Mistrust to Trust:NY, If we can do it here you

can do it anywhere.

THE PRESENTERS

Cindy Bautista-Thomas, LCSWAssociate Director of Field Education

Columbia University School of Social WorkPhD Student, The Graduate Center, City University of New

York, Urban Education Program

Linda Salazar, LCSW-RSocial Work Coordinator

Bronx School for Law, Government and Justice

Cole Hooley, LCSWDirector of Social Work and Counseling

Harlem Village Academies

THE OBJECTIVES

1. You will be able to articulate ways to develop a social work team staffed by graduate school interns by collaborating with non-profit organizations, school staff, families and universities.

2. You will be able to describe ways to work with social work interns in schools on all levels to develop social work skills.

3. You will be able to describe ways to work collaboratively with school staff and document the effectiveness in increasing academic outcomes.

4. You will be able to describe an evidence-informed clinical model being implemented in an urban school setting.

THE CHALLENGE

Prevalence

Out of 25 students

5 experience mental health challenges leading to severe impairment and/or distress (Merikangas, et al., 2010).

Prevalence

50% of all lifetime cases of mental illness

14 y/o

start by age 14.(Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2005)

Impact

Mental health difficulties impact:• Academic success (DeSocio & Hootman, 2004;

Esch, et al., 2014; Puskar & Bernardo, 2007; Repie, 2005)

• Attendance (Gall, et al., 2004)

• Concentration (Humensky, et al., 2010)

• Academic confidence (Masi, et al., 2001)

Lack of Services

• Most children with diagnosable mental illnesses don’t receive treatment (CSMH, 2013)

• Estimates of children who need but don’t receive services vary:– 70% (Greenberg et al., 2003)

– 63.8% (Merikangas et al., 2011)

– 45.3% (Green et al., 2013)

Lack of Services

Youth from minority or disadvantaged groups are less likely to have access to mental health care and receive quality care if they have access (Garland, Lau, Yeh, et al., 2005).

Estimate of NYC Youth 2010

Received Services Need Services

3.7%

456,17216,811

THE OPPORTUNITY

Access

• School mental health programs increase access. (CSMH, 2013)

• Most youth who receive mental health services gain access from a school setting. (Rones & Hoagwood, 2000)

School-Based Services Help

• Effective interventions are associated with academic gains (CHHCS, 2014)

– 28 studies between 2001-2013– Peer-reviewed journal or reputable

resource– Experimental or quasi-experimental

design– N>100

THE RESULTS

Our Results

NYC HVA BSLGJ

3.7%

107%

82%73%

OUR PROGRAMS

1. Relationships2. Interventions3. Feedback

Demonstrably effective (Cooper, 2004; Norcross, 2002)

1. Therapeutic alliancea) Agreement on therapeutic goalsb) Consensus on tasks that make-up

therapyc) The bond between client & therapist

Relationships

Demonstrably effective (Cooper, 2004; Norcross, 2002)

2. Goal consensus and collaborationa) Agreement on therapy goals and

expectationsb) Mutually working together in helping

relationship

3. Empathy

Relationships

Probably effective (Cooper, 2004; Norcross, 2002)

1. Positive regard2. Congruence/genuineness3. Providing feedback4. Repairing alliance ruptures5. Self-disclosure6. Relational interpretations7. Manage counter-transference

Relationships

Relationships

Rogerian Business-like

Interventions

Manual Modular Non-Directive

Interventions

Anxiety Coping Cat

Trauma TF-CBT

Depression TADS

Anger SAMHSA

Manual

Interventions

Modular

Interventions

• Psychodynamic– Relational– Object Relations– Attachment– Non-directive play therapy

Non-Directive

• Regular, systematic feedback from clients improves outcomes. (Cooper, et al., 2013; Duncan 2010; Duncan, 2011; Lambert, 2010; Miller, et al., 2006)

Feedback

Assessment Tool Area of Concern

PCOMS-CORS General

PCOMS-CSRS Alliance

SCARED Anxiety

GAD-7 Anxiety

PHQ-A Depression

CES-DC Depression

Developing Future School Social Work Leaders

• School social work • Culturally relevant practices• Setting the stage• Student/field instructor match

Field Instruction in School Social Work

• Supervision• Appropriate assignments• Partnerships with schools of

social work

QUESTIONS

References• Center for School Mental Health (2013). The impact of school mental health:

Educational, social, emotional and behavioral outcomes. Maryland: Author.• Center for School Mental Health (2013). The impact of school mental health:

Educational, social, emotional and behavioral outcomes. Maryland: Author.• Cohen, J.A., Mannarino, A.P., & Deblinger, E. (2006). Treating trauma and traumatic

grief in children and adolescents. New York: Guilford Press.• Cooper, M. (2004). Towards a relationally-oriented approach to therapy: Empirical

support and analysis. British Journal of Guidance and Counseling, 32(4), pp. 451-460.• Cooper, M., Stewart, D., Sparks, J., & Bunting, L. (2013). School-based counseling

using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23(4), 474-488).

• Curry, J.F., et al. (2000). Treatment for adolescents with depression study (TADS): Cognitive behavior therapy manual. Durham, NC: Duke University.

• DeSocio, J., & Hootman, J. (2004). Children’s mental health and school success. The Journal of School Nursing 20(4):189-196.

• Duncan, B. L. (2011). The partners for change outcome management system (PCOMS): Administration, scoring, and interpretation manual update for the outcome and session rating scales.

References• Duncan, B.L. (2010). On becoming a better therapist. Psychotherapy in Austrailia,

16(4), 42-51.• Esch, P., Bocquet, V., Pull, C., Couffignan, S., Lehnert, T., Fond-Harmant, L., & Ansseau,

M. (2014). The downward spiral of mental disorders and educational attainment: A systematic review on early school leaving. BMC Pscyhiatry, 14 (237).

• Gall, G., et al. (2000). Utility of psychosocial screening at a school-based health center. The Journal of School Health 70(7):292-298.

• Garland, A.F., Lau, A.S., Yeh, M., McCabe, K.M., Hough, R. L., & Landsverk, J.A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162, 1336-1343.

• Green, J. G., McLaughlin, K. A., Alegría, M., Costello, E. J., Gruber, M. J., Hoagwood, K., ... & Kessler, R. C. (2013). School mental health resources and adolescent mental health service use. Journal of the American Academy of Child & Adolescent Psychiatry.

• Greenberg, M. T., Domitrovich, C. E., Graczyk, P. A., & Zins, J. E. (2005). The study of implementation in school-based preventive interventions: Theory, research, and practice. Promotion of Mental Health and Prevention of Mental and Behavioral Disorders. (3). Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.

• Humensky, J. et al. (2010). Adolescents with depressive symptoms and their challenges with learning in school. The Journal of School Nursing 26(5):377-392.

References• Kendall, P.C., & Hedtke, K.A. (2006). Cognitive-behavioral therapy for anxious

children: Therapist manual (3rd ed.). Ardmore, PA: Workbook Publishing.• Kessler, R. C.; Berglund, P.; Demler, O.; Jin, R.; Walters, E. E. 2005. Life-time

Prevalence and Age-of-onset Distribution of DSM-IV Disorders in the National Co-morbidity Survey Replication. Archives of General Psychiatry 62: 593-602

• Lambert, M. (2010). Yes, it is time for clinicians to routinely monitor treatment outcome. In B.L. Duncan, S.D. Miller, B.E. Wampold, & M. A. Hubble (Eds). The heart and soul of change: Delivering what works (2nd ed., pp. 239-268). Washington DC: American Psychological Association.

• Masi, G. et al. (2001). Depressive symptoms and academic self-image in adolescence. Psychopathology 34:57-61.

• Merikangas, K. R. et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry 49(10):980-9.

• Merikangas, K. R., He, J. P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., ... & Olfson, M. (2011). Service utilization for lifetime mental disorders in US adolescents: Results of the National Comorbidity Survey–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 50(1), 32-45.

References• Midgley, N., & Kennedy, E. (2011). Psychodynamic psychotherapy for children and

adolescents: A critical review of the evidence base. Journal of Child Psychotherapy, 37(3).

• Miller, S. D., Buncan, B.L., Brown, J., Sorrell, R., & Chalk, M.B. (2006). Using formal client feedback to improve retention and outcome: Making ongoing, real-time assessment feasible. Journal of Brief Therapy, 5(1), 5-22.

• National Research Council and Institute of Medicine (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. M.E. O’Connell, T. Boat, & K.E. Warner (Eds.), Board of Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington DC: The National Academies Press.

• Norcross, J.C. (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. Oxford: Oxford University Press.

• Office of Mental Health (2014). Mental health service use for 2011. Retrieved from http://bi.omh.ny.gov/cmhp/dashboard#tab2

• Palmer, R., Nascimento, L.N., & Fonagy, P. (2013). The state of the evidence base for psychodynamic psychotherapy for children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 22 (2), 149-214.

• Puskar, K. R., & Bernardo, L. M. (2007). Mental health and academic achievement: Role of school nurses. Journal for Specialists in Pediatric Nursing, 12, 215-223

References• Reilly, P.M, & Shopshire, M.S. (2002). Anger management for substance abuse and

mental health clients: A cognitive behavioral therapy manual. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.

• Repie, M. S. (2005). A school mental health issues survey from the perspective of regular and special education teachers, school counselors, and school psychologists. Education and Treatment of Children, 28, 279-298

• Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology, 3(4), 223-241.

• The Center for Health and Health Care in Schools (2014). The impact of school-connected behavioral and emotional health interventions on student academic performance. Washington, DC: Author.

• United States Census (2010). United States census 2010. Retrieved from http://quickfacts.census.gov/qfd/states/36/3651000.html