Building on PBIS to Create a�Trauma-Sensitive School

Ensuring efficiency, effectiveness and sustainability

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Nic Dibble

Wisconsin Department of Public Instruction

nic.dibble@dpi.wi.gov

http://sspw.dpi.wi.gov/

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Lucille Eber, Midwest PBIS Network and National PBIS TA Center

lucille.eber@midwestpbis.org

Midwestpbis.org

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WI PBIS Conference August 19, 2015 Session E4

Overview

• Childhood trauma & its prevalence
• Trauma’s impact on development & learning
• Trauma-informed practice & trauma-sensitive schools
• Resources & professional development to support change efforts in schools
• Interconnected Systems Framework
• Examples
• SPARCS

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What is trauma?

• Trauma refers to extreme or chronic stress that overwhelms a person’s ability to cope & results in feeling vulnerable, helpless & afraid
• Can result from one event or a series of events
• Event(s) may be witnessed or experienced directly
• Experience is subjective
• Often interferes with relationships; self regulation; & fundamental beliefs about oneself, others & one’s place in the world

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Do you have students with these experiences?

• Simple trauma
• Serious accident (e.g., auto)
• Disaster (e.g., tornado, house fire)
• Physical or sexual assault

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• Complex/developmental trauma
• Witness to domestic violence
• Physical, emotional or sexual abuse
• Neglect
• Homelessness
• Living in homes with family members with untreated mental illness or substance abuse
• Having a family member serving overseas in the military

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• Historical/generational trauma

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Source: Washington State Family Policy Council

Prevalence of Trauma in Students

13 of every 30 students in a classroom experience toxic stress from 3 or more Adverse Childhood Experiences (ACEs)

Trauma & Brain Development

Typical Development

Developmental Trauma

Adapted from Holt & Jordan, Ohio Dept. of Education

Trauma affects learning

• Adversely affects students’ ability to …
• Acquire language & communication skills
• Understand cause & effect
• Take another person’s perspective
• Attend to classroom instruction
• Regulate emotions
• Engage the curriculum
• Utilize executive functions
• Make plans
• Organize work
• Follow classroom rules

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The Heart of Learning & Teaching Compassion, Resiliency & Academic Success (Wolpow et al, 2009)

Trauma affects school performance

• Lower scores on standardized achievement tests (Goodman et al, 2011)

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• Substantial decrements in IQ, reading achievement & language (Delaney-Black et al, 2002)

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• 2.5x more likely to be retained (Grevstad, 2007; Sanger et al, 2000; Shonk et al, 2001)

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• Suspended & expelled more often (Grevstad, 2007; Sanger et al, 2000; Shonk et al, 2001)

Daniel & Zarling (2012)

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Trauma changes our physiology�fight, flight or freeze response

Noticeable Effects

• Pupils dilate
• Mouth goes dry
• Muscles tense
• Heart pumps faster
• Breathing rate increases
• Chest pains
• Palpitations
• Perspiration
• Hyperventilation

Hidden Effects

• Brain prepares body for action
• Adrenaline released
• Blood pressure rises
• Liver releases glucose to provide energy for muscles
• Digestion slows or ceases
• Cortisol released (depresses immune system)

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What if this bear walked into this room right now?

• How are you feeling?
• What are you going to do?
• Flee?
• Fight?
• Freeze?
• Are you listening to the presentation?
• Critical learning – to many students impacted by trauma, adults are “bears” that sometimes are very dangerous

Misreading cues

• Young children impacted by trauma spend much time in a low-level state of fear learning to read adults’ non-verbal cues to keep themselves safe
• Their safety depends upon knowing when an adult becomes a “dangerous bear”
• Student may not interpret innocent or neutral looks, actions, & touches from others at school as benign
• Difficult for student to re-learn these cues as meaning different things in different environments

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Adapted from Chris Dunning

Impact on student’s view of world

• I live in a predictable & benevolent world
• I am worthwhile
• I am hopeful & optimistic about my future
• I have the ability to impact & change my life

• The world is not safe
• People want to hurt me
• I am afraid
• No one will help me
• I am not good/smart/ worthy enough for people to care about me
• It will never get better
• I need to establish personal power & control

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Typical Development

Developmental Trauma

vs.

Higher baseline state of arousal

• These students may be in a persistent physiological state of alarm
• (constant “yellow alert”)
• Likely to be more reactive than peers, as external stressors are introduced (e.g., complicated task at school, disagreement with a peer)
• Fight, flight, freeze
• Over-reading possibility of threat leads to lower brain functioning & impulsive acts
• e.g., striking out physically or verbally, leaving the classroom, shutting down
• Student views his/her actions as defensive & justified

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Adapted from Chris Dunning

Key Triggers for Students Impacted by Trauma

• Lack of personal power or control

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• Unexpected change

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• Feeling threatened or attacked

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• Feeling vulnerable or frightened

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• Feeling shame

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• Positive feelings or intimacy

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Triggers can be internal and/or external

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Trauma & behavior

• Behavior is the language of trauma, especially for children
• Most children lack the language skills to describe how they are feeling, so behavior is their expression
• Most expressive behaviors used by these children are considered “negative”
• Reactive, impulsive, aggressive, withdrawn, defiant
• Other behaviors – perfectionistic, lack of trust in adult & peer relationships
• Many of the most challenging behaviors are strategies that have helped the child to survive abusive or neglectful situations & have been generalized to other environments (e.g., school)

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Adapted from Chris Dunning

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The Heart of Learning & Teaching Compassion, Resiliency & Academic Success (Wolpow et al, 2009)

How do we see these students?

Uninformed view

• Anger management problems
• May have ADHD
• Choosing to act out & disrupt classroom (e.g., disrespectful or manipulative)
• Uncontrollable, destructive
• Non-responsive

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Uninformed response

• Student needs consequences to correct behavior or maybe an ADHD evaluation

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Adapted from Daniel & Zarling (2012)

Trauma-informed view

• Maladaptive responses (in school setting)
• Seeking to get needs met
• Difficulty regulating emotions
• Lacking necessary skills
• Negative view of world (e.g., adults cannot be trusted)
• Trauma response was triggered

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Trauma-informed response

• Student needs to learn skills to regulate emotions & we need to provide support

�The needed perspective shift�

Teacher responses to student outburst

“Ashley just transferred into my 5th grade classroom after being placed in foster care. I wanted to make her feel welcome. I moved to put my hand lightly on her shoulder when I was explaining an assignment & she slapped my hand away. Then she stared at me defiantly.”

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• Teacher response #1 – teacher-centered

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• Teacher response #2 – student-centered

Uninformed teacher response

“Why she just decided to slap me is beyond me. I was trying to be helpful & welcoming. Her reaction was totally out of proportion to the situation. Physical aggression simply cannot be tolerated or excused. She needed to learn that right away. There had to be immediate & significant consequences if I’m to maintain order in my classroom. When I tried to remove Ashley to the office, she just lost it. Instead of complying, she chose to struggle & started kicking me. I don’t like to see students suspended from school, but Ashley needs to learn that she cannot behave that way in school.”

Trauma-informed teacher response

“I must have frightened Ashley without meaning to. It’s clear she does not want to be touched. She may have other triggers, as well. Right now she is hyper-aroused & feels cornered. If I put any extra demands or expectations on her right now, she could escalate & that will just make the situation worse. I told Ashley we would talk about what just happened when she calms down. I need to help her feel safe or she won’t be able to learn in my classroom. I know it’s common for kids in foster care to have trauma. I need to find out more about what her needs are, maybe from her school records or from her foster parents & the caseworker. If I need to, I’ll contact our Building Consultation Team for support.”

Cues to Use “Alternative Behavior Lens”

• Known history of potentially traumatizing events or traumatic stress
• Behavioral responses are rapid &/or disproportionately intense given the stimulus
• Traditional approaches & responses not successful
• Efforts to teach alternative behaviors not working
• Rewards/consequences are activating
• Traditional FBA approach not successful
• Antecedent behaviors & patterns hard to identify (i.e., no pattern to where & when behavior occurs & who is present)
• Function of behavior may be neurological & not observable (i.e., not outcome driven)

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Adapted from Zivsak, Vidimos, & Mack

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Trauma-sensitive schools

Trauma-sensitive schools

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• recognize the prevalence & impact of traumatic occurrence in students’ lives &

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• create a flexible framework that provides universal supports, is sensitive to the unique needs of students & is mindful of avoiding re-traumatization.

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Adapted from Helping Traumatized Children Learn

Why use the PBIS framework for trauma-sensitive schools?� �The fundamental purpose of PBIS is to make schools more effective & equitable learning environments. Rob Horner, Co-Director of the OSEP Technical Assistance Center for PBIS�

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Predictable

Consistent

Positive

Safe

Department of Public Instruction Trauma-Sensitive Schools Resources�http://sspw.dpi.wi.gov/sspw_mhtrauma

Which Tier? �Depends on your Data

Tier 3 – Intensive mental health supports designed to meet the unique needs of students who already display a concern or problem.

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Tier 2 – Targeted mental health supports provided �for groups of students identified as at risk for a �concern or problem.

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Tier 1 – Universal supports that all students receive. �Promoting wellness & positive life skills can �prevent or reduce mental health concerns or �problems from developing.

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Review Students’ Mental Health Needs: Local Data Sources

• Data from your school or district
• disciplinary data
• truancy data
• dropout rates
• school counselors’ data on number of students served in a school year�
• Data from the community mental health partners
• number of students served by zip code/catchment area
• number of students with different diagnoses
• number of students who received different services

The Interconnected Systems Framework (ISF)�

• How Multi-Tiered Systems of Support (MTSS) can enhance mental health in schools

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• Installing MH through MTSS in Schools
• Systems
• Data
• Practices

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Advancing Education Effectiveness: Interconnecting School Mental Health &

School-Wide Positive Behavior Support

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Editors: Susan Barrett,

Lucille Eber & Mark Weist

pbis.org

csmh.umaryland

IDEA Partnership NASDSE

Core Features

• Effective teams that include community mental health providers
• Data-based decision making
• Formal processes for the selection & implementation of evidence-based practices (EBP)
• Early access through use of comprehensive screening
• Rigorous progress-monitoring for both fidelity & effectiveness
• Ongoing coaching at both the systems & practices level

ISF Defined

• Structure & process for education & mental health systems to interact in most effective & efficient way …

• … guided by key stakeholders in education & community mental health systems …

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• … who have the authority to reallocate resources, change role and function of staff, & change policy

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ISF Defined

• Tiered prevention logic
• Cross system problem-solving teams
• Use of data to decide which evidence-based practices to implement
• Progress monitoring for both fidelity & impact
• Active involvement by youth, families, & other school & community stakeholders

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The Need to Be Plan-ful

• Exploration-Adoption
• Installation
• Initial Implementation
• Full Implementation
• Innovation
• Sustainability

Implementation occurs in stages

Fixsen, Naoom, Blase, Friedman, & Wallace, 2005

3-Tiered System of Support

Necessary Conversations (Teams)

Check-In Check-Out

Skills Groups

Group w. individual

feature

Complex

FBA/BIP

Problem Solving Team Meeting

Tertiary Systems Team Meeting

Brief

FBA/BIP

Brief FBA/BIP

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Wraparound

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Secondary Systems Team

Meeting

Plans schoolwide & classroom supports

Uses process data; determines overall intervention effectiveness

Standing team; uses FBA/BIP process for one student at a time

Uses process data; determines overall intervention effectiveness

Universal�Team

Meeting

Universal Support

USDOE-OSEP Tertiary Demo Project

#H326M0060010

Coordinator vs. Facilitator

Coordinator

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• Organizes &/or oversees the specific interventions such as CICO, S/AIG & Group with Individual Features

• Roles include: scheduling meetings, review & collect data to share during team meetings, etc…

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Facilitator

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• Directly provides intervention support services to youth & families

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• Roles include: meeting with students for CICO, running groups

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USDOE-OSEP Tertiary Demo Project

#H326M0060010

USDOE-OSEP Tertiary Demo Project

#H326M0060010

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Quick Review: �Skill-based Instructional Groups

• Selection into groups should be based on youths’reaction to life circumstance, not existence of life circumstances (e.g., fighting with peers, not family divorce)
• Goals for improvement should be common across youth in same group (e.g., use your words)
• Data should measure if skills are being USED in natural settings, not in counseling sessions (transference of skills to classroom, cafeteria, etc.)
• Stakeholders (teachers, family, etc.) should have input into success of intervention (e.g., Daily Progress Report)

Choosing or Designing �Group Interventions

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• Choose & modify lessons from pre-packaged material based on the skill needed for the group

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and/or

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• Use already created universal behavior lesson plans or create lesson plans (Cool Tools) to directly teach replacement behaviors

Daily Progress Report (DPR) Sample�

NAME:______________________ DATE:__________________

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Teachers please indicate YES (2), SO-SO (1), or NO (0) regarding the student’s achievement� in relation to the following sets of expectations/behaviors.

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Adapted from Grant Middle School STAR CLUB

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Adapted from Responding to Problem Behavior in Schools: The Behavior Education Program by Crone, Horner, and Hawken

Daily Progress Report (DPR) Sample�

NAME:______________________ DATE:__________________

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Teachers please indicate YES (2), SO-SO (1), or NO (0) regarding the student’s achievement� in relation to the following sets of expectations/behaviors.

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Adapted from Grant Middle School STAR CLUB

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Adapted from Responding to Problem Behavior in Schools: The Behavior Education Program by Crone, Horner, and Hawken

“Social & Academic Instructional Groups”

Walk to class�Keep hands to self�

Use appropriate language�Raise hand to speak

Bring materials �Fill out assignment notebook

Daily Progress Report (DPR) Sample�

NAME:______________________ DATE:__________________

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Teachers please indicate YES (2), SO-SO (1), or NO (0) regarding the student’s achievement� in relation to the following sets of expectations/behaviors.

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Adapted from Grant Middle School STAR CLUB

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Adapted from Responding to Problem Behavior in Schools: The Behavior Education Program by Crone, Horner, and Hawken

Use your words

Use deep breathing

Keep arm’s distance

Use #2 voice level when upset

Ask for breaks

Self-monitor with DPR

“Individualized Student Card After FBA/BIP"

Where do specific “MH” Interventions Fit?

That depends on the data of

the school & community

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Examples of Expanded View of Data

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• Child welfare contacts
• Violence rates
• Incarceration rates
• Deployed families
• Homeless families
• Unemployment spikes

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A Trauma-Informed Intervention - SPARCS?

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Structured

Psychotherapy for

Adolescents

Responding to

Chronic

Stress

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DeRosa, R., Habib, M., Pelcovitz, D., Rathus, J., Sonnenklar, J., Ford, J., Kaplan, S. (2005). SPARCS: Structured Psychotherapy for Adolescents Responding to Chronic Stress: A Trauma-Focused Guide. Great Neck, NY: North Shore- Long Island Jewish Health system, Inc.

Facilitation Techniques for Instructional Groups

• Psychoeducation
• Skill-based
• Role-Play
• Group Discussion
• Games
• Experiential Instruction
• Teambuilding/Group Cohesion

A Typical SPARCS Session

• Check-in
• Practice from last session
• Mindfulness exercise
• Session-specific content & activities
• Example: Bottle about to Burst
• Check-out
• Remind to practice

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DeRosa, R., Habib, M., Pelcovitz, D., Rathus, J., Sonnenklar, J., Ford, J., Kaplan, S. (2005). SPARCS: Structured

Psychotherapy for Adolescents Responding to Chronic Stress: A Trauma-Focused Guide. Great Neck, NY: North Shore-Long Island Jewish Health system, Inc.

Schools & Community Mental Health: A True Collaboration

• “Upper Tier 2” intervention
• We sit on the Tier 2 team
• School staff identify students
• School staff make initial contact with parents/guardians
• We screen & assess students
• Co-facilitate SPARCS groups

A Problem

• “Students cannot benefit from interventions they do not experience ….. “

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© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008

• SPARCS
• Evidence-Informed

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• 16 Sessions
• 1 hour each

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• Adolescents
• 12 – 21 years old

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• History of Trauma

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• Chronic Stress

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• Exhibit Functional
• Impairment

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Research: SPARCS

• National Child Traumatic Stress Network Empirically Supported Treatments & Promising Practices List

http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices

• Clinical & anecdotal evidence
• Research Evidence
• Outcomes

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http://naswil.org/news/chapter-news/featured/for-school-social-workers-sparcs-sparks-interest-among-adolescents-in-champaign-county/

http://sparcstraining.com/index.php

Students who might benefit from SPARCS

• Affect & Behavioral Regulation: “I get upset over the smallest things & I don’t know how to calm down.” “Why wouldn’t I get high? What’s the point of staying sober?”
• Attention/Consciousness: “My teachers always say that I don’t seem to hear the directions & I don’t know what’s going on when they call on me.”
• Self-Perception: “I can’t do anything right; nothing I do ever works out.”
• Relationships: “I’ll beat the crap out of anyone who tries anything with me; I’m not letting anyone disrespect me.”
• Somatization: “I’ve had stomachaches and headaches ever since I can remember.”
• Systems of Meaning: “You’re born, you die, what’s the big deal?”

Complex Trauma Domains

• Emotional & Behavioral Regulation
• Attention/Consciousness
• Self-Perception
• Relationships
• Somatization
• Systems of Meaning

DeRosa, R., Habib, M., Pelcovitz, D., Rathus, J., Sonnenklar, J., Ford, J.,…Kaplan, S. (2005). SPARCS: Structured

Psychotherapy for Adolescents Responding to Chronic Stress: A Trauma-Focused Guide. Great Neck, NY: North Shore-

Long Island Jewish Health system, Inc.

SPARCS’ Goals: The 4 Cs

DeRosa, R., Habib, M., Pelcovitz, D., Rathus, J., Sonnenklar, J., Ford, J.,…Kaplan, S. (2005). SPARCS: Structured

Psychotherapy for Adolescents Responding to Chronic Stress: A Trauma-Focused Guide. Great Neck, NY: North Shore-

Long Island Jewish Health system, Inc.

Impact

• Reductions in problem behavior
• Improvements in attendance
• Improvements in grades
• Students “recruiting” other students
• Students who completed intervention supporting other students

Students Sharing Impact … their words …

Question 1

What skills did you learn in SPARCS that you now use in your daily life?

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• “Helps me slow down before I act”

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• “I think about some of the activities we do in group such as the bottle about to burst”

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• “I am able to help my friends think before they act”

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Question 2

What did you like about SPARCS?

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• “I learned things about myself”

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• “I felt a part of the group & knew that what I said would stay in the group”

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• “I learned to negotiate with my mom instead of arguing with her or walking out”

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Question 3

What suggestions do you have to improve SPARCS?

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• “Have more kids be a part”

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• “Be able to be a part of the group in the second semester”

Question 4

Would you recommend SPARCS to other students? If so, why?

• “It really helped me”

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• “You learn new ways of dealing with your anger”

• Questions?

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• Comments?

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• Thank you!

Featuring sessions specifically designed for our Mental Health, Juvenile Justice, and Family/Community Partners!

This two-day forum for school, state, district and regional Leadership Teams and other professionals has been designed to increase the effectiveness of PBIS implementation.  

PBIS: Integrated Multi-Tiered Framework for Educational Success

Visit the Upcoming Events page at www.pbis.org for more information

October 22-23, 2015

SAVE THE DATE

Donald Stephens Convention Center - Rosemont, IL

Donald E. Stephens

Convention Center

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Rosemont, Illinois

Sessions are organized by strands that support initial through advanced implementation in elementary, middle, and high schools as well as juvenile justice facilities:

PBIS Foundations

Classroom Applications

Tier 2 Systems & Practices

Tier 3 Systems & Practices

Aligning Systems

Juvenile Justice

Mental Health Integration

Equity

Applied Evaluation

Special Topics

OSEP Technical Assistance Center on PBIS 2015 Leadership Forum