Informing Prevention: Effectively Using Technology for School-Based Prevention

Good. Morning everyone we're. Going to get started with our webinar, the. Mountain Plains Prevention, Technology. Transfer Center at, the University of Utah. They. Excited. To welcome you to our six-part, web emphasis, at uh since a. Recording. Of this webinar will. Be posted on our website at. Pttc. Network, org. Forward. Slash mountain, plains. Slides. Of this, presentation in. PDF, format will also be posted, on our website. For. Those of you interested in a certificate following. Today's webinar please email mountain. Plains underscore. Pttc. At. Utah GD you, may. Attack approval, is pending for, all, other less ensure and credentials, please apply, directly, to your board, all. Participants. Have been muted we. Encourage you to use the chat feature for, questions, and messages. Following. The webinar you, will see a link in the chat feature along, with a QR code to complete the survey, the. Survey is required for all training events, funded, by the, substance abuse and, mental health services administration. They. Want to know how well we provide our services, and we want your feedback to, help us improve our trainings, the. Information, you provide is confidential. We, ask that you please take a few minutes to complete the Gipper evaluation. Form. It. Is my pleasure to introduce our, presenter today dr.. Aaron. Fisher is a faculty member in the educational. Psychology, department, of the College of Education at, the University, of Utah and works. With schools across, Utah to build and sustain contemporary. Behavior, and social-emotional. Programs both. In elementary, and secondary settings. Dr.. Fisher also has an appointment in the University, of Utah School of Medicine's, Department, of Psychiatry where. He is the director of their pediatric feeding. Disorders, Clinic, it is. My pleasure to turn the time over to dr., Aaron Fisher. Thank. You so much it's great to be here this morning with all of you thanks for joining, we. Will have some time at the end for questions but, please use, the chat feature to ask your questions that you might have along. Away. Okay. So, the talk this morning we, will be focusing on using technology in, school prevention, and this is an area that I'm really passionate about much. Of my research interests. Lie around. The integration, of contemporary. Technology in the practice, of, behavior. Mental health services in schools and today. I'm gonna give you somewhat of an overview of how, technology can be used in these services, and. Let me give you a little bit of an overview as. We jump in I wanted. To give a shout out to the, University of Utah technology. And training consultation. Lab. At. The University of Utah this. Shown here is the amazing. Members, of our lab that do a variety of different services and I want to take a few minutes to kind of talk about what those services are we, provide multi-tiered. Behavior, supports, and. Consultation. And really um for. The bulk of the first, half of this webinar this morning we'll be talking a lot about what those services look like and how we can help support, schools. Around. Prevention, efforts we, all were eloquent ation where we collaborate. With special, education, teachers in districts, across the state of Utah to build capacity and empower them with skills to, work with their students with behavior and social emotional problems and other other. Disabilities that impede their ability to be successful, during. The school day we.

Also Spend a lot of our time providing, schools, with professional, development and as you can imagine especially, since you're all here joining us today. Professional, development is a really important aspect and when you're thinking about teachers, and school staff who. Are dealing with a lot of very important. Frontline issues ongoing professional bell and. We're pretty excited that we get to work with over eight school districts and Utah to help, provide some of those professional. Development opportunities, we. Also do a lot of work around functional. Assessment. And function based treatment planning this, would be heavily influenced, from a behavioral psychology, approach and what we do is we, work with students. And teachers to try to understand why problem behaviors and. Issues occur in schools. Typically. This would be much more aggressive behaviors, and we provide treatments to support that the. Last two are some of our newer projects, that have a much more mental. Health focus, spin and really embody. A lot of the prevention, efforts that we're trying to do in our local Utah, schools and hopefully that, you all can get, inspired from and and potentially. Use some of the the same services. To improve students. And. Children and adolescents that you all might work with we. Provided multi-tiered, school Mental Health Program which we'll talk about in a little bit and then we have an integrated public school day truant program and this would be for students who have some of those most acute, needs within. School districts typically being sent out to a. Day, treatment program in, medical. Setting here. In Utah we have a psychiatric, institute that has data, room programs and so school districts in. Collaboration, with our team have, decided that they want to try to keep those students in schools to try to provide. Those services so that's a little bit about our team and what we do and. I'm gonna jump in with, a little bit of an overview about what we'll be focusing, on today first, we're gonna talk about behavior, and mental health concerns, in schools, overall, and why those issues, are important and why we should focus on those then. We'll talk about models, that. Are developed, to address these concerns and, what type of interventions, are included, in those models, well. Next, talk about using technology, for prevention, efforts and how, you. Can leverage certain. Technologies, to, make your jobs easier to. Help students, access. Important. Mental health services, that that maybe they can't otherwise and. Then talking about technology. Prevention. For schools and we're gonna highlight here. And Utah some of the excellent, services, that are technology-based, that. Are driving prevention, efforts in our state. Okay. So we think about mental, health and behavior concerns overall, we. Know that adolescents. Are increasingly. Becoming, more, impacted, by mental health concerns if. You all take a second, and think back to your time being adolescents, you probably remember it, was a pretty awkward time, there. Were definitely a lot of issues around figuring, your. Life out, dealing. With emotions. Coping. Skills those, are we're all probably varying. Lee taught. In your adolescence, and so we know that because. Increasing, issues are more apparent we, need to be able to help them and, we're seeing this if we kind of look in our society, now we're seeing these huge increases, much. More than in years past of anxiety. Depression suicidal. Ideation, some, of these more really profound issues, that affect our youth and if. These issues are left untreated, it. Can really adversely, affect the adolescents, ability to be successful, in their academic achievement. It also affects, physical. Health and can. Ultimately lead to things like dropout, incarceration. These really, really problematic, outcomes, when we.

Know That if we can address some of these mental health issues they have the opposite effect we see better. Academic. Success. They're achieving, more we see improved physical health we see more. Proactive. Pro-social. Behaviors. When it comes to peer interactions, and we. See the less dropout and less incarceration so, we know that we really need to try to address these things. Mental. Health problems will likely continue, if, they're untreated in adolescents into the adult life like, anything if we don't. Deal with those things put. Band-aids on them if, we temporarily try to treat those things but don't get to the root cause we. Will have these issues persist, and this is when it becomes incredibly, problematic and, so from a prevention standpoint, and from our efforts in schools. We, want to help these students as early on as possible and, so our services start, as early as elementary school. But. We really want to try to be able to get them at any point within that continuum, because our goal is to make, sure they have the skills the. Social-emotional, skills the, coping skills the problem-solving, skills before, they leave to, go to college or career, or whatever they might do after. Leaving their primary schooling. Over. 80% of, adults in the United States report struggling, with mental health problems with. Many of these conditions having, onset, during adolescence and, so when we track some of this data and talk, to individuals, and say hey one did anxiety, start, for you or when did you start becoming depressed, what. Was those traumatic events that happened well a lot of them stem back to those years and as you can imagine a, child. In adolescence, time. From 6. Through. 18, those are incredibly, formative, years, in anyone's, life and so, not, being able to deal with those things and, having them persist into adulthood can, have some really profound impacts. It's. Estimated, that, a third of, all school-age, children fail. To receive mental health supports and this is a staggering statistic because. These. Are just the, estimate, so not necessarily people who report, it for, those who are reporting, it ends up being a little bit less as you can imagine you, have to be pretty vulnerable and open and comfortable and a lot of the individuals, that we work with in schools don't, even know how to use the language to describe how. They're feeling these things or some. Of the issues that they're having and so this this number 1/3 is really, high and we need to do a better job of, addressing. These these issues, so. That they don't lead to further. Problems in, 2016. Alone less than half of the 3.1. Million adolescents with. Depression, in the u.s. receive, treatment that is such. A huge number of people not receiving treatment and as. You can imagine those. Are the individuals, who are very at risk for. Committing. Suicide, for, having substance, use issues, for, having other profound. Mental. Health and social problems that could, lead to really negative outcomes. When. We think about substance. Use prevention, for adolescents, substance. Use is inextricably. Connected with. Mental health and. It can be used as a coping mechanism for, untreated mental health issues but, substance, use can also result, in greater, likelihood of mental health issues later, in life and so we know that connections.

There We've seen, the. Impact of substance. Use and here, in Utah we, have an extremely large opiate. Use compared. To other states and so we are also looking at that and thinking about how, can we help support our adolescents. In Utah, as well as nationally, with. Better. Sustainable. Pro-social. Skills that. Don't ultimately end, up being substances. Or other means to cope. Substance. Use is associate with poor outcomes, in behavior as well as academic, success this sounds, similar as you can imagine to mental health shoes and some of those issues, including. An increased likelihood of dropping, out of school so, if we're already having mental health issues and this puts us at risk for all those negative school outcomes like academic, success, being. Able to socialize appropriately. Being. Able to have access to those opportunities and then we. Layer in substance. Use on top of that we are really, exacerbating. Symptoms and we're really making the problem even more complicated. Substance. Use in children adolescents is correlated, with increases, in suicide, mental. Health symptoms and diagnosis and, criminal, activity in adolescents, young adulthood and Beyond and as, a school-based, practitioner. This, one, piece, is so important, for me if we, can disrupt people. From, being incarcerated and, if, we know that the people with mental health issues with, disabilities, with substance use problems are at a higher proportionate. Likelihood, to be incarcerated we, need to do a better job to. Get them the mental health supports early I. Want. To think a little bit of time just to kind of review in light of some of those problems, that we talked about those, risk and protective, factors and, how we could potentially think. About these things in our. Approach. Moving forward to treating. But. More importantly preventing, these issues, in schools, so let's take some time and review a little bit the, risk factors, these are characteristics, within an individual, or conditions, in the family's core community that increase, the likelihood someone. Will engage in unhealthy behavior. So these are things that make, it more likely higher. Probability. That something bad is going to happen something. Bad being something. Antisocial. In the community. Something. That's harmful to the self or the others and these could be things like alcohol tobacco use other drugs, violence. Suicide early. Sexual activity those, all would increase, those outcomes the, more risk factors present in child's life the, greater the likelihood problems. Will develop in adolescence, and, we have really great ways of assessing some of these things through childhood trauma and other screening tools to look at we. Think about protective, factors these would be characteristics, within the individual, or, conditions. In the family school or community, that helps, someone cope successfully with life changes these would be the thing that we want the more of these things, the. More likely. We will be to be successful, when, people can successfully negotiate, or negotiate. Their problems and deal with pre-existing, risk factors, they are less likely to engage in unhealthy behavior, and these protective factors are instrumental, in healthy. Development because they build resiliency, skills, and, connections. And you're, gonna hear this as we kind of go through the webinar today this idea of social connectiveness. And connections, that, really is the theme of this prevention work when, we're thinking about how do we help adolescents. Many. Of the adolescents, we work with are lacking, that social, connectedness or whatever, connectedness, that they, perceive, to, be important, that we know drive some of these positive outcomes, okay. So let's dive into risk factors a little bit more we're gonna do the same with those protective, factors we. Can look at these risk factors as individual. Characteristics. Family characteristics school, and community and I want to go through each of these and kind of talk a little bit about the, influence, that these might have when, we think about the individual and their peers. Experience. Child abuse. Physical. Or, sector. Or. Other. Family Lakis risk factors are there having a vigil and for those of you who work with adolescents. If you're working in public schools you know that, abuse and neglect and other family violence is occurring, at an extremely, high rate particularly. When we're in schools that. Are more, at risk these title 1 schools where they have a higher proportionate, number of students who experience poverty, and. All the other risk, factors like mental health, poor.

Parent Involvement, substance. Use of parents mental health illness of parents and the list goes on, we. Have early, initiation, of problem. Behavior this, we also know is a big risk factor and loss, of cultural identity in connection, these are really big ones that can influence. An. Individual's outcomes. And the list goes on about a variety of other ones as. You can imagine these top three are really impactful, for the adolescent, when we think about family, risk factors, deaths by suicide of, a friend or family member this can be incredibly impactful. Particularly. For an adolescent who's trying to figure out their. Day to day they're trying to figure out their identity and who they are what their values, are and when people, commit. Suicide who, they know or love or care deeply about it, really. Makes, people, question. Those. Values, and those beliefs and the things that they thought were important, to them and can have much more of a risk, family. History of problem behavior family management, problems family conflict, as you can imagine if you come home from a place and it's tumultuous. It is, unpredictable it, is really hard to have clear, expectations and sustainability. Of the positive things that you want, to have in. Place in the family structure in. School. The academic, failure is gonna be huge you reduced, self-efficacy, if, I feel like I'm a bad student. I'm, not I'm not going to try as hard because I don't understand, the benefit I can get a hopeless, attitude, if I, have a lack of personal, commitment to school I don't know why this is important to me and maybe I start allocating my behavior to things that are more antisocial in, the, community. Potentially. Maybe being, involved in a gang because, I'm trying to seek some validation, some. Self-efficacy, that I'm not, achieving through, the school and then the community would be the, availability of substances. Community. Norms laws availability. Firearms. Poverty, and some of the other things that I have mentioned so, these risk factors are there and many many many children experience, these things, if, you look at the socioeconomic distribution. These tend to occur more when. We talked about in these areas that have higher poverty, but but don't get me wrong these things are happening and. It's important, for all of our students. As. Far as protective, factors go we. Can think about the individual, appears as engagement. In meaningful activities this. Is so so, important, when, individuals. Are going through elementary school and second early, secondary, they are trying to figure out what. Makes them happy and what they can get, involved with that is gonna give, them that reinforcement, and so finding, lots of great opportunities, for peers to get involved things. That make them feel valued. These, are all things that we can think about doing, to. Help protect and, then help build some resiliency, in adolescents, life, skills and social competence, this is where the social-emotional learning piece, comes in that we're going to talk about in a little bit this. Is a protective, factor if you know what how to navigate tough. Social, situations. If you, know how to get by doing things. In life that are really important, you, have. An ability to be successful in ways that individuals who don't have those skills cannot. Cultural. Identity and connection, this is so so important, with, the youth we're working with in our current social, political landscape, I think cultural, identity and connection is so important, and. When we're thinking about children. And adolescents being able to. Have. Conversations around these things and have connectedness, around these things it can be incredibly. Helpful. The. Variety of other items that think about would be positive. Personal qualities. Like. Being really resilient positive. Self-concept how, you're perceiving yourself, pure. Role models so who are the kids hanging out with that's, kind of one of the biggest factors that we'd like to consider religious. Identity, this is gonna be really important, because it can provide that connectiveness, a high. Grade, point average, this. So if you're very high achieving, of course you're going to have that self-efficacy it's, gonna drive, those positive, outcomes again, family, connectedness, we, look to family, this is such an important piece if we had all those, risk.

Factors Before, with family, engaging, in a poor way or not at all or making, it dysfunctional, if we can have, appropriate. Attachment, consistent, attachment, and relationships. Around these things that. Can be really really positive positive. Parenting, style having. Two or more parents, in a family. Higher, parent education high in parental expectations about school those are all going to be protective, when. It comes to school connected, to school we're, gonna spend a lot of time talking about how do we build school connectedness because this in and of itself is the prevention. Piece that. Is so important, and after, we lay the stage of why. School. Connectedness is important we're going to talk about how we can integrate technology. To execute, some of those things in an efficient way when. We go down looking at student. Participation extracurricular, activities again, this would be things, that students, can feel good about that they can practice that they can have. Reinforcing. Experiences. With and last. In the community positive connection with other adults safe, supportive neighborhoods, strong. Community infrastructure. Local. State policies that support healthy norms and range of opportunities, in the community for, youth engagement, if you, look through these protective, factors, the. Connection, piece is so important, culture. And identity and connection family. Connectedness, connected. To school positive. Connection to other adults what. We know is that the more people can, have healthy positive connected, relationships, with other people that. Is going to ameliorate, so, many of these negative, outcomes that, we see when it comes to adolescents, and potential. Substance, use down the road. So. Let's talk a little bit about school. Climate this is such an important, term. I don't know if this term is familiar. To all of you or, if you've heard it sort of in passing, school. Climate is really made up of a variety of different areas it, really speaks to the overall, feel, of the. School and, beyond. Sort of the anecdotal, pieces of when you walk through that building and how it feels, those, are driven. These, these domains, that we know drive, these outcomes first would be positive. Discipline, we, think about positive discipline we're going to talk a little bit more about it and in a couple slides this, is around creating, clear. Expectations. Having. Procedures. That people can follow consequences. That are logical, that, are restorative, in nature and that follow largely, a positive, behavioral, framework meaning that we're trying to build people up rather. Than beating them down teaching. People that it's okay to make mistakes while, you're learning as long. As you try again after, you've made that mistake those. Are the types of discipline strategies we need to have in our schools. The. Next thing we can think of is school safety for all students we, have to create spaces, that. Promote, all students, feeling comfortable, to, learn if students, show up in a place and they aren't comfortable to learn they're not going to learn. Another. Consideration would be positive prevention, systems and effective interventions, we have to use evidence-based trip strategies. We have to have systems, level infrastructure, where administrators are. Collaborating. With teachers and parents to drive, outcomes, based on data that is, informing, these things. Another. Important. Consideration would be the cultural competence, piece all schools. Have a unique culture and the populations. That are locally, surrounding, those schools and feeding those schools students. Have, their own unique cultural, influence. It, is important, for. Schools to understand how, the, culture, of that school influences, learning outcomes and what schools can do to foster the unique culture that's in place, I see. Schools as drivers. Of the, community, they have to be places that, empower, cultural. Cultural. Acceptance. Differences. In culture and those unique. Equitable. Efforts, that we have to make to ensure that students, from diverse backgrounds and. Minority. Youth are being, addressed another. Important, piece of school climate is this homeschool, collaboration piece, and we'll talk a little bit about some technology strategies, that can help facilitate this, but, the better schools, that I've worked in from, prevention, efforts always. Have great communication, when, it comes to home in school and to, me if we're thinking of collaboration, and prevent, and teaming, it all stems, on our ability to communicate effectively, around, these things, and. Last but not least like. We talked about before is this idea of school connectedness.

To. The extent that students, walk into the school and feel. Connected, with the people around them and their peers they will want to be there they will want to learn they will want to engage in the extracurricular, activities, and they will want to engage in pro-social, behaviors, if, we. Don't create a connected environment they will try to seek those things in the community and through, means that are not as beneficial. That have, contraindicated. Outcomes meaning that will make things worse things, like substance use. So. The idea, about how to address this school climate really stems from about, 20 years of research in the areas of multi-tiered. Systems. Of support or. Positive, behavior supports these tend to be synonyms the. Multi-tiered, system of support is, essentially. An umbrella term that is encompassed by the idea, of responsiveness. To interventions, or, a positive behavior framework, meaning that we have tiered, systems, that build on top of each other and all, students are taught, certain behavioral expectations, and rewarded, for following them and students. With more needs are provided increasingly. Intensive, interventions, to. Ensure success. Happens, at that student level, positive. Behavior supports are based upon behavioral, and biomedical, science, using. This model, of triaging. More, intensive need, with, hopefully fewer services, it's. Definitely, hinged. On applied behavior analysis research and has demonstrated the importance, of analyzing the interaction between behavior. In the environment, this is such an important piece and implementing. Intervention, strategies that are effective in, natural, everyday, settings and they have three tiers that make up their system you. Can conceptualize, this system as a, prevention. Model. And. So as we break in these models and look at them a little bit more hopefully. These triangles. Or the idea about a tiered system of support is. Somewhat, familiar. This. Infographic. Essentially. Breaks it down for behavior, but I want you guys to to. Kind of break some of those barriers down when we think about, multi-tiered. Systems of support positive, behavior supports social-emotional, we're really talking about similar things, it's just how are we focusing, the application, of the work we're doing these. Infographics. Will, break down some, of the common, barriers to implementing PBS, but what I really want you to focus on for these slides is the. Ideal. Behavior model, and then some of these ineffective, tiered behavior models and I'm gonna walk you through reaching them so. We're thinking about prevention. Models and schools we. Want to make sure that we are putting the biggest, amount of resources, and getting the biggest bang for our buck out of that Tier one, foundational. Universal support level that would be in green when, we look at the triangle and this would be about 80%, of students receiving services. What's. Really exciting about this model is. That we can train, teachers to, deliver behavioral. And social emotional supports, in their classroom, as a way, to address all students. And we'll, talk a little bit about what that looks like in some of the curriculum that are associated with that in. A little bit at. The tier 2 level, ideally. This would be less students receiving, a little bit more of an intensive, need, but. We'd only expect, 15%, of students to get these services and I'll talk a little bit more about what specific. Services, would be in each tier in the, next couple slides at. The tier 3 level we would expect 5%, of students a much smaller proportion high. High intensity, of services, and. So when we're doing this system, correctly we're. Putting, all of our effort to affect most students and putting in commensurate, effort that's. Needed, but far less than we would if we were doing this incorrectly so if you look at the left that's the ideal, behavior model, I want. You to take a second and look now on the right these, are our two ineffective. Tiered behavior, models or tiered mental health models, the. First one this is when I see often in schools is the hourglass, model typically.

What Will happen is they have some assemblance. Of, tier. 1 supports, they, may have some. School-wide, programming. Something, that all teachers are doing maybe they collect data as, a as. A whole, but. There's. Not really much going on at the, tier 2 level. And remember the tier 2 level these would be for students who are at risk this. Is not all the way those student with a Q yet that tier 3 level these are students, who just need. Some. Group instructions, some. Brief, interactions, to help maintain and. Help, support that they don't develop, any worse, symptoms, or have any problems down the road. When. That's missing, what tends to happen is that all those, students who probably could have been served at the tier two are now pushed up into, the tier 3 level and we start to see a strong. Strong, emphasis on. Individual. Intensive, services now this is great I love the idea of students, getting one-on-one. Individual, services, but. In a school system and if we're thinking about prevention, efforts, it's. Not an efficient what use of our time and efforts if we're, doing direct service when. Many, of those students, at the direct level could, benefit, the same way if they receive services in a group format so again bang for our buck and thinking about working smarter and not harder. The. Last model I want you to check out would, be this upside down triangle, and if you can imagine the, trying on the light the, left, being a correct, the ideal, triangle. We, want to avoid this upside-down triangle, at all cost and I mentioned those problems about tier, 3 supports and allocating, all of our efforts essentially, trying to put out fires and deal with those high acuity needs we. Never have enough effort. Or. Support. To build those foundational, capacities, which, really, take the temperature down and allow us to effectively, deal with those fewer students, at those higher need levels, and so, if you are working in sites, trying to do prevention efforts, a lot of the work could just be trying to get them to, have their school climate, and school culture follow, this more. Positive. Behavior ideal, triangle, where we're seeing eighty 15. Five distribution. Okay. So that sets the stage a little bit about these frameworks and how we're gonna approach these things from prevention lens I want. To talk a little bit from a mental health perspective with, adolescents, about what those services look, like and how, we as. Mental. Health practitioners. And providers, can, help support schools, to do some of this work I will. Say that this, requires, funding. Be able to do this luckily. In Utah we have a legislature, and local.

School Boards that are really, really focused, on improving, Mental Health Access and prevention. Efforts in schools and so because of that we've been able to really tap into these communities and help support the. Project that I'm describing is also funded, by the candy a Health Foundation, which. Has. Graciously given us funding. To support what, we're talking about here in this slide for the next two years, I'm. Gonna start at the bottom and work my way up talking. About what supports, are there and then once I finish talking about supports I'll talk a little bit about those arrows you see on the triangle on their right let's talk about some of the referral, processes. But. The tier 1 level when we think about prevention. Efforts what. We're doing is trying to deal with mental health because if we can deal with mental, health we can hopefully reduce. Substance. Use issues, as a, symptom, of the, apparent. Mental health problem so. What we would do is have social-emotional. Learning through, a second step second, step is a program, that we subscribe to and they don't pay us we. Have no investment. With, that company but, we find that the tools that they provide are really, really robust, they're, easy for teachers to use immediately and I'm gonna speak a little bit more about that program in a few slides. We. Also provide school-wide, social-emotional. Attitudes. And values, and. So we're trying to create in the school Oh in collaboration, with administrators. School counselors and, other school stuff the, values, and and beliefs. That we want, to, be, a parent, to develop that school climate in the school and these things would it be school rules reinforcement. Systems positive, behavior, interventions. And interactions, that they have with teachers, if you're, thinking about elementary, school this is really a lot of the time what's in place we want these things in place but when we're thinking about secondary. Students, adolescents. This. Is just the foundation the behavioral, rules now, we're doing much more sophisticated. Social-emotional. Learning that, really has. Profound. Impact, on these students we're, also working on things like school culture like we talked about class, wide psychoeducation around, individual, issues that may come up during a school year we, focus a lot on teacher well-being by providing you. The yoga, groups, for our teachers each week we. Also have quarterly. Family, involvement so they can come for trainings and other other. Skills that they can learn so, they can be involved in this process overall, we. Also have a ton, of communication. Using technology, which I'll talk about in a little bit when we talk about some of the technology, integrations, at. The tier 2 level, teachers. Should make. Student referrals to school counselors and then what happens is the school counselor makes referral to our well-being team WBT, is the name of our program we. Didn't want to take a strictly, mental health focus, so we talked about in a much more global well-being. And, what we do after. Getting that referral is we meet with students for a 20-minute check-in I will, mention. A little bit more about that in a second but really in that 20 minute check-in this is an interview, that we can student. Ask students about suicidal ideation or trauma we want to rule out some of these really high acuity, behaviors. So we can make, sure that we're meeting their need and. Then based on students global well-being the student may receive either, individual, psychotherapy or groups, depending. On how their triaged students. Remaining up to tier 2 level will have bimonthly, check-ins, with, a qualified. Mental health graduate. Provider who tends to be a graduate, student in training, and. Then the student well-being is. Monitored, over time so we kind of this this ability to connect, to the extent that the student needs and then, last but not least at this tier 3 level referrals. Can come from students themselves Guardians.

And/or. Teachers and students, at this level received therapy for, acute needs including major depression, psychosis, active suicidal ideation if it's, beyond, the scope of what we could handle we always refer out to community providers, and. We. Always have you. Know resources, available, if these, students need or their parents need if. They show a lack of interest we can always push, them into a tier 2 support so they can be with peers in a group, what's. Really important you have these multiple opportunities, for students. To communicate to, get information out about their. Need and, try to help them at whatever spot they're at, what. We try to focus to is we want to make sure that when people are making referrals for these students that we're focusing, on symptoms. And not diagnosing. We, really, are trying to teach people to have to be to normalize the, culture of social emotional learning and mental health has. Such a stigma as mental health providers many, of you probably experienced, similar things and so we're trying to break some of these barriers down and stop. You, know victimizing, or demonizing, people for being anxious or depressed or, being worried these, are normal things that people experience, and we want to talk about it in constructive, ways so. This really gives an idea of what services, are there and I'll dive in a little bit more about some of some of the specific, services, in a little bit as we, continue to jump into social-emotional. Learning and, considering, the, the way we triage those services, at the tiered model the framework that we're really adhering. To is. One that's put forth by Castle, which is one of the largest social. Emotional learning, nonprofit. Organizations, and they've. Come, up with this framework that, is, adheres. To the social. Ecological model, so if you guys are familiar with Bradford, Brenner, this, would be his model that, has been adapted when, we think about social emotional learning and so in the middle there's this idea about social, emotional and academic learning, that is you, know the core, foundational. Important, elements, of. Being. Successful as a student in schools and the, pieces that make those things up are self-awareness. Self-management. Social. Awareness, relationship. Skills and responsible. Decision-making these are the critical you, could almost consider them. These. Pivotal behaviors, that have profound. Impacts, if people. Can master these now, these are all couched, within classroom, curriculum and instruction school climate policies. And practices, and family community partnerships, so having this this, idea. That they all interact is really really important. So, let's. Talk more about social emotional learning and break, it down to some of these main areas. First. They want to identify emotions, in self-regulation, it really the, focus, of SEL. Is to help children gain, mastery. Over, feelings, thoughts and behavior to increase confidence and self-esteem it's. So you be surprised I mean I think a lot of the adolescents, that we would work with, don't. Really have the language they probably have thought about these things but maybe didn't, associate, it with it being a certain emotion, or feeling and, we may be surprised, with that but. Unless the things are explicitly, taught in. A constructive. And, evidence-based. Way, there. Can be some miss messages there can be some information. That falls to the cross the, cracks and they just may not be able to develop the proficiency, needed without, appropriate instruction, I think. Along the way we've. Forgotten, that kids need to learn these things and, unfortunately. Parents are. Less equipped because, they made them maybe not have the skills and so we're starting to see this kind of trickle-down. Effect. Where we now need to really provide some more of these supports building. Empathy and peer connections, we. Can assist you in some building empathy and understanding for. Others and how to form healthy peer relationships. This, is really important we have a big. Bullying, culture unfortunately, in, schools and I think it's trying to break a lot of those down through positive and empathic peer connections, a lot of social emotional learning programs are. Really hinged on this idea of empathy and. As you can imagine being, able to put yourself in someone's shoes is a really, really. Impactful. Experience. And exercise. Respecting. Boundaries teach, proper boundaries and other skills such as respect compassion and and other things that really drive pro-social.

Relationships. Promote, positive mental health you. Know demystifying, some of the stigmas but also understanding what mental health is and techniques that you can use to cope and deal with, difficult. Emotions so you can talk to how, you can navigate that, the difficulty, that comes along with those things and. Then decision-making, and problem-solving learning, how to effectively, make choices and apply, the, problem-solving, framework to daily life we, all do this instantaneously, again, if we aren't explicitly teaching kids, how to make it to good, choices and problem-solve particularly, when times. Might be hard, for them to make those decisions we're. Gonna have, potential. Negative outcomes including choices like substance. Abuse. Okay. So, let's jump in and talk a little bit more about, each of those levels and some of the specific stuff that we can do at each of those levels from a prevention standpoint and as we go through this I'm going to kind of sprinkle in some of, the, technology aspects, that. You could use as well. The, idea of Universal. Prevention is school-wide. This, is how do we make, social-emotional. Learning empathy, positive. Relationships, problem-solving, how do we have this happen at the school level well it means that everyone has to do those things and to do that everyone, has to start paying attention more so you'll notice take notice everyone, has to connect teachers have to say hi to students, they have to talk to them they have to ask them how they're doing and genuinely care they, have to prepare for their lessons so that they can be more available to connect with the students they, have to, be. Active, they have to have activities that are going on they also you want people to be physically active because that's gonna promote the, well-being, that we want. We. Also have to be generous in giving we have to, conduct. Ourselves in, our interactions, with the. Students with other staff whoever it may be we. Have to present. A positive and supportive attitude, we, have to you. Know teach from a loving place unconditional. Place rather than an, area of resentment. We. Have to be able to take that approach to be successful, in schools and we have to have this idea that we can keep learning we can make mistakes I mentioned, this before so. Many adolescents, and children are scared to make mistakes and do things wrong because they don't want to be reprimanded it's. Because we create space and a culture where people, do. Get reprimanded for making mistakes and mermaid' to feel bad for making a mistake. Or doing the wrong thing and schools need to do a better job of, recognizing, that, learning. Can only happen when, mistakes happen and to the extent that we can support people we, can drive some of those positive outcomes so again, it this all feeds into the climate how can we create this whole environment, that, makes people, want to come to school and makes them want to be connected and do well and. Allocate. Their behavior to the pro-social. Positive, things rather, than the stuff that's gonna hinder, them and lead. To substance, use or incarceration, or dysfunction. In their family with earth peers. My. Go-to, program, like I mentioned before is second, step and I would really like second step because as you can see in this picture it gives you all the materials it has videos it's makes it super easy for any teacher who has a limited, amount of time to just go onto the website push. Play and facilitate, it with their class this, example, is one of the posters that's up through, their bullying, lesson. And in this there. They kind of talk through what. You should do. The power that you can have as a bystander so let's kind of walk through this first. Would be to recognize that, there's a problem then, you would have to report that problem to, an adult and then you refuse to engage in that to, not participate. In bullying. Because, we all have to be able to take. Care of our own behaviors, and if, we do that hopefully. We can decrease some, of the effect that might have and then the the power of the bystander, which they talked about would, be reporting. Help standing.

Up For someone, being. Kind. And how that's a respectful, thing to do and. Including everyone and again I think the most important thing we can do in schools is to teach kids to. Promote. Connectedness, promote. Inclusiveness, to. Stand up for people when there's injustice those, are really powerful things that we need to teach our youth so that they can be successful in navigating their lives. Here. Are some other posters that second step offers what's, really great too that I didn't mention was that this program goes all the way from kindergarten through eighth grade and it has unique, individualized. Content, and videos and materials for, each grade so depending, on where you're at in this prevention, continuum. As. Far as the age range you can find programming, through this to address it and it looks, at things like how to calm down, how. To pay attention how, to problem-solve. How. To develop empathy and. These would be posters, for younger children on kind of some of the more mid. To late elementary, but. As you can imagine these, are really tangible, and the program does a really nice way of teaching us through behavioral, skills training, and, for those who are unfamiliar that'll be that I do we do you do tell show do having. That really evidence-based, teaching strategy. Okay. Moving. On to the tier two targeted prevention what we do is we do a lot of group therapies. Brief. Check-ins and electronic school home now as a way to do connect in this and let me talk a little bit about those with group therapies we're looking at things like. Important. Issues that impact a, population, and so for. The schools that we work in there are unique social. Emotional problems societal. Problems, community, problems that we have to address. You. Should always be open for the when you're doing your prevention, work some, of the stuff that we focus on and, these acronyms are ones some, that we made up and some that are existing.

Proprietary. Products, and I'll make sure to differentiate, as we go through one, that we are in the process of developing is called Rome and this focus is on essentially. Acceptance, and commitment treatment, so we focus on things like relaxation observation. Acceptance. Mindfulness. Values, we, call it Rome but we're really trying to focus on individuals who are anxious so, that we can help build some resilience, around. Some. Of the anxiety that may be experiencing. We, run, peers which is a proprietary, social. Relationship. Relational. Program. For adolescents we, also have, advanced. Decision-making, in problem-solving for teens which, is an excellent, manualized. Program by Jason burrows Sanchez that, focuses, on. Adolescent. Support. Around. These, critical. Aspects. That, you can imagine problem, solving decision making if we can get them to make those decisions when, they're, feeling. More depressed. Or anxious and then someone, potentially exposes. Them to a substance, and says hey I want you to try this they, are hopefully. Better. Positioned. To be successful, and then, last is another group that we've developed, or. That we borrowed through a local partner, here in the, Salt Lake Valley the. Program's called stand up and it's around female, empowerment. We. Also have, the check-ins and what I mentioned about this this is an opportunity, for us to have, those bi-weekly meetings, wearing it for 20 minutes to follow up on some of those important, information. Around. Symptoms. Or potential, psychopathology, again individuals, who are engaging, this or more at risk what. We'd like to do to incorporate technology with this is have more, web-based. Opportunities. For check-ins so like a survey that is sent we. Can also like to start, incorporating more. Tella consultation, for check-ins that brief time limited, check-in we know through. The telecon siltation literature would be a great, augment, to this and so we want to start doing a little bit of research to see in what ways we could we could actually help support in a more time limited capacity, and then. Last but not least at that peer to kind of targeted level is this idea of electronic, home note again, this would not be all students at your school so we're, 15%, if you had 100 students you're thinking about almost, 15, who, would be, able. To get this additional intervention and this is just an example but what the teachers, would be able to do throughout the day is follow that Google Form or Qualtrics, or whatever survey, that you would use at your school or. Your agency, and. Teachers, can fill out and then parents can fill it out and it's a nice way to have great communication between school and home and if you're an agency provider, trying to help with prevention efforts this, might be another great way to follow-through, with clients, and. There's some really great literature showing the benefit. Of getting parent, involvement it really is that driving force for, student outcomes and this is a nice way considering, how ubiquitous, technology. Is today. At. The tier 3 level we provide individual, prevention. Efforts around individual. Therapy and although this is treatments, though you. Know typically, when we're working with these. Adolescents. There isn't, as. Much substance, use as if. They were later older. Later in life so 18 and beyond. Having, those similar mental. Health issues we feel like we still have this ability to, get in there and help support and. So we still consider this much more prevention efforts especially with substance use because we could be working with people who are potentially, anxious to press or experience trauma and not, yet. Coping, in really, negative ways so hopefully that that provides some context, how we're providing these in a prevention. Conceptually. So. Who facilitates, these prevention efforts with students if we think more globally outside, of just some of the work that we've done here.

It's. Really anyone, you can think about the school certain people are primed more but technical, expertise and these would be people like social workers school counselors, school psychologists, but, we also want to look people in like school administrators, and teachers parents, and caregivers community. Agencies, in. Collaboration, with public schools these are all people who can do it and it really takes the village to be able to do these prevention efforts, for. Adolescents, if, only one of these people are doing it it's not happening school-wide if community's not involved we we are just not gonna have those same success, and I'll tell you what when everyone. On this list is clicking, and working, together to, have a similar, outcome for students, the. Positive, benefits it's are amazing, and if. You have the opportunity to see it it, is just phenomenal when, you can get everyone working collaboratively. Okay. So with, the last bit of time that we have this, morning I really want to highlight a little bit more about technology, and. Some of our technology, efforts and particularly, focusing on one. Of the apps that we use here in Utah that was developed through the college, of medicine and the, hospital here on campus so, the problem is. A lack of access to care shortage of mental health providers financial, barriers Geographic access, and. The, solution, to it is really technology-based prevention efforts for, children and with ubiquitous. Technologies, and smartphones computers. So. Much great technology, is really available, at our fingertips and, what we can do with it is still. Just being created. I mean there's, endless applications that. We can promote efficiency. So, when we think about prevention prevention, efforts. We, can think about technology. Thinking, about when prevention and treatment including, social-emotional, learning positive, behavior supports and those things are delivered in the form of technological. Interventions, including. Apps texting and other technical. Technology platforms, which would consider us or is this definition we can see those positive, outcomes and when, prevention, efforts are integrated, through technology, there's an enhanced ability to reach a wider audience for a lower cost than, traditional. Prevention, efforts so this is really really exciting. What. We know through, some of the positive outcomes of including, technology is that there's overall satisfaction and, positive outcomes. With. When, people integrate. Tech. Use so if they're using apps to help their treatment augmenting, their treatment through apps or video conferencing, the Eco melt like I told you about earlier we, are seeing reduce symptom ology and enhance access to care which is just amazing the, prayer if we're looking at who wants, to interact with technology, based interventions, we see a preference, for younger individuals, although I think as time goes on and people will become more inherently, proficient.

With Technology, I think we'll start to see technology-based, prevention efforts and interventions becoming much more ubiquitous, in mental, health and behavioral. Health and our medical. System. Cost. Savings are there there's, it's, it's extremely, helpful. To have automated. Processes, that can provide evidence-based, care considering. Their shortages of mental health providers this is really something that's important, increase, access that's, so important, especially for folks in remote or, underserved areas, enhanced. Practitioner, keep capacity. You can collect data in ways that you maybe couldn't before an, improved quality of life for individuals we work with so, let's talk a little bit about current technology, and prevention efforts highlighting, an app called safe UT this. Is an app that was developed from the medical school here like I talked about the. Safe UT crisis chat tip line is a statewide service, that provides real-time crisis, intervention to, you through live chat and confidential, tip, program right, from the smart phone it's free licensed. Clinicians, are in a 24 hour 7 24. Hours a day 7 days a week crisis line call center to respond to all incoming chats and calls by providing supportive. Or crisis counseling, suicide. Prevention and referral, services they, can help anyone with emotional crisis ease bullying, relationship, problems mental health or suicide. Related issues. This. Is kind of what the interface of the app looks like there's a chat or crisis line there's a call line I can get you someone and there's also submitting a tip and this is how you can do tips anonymously and, these would be things like school, administrators, getting. Informed about bullying threats substance, use violence, the. Interface looks like this, you. Can indicate what. School you would want to associate it with they have a list of every school in Utah and then, you can have a chat or if you have the tip summary you select your school and put all the information and someone gets back to you or. If it's anonymous this, little administrator is is informed. Of that and I can act on those things which as you can imagine are, incredibly. Helpful I've worked with many schools who have used this as a way. To, screen mental. Health issues and it's been an incredible, support. We've. Advocated, students, we work within our capacity to use this to make tips because, there's issues with reporting, and things like that so it's a really nice system that's in place. So. More about the, safe UT app. It. Really the, the counselors, who address, these issues they, can focus on topics like depression anxiety other mental health issues suicide prevention loss, and grief bullying. Cyber bullying drug and alcohol problems self-harm relationship. Difficulties in any life challenge and as you can imagine all, those things I listed is like a life in a day in the life of an adolescent, dealing with one, or more of those things it's. Free and confidential and it's really just a nice tool, to. Really, help build. Unfortunately. This is only for, Utah. But, I would encourage you guys to reach out to other folks because I think it's something that probably does exist in other places and if it doesn't it's, probably something that could be relatively, I don't. Wanna say easy because that probably is a misstatement. But, it's very feasible to create with the right resources, in place. Okay, so, moving forward here's a list of just, this isn't in no way exhaustive I'm. Very interested in all the apps that are constantly being developed but here's a list of apps you could check out one that is really, cool if you want to look into it is the com harm, it.

Kind Of follows a DBT. Dialectical behavior. Therapy framework. And it allows. Some. Supports around, issues of self-harm and some negative thinking so check out some of these these all are, available on the App Store or. The, Android Market, and just. See what, these may do for you I think the we, really need like a whole webinar just they even dive into how to evaluate these but there are so much out there to. Help around. Data reporting, symptom. Management, communication. And, I would as, practitioners, or folks interested in building this prevention efforts and schools use, these free. And. Robust tools, to help your efforts, okay. With the last few minutes we have. There. Are some practical considerations. To talk about privacy, and confidentiality when using technology clearly, this, is an issue you want to make sure using HIPAA and FERPA compliance. Software because, more in schools there's federal. Privacy. Guidelines for schools that we have to adhere to we. Also want to make sure that there's responsible, use of. This technology making, sure folks know, how to use it without. Potential. Problems like, one, of the big issues we see with adolescents, in schools right now and one that I'm really concerned about is social media and. Knowing. That, they can it can easily go the wrong direction responsible. Use and talking about that's really important and. Then training and professional development, you are all here today if you decide to use technology, make sure you have ongoing, training the. Technology, changes exponentially, one, year to the next it's amazing how quickly, it. Progresses, so, thank you all for being here to learn and continue, those efforts on. With. My last slide just, a summary. Behavior. Mental health concerns are on the rise schools. Are excellent places to provide prevention efforts for children adolescents and strong, collaborative models, produce. Produced. And emphasized that SEL. Produced the most positive outcomes. Technology. When effectively used can provide access to support for those services and like I mentioned there are so many great ones that are out there. I'd. Also like to remind. You all that we'll be having another, webinar, which is informing. Prevention, series the effects of drug use such as marijuana on adolescent, brain development that will be through by dr., glenn hansen and i, encourage you guys all to register, for, that webinar and, with, the last few. Minutes we have today i'd like to open it up in the chat for any questions, or comments, you all have please check out my, website and. If you're interested in learning more about technology, applications, here are two texts that i've edited with my colleagues that focus on this, work in schools, thank. You everyone for your time today. Thank. You, dr. fisher has a great webinar, like. He said will open the chat for some questions if anyone has any. Yeah. So if you wanna go yeah, perfect. We. Will remind you that we. Have our Gipper evaluation, so. For those of you that have, a QR code app. We. You can scan the, QR code or you, can click the link in the chat box. You'll. Be provided, with a, post evaluation along, with an option to complete a 30, day follow-up, survey. Ok, there's another question. Yeah. That's a great question we, do provide professional, development credits, it's teacher we license your credit and. We. Are able to provide that through our affiliation, with the University of Utah but, I imagine, that it's probably, relatively, I. Would. Say easy again but it's feasible, to be able to set those those continuing education opportunities up. So. It looks like um Jennifer. Hogue. The. References. I'm. Sure dr. Fisher has those references, yes and we, will send those out. Also. Aaron if you want to go to the next slide. We. You can find our past webinars on, our website, if you just go to PT, TC network org, forward. Slash mountain Plains and. Then. Choose. The on-demand webinars, those are where our past, webinars are held. Yes. Are. There any other questions. All. Right thank you everyone, for attending today's. Webinar. Have. A great day.

2019-05-19 17:31

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