Enhancing School Mental Health Enhancing School Mental Health Training: A Model of Recruitment and Training: A Model of Recruitment and

Ongoing Support for Graduate Ongoing Support for Graduate TraineesTrainees

1212thth Annual Conference on Advancing School Mental Annual Conference on Advancing School Mental HealthHealth

University of Maryland School of MedicineUniversity of Maryland School of MedicineDivision of Child and Adolescent PsychiatryDivision of Child and Adolescent Psychiatry

Center for School Mental Health (CSMH)Center for School Mental Health (CSMH)

University of Maryland School Mental Health Program (SMHP)University of Maryland School Mental Health Program (SMHP)David Agger, LCSW-C Tom Sloane, LCPC Ellen Rosen, David Agger, LCSW-C Tom Sloane, LCPC Ellen Rosen,

LGSWLGSW

October 26, 2007October 26, 2007Orlando, FloridaOrlando, Florida

AgendaAgenda

– History of University of Maryland SMHPHistory of University of Maryland SMHP– Baltimore City Public Schools (BCPSS) and Baltimore City Public Schools (BCPSS) and

School Mental Health ServicesSchool Mental Health Services– Growth of SMHP Growth of SMHP – Evolution of Graduate Intern/Extern ProgramEvolution of Graduate Intern/Extern Program– Lessons LearnedLessons Learned– From Graduate Intern to SMHP Clinician: an interview From Graduate Intern to SMHP Clinician: an interview

with Ellen Rosen, LGSWwith Ellen Rosen, LGSW

University of Maryland

The University of The University of

MarylandMaryland School Mental Health School Mental Health

ProgramProgram (SMHP) (SMHP)

• Established in 1989 in four Baltimore City Public Schools.Established in 1989 in four Baltimore City Public Schools.

• Gradually expanded to 25 schools.Gradually expanded to 25 schools.

• Primarily serving West, Southwest, and South Baltimore, with two Primarily serving West, Southwest, and South Baltimore, with two schools in North Baltimore. schools in North Baltimore.

• 2007-2008 SMHP staff:2007-2008 SMHP staff:– 3 psychologists 3 psychologists – 10 social workers (LCSW-C and LGSW),10 social workers (LCSW-C and LGSW),– 6 professional counselors (LCPC and LGPC)6 professional counselors (LCPC and LGPC)– 6 psychiatrists (First and second year post-residency fellows)6 psychiatrists (First and second year post-residency fellows)– 2 doctoral interns2 doctoral interns– 11 graduate social work interns from the UMB School of Social Work 11 graduate social work interns from the UMB School of Social Work – 11 psychology externs from a variety of psychology masters’ programs 11 psychology externs from a variety of psychology masters’ programs

(Loyola College, Johns Hopkins University, University of Maryland, (Loyola College, Johns Hopkins University, University of Maryland, Baltimore County, University of Baltimore, Towson University, and Argosy Baltimore County, University of Baltimore, Towson University, and Argosy University). University).

School Mental Health in the School Mental Health in the Baltimore City Public School SystemBaltimore City Public School System

(BCPSS)(BCPSS)

180 years in existence

Currently, over 120 of the 195 schools in the BCPSS have licensed mental health clinicians.

A growing city-wide coalition of over 20 school mental health programs.

A commitment to meet the needs of the entire school with a focus on school climate, working relationships with teachers, and becoming a team player with BCPSS mental health providers.

0

5

10

15

20

25

Schools

1989 1992 1995 1996 1997 1998 2001 2002 2007

Year

SMHP Growth

SMHP Intern/Extern Program

0

2

4

6

8

10

12

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Gra

du

ate

Stu

den

ts

Social Work Interns Psychology Externs

2006-2007 Clinical Services Provided by 2006-2007 Clinical Services Provided by 13 Graduate Interns and Externs13 Graduate Interns and Externs

• Individual client caseload – 79Individual client caseload – 79

Monthly individual therapy contacts – 254Monthly individual therapy contacts – 254

• Therapy groups – 5Therapy groups – 5

Monthly group contacts – 15Monthly group contacts – 15

• Prevention groups – 18Prevention groups – 18

Monthly group contacts – 80Monthly group contacts – 80

• Support groups – 2Support groups – 2

Monthly group contacts - 9Monthly group contacts - 9

2006-2007 Clinical Services Provided by 2006-2007 Clinical Services Provided by Graduate Interns and Externs (continued)Graduate Interns and Externs (continued)

• School Teams:School Teams: Student Support Team (SST)Student Support Team (SST)School Improvement Team (SIT)School Improvement Team (SIT)

School Climate CommitteeSchool Climate Committee Family Involvement CommitteeFamily Involvement Committee SMHP Liaison with Guidance Office and AdministratorsSMHP Liaison with Guidance Office and Administrators

• Other Projects/Activities:Other Projects/Activities:Tobacco Education Initiative – Towards No Tobacco Use (TNT)Tobacco Education Initiative – Towards No Tobacco Use (TNT)

Grandparents Networking GroupGrandparents Networking Group Guest Reading ProgramGuest Reading Program Fifth Grade Kindness PresentationFifth Grade Kindness Presentation Go-Girl-Go AssemblyGo-Girl-Go Assembly Winter Coat DriveWinter Coat Drive Suicide Prevention Awareness WeekSuicide Prevention Awareness Week Classroom Presentations on Bullying Prevention/Conflict ResolutionClassroom Presentations on Bullying Prevention/Conflict Resolution Fifth Grade Orientation & Pen Pal ProjectFifth Grade Orientation & Pen Pal Project Violence Prevention ProjectsViolence Prevention Projects Coordination of Intake/Assessment Process for Student ReferralsCoordination of Intake/Assessment Process for Student Referrals

2003 – 2005 Graduate Intern/Extern 2003 – 2005 Graduate Intern/Extern Professional Development WorkshopsProfessional Development Workshops

• Evidence-based PracticeEvidence-based Practice• Teacher ConsultationTeacher Consultation• Collaborating and Partnering with Community OrganizationsCollaborating and Partnering with Community Organizations• School Interventions for ADHDSchool Interventions for ADHD• Cultural CompetenceCultural Competence• Solution-Focused Therapy with Children and AdolescentsSolution-Focused Therapy with Children and Adolescents• Using Assessment Measures in SchoolsUsing Assessment Measures in Schools• Developmental Disabilities and School-Aged ChildrenDevelopmental Disabilities and School-Aged Children• Introduction to Child and Adolescent PsychotherapiesIntroduction to Child and Adolescent Psychotherapies• Violence PreventionViolence Prevention• Art and Play TherapiesArt and Play Therapies• Staff WellnessStaff Wellness• Resiliency in Urban Youth of ColorResiliency in Urban Youth of Color• Using Assessment Measures in SchoolsUsing Assessment Measures in Schools• Effective Non-Pharmacological Treatments for ADHD in ChildrenEffective Non-Pharmacological Treatments for ADHD in Children• Brief Solution-Focused Therapy for Children in SchoolsBrief Solution-Focused Therapy for Children in Schools

Enhancing School Mental Health Enhancing School Mental Health TrainingTraining

Lessons LearnedLessons Learned• Required attendance for group supervision Required attendance for group supervision • Confidence building (“I need more time.”)Confidence building (“I need more time.”)• Adjusting to the Baltimore City Public SchoolsAdjusting to the Baltimore City Public Schools• Peer support (group supervision)Peer support (group supervision)• Skill-based information (intervention strategies)Skill-based information (intervention strategies)• Practicing case presentations Practicing case presentations • Opportunities to address field supervision issuesOpportunities to address field supervision issues• Two semester training (full school year) with a Two semester training (full school year) with a

minimum of 2 days per week in the school.minimum of 2 days per week in the school.

School Mental Health ProgramSchool Mental Health ProgramSocial Work Intern/Psychology Extern Social Work Intern/Psychology Extern

OrientationOrientation

I.I. Welcome to the SMHP:Welcome to the SMHP:

- Introductions and Icebreakers- Introductions and Icebreakers

II.II. Our School Mental Health ProgramOur School Mental Health Program

- Mission- Mission

- History- History

III.III. Tools to Assist You in your Field PlacementTools to Assist You in your Field Placement

- Reviewing the Orientation Packet- Reviewing the Orientation Packet

IV.IV. Taking a Look at SMHP PaperworkTaking a Look at SMHP Paperwork

V.V. A Day in the Life of a School-Based Mental Health A Day in the Life of a School-Based Mental Health CounselorCounselor

VI.VI. Sharing Questions, Thoughts, and ImpressionsSharing Questions, Thoughts, and Impressions

•Re-Introductions•Pre-placement expectations •Barriers/Strategies to achieving expectations •Beginnings/Endings in the Therapeutic Process

•Surprises about the “Counseling Relationship”•A Way of Orienting Yourself to the Client•Timing in the Context of our Setting

•Developing Treatment Goals/Termination Issues•Reducing the Language Barriers Between Clinicians

and Educators•PLUSES and WISHES about your placement the student/supervisor relationship

October Intern/Extern Training

8:30 – 11:30

December December Intern/Extern Training AgendaIntern/Extern Training Agenda

8:30 – 11:308:30 – 11:30Case PresentationsCase PresentationsIntroduce a client that has presented significant challenges and/orIntroduce a client that has presented significant challenges and/orsuccesses for themselves and for you as the clinician. Briefly includesuccesses for themselves and for you as the clinician. Briefly includethe following:the following:

Client demographicsClient demographics Clinical questions for the groupClinical questions for the group

The primary goal is to use the group to identify best practices in clinicalThe primary goal is to use the group to identify best practices in clinicalwork with children and adolescents in a school setting.work with children and adolescents in a school setting.

A secondary goal is to experience the value in preparing and facilitatingA secondary goal is to experience the value in preparing and facilitatinga case presentation to peers for the purpose of professional selfa case presentation to peers for the purpose of professional selfreflection and the development of clinical strategies to maximize ourreflection and the development of clinical strategies to maximize oureffectiveness with clients.effectiveness with clients.

This activity will be limited to 15 minutes for each person:This activity will be limited to 15 minutes for each person:5 minutes to introduce the client5 minutes to introduce the client5 minutes to discuss the clinical questions5 minutes to discuss the clinical questions5 minutes to summarize feedback received5 minutes to summarize feedback received

•When you and the client reach a clinical plateau (Part I)

•Personal and Professional Growth Experience (Part A)“Listening to Students”Reflect and share about a client that you have a very difficult time listening to and what you can learn about yourself from this experience

•Personal and Professional Growth Experience (Part B)“Developing Relationships with Teachers, Administrators, and Parents”

•Reducing the Language Barriers between Clinicians and Educators”

•Personal and Professional Growth Experience (Part C)“The Challenges and Benefits of Working Within the Baltimore City public School System”Reflect and share ways in which your ability to provide “service” has expanded

•Termination Strategies and Clinical Issues

FebruaryIntern/Extern Training Agenda

8:30 – 11:30

Case presentations Highlight the strategies and support used during the

termination process with one of your clients.

The primary goal is to use the group to identify best practices in clinical

work with children and adolescents in a school setting.

A secondary goal is to experience the value in preparing and facilitating a

case presentation to peers for the purpose of professional self-reflection

and the development of clinical strategies to maximize our effectiveness

with clients.

This activity will be limited to 15 minutes •5 minutes to introduce the client•5 minutes to discuss the clinical questions for the group•5 minutes summarize feedback received

Unfinished termination issues with clients, Field Instructors, and the SMHP

Recommendations for Next Year

AprilIntern/Extern Training

Agenda