EBD Blog

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.

• Down load the press release (source of the excerpt quoted here).
• Read coverage in these newspapers:
  • Lynchburg News and Advance—Coalition pushes mental-health care for children
  • Washington Examiner&mdash:Advocates start bid to expand children’s mental health services under bleak budget;
  • Richmond Times Dispatch— Coalition advocate mental-health care for children
  • Washington Post (blog)—New coalition has AG’s support for mental health reforms
• Visit (and support) the Web site of the Campaign for Children’s Mental Health.
• Download pdfs of “Survey of Community Services Board Child and Adolescent Services” and “Review of Community Services Board Child and Adolescent Services“; these are report by James W. Stewart, Inspector General for Virginia’s Mental Health, Mental Retardation & Substance Abuse Services (now called Behavioral Health and Development Services). The list of key services comes from these reports;
• Visit the < href="http://www.facebook.com/pages/The-Campaign-for-Childrens-Mental-Health/183467424796?v=wall" target="_blank">Facebook page;
• Listen to a brief (3+ min) interview with Ms. Crowe from WMRA: Pushing for Children’s Mental Health Reform.

Hill Walker and colleagues reported that the First Step to Success program benefitted young children at risk for developing emotional or behavioral disorders. In a longitudinal study of the three-year program conducted in Albuquerque (NM, US), the researchers found substantial reductions in disruptive behavior and improvements in social functioning.

In a press release, Professor Walker said, “Albuquerque was the first opportunity we had to mount a large-scale study of the program using a randomized control group, the gold standard for research. First Step has been implemented widely, but not [studied] in this way.”
Continue reading ‘First Step takes off’

The Substance Abuse and Mental Health Services Administration, which is a part of the US Department of Health and Human Services, maintains a Web site where users can search for and learn more about methods for preventing or treating some Emotional and Behavioral Disorders. It’s called the “National Registry of Evidence-based Programs and Practices” (NREPP) and, for those who are concerned about employing or recommending evidence-based practices, it’s worth reviewing.

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.

The purpose of this registry is to assist the public in identifying approaches to preventing and treating mental and/or substance use disorders that have been scientifically tested and that can be readily disseminated to the field. NREPP is one way that SAMHSA is working to improve access to information on tested interventions and thereby reduce the lag time between the creation of scientific knowledge and its practical application in the field.

NREPP is a voluntary, self-nominating system in which intervention developers elect to participate. There will always be some interventions that are not submitted to NREPP, and not all that are submitted are reviewed. In addition, new intervention summaries are continually being added. The registry is expected to grow to a large number of interventions over the coming months and years. Please check back regularly to access the latest updates.

Although NREPP originally focused on substance abuse, its coverage is broader now. Look for resources about, for examples, Across Ages; Aggressors, Victims, and Bystanders: Thinking and Acting To Prevent Violence; Al’s Pals: Kids Making Healthy Choices; All Stars; Caring School Community; CASASTART; Children’s Summer Treatment Program (STP); Coping Cat; Creating Lasting Family Connections (CLFC)/Creating Lasting Connections (CLC); Early Risers “Skills for Success”; Families and Schools Together (FAST); Guiding Good Choices; Incredible Years; Keep A Clear Mind (KACM); Keepin’ it REAL; Lions Quest Skills for Adolescence; Multisystemic Therapy (MST) for Juvenile Offenders; Multisystemic Therapy With Psychiatric Supports (MST-Psychiatric); Positive Action; Primary Project; Project Northland; Project Towards No Tobacco Use; Project Venture; Promoting Alternative THinking Strategies (PATHS), PATHS Preschool; Protecting You/Protecting Me; Right Decisions, Right Now: Be Tobacco Free; SAFEChildren; Second Step; SMARTteam; Storytelling for Empowerment; Strengthening Families Program; Strengthening Families Program: For Parents and Youth 10-14; Success in Stages: Build Respect, Stop Bullying; Too Good for Drugs; and Too Good for Violence;

Summer in the US finds children and youths out of school and, perhaps, less vulnerable to some of the problems that are associated with the social and academic demands that are part of schooling. As a result, perhaps fewer of the familiar problems illustrated in this poster are apparent during summer.

If summer seems like a relief from such problems, though, that could be an important indicator that those very problems need to be addressed. A few weeks away from school probably will not cure them. Those same difficulties may still be occurring, just less obviously, and they are likely to recur soon.

Individuals or the families of children who experience the kinds of problems noted in the poster should consult the resources available from the US government’s Substance Abuse and Mental Health Services Administration. One will not find easy cures there, but by carefully perusing the resources available one can learn what signs to monitor and where to go to get help.

The image is hot. Click it to get to a good starting place.

Even though many schools in the US have closed for the summer or are about to do so, I want to remind folks that this is not a good time to take a break from considering the mental health needs of children and youth. Although they are likely to wax and wane over time, mental health problems don’t take many vacations.

Learn more about US resources for individual children and youths who have emotional and behavioral disorders by surfing the rich resources assembled by the Substance Abuse and Mental Health Services Administration (SAMSHA) of the US Department of Health and Human Services. Although some of the materials may be a tad out of date (e.g., prevalence figures have been updated for some disorders such as Autism), there are still plenty of valuable materials available from SAMHSA.

Go there! Compare what you see learn there with what’s available at other trustworthy sites. Learn what to do and from whom help is available.

Reporting on US National Public Radio’s Morning Edition, Joanne Silberner presented a story about police officers handling incidents in which they encounter people with emotional and behavior disorders who are behaving in ways that appear threatening to the officers. Although her story uses adult cases for illustrations, this topic should also be of interest for youths who have EBD and for the families of children with EBD.

Here’s an excerpt from Ms. Silberner’s report.

It’s a situation no one wants to see: An armed police officer is called because someone is in the throes of a psychotic episode. “How the officer handles that situation can have a significant impact,” says Russell Laine, head of the International Association of Chiefs of Police.
Continue reading ‘Officer training for handling incidents’

The US National Academies Press announced the publication of a book entitled Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities that discusses prevention of problems during childhood, adolescence, and young adulthood. Edited by Mary Ellen O’Connell, Thomas Boat, and Kenneth E. Warner, the book represents the work of the Board on Children, Youth and Families. It is available in hardback, as a PDF, or online (the last option is free).

Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders.

Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time.

Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.

Link to the press release or the ordering page.

For schools and local education agencies that are doing a good job of working collaboratively with local mental health agencies or aspire to do so, here is a fine funding opportunity. Wrap-around systems of care have well-known benefits for children and youths with Emotional and Behavioral Disorders.

Grants for the Integration of Schools and Mental Health Systems (Federal Register: January 12, 2009 [CFDA# 84.215M])

Purpose of Program: Grants for the Integration of Schools and Mental Health Systems will provide funds to increase student access to high-quality mental health care by developing innovative approaches that link school systems with the local mental health system.

==> Applications Available: January 12, 2009.
==> Deadline for Transmittal of Applications: February 23, 2009.

Eligible Applicants: State educational agencies (SEAs), local educational agencies (LEAs), including charter schools that are considered LEAs under State law, and Indian tribes.

==> Estimated Range of Awards: $150,000-$400,000.
==> Estimated Average Size of Awards: $325,000.
==> Estimated Number of Awards: 15.

Link to the request for proposals. For more about wrap-around services, see the following sources.

• Burchard, J. D. (2000). How wraparound can help overcome three common barriers to successful transition services. Reaching Today’s Youth, 2(4), 49-51.
• Duckworth, S., Smith-Rex, S., Okey, S., Brookshire, M., Rawlinson, D., Rawlinson, R., Castillo, S., & Little, J. (2001). Wraparound services for young schoolchildren with emotional and behavioral disorders. Teaching Exceptional Children, 26, 54-60.
• Eber, L., Nelson, C. M., & Miles, P. (1997). School-based wraparound for students with emotional and behavioral challenges. Exceptional Children, 63, 539-555.
• Eber, L. (1996). Restructuring schools through wraparound approach: The LADSE Experience. In R. J. Illback & C. M. Nelson (Eds.), School-based services for students with emotional and behavioral disorders (pp. 139-154). Binghamton, NY: Haworth.
• Eber, L., & Nelson, C. M. (1997). Integrating services for students with emotional and behavioral needs through school-based wraparound planning. American Journal of Orthopsychiatry, 67, 385-395.
• Epstein, M. H., Kutash, K., & Duchnowski, A. (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families. Austin, TX: Pro Ed.
• Malysiak, R. (1997). Exploring theory and paradigm base for wraparound. Journal of Child and Family Studies, 6, 399-408.
• Malloy, J., Cheney, D., & Cormier, G. (1998). Interagency collaboration and the transition to adulthood for students with emotional or behavioral disabilities. Education and Treatment of Children, 31, 303-320.
• VanDenBerg, J. E., & Grealish, E. M. (1997). Individualized services and supports through the wraparound process: Philosophy and procedures. Journal of Child and Family Studies, 5, 7-21.
• Walker, J. S., & Schutte, K. (2003). Individualized Service/Support Planning and Wraparound: Research bibliography. Portland, OR: Portland State University, Research and Training Center on Family Support and Children’s Mental Health.

Here’s a special opportunity to learn about how to address challenging behavior problems. This is a star-studded line-up.—JohnL

International Council for Children with Behavioral Disorders

Professional Development

2 0 0 9 International Forum

Achieving Academic and Social Competence: Improving Educational Outcomes for Challenging Students

Tuscany Suites and Casino
Las Vegas, Nevada

January 30-31, 2009

Continue reading ‘CCBD forum 2009′

Gerald R. Patterson

The American Psychological Association (APA) Division 7 (Developmental Psychology), which is holding its annual meeting this weekend in Boston (MA, US), will recognize Gerald R. Patterson with the Urie Bronfenbrenner Award for Lifetime Contribution to Developmental Psychology in the Service of Science and Society. The award will, no doubt, be based on Jerry’s extensive and sound research on the nature, causes, and treatment of anti-social behavior in families.

According to Web site for Developmental Psychology Division of APA,

The award is for an individual whose work has, over a lifetime career, contributed not only to the science of developmental psychology, and who has also worked to the benefit of the application of developmental psychology to society. The individual’s contributions may have been made through advocacy, direct service, influencing public policy or education, or through any other routes that enable scientific developmental psychology to better the condition of children and families.

This is a wonderfully well-deserved honor for Jerry. I was very fortunate to have the opportunity to work with Jerry and his colleagues for a couple of years during my graduate studies; I learned as much about research from hanging around that operation as I did from many of my formal classes combined. His work has influenced many other researchers and clinicians as well as having a direct, beneficial effect on children and youths and their families. Learn more about Jerry and his collaborators’ research at the Oregon Social Learning Center Web site. Also, see Division 7’s Web page about the Bronfenbrenner Award.

Wednesday Social Programs that Work, an organization dedicated to , recognized the Multidimensional Treatment Foster Care (MFTC) program as having strong evidence of its benefits for youths who have many strongly delinquent behavior problems. The developers of the MTFC program include Patricia Chamberlain, Ph.D., John Reid, Ph.D., Philip A. Fisher, Ph.D., and Gerard Bouwman; they are closely associated with the Oregon Social Learning Center (a long-time resident of EBD Blog’s Web resources list). Over the last ~10 years the researchers have conduct multiple randomized clinical trials testing the intervention, and they have consistently found positive outcomes for the youths and their families.

Multidimensional Treatment Foster Care (A foster care intervention for severely delinquent youths)

Randomized controlled trials show sizable reductions in youths’ criminal activity.

Description of the intervention: The Multidimensional Treatment Foster Care program provides severely delinquent youths with foster care in families trained in behavior management, and emphasizes preventing contact with delinquent peers. Typical community treatment for such youth, by contrast, often involves referral to a group care facility with other troubled youth.

As an example of the program’s behavior management techniques, foster parents track and regulate the youths’ behaviors using a point system, with youths receiving points for positive behaviors (e.g., completing chores, attending school regularly), and losing points for negative behaviors (e.g., not completing homework, or not listening to an adult). As youths accumulate more points, they are afforded more freedom from adult supervision.

The program provides the youths and their families with individual and family therapy during their participation in the program, and program case managers closely supervise the youths/families through daily phone calls and weekly foster parent group meetings. The average length of stay in the program is 6-7 months. The average cost is about $3,600 per month (2008 dollars), which is 30 to 50 percent lower than the cost of residential group care (the typical alternative treatment, in which youths are placed in group homes with other offenders, and often provided family therapy.)

Link for the SPTW Web page about the evidence for MFTC (source for the quoted material) and to the Web site that supports adoption of the program.

The most recent of a series of books examining the characteristics, causes, treatment, and consequences of antisocial behavior in children and youths, this volume by the Oregon Social Learning Center (OSLC) team examines the behavioral processes that build and sustain deviant interactions between children and their families (as well as teachers and others). Professors Patterson and Reid have been working on this topic for more than 40 years and they have examined these processes using many different scientific methods. They have assembled chapters from an all-star cast of people with whom they have worked during that time and the contributed chapters cover both the development of and intervention in antisocial behavior.

Reid, J. B., Patterson, G. R., & Snyder, J. J. (Eds.). (2002). Antisocial behavior in children and adolescents: A developmental analysis and model for intervention. Washington, D.C., American Psychological Association.

Learn more about the book from a page on the Web site of the American Psychological Association. To learn more about the OSLC, check the link in the sidebar. During my graduate studies, I worked with this research group for a bit more than a year; I learned a tremendous amount from the interactions and readings I had during that period.