The phrase evidence-based practice is now common parlance in mental health care. The call for using evidence-based practice can be heard across psychology, social work, psychiatry, occupational health, and a range of other professions.
Nevertheless, many decisions in mental health care, whilst being informed by such an evidence base, rely heavily on clinical judgement. As noted in Daniel Kahneman’s seminal Thinking, Fast and Slow, clinical judgement is often not as reliable as it seems, especially for longer term outcomes.
Then, there is also a need for practice-based evidence or the collection of evidence during on-the-ground work to measure outcomes for the individual client.
Unfortunately, the simple removal of psychiatric diagnosis (e.g. “You are no longer depressed”) cannot be considered an accurate measure of change for an person. For decades the unreliability of psychiatric diagnosis has been flagged as an issue and unfortunately not much has changed. Indeed, such diagnostic categories are not even considered scientifically valid.
However, range of scales and measures are available to monitor change for various problems. One example might be the Internal States Scale for someone having problems with fluctuating mood, the Hospital Anxiety and Depression Scale for someone who is feeling low, the Self-Compassion Scale for someone who is trying to develop compassion, or power mapping to measure someone’s level of personal control within their lives. Positive aspects of a person’s life can also be measured, such as user-defined recovery, quality of life, empowerment, and subjective wellbeing to name but a few.
Outcome measures can also be more tailored to the individual. Subjective units of distress, personal goals (with a clear 1-5 scale of how close one is to achieving the goals), subjective blob trees, and six part stories are other ways to measure the impact of interventions. In fact, such personalised measures may be more meaningful than a set of standardised questionnaires, which can often lack context.
Measures can be helpful to see whether an intervention is staying on track, and may give permission to discuss topics that are difficult to bring up (such as sex drive or self-harm). It may be that the professional has missed something in their questioning, which is revealed through outcome measures to be important to the client.
Clients may also value being able to review their progress, and there are some indications that the use of outcome measures can improve therapeutic outcomes. Outcome measures may additionally support the clinician to reflect upon their work, and ensure that the clinician’s views on progress match the client’s reality.
There are, however, some concerns about using outcome measures in clinical practice. This might include burden, time and paperwork for both client and professional, concerns about relevance and helpfulness of scales, and also concerns that any outcome scores may be misused by others. An over-reliance on scales to measure outcome may not be helpful or meaningful. Additionally, scales can only see a change in the concept that they are measuring – for example, a mood scale may miss out key components in somebody’s social life.
As such, like any clinical tool, outcome measures should be used in a person-centred fashion. Good clinical practice involves firstly using an outcome measure that is relevant to the individual. If a person who feels tired and low wants to get out more and make new friends, it may be helpful to set goals related to increased activity (rather than, say, simply using a scale of how low the person feels).
Secondly, an outcome measure should be feasible for the person. For some people, an hourly record of their day might be too much to ask, whereas for someone else it may be helpful and motivating. This can be subject to some experimentation and playfulness – the measure does not have to be “right” the first time but can be considered a work-in-progress.
Thirdly, an outcome measure should gather enough information to be useful, and no more. After all, measures take time and effort to fill in, and it is not ethical to ask someone to collect information that will not be used.
Finally, the progress of outcome measures should be shared and discussed with the client. They should not be collected simply for the sake of the professional, or the service, but should be a meaningful addition to any therapeutic intervention.
Therefore, whilst the concept of evidence-based practice is well known in mental health care, there is an important role for collecting outcome measures as part of everyday practice (practice-based-evidence). As long as such measures are focussed on outcomes which are meaningful to the client, and are used in an ethical and person-centred fashion, they can prove a valuable – if not integral – part of clinical work.
Family Team Time
It will come as no shock to most parents that a significant amount of time per week is spent running children from point A to point B and back again. What may be shocking, however, are the actual statistics surrounding the average family’s carpooling and chauffeuring routine. Research shows that, by the time children reach adulthood, parents will have spent almost 200 days behind the wheel running their kids from place to place.
Now, as much as educators, parents, and students embrace the notion of extracurricular activities, there are alternative ways to shape interests, take part in cooperative learning, build relationships, and experience new things. Perhaps it is time to consider putting a halt to the daily grind — with family team time.
What is Family Team Time?
Not to spoil the concept of extracurricular activities — as a teacher, I know that extracurriculars can truly change students’ lives — but there are also some factors to consider when it comes to the many activities children participate in. Clubs, sports, camps, classes — all these activities add up, both monetarily and in terms of time commitments. For families with multiple children, the desire to keep kids consistently “doing” can prove to be a costly, time-consuming, and even stressful undertaking. Family team time, substituting extracurriculars with engaging family activities could be a great alternative to try this winter. Simply put, family team time is anything the family does together for enjoyment. Below are options to try in place of signing up for another round of extracurricular activities this winter
Museums & More
Considering our proximity to D.C.’s many museums, theaters, and other cultural hubs, there are countless engaging options for your family to experience together this winter. Especially as the holidays approach, options will be plentiful: festivals, concerts, plays, ballets, and other performances. Consider taking in a show, visiting a museum, or simply touring the neighborhood’s Christmas lights. Plan ahead by checking Groupon and other sites for deals on attractions, discounted events and performances, and student rates. Museum visits are a great free option to explore art and history with the whole gang — not to mention, they are a great place to escape from the bitter winter weather while still stretching your legs.
Afternoon matinees can prove to be a wonderfully inexpensive way to get the family together for a few hours of entertainment. Another option is to have a weekly family book club, in which every member of the family reads the same book. Once a week, make some popcorn, get comfy in the living room, and discuss the recently read chapters. Once everyone has finished the book, consider renting the movie version, as many young adult and family novels have been adapted to film. After the movie, encourage a mock-film study, in which you talk about how the movie and the book are similar or different, and which one each person preferred. Then, allow someone else to choose the next novel/movie combination. Keep the weekly book talks going until everyone has had the chance to select a novel for the family. To save money, consider checking books out at the local library or purchase used books online. For struggling readers, consider an e-book or audiobook version so children can follow along while listening to the book aloud.
Physical Activity Fun
Ice skating, bowling, or an afternoon at the trampoline park can provide much-needed exercise when cabin fever starts to hit in the winter months. As opposed to chauffeuring each child from activity to activity, family team time allows for one trip, to one agreed-upon activity, all together as a family. Want to stay in? Try a competitive Top Chef-inspired cooking challenge, in which each member chooses a flavorful pancake topping, unique pizza toppings, or quesadilla fillings. An impartial blind taste-tester is all you need to settle the sibling rivalry or family food feud!
Volunteer as a Family
As opposed to hustling from a game, to a recital, to a playdate on a busy weekend, consider volunteering as a family. Clean out the toy room and closets to donate to children in need. These gestures show children the holidays are not only about receiving, but also giving. Decide as a family to demonstrate the spirit of giving by helping out at an animal shelter, soup kitchen, book drive, etc. After volunteering, discuss each family member’s favorite moment of the day — what was the best part of volunteering? What did you learn?
This season, take a break from the constant flurry of extracurricular activity and give your family the gift of time together.
How to Provide the Full-Service Community-Supported Public Schools We Need
All students have potential, but access to support and opportunity is not equally distributed. As a high school principal for 10 years, I encountered well-intentioned teachers and students racing toward adulthood with an endless variety of needs: students struggling with poverty; transience; family changes; immigration; addiction; the negative effects of trauma; and emotional, physical, and social health.
In most cases, these challenges directly affect a student’s ability to thrive in the classroom, and schools struggle because there is no prescribed or easy solution. The response to the academic struggles of our students has traditionally included longer days and school years, improved instructional strategies, targeted remediation, and focused test preparation. But schools have rarely attempted to combat the non-academic root causes which are negatively affecting the achievement of our students.
Simply put, not enough is being done to address the lack of equity experienced by students and their families. So we must ask ourselves a few questions: How can I ensure my students have the access and opportunity to fully realize their potential? How do we help each student understand his or her personal aptitudes and assets? How do we instill within a student a sense of optimism and a sense of purpose?
A Comprehensive School Offering Wraparound Support
To really help students succeed, schools need to implement a holistic approach by supplementing our extensive instructional efforts and becoming “full service” schools. With embedded essential community services such as basic needs provision, mental and physical health services, hard and soft skill development, and workforce exploration, students have their best chance at a successful start following graduation.
A comprehensive wraparound school is a place of hope, connection, and opportunity — a school that’s actively striving to make equity and future success attainable for its students. This means monitoring student setbacks and successes, providing academic and behavioral interventions in a timely manner, connecting students and families with support services, and offering high-quality aptitude-based career and college transition counseling.
“Whole child” schooling, paired with collaborative community partnerships, is a cornerstone in the common-sense revisioning of public education and a powerful solution we need now. Here are some tips to improve a school’s ability to provide comprehensive, wraparound community services and partnerships to ensure all students have the support they need and an equitable opportunity for success:
1. Evaluate Students’ Needs
A comprehensive full-service school is designed to meet the needs of its students by working with local individuals, agencies, and businesses to strengthen the community. First, schools must identify needs and establish priorities. Schools uncover specific barriers and concerns students are facing by speaking in depth with students, parents, and community members. High-quality needs assessments provide data that schools and communities use to prioritize the most pressing needs and opportunities for support and partnership.
2. Give Students Hope, Purpose, and Relevance
For struggling students, some of the most powerful interventions regarding post-high school planning lie in the realm of social and emotional learning — the development of a student’s self-discovery and aspiration leading to optimism, self-worth, and purpose. Aptitude-based assessments are capable of helping educators and parents learn much more about our teens than what is typically gleaned through traditional academic testing.
While I was a principal at Marietta High School, we partnered as a pilot school with YouScience, an aptitude assessment tool. YouScience uncovers students’ natural talents and matches them to careers in which their abilities add value to the workforce. Too often, we point students in directions or make course recommendations for them based on what we have available for scheduling, what we can gather from their academic test results, and our own personal hunches about what they might be good at or interested in. Typically, educators have little information which is relevant to whether the direction recommended is the best fit for the individual student. YouScience equips schools to engage in individualized goal-setting with students and parents through a process that is informative and inspires hope.
3. Compile Resources
With students’ needs in mind, schools must search the community to identify local resources, partners, service providers, and funding sources. Consider looking beyond the local community for resources if need be, and then connect students and families with the available services. Some schools might want to start small, with partnerships providing care closets, apprenticeships, job placement assistance, mediation services, or wellness coaching, and then gradually grow the number of services offered over time. Other schools might have the resources to introduce multiple community partners to work with students and their families on a regular basis. The important thing is that students are connected with community resources providing the support they need.
4. Commit to the Long Term
It’s important to remember that developing a school which provides comprehensive support is a process that takes intentionality, time, and patience. School districts must commit to discovery, innovation, and collaboration, and they must focus on a long-term goal of community improvement. It’s deep work that’s dependent upon trust and building relationships with students and community members. Start small and commit to the long haul.
Schools are microcosms of their communities. The time and energy invested in this process will benefit not only students and their families but also the community as a whole. Creating a “one-stop shop” of support and coordination of essential community services is the best way to address the most significant barriers our students face today, as well as set them up for success for years to come.
Is It More Than Just A Shooting?
Several articles in response to the shootings in Minnesota, New Orleans, and Dallas point fingers at racists, PTSD, and mental illness. Although these issues are valid, there is a multitude of factors making this issue far more complex than a singular culprit like mental illness.
Underneath all these shootings and acts of violence is fear, an emotion we don’t often factor in when discussing shootings. Fear causes fight or flight reactions in humans, a strong, protective instinct which can, at times, cause reactions that aren’t typical of our normal behaviors. When we experience fear, whether real or perceived, our adrenaline increases and as an act of self-preservation. Our reactions to fear may cause us to act in ways our “normal” brain might not have. Unfortunately, it can also cause us to react in a way which can take the life of someone in the name of self-protection or justice.
So, imagine the stress of living in a neighborhood where people are killed, gunshots are heard regularly, and those around you are involved in nefarious activities. Long-term stress can have severe consequences – such as physical health issues and problems with cognitive thinking. For children, toxic stress results in behavioral and development issues. Living in a state of constant fear never allows an individual to care for themselves, always on the alert for potentially dangerous situations. Living in fearful conditions where a community’s needs aren’t met and their safety is questionable, a physically and mentally harmful lifestyle is already enough to deal with. Now, factor in racial profiling, police bias and brutality, and classist targeting.
In low-income neighborhoods, police are not always responsive. The police don’t often know you or your family and tend to approach certain neighborhoods with harmful preconceived ideas. Whether it’s internalized hate, racial profiling and learned bias, classism or just plain ignorance, many police officers are not educated about communities different from their own and only have reference points from television and media, which reinforce harmful stereotypes. If this is the basis from which police are viewing the public, it’s highly likely police will target certain groups out of fear.
It is important as a society, we do not downplay the personal responsibility we have for our actions nor the sheer horror of violence. But we are not born disliking people of color, women, immigrants or cultures different from our own. Through our learned experiences with family, school, media, or religious institutions, we learn to be separate and fear groups who are not like us. We look around and see people who only look like us and learn to live in a comfortableness rather than question the status quo which oppresses certain groups more than others.
So, how do we get past this fear? Education, compassion, and empathy are key. As a community, we need to be more responsible to one another and have difficult conversations about race, gender, and class while challenging our own internalized biases. Speaking to our legislators, media representatives, friends, and family is a power to hold ourselves and others accountable for racial profiling, classism, abuse of power, and internalized fears. We need to put our foot down and refuse to settle for superficial conversations or answers to large, complex problems.
Procrastination: Why We Do It and How to Combat It
Consistently, procrastination creates a snowball effect, in which anxiety or stress further compounds the need for the task avoidance. In basic terms, the more a student puts off a task or assignment, the greater the stress of the impending due date or need for completion. We all know this and can relate to that instinct — we then put it off even further because it has become such a monster, we must avoid it or ignore it at all costs.
The other issue surrounding procrastination is we often procrastinate with the tasks or responsibilities which matter most or have the highest stakes. Whether we do this out of fear, denial, indifference, or laziness, the end result is typically the same: we experience a sort of self-destruction by missing an important deadline, or we cave in and begrudgingly and reluctantly complete the task in hurry. Either outcome is less than ideal, especially when grades are involved. Because of procrastination, students dig themselves into a hole, lose motivation, and therefore put forth even less effort with their school work.
Awareness is key to combating the instinct to put off undesirable tasks. Once students realize how they procrastinate, they can begin to alter those behaviors. For example, a student completing research for a paper will find ways to distract himself from the assignment while working. They may check social media, text friends, pause to watch a show, listen to music, or simply scroll through random websites — anything becomes more enticing than the actual research.
- Encourage students to limit distractions by keeping the phone off–limits during work sessions.
- Complete work in an area away from television, music, friends, and other distractions.
- Set a timer for 20-30 minutes of solid, uninterrupted work time. Then allow yourself to take a 3-5 minute break, but then get right back to work.
- Keep light snacks and water at hand while working to stave off hunger and the unnecessary urge to graze to avoid the assignment.
- Construct a checklist for a multi-step task and prioritize the tasks in order of difficulty. As students work, they should monitor the checklist and stick to the order of steps as necessary. Again, the urge to complete the easiest or most interesting steps is another procrastination tactic — instead, encourage students to tackle the challenging steps first. This will boost motivation and confidence while working.
- Organize to-do lists with tasks requiring the most time or focus at the top. These are typically the first things that students will avoid completing.
- Ask students to write down three things they have accomplished at the end of a work session. The successes, no matter how small, show students a strong work ethic and focus does help them to chip away at a daunting task they may have vehemently avoided in the past.
Procrastination is an all too familiar practice for many of us. While certain people are more likely to put off all tasks until later, we have all experienced the desire to push off occasional duties, errands, chores, or responsibilities. For students, no matter their age or academic aptitude, procrastinating can become an alluring yet problematic habit. Pushing off tasks can become a major pitfall for several different reasons, but there are methods to combat this bad habit — and they begin with awareness.
Four Ways Neurodiversity Holds the Key to the Future of Special Education
For ages, special education has been developing on its own, together with the development of ordinary education. It emphasizes disorders and the ways special education students are lacking compared to an average student. Those who have a noticeable dysfunction have even been mocked for their lack of focus or skill to learn something – sometimes by teachers too.
And even though the history of the special education has been filled with inappropriate names and terms, the future is bright. More and more scientists and educators are turning to the better ways of conducting special education – and one of those ways is related to neurodiversity.
This term was first used by journalist Harvey Blume in the early 1990s and means that autism, ADHD, dyslexia, and other special-needs conditions are the part of normal variations in the human population. And here is how neurodiversity changes the entire special education system.
1. In theory.
Special education as it is at the moment regards disability categories as something originated from biology, genetics, and neurology. Neurodiversity, on the other hand, focuses on the advantages these disabilities have to offer – they use this to explain why these genes are still here today and why people are still born with disabilities.
This new concept examines how a person with a disability can be lacking in some aspects but even more advanced than regular people in some. During the past decade, university programs such as London School of Economics’ Dyslexia and Neurodiversity program, or the College of William & Mary’s Neurodiversity Initiative are aimed to support neurodiverse students and create positive acceptance and niches for them.
Annabel Gray, neurodiversity specialist and educator at Origin Writings states, “Regarding a person as completely disabled is fundamentally wrong. Whereas a person with, for example, autism can be lacking in some areas of life, on a job which requires focus and attention to detail, this same person would do outstandingly well.”
2. The focus.
The focus of special education so far has been solely on assessing deficits and how to go about educating students based on these deficits. However, neurodiversity relies more on assessing the strengths, talents, abilities, and interests of disabled students. It is a strength-based approach where an educator would use a series of tests to discover the student’s abilities and teach them how to use them to tackle their everyday and educational challenges.
What is so great about neurodiversity approach is it gives the students all the necessary tools to cope with their day to day life by focusing on what they do best. This way the students are not feeling left out and they know there are some things where they can thrive in.
Workarounds are another way the neurodiversity improves the disabled students’ lives. What it essentially means is the educators are supposed to find ways for students to experience and learn which does not include their disabilities. For example, students with ADHD could be allowed to use special tools like stability balls or standing desks in order to focus on studying.
This could be expanded to create an individual education plan for each student based on what they need and in which environment they thrive the most. Placing those students in the traditional learning environment will help them to feel “lesser human being” or a burden.
Lila Christie, an educator at 1Day2Write and WriteMyX confirms: “Workarounds are some of the best ways of teaching the disabled students. We implement this strategy of putting each student in an environment that will allow them to learn without anything in the way. It not only works but also gives students the satisfaction and comfort.”
4. How to communicate with students.
While most special education programs still teach children about their disabilities, neurodiversity teaches them about the value of variation and being different. It teaches them how their brain works and how the environment affects it, how to use their skills to the maximum etc. This kind of mindset can help them realize the growth mindset can improve their performance.
To get the brain to its full potential it is important to get the students exercising in various ways, each suited to their own abilities – writing exercises are excellent ways to improve brain power and it can be easily accessible to students through tools such as Dragon NaturallySpeaking, Windows Speech Recognition, etc.
Neurodiversity is a great new approach to special education. It gives students opportunities and new ways of understanding themselves. This is a fresh take on educating those with disabilities – in fact, it relies more on their abilities and strengths. It can give students confidence and tools to be successful and do more later in their lives.
Note-taking November: For the Elementary Classroom
For elementary schoolers, note taking as a reading or comprehension strategy is likely unfamiliar, and for a legitimate reason — many younger learners are just beginning to get comfortable in their reading abilities at this stage. Many children view reading as a mundane task; but, if students begin to look at the reading material as a vessel for knowledge, they may change how they read for such information. Reading skills, particularly the ability to extract, analyze, and interpret relevant material, can be improved as students learn proper note-taking practices.
For elementary-age learners, taking notes while reading probably seems like an added burden on an already difficult task. Therefore, when introducing the concept, be sure to frame the instruction with expectations, benefits, and models of how the note taking should look.
Note-taking Takes Practice
Explain that note taking while reading is a practice which will take time — elementary schoolers should expect to practice this skill consistently before it becomes second nature. They should also expect their notes to be messy, which is why a pencil is a must. Begin the note-taking process by simply recording a stream of thought while reading.
Encourage students to mark up words and phrases which are:
- unfamiliar or confusing
- bolded, italicized, or repeated
- indicate the author’s purpose
- signify an important moment or realization
- present an interesting fact or take-away
Use these opportunities as a means of teaching context clues — if the term is unfamiliar, ask students if anything around the word or phrase provides insight into the unknown word’s meaning. Encourage them to brainstorm and experiment with possible word meanings until they land on something that makes logical, grammatical sense.
Don’t Be Afraid to Ask, “Why?”
Elementary schoolers should also feel comfortable asking “why?” while reading. Encourage them to add question marks to areas of text they don’t understand or don’t see the relevance.
Model the Practice of Close Reading and Active Note-taking with Students Regularly
For the most part, note taking is an unfamiliar skill for elementary-age kids. When modeling the process, start small. Perhaps you begin by using a text that students have read before. This sense of familiarity will promote risk-taking and allow students to feel more comfortable tackling the text with their thoughts and observations. As you move through the text together, show them how to refer back to earlier notes if they have made connections or discovered an answer to a previous notation or question.
Inform Students of the Benefits of Note-taking
They will be surprised to know that notes can mean an easier time when rereading or skimming while studying. If students get in the habit of taking copious notes, most of the studying “legwork” will be done ahead of time. Their notes should also act as place markers, meaning any content which struck them as important or especially tricky should be highlighted to indicate that it is vital to review. Also, let young readers know that note taking is a deliberate practice ensuring focus, comprehension, and other active reading skills on behalf of the reader. If your mind is disengaged or drifting, there is no way you will be able to maintain substantial notes or annotations.
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