BENEFITING: YMCA of the East Bay
We represent a partnership among a non-profit organization "The Y", a mental health clinic specializing in the treatment of severe trauma, and a school district. We have previously implemented an ongoing evidence-based, effective program in 9 New Haven Connecticut public schools, called Ask Every Child, that has had significant positive effects on individual student performance, classroom regulation, and overall school climate. Taking a strong public health prevention approach, we have identified many children who are under high levels of toxic stress before they break down into problematic behaviors or symptoms. Our goal is to replicate part of this program called Alive! in one or more elementary schools in the Richmond, California School District in order to then move toward state and national implementations.
Our programs are organized under the name ALIVE, which stands for Animating Learning by Integrating and Validating Experience. ALIVE programs follow several basic principles:
By middle and high school, many students have been burdened by stressors and their school performance has suffered. When possible, it is essential to identify students early in their elementary school career and provide supportive services then. The best way to do that is not through expensive, comprehensive assessments, but through brief but targeted screenings.
Immediate and Proximate Interventions
The usual process of identifying and referring students for supportive services often results in the student being seen several days or even a week later. Formal, weekly sessions with a counselor may not address the momentary disruption in the classroom. Teachers may not wish to call for assistance too often over relatively minor behaviors. Only when the student’s behavior becomes significantly disordered will a referral be made. The result is that many classrooms are frequently being disrupted by minor behaviors of a number of students, drawing the energy and attention of the teacher away from the main body of students who are trying to learn. Thus placing our staff in and around the classrooms provides a more immediate capability to address emergent problems.
Quite often students’ disruptive behaviors have been triggered by relatively small stimuli that tap into their background pool of stress, which if directly attended to, can lead to a rapid decrease in their activation. Teachers are constantly seeking effective ways of dampening down these students’ behaviors. Referral to school support staff typically involves a delay between the time a referral is made, and the time when the behavior is addressed with the child. The standard format of half hour or longer sessions has the negative impact of removing the student from the classroom for too long a time. Therefore, the most effective intervention is often a brief one with the expectation that the student will return to class. Waiting until the behavior becomes highly escalated will require longer removals from the classroom, whereas acting more quickly, preventively, requires much briefer interventions.
Developmentally Appropriate Intervention
Most elementary students have difficulty sitting in a chair and discussing how they are feeling and what is happening in their lives, for more than a few moments. Students who are under more stress or are less capable of managing stress are even less able to have these conversations. Many counselors will resort to games such as Uno, Checkers, Chutes and Ladders, to create a welcoming, relaxed environment for the child and intersperse questions about their feelings and events whenever they can. However, it is questionable how effective these interventions are. Providing the opportunity for elementary school children to engage in exuberant, physical role play with a trained drama therapist allows the student to engage in psychological exploration in a fun, developmentally appropriate manner. Our experience is that nearly 100% of the students we work with enjoy this format.
The teacher is restricted by his/her role in intervening in students’ disruptive behaviors: they must address the student in terms of expected norms of the classroom and their departure from those norms, as well as interactions between the students. Teachers are often aware that while a particular student’s behavior may be triggered by an event in the classroom, it is often generated by the strain from events at home or outside the classroom. Though teachers may be able to take the student aside and ask them about these events, there is a limit to how often they can do this, and doing so in the middle of a lesson is not possible. Having the student be able to talk about these stressful events privately and directly creates a greater possibility of decreasing their activation than purely suppressive methods. Utilizing counselors trained to interview children with traumatic experiences is an advantage because they are comfortable with direct questions and trained to handle the students’ responses to being asked about difficult things. The advantage of utilizing trained drama therapists is that they have the ability to weave into the roleplaying aspects of the student’s stressful experiences and feelings, providing not just a playful recess but a meaningful desensitization to stressful cues in the environment. The key element is the purposeful introduction of anxiety-provoking reminders of the student’s life into the supportive play environment.
In the Elementary Schools
We believe in the necessity of early and targeted screening for stress. In one elementary school, we have conducted a comprehensive screening of every kindergartener regarding stress, classroom behavior, symptoms, and grade level, in collaboration with the teaching staff. This assessment found that nearly 60% of the kindergarteners were students who behaved well in the classroom and showed no overt signs of disorder, but who were experiencing high levels of toxic stress! Unidentified, it is these students who will eventually break down and develop problems in later grades. The screening included a verbal inquiry, a play session, and teacher ratings of classroom behavior. The results of this screening are described in detail in our report: “Student Socio-Emotional Assessment- Strong School-2012.”
Our stress reduction program provides drama therapists who work with students selected by the teachers and taken out for only 15-20 minutes for exuberant, physical play in which themes related to their personal stresses are enacted and played through. The students return to the class significantly calmer, and whole classrooms have been calmed down through this approach. Teachers report the calming effect of the interventions last anywhere from an hour to the rest of the day. We do not serve here as mental health providers, but educational behaviorists, and children who need formal treatment are referred to the school’s social support teams, with whom we work collaboratively. By accessing the students this way, we have greatly reduced the need for more intensive services, identified problems earlier so that the parents can be brought into a partnership in solving the problem, and thereby reducing referrals to the Department of Children and Families for more serious offenses.
*Students love the program and on self-report measures they feel better immediately.
*Observers using standardized behavior rating scales, before and then after our interventions, found significant improvements in mood, attention, conformity to social norms, and motor restlessness:
*Disciplinary actions have been dramatically reduced. Office referrals, aggressive acts, and fighting among students have plummeted in the elementary schools we have served.
*In one elementary school, we have greatly reduced referrals to the principal for problem behaviors by providing counseling staff for nearly every classroom. In 2010-2011, we were not in the school; in 2011-2012 we covered six classrooms; in 2012-2013, we are covering 22 classrooms. The data below was collected by the school officials:
*This result has been achieved with only 22.5 hours a week of our counselors’ time.
*Improvements in Neuropsychological Functioning
In addition, we have tested the students before and after these sessions with a neuropsychological test (Stroop Test) that measures efficiency of executive functioning, and students are showing significant improvement in their executive functioning, mood, and behavior. By decreasing the effect of distracting toxic stress on the students, their capacities for attention and concentration improve.