School Psychologists and Mental Health: Early Intervention and Treatment
From Sol B. Heckelman
Among the many important and enlightening articles to be found over the years in CommonGround, the Sept 2016 issue featured Mental Health and Special Education: Early Intervention and Treatment for Childhood Mental Illness. The publication is to be commended for highlighting this crucial aspect of children’s growth and development. As we all know, children’s social and emotional health is an essential key to their cognitive and academic success; in fact, disturbances in such functioning are typically intertwined in learning disabilities, either as causes or as complicating consequences, or as the primary factor in a child’s special needs.
The article and a companion article both appropriately note the value of collaboration among the schools and broader community settings and services: What Can You Do to Support Children and Adolescents with Mental Health Issues? suggests that “Friends and family can be important influences to help someone get the mental health treatment and services they need.” The earlier article comments: “The American Academy of Pediatrics (AAP) promotes the use of schools in promoting access to health care for students not receiving this care elsewhere.”
However, the following statement in the same article, while well-meaning, indicates a lack of knowledge, in two vital respects, as to how schools and our staff (teachers and specialized support personnel) actually function:
“The American Academy of Pediatrics is calling on schools to establish a multidisciplinary student support team that includes school nurses, school counselors, and school physicians to provide interventions for students identified with a mental health problem.”
First: As school staff and many family and other communities know, schools have a long history of multidisciplinary support teams. (Perhaps too many overlapping teams in some settings.)
Second: The recommended support team has two glaring omissions. As important as the proposed team disciplines are, there is no mention anywhere of School Social Workers or of School Psychologists. (Full disclosure: I am a Past President of the NJ Association of School Psychologists [NJASP] and a longtime member of its Executive Board.)
These two disciplines are, in fact, the most highly and specifically trained of all school staff in providing interventions and supports for emotionally or behaviorally needy children and their families, both in general and special education settings. School Social Workers, of course, along with their counseling and consultation skills, are prime practitioners in coordinating family and community involvement with school functioning, in the interest of children’s mental health.
Permit me to focus on the roles of School Psychologists, as the discipline which integrates in its training cognitive, academic, and personal/social functioning of children in order to maximize their success. Understanding both educational and mental health development and needs blends a unique perspective which allows School Psychologists to provide comprehensive assessment, intervention and support for the whole child.
Crucially, such training and skills are not limited to the individual child or even to an individual classroom. By virtue of their living within the school community, School Psychologists become aware of the school as an organization, and of the talents and strengths which various staff members offer. Recommendations are fine-tuned so that learning and teaching styles, and personality patterns, complement each other. Thus, interlocking supports throughout the entire school organization become mutually reinforcing for the children’s benefit.
School Psychologists are well-known, along with the rest of the Child Study Team, for assessing children as to whether they qualify for special education instruction and settings. However, this “gatekeeper to special education” Child Study Team function is — or should be — only a step, albeit a very important one, down a road begun much earlier.
Collaborative interventions in general education settings, when indications of a child’s nonoptimal functioning first begin to be noticed by classroom teacher or parents, is the most efficient and productive application of support staff time. Such efforts often result in highlighting children’s patterns of strengths, both academic and personal/social, so that they can improve their functioning, remain productive and retain their social competence with peers in their regular classrooms. Relevant school staff and outside consultants should be accessed as needed.
This Response To Intervention (RTI) process has more recently been augmented as a MultiTiered System of Support (MTSS) in many states. Here in New Jersey, it’s been tweaked into what’s called NJTSS. The NJ Dept of Education (NJDOE) has been developing guidelines for this for a while now. Along with other sources, NJASP has been working closely with NJDOE in this respect. (This isn’t the place for extensive discussion of that effort.)
School Psychologists are prime players in the several stages of the NJTSS process, applying their psychoeducational skills in clinical observation, informal assessment and classroom management in collaboration with other staff and family. They provide recommendations for instruction and social supports, and followup, as well as implementing social/behavioral programs when needed.
If the initial level of NJTSS support efforts is not sufficiently successful, the team (including parents) then moves, in stages, to more intensive programming and supports. By the time some children have not benefited sufficiently at a third level of intensity, they can then be assessed more formally to investigate what other types of instruction or settings might be more beneficial.
The initial question is not Eligibility for Special Education. It is: what are a child’s patterns of strengths and weaknesses, and what programs/supports can be collaboratively maximized in order to take advantage of such potential? The smaller number of children for whom such efforts have not been sufficiently successful then may be found to benefit from a more restrictive instructional setting.
With respect specifically to mental health, NJASP has developed a formal statement on The Role of the School Psychologist in Behavior Assessment and Consultation. Some excerpts:
“The…School Psychologist…collaborates with other professionals using the problem-solving model to look at all pieces of data in order to inform a picture of the ‘whole child’….Comprehensive evaluation of behavior…includes(s) internal and external factors as well as learning and cognitive data….Both the antecedents and consequences are examined in order to understand why a behavior occurs in a particular environmental context….Social-emotional assessment – including an evaluation of thoughts, emotions, and interpersonal relationships….input from parents, student, and teachers….
“Behavioral intervention should be conducted at multiple levels of service and for all [emphasis in original] students….behavioral interventions should be made to promote positive behaviors, prevention of inappropriate behavior and social/emotional learning.”
What mental health services do School Psychologists in New Jersey actually provide? Presented below are excerpts from a statewide survey of its membership conducted by NJASP in 2013. These are functions reported by approximately 1/4 – 2/3 of respondents as activities in which they engage very frequently:
- advocate for children’s mental health
- consult and collaborate at individual/family/group systems levels
- monitor progress of student behavioral outcomes
- provide direct counseling
- school crisis teams
In addition to these functions, approximately 1/4 – 2/3 of these same respondents expressed the desire to apply their skills even more broadly in the following ways, given the time and opportunity:
- design and deliver programs which develop effective behaviors
- develop and implement school climate practices
- evaluate implementation and outcomes of behavioral and mental health interventions
- provide a continuum of mental health services
NJASP incorporates such direction from active practitioners of school psychology, along with its own initiatives, via professional development in semiannual statewide and regional conferences, in which mental health issues and practices have been a focus. Well-known evidence-based programs such as Positive Behavior Supports in the Schools, Social-Emotional Learning and Restorative Practices, as well as lesser known but productive techniques, have been featured. As it happens, the keynote address by Dr. Maurice Elias at this year’s (Dec 2016) Winter Conference is titled: ESSA, School Climate, and Social-Emotional Competence and Character….What role can and should school psychologists play…?
Starting this past June (2016), NJASP President Stephanie Frasier has been leading an after-hours informal networking series. Open to anyone, it has also attracted Learning Consultants, classroom teachers and administrators. Topics are chosen by the participants, with mental health drawing extensive discussion.
It might be instructive to conclude with comments of two School Psychologists from two different public school districts regarding their experiences addressing students’ mental health (personal correspondence):
“…School psychologists are on the frontline of mental health, especially our young adults who suffer from anxiety, depression, bipolar, social anxiety, and other related psychiatric needs. In fact, the executive functioning of these student learners is where School Psychologists make the most progress, especially with a myriad of supports, [e.g.], counseling, crisis intervention, consult[ing] with psychiatrist, etc. What’s more…without the data school Psychologists provide, the psychiatrists are [insufficiently] informed to effectively support the youngster because…the account[s] from parents don’t mirror the students’ presentation in school.” (Jacqueline Persico)
“I have…found TONS [caps in original] of opportunities to work in classrooms preventatively or to help with an issue on topics including stress, mental health wellness, attendance, study skills, strategies for managing emotions — particularly anger, how to listen, respect for others, how to create a safe space for debates, etc. (Amanda Montani)
Sol Heckelman is a retired school psychologist from Long Branch Bd. of Ed. who served for 33 years. He remains an active member of the New Jersey Association of School Psychologists.
Editor’s Note: In our original article, Mental Health and Special Education: Early Intervention and Treatment for Childhood Mental Illness, Common Ground referenced the American Academy of Pediatrics recommendation for multidisciplinary student support teams, including school counselors. We agree that this generic reference did not detail the important role that school social workers, guidance counselors, and school psychologists can play in the identification and treatment of students with mental health disorders.
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