Ohio Registry of Effective Practices
Youth Experiencing Success in Schools
Y.E.S.S.
Contents
- OMHNSS Interview/Site Visit Team
- Program and Contact Information
- General Program Overview
- Evidence of Effectiveness
- Capacity and Resources
- Family Partnerships
- Community Partnerships
- Sustainability Plan
OMHNSS Interview/Site Visit Team: Heather Alvarez, Dave Tener, Tracee Black
Program Name: The Youth Experiencing Success in School (Y.E.S.S) Program
Schools: The Y.E.S.S. Program has been implemented in the following schools
Central Intermediate (Logan-Hocking Local School District)
Central Primary (Logan-Hocking Local School District)
Green Elementary (Logan-Hocking Local School District)
Hocking Hills Elementary (Logan-Hocking Local School District)
Union Furnace Elementary (Logan-Hocking Local School District)
Addaville Elementary (Gallia County Local School District)
Southwestern Elementary (Gallia County Local School District)
Vinton Elementary (Gallia County Local School District)
West Union Elementary (Adams County/Ohio Valley School District)
The Plains Elementary (Athens City School District)
School Districts: Logan-Hocking School District, Gallia County Local School District, Adams County/Ohio Valley Local School District, Athens City School District
Partnering Agencies:
Ohio University
~Department of Psychology
~Department of Social Work
~College of Medicine
~Voinovich School of Leadership and Public Affairs
Logan-Hocking School District
Hocking County Juvenile Court
Family and Children First Councils in Hocking, Gallia, and Adams Counties
Gallia County Local Schools
Woodland Centers, Inc.
Athens City Schools
Adams County Schools
Shawnee Mental Health Center
Cleveland Clinic Foundation
Contact Persons and Contact Information:
Julie Owens, Ph.D.
Associate Professor
200 Porter Hall
Ohio University
Athens, OH 45701
(740) 593-1074
owensj@ohio.edu
Kristy Walter
Special Education Supervisor
Logan Hocking School District
28841 Chieftain Drive
Logan, OH 43138
(740) 385-7016
kwalter@loganhocking.k12.oh.us
General Program Overview
The Youth Experiencing Success in School (Y.E.S.S.) Program is a collaborative school mental health program designed to increase access to evidence-based mental health services for children who struggle with inattentive and disruptive behavior problems and their families. The program has developed over the course of seven years through a university-community partnership that includes representatives from Ohio University, school districts, juvenile justice, and community mental health agencies. The goals of the Y.E.S.S. Program are to enhance the use of evidence-based practice in schools, improve academic and behavioral functioning of students, enhance home-school collaboration and support for parents, provide ongoing, collaborative consultation for teachers, augment inter-agency care coordination, conduct research to evaluate program effectiveness, and provide interdisciplinary training experiences for Ohio University students.
The interventions and strategies provided by the Y.E.S.S. Program were selected because of the substantial scientific support for their effectiveness in addressing behavioral problems in elementary school youth. The primary interventions used include a Daily Report Card intervention tailored to the child’s individual needs, behavioral parenting sessions, and year-long collaborative teacher consultation to facilitate the classroom interventions and home-school linkages. The Y.E.S.S. program aligns with the Comprehensive System of Learning Supports (CSLS) that is endorsed by the Ohio Department of Education. Namely, the Y.E.S.S. Program has proven to be an effective evidence-based Tier 2 intervention that teaches students the skills needed to improve performance and interact appropriately in the classroom setting. In addition, the student’s family and teacher are provided education and support to assist the student in learning and maintaining these new skills.
The Y.E.S.S. Program prioritizes the integration of evidence-based mental health services into the school community, ongoing professional consultation for teachers as critical front line providers of intervention for children with disruptive behavior, and the development of interdisciplinary partnerships among education, health, and mental health professionals to engage in collaborative assessment, treatment planning, decision making, and coordinated service delivery that addresses strategically-targeted goals.
Daily Report Card
The Daily Report Card (DRC) procedure is used to identify, monitor and change individualized target behaviors, provide daily communication between home and school, and provide a positive context that motivates children to improve their behavior. Using this procedure, target behaviors are identified and agreed upon by the parents, teacher, and child. On a daily basis, the teacher provides feedback to the child regarding his behavior (percent complete with praise for achieving goal) and the child delivers the DRC to the parents. Parents provide a home-based privilege and consequence system that is contingent upon the child’s performance on his target behaviors. For more information about Daily Report Cards see www.yessprogram.com, links for parents and teachers.
Behavioral Parenting Sessions
The Y.E.S.S. Program provides individual parenting sessions on a flexible schedule. Although the sessions are tailored to each family’s needs, the content of the sessions is guided by three parenting programs that have empirical support for their effectiveness: Barkley’s Defiant Children Program, Cunningham et al.’s Community-Oriented Parenting Education Programs, and McMahon and Forehand’s Helping the Noncompliant Child Program. These programs are designed to enhance children’s rule following and interrupt any negative parent-child interaction cycles that have developed. Parents learn effective ways to provide attention to appropriate behaviors and ignore or provide effective consequence for inappropriate behaviors.
Teacher Consultation
The Y.E.S.S. Program provides collaborative consultation to facilitate teacher engagement and to enhance the adoption, implementation and sustainability of classroom interventions. Teachers receive initial in-service training on proactive classroom management strategies, Daily Report Card procedures, and relevant research findings. They also participate in on-going consultation through bi-weekly meetings during which clinicians and teachers jointly engage in behavioral assessment, as well as classroom intervention planning and troubleshooting. Y.E.S.S. facilitators receive training and technical assistance so that they may guide teachers in the processes of problem identification and analysis, and intervention implementation and evaluation. Y.E.S.S. facilitators try to create a consultation environment characterized by shared goals, joint decision-making, co-education, data-driven decisions, and interdisciplinary problem-solving.
Evidence of Effectiveness:
The Y.E.S.S. Program has an ongoing evaluation component. Treatment outcome is measured via parent and teacher ratings of child symptoms and functioning at three time points throughout the year (pre-treatment, mid-treatment, post-treatment). Treatment potency and utilization are measured through documentation of parent and teacher participation in the treatment components and implementation of the behavioral interventions. Finally, satisfaction is measured through anonymous surveys completed at the post-treatment assessment. Publications presenting effectiveness data in the context of treatment and delay-treated control conditions can be found in Journal of Attention Disorders, 9, 261-273 and Journal of Clinical Child and Adolescent Psychology, 37, 434-447. Selected data supporting the benefits of the Y.E.S.S. Program are described below:
Early Intervention and Enhanced Access to Services
- 70% of program enrollees are in third grade or below.
- Less than 50% of program enrollees were receiving needed mental health services at the time of program enrollment (despite demonstrating moderate symptoms and functional impairment).
- Satisfaction surveys indicate that some parents prefer receiving behavioral support services at school (instead of at a clinic) because school-based services minimize transportation and scheduling barriers (47% of parents), as well as embarrassment (38% of parents).
- The program is serving a subgroup of children that often has difficulty accessing care, as more than 60% of enrollees are children living in low-income families.
Intervention Embedded within the Classroom
- On average, across all target behaviors, teachers complied with daily report card implementation procedures on 77% of school days. Thus, teachers are successfully integrating evidence-based intervention into the daily routine.
- Satisfaction surveys indicate that 90% of teachers believe the interventions and consultation are helpful, and 78% believe the benefits outweighed the costs.
Improved Behavioral Functioning
- Parent and Teacher reports indicate that children in the Y.E.S.S. Program are showing statistically significant reductions in hyperactive/impulsive and antisocial behaviors, as well as statistically significant improvements in the relationships with adults and in overall functioning.
- Satisfaction surveys indicate that the majority of parents and teachers agreed or strongly agreed that program services improved behavioral performance (70% of parents; 72% of teachers).
Improved Academic Functioning
- Satisfaction surveys indicate that the majority of parents and teachers agreed or strongly agreed that program services improved academic performance (84% of parents; 54% of teachers).
- Program enrollees maintained a stable grade point average (GPA) over the course of the year. In contrast, the GPAs of children on the waitlist declined significantly over the year.
Qualitative Data
- Principals report significant reductions in office referrals, as well as efficiency of time spent with challenging students.
- Principals report that the Y.E.S.S. program has translated into global benefits for more than just program participants. Many teachers generalize strategies to other students (or to the class as a whole).
- The program also has resulted in improved relationships between school personnel and parents of Y.E.S.S. students. The Y.E.S.S. facilitator is often viewed as an important liaison between home and school, and an advocate for families who can facilitate positive communication and problem solving between schools and families.
- The program has improved parent’s readiness to consider special education and mental health supports, and has reduced the stigma of both for participating families.
Teachers report excitement about the success of the Y.E.S.S. program, and note their appreciation for the consultation meetings, as well as the program’s impact on enhancing parent involvement.
Capacity and Resources:
Program Facilitation Resources. The Y.E.S.S. Program has been implemented by graduate student clinicians, school guidance counselors and by community mental health center case managers. Y.E.S.S. facilitators spend two days per week on site at the elementary school to provide assessment, treatment, and consultation services in the context of a collaborative team that includes teachers, principals, school psychologists, parents and students, as well as other professionals (e.g., pediatrician, speech language pathologist). Facilitators typically carry a caseload of 6 to 12 children at each school. Prior to providing services, facilitators engage in an initial 15-hour training sequence. Content covered includes the rationale for inter-professional school mental health programming, evidence-based practices for disruptive behavior problems, and the relevant foundational theories. The training method includes didactic lectures, interactive discussions, modeling, and interactive role plays.
Graduate student facilitators then receive weekly clinical supervision with a licensed psychologist for the duration of the year-long traineeship. In addition, students also participate in a 6-session interdisciplinary didactic series designed to expand students’ understanding of school culture and expose students to professionals from other disciplines. This training mechanism facilitates clinician understanding of how professionals of different disciplines conceptualize, assess, and treat youth. Finally, student facilitators also participate in a 6-session interactive, interdisciplinary video-conference training series. This training opportunity allows graduate trainees in the Y.E.S.S. Program to practice communicating via video-conference technology with psychiatry residents. It provides an interactive platform for discussing discipline-specific literature on evidence-based practices, discipline-specific biases and challenges to interdisciplinary collaboration. Community facilitators receive ongoing technical assistance via face-to-face or video-conference meetings with a Y.E.S.S. Program staff. Community facilitators are also invited to participate in the 6-session interdisciplinary didactic training series.
Broadly speaking, the pre-service and professional development training initiatives are intended to (a) enhance knowledge and skills associated with delivering and evaluating evidence-based practices in community settings, (b) develop competencies related to interprofessional consultation and collaboration in the context of university-community partnerships, (c) educate pre-professionals about rural mental health practice, (d) expose trainees to videoconference technology to facilitate future use of innovative technology in professional practice, and (e) retrain trained professionals in Ohio and in rural communities across the nation. Funding for the program has been blended from multiple sources including the school districts, the county juvenile courts, the university, as well as research, training and service grants from local foundations, state agencies and national agencies.
School District Resources. Feedback from parents and teachers is prioritized within the program. Feedback from teachers following the first year of program implementation indicated that they valued the program; however, finding time for the bi-weekly consultation was a significant challenge, as these consultations often had to occur before school, after school, during lunch time, or during planning periods. In response, the university-community partnership developed an infrastructure to enhance the feasibility of ongoing behavioral consultation. Namely, the school districts employ a “floating” substitute teacher to relieve teachers from their classrooms on a bi-weekly basis for the 30-minute consultation sessions with the Y.E.S.S facilitator. In addition, the program prioritizes teacher professional development training as a mechanism for enhancing local capacity. Thus, all teachers are invited to participate in a day-long (in the first year of implementation) or half-day (subsequent years) in-service training in August. Teachers typically receive a stipend and continuing education credits for attending.
Family Partnerships:
A core element of the Y.E.S.S. program is the involvement of parents as partners across all phases of the intervention. Parents participate in an initial assessment to provide their perspective of the child’s strengths and weaknesses. They are involved in the design of the child’s daily report card and in the associated home-based privilege system. Parents are invited to meet with the facilitator on a weekly or bi-weekly schedule to address child challenges in the home, home-school communication issues, or obtain information about additional services and supports. Meeting times are flexible, and home visits and phone sessions have been used when barriers to face-to-face meetings arise. Parents are also compensated financially for completing all program evaluation paperwork.
According to parent report, the program has allowed families to seek both informal and professional support and has reduced barriers to mental health treatment (e.g., stigma, transportation, scheduling). The family is viewed by the Y.E.S.S. facilitator as a partner, and with that comes encouragement for regular communication between schools and parents. As a result, parents note that their experience in working with school staff is less negative after joining the Y.E.S.S. program. During the training sequence, facilitators discuss how to use language that is supportive and welcoming for families, devoid of clinical labels, and jargon-free. In satisfaction surveys and parent interviews, parents have reported an appreciation for the daily communication that is created via the daily report card, and a comfort in knowing that the Y.E.S.S. facilitator can help them communicate with the teacher and advocate for their child. One parent reported that the significant changes that were witnessed in both home and school behavior encouraged her to continue adhering to intervention techniques even when daily schedules became stressful. Parents also note that this program helps improve their child’s relationships with both adults and peers. Moreover, from the educator’s perspective, this program has improved parents’ follow-through when students are referred for mental health services. Finally, clinicians working with parents and families are in a position to help identify additional service needs (e.g., psychopharmacology) and enhance parents’ knowledge of and readiness to consider such treatments. Overall, the Y.E.S.S. program promotes family support, access to services, and improved relationships among all involved with the student.
Community Partnerships:
The Y.E.S.S. Program has been developed in the context of a university-community partnership with the goal of creating a program that benefits all stakeholders. The program was originally designed to strategically fill a gap in the continuum of existing community services (i.e., the need for more intensive behavioral intervention in the classroom and enhanced home-school linkages), while simultaneously providing a training and research mechanism for university students and faculty. This mutually beneficial arrangement has been maintained through extensive efforts towards partnership development, including the promotion of collaborative involvement of all stakeholders, co-learning and joint-decision-making, open communication about each agency’s priorities and operating demands, and the use of mechanisms to obtain feedback from families, schools, and program partners. By blending resources and expertise from multiple perspectives, these efforts provide a rich arena for the transportation of evidence-based practices to the community.
Y.E.S.S. Program planning meetings occur on a monthly basis in a manner that best suits the needs of each school district. In some districts, Y.E.S.S. programming meetings occur at the building level and in other districts they occur on district level. During the program development and planning phase, these meetings were designed to discuss community needs, faculty research interests, relevant evidence-based practices and innovative methods to collaboratively address the identified needs. These meetings now also include discussions about program implementation, intervention integrity, program evaluation, infrastructure needs, financial needs, and sustainability.
Sustainability Plan:
The Y.E.S.S. Program addresses sustainability through several mechanisms. First, the program has operated using funding from multiple sources, including the school districts (both the special education and general budgets), the county juvenile courts (e.g., Ohio Department of Youth Service RECLAIM funding), local foundations (e.g., Columbus Foundation, Holl Foundation), community mental health centers (billable services), Ohio University (e.g., graduate student stipends), state grants (e.g., Ohio Department of Mental Health (ODMH) Office of Program Evaluation and ODMH Office of Clinical Best Practices), and federal grants (e.g., Health Resources and Services Administration’s Quentin Burdick Program for Rural Interdisciplinary Training). Some of the funding sources have been consistent since the inception of the program, demonstrating the value placed on the program. It is anticipated that these funds will continue. In addition, with such diverse funding sources, the negative impact of budget cuts within a given funding source is lessened by the availability of other sources. Second, the Y.E.S.S. Programming committee is dedicated to examining opportunities for additional grant support. Because the Y.E.S.S. Program services a variety of missions (e.g., research, training, service), different stakeholders can contribute their expertise towards applying for different types of grant mechanisms. Third, in November, 2008 the Y.E.S.S. Programming committee in Hocking County held a strategic planning retreat to review data spanning the last five years of program implementation highlighting program strengths and challenges, and devote time to planning future directions. There remains considerable demand for Y.E.S.S. programming across elementary students in Southeast Ohio. With this demand, the Y.E.S.S. Program anticipates continued efforts to identify resources (both personnel and financial) to facilitate sustainability and continued expansion. Finally, through pre-service and in-service training on effective school mental health practice, the Y.E.S.S. Program endeavors to promote workforce retention in school mental health programming. In the past five years, the Y.E.S.S. Program has trained 11 psychology and 6 social work graduate students, many of whom continue to serve youth mental health needs through collaboration with schools.