The Comprehensive Behavioral Health Model
Comprehensive Behavioral Health Model Boston Public Schools Behavioral Health Services 443 Warren St. Boston, MA, 02101 CBHMBoston.com
A letter from Amalio Nieves Superintendent for Social Emotional Learning and Wellness Boston Public Schools is committed to transforming the lives of children through exemplary teaching and learning practices in a world-class and innovative educational system. We understand that physical and mental health, emotional well-being and positive youth development are linked with academic success. The Comprehensive Behavioral Health Model (CBHM) has been instrumental in enhancing the district’s capacity to meet the behavioral needs of students in our schools. Through the process of integrating the practices of CBHM in our schools, we are establishing a way to ensure all schools have access to high-quality and coordinated behavioral and mental health supports. Boston Public Schools believes that school communities are a network of support for its diverse students, families and staff. We believe that providing instruction, supports and services for Social Emotional Learning (SEL) and Wellness is essential for educational success. BPS has affirmed its strong commitment to the social-emotional learning and wellness needs of its students through the creation of a new department, the Office of Social Emotional Learning and Wellness. This new department strives to build upon CBHM‘s work integrating other BPS departments, services and supports to promote positive school climate and youth development, prevent violence and bullying, and engage students collectively. Our commitment to our students, families and community is to move from random acts of equity and pockets of excellence to systemic transformation. Though much has been accomplished, there is still much work ahead. We know that this work matters to our young people and their families, and we cannot do this alone. The Office of SEL and Wellness looks forward to harnessing the tremendous power of community to proactively and positively impact the lives of our children. To learn more about BPS or CBHM, please visit our websites at www.bostonpublicschools.org and www.cbhmboston.com. Your input is welcomed and vital to our continued success. We look forward to hearing from you. Sincerely,
Amalio Nieves
Improving school culture and addressing the behavioral health needs of students depends on integrated and sustainable partnerships. Therefore, we would like to thank our key partners and partnering organizations who have contributed to the development of CBHM (see page 21). Special thanks go to the staff of the Boston Public Schools Behavioral Health Services Department without whom this work could not happen. CBHM EXECUTIVE WORKGROUP ANDRIA AMADOR
JOHN RIORDAN
JENNIFER CORISH - WHITE
LAURA SHACHMUT
SHELLA DENNERY
JILL SNYDER
ELAINE LEONG
DANIEL WEINSTOCK
JOHN MACDONALD
MARY ZORTMAN COHEN
MELISSA PEARROW
Designed by students in Professor Lisa Rosowsky’s Community Designed students in Professor Lisa Rosowsky’s Community Partnership Design course at the Partnershipby Design course at the Massachusetts College of Art Massachusetts College of Art and Design, Fall 2015 and Design, Fall 2015: STUDENTS AUSTIN ALPHONSE
LUCIA CONCHELLO - BUEYES
NATHANIEL AMARO
OSCAR CROCKER
STEFANIE BAZARIAN
LAURA MENDEZ
JOHN BRADY
MONTAKAN NAMTHONG
MOLLY BREEN
DALENA TRAN
FAN CHEN
Imagine a school in which children, families, faculty and community partners feel welcome and valued. All children experience a social emotional learning curriculum as part of their classroom and school experience. Teachers periodically review each of their students’ behavioral health strengths and needs, and students in need of additional support are provided appropriate services quickly. Teams of teachers and administrators review student behavioral health data and progress on a regular basis. Community partners, families, and school personnel meet periodically and communicate regularly about children who are receiving additional support. You don’t have to imagine it: this is already happening in many of Boston’s public schools!
Comprehensive Behavioral Health Model 1
Welcome to CBHM What is the Comprehensive Behavioral Health Model? Opposite: Sharman Nathanson, Children’s Advocacy Center of Suffolk County, at the CBHM Showcase Event June 2015 Below: School psychologist, Kelly Cotton, with children at the Jackson-Mann K-8 school.
The Comprehensive Behavioral Health Model (CBHM) was developed by the Boston Public Schools Behavioral Health Services department, in collaboration with Boston Children’s Hospital. It is a district wide response to the need for behavioral health support for all students in our schools. CBHM is a multi-tiered system designed to give all Boston Public School students access to high-quality behavioral and mental health support.C BHM was put into place during the 2012–2013 school year; it is now used in forty schools, with more locations added every academic year.
Why do we need a Behavioral Health Model?
The goal of the Comprehensive Behavioral Health Model is to address students’ behavioral health needs in a positive way, making it easier for them to learn and communicate well. Both in and through CBHM’s universal screening process, at-risk students are identified as needing emotional support early, before a problem comes up. The three-tiered model ensures students receive the appropriate level of support, while the data gathered from the program helps your school ensure the supports are working. Models like this have been proven to improve academic performance—CBHM really works!
Comprehensive Behavioral Health Model 3
The Three Tiered System The core of the Comprehensive Behavioral Health Model is its 3-tiered system, which reaches out to all students in the Boston Public Schools that have implemented the model.
Universal
Individual
INTERVENTION
INTERVENTION
INTERVENTION
5-10% 10-20% 100% of students receive Universal Interventions
4 Boston Public Schools
of students receive Targeted Interventions
of students receive Individual Interventions
“It helps us to build a sense of community and grow the selfconďŹ dence and self-esteem of our students.â€? Tricia Lampron, Principal of Henderson School
Universal
Tier 1 is the core of the CBHM, and provides universal interventions designed to meet the needs of every student, every day. Students learn how to express themselves, communicate with others, and behave in positive ways both in and out of the classroom.
Targeted
Tier 2 serves students who continue to struggle with behavioral issues in school. It uses short-term, solution focused interventions to build skills. Tier 2 provides students who need it with regular supervision, corrective feedback, and positive reinforcement by adults and peers.
Individual
Tier 3 is designed to meet the unique needs of students who are experiencing high levels of distress. Individual interventions use the services of highly trained and specialized staff and healthcare providers. Interactions on this level are designed to address the strengths and needs of each individual student.
Comprehensive Behavioral Health Model 5
FAMILIES
6 Boston Public Schools
Maybe your child came home from school talking about the day’s lessons on respect. Or maybe she proudly showed you a certificate rewarding her for positive behavior in the classroom. Or you may have been contacted by your child’s teacher asking you to come in and talk about how to improve his social skills. This is the Comprehensive Behavior Health Model in action. Whether your student is in elementary school or in high school, CBHM can help improve your child’s behavior at home as well as in school.
Comprehensive Behavioral Health Model 7
CBHM & Your Family Your Child’s Academic Success
8 Boston Public Schools
Much research has been done to help us understand the connection between behavioral health programs and a student’s academic achievement. Studies have continued to show that strengthening students’ social, emotional, and decision-making skills has a positive effect on their academic achievement. Students learning in schools where CBHM has been implemented have demonstrated an increase in academic performance, as measured by the MCAS. As behavioral health improved between 2012 and 2014, average student scores in math and reading improved.
Schools Using CBHM
You will find students in every grade level have class time each week devoted to discussing social, emotional and behavioral topics. These topics range from sharing to staying organized, and everything in between. CBHM ensures topics are age appropriate and relevant for each school. Instead of testing students for their academic skills alone, teachers in your child’s school use a screening process, which helps them to identify a student’s academic and behavioral skills. All students are screened, and the information gathered helps your child’s school—and all Boston Public Schools—to identify areas of need and coordinate programming to meet these needs. Students who are identified as needing additional behavioral intervention gather in small groups outside of class time, and meet with teachers to set up a special plan for improvement. Students whose behavioral needs require further attention may be referred for counseling or other one-on-one supports.
Comprehensive Behavioral Health Model 9
Success Stories Joey
When Joey, a fourth grade student at Mason Pilot School in Roxbury, entered fourth grade he barely spoke, and when he did it was in whispers. As a student diagnosed with a mood disorder and PTSD, he was having difficulty regulating his emotions and behavior in the classroom, leading to frequent escalations. It was apparent that being in class every day was a challenge and his teachers were concerned about meeting his needs in an inclusive classroom. Instead of placing Joey into a separate “behavior” class, a team of qualified educators and family members came up with a plan to monitor, and improve his behavior. By the end of the year, Joey had fewer emotional escalations and he was able to pay attention in class far better than ever before. His shining moment was when he was awarded the class’ “Most Improved” award at an end-of-the-year ceremony.
10 Boston Public Schools
Edwin
Edwin is a 10-year old Jackson Mann student enrolled in the school’s Autism Strand. Edwin, who has difficulty with expressive language, was presented with a Golden Tiger certificate for showing Jackson Mann positive behaviors. A few days later, teachers found the Golden Tiger award in Edwin’s backpack—framed! At first, everyone thought Edwin’s mom must have framed his Golden Tiger award for him, but they later found out that Edwin framed it himself. Edwin couldn’t express his feelings about the award with words, but he certainly showed everyone how much it mattered to him!
Comprehensive Behavioral Health Model 11
SCHOOLS
12 Boston Public Schools
Whether you are a classroom or special education teacher, a school psychologist, school administrator, or staff, you want the best for your school. By nurturing an emotionally healthy school community, CBHM improves student test scores and reduces disciplinary rates, making for a happier environment both inside and outside the classroom. This model enables teachers and school staff to develop individual programs to suit each student who needs it. And the best part? CBHM really works!
Comprehensive Behavioral Health Model 13
CBHM in School Comprehensive Behavioral Health Model and your school
Below: Pupil Adjustment Counselors from Behavioral Health Services
14 Boston Public Schools
The Comprehensive Behavioral Health Model has clearly deďŹ ned behavioral expectations. Staff use consistent language to teach students core values and daily routines. Positive behaviors are recognized and reinforced, and success is celebrated. Schools using CBHM are expected to use multiple sources of data to analyze problems, plan instruction, make decisions and ďŹ nd solutions. After solutions are developed and implemented, they are evaluated to determine their effectiveness, and tweaked as necessary. Most importantly, educators in schools using the CBHM show students they care. Students know who they can turn to for support, and how to ask for the help they need.
BHS Sample Behavior Matrix
Classroom
RIGOR
INCLUSIVITY
RESPECT
Arrive to class on time
Listen to others
Come ready to learn
Behave in a way that allows you and others to learn
Respect all opinions
Challenge yourself
Learn about others
Be present
Be willing to work with and help others
Ask questions and give feedback
Embrace new ideas and concepts
Actively participate
Think of all students as learning partners
Be a positive role model
Demonstrate tolerance
Take advantage of available supports
Be welcoming
Be on time to class
Smile and greet others
Be positive
Help others make good choices
Throw away trash
Demonstrate tolerance
Follow school rules
Move to your destination quickly
Commitment to whole school improvement
Look out for each other
Use appropriate language
Follow directions from all adults
Respect physical and personal boundaries Use academic language Engage in learning
Shared Spaces
Be polite to cafeteria staff
Sit with new people
Look out for each other
Throw away trash
Use appropriate language
Clean up trash that is not yours
Be friendly
Share table space
Return materials on time
Work with others
Check out and read books
Use quiet voices
Be accepting of new ideas and concepts
Use library space productively
Take care of materials
Share materials
Explore new topics
Library
Make way for others
Cafeteria
Bring materials and assignments to class
Respect physical and personal boundaries
Be friendly Keep space tidy Be polite to library staff
Take advantage of available supports
Success Stories Harvard Kent
Opposite: Ashot Gheridian, a teacher at Brighton High, instructing his students. Below: Students from the Harvard Kent Elementary School celebrate a “fancy lunch” as a reward for showing the school’s Core Values
16 Boston Public Schools
The Harvard Kent began its CBHM work at the beginning of the 2014–2015 school year. Harvard Kent’s school values are centered on Purpose, Responsibility, Individuality, Determination and Engagement (P.R.I.D.E!). Students are rewarded with PRIDE! Bucks when they show those core values. Noticeable behavioral improvement has been seen in both the hallways and cafeteria and the program is starting to expand to other areas of the building. In the first two months of handing out PRIDE! Bucks; $32,000 in face value bucks was earned by our students and 480 times per day a student or an entire class was handed a Pride Buck by a staff person.
Brighton High
In 2014, Brighton High School decided it needed to change the way students were supported. The high school led the district in student suspensions, with nearly twice the city average. So it reached out for help and soon became a CBHM school. Within the first year, Brighton High School implemented new behavioral programs and the climate of the school began to change. Brighton High conducted a universal screening to identify what supports the students needed. This data led to the adoption of Restorative Justice and a complete change in the way the school approached discipline with the students. By the end of the first year, Brighton High had lowered student suspensions by 44% and students and teachers both reported a more positive school climate and a better learning environment. Brighton High continues to be an active school within the CBHM model.
Comprehensive Behavioral Health Model 17
PARTNERS
CBHM relies on partnerships to help accomplish its many required tasks. When partnered with institutions like universities and healthcare providers, CBHM works to reach out to those in need of comprehensive and accessible counseling. Grants and donations also go a long way to assist CBHM in its goal.
Partners of CBHM Why We Need our Partners
BPS is fortunate to have an abundance of community-based organizations that have helped develop CBHM. Some of our primary partners include Boston Children’s Hospital and the University of Massachusetts Boston (UMB) School Psychology Program. These district level partnerships have been instrumental to developing systemic solutions which outline best practices for serving students. Together, we have charted a vision for meeting the behavioral health needs of all BPS students.
Below (left to right): Patrick Kennedy, Melissa Pearrow: Professor, UMASS Boston, Stacy Skalski: Director of Professional Policy and Practice, National Association of School Psychologists, Michael Middleton: UMASS Boston Dean of Education and Human Development
20 Boston Public Schools
CBHM also partners with many community based agencies that provide services within our schools. School level partnerships enhance our capacity to meet the needs of students by providing direct services. These services include individual and group counseling, consultation, case management, and crisis intervention. We look forward to further developing these and new partnerships, as we continue to serve the Boston Public School’s students and families.
KEY PARTNERS ANDRIA AMADOR
CBHM Executive Workgroup
ACHILLES BARDOS AMY BRIESCH
University of Northern Colorado
Northeastern University
TOMMY CHANG
Boston Public Schools
JENNIFER CORISH - WHITE
CBHM Executive Workgroup
BARBARA DEANE - WILLIAMS
Boston Public Schools
DAVID DEMASO BOSTON CHILDREN ’ S HOSPITAL SHELLA DENNERY
Boston Children’s Hospital
STEPHANIE DOYLE JOAN DUFFELL
Boston Public Health Commission
Committee for Children
CBHM Executive Workgroup
JOHN MACDONALD
MICHAEL MIDDLETON SHARI NETHERSOLE
Boston Public Schools
AMALIO NIEVES
MELISSA PEARROW ROBERT PUTNAM JOHN RIORDAN
University of Massachusetts Boston
May Institute
Boston Children’s Hospital
LAURA SHACHMUT STACY SKALSKI
University of Massachusetts Boston
Boston Children’s Hospital
CBHM Executive Workgroup
National Association of
School Psychologists
KARLA ESTRADA
Boston Public Schools
JILL SNYDER
ADAM FEINBERG
University of Massachusetts Boston
GEORGE SUGAI
University of Connecticut
ROBERT VOLPE
Northeastern University
PATRICK KENNEDY AMY KAYE
Former US Congressman
Boston Children’s Hospital
ELAINE LEONG
CBHM Executive Workgroup
JIM MCDOUGAL
SUNY Oswego
JENNIFER MACONOCHIE
Boston Police Department
CBHM Executive Workgroup
DANIEL WEINSTOCK
Educational Consultant
MARY ZORTMAN COHEN CHARLENE ZUFFANTE
CBHM Executive Workgroup
Boston Metro Department
of Mental Health
PARTNERING ORGANIZATIONS
Boston Children’s Hospital Boston Metro Department of Mental Health
Massachusetts Safe and Supportive Schools Commission
Boston Police Department
May Institute
Boston Public Health Commission
Metro Boston Department of Mental Health
Boston Public School Principals
National Association of School Psychologists
Boston Public School Teachers
Northeastern University–School Psychology program
Boston Public School Students & Families
United States Department of Justice
Boston School Based Mental Health Collaborative
University of Massachusetts Boston–
Boston Teachers Union Committee for Children
Department of Counseling & School Psychology Screening for Mental Health
Comprehensive Behavioral Health Model 21
Success Stories Boston Children’s Hospital
Boston Children’s Hospital has partnered with BPS and the Behavioral Health Department to support the implementation of the CBHM across the district. Children’s Hospital provides financial and personnel assistance, including CBHM Executive Workgroup Representatives as well as school based service providers who are familiar with the CBHM model and can help facilitate thorough implementation across schools. As a key partner in CBHM Boston Children’s Hospital has co-sponsored professional development events, awareness events and co-presented with CBHM staff at national conferences. Boston Children’s Hospital and BPS are modeling how schools and hospitals can work together strategically to improve the lives of children.
Opposite: Partners from Children’s Hospital meet with Patrick Kennedy at the CBHM Showcase event.
22 Boston Public Schools
School Based Behavioral Health Collaborative
UMASS Boston
Working in partnership with the Boston Public Schools, the Boston Area School Based Behavioral Health Collaborative is a collective of state, city, and community based organizations committed to promoting the behavioral health, wellbeing, and academic success of students. The Collaborative is dedicated to ensuring equitable access to high quality, culturally competent school-based behavioral health services and resources for all students in the Boston Public Schools.
University of Massachusetts Boston has partnered with BPS and the Behavioral Health Department to support the implementation of CBHM across the district. UMASS Boston has representatives on the CBHM Executive Workgroup to support research, evaluation, and program delivery. In addition, UMASS Boston supports the involvement of school psychology practices and internship experiences in BPS to help deliver high quality behavioral and mental health supports for BPS students.
Comprehensive Behavioral Health Model 23
Next Steps for CBHM
The CBHM framework calls for the use of tiered interventions for addressing behavior and school climate. Research supports that using a similar tiered model for academic interventions also improves student outcomes. The Boston Public Schools is committed to implementing a comprehensive tiered model for behavior and academics. The Massachusetts Department of Education calls this model The Massachusetts Tiered System of Support (MTSS). MTSS supports both the academic and behavioral health of students through systems initiatives, core instruction, tiered interventions and progress monitoring. As BPS continues to develop MTSS, our CBHM team will work to integrate what we have learned from CBHM into MTSS. A basic graphic to represent this merger appears below. For more information about CBHM visit our website at www.cbhmboston.com
RTI
Academic
For more information about MTSS visit the Department of Elementary and Secondary Education website at www.doe.mass.edu/sped/mtss.html
Universal
Targeted
Individual
INTERVENTION
INTERVENTION
INTERVENTION
CBHM 24 Boston Public Schools
Behavioral
s
A letter from Amalio Nieves Superintendent for Social Emotional Learning and Wellness Boston Public Schools is committed to transforming the lives of children through exemplary teaching and learning practices in a world-class and innovative educational system. We understand that physical and mental health, emotional well-being and positive youth development are linked with academic success. The Comprehensive Behavioral Health Model (CBHM) has been instrumental in enhancing the district’s capacity to meet the behavioral needs of students in our schools. Through the process of integrating the practices of CBHM in our schools, we are establishing a way to ensure all schools have access to high-quality and coordinated behavioral and mental health supports. Boston Public Schools believes that school communities are a network of support for its diverse students, families and staff. We believe that providing instruction, supports and services for Social Emotional Learning (SEL) and Wellness is essential for educational success. BPS has affirmed its strong commitment to the social-emotional learning and wellness needs of its students through the creation of a new department, the Office of Social Emotional Learning and Wellness. This new department strives to build upon CBHM‘s work integrating other BPS departments, services and supports to promote positive school climate and youth development, prevent violence and bullying, and engage students collectively. Our commitment to our students, families and community is to move from random acts of equity and pockets of excellence to systemic transformation. Though much has been accomplished, there is still much work ahead. We know that this work matters to our young people and their families, and we cannot do this alone. The Office of SEL and Wellness looks forward to harnessing the tremendous power of community to proactively and positively impact the lives of our children. To learn more about BPS or CBHM, please visit our websites at www.bostonpublicschools.org and www.cbhmboston.com. Your input is welcomed and vital to our continued success. We look forward to hearing from you. Sincerely,
Amalio Nieves
Improving school culture and addressing the behavioral health needs of students depends on integrated and sustainable partnerships. Therefore, we would like to thank our key partners and partnering organizations who have contributed to the development of CBHM (see page 21). Special thanks go to the staff of the Boston Public Schools Behavioral Health Services Department without whom this work could not happen. CBHM EXECUTIVE WORKGROUP ANDRIA AMADOR
JOHN RIORDAN
JENNIFER CORISH - WHITE
LAURA SHACHMUT
SHELLA DENNERY
JILL SNYDER
ELAINE LEONG
DANIEL WEINSTOCK
JOHN MACDONALD
MARY ZORTMAN COHEN
MELISSA PEARROW
Designed by students in Professor Lisa Rosowsky’s Community Designed students in Professor Lisa Rosowsky’s Community Partnership Design course at the Partnershipby Design course at the Massachusetts College of Art Massachusetts College of Art and Design, Fall 2015 and Design, Fall 2015: STUDENTS AUSTIN ALPHONSE
LUCIA CONCHELLO - BUEYES
NATHANIEL AMARO
OSCAR CROCKER
STEFANIE BAZARIAN
LAURA MENDEZ
JOHN BRADY
MONTAKAN NAMTHONG
MOLLY BREEN
DALENA TRAN
FAN CHEN
The Comprehensive Behavioral Health Model
Comprehensive Behavioral Health Model Boston Public Schools Behavioral Health Services 443 Warren St. Boston, MA, 02101 CBHMBoston.com