Gerald Caplan s Preventive Psychiatry. Seminar in Preventive Interventions. Stephen E. Brock, Ph.D., NCSP 1



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Seminar in Preventive Psychological Intervention EDS 246b Stephen E. Brock, Ph.D.,NCSP Course Description: Study and application of various primary, secondary, and tertiary psychological interventions designed to prevent school failure and/or emotional challenges. Examines techniques of identifying pupils who are experiencing mental health difficulties that interfere with school functioning, and intervention techniques designed to address these problems. 1 Seminar in Preventive Psychological Intervention This course primarily addresses elements of NASP domain of school psychology training and practice 2.7; Prevention, Crisis Intervention, and Mental Health. It also addresses the following domains: 2.2, Consultation and Collaboration; 2.4, Socialization and Development of Life Skills; and 2.11, Information Technology. Specific student outcomes achieved during this course that are consistent with CSUS School Psychology Program Objectives are the following: Acquisition of knowledge important to successful collaboration with school and parents to implement interventions that promote positive outcomes for students. The ability to understand student needs from a developmental and ecological perspective. The ability to implement problem-solving approaches that either facilitate student coping and/or generate appropriate referrals. Development of an understanding of specialized needs of diverse student populations, including issues of culture, unique 2 learning needs, alternative lifestyles etc Gerald Caplan s Preventive Psychiatry Caplan,G. (1964). Principles of preventive psychiatry. New York: Basic Books. Primary Prevention Secondary Prevention Tertiary Prevention 3 Stephen E. Brock, Ph.D., NCSP 1

Primary Prevention Lowering the rate of new cases of a disorder in a population over a certain period of time by counteracting harmful circumstances before they have a chance to produce problems. Examples include Violence Prevention Skill Building (e.g., Problem solving, conflict management, social skills instruction, bully proofing, etc.) School Safety Planning Disaster/Crisis preparedness 4 Secondary Prevention Reducing the rate of disorders by shortening the duration of existing cases through early diagnosis and effective treatment. Examples include Violence intervention Student Success Teams School crisis response Psychological triage Crisis intervention Suicide intervention 5 Tertiary Prevention Programs designed to rehabilitate individuals with long term problems to return them to their productive capacity as quickly as possible to their highest potential Examples include Special education School referral to Mental Health 504 accommodation plans Disaster recovery Suicide postvention 6 Stephen E. Brock, Ph.D., NCSP 2

Prevention Providers While all primary, and most secondary, prevention activities are appropriate undertakings for general educators, tertiary prevention requires special expertise training and skill. This response requires long-term psychological, and psychiatric treatments that are typically beyond what most general educators can provide. Mental health professionals typically provide these services. 7 Typical Seminar Agenda 1. Questions (246b & Internship) 2. Lecture 3. Break 4. General discussion & activities 8 Course Overview Required Readings To be read by the dated indicated on the seminar outline. These readings are available online or in the required texts. Recommended Reading Supplemental material that will help you to better understand course content. Required Resources While not all are required reading these documents need to be made a part of each students electronic libraries. To document that your have obtained these documents place them on a CD and turn in each no later than the date indicated on the course outline. 9 Stephen E. Brock, Ph.D., NCSP 3

Course Overview Seminar Requirements/Activities: 1. Attendance/Class participation. 2. Field Observation/Interview. 3. Crisis Response Role-Plays/Observations. 4. Psychological Triage Activity. 5. Psychological l First Aid Script. 6. Psychological First Aid Role-Plays. 7. Psychological First Aid Observation. 8. Suicide Intervention Script. 9. Final Exam. 10. Extra Credit. 10 Youth Violence Prevention EDS 246b Preventive Psychological Intervention Stephen E. Brock, Ph.D., NCSP 11 School Killings October 2, 2006 Paradise, PA March 2005 -- Red Lakes, Minnesota February 19, 2002 -- Munich, Germany June 8, 2001 -- Osaka, Japan March 26, 2001 -- Kyanguli, Kenya March 5, 2001 -- Santee, California February 29, 2000 -- Mount Morris Township, Michigan April 20, 1999 -- Littleton, Colorado April 28, 1999 -- Taber, Alberta, Canada May 21, 1998 -- Springfield, Oregon March 24, 1998 -- Jonesboro, Arkansas December 1, 1997 -- West Paducah, Kentucky October 1, 1997 -- Pearl, Mississippi March 30, 1997 - Sanaa, Yemen March 13, 1996 -- Dunblane, Scotland May 1, 1992 -- Olivehurst, California January 17, 1989 -- Stockton, California September 26, 1988 -- Greenwood, South Carolina May 20, 1988 -- Winnetka, Illinois January 29, 1979 -- San Diego, California 12 Stephen E. Brock, Ph.D., NCSP 4

Preface: Schools are safe places. Homicides 30 Suicides 8 1718 At School Away from School 1,288 Dinkes, R., Cataldi, E.F., & Lin-Kelly, W. (2010). Indicators of school crime and safety: 2009 (NCES 2010-021/NCJ 228478). Washington, DC: National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education, and Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice. 13 70 School Associated Violent Deaths 60 50 40 30 20 10 Total number of student, staff, andnonstudent school-associated violent deaths Homicides of youth 5-18 at school Suicide of youth 5-18 at school 0 1992-93 1993-94 1994-95 1995-96 1996-97 1997-98 1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 14 School Associated Violent Acts Serious Violent Crimes Against Students Ages 12 to 18 2004 107,400 At School 228,600 Away from School 32% are school associated 15 Stephen E. Brock, Ph.D., NCSP 5

School Associated Serious Violent Crimes Serious Violent Crime es at School 350000 300000 250000 200000 150000 100000 50000 0 1992-93 1993-94 1994-95 1995-96 1996-97 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04 16 2004-05 Creating a Climate of School Safety Assess the school s emotional climate Do people in the school community feel safe? Respect and Listen All students (and staff) must feel that they are respected (schools as a shame free zone ) & listened to. Break the Code of Silence Unwritten, but powerful (e.g., my middle school experience) Encourage communication and change norms (i.e., make it heroic to break the code). 17 Creating a Climate of School Safety Stop bullying Empower students by involving them Especially important for adolescents. Ensure caring adult connections Relationships are a powerful protective factor Connections can easily be assessed 1. Alpha List 2. All staff check on list students they feel connected to 3. Emphasize relationships with those who are not checked. 18 Stephen E. Brock, Ph.D., NCSP 6

Creating a Climate of School Safety For further guidance on creating safe school environments refer to. Osher, D., Dwyer, K., & Jackson, S. (2003). Safe, supportive and successful schools: Step by step. Longmont, CO: Sopris West. (ISBN 1-57035-918-0) 19 The Importance of a Climate of School Safety % 87 86 85 84 83 82 81 80 79 Perceived Saftey at School by API Quintile 1st (lowest) 2nd 3rd 4th 5th (highest) API Score Percent of students who reported perceived safety at school was very positively correlated with API scores (California Healthy Kids Survey, 1999-2000) 20 The Importance of a Climate of School Safety 21 Stephen E. Brock, Ph.D., NCSP 7

The Importance of Caring Relationships 22 Specific Prevention Programs Selection requires assessment of unique school needs. Which problems are we likely to face in OUR school? What are the primary short-term and long-term objectives of OUR school violence prevention efforts? Who are the targets of the violence-prevention efforts? Are these prevention efforts organized primarily at the school or district levels? How are the prevention efforts linked to broader, community-level violence initiatives? 23 Adapted from Furlong et al. (2002) Specific Prevention Programs While prepackaged programs may work for specific schools with specific needs They cannot be randomly selection off the prevention program shelf and be expected to be beneficial. Knowing who you want violence prevention efforts to target and what aspect (or aspects) of school violence you are most interested in preventing will be a first step in program selection. Furlong et al. (2002, pp. 142-149) classifies Promising School Violence Primary Prevention Programs according to program targets and domains. 24 Stephen E. Brock, Ph.D., NCSP 8

Specific Prevention Programs Examples of Violence Prevention Programs: Primary Intervention Project Second Step I Can Problem Solve (Brock et al., 2002, Chapter 6) Peer Mediation (Brock et al., 2002, Chapter 10) Aggression Replacement Training (Brock et al., 2002, Chapter 12) Social Skills Training (Brock et al., 2002, Chapter 8) 25 School Violence Prevention: School wide or Curricular Approaches Second Step The goal of this structured and systematic curriculum is to foster socio-emotional development and school adjustment of children through h the development of empathy, impulse control, and anger management. Curricula are available for preschool through eighth grade. 26 School Violence Prevention: School wide or Curricular Approaches The Primary Mental Health Project By identifying, and intervening with, students at risk for developing school adjustment difficulties, this 44-year-old project aims at preventing young children from becoming troubled. By making use of a specially trained paraprofessional, it provides special adult attention (via child-centered play) to young students judged by teachers as being at risk for school adjustment difficulties. This special attention gives students an unequivocally positive experience with an adult at school. Several state legislatures have provided funding for the systematic implementation of this program. For example, in California, a Primary Intervention Program is made available by State Department of Mental Health grants (through its Early 27 Mental Health Initiative). Stephen E. Brock, Ph.D., NCSP 9

Targeted Violence vs. General Violence Targeted violence has been conceptualized as violence in which the perpetrator and the target(s) are identified or identifiable prior to an incident. The U.S. Secret Service uses this term when referring to individuals who make planned attacks against others. It has been suggested that students at risk for targeted violence may or may not possess many of the traditional risk factors associated with delinquency and general violence. 28 Targeted Violence vs. General Violence Juveniles who committed targeted homicide were less likely to have had problems with school adjustment, less likely to have prior mental health difficulties, less likely to have prior arrests or placement in juvenile detention facilities, and less likely to have histories of prior violent behavior than were those youths convicted of assault. In addition, those youths who were perpetrators of targeted school shootings may differ from individuals who commit different types of homicide as well as from those who engage in nonviolent delinquency. 29 U. S. Secret Service Report Ten Key Findings May, 2002 For hard copies of this report: www.secretservice.gov edpubs@inet.ed.gov ntac@secretservice.gov Fax requests to: 1-301-470-1244 30 Stephen E. Brock, Ph.D., NCSP 10

Key Finding #1: There s no accurate profile There is no accurate or useful profile of students who engaged in targeted school violence. 1. Attackers came from a variety of family situations. 2. Attackers differed from one another in academic achievement. 3. Attackers varied in the types of social relationships they had created. 4. Histories of disciplinary problems at school varied. 5. Most attackers showed no marked change prior to attack. 6. Over half of the attackers demonstrated some interest in violence. 7. Most attackers had no history of prior violent or criminal behavior. 31 Key Finding #1: There s no accurate profile Profiles are not effective Criticisms Unjustly stigmatizes students Information may result in discrimination, invasion of privacy, punishment, isolation, and exclusion from school and activities without due process (rather than as a tool for identifying youths in need of intervention). Focus on behavior and communications (not appearances) Appearances may direct our attention, but should not direct our action. Profiling focuses on appearances. Risk assessment focuses on behaviors/communications. 32 Key Finding #2: Many attackers felt bullied Many attackers felt bullied, persecuted or injured by others prior to the attack. Take bullying seriously. Ensure students are not bullied in school. Empower students to let adults know when they are bullied. 33 Stephen E. Brock, Ph.D., NCSP 11

Key Finding #3: Losses and suicidal attempts Most attackers had difficulty coping with significant losses or personal failures. Many had considered or attempted suicide. Listen for feelings of desperation or hopelessness. Consider the changes in a student s life. Monitor students who have displayed suicidal ideation 34 Key Finding #4: Incidents of targeted violence at school rarely are sudden, impulsive acts. Revenge was a motive for more than half of the attackers. Students do not just snap. Attacks are a result of a process of thinking & behavior. However, the time span may be short. Students whose primary motivation is revenge should be carefully monitored. Teach kids to cope with being upset. 35 Key Finding #5: Prior to the attack, others knew about the attacker s idea and/or plan to attack. Students are an important part of prevention efforts. Schools must have an effective system for dealing with information brought forward. Positive relationships among students and staff increases the potential for reporting incidents of concern. 36 Stephen E. Brock, Ph.D., NCSP 12

Key Finding #6: Most attackers did not threaten their targets directly prior to the attack. Do not wait for threats, but begin inquiry if behaviors are evident. Respond to ALL threats. 37 Key Finding # 7: Previous behaviors caused others concern Most attackers engaged in some behavior, prior to the incident, that caused others concern or indicated a need for help. Train staff & students to watch for Early Warning Signs, behavior, or comments, and to REPORT concerns. Have a reporting system in place & evaluate the process periodically. 38 Key Finding # 8: In many cases, other students were involved in the attack in some capacity. Pay attention to the role of friends & others and the impact of peer pressure. Evaluate the climate of the school. 39 Stephen E. Brock, Ph.D., NCSP 13

Key Finding #9: Most attackers had access to and had used weapons prior to the attack. Pay attention to weapons access, use, or communications about weapons. 40 Key Finding # 10: Most attacks were stopped by means other than law enforcement intervention Have protocols & procedures for managing threats and other behaviors of concern. We must act quickly. Practice and evaluate crisis procedures routinely. 41 Required Resources Dwyer, K., Osher, D., & Warger, C. (1998). Early warning, timely response: A guide to safe schools. Washington, DC: U.S. Department of Education. Available: http://cecp.air.org/guide/guide.pdf U.S. Department of Health and Human Services. (2001). Youth violence: A report of the Surgeon General. Washington, DC: U.S. Government Printing Office. Available http://www.surgeongeneral.gov/library/youthviolence/ /lib / th i l / 42 Stephen E. Brock, Ph.D., NCSP 14

Next Meeting Youth Violence Intervention Read Fein et al. (2002) Obtain Dwyer & Osher (2000) Dinkes et al. (2009) 43 Stephen E. Brock, Ph.D., NCSP 15