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Dawn Sherrill

Mock Comprehensive Counseling and Guidance Program Manual

2011-2012

Comprehensive Counseling and Guidance Program Plan

for 2011-2012 School Year

Developed by Dawn Sherrill

Adaptations from Missouri Center for Career Education and Iowa Comprehensive Counseling and Guidance Program

Standard Forms for the Guidance and Counseling Program______________________________

A. Introductory Letter for Parents B. Record of All Students SeenC. Individual Student Contact SheetD. Parent Contact LogE. Group LogF. Counseling Note

I. Guidance Curriculum________________________________________________________

A. Overview B. Missouri Comprehensive Guidance Program Big Ideas, Strands, ConceptsC. Curriculum Units (K-5) for 2011-2012 School Year

Example Lesson – Problem-Solving/Decision Making - KindergartenExample Unit – Friendship and Differences (3-5)Example Unit – Friendship and Feelings (3-5)Example Unit – Careers (K-2)

II. Responsive Services__________________________________________________________

A. OverviewB. Referral Process Flow ChartC. Referral Process Data Collection Flow ChartD. Staff Development Flow ChartE. Levels of Responsive Services Interventions F. Referral Process Forms

- Faculty/Staff Referral- Student Self-Referral - Parent/Guardian Referral Form- Information about Counseling for Parents- Informed Consent Form- Consent for Release of Information Form- Student Behavior Data Collection Form- Student Contact Data Table- Hotline Phone Call Information - Outside Referral Resources

II. Responsive Services (continued)__________________________________________________

Example Group – Kindergarten Boys’ Social Skills GroupExample Group Session – Test Anxiety Group (3rd)Example Brief Counseling Session – Social Skills (4th) Example Brief Counseling Session – Conflict Resolution (1st)

III. Individual Planning__________________________________________________________

A. Overview

IV. System Support _____________________________________________________________

A. OverviewB. Public Relations Ideas for 2011-2012 School YearC. Perceptual Data Forms

- Teacher Pre-Post Group Perceptions- Teacher/Parent/Guardian Small Group Follow-Up- Teacher Post-Group Perceptions- Request for Feedback from Parents/Guardians- Parent/Guardian Post-Group Perceptions- Student Feedback Form

Standard Forms for the Guidance and

Counseling Program

August 2011 Dear Parents, Welcome to the 2011-2012 school year at ___________ Elementary School. The school counseling program at __________ is based on the American School Counseling Association Model and Missouri Public School Standards. It includes a variety of components described below: Classroom Guidance sessions will occur throughout the year. The guidance curriculum for each class will include an emphasis on respect, responsibility and bullying for the K-3rd grades and bullying prevention for the 4th and 5th grades. The lessons will be weekly or bi-weekly and will not exceed more than 30 minutes. Small Counseling Groups will start in September. I will offer groups on a variety of topics including social skills, friendship, study skills and anger. All groups are formed on the needs of the students. Any staff or parent can refer a student they feel could benefit from small group counseling. All requests MUST BE submitted in written from. Individual Counseling in the elementary school is short-term, meaning a student would be seen no more than 8 times depending on the need and circumstances. Individual counseling can begin at anytime during the year. Transition Assistance will be for all new students. I will meet with the students during lunch to give them additional information about ________ and give each student a chance to ask questions. Teacher Consultation and collaboration is available every day. Parent Consultation is also available BY APPOINTMENT. Please feel free to set up an appointment by phone at (573) 823-0953 or you can e-mail me at [email protected]. I return calls and e-mail during the day when possible. I look forward to working together this year. Sincerely,Dawn SherrillProfessional School Counselor

mailto:[email protected]

Record of All Students Seen School Year _________ Page _____

Date Referred Student Grade Homeroom Reason DateRef. By Name Level Teacher Referred Seen

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Individual Student Contact Sheet

Student ____________Grade ______ Homeroom ______________ School Year ______Address ____________________________City/State/Zip _________________________Parent/Guardian Names ________________________________________________________________Home/Work/Cell Phones: _______________________________________________________________Additional Info _______________________________________________________________________

Date Person Referred Reason Interventions/Seen Seen By Referred Suggestions

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Parent Contact Log School Year _________ Page _____

Date of Who Parent Student Reason Interventions/Contact Initiated Name Name For Call Suggestions

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Group Log

Grade Level(s) ___________ School Year ________ Type of Group ________________

Facilitators ________________________________________________________________________

Group Members:1. ________________________________ 6. _________________________________2. ________________________________ 7. _________________________________3. ________________________________ 8. _________________________________4. _________________________________9. _________________________________ 5. _________________________________10._________________________________

Date Topics/Activities Absences Notes

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Date: ___________________

Today I worked with my school counselor, Ms. Sherrill.

We talked about My goal for today / this week is

I am feeling

If you have any questions or concerns,please contact Dawn Sherrill, (573) 823-0953

Date: ___________________

Today I worked with my school counselor, Ms. Sherrill.

We talked about My goal for today / this week is

I am feeling

If you have any questions or concerns,please contact Dawn Sherrill, (573) 823-0953

http://www.uploderx.net/dphrag/SmileyShocked645.png

http://www.uploderx.net/dphrag/SmileyShocked645.png

GUIDANCE CURRICULUMProvides guidance content in a systematic way for the purpose of skill development and application of skills learned

Areas and Activities Addressed:

• Academic Development Skill development Planning course of study Employment skill development Workforce Preparation Transitioning

• Personal/Social Development Conflict resolution Character education Violence prevention Goal Setting Substance abuse prevention Cultural understanding

• Career Planning Career awareness Career exploration Career decision-making Career transitions

Counselor Role• Structured Groups• Classroom instruction• Leadership and consultation

MISSOURI COMPREHENSIVE GUIDANCE PROGRAMSTRANDS, BIG IDEAS & CONCEPTS

STRAND PS: PERSONAL AND SOCIAL DEVELOPMENT

BIG IDEA: PS.1. Understanding Self as an Individual and as a Member of Diverse Local and GlobalCommunities

Concepts: PS.1.A. Self conceptPS.1.B. Balancing life rolesPS.1.C. Citizenship and contribution within a diverse community

BIG IDEA: PS.2. Interacting With Others in Ways That Respect Individual and Group DifferencesConcepts: PS.2.A. Quality relationships

PS.2.B. Respect for self and othersPS.2.C. Personal responsibility in relationships

BIG IDEA: PS.3. Applying Personal Safety Skills and Coping StrategiesConcepts: PS.3.A. Safe and healthy choices

PS.3.B. Personal safety of self and othersPS.3.C. Coping skills

STRAND AD: ACADEMIC DEVELOPMENT

BIG IDEA: AD.4. Applying Skills Needed for Educational AchievementConcepts: AD.4.A. Lifelong learning

AD.4.B. Self-management for educational achievement

BIG IDEA: AD.5. Applying the Skills of Transitioning Between Educational LevelsConcept: AD.5.A. Transitions

BIG IDEA: AD 6. Developing and Monitoring Educational Plans of StudyConcept: AD.6.A. Educational Planning for Lifelong Learning

STRAND CD: CAREER DEVELOPMENT

BIG IDEA: CD.7. Applying Career Exploration and Planning Skills in the Achievement of Life Career GoalsConcepts: CD.7.A. Integration of self knowledge into life and career planning

CD.7.B. Adaptation to world of work changeCD.7.C. Respect for all work

BIG IDEA: CD 8. Knowing Where and How to Obtain Information about the World of Work and Postsecondary Training/Education

Concepts: CD.8.A. Career decision makingCD.8.B. Education and Career Requirements

BIG IDEA: CD.9. Applying Employment Readiness Skills and the Skills for On-The-Job SuccessConcepts: CD.9.A. Personal skills for job success

CD.9.B. Job seeking skills

Curriculum Units (K-5) for 2011-2012 School Year

- Introduction to Counselor/School Expectations- Friendship

o Social Skillso Empathyo Differences/Diversityo Self-Awareness

- Self-Esteemo Feelingso Personal Strengths

- Problem Solvingo Decision Makingo Bullyingo Conflict Resolution

- Sexual Abuse Prevention- Safety- Study Skills

o Goal-Settingo Work Habitso Test-Taking

- Careers o Personal Strengthso Differences

- Transition and Summer Safety

UNIT TITLE: Problem Solving- Decision Making Created by Dawn SherrillGRADE LEVEL: K

Lesson Title: Make Good Choices Lesson # 1 of 1

Time Required for Lesson: 50 minutes

Missouri Comprehensive Guidance Standard: PS.3: Applying Personal Safety Skills and Coping Strategies

Grade Level Expectation(s) (GLE): PS.3: A.a. Identify problem-solving, decision making, and refusal skills needed to make safe/healthy choices in social situations

American School Counselor Association (ASCA) Standard: Personal/Social Development A. Students will make decisions, set goals and take necessary action to achieve goals.

Lesson Materials (Activity Sheets and/or suggested supporting resourcesTwo paper-bag raccoon puppetsPuppet theaterLyrics poster for “Make Good Choices” Book – “Hunter’s Best Friend at School” by Laura Malone ElliotVideo – “Life Skills 101-Problems and Choices”Game – “Consequences”Coloring page – Raccoon with the “Stop. Think. Review. Act” steps of decision making

Show Me Standards: Performance Goals (check one or more that apply)Goal 1: gather, analyze and apply information and ideas

X Goal 2: communicate effectively within and beyond the classroom

X Goal 3: recognize and solve problems

X Goal 4: make decisions and act as responsible members of society

This lesson supports the development of skills in the following academic content areas.Academic Content Area(s) Specific Skill(s)X Communication Arts 1. Discussion

2. Reading comprehensionX Mathematics 3. Counting

Social Studies

ScienceHealth/Physical Education

X Fine Arts 4. Music5. Dramatic play6. Coloring

Enduring Life Skill(s)Perseverance Integrity X Problem Solving

X Courage Compassion X ToleranceX Respect X Goal Setting

Lesson/Formative Assessment (acceptable evidence of what learners will know and be able to do as a result of this lesson):Students will sing the “Make Good Choices” song with their colored picture of the decision-making raccoon. The coloring page will also list the steps of decision-making (Stop, think, act, review) as a tangible reminder of the lesson.

Lesson PreparationEssential Questions:

How do people make decisions?

Engagement (Hook):

Counselor informs students that they will be talking about making decisions. Counselor explains that some decisions are easy to make (ie. what ice cream flavor they want at the ice cream parlor) while some decisions are hard like the one that the raccoon puppet is trying to make. Counselor will use a puppet theater and two raccoon puppets for an opening role-play (sample script attached). Counselor will pause role-play to discuss that one of the raccoons has a hard decision to make and that the class will now learn about how the raccoon could make his decision.

ProceduresSchool Counselor/Teacher Procedures:

1. Counselor will introduce the book “Hunter’s Best Friend at School” by Laura Malone Elliot, emphasizing that this book may help us learn more about how the raccoon puppet could solve his problem.

2. Counselor reads the book and asks students questions throughout the book.

3. Counselor summarizes the main point of the book that Hunter, the raccoon, made the decision to be his best-self even though he

Student Involvement:

1. Students are sitting on the carpet.

2. Students listen and interact or answer questions.

3. Students listen on carpet.

thought it might hurt his friends feelings. Counselor will explain that this was a hard decision for Hunter. In the end, Hunter and Stripe both had good behavior at school and remained friends.

4. Counselor introduces the video “Life Skills 101: Problems and Choices” and explains that in the book, Hunter had a decision to make and that decision took certain steps. Counselor explains that the video will explain the steps that people can take to make decisions and solve their problem.

5. Counselor asks students to remember the first, second, third, and fourth steps in the decision-making process.

6. Counselor reviews the four-steps (stop, think, act, review) of the decision-making model and introduces the “Make Good Choices” song that can help remind them of those steps.

7. Counselor sings through the “Make Good Choices” song with lyrics poster, then, asks students to repeat, then, have students sing with counselor.

8. Counselor explains that the decisions, or choices, we make have consequences whether positive or negative. Counselor explains that when students are in the thinking stage of decision-making that they should consider whether there will be a positive (good) or negative (bad) consequence). Counselor asks for examples.

9. Counselor introduces “Consequences” game. Counselor assists students in playing as a class.

10. Counselor hands-out a coloring page with a raccoon and the four steps of decision-making listed. Counselor asks students to return to their tables to color.

11. Counselor asks students back to the carpet for the ending role-play with the raccoon puppets. The role-play will summarize that some decisions can be easy or hard and that we can make those decisions by remember to stop, think, act, and review. The role-play will remind students to use the “Make Good Choices” song to remind them of those steps.


5. Students answer.


7. Students listen and sing when appropriate.

8. Students give example of good and bad consequences.

9. Students participate in game and discussion.

10. Students color at their tables


Classroom Teacher Follow-Up Activities The classroom teacher would encourage students to use the four steps of decision-making (stop, think, act, review) in the classroom.

School Counselor reflection notes (to be completed after the lesson)

Sample script:Opening puppet role-play

(Ben sulking/crying)

Kyra: Hey, Ben! What’s up?

Ben: (pouty) Nothing…

Kyra: You seem upset. Is everything okay?

Ben: Yeah…no…

Kyra: Can I help?

Ben: Well, it’s just that Pat and I are the best of friends but lately he’s been doing some bad stuff in class like not listening to the teacher. I want to be his friend, so today, when he asked me to burp during story time I did and, now, I’M in trouble. I don’t know what to do.

Kyra: Wow, that’s a tough problem. It seems like you have a hard decision to make. You want to be friends with Pat, but you don’t want to get in-trouble at school.

Ben: Yeah, I wish I knew how to figure this out…

Sample script:Closing puppet role-play

Ben: Hey, Kyra! I just got done talking with the school counselor about my problem with Pat. She taught me all about how to make decisions. All I have to do is stop, think, act, and review. I thought about the choices I could make, and I decided that if Pat is my real friend, he wouldn’t want me to get in-trouble. I’m going to try to set a good example for him, just like Hunter, the raccoon in a story that our counselor read to me.

Kyra: That sounds great, Ben! It sounds like you found a way to solve your problem with a good decision.

Ben: Yep, and I even know a song now to help me remember how I did it. Want to hear it?

Kyra: Yes!

(Puppets and class sing the “Make Good Choices” song)

Make Good ChoicesLyrics by Dawn Sherrill

To the tune of “Fere Jacques”

Make good choices (2X)Every day (2X)

Think about the options (2X)Choose the best (2X)

Friendship and Differences Unit

Prepared for Midway Heights Elementary by Dawn Sherrill

Week One: October 18-22

Note: October is Diversity Awareness Month. Open lessons explaining to students that it is important to appreciate the many differences that our friends may have.

I. 3rd grade lessonA. Discussion questions (opening)

1. Raise your hand if you have a friend here at Midway.2. Tell me something about your friend3. What made you want to be friends with them?4. Counselor states that sometimes we choose our friends based on things we might have in common with them like sports, but sometimes, we have friends who are different than us. Counselor should express that it is important to be respectful of others’ differences and that sometimes our best friends can be very different from ourselves. Transition into video.

B. Video1. How We’re Different and Alike – United Streaming2. Review video with students through discussion. Transition into activity by stating that we are going to use crayons to understand how important differences, or diverse friendships, are.

C. Activity 1. Each student will pick out one crayon to draw a picture with. After five minutes, they will receive a second picture that they can use as many crayons as they want. Students will return to the carpet and hold up their first picture for everyone to see, then, their second. Students will discuss which they liked better and why. Counselor will express that in our world, we have lots of different types of people which is what makes the world interesting, just like the picture with lots of crayons was more interesting. Counselor will emphasize the importance of diversity and introduce the book.

C. Book1. The Crayon Box That Talked by Shane Derolf and Michael Letzig

D. Discussion questions (closing)1. Ask students what they learned from the story.2. Emphasize that although the crayons were different, they each had something special about them. 3. Brainstorm with the students on why it is important to accept people different than us. Write answers on the board.

** Extra time activity- Ask questions regarding favorites (favorite food, favorite sport, etc.), have students discuss their differences and similarities as a class.

II. 4th and 5th grade lessonA. Discussion questions (opening)

1. Raise your hand if you have a friend here at Midway.2. Tell me something about your friend3. What made you want to be friends with them?

4. Counselor states that sometimes we choose our friends based on things we might have in common with them like sports, but sometimes, we have friends who are different than us. Counselor should express that it is important to be respectful of others’ differences and that sometimes our best friends can be very different from ourselves. Transition into video.

B. Video1. What it’s Like to be Different – United Streaming2. Discuss with students

C. Worksheet1. Getting to Know You (attached)

a. Students must pair-up with someone that they do not know that well. They will answer the questions for themselves and ask their partner for their answers. Students will present their differences and similarities. Discuss about how people can be friends even with differences.

D. Discussion questions (closing)1. What are some observations we can make about the similarities and differences among people? 2. What's good about having things in common? Are there difficulties with that? 3. What's good about differences? What's hard about differences?

** Extra time activity: Complete the “How to Treat Others” (attached) word scramble as a class and discuss answers.

Week Two: October 25-29

I. 3rd grade lessonA. Discussion questions (opening)

1. Review that we are focusing on Friendship and Differences and that it is Diversity Awareness Month. 2. Who can tell me what book we read last week? (The Crayon Box that Talked) 3. What did you learn from the book? (That we all have differences and that’s what makes the world so interesting) 4. Can you think of any differences that you might have with your parents, teachers, the principal, siblings, etc.?5. Today, we’re going to talk about two people who were able to be very good friends although they are very different.

B. Book1. Queen Munch and Queen Nibble2. Discuss the book with the students afterwards. Transition into the activity by stating that sometimes it can be difficult to have a different opinion than our friends, but if we all thought the same the world might be a very boring place.

C. Poem1. Read the poem “If all the Trees Were Oaks”2. Discuss with students how the poem encourages us all to be our own unique person and to appreciate the differences of others.

C. Activity1. Diversity trees (sheet attached)

a. Students will complete their diversity tree about their characteristics and decorate it as they wishb. Students will have the opportunity to present their trees

D. Discussion questions (closing)

1. What were some similarities that you noticed in our trees? What were the differences?2. What would our forest be like with all of these different trees?3. Why is it important to have diversity, or people who all have differences?4. How should we treat others, even if they are different than us? Why is this important?

** Extra time activity: Pick one aspect of the diversity tree (ie. eye color) and use the whiteboard to tally the differences. Discuss those differences. Discuss which differences we can learn about with just looking and which ones are more about the personality of a person such as likes/dislikes.

II. 4th and 5th grade lessonA. Discussion questions (opening)

1. Review that we are focusing on Friendship and Differences and that it is Diversity Awareness Month. 2. Do you think everyone in the world is alike? Or is everyone different? 3. Take a look around our room. Do all of your classmates look just like you or are they different? Do any of the students in this room look like me? I think we all agree that people are different. Differences are a good thing. It is because we are all different that the world is such an interesting place4. It is important to respect people even when they are different from you. This is called respect for diversity or respect of differences. It is also known as acceptance and tolerance. These are important character traits for everyone to have. If everyone respected differences instead of making fun of someone that is different or hurting people because they are different, it would increase peace in our schools, homes, communities, and in the world.

B. Video1. People by Peter Spier DVD (20 minutes)

a. Show the “Celebrating Differences” discussion program. It is in the Special Features section of the DVD

C. Activity1. Diversity BINGO (sheet attached)2. Pass out sheets to all students. Students are trying to get “BINGO” by asking students questions related to the BINGO card. A student can only sign another student’s card once.

D. Discussion questions (closing)1. Share something you learned about another student through BINGO. 2. Which squares were easy to fill? Which were hard? Why do you think that is?3. Which differences about people could you tell by appearance? Which ones did you need to ask? 4. Share something you learned about yourself during this activity.

Diversity

Born and raised on a farm

Likes sports A girl Blonde hair Has a sister

Brown eyes

Likes pop music A boy Black hair Has a dog

Brown hair

Red hair Blue eyes Born outside of Missouri Likes math

Likes country music

Green eyes Right-handedHas traveled outside of the

countryLikes science

Has a cat

Speaks more than one language Left-handed Has a brother Likes music

B I N G O

Friendship and Feelings Unit


Week: February 16-23I. 3rd grade lesson

Focus: Showing that We Care

A. Discussion (opening)1. Establish the need

a. Why do we need to understand other people’s feelings?b. What might happen if we didn’t understand how they feel?

2. Skill componentsa. Think about a person’s actions, sayings, expressionsb. Decide what feeling a person is showingc. Ask the person how he/she feelsd. Do or say something to let the person know you understand.

B. Video1. United Streaming – “Maya and Miguel: Team Santos”2. Discuss Maya and Miguel’s feelings, how they showed that they cared, etc.

C. Activities1. Model the skill

a. Teacher and student model the following situation: A student in his/her class has just received a low grade on a test, and says, “I thought I passed that test. Now I note that my grade is going down.”

2. Behavioral rehearsala. Select two students for each role play.b. Role plays

i. A student was teased about the way she came dressed to school.ii. A student came in last in the school’s play day raceiii. A student spilled his lunch in the cafeteria

c. Reinforce correct behavior, identify inappropriate behaviors, and reenact role play with corrections. d. Discuss and review

3. How Would You Feel sheet (attached)a. Students completeb. Discuss

4. Writing exercise a. Have students write about a feeling they might have shown at home or some member of their family might have shown, and how understanding was shown to them or by them for another person.

D. Discussion questions (closing)1. Share writing exercise and discuss other real-life examples of showing friends that you care

Additional Activities Simon Says "Feelings" Feelings Game: http://www.do2learn.com/games/feelingsgame/index.htm

II. 4th and 5th grade lessonFocus: Recognizing Another’s EmotionsA. Discussion questions (opening)

1. Establish the needa. Discuss with students that sometimes our behavior is affected by our feelings, which can be seen through the various moods and emotions we express. In order to get along with others, we must learn how to recognize and understand others’ feelings

2. Skill componentsa. Look at the personb. Decide what you think the person is feelingc. Ask the person if he/she is feeling the way you thinkd. Tell the person you would like to helpe. Leave the person alone until he/she asks for help

B. Video1. United Streaming – “Maya and Miguel: Team Santos”2. Discuss Maya and Miguel’s emotions, how did Maya know how Miguel was feeling3. Ask if anyone has experienced a similar situation

C. Activity1. Model the skill

a. Teacher demonstrates various emotions nonverbally. Tell the students the mood you are showing and how the might be able to distinguish them by noting body language

2. Behavioral rehearsala. Three students for each role play while others identify moods and emotionsb. Role plays

i. Student starts crying after teacher returns paperii. Student runs into room laughing and clapping his/her handsiii. Student slams books shut and throws away paper

c. Reinforce correct behavior, identify inappropriate behaviors, and reenact role play with corrections. d. Discuss and review

3. What Emotions Do You See sheet (attached)a. Students completeb. Discuss

4. Writing exercise a. Students can write on how they would use this skill in the lunchroom, playground, at home, or elsewhere

D. Discussion questions (closing)1. Share writing exercise and discuss other real-life examples

Additional Activities

Facial Expressions game: http://www.do2learn.com/games/facialexpressions/face.htm

Careers Unit


Week: March 21-25

I. Kindergarten and 1st Grade

Discussion – What is a job? What is a career?

Discussion – Career Path poster – Brainstorm jobs for each path

Video: “Everybody has a Job” Wheels on the Bus http://www.youtube.com/watch?v=ntfvGMsuYgc

SmartBoard Activities – Jobs at School – Tools of the Trade

Video: Auto-B-Good “Growing Responsible” Discuss

Worksheets: Learning About Jobs – Share and discuss

II. 2nd grade

Discussion – What is a job? What is a career?

Discussion – Career Path poster – Brainstorm jobs for each path

SmartBoard Activities – Jobs at School – Tools of the Trade

Website: Missouri Connections Junior – Search Occupations

Worksheet: Three Jobs with Two Reasons – Discuss answers

Additional Activities:

- Video – Maya and Miguel: Career Day

RESPONSIVE SERVICESAddresses the immediate concerns of learners. The purpose is prevention, intervention, and referral as needed.

Topics Addressed:

• Academic DevelopmentSchool-related concerns: Academics Attendance Behavior Drop-out prevention Special needs Accommodations

• Personal/Social Development Peer conflicts Coping with stress Crisis management Grief/loss/death Relationship concerns Abuse Substance Abuse

• Career Planning Job placement Assist in identification of support systems Addressing special needs

Counselor Role• Individual and small group, crisis and developmental counseling• Consultation• Referral

Concern for student

Referral made to professional school counselor by: Self (Student)-Student Self-Referral Form Parent/Guardian-Parent/Guardian Referral Form Teacher-Faculty/Staff Referral Form Administrator School Nurse Peer Outside Agency Other

Counselor assesses concern by collecting/reviewing dataLevel and type of intervention are determined

Student Behavior Data Collection Form, Student Contact Data Table

Counselor In-School Interventions:

Emergency Intervention Consultation/Collaboration

with Student, Parents/Guardians, and/or Teachers/Other School Personnel

Implementation of home/classroom intervention strategies

Individual Counseling Small Group Counseling

Counselor Referral toIn-School Resource(s):

Administrator School Nurse Special Services School Social

Worker Resource Officer Peer Mediation

Team

Counselor Referral to Community Resources: Mandated Reporting /Hotline Outside Counseling (e.g.,

Community Counseling Services)

Division of Children’s Services

Juvenile Office Other Community Services

(e.g., Food Pantry, Homeless Shelter, Church Outreach)Consent for Release of

Information FormFollow-up with the referring individual within the guidelines of confidentiality

(ASCA Ethical Standards, FERPA1, FERPA2)

REFERRAL PROCESS FLOW CHART

Implementation of intervention, monitor student’s response to the intervention, periodically re-assess as needed)Concern is identified on Referral Form(s)

http://www.ed.gov/policy/gen/guid/fpco/index.html

http://www.ed.gov/policy/gen/reg/ferpa/index.html

http://www.schoolcounselor.org/content.asp?contentid=173

Gather/Record Objective DataAttendanceDiscipline ReferralsGradesObservable Behaviors:FrequencyDurationIntensityCumulative file/recordStandardized Test ResultsServices ReceivedSchool Nurse’s FilesTest Scores

Student Behavior Data Collection Form Student Contact Data Table

Gather/Record Subjective DataAdditional Information from Referral SourceStudent InterviewsTeacher Narratives and AnecdotesObservationBehavior Rating Checklists (parent, teacher, or student)Student Behavior Data Collection Form

Student Contact Data Table

Use data to develop intervention plan

Share intervention plan with those involved in the Referral Process

Monitor selected intervention for specified time periodContinue or modify interventions as necessary

Analyze data to determine effectiveness

If intervention was successful, continue monitoring student

progress

If intervention was not successful, develop a new plan and implement

for a specified period

REFERRAL PROCESSDATA COLLECTION FLOW CHART

Concern for student arisesNOTE: In cases of abuse or neglect, the PSC should be contacted

immediately.

Parent/guardian contactClassroom Teacher (as appropriate) makes contact with the parent/guardian before

making a referral to the Professional School CounselorIndicate the outcome of the caregiver contact

STAFF DEVELOPMENT FLOW CHART

Potential areas of concernPersonal/Social DevelopmentAcademic DevelopmentCareer DevelopmentExamples:Peer relationshipsFamily issuesEmotional Examples:GradesAttendanceEducational planningExamples:Exploration/planningPost-secondary options

ApplicationsWhen concern arises, parents/guardians and/or school personnel (in consultation/collaboration with PSC) implement pre-referral interventions.

Discuss referral form with the Professional School Counselor

Pre-referral intervention strategies are documentedTeacher contact with parent/guardian; home intervention implementedPSC/teacher consultation/conference with student; classroom intervention implementedPeer helper/mentor support interventions

Complete referral formStudent Self-Referral Form, Parent/Guardian Referral Form, Faculty/Staff Referral Form

The Professional School Counselor in collaboration/consultation with parents/guardians and/or classroom teacher(s), develops, implements, evaluates

an action plan

Parent/guardian consent to counseling must be obtainedInformation about Counseling, Informed Consent Form

Follow-up with the referring individual within the guidelines of confidentialityASCA Ethical Standards, FERPA1, FERPA2




RESPONSIVE SERVICES: REFERRAL PROCESSLevels of Responsive Services Interventions

Emergency Intervention

Level OnePre-Referral/ Prevention

Level TwoShort-term

Intervention

Level ThreeExtended

Intervention

Level FourOutside Referral

StudentsStudents are encouraged to make peer and self-referrals.

Student safety is essential.

Student is able to see Professional School Counselor (PSC) as needed.

Formal Referral not required.

Provide information for students regarding personal/social, academic, and career development concerns.

Use the Student Self-Referral Form to begin the short-term intervention process.

Informed Consent Form may be required after talking with student.

Informed Consent Form is required to begin the extended intervention process.

Counseling process and confidentiality are explained to the student.

Consent for Release of Information Form is required.

Outside Referral Contact Form Cover Letter and Outside Referral Contact Form will facilitate the process.

Faculty & StaffFaculty/Staff are educated about the counseling process.

Faculty/Staff use appropriate forms to refer to the PSC.

PSC directs faculty/staff on how to support the student during an emergency.


Provide information for teachers regarding personal/social, academic, and career development concerns.

Use the Faculty/Staff Referral Form to begin the short-term intervention process.


Counseling process and confidentiality are explained to faculty/staff.


Outside referral counseling process and confidentiality are explained to faculty/staff.

Parent/GuardianParent/Guardian is educated about the counseling process.

Parent/Guardian uses appropriate forms to refer to the PSC.

PSC guides parent/guardian on how to support the student during an emergency.


Provide information for parents regarding personal/social, academic, and career development concerns.

Use the Parent/Guardian Referral Form to begin the short-term intervention process.


Explain the form Information about Counseling to the parent/guardian.


Explain the outside referral counseling process, confidentiality and Possible Questions to Ask Outside Referral Resources.

RESPONSIVE SERVICES: REFERRAL PROCESSFaculty/Staff Referral Form

Student Name _______________________________________________ Date _________________

Grade Level/ Home Room _____________________

Referred by: _________________________________ Title: _________________________________

Area(s) of Concern:Personal / Social Development Peer Relationships Family Relationships Emotional Other _______________

Academic Development

Grades Attendance Educational Planning Other _____________

Career Development Decision-making Exploration / Planning Post-Secondary Options Post-Secondary Applications Other _____________

Pre-Referral Intervention Strategies and Response to Intervention:

___________________________________________________________________________________

___________________________________________________________________________________

Reason for Referral: _________________________________________________________________

Student’s Strengths/Interests: _________________________________________________________

___________________________________________________________________________________

Specific Observable Behaviors: ________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Parent / Guardian Contacted: No Yes Date: _______ Outcome of Contact: ______________________________________________________________________________________________------------------------------------------------------------------------------------------------------------------------------------For Professional School Counselor Use Only:Informed Consent (attached) Yes Date________ NoAction Plan Date: ____________ Parent/Guardian Contact Group Counseling Individual Counseling Hotline School Nurse Referral Outside Resource(s) Special Services Administrator Referral Other __________________________________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Follow-up with referring person Date: ___________________________________________________________________________________________CONFIDENTIALITY – See ASCA Ethical Standards and FERPA1, FERPA2 Guidelines




http://www.missouricareereducation.org/doc/referral/ReferralProcess.doc#Confidentiality%23Confidentiality

http://www.missouricareereducation.org/doc/referral/ReferralProcess.doc#SpecialServices%23SpecialServices

http://www.missouricareereducation.org/doc/referral/ReferralProcess.doc#OutsideAgencyResources%23OutsideAgencyResources

http://www.missouricareereducation.org/doc/referral/ReferralProcess.doc#SpecificObservableBehavior%23SpecificObservableBehavior

http://www.missouricareereducation.org/doc/referral/ReferralProcess.doc#ResponsetoIntervention%23ResponsetoIntervention

RESPONSIVE SERVICES: REFERRAL PROCESSStudent Self-Referral Form

Dear School Counselor,

My name is __________________________________. I am in grade _________________.

My teacher is _________________________________. My classroom number is ________.

I need to talk with you about:

URGENT!!! Something private right away!!!

The death of a person or a pet I love

A friend I am worried about

My angry feelings

How to get along better with friends/peers

How to get along better with adults (parents/teachers)

How to get along better with brothers and sisters

How others are treating me

Feeling better about myself

Saying “NO!” and “STOP IT” when people want me to do things I don’t want to do

My grades and schoolwork

Planning now for the future

Something else

Other comments ______________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Signed _______________________________________________Date __________________

Return this form to Ms. Sherrill in the Guidance and Counseling Office. I will contact you as soon as possible unless you have indicated this is URGENT!!

RESPONSIVE SERVICES: REFERRAL PROCESS

Parent/Guardian Referral FormA Professional School Counselor is available for students, parents, faculty and staff by appointment. Please call (________________), stop by the counseling office, or e-mail (__________________) to schedule an appointment.

I am requesting that the Professional School Counselor talk with my child:

___ Urgent—today! ___ As soon as possible ___ After the school counselor and I talk

Student’s Name _______________________________________________ Grade _________________

Classroom/Homeroom Teacher __________________________

Your Name _______________________________ Relationship to Student ______________________

Phone ____________________________ Best times to reach me _____________________________

Your Signature_______________________________________ Date _________________________

My child’s strengths include _____________________________________________________________

___________________________________________________________________________________

My primary concern(s) (Check all that apply): Something’s wrong but I don’t know what

A loss (e.g. death of a person or pet, loss of a friendship, parents’ divorce)

Anger

Perfectionism

Relationships with friends/peers

Relationships with adults (parents/teachers)

Relationships with brothers/sisters

How my child is treated by others

Feelings of negativity, discouragement, self-doubt

Unhealthy or unsafe choices

Study skills, grades and schoolwork

Post-secondary options/Planning now for future

Other Concern(s)_______________________________________________________________

Additional information regarding concern(s) ________________________________________________

Return this form to Guidance and Counseling Office. I will contact you as soon as possible unless you have indicated this is URGENT!!

RESPONSIVE SERVICES: REFERRAL PROCESSInformation about Counseling

From Ms. Sherrill, Your Professional School Counselor

If your child is referred to the school counselor, the very word “counseling” may make it sound like a mysterious process. It isn’t! Counseling is a relationship built on Confidentiality and trust—student trust, parent trust, teacher trust. Adequate information is the foundation of trust—all involved must have information about the limits and processes of counseling. The following information describes the overall process of counseling.

How students are "selected" for counseling: Students may be referred to the Professional School Counselor (PSC) for individual and/or small group counseling by their parents or guardians, school faculty and staff, a concerned friend, or themselves. When a referral is received, the PSC meets with the student and the classroom teacher to determine the next steps.

Who provides the counseling? Counseling is provided by a state certified Professional School Counselor (PSC). The PSC has a Master’s degree with an emphasis in school counseling; in addition, he or she may be a Licensed Professional Counselor (LPC), a Registered Play Therapist (RPT) or a State certified School Psychologist.

Counseling for your child is voluntary. It is your choice to consent to or decline counseling for your child.

What counseling for your child will involve: Counseling may include small group or individual sessions. During the sessions, your child and I will work together to help him or her understand the problem, the present and future consequences, develop goals for change and a plan of action for change. A variety of activities will be used, e.g., writing, role-play, art, focused discussions.

Sharing of Information: Trust is the basis for effective counseling. The ethical guidelines of the American School Counselor Association emphasize the importance of confidentiality between school counselors and students at the same time recognizing the rights of parents. As a parent or guardian, you must trust that I will “take good care of” one of your most prized possessions. Your child must know and trust that, what is shared with me will stay with me unless he or she gives me permission to share information or if I suspect child abuse, if he or she is in danger of hurting himself or herself or poses a danger to others.

Confidentiality: Trust and confidentiality work together. Counseling records do not become a part of the student’s permanent record except as required by school policy. We may indicate that a student was seen by the Professional School Counselor; however, the topics discussed are not included unless required by the school board policy. The requirements of the Family Education Rights and Privacy Act (FERPA) are enforced—information will not be released to anyone outside our school without your written permission. I may talk with the classroom teacher about how he or she can help your child in the classroom; however, specific information will not be shared.

Possible outcomes: Through counseling, your child may be taught strategies to help him or her make more effective and healthier decisions, increase the ability to set and reach goals, build better relationships with others, and be more successful in school. We all must realize that changes take time; his or her problem did not develop overnight, nor will it disappear overnight. Counseling will be successful when students, school counselors, teachers, and family members work as partners.

Cost: There is no cost to you for any of the counseling your child receives as a part of our district’s Comprehensive Guidance Program.

Please contact me if you want more information or have ideas about how we can better help your child.

My contact information is: School Phone: _______________ e-mail _____________________





RESPONSIVE SERVICES: REFERRAL PROCESSInformed Consent Form

I have read and understand the information provided by the Professional School Counselor and have had an opportunity to ask questions about counseling.

___ I consent for my child to participate in counseling.I understand that participation is completely voluntary and that classroom requirements take precedence over participation in counseling.

___ I do not consent for my child to participate in counseling.

Student First/Last Names (please print) _________________________

Grade _________ Teacher ____________________

Parent/Guardian/Student Signature Date

___________________________________ ________________

Please return this form to the Guidance and Counseling Office by __________________.

RESPONSIVE SERVICES: REFERRAL PROCESSConsent for Release of Information Form

Student’s Name: ___________________________________ Date of Request: ____________

Student’s Birth Date/Year: _______________ Grade: __________Teacher _______________

I hereby authorize the release of information about my child to:

____________________________________________________________________________(Name of District/Specific School/Agency/Individual)

____________________________________________________________________________(Address)

____________________________________________________________________________(City) (State)

(Zip Code)

____________________________________________________________________________(Phone number) (Fax number)

(E-mail)

This information is requested for the following purpose(s):

____________________________________________________________________________

I authorize the release of the following information (check all that apply):

_______ Cumulative permanent school record/transcript

_______ Attendance/discipline records

_______ Withdrawal grades and date

_______ Psychological reports (IEP, testing, diagnostic report)

_______ Diagnosis and treatment plans

_______ Medical/Health records

_______ Other _________________________________________________________________

I understand this information is confidential and will be released in accordance with the Family Educational Rights Privacy Act (FERPA). I understand that I may revoke this consent at any time by submitting written notice of the withdrawal of consent to this school district.

__________________________________________________________ _________________(Signature of Parent/Legal Guardian or emancipated student (Date

This Consent for Release of Information is valid for this school year.

RESPONSIVE SERVICES: REFERRAL PROCESSStudent Behavior Data Collection Form

STUDENT______________________________TEACHER_____________________________DATE___________

Teachers: please indicate areas of concern in the left hand column.

PSC: use columns on right side.Performance Indicators:

(+) = Excellent (/) = Satisfactory (-) = Area of ConcernTeacher Concerns (mark with X)

Observed Behaviors Professional School Counselor rating

Mar

kin

g Pe

riod

1

Mar

kin

g Pe

riod

2

Mar

kin

g Pe

riod

3

Mar

kin

g Pe

riod

4

Mar

kin

g Pe

riod

5

Academic DevelopmentFollows directionsListens attentivelyStays on taskCompliance with teacher requestsFollows rulesManages personal and school property (e.g., prepared, organized)Works neatly and carefully Participates in discussion and activities (e.g., motivation, lack of participation)Completes and returns homework

Personal and Social DevelopmentCooperates with othersShows respect for othersAllows others to work undisturbedAccepts responsibility for own misbehavior (e.g., provoking fights, bullying, fighting, defiant, anger, stealing)Emotional Issues (e.g., perfectionism, anxiety anger, depression, suicide, aggression, withdrawn, low self-esteem)

Career DevelopmentAwareness of the World of WorkSelf-AppraisalDecision MakingGoal Setting

Add Other Concerns:External Issues (e.g., divorce, death, abuse, socio-economic, incarceration, military deployment) Other

School Record Data (To be completed by PSC)Attendance: # of days absentAttendance: # of days tardyDiscipline: # of referralsGradesSchool nurse visitsTest Scores

RESPONSIVE SERVICES: REFERRAL PROCESSStudent Information Personal Social

DevelopmentAcademic

DevelopmentCareer

DevelopmentLevel of Concern1=low

5=high

Students’ NamesD

ate

Gra

de

Lev

el-

Peer

Fam

ily

Emot

iona

Oth

er

Gra

des

Atte

ndan

ce Educ

atio

nal

Oth

er

Expl

orat

i

Post

-

Appl

icat

i

Oth

er 1 2 3 4 5

RESPONSIVE SERVICES: REFERRAL PROCESS Hotline Phone Call Information

Missouri Child Abuse and Neglect Hotline Phone Number: 1-800-392-3738National Child Abuse and Neglect Hotline Phone Number: 1-800-422-4453

Ask the worker for his or her name and badge ID for your records.You may be asked the following questions during a hotline phone report. It is to your advantage to have this information available prior to making the phone call.

Your Name and Position

Would you like to remain anonymous? (Mandated reporters may not remain anonymous)

Have you reported with us before?

Student Name

Student Age / Birth Date

Student Address

Student Phone Number

County

Parent’s Name(s)

Parent’s Place of Employment (if there is no home phone number)

What is the make up of the household?

Sibling’s Name(s) and Ages

Are there any other adults in the home?

Name of School and School Hours

Nature of the hotline phone call with details

How did you learn about this situation?

When did you last see the child?

Is the child in immediate danger?

Could this child be targeted or singled out for abuse?

Where is the child now?

Where will the child be in the next 24 hours?

Can the child return to the house?

Are there any known dangers in the house (drugs, weapons, animals, domestic abuse)?

Would you like to receive a follow up to the disposition of the report?

The worker should tell you in what county the report will be filed and the phone number to the facility. If he or she does not, it is appropriate to ask.

RESPONSIVE SERVICES: REFERRAL PROCESS Outside Referral Resources

Note: These resources are provided to stimulate your thinking about resource availability in your local area. The list is not exhaustive nor is a listing an endorsement of the services any one agency or individual provides. Other sources for resources to add are: “Community Human Services” sections and yellow pages of local phone directories; state legislators from your local area may publish a booklet of area resources.

Area Support Groups American Red Cross United Way Easter Seals Hospice Compassionate Friends (loss of a child) Local Chapters of organizations for specific illnesses (e.g. M.S. Society) National Alliance for Mental Health (NAMI)

Assistance Programs County Health Clinic Employee Assistance Programs Social Security Medicare Medicaid

Civic Groups/Youth Clubs Faith-based Groups Kiwanis Lions Club Rotary Club

Counseling Centers Community Mental Health Centers Private Practice Groups/Individuals Licensed Professional Counselors Licensed Clinical Social Workers Psychologists Psychiatrists

Daycare Providers Adult care Providers Childcare Providers

Mental Health Services Area Agencies, e.g. “Pathways” Psychiatric Hospitals Residential Placement for Children and Adolescents National Suicide Hotline

Shelters Domestic Violence & Assault Homeless

Specialized Education Programs Employment and Training Programs Language Center for non-English Speakers Parents as Teachers Practical Parenting Partnerships Vocational Rehabilitation Career Centers & other Technical Educational Programs

Special Schools Missouri School for the Deaf Missouri School for the Blind

Substance Abuse Al-Anon (support for families of alcoholics) AlAteen (support for children of alcoholic parent[s]) Drug and Alcohol Treatment Facilities

Youth Groups 4-H Big Brothers Big Sisters Boys & Girls Clubs YWCA/YMCA Boys Scouts Girl Scouts

Kindergarten Boys’ Social Skills Group (B)Created by Dawn Sherrill

Goals1) Following directions2) Impulse control3) Staying on-task

Week One – October 27, 2010

1) Introduction name activity with drum. Drum “What’s Your Name” and say name in rhythm with syllables (1st

time – just say names in rhythm 2nd time - pass drum around asking each time saying please, thank you, you’re welcome 3rd time -pass with question relating to positive behavior)

2) Group expectations Each member of the group will contribute one expectation to be written on

poster board3) Group name

Group will brainstorm on ideas for the name4) Unity hand circle

Each member will be asked to have their hand drawn on the poster board when they are exhibiting the desired behavior (ie. sitting criss-cross applesauce, hands in lap, eyes on speaker, voice off).

Facilitator will trace each members hand in a circle formation, demonstrating the cohesiveness of the group.

Members will decorate their own hand, representing their unique perspective that is being brought into the group.

5) Assessment Members will complete assessment sheet on how they felt that day at home,

at school, and after group. There will be three different faces for each category (happy, indifferent, sad)

Week Two – November 3, 20101) Introduction2) Review group expectations with poster board3) Freeze game

1st round – Traditional freeze where members move until music is stopped by facilitator. After 1st round, discuss what their brain had to tell their body to do in order to stop moving.

2nd round - As the music plays, the facilitator holds a picture of a stick figure in a certain pose above her head. The children are supposed to observe the position of the figure without doing it, and when the music ceases, they assume that position and that position only. After 2nd round, discuss with members about what was different or more difficult about this round.

3rd round – Half of the members will continue to play with the same directions as the 2nd round, but half will be instructed to stand still. After 3rd round, discuss the challenges of not being able to move while others were. Discuss how they were able to maintain being still.

4) Assessment Kinesthetic assessment of the below statements by (1) thumbs-up if

they feel they are good with the behavior 2) middle thumb if they are so-so 3) thumbs-down if they need to work on the behavior. Facilitator will record results. Discuss each behavior as it relates to their week.

I wait patiently for my turn in games. I listen to my teacher without talking to my neighbor. I calm myself down when I feel angry. I ask to borrow things before taking them. I have a safe body in public places. I walk through the halls quietly. I think before I speak. I stop myself from laughing at others.

Week Three1) Introduction2) Review group expectations with poster board3) Balloon activity

Blow up a balloon and tie a knot in it. Have two (2) students sit in chairs facing one another. Instruct the students how many times they can hit the balloon back and forth without it touching the without getting out of their seats. Afterwards, discuss whether or not they had impulses slam” the balloon at the other person. If so, ask them to explain what they did about impulse. How did they stop themselves?




Week Four1) Introduction2) Review group expectations with poster board3) Candy exercise

Place a small piece of candy in front of each student. Tell the students they can either eat the piece of candy now or, if they wait 15 minutes, they can have 2 pieces of candy. Continue with other discussions and activities during this “waiting period.” Periodically during the waiting period you can “tempt” the students with the idea of eating their candy early and then ask them what ways they are using to resist

the temptation. After 15 minutes, allow the students to eat both the original candy and the reward candy. Ask them to rate how difficult this exercise was on a scale of 1-10. Ask them what they did to ensure success in waiting.

4) Coloring activity Have the students draw a picture of a person as fast as they

can. Then have them draw a picture of a house as carefully as they can (using stop and think). Discuss how the first one was done impulsively and how the second one was done with impulse control. Which one do they like better? What are some differences? Which one are they the most proud of?




Week Five1) Introduction2) Review group expectations with poster board3) Simon Says

* Traditional “Simon Says.” Discuss how they made sure to only act when “Simon” said.

4) Stance Contest Members will pair-up and face each other in a specific posture or stance as dictated by the facilitator. When the facilitator says "go," neither student may move, talk or change facial expression. The student who is able to remain still the longest wins. Discuss what was difficult about the activity and how they were able to maintain their pose.



I wait patiently for my turn in games. I listen to my teacher without talking to my neighbor. I calm myself down when I feel angry. I ask to borrow things before taking them. I have a

safe body in public places. I walk through the halls quietly. I think before I speak. I stop myself from laughing at others.

Week Six

1) Introduction2) Review group expectations with poster board3) Vote for two favorite activities played in group4) Assessment

Kinesthetic assessment of the below statements by (1) thumbs-up if they feel they are good with the behavior 2) middle thumb if they are so-so 3) thumbs-down if they need to work on the behavior. Facilitator will record results. Discuss each behavior as it relates to their week.


Collect perceptual data of group

Test Anxiety Group

Meeting #1March 2, 2011

Our agenda on March 2, 2011

1) Test Anxiety Quiz

- We reviewed our answers. Those who rated “never” on an item would brainstorm with those who chose “sometimes” and “always” on how they might work on this issue over the next few weeks.

- We charted our results to see if any change in the next few weeks.

2) Review Reducing Test Taking Anxiety Sheet- The tips listed on this handout describe numerous great ways to reduce test anxiety. Everyone will select two personal goals from this list that you will journal on in-between groups.

3) Set two personal goals for the next few weeks.

Write your goals here:

1) ______________________________________________

2) ______________________________________________

Upcoming Meetings:

Wednesday, March 16, 2011

Wednesday, March 23, 2011

Wednesday, April 20,, 2011 – Debriefing Session

Individual Counseling Session Plan

Dawn Sherrill – Session Plan for VideoPracticum II – COUN620 – Spring 2011

Stephens College – Master of Education in CounselingInstructors: Carolyn Roof and Ann Landes

Site Supervisor: Jill Evans (Midway Heights Elementary)

Student Initials: C Counselor’s Name: Dawn Sherrill Purpose of Individual or Small Group Counseling: Social Skills

Session Goal: Communicating Feelings Session #2 of 4

Grade Level: 4th grade Length of Session: 20 minutes

Missouri Comprehensive Guidance Strands/Big Ideas/Concepts:

Strand: Personal and Social Development

Big Idea: PS.2. Interacting With Others in Ways that Respect Individual and Group Differences

Concepts:

PS.2.A. Quality RelationshipsPS.2.B. Respect for Self and OthersPS.2.C. Personal responsibility in relationships

Session Materials

- SmartBoard for interactive game, activity, and PowerPoint- PowerPoint presentation (slides attached)- Feelings Check-In Sheet:

http://www.do2learn.com/activities/SocialSkills/EmotionCheckIn-Checkout/EmotionalCheckIn-Out_level01.pdf

- Online Feelings Game: http://www.do2learn.com/games/feelingsgame/index.htm- Online Facial Expressions Activity http://www.do2learn.com/games/facialexpressions/face.htm- Notebook for journaling- Taking Part Individual Social Skills checklist (attached)- Communicating Feelings Handout (attached)- Small Group Follow-Up Sheet (attached)

http://www.do2learn.com/games/facialexpressions/face.htm

http://www.do2learn.com/games/feelingsgame/index.htm



Session #1 Goal : Making Conversation

Session #2 Goal: Communicating Feelings

Session #3 Goal: Expressing Oneself

Session #4 Goal: Cooperating with Peers

Group/Individual Counseling Assessment/Evaluation:

X - Perceptual:

1) Teacher/Parent/Guardian Small Group Follow-up2) Feelings Check-In/Out Sheet

X - Results-based:

1) Taking Part Individual Social Skills Checklist

Counselor reflection

A female fourth-grade student at Midway-Heights Elementary was selected for an individual social skills intervention, based on the six unit social skills building program “Taking Part: Introducing Social Skills to Children” by Gwendolyn Cartledge and James Kleefeld. The units are as follows: Making Conversation, Communicating Feelings, Expressing Oneself, Cooperating with Peers, Playing with Peers, and Responding to Aggression and Conflict.

The student demonstrated deficiencies in these areas, which was the basis for her selection. The above listed perceptual data forms were collected. The actual results were collected based on the Individual Social Skills Checklist included in the Taking Part program.

The intervention was designed to be six weeks long, with each week building on a social skills unit. However, due to scheduling circumstances, the intervention was reduced to four weeks.

The student was tested over each individual unit before and after the intervention, receiving a rating of either Needs Instruction, Shows Some Competence, or Mastered. Additionally, the student was tested over the entire program before and after the intervention to collect an overall result of the impact of the program on her social skills competencies.

For this session (Communicating Feelings), C’s responses indicated a lack of understanding of what skills are important in effective communication. She was able to identify feelings when presented with the interactive material, but seemed unable to verbalize critical thinking on feelings and why it is important to communicate them. This would be an area that she needs more work o, and would now have a more basic foundation of knowledge to grow upon.

Time constraints were the greatest challenge in this intervention. The most appropriate meeting time for C was during her lunch. This meant that sessions had to remain in the 15-20 minute range with an added distraction of eating a meal.

However, even with time limitations, the experience of getting a “special” time with the counselor seemed to boost her self-esteem and give her sense of pride when arriving to sessions. She will now have had basic exposure to social skills language and may have a better foundation for developing skills later.

Counselor/Teacher/Parent follow-up

Parent involvement in this intervention was encouraged through the follow-up forms which were sent home with C after each session and with the journaling exercises.

C’s teacher was given the list of topics that would be focused on for each week.

Additional perceptual data was collected from C’s teacher and her parent including:

1. Teacher Pre-Post-Intervention Perceptionsa. Individual Student Behavior Rating Form

2. Teacher Post-Intervention Perceptionsa. Teacher Feedback Form: Overall Effectiveness of Group

3. Request for Feedback from Parents/Guardiansa. Parent/Guardian Feedback Form: Overall Effectiveness of Group

I. Making Conversation

A. Skill One: Naming Feelings

B. Skill Two: Naming My Feelings

C. Skill Three: Naming Others’ Feelings

D. Skill Four: Sending Messages

E. Skill Five: Controlling Temper

Teacher/Parent/Guardian Individual Session

Follow-up

GROUP TOPIC: Social Skills Session # 2

Student’s Name: C Date: 3/2/2011

Today I met with Dawn (counseling practicum student) and a friend to work on

feelings and friendship.

Session Goal: Communicating Feelings

Today we talked about the following information during our group:

Friendship Study Skills Attendance

Feelings Behavior School

Performance

Family Peer Relationships Other:

Communication

Group Assignment :

I will complete or practice the following at school and/home before our next session.

Journal assignment: Identify a time this week that you feel angry. Send a clear message to another person that you are feeling angry and may not be ready to talk about it yet. Use feeling words. Practice good communication (eye contact, body language, etc.)

Our next group meeting will be:

Date: 3/ 16/2011 Time: 11:40am

Additional Comments:

Please contact Dawn Sherrill, if you have further questions or concerns.

Brief Counseling Session – December 2010Delivered by Dawn Sherrill at Midway Heights ElementaryMale, 1st grade studentReferred by teacher for issues with conflict resolution in class (ie. telling lies, difficulties with peers, bullying concerns)

Rationale for session: The use of the whiteboard allowed a visual interpretation of the faulty logic behind the student’s behavior. The main concern of the “lies” was highlighted and also, solutions that focused on apologizing and “owning-up” to his actions were created.

INDIVIDUAL PLANNINGAssists students in planning, monitoring, and managing their educational, personal/social, and career development goals

Topics Addressed:

• Educational Development Setting educational goals and assessing Transitioning needs Education options

• Personal/Social Development Setting personal goals Improvement planning

• Career Planning Career assessments (interests)

Counselor Role• Assessment• Planning and placement• Individual conference planning, implementation, and assessment

SYSTEM SUPPORTIncludes program, staff, and school support activities and services. The purpose is to provide support and leadership in program delivery

Topics Addressed:

• Guidance program development, implementation, and assessment• Parent education• Faculty/administrator consultation• Staff development for educators• Counselor professional development• Incorporation of educational initiatives into one of the four guidance components• Research and publishing• Community outreach• Public relations• Building Assistance Teams• Crisis Management Plan• Comprehensive Study Skills Program• School Improvement initiatives• Special initiatives to address behavior and learning

Counselor RoleProvide leadership, facilitative, and organization skills in:

• Program management• Leadership and consultation

Public Relations Ideas for 2011-2012 School Year

- Develop a brochure on comprehensive guidance program components

- Write articles for school building/district, local newspaper, on topics related to current issues

- Provide parent education materials at open house, conferences, through mail, or website

- Be involved in school and community activities

- Coordinate school programs (ie. Red Ribbon Week)

- Present program components at staff in-service, parent meetings, and school board

- Ask for time related to guidance program on the agenda at staff meetings

- Continue professional development through conferences, workshops, classes, etc.

- Make a packet for new students on the comprehensive guidance program

- Establish orientation program for new students

TEACHER PRE-POST-GROUP PERCEPTIONSIndividual Student Behavior Rating Form

(Adapted from Columbia Public Schools’ Student Behavior Rating Form)

STUDENT GRADE TEACHER

DATE: Pre-Group Assessment Date: Post-Group Assessment Part 1 - Please indicate rating of pre-group areas of concern in the left hand column.

Part 2 - Please indicate rating of post-group areas of concern in the right hand column.

Pre-Group ConcernsRank on a scale of 5à1

(5 = HIGHà1 = LOW)

Student Work Habits/Personal Goals ObservedColleagues, will you please help us evaluate the small group intervention in which this student participated. Your opinion is extremely important as we strive to continuously improve our effectiveness with ALL students!

Post-Group ConcernsRank on a scale of 5à1

(5 = HIGHà1 = LOW)

Academic DevelopmentFollows directionsListens attentivelyStays on taskCompliance with teacher requestsFollows rulesManages personal & school property (e.g., organized)Works neatly and carefully Participates in discussion and activitiesCompletes and returns homework

Personal and Social DevelopmentCooperates with othersShows respect for othersAllows others to work undisturbedAccepts responsibility for own mis-behavior (e.g., provoking fights, bullying, fighting, defiant, anger, stealing)Emotional Issues (e.g., perfectionism, anxiety, anger, depression, suicide, aggression, withdrawn, low self-esteem)

Career DevelopmentAwareness of the World of WorkSelf-AppraisalDecision MakingGoal Setting

Add Other Concerns:

Teacher/Parent/Guardian Small Group Follow-up

GROUP TOPIC: Session # _________

Student’s Name: Date: ____________________

Today I met with my school counselor and other group members.

Session Goal: __________________________________________________________

Today we talked about the following information during our group:

Circle one or more items.

Friendship Study Skills Attendance

Feelings Behavior School Performance

Family Peer Relationships Other ________________

Group Assignment:

I will complete or practice the following at school and/home before our next session.

_____________________________________________________________________

Our next group meeting will be:

Date: ____________________________ Time: ____________________________


Please contact Dawn Sherrill, Professional School Counselor, if you have further

questions or concerns.

TEACHER POST-GROUP PERCEPTIONS:

TEACHER FEEDBACK FORM: OVERALL EFFECTIVENESS

We are seeking your opinion about the effectiveness of the group e.g., students’ relationship with the professional school counselor and other participants in the group and your observations of students’ behavioral/skill changes (positive OR negative). We appreciate your willingness to help us meet the needs of ALL students effectively. The survey is anonymous unless you want us to contact you.

Teacher’s Name (optional): ___________________________________________ Date:_____________

Professional School Counselor’s Name:___________________________________________________

Small Group Title: ____________________________________________________________________

Before the group started, I hoped students would learn:

___________________________________________________________________________________

___________________________________________________________________________________

While students were participating in the group, I noticed these changes in their behavior/attitude

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Using a scale of 5 to 1 (5 being the highest and 1 the lowest), please circle your opinion about the following

What do you think? 5=High 1=Low

Overall, I would rate my students’ experience in the counseling group as:

5 4 3 2 1

Students enjoyed working with other students in the group. 5 4 3 2 1

Students enjoyed working with the counselor in the group. 5 4 3 2 1

Students learned new skills and are using the skills in school 5 4 3 2 1

I would recommend the group experience for other students. 5 4 3 2 1

Additional Comments for Counselor:

Request for Feedback from Parents/Guardians

Small Group Counseling topic/title: ________________________________________________

Student’s Name ____________________________ Teacher’s Name _____________________

Date: _____

Dear Parent/Guardian,

I have enjoyed getting to know your child in our small group counseling sessions. Next week will be the last session for our group. During the group sessions, we shared information related to a variety of topics. Below is a list of topics discussed during the group sessions.

Session 1: ________________________________________________________________

Session 2: ________________________________________________________________

Session 3: ________________________________________________________________

Session 4: ________________________________________________________________

Session 5: ________________________________________________________________

Comments about your child’s progress:

Attached is a feedback form. I would appreciate input from you about your child’s experience in the small group. Please complete the attached Parent/Guardian Feedback Form and send the completed form back to school with your child by ______________.

Thank you for your support and feedback. Please contact me if you have questions or concerns.

Sincerely,

Dawn SherrillProfessional School Counselor

PARENT/GUARDIAN POST-GROUP PERCEPTIONS

Parent/Guardian Feedback Form: Overall Effectiveness of Group

Your child participated in a small counseling group about _____________. Was this group experience helpful for your child? Following is a survey about changes (positive OR negative) your child made at home while participating in the group at school and since the group ended. The survey will help us meet the needs of ALL students more effectively. The survey is anonymous unless you want the school counselor to contact you. We appreciate your willingness to help us

Professional School Counselor: ____________________________________________Date:_________________

Small Group Title: ____________________________________________________________________

Before the group started, I hoped my child would learn _______________________________________

___________________________________________________________________________________

I’ve noticed these changes in my child’s behavior and/or attitude as a result of participating in the group:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Using a scale of 5 to 1 (5 being the highest and 1 the lowest), please circle your opinion about the following

What do you think? 5=High 4 3 2 1=Low

Overall, I would rate my child’s experience in the counseling group as:

5 4 3 2 1

My child enjoyed working with the other students in the group

5 4 3 2 1

My child enjoyed working with the counselor in the group.

5 4 3 2 1

My child learned new skills and is using the skills in and out of school

5 4 3 2 1

I would recommend the group experience to other parents/guardians whose children might benefit from the small group.

5 4 3 2 1


Student Feedback Form

Directions: Please complete the Student Feedback Form after completion of the unit.

Name: ______________________________ (optional) Date: _____________

When I started the group, I wanted to learn __________________________________about (the topic of

the group).

Instructions: Read each sentence. Put a circle around the face that shows how you think and feel right now about what you learned in the group.

= I agree = I’m not sure = I disagree_________________________________________________________________________________________1. Overall, I enjoyed working in the group:

= I agree = I’m not sure = I disagree

2. I enjoyed working with other students in the group

= I agree = I’m not sure = I disagree3. I enjoyed working with the counselor in the group.


4. I learned new skills and am using the skills in school.


5. If other students ask me if they should participate in a similar group, I would recommend that they “give-it-a-try”


Additional comments you would like to share with the school counselor:

dawn sherrill€¦ · web viewmock comprehensive counseling and guidance program manual....

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