE: In
•
WHEN: As
•
HOW: School-based
of MH
and
community-based providers
•
students
of
behavioral supports
school
needed
and
community-based providers
THROUGH: application of
MTSS framework principles
17
How the MTSS framework principles
impact MBI:
MBI (example of
MTSS):
MTSS applied principles:
WHO: All students
All staff and students including SPED
WHAT: Continuum of behavioral
supports
Tier 1,2,3 of evidence-based behavioral
supports developed to fit individual school
population needs
WHERE: In school
In school + home, community as indicated
WHEN: Tier 1 – always; Tiers 2 & 3
as needed
Data-driven as indicated by decision rules
between Tiers that encompass whole child
HOW: School-based and community- District and building systems are developed;
based providers
tiered teams comprised of all impacted
parties.
18
Pros and Cons of MBI & SMH
Ohio Project AWARE Brief No. 1: March 2015
ISF Final Monograph: Barrett, S., Eber, L., & Weist, M. (Eds). (2013) Advancing Education Effectiveness: Interconnecting School
Mental Health and School-Wide Positive Behavior Support
MBI
PROS
SMH
CONS
PROS
CONS
Decreased problem
behaviors
May not fully
address the
emotional needs of
all students with
more complex MH
issues
Early identification of
possible conditions
Difficulty
implementing SMH
programs due to too
few staff with too
many additional
duties
Improved school
climate
Resources and
structures at the
upper tiers are less
well-developed and
validated
Improved prevention
strategies
Lack of integration
among school-based
and community
providers
Improved attendance
Less well-developed
and validated in high
schools
Improved service
access
Unrefined use of data
to drive decisionmaking
Improved academic
achievement
Decreased MH stigma
Improved social
competence
Spreads service
19
AGENTS:
ESTABLISH EYE CONTACT PARTNER
DEFINE HOW THIS NEW APPLICATION OF MTSS
COULD SHAPE THE FUTURE OF MONTANA
THIS MESSAGE WILL SELF-DESTRUCT IN
2 MINUTES
2
ISF:
The How
PBIS(MBI):
Multi-Tiered System of Supports (MTSS) Framework
Academic Systems
Tier 3/Intensive Interventions
1-5%
•Individual students
•Assessment-based
•High intensity
Tier 2/Targeted Interventions
Behavioral Systems
1-5%
Tier 3/Intensive Interventions
• Individual students
• Assessment-based
• Intense, durable procedures
5-15%
5-15%
•Some students (at-risk)
•High efficiency
•Rapid response
•Small group interventions
• Some individualizing
•
•
•
•
•
Tier 2/Targeted Interventions
Some students (at-risk)
High efficiency
Rapid response
Small group interventions
Some individualizing
80-90%
Tier 1/Universal Interventions 80-90%
Tier 1/Universal Interventions
• All settings, all students
• Preventive, proactive
•All students
•Preventive, proactive
Presented with academics b/c it’s installed in school;
encourages whole-child view (behavior, academics,
mental health, physical health, social emotional learning)
Core + more model
IAdapted from “What is school-wide PBS?”
OSEP Technical Assistance Center on
Positive Behavioral Interventions and
Supports. Accessed at
http://pbis.org/school-wide.htm
Early identification & intervention
Kids responding to environment
23
PBIS (MBI):
Social Competence & Academic Achievement for ALL Kids
OUTCOMES
Supporting
Staff
Behavior
SYSTEMS
DATA
Supporting
Decision
Making
PRACTICES
Adapted from “What is a systems
approach in school-wide PBS?”
OSEP Technical Assistance on
Positive Behavioral Interventions and
Supports. Accessed at http://www.
pbis.org/schoolwide.htm
Supporting
Student Behavior
24
IOWA MTSS MODEL
Tier 1:
Universal
Tier 2:
Check
In
Check
Out
Tier 2:
Check In
Check Out
With
Modified
Features
&/OR
Tier 2:
Social/Academic
Instructional
Groups
Tier 2:
Check &
Connect
&/OR
Tier 3:
Brief
Functional
Behavior
AnalysisBehavior
Intervention
Plan
Tier 3:
Complex
Functiona
l Behavior
Analysis –
Behavior
Interventi
on Plan
&/OR
Tier 3:
Wraparound
Two ways that students are placed into the continuum of interventions:
1. Bottom up: students are identified through decision rules as needing additional level
supports.
2. Immediate need: students present as needing higher level supports right away and are
placed in appropriate intervention based on meeting decision rule criteria
25
IOWA PBIS MTSS MODEL of EVIDENCE-BASED PRACTICES
TIER/TY
PE
EVIDEN
CEBASED
PRACTI
CES
TIER 1/UNIVERSAL:
ALL
STUDENTS/STAFF
FUNCTIONINFORMED
INTERVENTION
100% of students
receive
TIER 2/TARGETED:
LARGE/SMALL
FUNCTION-INFORMED
GROUPS
5-15% of students access
Universal PBIS:
• Direct instruction
of behavior
• Reinforcement of
desired behaviors
• Pre-correction
• Re-teaching
•
All year/daily
•
DURATI
ON/
FREQUE
NCY
PER
CYCLE
•
DATA
REVIEW
•
•
•
•
Monthly
TIER 2 /TARGETED:
INDIVIDUALIZED
FUNCTIONINFORMED
INTERVENTIONS
•
Check-In Check Out
(CICO)
Check-in Check Out
With Modified
Features
(CICOWMF)
Social Academic
Instructional Groups
(SAIG)
TIER 3/INTENSIVE:
HIGHLY
INDIVIDUALIZED,
FUNCTION-BASED
INTERVENTIONS
1-5% of students access
•
Individualized
Adult-Student
Mentoring: (Check
& Connect)
•
•
•
Brief FBA/BIP
Complex FBA/BIP
Wraparound
• Embed in all
of the above:
Individualize
d CICO
(WMF) ,
SAIG, C&C
CICO & CICOWMF: •
4-6 weeks/15 minutes
throughout day
SAIG: 4-6 weeks/30
min block 1-2x a
week
C&C: 2
years/weekly 30
minutes minimum
per student based
on data outcomes
•
BFBA/BIP: 4-6
weeks + /daily
CFBA/BIP & WA:
high
frequency/structur
e until progress
made
1-2x/month
2x/month + as
needed
•
•
•
Weekly + as
needed
26
WHAT’S THE DIFFERENCE?
Iowa PBIS MTSS Model of Evidence-Based Practices
FUNCTION-INFORMED
INTERVENTIONS
 We are aware of the main functions
of behavior fulfilled by each lowerlevel evidence-based interventions
we provide to students
•
•
 Within
a MTSS, we create a
continuum of lower level
interventions that fulfill most
common functions of behavior
 Students
are placed into the lowest
level but most effective intervention
possible
 Based
on data outcomes, if students
“respond” to the intervention they
receive, we assume their function
has been met
 Duration/intensity/frequency
interventions is smaller
of
FUNCTION-BASED
INTERVENTIONS

Function-based interventions are
individualized per student by data
collection via the evidence-based FBA/BIP
process

Within a MTSS, function-based
interventions are reserved for 1-5% of the
student population at the top of the
triangle

Students have either been unresponsive to
lower level interventions or have intensive
presenting needs

Based on data outcomes, the individual
plan is adjusted to ensure function is met
through the diminishing/eradication of the
problem behavior and promotion of a
replacement behavior

Duration/intensity/frequency of
interventions is greater
27
IOWA PBIS MTSS TEAMING MODEL
TIER 1/
UNIVERSAL
:
ALL
STUDENTS/
STAFF
FUNCTIONINFORMED
TIER 2/TARGETED:
FUNCTION-INFORMED
LARGE/SMALL GROUPS
TIER 2/TARGETED:
INDIVIDUALIZED,
FUNCTION-INFORMED
INTERVENTIONS
TEAM
MAKEUP
Tier 2/3 Internal Coach plus Tier
2 Intervention Coordinator(s)
and individuals able to provide
applied behavioral expertise,
administrative authority,
knowledge of students, and
knowledge about operation of
school across grade levels &
programs
Tier 2/3 Internal Coach plus Tier
2 Coordinator(s) plus standing
problem-solving team with
individuals able to provide
applied behavioral expertise,
administrative authority,
knowledge of students, and
knowledge about operation of
school across grade levels &
programs
FREQUENCY
OF MEETINGS
1-2 x/monthly with agenda,
minutes, roles, & action plan
Every two weeks with agenda,
minutes, roles, & action plan
RESPONSIBIL
ITIES&
CONVERSATI
ONS
Review of fidelity data,
placement of students within 3
days of request for assistance,
staff & family communication
Review of fidelity data &
individual student data (in/on/out
decision rules), placement of
students within 3 days of request
for assistance, staff & family
communication
TOOLS
Tiered Fidelity Inventory,
Tiered Fidelity Index, Tier2/Tier3
TIER
3/INTENSIVE:
HIGHLY
INDIVIDUALIZE
D, FUNCTIONBASED
INTERVENTIONS
28
Iowa PBIS TIER 2/3 Teaming Structure
Tier 2/3 Internal Coach
Intervention
Coordinator
CICO
Intervention
Coordinator
CICOWMF
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Facilitator
Intervention
Coordinator
SAIG
Intervention
Coordinator
C&C
29
Iowa PBIS
Coordinator vs. Facilitator
Coordinator
Facilitator
•
Develops curriculums
•
Directly provides intervention support services to
youth
•
Organizes and/or oversees the specific interventions
such as CICO, CICOWMF, SAIG, and C&C
•
Collects fidelity data on intervention and gives to
coordinator
Accepts the student referrals & places students in
interventions
•
Does NOT need to be a behavior specialist
•
•
Inputs individual student & fidelity data, reviews
every student’s data every 2 weeks and then formally
at end of intervention period to make a decision to
maintain/add a layer/exit or fade intervention, & then
shares both types during team meetings
•
Provides orientation & progress monitoring to
parents/student/staff
•
Usually has behavioral expertise
30
PBIS:
Social Competence & Academic Achievement for ALL Kids
Adapted from “What is a systems approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Supporting Staff
Behavior:
• Follow district
oversight
guidelines
• DIP/SIP integration
• Select SWE
• Map out
tiers/decision rules
• Develop team
structure per tier
• Develop training,
coaching, TA plan
OUTCOMES
SYSTEMS
DATA
PRACTICES
Supporting Decision
Making:
• Ensure Tier 1 is
being implemented
with fidelity before
Tiers 2/3 added
• Decide what data
to keep and
problem-solving
process for each
tier
Supporting Student Behavior:
•
Determine your culturally relevant and appropriate evidence-based practices, including
universal screeners, for PBIS per tier
• Determine where and when EBP will occur per tier
• Decide how students & their parents, and teachers will be partnered with
31
AGENTS:
Decode this.
What’s the word?
KERBA
32
ISF:
The
Outcomes
ISF State View: Blending PBIS + SMH
Adapted from “What is a systems approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from ISF Final Monograph: Barrett, S., Eber, L., & Weist, M. (Eds). (2013) Advancing Education Effectiveness:
Interconnecting School Mental Health and School-Wide Positive Behavior Support
OUTCOMES
SYSTEMS
DATA
PRACTICES
Supporting Decision Making:
BEFORE…
AFTER…
• Siloed, duplicative,
and/or inconsistent
definitions and sources
of data
• Shared, cohesive, and
strategic data collected
across cross-sectored
ISF partners
• Data not collected or
not used once collected
Data-driven decision
making
35
ISF State View: Blending PBIS + SMH
Adapted from “What is a systems approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from ISF Final Monograph: Barrett, S., Eber, L., & Weist, M. (Eds). (2013) Advancing Education Effectiveness:
Interconnecting School Mental Health and School-Wide Positive Behavior Support
Supporting Staff Behavior:
OUTCOMES
SYSTEMS
DATA
PRACTICES
BEFORE…
AFTER…
Independent missions &
values per entity
Shared vision across
cross-sectored ISF
partners
Competitive and siloed
resources
Leveraging cross-sector
assets & resources among
ISF partners
Initiatives applied for,
placed in, and facilitated
throughout the state
randomly
Building and facilitating
strong, well-informed, and
effective leadership that
make decisions through
the ISF lens that
emphasize capacitybuilding, sustainability, &
fidelity of implementation
36
ISF State View: Blending PBIS + SMH
Adapted from ISF Final Monograph: Barrett, S., Eber, L., & Weist, M. (Eds). (2013) Advancing Education Effectiveness: Interconnecting School Mental
Health and School-Wide Positive Behavior Support
Supporting Student Behavior:
OUTCOMES
SYSTEMS
BEFORE…
AFTER…
Siloed services and
trainings per entity
Cross-initiative training,
coaching, and technical
assistance to create an
effective, inter-connected
workforce
Use of random practices
Use of evidence-based
practices that are
culturally appropriate
and relevant to the
population being served;
additional participation
in research of promising
practices to help grow
field
DATA
PRACTICES
37
ISF District View: Blending PBIS + SMH
Adapted from “What is a systems approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from the National Community of Practice on Collaborative School Behavioral Health:
https://www.youtube.com/watch?v=mZvXX7NWpDk
Supporting Decision Making:
OUTCOMES
SYSTEMS
DATA
BEFORE…
AFTER…
District applies for
hodgepodge of grants b/c
there is $$ attached;
services end once grant
concludes
District & community
leadership team use data
that reflects
student/family/community
needs to drive decisions
around joint selection,
planning, implementation,
and monitoring of
collaborative
behavioral/SMH
interventions and
supports;resources
allocated for on-going
support
PRACTICES
PBIS and SMH may or
38
ISF is included in the DIP
ISF District View: Blending PBIS + SMH
Adapted from “What is a systems Approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from he National Community of Practice on Collaborative School Behavioral Health:
https://www.youtube.com/watch?v=mZvXX7NWpDk
Adapted from Wisconsin PBIS Network: http://www.wisconsinpbisnetwork.org/
Supporting Staff Behavior:
OUTCOMES
SYSTEMS
BEFORE…
AFTER…
Each school works out
their own plan with a MH
agency
District has a systemic,
collaborative agreement
with local MH providers
for all schools in their
district
Universal screening for
behavioral/MH needs may
or may not exist in each
school; if existent, various
screeners utilized
District establishes at
least annual, culturally
relevant universal
behavioral/MH screening
using consistent, preselected screeners that are
age-appropriate for each
building
Behavioral staff are not
Job descriptions are
DATA
PRACTICES
39
ISF District View: Blending PBIS + SMH
Supporting Student Behavior:
OUTCOMES
SYSTEMS
DATA
PRACTICES
BEFORE…
AFTER…
Stakeholders may/may
not be aware of available
interventions and
supports or view them as
punishments
ISF practices are
embedded into district
handbooks, explaining
available interventions
and supports and
collaborative
partnerships available
throughout the school
district that are there to
support all students as
needed
40
ISF School View: Blending PBIS + SMH
Adapted from “What is a systems Approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from he National Community of Practice on Collaborative School Behavioral Health:
https://www.youtube.com/watch?v=mZvXX7NWpDk
Supporting Decision Making:
OUTCOMES
SYSTEMS
DATA
PRACTICES
BEFORE…
AFTER…
No data is used to identify
students for Tier 2/3
interventions, staff waits for
a major incident to occur
before referring, and/or
referrals made due to life
events vs. display of needs
Data-based decision rules are
developed for each tier based
on school & community
factors that allow students to
be readily identified, placed,
and then transitioned out of
appropriate levels of support
based on need
No data is used to monitor
the fidelity of
implementation/effectiveness
of the Tier 2/3 interventions
and/ or data not kept by CMH
providers
Process data is used at all
three tiers for all
interventions/supports;
individual student data is
utilized by the teams at Tier
2/3
If data is utilized to identify
students for interventions &
Decision rules and
interventions/supports reflect
41
ISF School View: Blending PBIS + SMH
Adapted from “What is a systems approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from the National Community of Practice on Collaborative School Behavioral Health:
https://www.youtube.com/watch?v=mZvXX7NWpDk
Adapted from Wisconsin PBIS Network: http://www.wisconsinpbisnetwork.org/
Supporting Staff Behavior:
BEFORE…
OUTCOMES
SYSTEMS
DATA
PRACTICES
AFTER…
SMH staff is housed in the SMH + CMH staff + other
school 1 day/week to “see” school stakeholders
students
participate in tiered teams
and facilitate/co-facilitate
tiered
interventions/supports
based on strengths of
team members
Crisis is the norm; SMH
staff has to cancel groups
and individual
appointments to handle
chaos
Decreased crises; lower
level supports are
effective for majority of
students in the building.
Additional team members
can run interventions.
42
ISF School View: Blending PBIS + SMH
Adapted from “What is a systems approach in school-wide PBS?”
OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at http://www.pbis.org/schoolwide.htm
Adapted from the National Community of Practice on Collaborative School Behavioral Health:
https://www.youtube.com/watch?v=mZvXX7NWpDk
Adapted from Wisconsin PBIS Network: http://www.wisconsinpbisnetwork.org/
Supporting Student Behavior:
OUTCOMES
SYSTEMS
BEFORE…
AFTER…
Random, non-EBP
provided as interventions
Relevant, culturally
competent EBP are
selected based on school &
community factors
impacting kids via data
outcomes
Random, individualized
skill sets taught by staff
Systemic implementation
of behavioral/SEL/MH
EBP taught at all three
tiers
Supports for parents come
in the form of a call or
brochure
Information, interventions,
and supports offered to
caretakers by school &/or
CMH
DATA
PRACTICES
43
ISF Outcomes Example #1
•
State,
district,
or school
level?
•
Tier?
•
D,S, or P?
•
Identify
PBIS +
SMH
parts
A school district had numerous kids that were failing to show up for
psych appointments at the local CMH facility, prescriptions were
not filled when prescribed, and even if filled, they were not properly
administered to the students by caretakers.
The district approached the CMH partner and arranged for
tele-psych 2 days/week at 3 buildings in their district.
The buildings were selected based on the # of students being seen
by the child psychiatrists and who were missing appointments;
transportation was then provided by the school for students in
other buildings.
School district nurses organized a system to have
medications sent to the school for disbursement after they
were renewed.
Parents were informed of all new services available to them to help
support their students, given the option to grant permission for
their student to participate, and offered education on medication
disbursement.
44
ISF Outcomes Example #2
When a school looked at their data, they had a group of kids that
were not responsive to Tier 1 + Tier 2 large behavioral group
interventions. When they examined the students data, they found
that they could meet the needs of about 2/3 of them with in-house
small groups.
The SW knew of a local CMH partner who provided a group
that would meet the needs of the other 1/3. She called her
connection at the CMH center to inquire if the curriculum
was an EBP, if individual and process data was kept on the
intervention, and about the duration of the group to make
sure it would fit within their MTSS framework.
The school got permission from the district to approach the CMH
partner and invited them to host the intervention group at their
building.
Parents were informed of the new service available to them
to help support their students and given the option to grant
permission for their student to participate.
• State,
district,
or
school
level?
• Tier?
• D,S, or
P?
• Identify
PBIS +
SMH
parts
45
ISF Outcomes Example #3
When a school examined the demographics of students
who were receiving frequent ODRs, they discovered a
disproportionate amount of students were from local
Army families who had experienced multiple school
placements and deployments.
The school partnered with mental health staff from
the local Army installation who trained the
teachers on awareness and specific skills to help
support the particular needs of this group of
students.
ODRs decreased most significantly for those students
originally identified as at risk but also for the student
body as a whole.
Example cited from the following PP:
Interconnected Systems Framework: Integrating SMH Through MTSS of Academic/Behavior Support in Schools
• State,
district,
or
school
level?
• Tier?
• D,S, or
P?
• Identify
PBIS +
SMH
parts
46
ISF Outcomes Example #4
•
A school received multiple grants for academic RTI, PBIS, SMH, bullying
prevention, and SEL so decided to braid the initiatives within a MTSS
framework.
•
They collected behavior and academic data on all students to
determine what needs were present in their building.
•
Next, they selected EBPs in each topic for Tier 1,2, & 3 and created decisionrules that would identify, monitor, and transition students up & down the tiers
as needed.
•
Then they redesigned their bell schedule to create a unified time that
all students would receive an academic, behavioral, and/or enrichment
intervention each day (interventions ran MWF or TTh).
•
Staff were assigned to teach academic interventions, the school partnered with
CMH agency for some of the behavior interventions, and enrichment
interventions were taught by staff who volunteered and parents or community
members who volunteered.
•
Additionally, the principal surveyed all students and created a student
insight team that he met with to include their voice in the
type/availability of supports and culture of the school as they
implemented.
• State,
district,
or
school
level?
• Tier?
• D,S, or
P?
• Identify
PBIS +
SMH
parts
47
ISF Outcomes Example #5
After the first statewide MH conference, Montana’s
Department of Public Health and Human Services and
Office of Public Instruction collaborated to hire a
researcher to develop and disseminate a White Paper on
SMH best practices and evidence-based practices to inform
Administrative Rules for Montana’s School Mental Health
Program policies
This led to changed rules, specifications, and increased
collaborations that increased MH accessibility in Montana’s
public schools around:
– services and staffing in contracts between licensed MHC &
school districts
– school provision of space, technology, & transportation
– referral process
– PBIS requirement in schools where CSCT is housed
– parent training
– data sharing
– administrative requirements
Adapted from ISF Final Monograph: Barrett, S., Eber, L., & Weist, M. (Eds). (2013) Advancing Education
Effectiveness: Interconnecting School Mental Health and School-Wide Positive Behavior Support
•
Districts then
used this
research/model
to apply for
grants
• State,
district,
or
school
level?
• Tier?
• D,S, or
P?
• Identify
PBIS +
SMH 48
AGENTS:
QUICKLY FORM SMALL GROUPS WHERE YOU
ARE SEATED
IN 4 MINUTES, IDENTIFY HOW USING THE
MTSS FRAMEWORK HELPS FULFILL THE
ASCA MODEL NATIONAL STANDARDS FOR:
• FOUNDATION
• DELIVERY
• MANAGEMENT
• ACCOUNTABILITY
SIGNAL YOU ARE DONE WITH ONE OF THE
FOLLOWING:
ORCHESTRATED GROUP CLAP
YELL “SHAKEN NOT STIRRED”
RAISE YOUR HANDS
49
ISF:
Tools
50
ISF TOOLS AT A GLANCE (pbis.org)
Name of Tool
Implementation
Level
District/Community
Description/Purpose
Authors/Citation
District
Community
Implementation
Guide
156-163: “KDS”
Survey on School School
Readiness for
Interconnecting
Positive
Behavior
Interventions and
Supports and
School Mental
Health
128-133
Selecting Mental School
Health
Interventions
within a PBIS
Approach
142-155
District/Community
Implementation
Guide: Funding
136-137
The ISF Implementation Guide provides a structure for ISF facilitators to
use to install core features of ISF at the District/Community level.
Guiding questions, tools and activities are organized around the Phases
of Implementation.
Barrett, Eber, Hearn and Luecking, 2015
The purpose of the survey is to evaluate readiness to interconnect PBIS
and SMH; that is, delivering SMH services through the PBIS framework.
Readiness includes perceptions of all those involved (teachers, students,
administrators, family members, etc.), feasibility of implementing
changes, and types of available resources.
Vittoria Anello and Mark Weist
When a data indicates a need for a new initiative, this guide, checklist
and case examples should be used to determine the best fit and will also
guide teams to install systems features like data decision systems as well
as training and coaching features that increase intervention fidelity and
positive outcomes for children, youth and families.
Robert Putnam, Susan Barrett, Lucille Eber, Tim
Lewis, and
George Sugai
This guide can is used when funding is a barrier to an integrated
approach. The questions promote dialogue around current funding
status and help teams determine specific action steps to promote flexible
funding model. (i.e. clinicians can be paid to participate in school teams)
ISF Development Team (Barrett, Eber and Weist
2011)
District/Community
Implementation
Guide: Evaluation
Tools
138-139
This guide can be used for teams who are in the process of developing an
integrated evaluation plan. The desired outcome of the guide is to create
an evaluation system (context, input, fidelity, impact, replication,
sustainability,
and improvement) used to improve effort, justify integration and access
necessary resources required for sustained integrated effort.
ISF Development Team (Barrett, Eber and Weist,
2011)
District/Community
Implementation
Guide: District
Community
Leadership Teams
140-141
This guide can be used to assess current district/community team or
stakeholders who are in the process of developing an integrated approach.
Teams are encouraged to develop a multi-agency leadership team and
link their effort to measureable outcomes and develop a multi- year
action plan organized around stages of implementation. The questions
promote dialogue around current status and help teams determine
specific action steps to promote integrated model.
ISF Development Team (Perales, Barrett, Eber
and Weist 2011)
Resource
Mapping in
Resource mapping offers a method to link regional, community, and
school resources with an agreed upon vision, organizational goals, specific
strategies for addressing problems, and expected outcomes so that youth
and families have access to the full array of services that they need.
Lever, N., Castle, M., Cammack, N., Bohnenkamp,
J., Stephan, S., Bernstein, L., Chang, P., Lee, P, &
Sharma, R. (2014). Resource Mapping in Schools
and School Districts: A Resource Guide.
District/Community
and School
Considerations for Use
Who: ISF facilitators supporting District
Community Teams
When: Across Phases of Implementation
Who: Teachers, Students, administrators,
family members
When: Exploration Phase: Prior to initial
implementation
Who: School Community Team who include
stakeholders who are responsible for selecting
and installing new initiative
When: Data determines need for new initiative
Who: DCLT
When: Exploration Phase Funding structure
prevents integrated approach
Who: DCLT
When: Exploration Phase: Prior to developing
an ISF Evaluation Plan
Who: Stakeholders interested in forming DCLT
for existing team interested in integrated
approach
When: Exploration Phase when developing an
Integrated ED/MH team
Who: DCLT, SLT
51
When: Exploration Phase to identify and
organize resources and services available within
PBIS (MBI) & ISF FIDELITY TOOLS AT A GLANCE (pbis.org):
Name of Tool
Tiered Fidelity
Inventory (TFI)
*There is now
also a ISF-TFI
version
Implementatio
n Level
School
Description/Purpose
Authors/Citation
The TFI is based on earlier PBIS
fidelity surveys (SET, BoQ, TIC,
SAS, BAT, MATT). The TFI gives
teams a single, efficient, valid,
reliable survey to guide
implementation and sustained use
of SWPBIS. Using the TFI, teams
measure the extent to which school
personnel apply the core features of
SWPBIS at all three tiers – either
individually or collectively. Schools
may take the TFI as:
An initial assessment to determine
if they are using, or need, SWPBIS
A guide for implementation of Tier
I, Tier II, and/or Tier III practices
An index of sustained SWPBIS
implementation
A metric for identifying schools for
recognition within their state
implementation efforts
Algozzine, B., Barrett,
S., Eber, L., George, H.,
Horner, R., Lewis, T.,
Putnam, B., SwainBradway, J., McIntosh,
K., & Sugai, G (2014).
School-wide PBIS
Tiered Fidelity
Inventory. OSEP
Technical Assistance
Center on Positive
Behavioral
Interventions and
Supports
Considerations for
Use
Who: School Systems
Planning teams – a
team of three to eight
people including the
administrator and
district coach – with
input from Tier I, II,
and/or III teams. It is
strongly recommended
the team complete the
TFI with an external
SWPBIS coach serving
as a
facilitator. Coordinator
s and school teams can
enter TIC results in
PBIS Assessment.
When: First-year
implementers may
conduct the TFI as an
initial assessment –
moving to
administering the
survey every third or
fourth meeting. Schools
reaching 80% fidelity
three consecutive times
may choose to take the
TFI as an annual
52
To learn more:
• www.pbis.org (plus all of the national/regional
conferences/regional PBIS hubs)
• https://www.pbis.org/common/cms/files/Current%20Topics/Fi
nal-Monograph.pdf
• www.patton.org
• www.pasocpartnership.org/
• www.papbs.org
• http://www.midwestpbis.org/system/app/pages/search?scope=s
earch-site&q=interconnected+systems+framework
• http://www.wisconsinpbisnetwork.org/search.html?advSearch
=oneword&search=interconnected+systems+framework&sub.
x=0&sub.y=0&sub=Go
• http://www.schoolmentalhealth.org
• http://nrepp.samhsa.gov/01_landing.aspx
53
Head, Heart, & Hands/Feet
What did you learn?
What will
you do?
What did
you feel?
THANK YOU FOR BEING AGENTS OF CHANGE!!