Clinical and School Psychology Final

Culture

"An integrated pattern of human behavior that includes thoughts, communications, languages, practices, beliefs, values, customs, courtesies, rituals, manners of interacting and roles, relationships and expected behaviors of a racial, ethnic, religious or social group; and the ability to transmit the above to succeeding generations."

Top 3 Ethics Related Concerns Reported by SPs

Administrative pressure 43 (%within Top 3) 89 (N) Unsound educational practices 41 86 Assessment related concerns 27 56 Confronting unethical colleagues 24 50 Storage and disposal of records 22 45

What is Clinical Psychology?

A field that integrates the science, theory and practice of psychology to understand, predict and alleviate human suffering as well as to promote human adaptation, adjustment and personal development.

What is different about CBT?

A short-term, present-focused treatment that focuses on solutions and doesn't aim to change the past Utilizes learning principles (classical and operant conditioning) Goal: Reduce symptoms through increased cognitive flexibility and behavior modification

SP Indirect Services

Consultation, program development, advocacy, education

Section 504: Major Life Functions

Caring for one's self Performing manual tasks Walking Seeing Hearing Speaking Breathing Learning Working Eating Sleeping Standing Lifting Bending Reading Concentrating Thinking Communicating Functions of the immune system Normal cell growth Digestive Bowel Bladder Neurological Brain Respiratory Circulatory Endocrine Reproductive functions

How People Defend

Defenses protect us against anxiety but also blunt our full contact with reality and expression of core emotions. Paying attention to defenses can tell us a lot about how a person organizes their world and points us to important information. Knowing our own patterns of self-protection can help us know ourselves better.

Triangle of Conflict

Defensive behavior thoughts and feelings Anxiety, guilt shame pain Feelings

Affect Regulation

Definition: the ability to maintain or increase positive feelings and states of well-being and to minimize or regulate stress feelings and defensive states. It is the ability to keep affective arousal within tolerable limits, neither escalating to states of hyperarousal or becoming numb or frozen in states of hypoarousal.• Emerging as a powerful common ground among many approaches to psychotherapy. •Integrates knowledge of the brain and how it can become dysregulated, how infant-caregiver attachment affects our capacities to self-soothe, and how neurobiological systems can aid in affect regulation and self-regulation. •Provides a less pathologizing and more compassionate way of conceptualizing a lot of human troubles. Problems with affect regulation are common to most mental health disorders. •Provides a way of understanding both what happens in the treatment room and what we would increasingly want clients to be able to do for themselves.

Best Research Evidence

Depends on the question to be answered: different research designs are needed to answer different types of questions. Treatment efficacy gold standard is randomized clinical trials, but multiple strands of evidence of necessary for effective practice. The Spring article talks about how psychology programs may overemphasize this aspect, with relatively less focus on clinical expertise and patient values.

Implicit Bias

Despite the consistent and extensive research that shows African American males being disproportionately overrepresented in discipline referrals, no significant studies support the claim that African American boys are actually more disruptive than their non-African American peers

1962

Journal of School Psychology is founded (1st school psychology journal)

Ethical Dilemma: Lack of Clarity

Ethical standards may be unclear or ambiguous. For example, what, exactly, does this principle recommend? "School psychologists consider children and other clients to be their primary responsibility, acting as advocates for their rights and welfare" (NASP, IV. A. 1.) ▸Who are "children and other clients?" ▸What are appropriate forms of advocacy?

Population of the U.S.

Ethnicity 2014 2060 White/Caucasian 62.2% 43.6% Hispanic/Latino 17.4% 28.6% Black/African American 13.2% 14.3% Asian-American/Pacific Islander 5.4% 9.3% American Indian/Alaskan Native 1.2% 1.3%

EBP vs. EST

Evidence-Based Practice (EBP) An approach to treatment that integrates "best research evidence with clinical expertise" within the context of client characteristics, culture and preferences (APA, 2005). It is an ongoing, decision making process. Empirically-Supported Treatments (EST) -Interventions found to be effective by research -Often classified by levels of support EBP will use ESTs whenever they are appropriate

Challenges to Psychotherapy as a Humanistic Enterprise

I. Redesign of DSM The aim to be more useful to researchers had great impact on clinicians as well Diagnostic criteria went from contextual and dimensional models to externally defined and described criteria II.Rise of Managed Care Funding healthcare in what is "essentially a venture-capitalist model." Creating an incentive system to deny care Use (and abuse) of empirically supported treatment movement to assist in that denial of care III. Role of Pharmaceutical Industry Their profitability depends on making human problems into chemically treatable disorders Their ability to market directly to the public has made the "better living through chemistry" approach much more visible than our much less Madison Avenue savvy position 4:IV.Estrangement between academic researchers and clinicians in psychology Academics and clinicians lead such different lives that they are often out of touch with each other. Contempt of one side for the other leads to inability to work together to solve the problems confronting us.

Eligibility Determination

Is there a disability that impacts education/learning? No: Continue to work with family, teacher, student. No formal involvement with special education or related services; no IEP or Section 504 Service Plan Yes: Formal involvement. Do they need special education OR do they need a Section 504 Service Plan?

Referral- The What?

Location, referral and identification Each district board of education shall develop written procedures for students age three through 21, including students attending nonpublic schools located within the district regardless of where they reside, who reside within the local school district with respect to the location and referral of students who may have a disability due to physical, sensory, emotional, communication, cognitive or social difficulties. ●Written procedures for referral ●Ages 3-21 ●Including students attending nonpublic schools

Dodo Bird Verdict

Many outcome studies have pitted one therapy against another. Again and again, the surprising result, one disappointing to adherents, has been that the results are usually a virtual tie.

Why do we need to belong? (Maslows Hierarchy of needs)

Maslow- feelings of belonging and connectedness are fundamental human needs

Masters/Specialists vs. Doctorate in SP

Masters/Specialists ●60 graduate semester credits and 1,200 hour internship ●3 years (2 yrs of courses + 1 yr. internship) ●School Psychologist Certification ●Career in school setting Doctorate ●Variable length (5-7 years) ●Licensed psychologist ●Variable settings, including private practice, hospitals, community clinics, etc.

Socioeconomic Status (SES)

Our social and economic position based on income, education, occupation Low SES is related to poorer physical health, poorer housing, fewer educational and sports/extracurricular opportunities

1990

PL94-142 Renamed Individuals with Disabilities Education Act (IDEA) Reauthorized every 7 years

Roles: Advocacy

NASP and state professional associations are dedicated to advocacy. School psychologists encourage and sponsor: ●Appropriate educational placements. ●Education reform. ●Legislative involvement. ●Community services and programs. ●Funding for adequate resources. ●Employment of highly qualified school personnel. School psychologists and teachers can work together to advocate for the needs of students at the school, local, state, and national level.

1969

National Association of School Psychologists (NASP) is founded to represent non-doctoral level school psychologists

PH.D Psy.D caveat

Some Ph.D. programs have evolved over the years to more resemble Psy.D. programs, so there may be some Ph.D. programs out there that could meet practitioner needs. The key is to closely look at the program and see if their emphasis is upon research or practice. The Rutgers Ph.D. program (in contrast to the Rutgers Psy.D. program) has the traditionally heavy emphasis upon research, publication and primarily academic careers.

Level 5 on Empathy Scale

The counselor's responses add significantly to the feeling and meaning of the client's expression -- feelings are accurately expressed at levels beyond what the person him/herself was able to express and is able to be fully present for the other person in his/her deepest moments

Achievement Gap

The disparity in academic performance between groups of students ●Grades, standardized-test scores, course selection, dropout rates, & college-completion rates ●Achievement gap between SES group, race, disability vs. no disability, English language proficiency vs. CLD

Under stress

We are designed for bottom-up processing under stress. "Bottom-up hijacking" is triggered by a "false alarm," responding as if threatened when there is no danger. Cognitive processing is inhibited.

ICD (International Classification of Diseases)

World Health Organization

Referral - From Who?

a)ii Referral by instructional, administrative and other professional staff of the local school district, parents and state agencies, including the New Jersey Department of Education and agencies concerned with the welfare of students. ●Parents, teachers, I&RS, doctors, speech, OT, psychologists ●Within school- typically from I&RS (Intervention and Referral Services)

Consent

▹Unless otherwise ordered by court, parent or legal guardian is authorized representative consenting to treatment ▸They sign any authorization to consent to treatment and release information ▹If child is 14 years old or more, they also sign authorization ("dual consent") ▸Obtain "assent" for kids under 14 ▫At least one parent or guardian must provide consent ▫Other parent may object, but minor can still be treated ▫Divorce: Parent with legal medical decision making rights must provide consent

●What do School Psychologists do?

○Address those variables that impact a child's educational performance, whether internal to the child or part of the various systems (home, school, etc.) that the child functions in. ○Work with student, families, teachers, community providers, medical providers, and other stakeholders important in the child's life.

Three Stage Model of Trauma Treatment

¡1. Establishing safety §May be brief if trauma is single-incident §May be longer if a lifetime of trauma ¡2. Treatment of the Trauma Itself §A variety of current treatment techniques § ¡3. Restoring the connection between the survivor and his/her community

CBT Treatment Structure and Style

•Structured session using "agendas" of what will be accomplished during a given visit •Collaborative in decisions about what will be done in treatment. Rationales given for decisions •Active practice (often called "homework") is done regularly outside sessions •168 hours in a week...you spend 1 of them with a therapist •Use of regular goal/symptom monitoring to evaluate progress during treatment •Every case is like a mini empirical study with one subject. If the data says it isn't working, re-evaluate. •Short-term (months, not years) •16-20 sessions, sometimes fewer

Core Concepts: Transference

•In one sense, transference is no more than this seeing the past in the present. When we first meet someone, we try to navigate the new situation be seeing it through the lens of our past experiences. Old scripts, expectations, desires, etc. are activated and become alive in the therapy relationship.

Top-down processing

•Mediated by the Frontal Lobes •Mindfulness •Cognitive Processing •Meaning Making •Modulates our Emotions

Outside the therapy roomskills for affect regulation

•Mindfulness Meditation •Many therapists highly recommend this. •CAPS has a workshop available for students •Breathing Techniques •Exercise •Guided Imagery •Hypnosis and Self-Hypnosis •Computer Training Programs like Heartmath

Social Work

■Historically worked with social forces and outside influences that impacted individuals. Recently moved more into delivery of psychotherapy. ■A fast-growing profession, currently 60% of licensed mental health providers. ■Has MSW degree

Counseling Psychology

■Overlap with Clinical Psychology ■Traditionally worked with normal or moderately maladjusted individuals. ■Historically have done a lot of vocational and educational counseling

Where Do Clinical Psychologists Work?

■Private Practice - most frequent setting ■University Settings ■Psychiatric Hospitals ■Outpatient Clinics ■Community Mental Health Centers ■Medical Schools ■VA Hospitals ■Correctional Facilities ■Nursing Homes ■Rehabilitation Centers

Activities of Clinical Psychologists

■Psychotherapy ■Diagnosis/Assessment ■Teaching ■Clinical Supervision ■Research/Writing ■Consultation ■Administration

Lightner Witmer

■Started the first psychological clinic at the University of Pennsylvania in 1896 ■The second was started at Rutgers by a student of Witmer, Henry Starr

Battle with Psychiatry

■Treatment of mental illness by 19th century in the hands of psychiatry. ■Much of the history of clinical psychology is the history of our political battles with psychiatry.

Intelligence

▣The global capacity to profit from experience and to go beyond given information about the environment. (APA, 2016) ** Intelligence = IQ = Aptitude = Cognitive Ability = Ability to Learn

Core Concepts: Unconscious

•Much thinking and feeling goes on outside conscious awareness. •Modern cognitive science has much support for this, often calling it implicit or procedural memory. •Psychodynamic theory focuses on the ways in which we do not know our own mind, and may not WANT to know our own mind, how we look away from what frightens us or threatens us.

Core Concepts: The Past is Alive in the Present

•Our past is important, not just as a history, but because it becomes a template through which we view current reality. •The goal of psychoanalytic psychotherapy is to loosen the bonds of past experience to create new life possibilities.

Core Concepts: Defenses

•Psychological ways of protecting ourselves from anxiety. Mechanisms that deny, distort or minimize reality. •Examples: Denial Projection Intellectualization Sublimation

LIMITS of CONFIDENTIALITY

▹Exceptions to confidentiality ▸Imminent risk of harm to self or others ▸Child abuse ▹If know of imminent risk or harm to self or others, required to take steps: ▸Protect from harming others ▸Protect child from suspected harm by others ▸Protect from harming self ▹SP's (an in NJ all people) are mandated reporters - who do we report to?

NASP's Ethical Principles

▹NASP's Principles of Professional Ethics are based on 2 assumptions: ▸"School psychologists will act as advocates for their students/clients ▸At the very least, school psychologists will "do no harm" (NASP 2000a, pg 13)

Ethical Principles

▹Respecting the Dignity and Rights of all Persons ▹Competence and Responsibility ▹Honesty and Integrity in Professional Relationships Responsibility to Schools, Families, Communities, the Profession, and Society

Respecting the Dignity and Rights of All Persons

▹School psychologists engage only in professional practices that maintain the dignity of all individuals. ▸In their words and actions, school psychologists demonstrate respect for the autonomy of persons and their right to self-determination, respect for privacy, and a commitment to just and fair treatment of all persons. ▹Respect for Autonomy of Persons (Consent) ▸School psychologists respect the right of persons to participate in decisions affecting their own welfare. ▹Respect for Privacy (Disclosure) ▸School psychologists respect the right of persons to choose for themselves whether to disclose their private thoughts, feelings, beliefs, and behaviors.

DISCLOSURE of INFORMATION

▹Start treatment with explanation of limits of confidentiality ▹Developmentally appropriate language ▹Therapeutic contracts spell out limits and give examples ▹Legal guardian has the right to minor's records ▹Most information does not need to be disclosed to parents ▸Not required to release info related to STD's, abortion, substance use

IDEA: Disability Categories

●Autism ●Deaf-Blindness ●Deafness ●Emotional Disturbance ●Hearing Impairment ●Intellectual Disability ●Multiple Disabilities ●Orthopedic Impairment ●Other Health Impaired ●Specific Learning Disability ●Speech or Language Impairment ●Traumatic Brain Injury ●Visual Impairment

Child Interview: Understanding Emotions

●Below age 10, idea of mixed emotions is difficult for kids ●Leads to "all or none" feeling states ●Hard for kids to understand concept of ambivalence ●Negative feelings are more scary ●Limited capacity to think abstractly, which makes describing emotions difficult ●Feelings chart

Assessment: Team

●Child Study Team ○School Psychologist ○Social Worker ○Learning Disabilities Teacher Consultant ●Teacher ●Speech-language specialist ●School specialists (OT,PT) ●Outside providers (neurologists, psychiatrists, medical doctor, etc.)

●Child forms Internal Working Model (IWM) of relationships

●Child forms Internal Working Model (IWM) of relationships ○Primary caregiver serves as prototype for later relationships ○Development of IWM of relationships influences the quality of later attachment relationships

Types of Assessment

●Cognitive/Intelligence/Aptitude ●Educational/Achievement ●Personality ●Social/Emotional ●Behavior ●Adaptive

Adaptive Measures

●"Practical, everyday skills needed to function and meet the demands of one's environment, including the skills necessary to effectively and independently take care of oneself and to interact with other people" (PAR, 2016) ●Examples: Dresses self in morning; Contacts friends outside of school (choose whether this is done independently or with what level of help needed) ●Teacher and Parent Form. NO Self-Report Form ●Needed for Intellectual Disability diagnosis and classification

1905: Binet-Simon

●1st test of intelligence ●Scale to identify students who were having trouble learning ●Included items related to skills needed for daily living (e.g., counting coins) ●Goal of testing: identify in order to remediate through education, not to stigmatize/ segregate through removal

Referral Patterns

●2/3 of students in Special Education referred between K-5th grade ●Majority of students referred for reading difficulties

Achievement Gap: Poverty

●2016 Census Bureau: ○20.6% African-American population making under $15,000/year ○12.6% Hispanic population making under $15,000/year ●Those who are members of racial minority groups are overwhelmingly concentrated in the lowest-achieving schools ●By age 3, children in poverty have smaller vocabularies and lower language skills than children from middle-income families ●Children who both live in poverty and read below grade level by 3rd grade are three times as likely to not graduate from high school as students who have never been poor (Hernandez, 2011)

Child Interview: Perception of Others

●Below age 7/8, kids focus on describing external features of others ●Ability to describe others increases with age ●Can present a picture of a family and ask child to point out who is happy/sad/mad ●Developmental changes in the way relationships are viewed will influence child's capacity to describe them (he is cool because he is fast vs. he is cool because he is nice to me when we play)

1905

●Binet-Simon intelligence scales are established in Paris, France ○To ID students w/ below avg. IQ due to mandatory education law

Play Therapy: Advantages

●Builds rapport ●Flexible format can be adapted to developmental stage ●Observe behaviors that don't occur in more restrictive styles of interaction

Attachment: Anxious

●Caregiver: emotionally unavailable; neglectful and then overindulgent; high control, low warmth/support ●Child: Experiences anxiety/uncertainty about caregiver's predictability and capacity to soothe; suspicious and distrustful while also clingy and hyper-vigilant; lower self-control and self-reliance

Attachment: Avoidant

●Caregiver: over-involved, smothering, low warmth/ support ●Child: prefers distance to manage overwhelming affect and/or inconsistent caregiving; social difficulties

Attachment: Disorganized/Chaotic

●Caregiver: physically or emotionally abusive, mental health concerns ●Child: attachment figure is source of child's distress; may dissociate/detach from what's happening to them; tend to reenact pattern; riskier behaviors, lower self-esteem, dependent and submissive or hostile and rebellious (Ainsworth, Baumrind)

Attachment: Secure Attachment

●Caregiver: predictable, reliable, high control, high warmth/support ●Child: can use relationship with caregiver to return to on a predictable basis for comfort, can self soothe; higher school achievement; healthier relationships Mary Ainsworth Strange Situation Experiment

SES & Race Interaction

●2016 Census: Median household income for Whites ($65,041) was higher than for Hispanics ($47,675), which was higher than for African Americans ($39,490) ●According to spatial assimilation theory, these numbers alone should result in racial segregation, even if no discrimination was present ●Children are then born into these families and attend schools in these segregated neighborhoods, where different education is provided due to a difference in funds

Preschool Child with a Disability (NJ)

●3-5 years old ●Has a developmental delay in... (1) Physical, including gross motor, fine motor and sensory (vision and hearing), (2) Intellectual, (3) Communication, (4) Social and emotional, OR (5) Adaptive ●33% delay in 1 developmental area, or a 25 % delay in 2 or more developmental areas ●OR Has an identified disabling condition that adversely affects learning or development ●Requires special education and related services.

NASP 2015 Member Survey

●83% Female, 16% Male, .10% Agender ●Median age 42.4 (1st time age has decreased since 1990) ●87% White, 5% Black/Af.Am., 2.8% Asian, 6% Hispanic ●86% Speak only English, 7% Spanish, 1.3% ASL, 5.3% Other (27 different languages), 7.9% provide multilingual services ●Mean age went down, field still White and female (but more diverse, more female than in the past)

Social Maladjustment

●A consistent inability to conform to the standards for behavior established by the school. Such behavior is seriously disruptive to the education of the student or other students and is not due to emotional disturbance as defined in (c)5 above.

Orthopedic Impairment (O. Handicapped)

●A disability characterized by a severe orthopedic impairment that adversely affects a student's educational performance. ●The term includes malformation, malfunction or loss of bones, muscle or tissue. ●A medical assessment documenting the orthopedic condition is required.

Eligibility Determination Categories (NJ)

●Auditory Impairment ●Autism ●Intellectual Disability ●Communication Impairment ●Emotional Regulation Impairment ●Multiple Disabilities ●Deaf/Blindness ●Orthopedic Impairment ●Other Health Impairment ●Preschool Child with a Disability ●Social Maladjustment ●Specific Learning Disability ●Traumatic Brain Injury ●Visual Impairment

Roles: Consultation

●Collaborate with teachers to help them identify classroom-based problems and implement data-based interventions. ●Support implementation of effective instruction and behavior management at the classroom level. ●Assist parents to develop skills to help their children succeed at home and in school. ●Collaborate with admin and other school personnel to identify systemic concerns and promote systems-level change.

Deaf/Blindness

●Concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational problems that they cannot be accommodated in special education programs solely for students with deafness or students with blindness.

IEP: Related Services

●Counseling ●Occupational therapy (OT) ●Physical therapy (PT) ●Speech-language services ●Transportation ●School nurse services ●Recreation ●Social work services ●Medical services

Discipline: Prevention

●Culturally Responsive Pedagogy (CRP): ○Make instruction culturally relevant ○Communication of high expectations ○Learning within the context of culture ●School-wide positive behavior supports ●School connectedness - foster inclusive environments ●Presence of teacher/adult that expresses belief in abilities, capacity for hard work ●Evidence-based disciplinary practices ○Restorative practices, behavioral theory

Positive Effects of School Connectedness

●Decreased ○Maladaptive behaviors (drug and alcohol use, truancy, early sexual behaviors, violence, and risky behavior) ○Conduct problems, antisocial behavior ○Mental health problems (lower depression, anxiety, emotional distress, and suicidality) ●Higher self-esteem, self-efficacy, optimism, and positive peer relationships ●Higher academic achievement, overall grades, and scores on standardized tests ●Higher student motivation, self-regulation, and student attitudes towards school Better attendance and higher graduation rates

Roles: Mental Health

●Deliver school-based mental health services such as group, individual, and crisis counseling. ●Coordinate with community resources and health care providers to provide students with complete, seamless services. ●Partner with parents and teachers to create healthy school environments. ●Promote mental health in the school setting. ●Provide counseling, instruction, and mentoring for those struggling with social, emotional, and behavioral problems.

DSM-V vs. IDEA

●Eligibility categories/classifications vs. DSM diagnoses ●Overlap ●Categories require adverse effect on educational performance ●Students may have DSM-V diagnosis that does not have adverse effect on education

School Psychologists and Special Education (IDEA)

●Eligibility determination ○Identification ○Classification ●Case management ●Development and implementation of IEP ●Consultation and support

Exosystem

●Environmental elements that influence child's development, even though child is not directly involved with them ○Parents' work environment ○Mass media ○School boards

Behavioral Measures

●Examine attention, hyperactivity, conduct, antisocial tendencies, oppositional behavior, executive functioning (planning, organizing, regulating) ○Examples: Fidgets in class; Brings needed materials to class ●Self (student), Parent, and Teacher Forms ●Example: Behavior Rating Inventory of Executive Function

Social-Emotional Measures

●Examine relationships, self-esteem, mental health (depression, anxiety), withdrawal, attention, aggression, somatization ●Usually have "critical" items ○Examples: "I hear voices."; "I have no friends." ●Self (student), Parent, and Teacher Forms ●Example: Behavior Assessment System for Children

1899

●First school-based psychological clinic is established in Chicago public schools

Assessing Diverse Populations

●Linguistic: ○Tests should be administered in the child's native tongue or mode of communication, if possible ○Consider test that doesn't use spoken language ●Cultural: ○Consider substituting subtests that are especially culture-related ○In your report, note the possible impact on the result ●Representation within Norming Samples

Section 504 vs. IDEA

●Major Differences ○Services in general education versus services in special education ○Nature of services is different

1988

●NASP institutes National School Psychology Certification Board

School Connectedness: School Psychologist's Role

●Stressing importance and benefits to school board/ politicians ●Educating and training teachers on its importance and strategies ●Educating parents as well and empowering them with skills. ●Conducting a school-wide assessment to determine which students are not feeling connected ●Advocating for system-wide programs ●Utilizing the resources through NASP for school connectedness ●Developing individualized interventions ●Encouraging the formation of support groups for disconnected and marginalized youth

Child Interview: Types

●Structured ●Semi-structured ●Sentence completion ○Read through all of the questions ○Ask a neighbor 5 or more questions that you think would be relevant

School Connectedness: At Risk Populations

●Students who are culturally or linguistically diverse ●Students with a disability, mental health disorder, or chronic health issues ●Students who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) ●Students living in poverty

When should teachers see a School Psychologist?

●Tackling challenging academic or behavioral situations. ●Implementing effective individualized instruction. ●Providing evidence-based practices and interventions (in accordance with new laws) to address students' learning needs. ●Evaluating student progress towards individual goals and state standards. ●Advocating for resources within the school and community for all students and their families.

Multiple Disabilities

●The presence of two or more disabling conditions, the combination of which causes such severe educational needs that they cannot be accommodated in a program designed solely to address one of the impairments. ●Multiple disabilities includes cognitively impaired-blindness, cognitively impaired-orthopedic impairment, etc. The existence of two disabling conditions alone shall not serve as a basis for a classification of multiply disabled. Multiply disabled does not include deaf-blindness.

Criticisms of the DSM - Jerome Wakefield

◦Dysfunction is hard to define, because each of these views of disorder are flawed ◦No such thing as disorder ◦Pure value ◦Whatever we treat ◦Statistical deviance ◦Biological disadvantage ◦The DSM doesn't account for normal responses to negative environments ◦ ◦Data show that it is difficult to replicate syndromes across cultures ◦ ◦Disorder should be: Value-laden, socially unacceptable behavior and inability to perform natural mental functions

Well-Known MCT Models

◦Ecological and structural models (context) ◦Bronfenbrenner's bioecological model ◦Oppression - a structural system that confers unearned power and privilege (bias, attitudes) ◦Identity models ◦Race/ethnicity, LGBTQI, gender, religion, immigration/acculturation, etc. ◦(modalities, helping roles, liberate consciousness) ◦Risk & resilience models [need more data] ◦Protective and resource factors ◦Vulnerability and risk factors ◦All are important for couples/families

Perspective #2 (WHO'S Version) Steps in Translation: (WHO's Adaptation)

◦Establishment of a bilingual group of experts​ ◦Examination of the conceptual structure of the instruments by the experts​ ◦Translation​ ◦Examination of the translation by the experts​ ◦Examination of the translation by a monolingual group​ ◦Blind backtranslation​ ◦Examination of the blind back-translation by the experts Is it comprehensable, is it acceptable, is it relavent, is it complete

What is school psychology?

"As a practice specialty within professional psychology, school psychology is grounded in the theory and science of psychology; is concerned with the science and practice of psychology with children, youth, families, and learners of all ages; and is committed to the application of psychology to education and the schooling process." "School psychology is differentiated from the other specialties in professional psychology by its focus on the application of psychological knowledge and methods to solve problems or improve processes and outcomes within educational institutions or with individuals involved in the learning process."

Humanistic Psychotherapy

"The romantic vision is fundamental to humanistic psychotherapy...it emphasizes the cultivation of emotional sensitivity and expressiveness and seeks to develop in clients spontaneity, creativity, authenticity, agency and experiential intensity." Values living authentically in the moment Adjustment to society not a prime goal. People are fundamentally good, unfallen.

Discipline Gap

"instances when students who belong to specific demographic groups (e.g., race/ethnicity, sex, disability status) are subjected to particular disciplinary actions...at a greater rate than students who belong to other demographic groups" focused on in-school and out-of-school suspensions

Referral - Conditions

(b) Interventions in the general education setting shall be provided to students exhibiting academic difficulties and shall be utilized, as appropriate, prior to referring a student for an evaluation of eligibility for special education and related services. (c) The staff of the general education program shall maintain written documentation, including data setting forth the type of interventions utilized, the frequency and duration of each intervention, and the effectiveness of each intervention. c)1 When it is determined through analysis of relevant documentation and data concerning each intervention utilized that interventions in the general education program have not adequately addressed the educational difficulties, and it is believed that the student may have a disability, the student shall be referred for evaluation to determine eligibility for special education programs and services under this chapter. (d) A direct referral to the child study team may be made when it can be documented that the nature of the student's educational problem(s) is such that evaluation to determine eligibility for special education services under this chapter is warranted without delay.

IDC-10

(continue)

Mean Salaries of School Psychologists

+ Northeast: $75,121 (SD: 21K) + West: $71,123 (21K) + Midwest: $66,075 (20K) + Southeast: $61,212 (15K) + Southwest: $60,421 (13K)

NASP contracts

+50% 164-191 days (9 months) + 25% 192-206 days (10/11 months) + 25% 207+ days (12 months) +Union vs. non-union contract +Benefits +Bargaining power +Security +Teacher pay scales

Focus on building relationships. Connect outside of the classroom.

+Attend the extracurricular events students are involved in. +Know students' names as well as the people, activities, etc. that are important to them. +Connect academic goals and curricula to the personal interests of students. +Greet students at the door of your classroom every day. +Provide a safe, disruption-free learning environment. +Encourage students to take risks and make mistakes. +Display student work—not just exceptional work of individuals. +Display images on classroom walls that represent the demographic of the class and counter stereotypes (e.g., a female scientist).

What do school psychologists do?

+Enhance the educational performance and emotional well-being of children and learners in all types of educational settings +Address those variables that impact a child's educational performance, whether internal to the child or part of the various systems (i.e. home, school, etc.) in which the child functions ●Assessment ●Consultation ●Prevention ●Intervention ●Staff, parent, and student education ●Research program development ●Mental health care ●Advocacy ●Systems change

+Targeted Programs and Approaches (school connectedness)

+Small group work +Class discussion +Peer tutoring +Cooperative learning activities +Saying students' names +Allowing choices in assignments +Incorporating student-relevant examples

+Universal Programs (school connectedness)

+Social-emotional learning (SEL) programs +Aim to reduce a wide array of risk factors, while fostering many protective and resiliency factors. +Research suggests SEL programs are effective at all grade levels and in all community settings. +SEL programs are backed by a great deal of strong empirical support.

Why Multi-Tiered systems of support (MTSS)?

-Provide school-wide programming and interventions to keep students engaged, connected, and empowered -Support those students who are not getting their needs met at Tier 1 -Provide most intensive services to students with the greatest needs - this way, everyone is accounted for - efficient allocation of resources

Section 504 and School Psychologists

-Seen as "disability experts" in the schools -Consult with teachers, administrators and families regarding interventions and supports -Help implement classroom-wide interventions -504 plans -Help develop and provide feedback -SMART goals -Evidence-based practice and data-based decision making

Multicultural Theory (MCT) A Supplemental Metatheory

1. All theoretical orientations are grounded in a biased cultural context 2. Interrelated contexts must be considered 3. Cultural ID influences attitudes 4. Enhance treatment by using modalities that fit diverse clients 5. Use diverse useful helping roles 6. Liberation of consciousness and social justice are legitimate therapeutic goals 7. Each aspect of cultural ID has its own frameworks/micro-theories

Five Objectives for Translated Measures (Perspective #1)

1. Content equivalence - Content of item is relevant to the culture ​ 2. Semantic equivalence - Meaning from one language to another remains the same​ 3. Technical equivalence - The method of assessment (I.e. paper and pencil) is comparable in each culture​ ​ 4. Criterion equivalence - "The interpretation of the measurement of the variable remains the same when compared to the norm of each culture studied"​ 5. Conceptual equivalence - Tool is measuring a consistent theoretical construct across cultures​

Referral

1. The parent may make a written request for an evaluation to determine eligibility for services under this chapter. Such a request shall be considered a referral and shall be forwarded without delay to the child study team for consideration. ●Meeting is held with the parent to discuss if evaluation is warranted, and if warranted, what evaluation will include ●Parents must sign consent for evaluation ●Once parents sign the district has 90 calendar days (NJ) to complete evaluation (reports 10 days prior) (c) If the parent refuses to provide consent to conduct the initial evaluation, the district may file for a due process hearing pursuant to N.J.A.C. 6A:14-2.7 to compel consent to evaluate.

Discrepancy Model

1.A child with a high IQ and low academic achievement can qualify for special education services 1.A child with a low IQ and even lower academic achievement can qualify for special education 1.A child with a low IQ and low academic achievement, would NOT qualify for special education because there is no discrepancy between IQ and achievement.

Suggestions to Maximize your Chances for Graduate school

1.Consider your options and select the program best for your goals. 2.Keep your GPA as high as you can. 3.If your GPA isn't stellar, consider going to a Master's program, and if you do, ace it. 4.It may take more than one try to get in. 5.Apply broadly, not to just one or two programs. 6.Plan to take the GRE's early, especially the Psych GRE, which is offered less frequently. 7.The Princeton Review is an expensive investment, but may be helpful in raising scores. 8.Think about what you want and if there are faculty at the school doing what you want to do. 9.Consider the personal fit: "Are there people there who look like you?" 10.Get some sort of clinical and experiential work or volunteer experience if you want to go to practitioner programs and research experience if you want to go to a traditional Ph.D. program.

IDEA- Eligibility NJ6A:14-3.5(c)

1.It is determined that the student has one or more of the disabilities defined in (c)1 through 14 below 1.The disability adversely affects the student's educational performance 1.AND the student is in need of special education and related services.

Challenges and Controversies of Today

1.Proliferation of other psychotherapy providers 2.Prescription Privileges - should psychologists seek it or not? 3.Evidence-based practice and pros and cons of manualized treatment 4.Rise of managed care and intrusion of insurance into client care 5.Influence of Technology - promise and limits of Telepsychology

Problem Solving Model in Assessment

1.Referral 2.Choose assessment methods, tools, procedures 3.Assess 4.Write report 5.Review all data (talk with the team) 6.Make eligibility determination 7.Communicate results/ recommendations

Eligibility for section 504 and the IDEA

504- children with physical or mental impairments that substantially limit a major life function. These children would recieve a 504 plan- not an IEP IDEA- Children who have one of the 13 IDEA disabilities and who needs special education services. These children receive an IEP (individualized education program)

Assessment: Requirements

6A:14-3.4(f) An initial evaluation shall consist of a multi-disciplinary assessment in all areas of suspected disability. Such evaluation shall include at least two assessments and shall be conducted by at least two members of the child study team in those areas in which they have appropriate training or are qualified through their professional licensure or educational certification and other specialists in the area of disability as required or as determined necessary ●Multisource- evaluators, teacher/parent input ●Multimethod- observation, interviews, record reviews, rating scales, standardized assessments Multisetting- classroom(s), specials, recess, home

●New Jersey Anti-Bullying Bill of Rights Act - 2002, 2011 ○Definition: "Harassment, intimidation or bullying" means any gesture, any written, verbal or physical act, or any electronic communication, whether it be a single incident or a series of incidents, that is reasonably perceived as being motivated by an actual or perceived characteristic such as: •Race, color, religion, ancestry, national origin, gender, sexual identity and expression, or a mental, physical, or sensory disability, or by any other distinguishing characteristic, that:

A)Takes place on school property, at any school-sponsored function [or],on a school bus, or off school grounds, and that: B)A reasonable person should know, under the circumstances, will have the effect of physically or emotionally harming a student or damaging the student's property, or placing a student in reasonable fear of physical or emotional harm to his person or damage to his property; or C)Has the effect of insulting or demeaning any student or group of students, D)creates a hostile educational environment for the student

In the first half of the 20th century, practicing psychologists were most known for

A.Psychological tests and measurements

Cultural Competence

APA Ethical Guidelines require us to be knowledgeable "Where...knowledge in...psychology establishes that...understanding of...age, gender identity, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status is essential for effective ...services...psychologists...obtain the training... necessary to ensure the competence of their services..." Awareness: ●Assumptions, values, biases Understanding: ●Our worldview, worldview of others, including those that are culturally and linguistically diverse (CLD) Knowledge: ●Cultural differences, assessment, and intervention strategies Skills: Providing counseling, assessment, and intervention services

ACE Study

Adverse Childhood Experiences of abuse, neglect and other traumatic stressors in relation to health outcomes. Subjects were given an "ACE score" for the total number of events reported in 7 categories. They found a strong and graded relationship between the score and health outcomes in adulthood.

:Shared World View

Alternative to SOLER

DSM (Diagnostic and Statistical Manual of Mental Disorders)

American Psychiatry Association

1862

American Psychological Association is founded

Inequality in Funding

Amount spent per child per year in 2005: NYC $11,700 vs. Manhasset, Long Island $ 22,000 Median Teacher Salary by district: New York City $53,000 Manhasset, Long Island $87,000

Auditory Impairment (Deafness or Hearing Impairment)

An inability to hear within normal limits due to physical impairment or dysfunction of auditory mechanisms characterized by: ●"Deafness"--The auditory impairment is so severe that the student is impaired in processing linguistic information through hearing, with or without amplification and the student's educational performance is adversely affected. ●"Hearing impairment"--An impairment in hearing, whether permanent or fluctuating which adversely affects the student's educational performance

Waves of Approaches to Psychotherapy

AnalyticBehavioralHumanisticFamily Systems/Multicultural

Top Ethical Dilemmas Observed by SPs

Assessment 86 % Intervention 79 Administrative Pressure 76 Informed Consent 51 Parent Conflicts 48 School Records 38 Job Competence 36 Confidentiality 33 Conflictual Relationships 20

Competence and Responsibility

Beneficence, or responsible caring, means that the school psychologist acts to benefit others. To do this, school psychologists must practice within the boundaries of their competence, use scientific knowledge from psychology and education to help clients and others make informed choices, and accept responsibility for their work. ▹Competence ▸To benefit clients, school psychologists engage only in practices for which they are qualified and competent. ▹Responsible assessment practices ▸Protect test security ▸Use valid tests

Clinical Psychology

Clinical psychology is the psychological specialty that provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Measuring Intelligence: Modern Day

Cognitive tests aim to measure things like: ●Reasoning ●Problem Solving ●Working Memory ●Visual and Auditory Processing Speed, Acquired Knowledge **Not all tests measure all of these areas!** Most common areas included: ●Verbal ability ●Nonverbal ability (Perceptual Reasoning) ●Processing Speed ●Working Memory

Counseling Psychology

Counseling psychology is a general practice and health service provider specialty in professional psychology. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well‐being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Level 1 on Empathy Scale

Counselor's responses do not attend to or detract from what the client is expressing. There is no awareness of even the most obvious expressed feelings

IQ Testing Controversy

Critics suggest that IQ tests have been used to support racial inequalities and subsequent inadequate educational opportunities for minorities Larry P. vs. Riles (1979, San Francisco) ●Claimed that IQ tests were culturally biased and that their use resulted in overrepresentation of minority students ●Claim that items were drawn from White middle class culture; language of Black children different from the language of the tests; tests are standardized on predominantly white sample ●Court ruled in favor: the state of CA could not use IQ tests to identify black children for placement

Disproportionality in Special Education (SE)

Disproportionality is an issue of equity and access in general and special education. It refers to " the extent to which membership in a given...group affects the probability of being placed in a specific disability category." (Oswald, et al., 1999) Underlying premise: all groups should be represented in special education at same rate as in general population. If not, bias could be present (Reschly, 2003) Compared to white students, black students have been persistently overrepresented in special education nationally, along with American Indian students. Hispanic and Asian/Pacific Islander students are underrepresented ●Differences in early learning and school readiness ●Inequitable opportunities due to tracking, poor resources and limited teacher training ●Lack of culturally relevant curriculum ●Limited family involvement and advocacy in schools ●Funding which favors special education ●Racism and systemic bias that all CLD youth require special education

Ph.D. vs. Psy.D.

Doctor of Philosophy Ph.D. ●Focus on research production ●Longer program ●More funding available ○Typically paired with faculty member ●Smaller cohort ●Typical Career: University Faculty Doctor of Psychology Psy.D. ●Focus on APPLICATION of research (practice-oriented) ●Shorter program ●Less funding available - depends on the program ●Larger cohort ●Typical Career: Applied setting

SOLER

Face Client Squarely Open Posture Lean Towards Client Eye Contact Relaxed

Special Education Laws

Federal ●1975: Education for all Handicapped Children Act (PL 94-142) ○1990: Individuals with Disabilities Education Act ○2004: IDEA Reauthorized - IDEIA State ●N.J.A.C.6A:14- Special Education

1954

First National School Psychology conference Brown v. Bd of Ed: landmark Supreme court case intended to end racial segregation in public schools by providing equal opportunity; racially segregated schools (i.e., separate but equal) were ruled unconstitutional

Take home pay (SP)

Gross $3,500 Taxes (State & Federal) $665 19% Pension & Grp Life $280 8% Healthcare $385 11% Union Dues $70 2% Net $2,100

Guidance Counselor vs. School Psychologist

Guidance Counselor ●Masters (48 credits, 600hr internship, 2yr program) ●Work with all students ●Make class schedules ●Check in with students ●Social skills/lunch bunch ●College admissions prep School Psychologist ●Masters/SSP/EdS (60 credits, 1200hr internship, 3yr program) ●In NJ, typical focus on SPED students ●Assessments, reports (IQ, ACH, RISK) ●Plan/monitor interventions ●Counseling on more serious issues

IDEA vs. NJ 6A:14 Disability Categories

IDEA ●Autism ●Deaf-Blindness ●Deafness ●Emotional Disturbance ●Hearing Impairment ●Intellectually Disabled ●Multiple Disabilities ●Orthopedic Impairment ●Other Health Impaired ●Specific Learning Disability ●Speech or Language Impairment ●Traumatic Brain Injury ●Visual Impairment NJ6A:14 ●Auditory Impairment ●Autism ●Intellectual Disability ●Communication Impairment ●Emotion Regulation Impairment ●Multiple Disabilities ●Deaf/Blindness ●Orthopedic Impairment ●Other Health Impairment ●Preschool Child with a Disability ●Social Maladjustment ●Specific Learning Disability ●Traumatic Brain Injury ●Visual Impairment

Discipline Gap: Implicit Racial Bias

Implicit social cognition is the process by which the brain uses "mental associations that are so well-established as to operate without awareness, or without intention, or without control." (Graham & Lowery, 2004)

IDEA

Individuals with Disabilities Education Act Provides... ○Free Appropriate Public Education (FAPE) ○Least Restrictive Environment (LRE) ○Guidelines and criteria for special education (accommodations/modifications) and related services ●Documented in an Individualized Education Plan (IEP) IDEA = Services & Supports through Special Education

Psychoanalytic Psychotherapy

More allied to the tragic and the ironic visions. "The outcome of psychoanalytic treatment is not ... all obstacles overcome, but the fuller recognition of what one's struggles are about." The focus in multiple meanings and an underside to every upside (and vice versa) owes a lot to an ironic perspective.

Objective vs. Projective

Objective Rating Scale or Self-Report Measure ●Require true/false, frequency rating responses (NSOA), likert scale ●Structured ●Types: self-report measures, behavior rating scale ●Examples: Child Behavior Checklists (CBCL), The Children's Depression Inventory ●Advantages: standard measurement, higher reliability/ validity measures ●Limitations: possible bias (e.g. picking the more socially desirable answer), students restricted in what they can report Projective Free Response Measures ●Questions that are open-ended (often a response to ambiguous stimuli) ●Unstructured ●Types: drawing, story telling, sentence completion ●Examples: Thematic Apperception Test, Rorschach, Draw a Person task ●Advantages: greater flexibility in test administration, may be less threatening the child, child doesn't need to understand the purpose of the task ●Limitations: may be less valid/reliable, rely heavily on clinical judgment, extensive training required, many are not standardized

Ethical Dilemma: Competing Principles

Often, situations involve competing ethical principles. "School psychologists understand their obligation to respect the rights of a child to initiate, participate in, or discontinue services voluntarily" (NASP, III. B. 3). vs. "School psychologists respect the wishes of parents who object to school psychological services" (NASP, III. C. 4.)

How SPs Decide How to Handle Dilemmas

Peer consultation 66% Consulted ethics codes, laws, or other guidelines 42 Thought about risks/benefits of actions 41 Used systematic decision-making model 16 Contacted a state professional organization 6 Contacted NASP 2

504 Plan: Common Accommodations

Presentation accommodations Listen instead of read Lesson outline instead of notes Response accommodations Oral instead of writing Type instead of write Setting Accommodations Small group Sensory tools- chair band Timing accommodations Extended time Frequent breaks Scheduling accommodations More time for projects Take tests in am vs. pm Organizational skills accommodations Highlight texts Timer to stay on task

Scholar Practitioner

Psy.D. model endorsed by the Vail Conference in 1973

Who can prescribe psychotropic medications?

Psychiatrists

Relationship of Psychology and Psychiatry for much of 20th Century

Psychiatry on top; psychology fighting for a place at the table

Who can do psychological testing?

Psychologists

Who can do psychotherapy?

Psychologists and Psychiatrists and Social Workers

Don PetersonFormer Dean of GSAPP

Psychology is the only discipline that combines science and practice in a single field. Other disciplines have more separation, for example, Sociology and Social Work, Physical Sciences and Engineering; Biological Sciences and Medicine. The same person is not expected to be both researcher and practitioner. There is a tension inherent in creating an umbrella discipline.

Level 4 on Empathy Scale

The counselor's responses add noticeably to the expressions of the client in such a way as to express feelings a level deeper than the client was able to express.

International and National Movements toward adopting EBP as policy

Quality and Accountability Policy - e.g. whether insurance will cover a claim Growth of the Behavioral Science Evidence Base A common vocabulary with other disciplines Useful Infrastructure/Accessible Databases Lifelong Learning

Race & Ethnicity

Race: ●Biologically determined traits ●Members of a racial group may comprise different ethnicities and cultures Ethnicity: ●Group that shares a common history, culture, values, behaviors ●These features cause members to have a shared identity. ●Definition is similar to culture but members of same ethnic group may have different cultural experiences depending on degree of acculturation

School Psychology

School Psychology is a general practice and health service provider specialty of professional psychology that is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development.

Responsibility to Schools, Families, Communities, the Profession, and Society

School psychologists promote healthy school, family, and community environments. They maintain the public trust in school psychologists by respecting law and encouraging ethical conduct. School psychologists advance professional excellence by mentoring less experienced practitioners and contributing to the school psychology knowledge base. ▹Maintaining Public Trust by Self-Monitoring and Peer Monitoring ▸School psychologists accept responsibility to monitor their own conduct and the conduct of other school psychologists to ensure it conforms to ethical standards.

Roles: Education

School psychologists provide teachers and parents training in... ●Teaching and learning strategies and interventions. ●Parenting and disciplining techniques. ●Classroom and behavior management techniques. ●Working with exceptional students. ●Strategies to address substance abuse, risky behaviors, or mental illnesses that affect students. Crisis prevention and response

Within-School Factors

Schoolwide: ●Low expectations for student achievement; ●Lack of rigor in the curriculum; ●Large class size; ●Tracking groups of students into a less demanding curriculum; ●Unsafe schools; ●Culturally unfriendly environments; ●Poor, or no, instructional leadership. Teacher- & Teaching-Related Factors: ●Uncertified and inexperienced teachers ●Insensitivity to different cultures; ●Poor teacher preparation ●Low expectations of students ●Inadequate materials, equipment, & resources, including technology-based resources.

Section 504 of the Rehabilitation Act (1973)

Section 504 covers qualified students with disabilities who attend schools receiving Federal financial assistance. To be protected under Section 504, a student must be determined to: (1) have a physical or mental impairment that substantially limits one or more major life activities; or (2) have a record of such an impairment; or (3) be regarded as having such an impairment. Section 504 requires that school districts provide a free appropriate public education (FAPE) to qualified students in their jurisdictions who have a physical or mental impairment that substantially limits one or more major life activities. As of January 1, 2009, school districts... must not consider the ameliorating (improving) effects of any mitigating measures that student is using. The mitigating measures are as follows: medication; medical supplies, equipment or appliances; low-vision devices (which do not include ordinary eyeglasses or contact lenses); prosthetics (including limbs and devices); hearing aids and cochlear implants or other implantable hearing devices; mobility devices; oxygen therapy equipment and supplies; use of assistive technology; reasonable accommodations or auxiliary aids or services; and learned behavioral or adaptive neurological modifications. Section 504 = Services & supports through GENERAL EDUCATION

Cognitive-Behavioral Therapy

Seen as more allied with Comic vision. "In CBT, conflict may be ascribed to external situations or internal forces that can be mastered through application of therapeutic technology. CBT therapists are more interested in the direct alleviation of suffering than in the exploration of internal struggles."

Social Worker vs. School Psychologist

Social Worker ●Masters (30-60 credits, 900-1200hr internship, 1-2yr program) ●SPED or Gen Ed focus ●Family aspect of child ●Counseling/Social skills ●Social histories ●Community resources School Psychologist ●Masters/SSP/EdS (60 credits, 1200hr internship, 3yr program) ●In NJ, typical focus on SPED students ●Assessments, reports (IQ, ACH, RISK) ●Plan/monitor interventions ●Counseling on more serious issues

World War I for psychology

The First World War gave a big push to psychology as the military turned to them to develop tests to help manage the huge influx of recruits who needed to be assessed for mental fitness and best assignment of duties.

Cochrane Collaboration Promotes evidence-based healthcare for the purpose of enabling patients and doctors to make informed decisions about treatment and care. www.cochrane.org National Institute of Clinical Excellence Set up in 1999 in England to standardize services offered within the National Health Service. The are guidelines that take into account both efficacy and effectiveness. www.nice.org.uk

The National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of mental health and substance abuse interventions that have been reviewed and rated by independent reviewers. https://www.samhsa.gov/ebp-resource-center The Substance Abuse and Mental Health Services Administration (SAMHSA) created this registry to improve access to information on tested interventions and to reduce the lag time between the creation of scientific knowledge and its practical application in the field

World War 2 for psychology

The VA's demand for psychologists to meet the needs of returning veterans led to great growth in the field.

Level 3 on Empathy Scale

The counselor accurately reflects the feelings of the client. What he or she says is essentially interchangeable with the feelings and the meaning of the client's message.

Level 2 on Empathy Scale

The counselor responds to the feelings of the client, but not in a helpful way. The feelings are not accurately responded to and meaning may be distorted.

Cultural Competence?

The literature is converging on four main multicultural practice competencies: ◦Cultural Self-Awareness ◦Cultural Knowledge ◦Culture-Specific Expertise ◦Culture-Sensitive Advocacy

Congruence

The therapist is real, genuine, and transparent.

Unconditional Positive Regard

The therapist unwaveringly shows respect for the client as a human being.

What Works for Particular Clients

These are client dimensions that may guide the therapist to make adjustments to fit individual differences: •Reactance •Refers to being easily provoked and responding oppositionally to external demands. •Highly reactant clients do better with low directiveness and more self-control •Low reactant clients do better with high directiveness. •Functional Impairment •Refers to the severity of the client's subjective distress as well as reduced behavioral functioning. •More functionally impaired clients have worse outcomes. •Greater impairment in clients may indicate greater benefit from more intensive therapy and multiple modalities (adding group, medication, increased support) •Stages of Change •Stages: precontemplation, contemplation, preparation, action, maintenance •Therapist's optimal stance depends on stage of change, aligning the relationship to the stage and adjusting tactics as the clients moves through the stages.

90-day rule

This is the amount of time the district has to complete an evaluation once the parent has signed consent.

Visions of Reality

This refers to assumptions about the nature and content of human reality Has been used to illuminate the way in which different kinds of theories highlight different dimensions of human experience. Romantic "Life is an adventure or quest in which each person is a hero who transcends the world of experience, achieves victory over it, and is liberated from it." "The romantic vision idealizes individuality and what is 'natural.' It advocates free, uninhibited, and authentic self-expression." Ironic Antithetical to the romantic view An attitude of detachment, of keeping things in perspective, of recognizing the fundamental ambiguity of every issue that life present to us. Each aspect of behavior may represent something else. Life cannot be fully mastered or understood Tragic "Tragedy, unlike irony, involves commitment." In a tragic drama, the hero has acted with purpose and has committed an act causing shame or guilt. He suffers by virtue of a conflict, e.g., between passion a duty, and after considerable inner struggle, arrives at a state of greater self-knowledge. Limitations of life are accepted - not all is possible, not all is redeemable. Comic "In comedy the direction of events is from bad to better, or even best. Although there are obstacles and struggles in a comedy, these ultimately are overcome and there is a reconciliation between hero and antagonist, between the person and his or her social world. Harmony and unity, progress and happiness prevail."

Dissemination of Psychological Research

This refers to the critical issue of how the information from research studies reach the practitioners in the field who actually apply the concepts to the people they see in treatment. The databases we have been discussing are one part of this effort, though one which is still underutilized.

Basic Model of CBT

Thought, behavior, emotion

Polyvagal Theory -- Stephen Porges

Three Neural Circuits that regulate our relationship with the world - deciding whether the environment is safe or dangerous, whether other humans are safe or dangerous. 1. Immobilization •Feigning death, shutdown. Imagine the limp mouse in the mouth of the cat. •Most primitive component •Dependent on the oldest branch of the vagus nerve -- the unmyelinated dorsal vagal 2. Mobilization •Fight or Flight behaviors •Dependent on the sympathetic nervous system 3. Social Engagement System: •Facial expression, vocalization, listening •Dependent on the myelinated vagus. It fosters calm behavioral states by inhibiting the influence of the sympathetic nervous system on the heart. •We can only access this system when we are not in disturbed states of hyper or hypoarousal.

Honesty and Integrity in Professional Relationships

To foster and maintain trust, school psychologists must be faithful to the truth and adhere to their professional promises. They are forthright about their qualifications, competencies, and roles; work in full cooperation with other professional disciplines to meet the needs of students and families; and avoid multiple relationships that diminish their professional effectiveness. ▹Multiple Relationships and Conflicts of Interest ▸School psychologists avoid multiple relationships and conflicts of interest that diminish their professional effectiveness

Goal of Psychodynamic Psychotherapy:

To loosen the bonds of past experience to create new life possibilities. -Shedler

Professional Practices

To what degree do you engage in the following practices

Professional Practices (pt 2)

To what degree do you engage in the following practices

Scientist Practitioner

Traditional Ph.D. model established in 1949 at Boulder Conference

Empathy Scale

Truax, and later refined by Carkhuff, created an empathy scale to operationalize Roger's concept and to use it in research. To be effective, a therapist needs to be able most of the time to have interventions at a Level 3, as a baseline of effective functioning. Levels 4 and 5 may come more rarely, and usually after we have a really good sense of the client and their struggles, but the client can feel heard if you consistently, accurately reflect at a Level 3.

Survival responses are bottom-up responses

Under threat, the thalamus receives the sensory input, relays threat information to the amygdala (the smoke alarm of the brain) that initiates sympathetic nervous system responses. The frontal lobes shut down to ensure instinctive responding.

School Connectedness: How Do We Improve It?

Universal Programs and/or Targeted Programs and Approaches School policies that reflect the value of school connectedness +Examine guidelines for report cards, assessment tools, and parent conferences to ensure they allow for reflection of students' strengths Provide education and opportunities to enable families to be actively involved in their children's academic and school life. +Provide before- and after-school and weekend activities, and family centered activities at the school site. +Ask families to volunteer to plan and coordinate activities that are meaningful to their communities. ●Provide students with the academic, emotional, and social skills necessary to be actively engaged in school. ●Provide professional development and support for teachers and other school staff ●Make learning opportunities engaging & meaningful ●Ensure that every student has an advisor. ●Involve students in setting behavioral and academic standards. Provide opportunities for students to in engage in project-based learning around their own interests and ideas.

Parental Rights In Special Education

What happens if I disagree with the school district over the identification, evaluation, classification, educational placement or the provision of a free, appropriate public education? There may be a time when you and the school district disagree. Many disagreements can be resolved by communication with your child's teacher, case manager, the school principal, or other school district personnel. There are also procedures established under state and federal law to address your concerns, such as complaint resolution, mediation or a due process hearing.

Section 504: Impairment

What is a physical or mental impairment that substantially limits a major life activity? Any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular; reproductive; digestive; genito-urinary; hemic and lymphatic; skin; and endocrine; or any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.

Colleague Misconduct

When a school psychologist suspects that another school psychologist or another professional has engaged in unethical practices, he or she attempts to resolve the suspected problem through a collegial problem-solving process, if feasible. ▹Approach colleagues with the goal of helping them improve their professional performance ▹Avoid a judgmental tone and making colleagues feel defensive ▹Express concerns about specific actions; avoid generalizations ▹Convey the seriousness of the situation and need for action ▹It may be necessary to consult a trusted colleague about the manner in which the situation should be addressed ▹Document attempts to address the matter with the colleague

Carl Rogers

client-centered therapy, active listening, unconditional positive regard Carl Rogers has had a huge impact on how we do therapy. Many of the notions we take for granted in how clients and therapists interact are taken from Roger's approach.

William James

founder of functionalism; studied how humans use perception to function in our environment •Taught first psychology class at an American University •Also considered a philosopher, developer of major concepts in both field that are still respected today. Founder of APA

Wilhelm Wundt

german physiologist who founded psychology as a formal science father of psychology Studied mind in more structured way, seperating psychology from philosophy established the first psychology laboratory at the University of Leipzig, Germany

The Ph.D. degree

is aimed at producing the clinical scientist, for those who want to do empirical research and add to the knowledge base. The products are scientific research and knowledge.

The Psy.D. degree

is for those who want to practice psychology. In professional school training, students begin applied practical training early on. The emphasis is on being informed consumers of research rather than producers of research.

Prolonged Exposure Therapy: imaginal exposure to traumatic memory with emphasis on "hot spots", in vivo exposure to avoided situations, some cognitive restructuring, breathing retraining, psychoeducation, 10-12 sessions (cBt) (2) Cognitive Processing Therapy: written exposure to traumatic memory, cognitive restructuring with emphasis on "stuck points", Psychoeducation, 10-12 sessions (Cbt) Dropout rates with PE/CPT can be high: 25% (Hembree et al., 2003) (3) Written Exposure Therapy: repetitive written exposure to traumatic memory, psychoeducation, 5 sessions; designed to be easily disseminated and well-tolerated, promising early results

¡Medications for PTSD: SSRI's most frequently prescribed. May help with some symptoms, but less helpful for resolution. ¡Experimental and Under Study: §MDMA (Ecstasy) §LSD (and other Hallucinogens) ¡Drugs that affect memory

EMDR therapy is an eight-phase treatment. Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, the client is asked to hold different aspects of that event or thought in mind and to use his eyes to track the therapist's hand as it moves back and forth across the client's field of vision. The eyes are moving in the way they do in (REM) sleep. Internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, "I survived it and I am strong." Unlike talk therapy, the insights clients gain in EMDR result not so much from clinician interpretation, but from the client's own accelerated intellectual and emotional processes.

¡Sensorimotor Psychotherapy (Pat Ogden) and Somatic Experiencing (Peter Levine - Body focused approaches ¡Accelerated Experiential Dynamic Psychotherapy (Diana Fosha) - Emotion and Relationship focused approaches

Mental Health/Academic: Tier 2

×Check ins with at risk students ×New students ×Lunch social groups ×Targeted academic groups ×Instructional Support ×Basic Skills

Mental Health: Tier 3

×Individual counseling ×Individualized academic interventions ×Wraparound services ×Specialized programs ×OOD schools

Tiered MOdel: Common Mistakes

×Jump to Tier 3 ×Inconsistent interventions across Tiers ×Lacking sufficient supports across all Tiers

Social-Emotional Learning (SEL)

×Social-emotional learning (SEL) Programs ×Aim to reduce a wide array of risk factors, while fostering many protective and resilience factors. Research suggests SEL programs are effective at all grade levels and in all community settings. Self-Awareness Self-Management Responsible Decision-Making Social Awareness Relationship Skills

Tier Model

×Tier 1: Primary - Supports all students in a school. ×Try to prevent issues from developing through whole-group interventions ×Tier 2: Secondary - Provides additional support for smaller groups of students. ×Try to prevent even further development of issues and provide more targeted help through interventions ×Tier 3: Tertiary - Provides intensive interventions and support for individual students not successful with Tier 1 and Tier 2 interventions. Success rate: 1-5% tier intensive specialized interventions3, 5-10% tier 2 targeted interventions, 80-90% tier 3 schoolwide interventions through best practices in classrooms

Mental Health: Tier 1

×Universal screenings ×Data collection ×Flag problems early ×Universal screening ×Depression screening for freshmen in health ×Sociogram ×Universal Interventions for climate of school ×School/classroom wide behavior plans ×Recess/physical engagement •Mindfulness ×School connectedness strategies ×Greeting kids by name ×Restorative practices ×https://www.edutopia.org/video/justice-committee-using-restorative-practices-resolve-conflicts

Thinking traps

ØCatastrophizing - Overestimating the negative consequences of an event (e.g. if I get contaminated, I will get sick and die) ØOvergeneralization - Drawing conclusions on a single incident (e.g. I got sick that one time I ate that food, so all foods like it must be toxic) Arbitrary Inference: Drawing a conclusion that is not supported by evidence. ØDichotomous Thinking: All or Nothing; "If I'm not a total success, I'm a failure" ØDisqualifying: Disregard positive experiences or qualities as without value ("I got lucky.") ØMind Reading: Belief that you know what others are thinking to the exclusion of other likely possibilities

What does the multicultural wave in therapy add?

•Attention to culture •Attention to power and privilege •Attention to systems •Attention to who is telling the story

What Does Not Work

•Confrontations •Negative Processes •Assumptions •Therapist Centricity •Rigidity •Ostrich Behavior •Procrustean Bed

What Works in General

•Empathy •Alliance (measured as agreement on therapeutic goals, consensus on treatment tasks, and a relationship bond - relationship is broader than this alone) •Cohesion (groups) •Goal Consensus and Collaboration •Positive Regard •Congruence/Genuineness •Feedback •Repair of Alliance Ruptures •Self-Disclosure - Research suggests that therapists should disclose infrequently, to validate reality, normalize experiences, strengthen the alliance or offer alternative ways to think or act. Therapists should avoid self-disclosures for their own needs or that move focus from client. •Management of our own feelings towards clients - not acting it out •Quality of Relational Interpretations

A Good Theory Should

•Explain the phenomenon you are looking at •Predict what might happen next or what the intervention outcome might be •Guide your case conceptualization, techniques and procedures.

A brief history of CBT

•First wave •(1940/1950's) •Behavior Therapy •Learning principles (operant/classical conditioning) drive all behavior •Second wave (1970's): •Integrated Cognitive-Behavioral Therapy •Addition: unobservable cognitive and emotional processes also affect behavior. •The world is filtered through our interpretation •Third wave (1990's): •Mindfulness and •values-based • • •Still Cognitive-Behavioral Therapy (new names like DBT, ACT) •

A 2014 summary of research found that the variance in outcome could be attributed to

•Goal Consensus 11.5% •Empathy 9% •Therapeutic Alliance 7.5% •Positive Regard 6.3% •Congruence/Genuineness 5.7% •Therapist Factors 5% •Treatment Method 1%

Neuroplasticity

•The concept that the brain can change as a result of experience, that it is "plastic" and changeable. •Replaces the older belief that the brain could not change after crucial developmental periods. •We can use this knowledge to help people change in therapy: "Neurons that fire together, wire together." •Much of this neuroplasticity is experience-dependent. The brain changes with experience and we get better at what we practice. Whatever the brain does most, it devotes more resources to. Examples of the hippocampus of taxi drivers, the amygdala of trauma survivors. •The neural networks we use frequently get stronger, while those we use less frequently get weaker. •One way of assessing the strength of a network is the speed with which it can be accessed. (Experiment)

In the therapy room

•The therapist him or herself is an affect regulator. •The presence of an attuned other can be very regulating. •We accomplish this by many of the basic skills we have discussed already: empathy, the tone of our voice, our posture, the quietness of the space we provide.

WHAT IS CENTRAL TO THIS APPROACH TODAY?(CBT)

•To treat a disorder we must: •Understand learning principles: "All behavior is lawful." •Recognize the role of cognitions in psychopathology

Empathy

•To understand the inner world of the individual, seeing the world through her eyes, knowing what it is like to be her, and •To transmit this understanding to the client.

ROLE OF COGNITIONS

•Types of Cognitions: •Automatic Thoughts - Quick thoughts that often pass through awareness when triggered by situation •"I don't understand this assignment. I suck at math" •Intermediate Beliefs - Attitudes, Rules, Assumptions about the world •"If I don't get it the first time, I never will." •Core Beliefs - Fundamental truths about the self, the world, and the future; lenses through which information is filtered •"I'm a failure"

Assessment of Cognitions/Behaviors

•Understanding behavior IN CONTEXT •Look for: •1) Immediate triggers (stimulus antecedents) •2) Factors that make client more vulnerable to triggers (setting conditions) •3) Short and long term consequences (consequent variables; reinforcement)The target of treatment becomes not what the client "has" but what he/she "does"

Core Concepts: The Mind in Conflict

•We are of two minds about many things. Psychodynamic theory places a great deal of emphasis on ambivalence, that we can have positive and negative feelings, approach and avoidance tendencies, towards the same thing. •The more torn we are in different directions, the more of our energy we have to spend dealing with the conflict. There are different systems in the brain, evolving at different times for different purposes that may find themselves in conflict

Mental Health Needs of Students

›20% of students have emotional symptoms severe enough to impair their daily lives (Merikangas et al., 2010) 70-80% of these students do not receive mental health services (Tharinger & Stafford, 1995

Role of School Psychologist (non-traditional)

›Behavioral consultation ›Behavior plans ›Classroom and school wide intervention ›Crisis intervention ›Crisis/ Suicide/ Homicide screening

Counseling in Schools: Challenges

›Confidentiality ›Teachers, administrators, parents ›Time ›Space ›Resources ›Continuity ›Creating groups ›Does the student really need counseling? ›Educational impact ›Cost of missing class

Counseling in Schools: Advantages

›Greater access to individuals than outpatient setting ›Can receive immediate feedback from teachers ›Can coordinate a variety of services in the school ›Long term follow up is possible ›You are readily accessible in the event of a crisis ›Barriers exist that often prevent people from getting counseling. These barriers don't exist in schools. Examples of barriers include: ›Cost/Lack of insurance ›Transportation

Counseling Models

›Individual Counseling ›Anxiety, depression, tics, emotion regulation, coping strategies ›Group Counseling ›Social skills, topic specific, classroom (program) wide ›Problem solving ›Discipline referrals ›School based programs ›The Haven, The Teen Center, BRIDGE Center ›Life Skills Programs ›Career development program

Consultation

›Process in which consultant works with consultee (parent, teacher, administrator) with the goal of bringing about a positive change in the client (child) ›Indirect service delivery model ›Consultation can be done on every level of the Tier Model

Consultation: Challenges

›Relationships ›Generating buy-in ›Talk the talk when you don't walk the walk ›Delivery of information

Consultation: Topics

›Student Discipline ›Academic Interventions ›Behavioral Issues in Classroom ›Substance Abuse ›High-Stakes Testing ›Professional Development ›Special Education Law ›Mandated Reporting ›Diagnoses/disorders ›Special Education Law ›"His IEP doesn't mention math but he's struggling. Can I add math to his IEP?" ›High-Stakes Testing ›"Teachers' salaries should be based on student performance." ›Mandated Reporting ›"The student told me that the bus driver hit him. What do I do?" ›Diagnoses/disorders ›"He's faking his concussion." "This paper says she has Trichotillomania. What's that?"

Role of School Psychologist

›Traditional vs. Non-traditional roles ›Masters vs. Doctorate ›Counseling as a related service in an IEP ›Individual vs. group vs. consultation ›Counseling services not in IEPs ›504s, crisis, parent consent

Consultation: Benefits

›We can impact many students by consulting with teacher/administrator (greater impact) ›Teach skills to reduce your workload

Marriage and Family Therapist

■Generally a 2-year master's ■Trained in psychotherapy and family systems and treat problems within the context of relationships

Professional Counselor

■Generally a 2-year master's ■Focus on counseling ■Little emphasis on testing or research.

Psychiatry

■Has M.D. degree plus 4-year residency ■Can prescribe medication ■Declining in popularity among medical residents

Other Health Impairment (OHI) (Chronically Ill)

●A disability characterized by having limited strength, vitality or alertness, including a heightened alertness with respect to the educational environment, due to chronic or acute health problems, such as attention deficit disorder or attention deficit hyperactivity disorder, a heart condition, tuberculosis, rheumatic fever, nephritis, asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, diabetes or any other medical condition, such as Tourette Syndrome, that adversely affects a student's educational performance. ●A medical assessment documenting the health problem is required

Specific Learning Disability

●A disorder in one or more of the basic psychological processes involved in understanding or using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. ●Can be determined when a severe discrepancy is found between the student's current achievement and intellectual ability in one or more of the following areas: (1) Basic reading skills; (2) Reading comprehension; (3) Oral expression; (4) Listening comprehension; (5) Mathematical calculation; (6) Mathematical problem solving; (7) Written expression; and (8) Reading fluency. ●A specific learning disability may also be determined by utilizing a response to scientifically based interventions methodology as described in N.J.A.C. 6A:14-3.4(h)6. ●The term severe discrepancy does not apply to students who have learning problems that are primarily the result of visual, hearing, or motor disabilities, general cognitive deficits, emotional disturbance or environmental, cultural or economic disadvantage. ●The district shall, if it utilizes the severe discrepancy methodology, adopt procedures that utilize a statistical formula and criteria for determining severe discrepancy. ●Evaluation shall include assessment of current academic achievement and intellectual ability.

Communication Impairment

●A language disorder in the areas of morphology, syntax, semantics and/or pragmatics/discourse which adversely affects a student's educational performance and is not due primarily to an auditory impairment. ●When the area of suspected disability is language, assessment by a certified speech-language specialist and assessment to establish the educational impact are required. The speech-language specialist shall be considered a child study team member.

Autism

●A pervasive developmental disability which significantly impacts verbal and nonverbal communication and social interaction that adversely affects a student's educational performance. Onset is generally evident before age three. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routine, unusual responses to sensory experiences and lack of responsiveness to others. ●An assessment by a certified speech-language specialist and an assessment by a physician trained in neurodevelopmental assessment are required

1998

●APA grants recognition to school psychology as a specialty area within psychology

1945

●APA has first national organization for school psychologists (Division 16)

Assessment: Objectives

●Academic skills ●Instructional level ●Ability vs. performance ●Social, emotional, adaptive functioning ○Social skills, behavioral concerns

School psychologists work with children, parents, and staff to help determine a child's...

●Academic skills. ●Instructional level. ●Learning aptitudes, strengths, and weaknesses (IQ). ●Personality and emotional development. ●Social skills and behavioral concerns. ●Learning environment. ●School climate. ●Special education eligibility.

Discipline Gap: Perception of Others & Implicit Bias

●African American adolescents have been found to be more commonly perceived as defiant and uncooperative by their teachers, lacking contextual considerations (APA Task Force, 2008; Gregory & Weinstein, 2008) ●White children are often disciplined for objective offenses (e.g. vandalism), and Black children are often disciplined for subjective offenses (e.g.disrespect) (Okonofua, Walton & Eberhardt, 2016) ●The discipline gap between Black and White students starts in pre-kindergarten & gets larger throughout the school years (Gopalan & Nelson, 2019)

Inequality

●African American and Latino students are more likely to attend high-poverty schools than Asian American & Caucasian students (National Center for Education Statistics, 2007). ●High-achieving African American and Latino students may be exposed to less rigorous curriculums, attend schools with fewer resources, & have teachers who expect less of them academically than they expect of similarly situated Caucasian students (Azzam, 2008)

Traumatic Brain Injury (Neurologically Impaired)

●An acquired injury to the brain caused by an external physical force or insult to the brain, resulting in total or partial functional disability or psychosocial impairment, or both. ●The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual and motor abilities; psychosocial behavior; physical functions; information processing; and speech.

Visual Impairment (V. Handicapped)

●An impairment in vision that, even with correction, adversely affects a student's educational performance. ●The term includes both partial sight and blindness. ●An assessment by a specialist qualified to determine visual disability is required. ●Students with visual impairments shall be reported to the Commission for the Blind and Visually Impaired.

APA: Clinical vs. Counseling vs. School

●Areas officially recognized by APA ●Eligible to become a Licensed Psychologist ○Same license for all three specialty areas ●Training/areas of focus differ ●Career fields can overlap but is based on the training received by the individual ○Specialization is key

SP Direct Services

●Assessment, testing, counseling, crisis intervention

Macrosystem

●Attitudes and Ideologies of the culture ○Laws ○History ○SES ○Ethnicity ○Geographic location

Modern Intelligence Tests: Scoring

●Standardized, normed, based on age ●Average: 90-110 ●Mean: 100, SD: 15 ●Scored in ranges ●Sample Report (Start pg. 36)

Emotion Regulation Impairment

●Formerly "Emotional Disturbance" ●Condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a student's educational performance due to: ○i. An inability to learn that cannot be explained by intellectual, sensory or health factors; ○ii. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; ○iii. Inappropriate types of behaviors or feelings under normal circumstances; ○iv. A general pervasive mood of unhappiness or depression; or ○v. A tendency to develop physical symptoms or fears associated with personal or school problems

Factors that Influence Intelligence

●Genetic Influences ○Polygenic model: Intelligence is a result of the combined action and influence of many genes, rather than a single gene ○The more similar people are genetically, the more similar their IQs are ●Environmental Influences ○Perinatal and early developmental influences ○Nutrition ○Family background and home environment ○Poverty ○Quality of Schooling (Sherbow, 2015)

1997

●IDEA reauthorization serves children ages 0-21

Suicide Assessment

●Ideation/desire ●Intent ●Plan ●Means ●Access ●Rehearsal ●Substance use, risky behaviors ●Reasons for living, reasons for dying ●Level of impulsivity ●Risk factors (burdensomeness, prior attempts, family history of suicide, access to firearms), protective factors (family/community support, adaptive coping skills, religious/cultural beliefs discourage suicide)

Assessment

●Identify students with disabilities that need support ●Federal/state law requires assessment before formalized support is provided NJ 6A:14-3.1(d)Child study team members and, to the extent appropriate, specialists in the area of disability: Shall participate in the evaluation of students who may need special education programs and services according to N.J.A.C. 6A:14-3.3 and 3.4

Individualized Education Plan (IEP)

●If a student qualifies for special education, they will have an (IEP) ●Legal document ●Parts ○Present Levels of Academic Achievement and Functional Performance (PLAAFP) ○Measurable annual goals and short-term objectives ○Progress reporting ○List of accommodations/modifications ○Supplementary aids and services ○Consent Many people contribute to this document but ultimately it is the case manager's responsibility to ensure that the document is complete and correct.

Roles: Prevention

●Implement programs to build positive connections between students and adults. ●Support early identification of potential academic skill deficits and/or learning difficulties. ●Design and implement programs for children deemed "at-risk" ●Create safe, supportive learning environments. ●Promote wellness and resilience by reinforcing communication and social skills, problem solving, anger management, self-regulation, self-determination, and optimism ●Enhance understanding and acceptance of diverse cultures and backgrounds. Foster tolerance and appreciation of diversity.

Prevention

●Improve early healthcare and exposure to educational material ○Sesame Street ○Prenatal care and parenting support ○Head Start programs—improve literacy ●Increase exposure to educational materials ○Studies have found that children in poverty whose parents provide engaging learning environments at home do not start school with the same academic readiness gaps seen among poor children (U.S. Department of Education, 2000; Viadero, 2000, Sparks, 2011). ●Universal preschool programs becoming more common

Diversity statistics

●Increasing diversity in US schools ●Ethnically and racially diverse students comprise 49% of US student population ●21% of the U.S. population (five years old and older) speaks a language other than English at home ●Approximately 9% of children are identified as English Language Learners (77% speak Spanish)

2004

●Individuals with Disabilities Education Improvement Act (IDEIA) authorized ○Changed criteria for classifying learning disability ○Introduced concept of Response to Intervention

School Funding

●Inequality in how schools are funded: ○Schools are primarily funded at the LOCAL level ○This leads to different areas having vastly different funds available, and hence vastly different resources and educational opportunities for students ○Many schools with fewer funds have eliminated arts programs and decimated athletic opportunities ●Some people have argued for schools be primarily funded at the state level ○This would allow funds to be distributed equally among schools

Measuring Intelligence: Format

●Intelligence is measured through responses to questions and tasks ●We measure intelligence using items on subtests ○Subtests are comprised of individual test items/questions ○Each subtest consists of a number of items that are similar, but get increasingly difficult from beginning to end ●Subtests vary based on domain

Child Interview: Language

●Interview must be adapted based on child's reaction ●Language is a key developmental issue - Child's verbal expression and understanding increase with age. ○Below 8 years old, child attends more to context cues than words, especially if they differ. Can use play materials and pictures to enhance understanding (e.g., anger "thermometer")

Discipline Gap: Factors

●Is this a "good kid" or a "bad kid?" ●Is (s)he from a good family? ●Is this student dangerous or potentially dangerous? ●Was this a misguided moment or evidence of a pattern? ●Is (s)he a threat to me or to the school? ●Is (s)he being intentionally defiant or insubordinate? ●Is (s)he challenging my authority in front of others; do I need to set an example? ●Is (s)he showing proper respect or defying me?

Attachment

●John Bowlby ●Attachment ○Special enduring "emotional" relationship/affectional bond with a specific person (i.e. primary caregiver) ○Bond between child and primary caregiver ○Biologically based, interactive, and reciprocal process

When should kids see a School Psychologist?

●Learning difficulties. ●Behavioral concerns. ●Attention problems. ●Problems at home or with peers. ●Advocacy of their learning and mental health needs. ●Fears about war, violence, and terrorism. ●Depression and other mental health issues. ●Coping with crisis and trauma. ●Poverty, violence, or life changing events.

1896

●Lightner Witmer establishes first psychological/child guidance clinic at the University of Pennsylvania ○Invented the term "clinical psychology" ○Used the idea of teaching to weaknesses (LD, spelling)

Eligibility Determination

●NJ6A:14 3.5(c) A student shall be determined eligible and classified "eligible for special education and related services" under this chapter when it is determined that the (1) student has one or more of the disabilities defined in (c)1 through 14 below; the (2) disability adversely affects the student's educational performance and the (3) student is in need of special education and related services. Classification shall be based on all assessments conducted including assessment by child study team members and assessment by other specialists as specified below.

Child Study Team (CST)

●New Jersey specific ●Multi-disciplinary team mandated in every public school ●Members ○School Psychologist ○Social Worker ○Learning Disabilities Teacher Consultant (LDTC) ●Primarily responsible for Special Education eligibility determination and case management

Assessment: Tools

●Observations (where, when?) ●Interviews (who?) ●IQ Tests ●Achievement tests (not usually done by SP in NJ) ●Rating scales/Checklists ●Record reviews

Microsystem

●People that child has direct contact with ○Family ○Friends ○Classmates ○Teachers ○Neighbors ○Others?

Important

●Person-first language ●Someone with a disability. NOT a disabled person. ●BIG difference!

1971

●PhD at University of Texas: 1st APA accredited doctoral program in school psychology

Play Therapy: Technique

●Play, not language, is the child's mode of communication ●Play may be the way the child works out conflicts ●Play materials are good adjuncts to interviewing - child may more readily show emotions through play ●Select developmentally appropriate play/game materials ●Have a selection of multicultural dolls, figures, books, etc. to build rapport ●Use play materials to build rapport and for interviewing

Roles: Assessment

●Primary role of school psychologist ●Federal & state laws require assessments before students are placed in special education ●Assessing barriers to learning and determining the best instructional strategies to improve learning can increase achievement ●Studies show school psychologists spend 46% of their time spent on assessment (Bramlett, 2002) ●Very systematic ●An ongoing process of data collection according to a problem-solving model ●Broader than just psychological testing ●"Problem Identification" occurs first ●Multi-method, multi-informant, multi-source ●Ongoing process ●Guided by theory

Roles: System-Level Change

●Promote change at different levels in a system ●Focus on more than one area of an individual's life ●Constantly look to improve the environments where they work and their clients operate

1975

●Public Law 94-142, Education of All Handicapped Children Act enacted by Congress (takes effect in 1977) ○Guarantees Free and Appropriate Public Education (FAPE) in Least Restrictive Environment (LRE) ○Law mandates the role of school psychologist

Suspension

●Punitive discipline can have negative consequences ●After accounting for demographics, attendance, and course performance, each additional suspension further decreases a student's odds of graduating high school by 20% (Balfanz, Byrnes, and Fox, 2013) Segregation of students who break rules with students who also break rules can increase negative behavior

1918: Large-Scale Assessment & Army Mental Tests

●R.M. Yerkes persuaded US army to test 1.75 million men during WWI ●1918: 1,726,966 men enlisted in the Army were tested in groups ●More than 83,500 enlisted men were given individualized tests ●Differences in performance between black and white males were attributed to genetics, not environment

Roles: Research & Development

●Recommend and implement evidence-based programs and strategies. ●Conduct school-based research to inform practice. ●Evaluate effectiveness of programs and interventions independently and as part of a school-based evaluation team. ●Contribute to school-wide reform and restructuring.

Mesosystem

●Relationships, interconnections, interactions between microsystems

School Connectedness/ Belongingness

●Research has found that a student's sense of belonging to their school community decreases as they progress through primary and secondary education (Niehaus, Rudasill & Rakes, 2012; Marks, 2000; Ryan & Patrick, 2001). ●The issue of school disengagement has actually become a chronic issue, especially by the time many students enter high school. ●Research has found that students' school connectedness declines over the middle school years, and is associated with increased externalizing problems (Loukas, Cance & Batanova, 2016).

Achievement Tests

●Same standardization, scoring model, subtest concept as IQ ●Measures areas of academics ○Reading ○Writing ○Math ○Spelling ○Listening ○Fluency

Where do School Psychologists work?

●Schools (private, public, preschool-12th) ●School district administration offices ●Universities ●School-based mental health centers ●Community-based day treatment or residential clinics and hospitals ●Juvenile justice programs ●Independent private practice Primary setting results 86% Public schools 10% University 8% Private schools 7% Independent practice 6.7% Faith-based schools 1.5% Hospital/Medical 1.6% State Department

Review Data/ Write Report

●Score assessments (paper vs. online) ●Compile information ●Write report (psychological vs. psychoeducational) ○Provided 10 days prior to eligibility determination meeting ○Charts/graphs

Full Scale IQ

●Scores on subtests are taken together and represented as one score - the Full Scale IQ ●A combination of all of the indices and the best estimate of overall cognitive functioning ●Individual's scores are compared to individuals' of the same age (normed)

Intellectual Disability

●Significantly below average general cognitive functioning existing concurrently with deficits in adaptive behavior; manifested during the developmental period that adversely affects a student's educational performance ●Mild, moderate, severe

Craniology/phrenology

●Size/shape of brain related to intelligence ●Very localized/ specific parts

Attachment: SchoolImpact

●The student will play out style of IWM's and may have unconscious goals of interactions ○Unconscious attempts to reenact past relationships ○To increase interactions with school staff ○To keep others at a distance ○To "prove" their cognitions, including anticipated rejection, are true ○Survival strategies designed to protect themselves ●Research supports strong association between early attachment experiences and subsequent behavioral, social, and academic outcomes (Kennedy & Kennedy, 2004) ●Relationships with Teachers: ○Both teachers and children bring attachment history to school ○Interaction between teacher's and child's style ○Disorganized style: kids are often perceived as/behave as more aggressive, reactive, unpredictable and elicit more punitive responses (Kennedy & Kenney, 2004)

Ecological Systems Model

●This model provides an organizing framework from which to view individuals ●Allows us to consider variables inside and outside of the individual ○Can help prevent the fundamental attribution error and self serving bias ●Provides ideas for multiple layers of intervention ●Encourages comprehensive assessment Uri Bronfenbrenner ●Microsystem ●Mesosystem ●Exosystem ●Macrosystem ●Chronosystem

Chronosystem

●Time Dimension ○Major life transitions or events in a child's life ○Historical events ●Examples: parent divorce, relocation, natural disasters

Child Interview: Disadvantages

●Time consuming ●Lack of standardization lowers reliability ●Bias can enter (and subjectivity) ●Different levels of information from different children

What is a School Psychologist

●Type of psychologist ●Have graduate training ○Coursework and practical experiences relevant to both psychology and education. ○Specialist-level degree program (3 yrs, at least 60 graduate semester hours) or a doctoral degree (4-6 yrs) ●Hold a certificate to practice School Psychology ○Must be credentialed in state in which work ○Can also be nationally certified ●Psychologist vs. School Psychologist ○SP's don't have to work in a school but to work in a school, MUST have certificate "School psychologists are uniquely qualified members of school teams that support students' ability to learn and teachers' ability to teach. They apply expertise in mental health, learning, and behavior, to help children and youth succeed academically, socially, behaviorally, and emotionally. School psychologists partner with families, teachers, school administrators, and other professionals to create safe, healthy, and supportive learning environments that strengthen connections between home, school, and the community." (NASP, 2016)

Child Interview: Advantages

●Understand how the child views their world ●Observe child's behavior ○Both verbal content & non-verbal behaviors are data ○Interaction between child & parent including separation from parent ○Child's response to the structure of interview ●May give us information we can't obtain any other way (i.e., feelings & cognitions can't be observed) ●Adults are less accurate in reporting a child's subjective and internal feelings

Child Interview: SP's Language

●Use the child's words ●Match complexity of your language ●Frequently check for child's understanding ●Close-ended questions can help get specific responses

How does disproportionality happen

●Vague and inconsistent state criteria for classification ●High degree of subjective professional judgment due to vague disability definitions ●Bias in referral, assessment, and placement ●Interpersonal bias and lower expectations ●Failure to effectively create pre-referral interventions

Achievement vs. IQ

●We use test results to inform presence of a Specific Learning Disability ●Discrepancy Model ○How does a child's IQ score compare to their educational achievement scores? ○Do score comparisons in each area of academics listed in code?

Hold Meeting/ Share Results

●Who goes first? ●Do I just read my report out loud? ●Visual aides ●How to deliver difficult information ●Be clear/ don't use jargon

Roles: Intervention

●Work directly with children, teachers, administrators, and families. ●Develop individualized, classroom, and school-wide interventions for learning and adjustment. ●Design and implement crisis response plans. ●Provide counseling, social skills training, and academic and behavioral interventions. ●Develop strategies for modifying instruction to optimize student progress

Pamela Hays' "ADDRESSING" Model

◦Age ◦Developmental Disabilities ◦Disabilities (Acquired) ◦Religion ◦Ethnicity ◦Socioeconomic Status ◦Sexual Orientation ◦Indigenous Heritage ◦National origin ◦Gender

◦Culture

◦Beliefs and values that influence norms, customs, practices, social institutions, psychological processes and organizations ◦Embodied worldview, including religion and spirituality

The Necessity for Cultural Competency

◦Changing Demographics ◦39% of U.S. residents non-white minority status1 ◦Persons of color majority by 20452 This includes African-Americans, Latinos, Asian-Americans, Arab-Americans, Southeast Asian-Americans, and immigrants from various countries in the developing world. ◦Ethics and Treatment Effectiveness ◦Disparities in mental health care for minorities3 ◦Cultural Competence essential to treatment process & outcome4 ◦Culturally insensitive therapy is barrier to treatment and damaging ◦Because of these predictions, culturally competent practice, guidelines, and research, though historically slow to develop, are more and more recognized as vital to our field. APA requires that programs not only offer courses in working with diverse populations, but that this be infused across the curriculum ◦ ◦Our psychological theories have historically overlooked culture and have been formulated on white, Western, affluent client and majority cultures.

Ethnicity

◦Common ancestry and history with a group of people ◦Evolves over centuries from shared values and customs ◦Retained through race, religion and cultural history ◦Leads to acceptance of group mores, such as common values, views and styles of interacting with others ◦Often includes a sense of belonging

How Problems Can Occur Related to Culture, Race, and Ethnicity

◦Ethnicity and culture determines what is acceptable and the meaning given to deviant behavior ◦ ◦Each culture socializes its children towards the particular competencies needed for functioning in their particular environment, and not others ◦ ◦Because of this, it is problematic when both dominant (universal) and specific norms are not used, such as both the DSM, and specifics re: ◦Ethnic/racial/cultural factors ◦Historical and other contextual factors ◦ ◦Organizational and individual biases and power are not addressed (e.g. dominant vs. non-dominant paradigms) ◦ ◦Strengths are not identified and used

Underlying Goals in Addressing Diversity

◦Humanize and destigmatize others - similarities ◦Other groups are normal ◦Other groups have strengths ◦Legitimize differences ◦Other ways of being (worldviews, experiences and contexts, power, felt distance) are real and legitimate ◦They are not inferior (culture of poverty) ◦Integrate and include other groups in your thinking ◦Acknowledge and understand structural oppression ◦Widespread policies and practices that disadvantage minority groups ◦These include negative portrayals that lead to widespread and systematic interpersonal discrimination

◦Race

◦Social construct, assigned on basis of physical characteristics, such as skin color, facial features and hair texture

What is Normal/Universal vs. Abnormal(DSM'S View)

◦The DSM-5 addresses culture in these ways: ◦ ◦Culture-related diagnostic issues ◦Given for each disorder ◦Example: somatic symptoms may predominate for GAD in some cultures ◦Cultural concepts replace culture-bound syndromes ◦Refers to ways that groups experience, understand, and communicate suffering and problems (has glossary) ◦Cultural syndromes - Refers to locally recognized patterns of experience ◦Cultural idioms of distress - Refers to shared ways of expressing ◦Cultural explanations - perceived causes, labels features ◦Cultural formulations

Constructing Personal Guidelines

◦The final way to consider health and pathology across culture is to think of your own personal guidelines that you have used in making this determination, and revisit them periodically ◦What is pathology/problematic behavior? ◦What are universal aspects of healthy children/families? ◦How and why did you develop these guidelines? ◦How do you now think of them in light of the lecture?

Cultural Competence vs. Multicultural Humility

◦The latter is becoming a preferred term. "Competence" may imply there is an endpoint we can arrive at ◦Interpersonal dimensions of multicultural humility: ◦Other vs. Self Orientation ◦Respect for other and their values and ways of being ◦Attitude that includes a lack of superiority

Culturally-Sensitive Advocacy

◦The process through which clinicians become aware of social or cultural barriers that clients face and work with clients to constructively address these barriers ◦Discrimination is disempowering. At a minimum, therapists need to display empathy and not attribute experiences to individual dynamics when it is more likely systemic. ◦This may be macro abuses like racial profiling or more subtle ones like microaggression. ◦Therapists need to NOT be neutral in the face of these injuries.

Culture-Specific Expertise

◦This may involve educating oneself about the specific cultures of the clients with whom one works ◦It may also involve understanding the stressors of the environment on them The therapist's ability to intervene in a manner that is culturally sensitive and relevant

Cultural Awareness and Beliefs

◦What are the lenses through which I see the world? ◦Provider's sensitivity to her or his personal values and biases and how these may influence perceptions of the client, client's problem, and the therapeutic relationship ◦This includes an awareness of the various kinds of privilege that we may have and the ways in which that may distort our lenses.

Cultural Knowledge

◦What are the lenses through which my client sees the world? What is their experience? What are they going through? ◦The therapist's knowledge of the client's culture, worldview, and expectations for the therapeutic relationship.

DSM Cultural Formulation Interview

◦semi-structured interview that elicits info from the client and an informant within client's social network ◦Supplementary modules online at www.psychiatry.org/dsm5 ◦Left column - instructions/goals ◦Right column - how to explore the domains ◦Four domains of assessment, 16 questions: ◦Cultural definition of the problem (q1-3) ◦Cultural perceptions of cause, context and support (q4-10) ◦Cultural factors affecting self coping and help seeking (q11-13) ◦Cultural factors affecting current help seeking (q14-16) ◦Can use part or all, especially with dx difficulty, uncertainty about cultural fit, illness severity/impair, disagreement about the course of care, and limited engagement in tx