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A strategy of ready, fire, aim for student behavioral health





At the risk of being the fool who rushes in where angels fear to tread, I am astonished by the great consternation around the question of how to assess the effectiveness of behavioral health services for students. After all,  these services have been provided for long enough that we ought to know what works and what assessment criteria and protocols have been agreed on.

Or are we just pursuing the strategy of ready, fire, aim?

If a student is identified with a behavior issue, the teacher should know how to identify what purpose that behavior is serving. For example, if the child is acting out to get attention from peers (not necessarily a reason for a referral for services), the teacher should know the proper way to intervene and dissuade future incidents. If the teacher does, but the behavior persists, a simple form and rubric could identify the behavioral problem and assess its severity.

Behavioral health care providers should then conduct an initial assessment and share their findings with teachers and parents or guardians, along with a plain-language explanation of what the treatment will be and what all parties must do to support its effectiveness, followed by a meeting of all the parties to reach consensus on how the student's progress will be assessed.

Why are these steps not being taken years after behavioral health services have been recognized as an essential component of many students' educational success?

If we are, in fact, starting from scratch, here's an example of how a process might work.

"Darren" is persistently disruptive in class, yelling out answers and refusing to remain in his chair. "Teacher Joan" tries both incentives and disincentives to no avail. She submits a referral and rates the behavioral issue using the rubric prepared by the behavioral health provider, who observes Darren in the classroom and facilitates a discussion with Teacher Joan and Darren's mother.

In this discussion, all three parties agree on what each of them will do to support the improvement of Darren's behavior. They agree on when and how they will meet again to assess his progress. This process will be repeated at agreed-on intervals until Darren's behavior reaches the score at which all parties agree it is acceptable.

Granted, such a process can be much more challenging than it sounds. For example, it assumes that all three parties will work together to address Darren's issue. What happens if the teacher or parent cannot uphold their end of the bargain? What does the School District do to ensure that all teachers understand behavior and its underlying purpose? Does the city's Department of Behavioral Health monitor and enforce provider quality standards? Can the behavioral health provider be solely accountable for progress or lack thereof? Do we need access to specialized behavioral health providers, because one agency may be great in addressing trauma but less great in addressing depression? What happens if the provider believes that medication is the optimal or only treatment but the mother refuses, or agrees to it and fails to ensure that he takes it as prescribed?

It's hard to imagine that in all the years of providing behavioral health care for students, there is no evidence-based practice for treating a student like Darren. Don't we know what works -- not just in general terms or under optimal conditions, but in the gritty environment of children from concentrated poverty attending over-burdened and under-resourced public schools and families that struggle with the basics of survival?

We must find the schools and behavioral health providers in the District that have figured out how to make behavioral health care work for a student like Darren and whose approach can be replicated. If we cannot find them here, let's look elsewhere until we do, because too many students have too many behavioral health barriers to their academic progress to ignore the problem or continue pursuing inadequate responses.


Debra Weiner is a longtime advocate for public education at a variety of nonprofit organizations and higher education institutions. She is a member of the Notebook's editorial board. 

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