o Children who exhibit explosive or noncompliant behavior present a difficult challenge to school personnel and parents.
o The increasing number of students who attend school with behavioral and emotional problems is of growing concern.
A Student in Crisis
Smallwood, 2003Dubitsky & Quintero, 20103
o Teachers who lack the ability to cope with student misbehavior may perceive themselves as unsuccessful
o Teachers have expressed more anger and helplessness concerning the child they perceived as most disruptive
The Teacher’s Challenge
Stoughton, 2007; Spilt & Kooman, 2009Dubitsky & Quintero, 20104
oPrevalence of childhood mental disordersoClassroom strategies:
– Prevention– Response– Restoration
Training Outline
Dubitsky & Quintero, 20106
oPrevalenceoCommon Childhood Mental DisordersoCultural Considerationso Educational Implications
Mental Health Needs of Students
Dubitsky & Quintero, 20108
o According to a 2000 Surgeon General Report on Children’s Mental Health, a high rate of disruptive behaviors exists
o Approximately 15 million children and adolescents in the United States have mental health problems
o Less than 35% receive treatment for these disorders
Prevalence
National Health Interview SurveyCenters for Disease Control
Dubitsky & Quintero, 20109
2008 National Health Interview Survey
o Parents of 15% of US students 4-17 y.o. sought help
o 89% of these children were prescribed medication for Attention-deficit/Hyperactivity Disorder (ADHD)
o Increase in children receiving stimulant drugs and antidepressants
Medical Trends
National Health Interview SurveyCenters for Disease Control
Dubitsky & Quintero, 201010
oAttention-deficit/Hyperactivity Disorder (ADHD)
oAnxietyoDepression
Common Childhood Mental Disorders
Dubitsky & Quintero, 201011
o ADHD is a neurobiological disorder
o Marked by inattention, hyperactivity, and impulsivity
o Approximately 3% to 7% of the school-age population has ADHD
ADHD
American Psychiatric Association, 2000Dubitsky & Quintero, 201012
o In the classroom this may look like:– Difficulty organizing tasks and activities– Loses things– Easily distracted– Difficulty remaining seated– Blurts out answers before questions are asked– Memory difficulties – Difficulties with social and adaptive functioning
ADHD
Dubitsky & Quintero, 201013
Brock, Grove, Searls, & Martinez, 2008; Sattler, Weyandt, & Willis, 2006
o Worry: repetitive thoughts related to possible threatening outcomes and potential consequences
o Girls twice as likely as boys
o Separation Anxiety Disorder is specific to children
Anxiety
Huberty, 2008Dubitsky & Quintero, 201014
o In the classroom this may look like:– Restlessness – Erratic behavior – Withdrawal – Worry
Anxiety
15Dubitsky & Quintero, 2010 Huberty, 2008
o Depression and anxiety frequently occur together
o Anxiety most likely preceded depressiono The ratio of girls to boys is about 2:1 to 3:1o Rates for girls tend to increase at about 13-15
years old
Depression
Huberty, 2008Dubitsky & Quintero, 201016
o In the classroom this may look like:– Shows limited effort – Irritability – Inappropriate responses to events – Concentration problems
Depression
17Dubitsky & Quintero, 2010 Huberty, 2008
o Children from impoverished communities are more likely to have behavioral and academic difficulties
o Acute stressors: Exposure to community violence and homelessness
o Chronic stressors: Hunger, insufficient household heat, decrepit living conditions, and worries about the safety of loved ones
The Impact of Poverty
Mendez, 2010; Buckner, Mezzacappa, & Beardslee, 2009
Dubitsky & Quintero, 201018
Classroom Environment
Crisis ResponseRestoration
A Model of Prevention, Response, and Restoration
Dubitsky & Quintero, 201019
o Classroom Environment– Teacher-student relationships and a strength-
based classroomo Crisis Response
– Response to a child experiencing a crisiso Restoration
– Psychological intervention for the student and reintegration of the student into the classroom
A Model of Prevention, Response, and Restoration
Dubitsky & Quintero, 201020
o Efficacy of positive teacher-student relationships
o Creating a Safe Placeo Building a strength-based classroomo Incorporating Solution-focused Brief Therapy
techniques in the classroom
Classroom Environment
Dubitsky & Quintero, 201021
Classroom Environment
o Efficacy of positive teacher-student relationships– Development of early competencies linked to the
quality of the teacher-child relationship– Emotional support and closeness function as
protective factors for children with behavior problems
Classroom Environment
Pianta & Stuhlman, 2004; Spilt and Koomen, 2009Dubitsky & Quintero, 201022
o Efficacy of positive teacher-student relationships– Students who feel connected to teachers are more
likely to:• use those teachers as models• accept feedback from them• try to meet their behavioral expectations• perform better academically
Classroom Environment
Osher et al., 2008Dubitsky & Quintero, 201023
oCreating a Safe Place– A safe place provides a safe haven– Allows students to regain composure– Can be used to remove a student
experiencing an emotional crisis from the main classroom space
Classroom Environment
Bafumo, 2006; Smallwood, 2003; Dwyer et al., 1998
Dubitsky & Quintero, 201024
oCreating a Safe Place– Located in a corner of the classroom,
behind a partition, or in an alcove– Fairly private, comfortable, and accessible
for all students
Bailey, 2001
Classroom Environment
Dubitsky & Quintero, 201025
o Strength-based classroom– identifies a student’s “signature strengths” -
strengths that students already possess– The teacher tries to change the context
from one of failure (problem-focused) to hopefulness (solution-focused)
Classroom Environment
Cantwell, 2006; Melvin, Korthase, & Marquoit, 2005;
Metcalf, 1999
Dubitsky & Quintero, 201026
o Solution Focused Brief Therapy (SFBT) in the Classroom
– From a solution-focused approach, kids know what would make life better and have some ability to make it happen
Classroom Environment
Dubitsky & Quintero, 201027
o Solution-focused Brief Therapy Techniques– Strength-Based Language:
• Highlights what the student is doing that is working.
• It invites the student to do more of what is already working or to try changes to achieve success.
• The teacher asks the student, “How did you do that?” or “How have you managed to prevent things from becoming worse?”
Classroom Environment
Metcalf, 1999Dubitsky & Quintero, 201028
o Solution-focused Brief Therapy Techniques– Miracle Question:
• Helps the student describe small, realistic doable steps they can take as soon as the next day
• For example, “If you woke up tomorrow and discovered that a miracle had occurred overnight, what would be different as you went through your day that would tell you things were better for you?”
• To encourage the student to begin taking action, “How could you begin achieving that on a very small scale, on your own, just for the next week?”
Classroom Environment
Metcalf, 1999Dubitsky & Quintero, 201029
o Solution-focused Brief Therapy Techniques– Exceptions:
• Something that happens instead of the problem• Often spontaneously and without conscious
intention• The question asked to the student is, “What is
different about the times when this is less of a problem?”
Classroom Environment
Metcalf, 1999Dubitsky & Quintero, 201030
o Solution-focused Brief Therapy Techniques– Scaling:
• Scaling is useful in helping students to assess their own situations, track their progress, or evaluate how others might rate them on a scale of 1 to 10.
• “On a scale of 1 to 10 with 1 being the problem is in control to 10, you are in control of the problem; where are you at today?”
• “Where would you like to be next time and what will you need to do to get there?”
Classroom Environment
Metcalf, 1999Dubitsky & Quintero, 201031
o Establishing a Plano Early Warning SignsoResponding to Disruptive Behavior
Crisis Response
Dubitsky & Quintero, 201032
Crisis Response
oEstablishing a Plan– Develop a procedure– Identify which staff members will be
involved– Partner teachers– Select community outlets– Include steps for keeping everyone safe
Crisis Response
Dwyer, et al., 1998; Barbetta, Norona, & Bicard,2005; Adamson & Peacock, 2007
Dubitsky & Quintero, 201033
oActivity: Creating a Plan- The teacher’s responsibility:
• Who to Call• Partner Teacher(s)• Evacuation Areas
Crisis Response
Dubitsky & Quintero, 201034
oEarly Warning Signs– Students with mental illnesses and severe
behavioral difficulties– May express frustration with severe emotional
outbursts or self-injurious behavior– Be aware of the early warning signs associated
with emotional outbursts and violence
Crisis Response
Gecker, 2008; Dwyer et al., 1998Dubitsky & Quintero, 201035
oEarly Warning Signs–Environmental:
• being a victim of violence • drug and alcohol abuse• gang affiliation• access to weapons
Dwyer et al., 1998
Crisis Response
Dubitsky & Quintero, 201036
oEarly Warning Signs–Social:
• social withdrawal• being bullied• intolerance of differences
Dwyer et al., 1998
Crisis Response
Dubitsky & Quintero, 201037
oEarly Warning Signs–Emotional:
• feelings of isolation• rejection• uncontrolled anger
Dwyer et al., 1998
Crisis Response
Dubitsky & Quintero, 201038
oEarly Warning Signs–Behavioral:
• low school interest• depictions of violence in writings or drawings• bullying others• a history of past aggressive or violent behavior• a history of discipline problems• serious threats of violence
Dwyer et al., 1998
Crisis Response
Dubitsky & Quintero, 201039
o Imminent Warning Signs– Can signal that a student is close to dangerous or
severely disruptive behavior– Behaviors are much more severe– Require an immediate response– Safety is the foremost priority– Initiate the response plan for a child in crisis
Dwyer et al., 1998, Dwyer & Jimerson, 2002
Crisis Response
Dubitsky & Quintero, 201040
o Imminent Warning Signs– serious physical fighting with other students or
family members– severe destruction– extreme rage for seemingly minor occurrences– detailed threats of serious violence– possession of a weapon – self-injurious behavior – threats of suicide
Dwyer et al., 1998
Crisis Response
Dubitsky & Quintero, 201041
oResponding to Disruptive Behavior–Initiate the crisis plan–Try to remain calm–Ensure the safety of all students and
staff members
Crisis Response
Loucks, Rutledge, Hatch, & Morrison, 2010; Widger, 2007; Merchen, 2010
Dubitsky & Quintero, 201042
oResponding to Disruptive Behavior– Avoid attempting to de-escalate the crisis
through physical or threatening means– Validate the child’s feelings – Reinforcing appropriate behavior or coping
strategies– Just standing in the room may be the best
course of action until help arrivesMerchen, 2010
Crisis Response
Dubitsky & Quintero, 201043
oThe ABC’s of Crisis Response–Alert Response Staff
–Be Safe!
– Keep Calm
–Don’t Interfere
–Evacuate Students (if necessary)
– Validate Feelings until help arrives
Crisis Response
Dubitsky & Quintero, 201044
oResponding to Disruptive Behavior– Contact identified responders
• school administrators, school psychologists, and partnering teachers
• quick response from these personnel may lessen the emotional, psychological and physical damage a student in crisis may cause
Crisis Response
Dwyer et al., 1998Dubitsky & Quintero, 201045
oResponding to Disruptive Behavior– Ensure safety– If the student is violent or destructive, the
classroom may need to be evacuated– If the student is not violent, but self-
injurious or inconsolable, the student may be moved away from the classroom space
Crisis Response
Dwyer et al., 1998; Dwyer & Jimerson, 2002Dubitsky & Quintero, 201046
oResponding to Disruptive Behavior– Stay within a safe proximity to the child in crisis
until help arrives– Model composure and facilitate communication– Speak calmly– Allow the child to vent– Validate the child’s feelings
Widger, 2007
Crisis Response
Dubitsky & Quintero, 201047
oResponding to Disruptive Behavior– Do not to physically intervene to protect
school or personal property– Do not take items from the student or stand
in the student’s way
Crisis Response
Merchen, 2010; West & Kaniok, 2009Dubitsky & Quintero, 201048
oPsychological Intervention: Psychological First Aid
oReintegration into the ClassroomoChanging Behavior Through Positive
Behavioral Interventions
Restoration
Dubitsky & Quintero, 201049
Restoration
o Psychological Intervention: Psychological First Aid– Restore the classroom environment– Let the child know he or she is cared for– Calmly discuss the situation with the
student upon their return
Restoration
Brock, 1998; Dwyer et al., 1998; Dwyer & Jimerson, 2002
Dubitsky & Quintero, 201050
o Psychological Intervention: Psychological First Aid– Other students may also need to discuss their
feelings – Students may need guidance on how to act when
the child in crisis re-enters the classroom– The classroom community can design a plan that
makes it easier for the students to cope
Restoration
Brock, 1998; Ruzek, et al., 2007; Dwyer et al., 1998
Dubitsky & Quintero, 201051
oPsychological Intervention: Psychological First Aid–Listen –Protect–Connect
Schreiber, Gurwitch, & Wong, 2006
Restoration
Dubitsky & Quintero, 201052
oReintegration into the Classroom– Re-enter the child who experienced the
crisis back into the place where the crisis occurred
– Discuss with the child how their actions affected other students
Restoration
Brock, 1998; Schubert, 2007Dubitsky & Quintero, 201053
o Using SFBT to help the student reintegrate– Focus on prevention of future incidents– Help the child realize that change is possible– Set goals together that will facilitate positive
change– The child can walk away from the conversation
feeling hopeful
Metcalf, 1999
Restoration
Dubitsky & Quintero, 201054
o Using SFBT to help the student reintegrate– Exceptions– Strength Based Language– Miracle Question– Scaling
Restoration
Dubitsky & Quintero, 201055
o Changing Behavior Through Positive Behavioral Interventions– An FBA may prevent future occurrences of the
behavior– Outside counseling with a community agency– Students can be taught to monitor their feelings
for signs of a meltdown – They can advocate for their own emotional well-
being
Restoration
Smallwood, 2003; Sandoval et al., 2009Dubitsky & Quintero, 201056
Adamson, A.D. & Peacock, G.G. (2007) Crisis response in the public schools: A survey of school psychologists’ experiences and perceptions. Psychology in the Schools, 44, 749-764.
American Psychological Association. (2000) Diagnostic and Statistical Manual of Mental Disorders: Text Revision, 4th Edition. Washington, D.C.: Author.
Bailey, A.B. (2001). Conscious Discipline. Oviedo, FL: Loving Guidance , Inc.Blum, R.W. (2005). A case for school connectedness. Educational Leadership, 62, 16-20. Buckman, J.C., Mezzacappa, E., Beardslee, W.R. (2009). Self-regulation and its relations to adaptive
functioning in low income youths. American Journal of Orthopsychiatry, 79, 19-30.Barbetta, P.M., Norona, K.L., & Bicard, D.F. (2005). Classroom behavior management: A dozen
common mistakes and what to do instead. Preventing School Failure, 49, 11-19.Barfumo, M.E. (2006) Constructing a community. Teaching Pre K-8, 37, 10-12.Brock, S.E. (1998). Helping classrooms cope with traumatic events. Professional School Counseling, 2,
110.Cantwell, L. (2006). Creating the teaching and learning environment you’ve always dreamed of.
Educational Horizons, 84, 161-169.
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Center for Disease Control & National Center for Health Statistics (2008). Summary health statistics: National health interview survey, 2008. Retrieved February 15, 2010, from http://www.cdc.gov/nchs/data/series/sr_10/sr10_244.pdf.
Dwyer, K., Osher, D., & Warger, C. (1998). Early Warning, Timely Response: A guide to safe schools. Retrieved February 15, 2010, from http://www.ed.gov/offices/OSERS/OSEP/earlywrn.html.
Dwyer, K.P. & Jimerson, S.R. (2002). Enabling prevention through planning. In S.E. Brock, P.J. Lazarus, & S.R. Jimerson (Eds.), Best Practices in School Crisis Prevention and Intervention. Bethesda, MD: National Association of School Psychologists.
Huberty, T.J. (2008). Best practices in school-based interventions for anxiety and depression. In A. Thomas, & J. Grimes (Eds.), Best Practices in School Psychology V. Bethesda, MD: National Association of School Psychologists.
Gecker, E. (2008) How do I know if my student is dangerous? Education Digest, 73, 37-39.Loucks, J., Rutledge, D.N., Hatch, B., & Morrison, V. (2010). Rapid response team for behavioral
emergencies. Journal of the American Psychiatric Nurse Association, 16, 93-100.Melvin, C., Korthase, N, & Marquoit, J. (2005). Beyond behavior. The journal of Strength-Based
Intervention, 14, 112-117.
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Mendez, J.L. (2010). How can parents get involved in preschool? Behavior and engagement in education by ethnic minority parents of children attending head start. Cultural Diversity and Ethnic Minority Psychology, 16, 26-36.
Merchen, H. (2010) Handling violent students requires calm, preparedness. Retrieved February 15, 2010, from http://www.okea.org/legal/fromyourcounsel/ Handling%20violent%20 students%20requires%20calm%20preparedness.pdf.
Metcalf, L. (1999). Teaching towards Solutions: Step-by-step strategies for handling academic, behavior & family issues in the classroom. New York: The Center for Applied Research in Education.
Osher, D., Sprague, J., Weissberg, R.P., Axelrod, J., Keenan, S., Kendziora, K., & Zins, J.E. (2008). A comprehensive approach to promoting social, emotional, and academic growth in contemporary schools. In A. Thomas, & J. Grimes (Eds.), Best Practices in School Psychology V. Bethesda, MD: National Association of School Psychologists.
Pianta, R.C. & Stuhlman, M.W. (2004). Teacher-child relationships and children’s success in the first years of school. School Psychology Review, 33, 444-458.
Reinke, W.M., Splett, J.D., Robeson, E.N., Offutt, C.A. (2009). Combining school and family interventions for the prevention and early intervention of disruptive behavior problems in children: A public health perspective. Psychology in the Schools, 46, 33-43.
Ruzek, J.I., Brymer, M.J., Jacobs, A.K., Layne, C.M., Vernberg, E.M., & Watson, P.J. (2007). Psychological First Aid. Journal of Mental Health Counseling, 29, 17-49.
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Schreiber, M, Gurwitch, R, & Wong, M. (2006). Listen, Protect, and Connect – Model & Teach: Psychological first aid for children. Retrieved February 15, 2010, from http://www.ready.gov/kids/_downloads/PFA_SchoolCrisis.pdf.
Schubert, J. (2007) A restorative approach to postvention. Reclaiming Children and Youth: The Journal of Strength-based Interventions, 16, 45-47.
Smallwood, D. (2003). Defusing violent behavior in young children: An ounce of Prevention: Information for school principals. Retrieved February 5, 2010, from http://www.nasponline.org.
Spilt, J.L. & Koomen, H.M.Y. (2009). Widening the view on teacher-child relationships: Teacher’s narratives concerning disruptive versus nondisruptive children. School Psychology Review, 38, 86-101.
Stoughton, E.H. (2007). “How will I get them to behave?”: Preservice teachers reflect on classroom management. Teaching and Teacher Education, 23, 1024-1037.
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