At Risk Children
Professor and Director
Dr. R. G. N. Laidlaw Research Centre
Institute of Child Study
Department of Human Development and Applied Psychology
OISE /University of Toronto
TABLE OF CONTENTS
CASE STUDIES: INSTITUTION BASED MODELS
CASE STUDIES: COMMUNITY BASED MODELS
Los Angeles, California
Youth And Family Centers, Dallas, Texas
San Antonio, Texas
FINDINGS AND CONCLUSION
REFERENCE LIST AND SELECTED BIBLIOGRAPHY
PARTICIPANTS, KEY INFORMANTS AND RESOURCE LIST
In reviewing the literature on school-linked services since
the 1970s, it is clear that in spite of good intentions, attempts
to link schools to other human service agencies have revealed
the difficulty of implementing systemic educational change. Franklin
and Streeter (1995) have outlined five emerging alternative models
for linking schools and services: informal, coordinated, partnerships,
collaborations, and full integrations. However, Knapp (1995) concludes
that it has proven very difficult to institutionalize any of these
linking initiatives. Despite strong advocacy and clear recognition
of need, schools remain narrowly focused and protective of their
turf (Adelman and Taylor, 1997). Despite years of evaluation,
service integration has not led to demonstrable cost savings,
better use of facilities, or reduced bureaucracy at a level or
on a scale that would count as a fulfillment of what has been
promised by advocates (Crowson and Boyd, 1993; Chibulka and Kritek,
1996). Fears over loss of autonomy and power remain seemingly
intractable barriers to social and educational change (Fullan,
The promise of a package of coordinated services that would provide more, while using the same (or fewer) resources, however, continues to have obvious appeal. As part of his argument for the "school of the twenty first century" to act as the hub of services, Ziegler (in Kagan and Weissbourd, 1994) noted that we have both knowledge and resources enough to do what is needed to help children and their families. The issue is not one of lack of resources but of fragmented and uncoordinated services. Children have complex problems and multiple needs that are not well served by specialized and categorical services (Richardson, Casanova, Placier, and Guilfoyle, 1989; Donmoyer and Kos, 1993; Dryfoos, 1994; APA, 1996; Burt, Resnick, and Novick, 1998). Hence, service integration is the sensible and appealing symbol for ways of increasing efficiency and availability. Efficiency involves matching needs with resources. Availability refers to coordination and accessibility of services. These extended supports are an important aspect of the ability of teachers to address the full range of students needs.
This report addresses the following research questions delineated in Section: 7.0 (Special Needs/At Risk) of the Ministry of Education and Training's research priorities for 1998/1999.
Linking school services to other service agencies and community stake-holders is part of a strategy to deal with changes in society. Transformations in the family, social isolation, and loss of community have revealed the ineffectiveness and inefficiency of fragmented responses from educators and other human service providers (Schorr, 1997; Sefa Dei, Massuca, and McIsaac, & Zine, 1997; Volpe, Clancy, Buteau, and Tilleczek, 1998). School-linked services are part of a larger movement for the reform and integration of education, health, recreational and social services. Uncoordinated services have clearly shown themselves to be deficient in their ability to produce desired outcomes (Evans, Hurrell, Lewis, and Volpe, 1998).
Diversity and fragmentation have challenged our ability to deliver educational, health, and recreational services. Linking school services to other services is part of an effort to re-knit communities (Volpe, 1995). As a consequence, the terms partnership and collaboration in human service delivery are used throughout government. These terms cover a host of system reform perspectives that include school-linked services, co-location of services, school-based clinics, one stop shopping, wraparound services, seamless services, and comprehensive school health (Swan and Morgan, 1993). Although the term school-linked services will sometimes be used in this report, service integration is the most inclusive and widely used term. In many discussions of service coordination it subsumes the creation of more effective connections between parents and teachers, increased parental involvement, the development of communities of learners, closer community governance of schools, vigorous outreach initiatives, and a variety of work-study combinations.
Kahn and Kamerman (1992) define service integration as "a systemic effort to solve problems of service fragmentation and of the lack of an exact match between the individual or family with problems and needs and an intervention program or professional specialty, with the goal of creating a coherent and responsive human service system."
Although service integration has been attempted since the turn of the century (Sutherland, 1976), most contemporary formally evaluated second generation projects began in the 1970s and 80s. Many of these early efforts at system reform have given way to a "third generation" of service integration efforts.
The first generation of school-linked children's service integration occurred in such efforts as the Progressive Education, Public Health, Mental Hygiene and Child Study movements in the 1920s and 30s. Educators, nurses, social workers, pediatricians, and psychologists established school-based clinics and implemented preventive interventions (Volpe, 1990). The second "post World War II" use of integration as an organizing principle is about 25 years old. This form of integration was more top down than bottom up with governments awarding demonstration grants sought to link two or more service providers to allow for more effective individual or family treatment.
Current service integration efforts combine top down and bottom up initiatives that reflect reforms that are being sought across the whole spectrum of human services. What characterizes the real difference in these efforts is the extent to which they are more targeted and community focused (Volpe, 1998). These changes, called "new wave" (Crowson and Boyd, 1993; Waldfogel, 1997), reflect lessons learned during the earlier pilot and demonstration phase. Shorr (1997) notes that most of the programs initiated during this phase have disappeared along with a naive optimism in regard to total system.
The case studies presented here extend our knowledge base about school-linked services to include the as yet unreviewed third generation integration efforts. The policy and practice significance of this undertaking should be derived from having available descriptions and analyses of models of mature third generation effective service integration.
Service integration involves a complex range of activities and practices, and therefore, reform to service delivery models must be understood and described in terms of that range, including type, level and locus. Type refers to policy, governance, management (administrative) and front line reform. Level examines the layer of government (local, provincial, state, or federal)at which change is undertaken. Locus looks at whether reforms are intra or inter professional, agency, or school (Kagan and Neville, 1993). The creation of context sensitive case studies of models of effective school-linked services that will have applicability to Ontario's needs required a data gathering design that depicted explicit and implicit models by describing both the structures and processes (power dynamics) associated with linking schools and social services.
This project is a study of integrated services using existing information obtained through a collaborative identification of local and national programs and policies obtained by contacting key informants (government and foundation officials, project directors and program officers). Document examination and key informant interviews were used to gather the latest information on third generation children's service integration initiatives. The key informant technique traditionally refers to the intense interviewing of knowledgeable community members to obtain various forms of information (Tremblay, 1982). In this survey, the interviews were largely semi-structured telephone interviews designed to elicit program nominations, descriptions, and consent to supply policy, program, and evaluation reports. After interviewing key informants, exemplary practice nominations were selected. Selection criteria included the following: credibility of source; reputation; frequency of referral; region; and clarity of policy articulation. Once selected, informants were asked to provide policy, implementation and evaluation documentation, and where available, project descriptions, year-end reports, and video coverage. Case study reports on sites, projects, and programs were created on the basis of interviews and careful examinations of submitted documents.
The following are examples of entry questions for key informants acting as referral agents:
· To what extent do your various departments or ministries (health, social service, and education) working on behalf of children and families collaborate? To what extent can they be said to be integrated?
· What are some of your best examples of practices that illustrate your work in these areas?
The most consistently nominated and highly recommended programs were defined as effective and subsequently selected for telephone interviews of stake-holders. Information in four principal areas of implementation was sought:
· at the mandating level, information was collected on legal frameworks and policies (local and national);
· at the strategic level, data was gathered from senior managers and coordinators on the functioning of identified services;
· at the operational level, information was sought on issues such as budget and personnel allocation, and their relationship to problem identification and prioritization; and
· at the field level, data was gathered on the way in which services work in practice, including the service delivery process and outcomes for professionals and clients.
The rationale for this approach was twofold. First, it provided
the description of select nominated programs. Second, it provided
a comprehensive referral resource list of nominated programs,
their addresses and primary contact persons.
The resulting case studies reflect program materials, evaluation reports, and interviews with policy makers, program managers, staff, and clients. The overall report and each case study are organized in terms of the Case Study Evaluation Model (Volpe, 1996).
Case Study Evaluation Model
Service integration can be implemented on three levels. The first level consists of multi-disciplinary cooperation and decision-making to serve individual children and their families. The second extends interagency coordination through formalized relations that concern decisions affecting entire programs. The third is the most joined level of service provision that involves all parties sharing both means and ends. All levels of integration require considerable cooperation and communication. Since integration is a multidimensional process which can take different forms, it requires an evaluation model that incorporates the following dimensions:
· Organizational Climate: The atmosphere that surrounds the administration and provision of services reflects the priority given to cooperative and collaborative undertaking between agencies.
· Allocation of Resources: The distribution of suitable resources to interagency work seen in the way money, personnel, and space are allocated.
· Principles of Practice: The rules and policies governing practice including the existence and generation of protocols, regulations, guidelines, and agreements will reflect the priority given to service integration.
· Personnel: The success or failure of coordinated efforts is to a large extent determined by the people involved. The levels, qualifications, and commitment of all involved personnel are helpful indicators.
· Program Implementation and Operation: The extent to which service providers are able to communicate, meet together and share decision-making can be determined to be either supportive or undermining of collaborative efforts.
· Organizational Structure: The way decision-making and resource allocation functions are structured will determine the extent to which agencies are able to maintain the flexibility and adaptability to work together and be responsive to the real needs of all community participants.
The integration of services involves a number of challenging policy concerns such as the nature of access, local planning, priority setting, funding and accountability. Thus, the evaluation of integrated services requires a complex evaluation framework. The Case Study Evaluation Framework is such an approach. It provides a means of organizing complex information collected via a number of methods. This Framework can form the case record on which multilevel case studies depicting models of school-linked services can be derived.
The Case Study Evaluation Framework is based on an approach originally conceived by Stufflebeam (1983) as a way of moving evaluation research away from a narrow focus on whether programs achieved their stated objectives to a more constructive emphasis on the general information needed for decision-making.
Unlike Stufflebeam's examination of context, input, process and product (CIPP) as discrete evaluation areas, the Case Study Evaluation Framework treats them as a dynamic system. The emphasis of this approach to evaluation is on describing means/ends and intended/actual dimensions of service delivery. Each of the CIPP areas are presented along with illustrative questions that are put to existing data sources and confirmed with key informants.
The first major heading, Context, looks at that which is of relevance surrounding a program, and includes the background of program objectives, the environment and events surrounding the development and implementation of a program or service system. Included under this heading are previous research and evaluation studies, socio-political occurrences, and community reactions. More specifically, Context includes the apparent need for service, the legal mandates that exist in a given community, the preparation and practice traditions of associated professionals, and the existence of special funding opportunities. The primary orientation here is to describe the history and background of a service program. For the case study it is important to note how the program has been, and is currently, perceived by clients, associated professionals, and sponsors. The intended ends of the program are determined in association with the needs, issues, and opportunities available to the program designers. These decisions are usually articulated as goals and objectives.
· When was the program devised? (History and background of program)
· Who initiated the program staff, board, community school partners?
· What were the original goals and objectives?
· Can you describe the academic environment or events that surrounded the development of this program?
· What were the community reactions at the time?
· What were the reactions of the school personnel?
· What were the problems at the school prior to the program implementation?
· How is the program perceived presently by clients, associated professionals, and sponsors?
· Can you describe the community surrounding the school?
· Who are the chosen community partners?
Input deals with the nature and kind of resources developed for, and allocated to the sites. Inputs to the program involve the commitment of financial resources and the choice of the strategies employed in the delivery of services. In this dimension it is useful to note what alternative implementation and service delivery strategies are actually available. Important here is making clear the procedural design of service delivery activities and special protocols for interagency collaboration. The intended means by which articulated aims are to be achieved involves outlining procedures to be followed by providers via a series of structuring decisions.
· What financial resources and strategies are employed in the delivery of services?
· What are the special protocols for interagency collaboration...procedural design?
· Have you outlined procedures to be followed by providers via a series of structuring decisions?
· What were the kinds of resources developed for and allocated to the sites?
Process involves answering the "how it's done" questions of interpersonal relations and power dynamics with respect to the governing, administrating, managing, implementing, and practicing. Process refers to the way implementation is guided on the operational level and requires a look at what sort of checks on implementation have been made, and what evidence exists as to the relation between what was intended in a program design and what actually exists. The monitoring of programs gives feedback and enables adjustments between what is intended and what actually happens on the ground.
· How is feedback structured and given to management and front line services, teachers and students?
· What sort of checks on implementation have been made?
· What evidence exists as to the relation between what was intended in the program's design and what exists today?
· How and when are adjustments to the program made?
· Who attends meetings? Frequency of meetings devoted to the program.
Finally, Product includes the observable impact and outcome effectiveness of service coordination attempts. Further, analysis of this phase provides summative interpretation, conclusions, and recommendations derived from the obtained data. Product examines the actual practices of both professionals and clients. This component asks how practitioners, participants, and observers judge the attainments of the program. Included here are the actual outcomes of service delivery. Both long and short term outcomes are of interest. Legitimate vantage points for measurement, interpretation, and judgement can be achieved by obtaining information from both individuals and aggregates of stake-holders. Also important is the need to examine the relation of intended ends and unanticipated positive and negative outcomes.
· How do practitioners, participants and observers judge the attainments of the program?
· What are the short term and long term outcomes of the program?
· What were any unanticipated positive or negative outcomes of the program?
· How do you measure success or effectiveness of the program?
· How did the program provide documentation to the Board or Department of Education?
The collection of information for the case studies has, therefore,
been derived from a variety of resources and employed multiple
methods. The application of this material aims to provide a coherent
depiction of a program or service delivery system models in terms
of the interplay of their aims, structure, process, and product.
The Case Study Evaluation Framework makes service integration
models available for comparison and contrast which, in turn, aids
decision-making (Volpe, 1996).
In addition to using the Context, Input, Process, and Product designations, the following case studies have been divided as to their origin in either Institutions (Schools, Boards, or Governments) or Communities (Foundations, Business/Corporations, or NGOs).
INSTITUTION BASED MODELS
THE INTEGRATED RESOURCES IN SCHOOLS INITIATIVE
The School Mental Health Project (SMHP) was created to pursue theory, research, practice, and training related to meeting the mental health needs of students through school-based interventions. In 1995, the Department of Health and Human Services (Public Health Service, Health Resources and Services Administration, Bureau of Maternal and Child Health, and the Office of Adolescent Health) implemented a major initiative to foster mental health in schools. Five statewide, multi-year projects and two national and Technical Assistance Centers were established. The purpose of these Centers is to improve how schools address barriers to learning and to enhance healthy development. The two national health centers are the Center for School Mental Health Assistance at the University of Maryland at Baltimore and the Center for Mental Health in Schools at UCLA.
In October of 1995, Kentucky's Department for Public Health was awarded a grant from the Federal Department of Health and Human Services, Maternal and Child Health Bureau. This grant charged Kentucky along with Maine, Minnesota, New Mexico, and South Carolina to look into their existing infrastructure and examine ways to do more for the mental health of children. In this report, Kentucky and Maine's initiatives will be examined. All five states are involved in the development of model sites that include school-community collaborations and that aim to enhance the availability and accessibility of services.
History and Development: The Integrated Resource in Schools
Initiative (IRIS), Kentucky
IRIS, Kentucky's primary prevention initiative, was established to address the mental health, prevention and early intervention needs of its children. The project is designed to address a significant problem in Kentucky's human service systems. The health, education and mental health systems are structured and funded to carry out their vital roles with limited integration or collaboration at the community level. The initiative was designed to build upon the Kentucky Educational Reform Act (KERA) which encompasses school-based health and social service reforms. IRIS focuses on creating solutions through a state and local partnership that address gaps and barriers to integrated delivery of primary/preventative mental health services in a school-based or linked atmosphere. The family and the community are viewed as the engine for system design and delivery. The goals of this project are to:
· establish and expand the prevention focus of the state level infrastructure, reducing fragmentation and increasing coordination at the local level;
· create an environment for the delivery of primary preventive mental health services that are school-based or school-linked, flexible and centered on the child and family; and
· implement mechanisms to build long-term capacity to support integrated prevention and early intervention efforts among schools, health centers and mental health centers.
These goals are guided by a holistic approach to service delivery
and prevention efforts centered on families and children and to
encompass physical, mental and social health.
In order to be selected as a demonstration site, the communities submitted proposals exhibiting a desire to work in a collaborative manner. After a site selection process three pilot communities were named for the IRIS project:
· Blaine, located in Lawrence County;
· Liberty, located in Casey county; and
· Owensboro, located in Daviess County.
Later, a fourth site, Radcliffe, located in Harden County,
approached IRIS for technical assistance. This site integrated
funding in order to support its own coordinator and was accepted
as an IRIS pilot site. Telephone interviews were conducted with
the Coordinator for the four IRIS sites and with the IRIS Site
Coordinator at Foust Elementary School in Owensboro. Therefore,
examples from this school will be used to illustrate the IRIS
Initiative in Kentucky.
In November 1996, local councils from each of the pilot sites and the IRIS Advisory Team (representatives from each partner agency or organization) came for their first IRIS statewide training. Forming focus groups, they began the process of identifying where the existing prevention and early intervention system changes should occur in order to support their communities. In April 1997, the councils presented to the Advisory Team, outcomes they felt would help enable them to fulfil the IRIS mission. Suggestions were later presented to the State Inter-Agency Council (SIAC) which is made of commissioners who represent various agencies. The SIAC created a System Change Work Group to flesh out ways for achieving those outcomes.
The Coordinator of the four pilot sites affirmed that this initiative is unique because the focus shifted from providing direct services to strengthening existing services using an interagency approach. IRIS is interested in examining how to change systems with the goal of reducing fragmentation. An environmental approach to primary prevention is emphasized; hence, this initiative is driven by the needs of the community, families, and peers. The "I Am Your Child" campaign on early brain development and the Developmental Assets Model from the Search Institute are two methods used by this initiative and provide strategies to establish primary prevention as a way of life. Early Brain Development is exemplified in Casey and Harden Counties, and the Developmental Assets are promoted within Owensboro. The aforementioned goals are achieved by educating and training the community at large to find ways to build upon their existing "assets" as opposed to concentrating on the "deficits". Inherent in this approach, is the view that the family and the community is the engine that drives the system.
Foust Elementary School
Foust community is home to 6,000 persons. The elementary school's student population is 39% African-American and 23% Caucasian. Foust Elementary is a Title One School, meaning that government dollars are provided for free lunch and breakfast for eligible students. This community is described as the most ethnically diverse in Owensboro. The average years of education of its residents is 10.5 and majority of the families are in the low to middle income range.
In order to be elected as an IRIS site, the community needed to evidence efforts of service integration. Within Owensboro, a collaborative effort was displayed in the development of Family Connections, a resource center in partnership with schools, founded in August 1997.
Three individuals saw a need for a collaboration of partners (community leaders). Therefore, the Human Development Council inventoried existing services and agreed that the community had a myriad of good services; however, they lacked service coordination and communication. As a result, the development of neighborhood based service centers (these centers were to coordinate existing services providing an integrated system of delivering services) was recommended. Owensboro County was chosen to house these centers and the service center opened within Foust Elementary.
A survey of 129 homes was conducted to determine the community's needs and concerns to be addressed. This survey formed the base for the majority of the work. The Site Coordinator describes the school as the "hub of the community, and therefore Family Connections is the closest thing to a community school".
Funds for the IRIS Initiative were granted to the Department for Public Health, which worked collaboratively with the Department for Mental Health/Mental Retardation and the Department for Education. Department for Mental Health houses the initiative's state staff, and the Department of Public Health provides personnel to direct the initiative. Eastern Kentucky University administers the funds and the Department of Education opened its doors to Early Brain Development and the KISSED training programs. The KISSED program is focused on training for teachers in the social and emotional indicators of development.
The Hager Educational Foundation provided the initial grant to begin Family Connections, and also gave money to support the coordinators' position and training for three years. The Cabinet for Human Resources also provided dollars to purchase computers and hire network support people. For this program, the Owensboro's Board of Education provided space and up-front administrative work.
IRIS consists of three standing committees and one ad hoc committee: the Communications Committee, the Evaluation Committee, Technical Assistance and Training Support, and the Site Selection and Ad hoc Committee. The Advisory Team is composed of representatives from various agencies involved in the partnership such as the Administrative Office of the Courts, Champions for a Drug Free Kentucky, and the Commission on Human Service Collaborative. The Advisory Team oversees policy development and provides advice to the IRIS Project Director, the IRIS staff and the local councils as requested.
Each of the three communities has a local council made up of a representative from each of the participating partners. Education, Health and Mental Health are represented, among other collaborating partners, depending on the community.
A consensus decision-making process is actively employed. Each site has local control in decision-making. The Project Coordinator expresses that consensus can be reached because everybody on the Team shares the same vision: a focus on outcome (quality mental health). However, protocol does exist when a decision cannot be reached.
In Kentucky, collaboration is extremely necessary and is expected. The existence of a Commission on Human Service Collaborative at the secretarial level is indicative of how an interagency approach is part of Kentucky's culture. However, territorial issues arise when so many different stakeholders are involved, and this can impede the collaborative process.
Developmental Assets Model adopted by IRIS
The Developmental Assets model (D.A.), developed by the Search Institute in Minnesota (a research institute of child and family) informs the strategies used to build long-term capacities to address the gaps and barriers in the integrated delivery of mental health services and to promote preventative mental health. In this model, forty Developmental Assets or building blocks (what child needs to develop into a healthy and responsible citizen) were identified. Search conducted a scientific survey entitled Profiles of Student Life in 1996/97. Surveyed were 100,000 students in grades 6-12 across the United States of America. External D.A (e.g. support, expectations) and internal D.A. (e.g. commitment to learn, positive values, social expectations) are identified by this research. Correlations between the number of assets one exhibits and the probability of behaviour can be determined through this survey.
Training and educating the community at large and implementing preventative approaches to mental health are methods used to promote this model. Underlying this approach is an attempt to shift the community's perspective towards an assets/strengths versus a deficit orientation. The purpose of this is to promote a framework that encourages positive interaction between adults and youth. This approach makes everyone responsible for raising children; "it takes a village to raise a child". It is an empowering, strength-oriented, and supportive framework to organize any service, program, or organization.
In Owensboro, strategies that have been most effective in enhancing an interagency approach to preventative mental health in community schools include:
· a supportive environment: the relationship among partners and the support they exhibit towards each other is the largest contributing factor in the success of a shared vision;
· communication: including feedback from residents and continuous surveying of needs;
· physical structure: located in school, accessible to community;
· community based workers on line with state: casework in state system;
· interagency agreement: sharing information, signed by other agencies, for example, Family Connections has a confidentiality agreement so all partners share information, and students and families have a choice regarding what agencies they will allow information to be disclosed to (such tools help facilitate collaboration);
· a team approach;
· trust; and
· aligning with each other, sharing information and concerns.
Attitudes toward youth were identified as possible barriers in promoting the D.A. and environmental approaches to primary prevention. Other identified obstacles within Owensboro include resistance to mobilizing the community and to administering and completing surveys, as well as resistance to the acceptance of survey results.
The largest challenge cited is assessment and evaluation of this initiative. Evaluations need to be structured around program objectives to show the initiatives' effectiveness. Longitudinal data is needed to show the impact of primary prevention approaches to mental health and since the initiative is still new, such data does not exist.
In Owensboro, evaluation and feedback occur on informal levels. Measures of effectiveness include speaking to people regarding whether and how their needs are being met, developing interest groups (e.g. positive role models-community driven), and recording hard data on the number of persons served and cases closed. Observable effects have included empowered residents, increased self-respect, families motivated to be self-sufficient, the elimination of duplicating services, and the creation of preventative approaches to mental health. Problems arise in the administration and in the blending of interagency rules and regulation. However, measurable indicators for success are still needed.
An outside evaluator, from REACH of Louisville, has conducted a baseline evaluation about what is going on in the community and what the needs are. Follow-up evaluations are conducted and compared to this baseline report to provide feedback about the impact of IRIS in Owensboro.
This project has implications for future school-community collaboratives. It is IRIS's vision that primary prevention efforts will be integrated into all systems and more respect and understanding for community needs will be accomplished by an approach to mental health that is integrative and preventive.
SCHOOL-LINKED SCHOOL-BASED MENTAL HEALTH SERVICES
Maine is one of five states to receive a multi-year State-Level Partnership Grant Award from the Federal Department of Health and Human Services, Maternal and Child Health Bureau. The purpose of this grant is to help Maine develop an infrastructure at the state level which will enable schools to increase mental health and substance abuse services including prevention, identification, early intervention, and treatment and referral services for students through school-based health centers or school-linked health centers. Infrastructures are the basic facilities, equipment, and installations needed for the functioning of a system. Primary state level infrastructure components targeted by this project are financing, training/education, program development, data and evaluation, and local level implementation.
The fragmented nature of service delivery was well recognized in Maine, and, locally, a need for support services in the Health Centers was identified. Conversations regarding the need for an integrative and collaborative approach to service delivery began among the Department of Human Services, the Department of Education, and the Department of Mental Health and Retardation. As a result, the Department of Human Services, Division of Maternal and Child Health applied for federal funding. After the grant was received this Project was named the School-Based School-Linked Mental Health Project.
Each site has a unique set of programs, a distinct service delivery system and is focused on developing processes for outcome-based evaluations. The results from these evaluations can be used at the state policy level to improve state level infrastructure in support of school-based and -linked programming. The goals of Maine's initiative are to identify and disseminate information about exemplary practices and programs from the demonstration sites in order to promote a variety of approaches that are effective or that have promise. Hence, six different demonstration sites across the state are supported through this initiative.
As a result of their innovative approaches to service integration and delivery, two sites were nominated for the purpose of this research: Maranacook Community School in Readfield and Penobscot Nation Health Department, Indian Island. The Coordinator from each site was interviewed, and therefore, this case study is a synthesis of the written documents received and of the information gathered through the interviews.
Maranacook Community School
Maranacook Student Health Center
The coordinator of the Maranacook Student Health Center describes Readfield as a rural area, in which Maranacook Community School serves four towns. The State Capital, employer of many of Readfield's residents, is located 10 miles from Maranacook Community School. The family income and socio-economic status in this area range from working-class poor to affluent. The school is predominately white and houses students from grades 7-12. Two percent of the school population is non-white (i.e. Asian/African-American). In Maine, School-Based Health Centers have been in operation for twelve years and Maranacook Community School, in its sixth year, is one site that houses this project. This is the second year for Maranacook as a demonstration site for the School Mental Health Project (SMHP), 1997-98 and 1998-99. With funding from this Project, services of the Health Center have been expanded to increase mental health, counselling, early intervention, and preventative services.
The Maranacook Student Health Center (MSHC) provides medical services including diagnosis and treatment for acute care as well as management of chronic illness to all students. Medical staff provide prescriptions or medication on-site. Health education and preventative health care such as sports physicals are also available. The MSHC provides increased access to primary care and behavioural health services for adolescents and is located at the school. MSHC services are available for all students and are provided by the school nurse. Expanded services are available for students if their parents choose this option. A physician assistant or a licensed counselor provides these services. Various payment options are available for the expanded services. These options are:
· there is no fee if the student is enrolled in a managed care (IIMO) Health Insurance plan, or in Medicaid, or is eligible for free or reduced cost lunch;
· the students' family can choose to have the Health Center bill their private health insurance;
· if the family does not have insurance, the Health Center can bill the family directly; or
· the family may choose a one time $60.00 annual fee for the entire school year.
The School-based Mental Health Project
At the local level, health center staff, guidance staff, school administrators, and three public mental health agencies in the community had already formed collaborative working relations with each other and joined Maranacook Community School as a partner in the school's initiative to increase services in the student health center. The three agencies formed the School-Based Behavioral Health Collaborative (SBBHC).
As a result, in the first year of the SMHP, individual and family counselling was implemented. This was followed by crisis intervention, drop-in services, and educational seminars in the second year. The collaborative organizations bill for their services through their home offices. The availability of flexible funding has enhanced the model which in year one was treatment focused to allow for more primary prevention (e.g. educational seminars for staff, parents, and students) and early intervention strategies (more educational support groups and drop-in hours).
The Collaborative offers on-site mental health services. These services are available three days a week and include individual, family, and group counselling; substance abuse assessment and treatment; consultations to staff; referrals for off-site treatment; educational seminars for students, staff, and families. The SBBHC works with school staff, family, and community providers to refer students and their families to community services as needed. A holistic approach to a collaborative and integrative service delivery system is evidenced at the SBBHC through the established services and programs designed and delivered within the context of the community, family, and individual. Maranacook's initiatives in school-based health care reduce barriers to learning by providing and coordinating services that address all the health needs to enhance students' ability to learn.
Penobscot Nation Health Department, Indian Island
At this demonstration site, a school-linked model of service delivery is employed. The social services agencies involved work together to incorporate culturally sensitive and relevant services as best practice strategies in their daily work. According to the Clinical Supervisor and Program Director of Counseling Services, Penobscot Nation Health Department was chosen as a demonstration site for the School Mental Health Project because of its application of a school-linked model for a Native American population.
Indian Island is a Native American Reservation. The Island's population is Native American who qualify for direct services if they belong to any federally recognized Tribe in the United States. An elementary school is located on the Indian Island; however, the children must leave the Island to attend the public high school. The community is largely working class and the main source of economic stability is the paper mill.
With the help of the School Mental Health Project, an existing primary prevention program at Penobscot Nation Health focused on the prevention of drug and alcohol abuse, is being expanded. The Health Department is also looking at ways to address the transition that the children make from the school system, on the Indian Island, to the larger public school system. A bridge that connects the Island to the town is seen as a metaphor that describes this transition. As explained in the interview, when the children leave the Island to attend high school they tend to face academic or social difficulties as a result. The goal is to understand the impact of this transition and to determine how the Health Department can intervene to reduce any barriers to social and academic development.
Maranacook Community School
The Student Health Center
Originally, the MSHC was funded through the Department of Human Services, Division of Community and Family Health. Currently, the Center is supported with additional funding from the Kennebac Valley Medical center, Blue Cross/Blue Shield, Health Source, Medicaid and other 3rd party reimbursement, and annual fees. Other funding sources for the Health Center include in-kind contributions from the school system valued approximately at $50,000. A full-time nurse, health center space, and maintenance are examples of what these dollars have funded. Various grants and billing options provide support for the medical director, physician assistants, health center coordinator, health center supplies/expenses, and professional development.
The School Mental Health Project
A flexible service model for billing and funding is used. The on-site collaborative counselling staff bill their respective agencies directly. The schools can also buy services. For instance, they can purchase trained staff time to conduct educational groups on substance use or eating disorders. The grant for $15,000 received from the School Mental Health Project is used to support drop-in time and crisis intervention; enhance primary prevention education and early intervention efforts in mental health and substance abuse; and to support a portion of the Health Center Coordinator's time.
The agencies providing services as part of the School-Based Behavioural Health Collaborative include the Kennebec Valley Mental Health Center, Crisis and Counseling Center, and HealthReach. These three agencies responded to Maranacook Community School as a group and are partners in school-based health care.
In most school-based health care settings, a community medical provider from a rural health center or hospital, operates the Health Center. The medical provider is responsible for providing the health care staff to the school, assuring quality of service, and providing medical supervision to the staff. Centers are staffed by nurse practitioners and by physician assistants. Medical providers work within the school setting to increase student access to prevention and early intervention services. Staff are recruited based on their experience working within a school system and with adolescents, and receive an orientation to the school, to the Guidance Department, and to the Health Center.
Penobscot Nation Health Department
The Tribal Agencies, tribal members from the community, are the most cohesive and coherent partner in the collaborative effort at Penobscot Nation Health Department. They form the "concentric circle" or inner circle, and surrounding them is the larger circle. This outer circle is comprised of community members from other agencies such as the Psychiatric Hospital and the Detox center. Political support for an integrated approach comes from both the Bureau of Indian Affairs and from an Indian Health Research oriented branch out of the University of Southern Maine, which focuses on innovative public policy. The University of Maryland and the University of California offer technical assistance, professional development and training in areas such as data collection methods and grant writing.
Geared towards providing services for families and children are educators, human service providers, and clinicians. Multidisciplinary Team meetings are held for half a day every week. Part of the function of the Team is to exchange referrals, conduct multidisciplinary assessments, plan programs and treatment. Present at these meetings are the Health Center staff, the counselling staff, the physician, the medical staff, the Tribal Department of Human Services, Child Protective Services, the school counselor, and other people as needed. In the past these meetings were more inclusive. For instance, the Tribal Core, the nutritionist, and the pharmacist also attended. However, confidentiality problems surfaced and this strategy was abandoned.
In a 30-hour week, the Health Centre director functions as a clinical supervisor, program manager, prevention specialist, and a direct service provider. Also employed are a consulting psychologist, two full-time native counsellors (a male substance abuse counsellor, and a female mental health and substance abuse counsellor). A part time non-Indian female counsellor for substance abuse and mental health, and a part-time tobacco educator/prevention specialist, also staff the Health Center. The Health Center staff provide clinical services for the Native children at the local high school because that is where the students and the services are most easily accessed. When asked if resources were lacking, the Health Center Director expressed that an ideal would be to have more staff, such as social workers, but otherwise, that the Health Department functions well with the resources they currently have.
Maranacook Community School
The School-Based Health Centers operate under the guidance of a locally controlled Advisory Board. The Board broadly represents the community, including parents and students, and is directed by the local medical director. Parent and student advisory committees identify needs and offer guidance to the Board before decisions are reached. Collaborative staff, administrators, and the Health Center Coordinator also meet monthly to discuss systemic and programmatic issues of the SBBHC.
As described in the interview, this SBBHC collaboration effort initially went through a "honeymoon" period; however, certain growing pains were experienced this year. For instance, partnering agencies stipulate that clinicians have billable clients every hour, although, in a school system, counselors do not always have a full caseload. The Coordinator is responsible for pulling together and facilitating meetings to hammer out such issues. A consensus decision-making process is employed. Open communication, regular feedback (satisfactory surveys from students, staff, and parents) and active listening are all strategies that enable consensus to be reached. The importance of identifying and involving key people in the collaborative process from the onset is recognized and strongly adhered to as a lesson learned. At Maranacook, Community School meetings are held with every grade level staff, guidance staff, special education staff and administrators on a regular basis to get a sense of concerns. These tactics lay the necessary groundwork for a smoother transition to working collaboratively and for minimizing conflicts related to process.
Penobscot Nation Health Department
In the past, the United States Bureau of Indian Affairs, a separate governmental jurisdiction, and the Indian Health Service signed a joint memorandum stating that the Tribes have the authority to do what's necessary to help the students and their families. This memorandum served as an impetus for the Tribes to set up multidisciplinary treatment teams. Today, the Multidisciplinary Team meetings at Penobscot Nation Health Department are held on a regular basis. Cooperative agreements signed by the different programs and agencies involved, help facilitate the sharing of information.
Positive relations, developed with the Dean of Students at the public high school, have helped the Health Department with accessibility to the adolescents there. For example, formal drop-in time for counselors to meet with the students individually and in-groups has been established. This has further fostered a strong collaborative working relationship with the school.
Due to the small size of the Island population, client confidentiality does become an issue. At times, during team meetings, clients' names are not disclosed at their request because the clients know the team members. To deal with such issues, clear boundaries and signed consent forms are required. Formal processes, however, do not exist at present within the collaborative team for conflict management.
Those involved in the collaborative have worked together for many years, so when conflict does arise, non-written systems for working through the disagreements are in place. Minor conflicts are worked out informally and through personal conversations. The culture of the people on the Island is mirrored in the working relationships of the staff at Penobscot Nation Health Department by the use of open, direct, and personalized communication. When advertising or promoting a program, for example, "flyers can be sent, bill boards can be posted or the Good Year Blimp can be flown . . ." However, no one will attend unless personal invitations are extended. Hence, decision-making and conflict resolution/management strategies at the Penobscot Nation Health Department involve speaking and listening to each other in an informal and respectful manner.
Structurally, there has been little reorganization; however, reorganization in relationships has occurred over the years. Changes in relationships are mainly reflected among service providers. For example, past efforts to establish a prevention coalition have failed; however, now with changes in personnel and the grant from the SMHP, a positive reconstruction in relations and attitudes has occurred to allow this coalition to proceed with development.
The systemic problem in education is selling the concept to teachers who already have a lot to do, ". . . everything from teaching arithmetic to brushing teeth . . . and dealing with mental health problems . . . it's just one more thing" added to their plate. Most significantly, with the onset of the SMHP initiative, a mutual language that can be shared among service providers, educators, and other professionals has developed. "Rather than speaking about mental illnesses, problems and deficiencies . . . the term 'barriers to learning' is used". This language sensitizes teachers to the issues of schooling contextualized in social, community, and family development. Teachers are interested in 'learning', not 'paranoid schizophrenia'; hence, this new language is a major contributor to integrating and mediating the different systems involved in this project, namely mental health and education.
Maranacook Community School
Evaluation data is vital in order to document impact and to provide feedback for program improvement. Evaluation at Maranacook Community School is ongoing. In the second year of the project, it is evident through verbal feedback that parents are not feeling as involved. Hard data are compiled on a regular basis. For instance, statistics on the frequency of use of services, and the percent usage of services by grade level and gender are recorded.
Penobscot Nation Health Department
The Native American population on the Island experiences surveys and questions as intrusive. "The normal quantitative types of data collection does not work well in this environment, because story-telling is more culturally relevant". Therefore, in order to determine the impact of transition from the Indian Island school to the high school, data that is in the form of stories will be collected. A predicted barrier to research is developing outcome-based reporting required by the State and grantors.
The School Mental Health Project enables the Penobscot Nation Health Department to feel part of a larger systemic reform effort. The state level Advisory Board meetings provide an opportunity to network and meet people from the Department of Education, the Department of Mental Health, and stakeholders from other schools throughout the state. These meetings help conciliate the mission that is shared among all those in attendance. The opportunity to network in an environment that is conducive to learning and to brainstorming creative and effective ways to better meet the mental health needs of children and families in the context of education is imperative to the successful development and to the growth of an interagency approach.
THE CHILDREN'S AID SOCIETY'S COMMUNITY SCHOOLS
TECHNICAL ASSISTANCE CENTER
Washington Heights Community School, New York, New York
The New York Board of Education, the local school district, Community School District 6, and The Children's Aid Society have opened four Community Schools in Manhattan's Washington Heights community. The four schools, elementary schools PS 5 and PS 8, and middle schools IS 218 and IS 90, provide coordinated services for 7,000 children and their families in the Washington Heights-Inward area of New York City. The philosophy underpinning the Community Schools' approach is that emotional, social, and health needs all impact on children's ability to learn. The involvement, participation, and sanction of parents are cited as the keys to this process.
Community Schools engage families as early as possible with programs for infants, toddlers, and pre-schoolers, working to both enhance children's learning and their home environments. These goals are also facilitated by providing on-site health care, mental health counselling, advocacy for public benefits, adult education, job training, parenting programs, and after school activities. Community Schools remain open six days a week, 15 hours a day, all year. They serve as a focal point in the community for education, as well as other supportive services, to which children and their parents can turn. They are also known as "full-service" schools or "extended service schools". The goal is to transform schools into new institutions that are primarily focused on educating children, but can also help strengthen the entire community.
In 1987, CAS conducted an assessment of community-based social services for children and families in the Washington Heights-Inward area. The school system in this district ranked low in reading scores and high in truancy, drug abuse, and child abuse reports. Following this, conversations among the Central Board, the Chancellor, and the Community School District ensued. These members were all very receptive to a new approach to schooling based on a premise that academic achievement has a social context. The city was determined to invest 4.3 billion in new school buildings. CAS proposed that if the Board of Education made a new school available, CAS would bring its entire repertoire of services to the school and would help to sustain these services by raising substantial funds to assist defraying their costs.
In 1994, CAS opened a Technical Assistance Center to help others adapt the model. Since 1996, the Center has been providing intensive technical assistance to seven Community School projects. Originally, CAS supported community centers in affluent areas. To raise funds for the new community schools, these centers were then required to be self-sustaining through user fees and therefore the money originally intended for the centers was redirected towards supporting two Community Schools. In this review, information from written documents is supplemented with examples and experiences in the development of Salome Urena Middle Academies, IS 218 as articulated in the interview with the former Director of IS 218.
The Community School Model
A Community School model has emerged at IS 218. It shares elements of existing models but also has unique components.
The Community Centered Model - Shared Elements
· Creation and support of natural helping networks; social worker stimulates and motivates individuals to take an active role in the system.
· All providers are sensitive to the social dimension of health and learning.
· The service recipients are seen as active partners and relationships with practitioners, social workers, and teachers are personalised, informal, and egalitarian.
· Administratively the bureaucratic, hierarchical model is rejected for a management style suffused by a democratic ethos.
Model Elements Unique to IS 218
· An inclusive view of human resource development that encompasses service providers.
· CAS community school director sees staff development as a primary component of her job.
· A longitudinal view of education and service which includes a long-term, if not lifetime commitment.
· Interviews indicate that, like relationships, the working relationship between the principal and the on-site Director of the CAS program needed sufficient time to grow.
· The administrators have to achieve a level of comfort with one another that can be established only during months of working together.
· A needs assessment was conducted.
· Reorganizing education and child welfare systems to include integrated planning for children and families.
A myriad of services and programs were developed to enrich the learning environment of students, parents, and staff.
Parent Support and Involvement
Parents are actively involved in the delivery of services. Social workers, paraprofessionals, graduate students, parents, and other volunteers staff the Family Resource Centers (located within the schools). These Centers provide access to on-site health and learning services, food, housing, legal aid, employment assistance referrals, and immigration assistance. The Centers conduct parenting-skills training workshops, and serve as a central meeting place for parents. Adult Education classes in ESL, literacy, GED, computers, and math, for example, are made available. Parents are also encouraged to volunteer and work on parent committees that are actively involved with school governance. In this setting, parents are able to provide each other with invaluable support.
Innovative Curriculum and Structure
At IS 218, students are divided into four theme-based academies, or mini-schools: business; community services; expressive arts; and mathematics, science and technology. Each academy has two self-contained units with five classes and five teachers who act as advisors. Creative methods of learning such as interdisciplinary instruction, flexible scheduling, and cooperative learning are part of the Community School model.
Extended Day Programs
All the extended day programs are voluntary. Extended day academies tie in directly with what students are learning during the day. For instance, students in the Business Academy have the opportunity to run joint ventures. Art, sports, and recreational activities are available after school for all students, including teen and youth development programs. In the summer many activities and days camps are planned, including teen day trip programs and summer dance camps.
On-Site Health Care
Each Community School has on-site medical, dental, and eye clinics. Children from birth and onward are served. Medical services include primary care, immunizations, first aid, emergency care, and prophylactic medication. Dental services include X-rays, cleanings, and some extractions are also available. Vision and hearing screenings are conducted for every child, and glasses can be obtained from IS 218's eye clinic.
Mental Health Services
To provide these services, each school is staffed with social workers, a part-time psychologist, psychiatrist, and an art therapist. At each Community School, individual, family, and/or group counselling is available. A teen pregnancy program has been launched at IS 218. Also unique to IS 218 is the Peer Mediation of conflicts referred by teachers.
Comprehensive services are made available for children from birth through age 3 and their families. To further involve and develop communities, parent advisory and business councils have been created. Both are locally recruited and provide assistance in building partnerships with community agencies and leaders.
The strategy behind this model is to build school-community partnerships that bring teachers, parents, and community agencies together to ensure that every child enters the classroom ready to learn. Communities must develop and tailor programs that reflect their strengths, their resources, and the needs of their children and families.
The Community Schools in Washington Heights are now funded through a mixture of private dollars, money from the local District and grants. CAS's ability to bring in other partners to take on certain aspects of the program, such as the adult education component, enhances the sustainability and uniqueness of this model.
Potential partners are recruited by and approach CAS. Critical partners identified include school representatives such as superintendents, principals, teachers, staff; community, social and youth service agencies; community-based and comprehensive service agency leaders; parents and other community members; children; and funders.
The school has its own organizational structure, and therefore CAS works with the existing structure. CAS has a full-time Community School Director on-site, who is a Masters level professional, (preferably a social worker). Program Directors help manage the day-to-day operations; for example, one may be responsible for a particular after school program. The Director of Community Schools oversees all nine schools, the two administrative supervisors, the on-site Community School Director, and the Program Directors.
As developed by IS 218, the Cabinet is the governing body and consists of principals, school leadership, leaders from CAS, parents, community, school leadership, and the Community School Director. The Cabinet meets regularly to see how to support the school and its mission. Disagreements are discussed and are hashed out. Partners may view children from different lenses and they may not agree on the most appropriate route; however, there is a consensus on intended outcomes. This shared vision is instrumental in facilitating consensual decision-making and allowing stakeholders with differing philosophies to work together. Also critical, is formal time for meetings to be set aside and the opportunity for informal meetings to be made available. This helps develop trust, which in turns fosters amicable and productive working relationships.
Turf issues are cited as a challenge in such collaborative efforts. A power shift away from the school board and the Principal towards a shared partnership with community agencies and parents is needed to overcome issues of territory. Hence, the system of service delivery needs to be reorganized in order to share decision-making power. Other such obstacles include conflicting working styles, speaking different "languages", and differing priorities. A consensus on common priorities, a vision statement, and endorsing a partner versus tenant attitude, are techniques that facilitate overcoming barriers and obstacles that are likely to be faced in any collaborative endeavour.
Part of developing and maintaining 'interagency-related relations' involves having the ability and the procedures in place to resolve disputes. According to this model, communication that is open and non-reactive, and making sufficient time available to plan, are useful processes that help to minimize conflict and to resolve disputes. Most important to the success in the development of a Community School at IS 218, is a power shift from singular control by the Principal and local Board of Education to a shared partnership with human service agencies. Relationship building is the key to success of an interagency collaboration. Agencies can achieve this by maintaining a visible presence in the school and by providing services from which the entire school-community can benefit. This helps change how people look at schools and how schools perceive the community. A cultural transformation needs to occur in the school and in the community in order to create a new Community School entity. The general difficulty, however, is the lack of time afforded to allow relationships to form and mature. Hence, building and maintaining partnerships between the school and the community as equals may be the most critical and the most difficult part of the collaborative process.
How to Build Collaboration
· Plan together from the start to enhance the level of commitment and understanding of the program's goals.
· Clarify your mission by creating a vision statement, which will outline goals, purpose, and philosophy.
· Set ground rules regarding who will lead meetings, and the decision-making process.
· Start small and build gradually.
· Bring parents in early to mobilize support and build community acceptance.
· Share decision-making.
· Prepare team members to work together by providing training in small interactive groups on team building, shared decision-making, communication, conflict resolution skills, and cultural sensitivity.
· Stay flexible.
In their experience, CAS was able to build positive relationships with teachers and other professionals by maintaining their presence in the school and by taking on specific tasks to support the school. They were also instrumental in bringing in quality services, and helping to increase parental involvement.
How to Maintain Interdisciplinary Collaboration
· start with a legitimate community-wide planning process that is indigenously generated
· provide strong leadership
· include broad citizen and parent involvement
· focus on accountability
· encourage participants to proceed step by step into the collaboration
The obvious benefits of the Community School approach are the practice of a
preventative approach to service delivery and the ability to plan ahead and look at
families earlier in the larger societal context. Collaboration reduces service duplication,
frees up time and funds for additional services, and increases effectiveness of
professional services. However, this process is extremely costly and therefore, building
and sustaining the relationships required for success prove to be a challenge.
Although the longitudinal aspect of the research on the Community Schools in the Washington Heights-Inward is still in formation, two former evaluations of the Community Schools have been conducted by the Fordham University to date. These interim evaluations document the development and processes that support the new learning environment and its early outcomes. The interim evaluation of IS 218 (Robison, 1993) is used as a guide to examine what is happening in the schools and in the community and to determine where the focus needs to be shifted.
The Interim report indicates that impressive results have been connected to the project
(Robison, 1993). After 6 months of operation, many of the program elements are still in the beginning stages of implementation. Nevertheless, many positive signs have been noted to indicate that the project is having at least three intended effects on the children:
· positive attitudes - no graffiti, no truancy, and no destruction of school property;
· academic achievement - increased interest, enriched and experiential grounded curriculum and activities; and
· dedicated teachers and staff; and excellent attendance.
The on-site Community School Director is responsible for filling
monthly reports that address the emerging issues, and assess school-community
needs. Feedback from parents and anecdotal evidence thus far depict
that this model has had an impact on the emotional, social, and
academic development of the student and community members. Higher
attendance rates and levels of participation, and lower mobility
rates are indicators of the success enjoyed by IS 218.
There has been a change in the school-wide culture, which has implications for future application of the Community School model.
The complicating factor in the IS 218 project is the presence of parallel disciplines with differing criteria for assessing their own effectiveness and efficiency, different organizational and professional loyalties, different informational needs, and different central tasks and activity configurations (Robison, 1993). These factors create barriers that have been associated with failures of collaborations. A cultural gap that existed between teachers and the CAS initially reinforced such barriers (Robison, 1993). Key is that all participants want to see every child succeed and that all stakeholders recognize the unique contribution each profession can make to that goal through combined effort and rational deployment of resources.
Essential to success is a committed partnership between the school and school district, social service providers and parents; shifts in the ownership of the school; shared ownership; a seamless network of services; and the expansion of the schools as the center of community life. The capacity and willingness to connect grass-roots efforts to broader sources of support has been identified as an important condition of project stabilization. A new entity must be created when there is a collaboration between educators and social services providers. Collaboration is ongoing and it must be continually scrutinized as it develops. In doing so, many implications for future practice are noted. These include: an influence on professionals' attitudes and methods of service delivery, an impact on how universities prepare professionals, and an expanded conversation about the role of principals, teachers, and mental health workers.
TRAINING AND INFORMATION CENTER FOR THE EDUCATION
CENTER DE FORMATION ET INFORMATION POUR LA
DES ENFANTS DES MIGRANTS (C.E.F.I.S.E.M.)
Languedoc-Roussillon is located in the capital city of Montpellier in southern France. Languedoc-Roussillon has a population of approximately 208,100 including immigrant and nomadic peoples. Compared to the rest of France, this city has a high rate of unemployment. High levels of immigration into this area bring together a host of people with differing cultural and linguistic backgrounds. The racism that was prevalent in France is now less evident as anti-racism movements have flourished. However, problems still experienced in this community concern the lack of understanding towards an immigrant population with diverse linguistic and cultural backgrounds.
The development of appropriate methods of schooling was required to assist immigrant children to succeed in a foreign educational system. Every year the school system opens its doors to approximately 800 new foreign youths. The major impetus in the creation of the Training and Information Center for the Education of Immigrant Children (CEFISEM - Center de Formation et Information pour la Scolarisation) was the desire to see children succeed. From this desire stemmed the need to provide teachers with the specialized assistance necessary to meet the unique needs of immigrant students. As a result, in 1990 the Minister of Education formed CEFISEM, and organized a partnership between this Center and the surrounding schools (circulaire 90-270, October 9, 1990). The Center, established in Montpellier in 1992, aims to:
· provide training for teachers and other partners involved;
· make available members of the CEFISEM within the pedagogical didactic team to the school;
· provide immediate and tailored solutions according to the needs of the teachers - solutions involve assistance in analyzing the situation, making suggestions, training, providing documented resources, and helping to define particular projects; and
· help the school with administrative-related duties.
In 1993, CEFISEM was linked to a national organization responsible for the training of educated professionals, Mission Academique Pour la Formation du Personnel de l'Education National (MASPEN). This new partnership demonstrated the Center's commitment to teachers of the schools in this region. An important turning point for the Center was the development of a web site used to communicate and distribute information. In 1994, a partnership between the Social Action Fund for immigrant workers and their families (FAS, Fonds d'Action Sociale pour les Travailleurs Migrants et leur Familles) was created. This new collaborative relationship stimulated increased action around partnership training, school fellowship, and school mediation.
The goals of the Center have not changed from their initial articulation. However, the value placed in building relationships based on partnerships with other associations geared to the immigrant population has gradually increased. Helping different partners understand each other, and training the school mediation teachers are vital parts of this project. The Center's evolution into a collaborative endeavour is regarded as a positive development.
The Center is organized into two areas, teacher training and pilot services. The integration of services was a response to the need for collaboration, brought on by the political climate and increases in the student immigrant population. In particular, the services of the Center include:
· to assess the students' abilities, especially the language abilities;
· to provide special classes for pupils waiting to be integrated into the regular class;
· to assume the role of a guide or resource for teachers and their partners; including recruiting other partners as the need arises;
· to provide teachers with training in cultural awareness; and
· to help teachers develop special projects or programs for children.
The Center is also responsible for maintaining partnerships among the different public services, the various Ministries, such as the City Council (Politique de la Ville), the National Education organization (Education Nationale), and the Social Action Fund for immigrant workers and their families (Fonds d'Action sociale pour les Travailleurs Migrants et leur Familles, FAS). The family remains the focus as the Center believes that the family is crucial to the design, introduction, and implementation of any intervention or mediation.
Services are publicly supported by MASPEN (which provides eighty percent of the funding), by the Minister, and by the Social Action Fund. Schools in this area are allotted special funds by the government, (ZEP, Zone d'Education Prioritaire), due to the high rates of poverty. Political support from the Mayor and others was deemed desirable.
Having the Center as part of the school facilitates collaborative working relationships between the school and the Center staff. Personnel within the Center and within the school overlap (teachers, school inspectors, for example). Monthly meetings are organized by the Center and chaired by the Director, and bring together the Coordinator, and the trainers. School Principals are provided with these monthly reports. The Center is responsible for annual reports to the school, though the reports have been less frequent than ideal.
School Inspectors act as a liaison between the teachers, the principal, and the parents on one hand and the coordinators, trainers, and directors on the other. The Inspector, rather than the Principal of the school, has authority over the teachers, and therefore, keeps the Principal informed about the interventions adopted in his/her school. Decisions are made together by a Center representative and the teachers. The Center also works with the regional coordinator, who is a teacher, on problems that require higher levels of input.
Initially, the teachers did not respond well to the development of the Center and its goals as they perceived its creation to be a threat to their authority and expertise as teachers. The misperception that the Center was "taking over" the teachers' responsibility for their students, was a barrier; however, it was overcome by increased communication and contact with all staff involved within this collaborative effort. Another initial barrier was that teachers were not convinced that training was the answer to their problems. After some initial difficulties, however, the Center was able to garner trust from all of its partners, and the teachers became more open and willing to work together with staff from the Center.
Conflicts among teachers and other staff involved with the Center rarely occur. The Center tries to solve conflicts by negotiating solutions and by bringing in other players, such as experts from organizations that can knowledgeably mediate a particular situation. For example, when there is a disagreement with the decision proposed by the Principal of the school, solutions are negotiated and outside experts are brought in to assist with this negotiation process.
The Center has found it difficult to measure the effectiveness of its interventions because base line data and evaluation were not initially conducted. The importance of including all teaching and school staff from the onset of this endeavour is punctuated. During 1998, immigration decreased and the Center thus shifted its focus to students living in poverty and to students that faced learning challenges. However, when the rate of immigration increased again, the Center resumed its initial focus.
COMMUNITY BASED MODELS
THE URBAN LEARNING CENTERS
A NEW AMERICAN SCHOOLS DESIGN
Los Angeles, California
The Urban Learning Center (ULC), formerly known as the Los Angeles Learning Center is a comprehensive prekindergarten through grade twelve model for urban schools. The Learning Center Design calls for significant changes in teaching, learning, school management, and governance. To overcome barriers to learning, the Design also addresses the health and well-being of students. This Design seeks to create a learning environment strongly connected to its community, where a well-organized and a well-managed school support high-quality instruction. The Design is composed of three parts: teaching and learning, governance and management, and learning supports. Two additional features that underlie the implementation of the aforementioned components are technology and professional development.
The Urban Learning Center Design was developed through a collaboration between a school district, and a teachers' union, with the support of the New American Schools Development Corporation. The New American Schools Development Corporation represent a public-private collaboration of the Los Angeles Unified School District (LAUSD), United Teachers of Los Angeles (UTLA), and the Los Angeles Educational Partnerships (LAEP). Support was also provided by other educational, corporate, and community organizations. The California State Department of Education, the LAUSD, and the UTLA have adapted the Design's Learning Supports component as a critical factor in preparing children to learn. To implement this model, the initial processes include a school-wide assessment, background training on the elements of the design, and the development of a strategic plan for implementation. Depending on the needs of the community a unique implementation plan is developed for each school.
The Urban Learning Center Model
Funded in 1993, the ULC Design has reconstructed schools from pre-school through 12th grade by weaving research-based and proven educational strategies into one design for improving student learning. A three-year time line for whole school change is recommended for the implementation of the ULC Design. The first 3-6 months are required for orientation. Foundation building takes approximately 12-18 months with an additional 12-24 months for capacity building. During this time, the activities that are undertaken include a school-wide self-assessment (mapping existing programs against components of ULC Design); coaching from external design coordinators (a team of expert consultants in each of the components); and training in the application of technology to creating solutions in management, instruction, and learning supports. The ULC Design addresses processes related to teaching, managing, governing schools, and ensuring the physical and emotional well-being of students and their families.
The Design is based on the following principles: rethinking education, (Teaching and Learning), restructuring schools, (Governance and Management), and rebuilding community (Learning Supports, which promote the physical and emotional well-being of students and their families). Rethinking education is reflected in high student achievement and relevant learning. The schools are restructured so that a democratic model of governance is employed and long-range organizational plans are developed. The Learning Supports aim to restructure and integrate school and community resources to improve the health and well-being of students and families. The focus is not only on learning, but on enabling students to learn.
Rethinking Education (Teaching and Learning)
Urban Learning Centers practice team planning and collaborative instructional strategies. At these schools curriculum is designed and implemented as interdisciplinary, thematic, and student-centred with a wide range of tools used to assess performance. The curriculum is organized around central themes and across subject areas. The ULC Career Academics, in collaboration with local businesses and community agencies, prepare students for the transition to work or post-secondary education. Advanced technology provides resources for students, teachers, and parents. At an ULC, a teacher is a facilitator of learning, a designer of curriculum, an instructor diagnosing and addressing student progress, and a continual learner. A variety of tools, including sample interdisciplinary units and curriculum templates to assist teams of teachers in creating their own lessons are available for any school that wants to adapt the design.
Restructuring Schools (Governance and Management)
Authority and responsibility for budgeting, governing, and learning are shared among teachers, staff, administrators, parents, community members, and secondary school students. Time for ongoing professional development and planning is integral to the success of this Design.
Rebuilding Community (Learning Supports)
The purpose of the Learning Supports is to connect schools with health, human services, and community resources. These Learning Supports (such as comprehensive referral and counselling systems, organized community outreach, and extensive volunteer involvement), help engage and create a community that supports learning. In order to further support learning, the ULC Design assists schools in building partnerships with appropriate social and community services that are not traditionally part of the schools' programs. These activities and services are coordinated by a Family and Community Service Center facility located at the school, and are staffed by professionals and volunteers from the school and private and public agencies. School support services are comprehensively integrated and linked with community resources as a strategy to prevent and remove barriers to learning.
For the purposes of this case study, the Principal, from Foshay Learning Center, a Technical Assistant from Corona Avenue Elementary, the Director of the Urban Learning Centers, and an Organizational Development Consultant were interviewed. Written documents about the aforementioned schools and the ULC Design supplement the information obtained through these interviews.
Elizabeth Learning Center Elementary in Cudahy and Foshay Learning Center in South Central Los Angeles are the original Urban Learning Center sites. Elizabeth Street Elementary was the first site selected in July 1993 by the Design Team to develop and implement the ULC Design. Foshay Middle School was chosen as the second site and implementation of the Design began in July 1994. Two newer sites are in progress at Corona Avenue Elementary in Southeast Los Angeles and at 32nd Street Magnet in South Central Los Angeles.
In 1989, Foshay Middle School was sited as the one of 31 worst schools in Los Angeles. As described in the interview with the Principal, ". . . it was a dirty inner-city school, and the students were found wandering the halls". The staff and community wanted change so when The New American Schools Corporation invited applications for school reform designs, the community applied. The Principal of Foshay Learning Center was on the ULC Design Committee to write and implement the model at its first site. In 1991, Foshay Middle School along with many other schools were successful in receiving a state grant of 1.5 million over 5 years to implement a New American Schools Design.
Foshay Learning Center
In 1994, Foshay Middle School housed 1,800 students and by 1999 the student population grew to 3,400. Now known as the Foshay Learning Center, the school has also expanded to being a prekindergarten to grade twelve site. The school has 180 elementary students, 2,600 middle school students and 630 students in the high school program. Seventy percent of the student population is Hispanic, and approximately 30% are African-American. Ninety-eight percent of the student body are eligible for free or reduced fee lunch. Foshay Learning Center is now considered the best Title-1 school in the District.
The school is structured so that academic classes run all-year round, with intersessions to allow students to catch up or develop new skills. More specifically, the school session is 16 weeks, with an 8 week intersession (vacation). This system is known as multitracking. As a result of the size of the student population, one-third of the middle school students are on vacation at any given time. The elementary and high schools, however, operate on a one track system.
Marriage, family, and child counsellors and social work interns from the University of Southern California staff the Family and Community Service Centers. Everyone in the community who uses the Center (except for the students) pays a nominal fee or donates time for the services they receive. Parent training programs are also available after school and on weekends. These Centers provide coordinated health-related services for students and families and address the Learning Supports component of the Design by offering services that extend beyond and link with traditional counselling. These Centers assist with enabling students to learn by situating academics within the context of student well-being, and thereby promoting a holistic approach to learning.
Corona Avenue Elementary School
Corona Avenue Elementary School is a Los Angeles Unified School located southeast of downtown in the city of Bell. It is a multitrack year round, predominately bilingual school with a student population of approximately 2,100. Seventy-five percent of the students originate from families whose primary language is Spanish. HyperCard technology has been integrated into the daily curriculum and instruction since 1986; hence, Corona Avenue Elementary is recognized as an established California Model Technology School (MTS).
Corona Avenue Elementary shortens the school day one or two days a month (to 1:40 p.m.) and opens its doors to parents, who can attend classes with the students as learners. Usually, 140-400 parents attend per day. Integrating parents into the learning environment furthers the goal of making the school central to the community and the community part of the school. Academy special interest classes (e.g. woodworking, art) are available for the students to enhance their learning experience. Parent classes and training for example in computer literacy or ESL, are also offered during and after school hours.
The major partners involved are ULC staff in LAEP, UTLA, and the District. As an ULC, Foshay can obtain waivers to change certain District regulations that are not consistent with or do not support the goals and the structure of the ULC design. The District allows Foshay Learning Center the freedom and discretion to apply for these waivers. The New American Schools Corporation provided Foshay Learning Center an amount in excess of 2 million dollars for training, computers, and expertise when the Urban Learning Center Model was implemented.
ULC staff provide ongoing professional training, and technical assistance with the implementation of site-based decision-making, advanced technology, and with models that effectively engage parents and communities. The Technical Assistance Team is a group of Consultants assigned to the school to assist with the implementation of the design; for instance, planning, facilitating the change process, introducing technology as a tool, integrating learning supports on campus, and organizing and delivering professional and stakeholder development sessions.
Each group of stakeholders in the school elects or appoints representatives to a committee, which drafts and presents the governance plan for review by all groups. Once a plan is accepted, school governance is carried out by a Site-Based Management Council (the decision-making body) made up of key partners such as teachers, parents, students, staff members, and administrators. At Corona Avenue Elementary, the governance council follows state and federal guidelines. The Council at this site is made up of 14 members: seven representing parents, the Principal, one lead teacher, one member elected from each of the three tracks, one classified member (custodian, office support), and one teaching assistant. The council works with sub-committees, to make decisions regarding budgeting, curriculum, student discipline, and community relations with input and involvement from the full school-community.
Training provided by the Organizational Development Consultants is informed by the Harvard Negotiation Project and systems thinking as described by Senge (1990). A win-win problem solving paradigm is the framework that guides this training. "The ULC Design promotes solutions that work for everybody". The role of the Organizational Development Consultants is to facilitate and intervene when the decision-makers reach an impasse and to provide training to various stakeholder groups. Some of the topics covered in this training include: roles, goals, and processes in meetings, active listening, overt team building, effective consensus decision-making, and goal setting. The training is hands-on and interactive. Unfortunately, due to economic constraints, only leadership partake in this training. To offset this limitation, mixed stakeholder training sessions are held. However, the entire school-community are potential benefactors and therefore training similar to this for an expanded group of stakeholders is strongly advised. The assumption underlying this approach is that through consensus, better decisions are made and these decisions are more likely to be supported when stakeholders are regularly included and are integral to the process from the onset.
Foshay Learning Center
At Foshay Learning Center a School-Based Management Leadership Council was in existence prior to the implementation of the Urban Learning Center Design. This council consists of nine teachers, nine parents, three students, two classified (non teaching) staff members, the Principal, and a Union Chair member. Members of this Council are selected by their constituents. Each of the multi-track teachers, the high school and elementary teachers select a representative, and in total four teachers are elected. The Title-1 and Bilingual Chair coordinators are elected by the teachers as is the UTLA (union) Chapter Chair. Parents elect nine other parents to represent them on the council, and classified staff elect two representatives from their group. The students are elected by the student government classes. The Principal, of course, is not elected. The Council meets every other week and sets policy for the school. The Principal is responsible for enforcing this policy. Accessibility to the decision-making process and representativeness on the Council is paramount to arrive at informed and effective decisions.
Corona Avenue Elementary
The Council at Corona Avenue Elementary make decisions about money, plant allocation, usage, and curriculum. If consensus is not reached, by-laws provide for a vote. Academic committees have been established for the different curriculum areas. These committees are responsible for handling the budget and personnel issues for their respective curriculum area. These Committees range in size, and represent staff and parents. As a newer ULC site, the governance council at Corona Avenue Elementary is still in its formative stages of development, and therefore, is continuously evolving to meet the needs of the school and the community.
As part of the governance and management strategy (the restructuring schools component of the Design), a democratic model of governance is employed. In this model, consensus is defined as "agreement to support the best alternative choice available at the time even if it is not the first choice". Consensus is arrived at through discussion about the issues, the use of active listening skills, and other techniques learned through training offered by the Organizational Developmental Consultants. "Building consensus is a long, hard process"; hence, the intervention and training provided by these consultants is identified as the most useful tool for enabling consensual decision-making to occur. Decision-making is the heart of the work and it revolves around using the most facilitative and appropriate techniques.
Knowledge of the processes involved to effectively resolve
disputes helps equip the participants with the skills that enable
them to make effective decisions. Principals make decisions when
time is short, based on their knowledge of community and school
needs. In resolving disputes as a group, generally a 24/48 rule
is recommended - think it through for 24 hours, and bring it up
in 48 hours or drop it. Creating an opportunity at the beginning
of the meeting to warm up or to engage in team building exercises
to learn more about each other is also recommended. Another effective
strategy that can be used in a group to avoid an impasse or to
overcome a deadlock, is to take a few minutes at the end of a
meeting to review what has worked and what could have been done
differently. When trying to resolve disputes, the least successful
technique "is when the administration or the District seizes
the decision back and makes it for the entire school-community".
The following is an example described in the interview with Karen Bading that highlights a process that can be used to resolve disputes and reach decisions that increase the likelihood to be upheld by all involved. In California, bilingual education is an issue of contention. The question posed is whether every child should be entitled to interaction in their native language. The two positions are either yes or no. To facilitate conversations and a decision-making process that is not impeded by positional attitudes, each side is asked to determine what issues and concerns underlie their position. The groups are then required to examine possible issues the other perspective may have. The purpose of this procedure is for each group to develop an ability to empathize and to understand the assumptions/concerns of the other group. After considering all views that they have arrived at, the groups are then separately asked to write a proposal that incorporates and considers the concerns of both sides and to suggest possible solutions that may be acceptable as a best alternative. Proposals are then brought back to the larger group and dialogue ensues about the possible solutions.
The goal of this process is to uncover the assumptions underlying the positions that are upheld by each side, and to facilitate conversation that is based on an understanding of, and consideration for, the different perspectives. When all the issues and assumptions are surfaced, decision-making and conflict management abilities are enhanced. "The quality in the execution of decision-making is the most significant factor for successful collaboration . . . however, training in soft skills is the hardest to sell because it is the most growth provoking and painful". If stakeholders resist, the group can assist by inviting them to participate. To affect long-term change, structural reorganization cannot occur in isolation. A reorganization in relationships is needed.
Each collaborating partner has a different philosophy and approach to service delivery and to the integration of these services. In order to integrate these differing ideologies, the commitment to change must extend throughout the entire organizational structure of each participating agency. The different partners involved need to take the time to get together and openly discuss their respective strategies. This will help uncover their respective issues and will facilitate the development of effective working relations in a collaborative environment. Differences can be celebrated and incorporated when the procedures inherent to decision-making include the process outlined above.
"Power is a fact of life, resulting in not wanting to share what you do or know". In this model, teachers and parents have more power, because everybody has their own distinct role and opportunity to contribute to the decision-making process, and, therefore, power issues and struggles are hopefully minimized. Thus, inherent to the success of the implementation of this design is a paradigm shift towards empowering all stakeholders and a win-win problem solving approach.
Both high schools have demonstrated high attendance rates, strong grade-point averages, and low dropout rates since the implementation of the ULC model. Parental presence at both schools is up dramatically and this has reduced student misbehaviour on campus. Career academies and their specialized curriculum allow high school students to apply educational knowledge to real life, resulting in students who are more engaged in learning and more prepared for the transition from school to either work or college.
At Foshay Learning Center certain behavioural measures depict effectiveness of the ULC Design. At this site:
· students test scores have increased (Stanford 9, and the California standardized test)
· attendance rate averages 94-96%
· there is a zero drop out rate
· fights are minimal
· the school is cleaner
· vandalism in a six month period amounted to $180.00
· overall grades are better
· school to work transition internships work well
Similar results are found at Corona Avenue Elementary with
more staff and parent involvement cited as major indices of change.
The main vehicle for feedback at both sites is meetings held by teachers in the same multi track or by high and elementary schools once a month. Meetings with members of staff and the community held on a regular basis is a vehicle for informal feedback. Information about the use of services and other client data is stored district wide. However, at Corona Avenue Elementary, information on the students' test scores, their participation in various programs, and special needs is recorded internally.
As explained in interviews with various ULC staff and stakeholders at these schools, school reform takes a lot of time, and extra time on the part of staff and parents. For example, at Foshay Learning Center, results depicting change were not evident until 5-7 years after the Design was first implemented.
To increase parental involvement and presence at Corona Avenue Elementary, an all stakeholders' day is held once or twice a month. At these meetings updates on the school are provided and discussed and all those in attendance have an opportunity to vote on waivers. Parental involvement and community engagement is critical to the Learning Supports component of this design. As a strategy to increase parental engagement, students are requested to give presentations at these meetings.
The importance of training co-administrators in the model was not originally recognized. Changes in the model call for increased training and the inclusion of all stakeholders in the training.
Partnerships with agencies must be negotiated very carefully as there are always issues of territoriality. "Once the school sees its role as convenor of the community of learners and does it with an understanding of other agency and community needs" school-community collaborations and lasting reform can be a reality.
The major challenge still facing Corona Avenue Elementary is having teachers and others understand the need for, and benefits of, a comprehensive and integrative approach to mental health and education. Important also, is the need to revisit what is working and to identify strategies that need to be changed. "There are no simple solutions to the problems of urban education. Try, evaluation, and try again". Outside expertise to deal with specific problems is a great tool that should be utilized. "If we do not deal with all aspects of our students and society, we can never succeed".
DALLAS INDEPENDENT SCHOOL DISTRICT
OFFICE OF INTERAGENCY COLLABORATION
YOUTH AND FAMILY CENTERS
The Hogg Foundation was established more than 50 years ago by the children of former Governor James Stephen Hogg. Its goal was to develop "a broad mental health program for bringing great benefits to the people of Texas" (Hogg Foundation, 1994). The Foundation is an integral part of the University of Texas and focuses most of its efforts in "awarding grants to qualified organizations in Texas, providing technical assistance to grant recipients and other agencies, presenting programs in mental health education through conferences and publications, and developing and directing mental health projects under its own auspices" (Hogg Foundation, 1994).
In the summer of 1990, the Hogg Foundation created the School of the Future Project with the overall goal of enhancing the lives of children and families living in poverty. The concept for School of the Future grew out of the work of Dr. James Comer of Yale University School of Medicine and Dr. Edward Zigler of Yale's Bush Child Development Center. The idea was to use schools as the Centers of service delivery and to integrate a variety of health and human services through the schools. A multimillion dollar initiative, the School of the Future Project committed to funding four pilot sites, each with $50,000 per year for a period of five years. This money was intended to provide the financial support for a full-time social work coordinator at each site. In addition, the Foundation set aside an equal amount of funding to provide each site with the necessary technical assistance and evaluation support.
The initial project had four key aspects: school-based services, prevention, educational enhancement, and outside support. The four pilot sites were selected on the basis of five essential criteria: the integration of a broad spectrum of health and human services in public schools, involvement of parents and teachers in the program activities, involvement of many public and private organizations as partners, a strong commitment to the project by superintendents, principals, and other school administrators, and a willingness to participate in the evaluation of the project. In addition, each pilot site was to target preschool, elementary, and middle school levels of education. The School of the Future project emphasized the development of service integration through long-term collaborations between schools, human service agencies, and communities. It was expected that education, physical health, and mental health would all be influenced positively over time and a variety of improvements were expected for students, families, schools, and communities.
Nolan Estes Plaza, Dallas, Texas
In 1976, the Dallas Independent School District (DISD) purchased a shopping Center that had closed in South Oak Cliff. This was an area characterized by unemployment, single-parent families, a high percentage of minority residents, substance abuse, and crime. The community was severely lacking in medical, social, and recreational facilities and the schools were low in attendance, achievement, and parent involvement. The DISD renamed the former mall Nolan Estes Education Plaza and opened two elementary schools there: McMillan, comprised of 375 students in pre-kindergarten to grade three and Patton, comprised of 210 students in grades four to six. A large majority of the students were African-American and Hispanic and most were eligible for the reduced fee/free lunch program.
In 1987, the Community Oriented Primary Care Plan (COPC) was developed through the Parkland Health and Hospital System in order to provide efficient, low-cost, and quality family-oriented primary care services within a neighbourhood setting. The plan was implemented in 1989 and COPC clinics offered health care services to students and their families.
Around the same time that the Hogg Foundation began planning for its School of the Future project (in the late 1980s), the Dallas school board began investigating ways in which to provide students and families with social and health services. Through its Commission on Educational Excellence, the school board had begun to develop a model for coordinating services in the schools and negotiations had begun with several agencies to base social programs on school campuses. In addition, ideas were being formulated for obtaining and renovating space so these services could become permanent fixtures in schools. In general, the district's goals were to:
· provide a cluster of district services at selected schools serving students and their families from pre-kindergarten through eighth grade;
· establish problem-solving teams on each campus to address individual needs of students and their families and train staff members and parents in team building and problem solving;
· develop a cluster of community services tailored to the needs of neighbourhood families and make them accessible through the schools;
· involve family members and school personnel in the planning process and in the identification of service needs; and
· evaluate the impact of the program through attendance and achievement gains, changes in student behaviour, increased parental involvement, and improved availability and utilization of community services.
In 1990, the Hogg Foundation approached the DISD when the concept,
timing, community population, and space were right. As a result,
the Hogg Foundation obtained the vacant space at the Nolan Estes
Plaza as a pilot site for its School of the Future project in
Dallas. Aided by two school administrators who served as liaisons
to the project (Allen R. Sullivan and Ruth Turner), the Hogg Foundation
and the DISD worked out the details for the project. McMillan,
Patton, and the nearby Boude Storey Middle School became the pilot
schools for the School of the Future Project in Dallas.
Around the same time, a document from the DISD's Commission on Education Excellence was released. Its purpose was to determine how to better work together in providing services for children and families. In 1992, the Youth Services Network was established to try to implement the recommendations made by the Commission on Educational Excellence. These included the creation of eight to ten school support Centers which would be structured to meet the specific needs of the school staff, students, and community in the immediate area. A Request for Proposals (RFPs) was put out to bring two of the programs together: the Youth Impact Centers and the School of the Future Program.
Initially, there were many enthusiastic players involved, but no funding existed to support this initiative. It was then suggested that perhaps, this collaboration could be implemented internally, within the School District. As a result, a federal RFP was put out which said that all of the federal dollars from a Title XI grant could be used for the collaboration. The district applied for the Title XI grant which would now fund the collaboration. Title XI funding was plugged in and the program now had approximately $2 million to fund project managers, clerical staff, administrative staff, supplies, etc. In addition, the program recruited Mental Health Mental Retardation (MHMR) in Dallas to provide services. The program would provide for all of the overhead costs and MHMR would provide services.
In 1995, the DISD, COPC, and MHMR came together to create the Youth and Family Centers. Once the three programs came together, there was a combined total of seven sites. The program has since expanded to nine Centers and these Centers are located strategically in nine different geographic regions of Dallas. There are currently 302 schools in Dallas, all of which are serviced by a Youth and Family Center. In addition, there are two new programs, the Before & After School Program and the Homeless Program, presently administered by OIC, but not currently integrated with YFC. Approximately 21,000 students in the Youth & Family Centers Program, approximately 22,000 students in the Before & After School Program, and approximately 2,000 students in the Homeless Program receive services.
Two core services are offered by the overall program: physical health and mental health. Physical health involves the provision of immunizations, episodic care, and some chronic (eg. "well-child") care. Mental health involves the provision of psychological evaluations and counselling. The three program partners, the DISD, Parkland Health and Hospital System's Community Oriented Primary Care (COPC), and Dallas County MHMR set 8 program goals for the Youth and Family Centers:
· To implement school-linked Youth and Family Centers that address physical, emotional, and social needs of the students.
· To promote articulated health and mental health services for the mutual clients of coalition partners at the Youth and Family Centers.
· To provide access to equitable health and mental health services throughout the Dallas Public Schools within five years.
· To promote family focused programs, which enhance the well being of families (recreation, adult basic education, and family training).
· To obtain resources and procure grants from city, county, state, and federal entities, including Medicaid, as well as other third party reimbursements.
· To provide training for collaborative project partners staff.
· To link local, state, and national school-based health and mental health organizations.
· To develop appropriate evaluation tools to assess and modify services on an annual basis (Baker and Associates, 1996).
Their mission statement reads as follows:
The Youth and Family Centers Partnership has been formed to promote and assure health, mental health care, and other support services to Dallas children and their families. The collaborative project partners believe school-based Youth and Family Centers represent an essential strategy toward improving the lives of children and optimizing their ability to be successful in school and become contributing members of society. The collaborative project partners believe that academic, social, emotional, and physical health development are directly linked. By increasing access to physical/mental health and other support services in a school setting, Youth and Family Centers offer compassionate and competent care which addresses the unique needs of children and their families.
A recent report by Bush, Alexander, Mitchell, and Webster (1997)
found that 52% of the students served were male, 45% Hispanic,
40% African-American, and 13% Anglo.
The program which currently exists in Dallas, the Youth and Family Centers, evolved and expanded tremendously from the 1990-1995 School of the Future pilot program.
A variety of services are offered in each of the Centers, depending upon the needs of the families. A Center Coordinator at each site is responsible for coordinating the services which are offered. Various agencies provide satellite offices which are housed within the Youth and Family Centers. As a result, families can access numerous services in the same place. A referral process is in place within the schools in order to refer children and their families for services at the Centers. In addition, the Centers may dispatch workers to the school for various reasons.
The DISD provides the administrative structure, space, and case management for the nine Centers. MHMR provides for students' mental health needs through psychiatric, family, psychological, and medication services. COPC provides for students' health history, health maintenance, medication, and laboratory tests.
The initial funding for the three Parkland clinics came from the federal Maternal and Child Health Services. Funding for the earlier Youth Impact Centers was provided by several foundations and corporations: the Robert Wood Johnson Foundation, the Communities Foundation, Rosewood Corporation, Southwestern Bell Foundation, Exxon Corporation, Zale Corporation, Hobiltzelle Foundations, the Meadows Foundation, and an anonymous foundation (Bush, Alexander, Mitchell, & Webster, 1997). The Hogg Foundation provided further funding, at $50,000 per year for five years, through the School of the Future Project. Title XI funds are limited to funding the program's infrastructure and direct services must rely upon other forms of funding.
Model Adopted by the Youth Family Centers
The Centers each service one of nine high school feeder patterns in Dallas and all of the Centers operate within or near the school campuses. The Centers all use a systemic model which is geared towards integrated service delivery. This approach is based on the work of Botvin (1986), who believes that "adolescent high-risk behaviours stem from a complex interplay of factors: social influences from parents, peers, and the media; personality characteristics, and values. Thus, interventions must be designed to address these multiple antecedent factors by dealing with social influences and by teaching coping skills." The model views a border between school and community, with community providing physical health care, mental health care, student and family counselling, parent and home education, youth development, and after school care. The family is housed within the school and the child exists within the family. The model views the Youth and Family Centers as the link between the school and the community.
The services offered at each Center are categorized as physical health services, intensive mental health services, and support services. The physical health services include health maintenance exams, urgent care, immunizations, sports physicals, medication, nutrition counselling, lab work, episodic care, and chronic disease management. Social workers complete a family history at the clinic and a medical evaluation is done. A collaborative treatment plan is then developed and the clinic staff follows up with the school nurse (Bush, Alexander, Mitchell, & Webster, 1997).
The mental health services are provided through MHMR and take place in the form of psychiatric evaluation and medication. Parents are required to attend the mental health visits with their children. When the child arrives at the Center, an assessment is completed by a collaborative treatment team which includes a child and adolescent psychologist, mental health professionals, and school staff. They then develop a collaborative treatment plan as well as a school service plan. Specific treatment services may include individual, family, or group therapy, medical evaluation and intervention, medication, school interventions, and student support groups (Bush, Alexander, Mitchell, & Webster, 1997).
Other support services offered by the Centers include counselling, parent education/home education, family therapy, group therapy, individual therapy, support groups, the Legal Advocacy for Minors Program (LAMP), drug education, Adult Basic Education (ABE), the Family Youth/Interaction (FYI) Program, the Power of Parenting Program (POP), and others. Youth development activities such as youth clubs, recreation activities, and art classes are offered (Bush, Alexander, Mitchell, & Webster, 1997).
Strategic planning takes place at the District level every three years. Statistical results from research, evaluation, and surveys are used in this process. In addition, there are two specific planning groups in place. The larger planning group, which is made up of upper and middle managers from all of the partners, meets once per month to discuss policy issues, engage in long-term planning, and review the overall progress of the collaboration. A subcommittee of this group, referred to as the Operations Development Committee, is made up of only middle managers. This group discusses day to day issues on a weekly basis (Bush, Alexander, Mitchell, & Webster, 1997). In addition, each Center has an Advisory Board which makes decisions about services to be offered based on the needs of the students and families in the area. Each Advisory Board is staffed 50% by parents and 50% by community members, business members, teachers, etc. The Center Coordinator arranges the staffing for the Advisory Board but does not sit on it. Currently, the smallest board has seven members and the largest board has 23 members.
There are currently three levels of decision-making for each of the Youth & Family Centers:
· the Advisory Board of each Center;
· the Center Coordinator and the Middle Managers of the various agencies; and
· the Quality Management Teams - comprised of the Directors of the Collaborating Agencies.
Decisions can be "bottom up" or "top down"
however all services and decisions are driven from a "needs"
viewpoint. If a need is identified, a way to service it is found
and decisions are made accordingly.
Generally speaking, all of the staff involved have very positive feelings about the collaboration. Interaction among professionals is considered to be very good at the service provision level (e.g. among workers within the Centers) and at the very top level (ie. directors, superintendents, head of MHMR, head of social services for the county, etc.). The service providers are the front-line workers in the Youth & Family Centers and they work together very well because they are required to work with one another on a regular basis within the Centers. The top level players are essentially good politicians. Their interaction is very good because, philosophically and financially, they all agree on the concept of collaboration.
The problems in interaction occur at the level of middle management because these are the people who are instructed by the Directors to organize and implement the structure for the collaboration. These individuals worry whether or not they will still have a job because there are many managers from the various agencies who essentially do the same thing. In addition, "turf" issues arise among the managers from the different agencies. For example, each agency maintains its own form, even though the different forms essentially ask for the same information. This makes it redundant for a family which comes to the Center for a variety of services, as they are required to fill out a different form, with the same basic information, for each agency. Despite some of these challenges however, no agency has left the collaboration from any of the nine Centers.
When conflict arises at the middle-management level, it is expected that those involved resolve the conflict on their own, through collaboration and compromise. Although decisions could be made at the level of upper management, there is not a large amount of invested interest in doing so. As far as the District goes, there are 100,000 students and approximately 22,000 are serviced through the Youth & Family Centers. Since this is a small responsibility in the large scheme of things, upper level managers do not really get involved in resolving conflicts between agency participants.
Evaluation of the program is gathered through a variety of Satisfaction Surveys every year. Satisfaction Surveys are sent to the schools (targeting the teachers, counsellors, and students), to the participating agencies, and to parents who have used the services. Information is pooled together from all nine of the sites and District-wide analyses are conducted and interpreted.
Overall, there have been tremendous benefits to the families and children in Dallas as a result of the collaboration between the schools and the participating agencies. The main benefit is the accessibility of services to families and children. In addition, a wide variety of services are provided and more needs can be met.
Investigations regarding the specific benefits of the collaboration, in terms of student attendance, student achievement, and parent education are ongoing. Administrators, Center personnel, students, and families tend to vary in their responses about the benefits of integration. Overall, the responses are positive but it appears as though school administrators feel the least positive about the integration process (in comparison, to centre personnel, students, and families).
Several problems with the collaboration were cited by the Coordinator of the Office of Interagency Collaboration (OIC). First, the process is very tedious and time consuming, both to initiate and to maintain. In addition, embarking on this initiative was very difficult for the District because no precedent existed for the collaboration. Furthermore, the collaborating partners are from large entities, which meant there are many boards of directors involved in the governance, hence limiting the effectiveness of the collaboration. At such a large level, many players regularly get told what to do and this can result in the alienation of workers and agencies. Lastly, the Dallas Independent School District is not a neutral organization and some agencies will not get involved simply because the DISD is the organizing body.
Funding continues to be an issue in the level of service offered by the Youth and Family Centers. Many of the centers feel the need for additional staff members in order to adequately meet the needs of the students and communities they service. In addition, space limitations are a concern at several of the sites and the Pinkston site was described as deplorable, displeasing, and unsanitary in a recent evaluation report (Bush, Alexander, Mitchell, & Webster, 1997).
With respect to the collaborative effort itself, the Coordinator of the OIC suggests that such an endeavour could be set up as a non-profit initiative with agencies agreeing to collaborate and provide services. He explains that at a smaller level, the process could be more collaborative. In addition, a non-profit organization is viewed as being neutral and credible and this could result in the alienation of fewer agencies.
SAN ANTONIO INDEPENDENT SCHOOL DISTRICT FAMILY SUPPORT PROGRAM
San Antonio, Texas
J.T. Brackenridge Elementary in San Antonio, along with De Zavala Elementary and Tafolla Middle School, was selected as one of the four pilot sites for the School of the Future project. J.T. Brackenridge services children and families who mainly live in Alazan-Apache Courts, the oldest housing project in the United States. The children come from families who are below the low income standard in the U.S., with an average family income less than $5,000. The families are predominantly Mexican-American, 80-90 percent are single-mother families, and every student in the school qualifies for the free lunch program. The area is characterized by a high level of crime which includes child abuse, drive-by shootings, gang activities, and drug use. In fact, the 78207 zip code has been established as having the highest rates of juvenile crime and domestic violence in the United States.
During the 1980s, a couple, one of whom was a teacher at J.T. Brackenridge, started a social service agency in the neighbourhood. They soon learned that the Hogg Foundation was looking for schools in which to pioneer and fund a School of the Future project, involving the integration of mental health and social services within schools. The couple approached the Hogg Foundation for funding to begin the School of the Future project at J.T. Brackenridge. The funding was granted and one of the couple became the Project Coordinator at the school.
When the School of the Future project started in 1990, there were 832 students in the school. Since then, two factors have led to a substantial decrease in the number of students attending J.T. Brackenridge (there are currently 550 students in the school). First, the state of Texas began providing families with vouchers so their children could attend private schools and, second, one-third of the housing project where the children lived has been demolished. However, new housing is being developed in the form of houses instead of apartments and once these new homes are completed, it is expected that the school will have 700-800 students. In addition, some of the families who have sent their children to private schools (through the state vouchers) found that the schools were not "in-touch" with the children's needs and the children were not getting the same quality of services there. As a result, some of these families are now re-enrolling their children at J.T. Brackenridge. The 550 students at J.T. Brackenridge range from pre-kindergarten to grade five, and there are approximately 22 children per class.
When it was first conceptualized at J.T. Brackenridge, the School of the Future Project had two main drives: A Parent Involvement Program and the Provision of Mental Health and Social Services at the school. During the 5-year pilot period, the program was staffed with contractual therapists from a local mental health agency and with practicum students in both Marriage and Family Therapy and Social Work programs at Our Lady of the Lake University and St. Mary's University. The Project Coordinator was extremely committed to the Parent Involvement Program and engaged in a tremendous amount of outreach in order to encourage parents to become actively involved in the school. A conflict resolution and peer mediation program was also started at the school.
Following the termination of the five-year funding from the Hogg Foundation, the San Antonio Independent School District (SAISD) decided to continue funding the program. In addition, the school was given the option to revise the composition of its counselling staff and to utilize Title-1 funding (funding which is given to schools for serving low income and at-risk children). The program was re-named the Family Student Support Program (FSSP) and three key personnel, who were to be supervised by the School Principal, were hired. These new on-site personnel were a Campus Social Worker, a Student Support Coordinator, and a Student Support Facilitator. The Campus Social Worker was to provide social services, counselling, therapy, faculty support (training and guidance), family services, crisis intervention, and other related services. The Student Support Coordinator was to provide the same services with more of a focus on therapy and counselling. The Student Support Facilitator was to facilitate all referrals to special education and other special programs. In addition, a new Family Student Support Program Coordinator was hired to help facilitate and oversee the implementation of the FSSP on a district-wide level.
The transition of the program from the pilot to the current program was challenging and difficult. The couple who had guided the program from its inception, eventually left the program. In addition, most of the new staff were new to a school setting. However, they did possess a wide array of knowledge of community services and brought with them varied experiences from mental health agencies, child protective services, city programs, school-related programs, and community agencies. The main goals of the post-pilot phase School of the Future program, now the Family Student Support Program, were as follows:
· to improve the physical and mental health of students and families;
· to increase positive interaction between family members and their children and to increase parent involvement in their children's education;
· to increase the number of available and affordable services for neighbourhood residents and to create a supportive school environment for students, teachers, parents, administrators, and community partners; and
· to improve the image of the school in the community and to integrate school and community activities.
A variety of services have been linked to J.T. Brackenridge since the inception of the School of the Future Project. These include the Hogar Program, the Transitions Program, Los Ninos Program, Mentoring Programs, a Conflict Resolution Program, an After-School Program, a Big Brothers and Big Sisters Program, and a Middle School Pals Program.
Hogar Program ("hogar" means "the home"
This program was funded by Americorps, a national program which employs people to work in needy areas in exchange for money to go to college. The Hogar Program was in place from approximately 1990 until the end of last year. This program targeted families with children aged 0-3 years. It provided support, training, pre-natal care referrals, and baby formula to parents. There were 3 workers provided for this program. At one point, the district was funding BA and MA level university students for this, but the funding was cut. This program was cut this year, probably because the funding disappeared.
The Transitions Program
The program targets homeless families. "Homeless" also refers to families who are living with other families. Funding comes through the District and is provided by the McKinney Act. A therapist, social worker, and coordinator are housed at the school. They have space in classrooms which have been converted into offices. The workers visit shelters, provide referrals, and advocate for the homeless.
Some of the large private businesses in the area allow their workers to come to the school to provide tutoring for the children. A specific grade-level is targeted for this program and professionals come during the day. The businesses have also donated nice benches to the school for this purpose. Some of the businesses involved are an Energy Company, City Corp Bank, and Insurance Company USA.
Conflict Resolution Program
A conflict resolution program is implemented for approximately 20 children in a selected grade after school. Innercity Agency provides this program.
The program runs from 3:00pm-6:00pm, and tutoring and computer time are provided for the students. The workers are teachers from the school and paraprofessionals. Funding is provided by the City of San Antonio.
Los Ninos Program
Trainers from an agency situated 1/2 block away from the school come in 1-2 days per week after school to implement a substance abuse prevention program with the children. A specific grade-level is targeted for the program and 10-20 children from this grade are selected go participate for the year. Funding is provided by the Texas Commission on Alcohol and Drug Abuse.
Big Brothers and Big Sisters
This program goes to the high schools and recruits/selects honour students to be big brothers and sisters. The students come to the school once per week after school and work on character development with 10 children for half the year. A different 10 children are selected for the second half of the year.
Middle School Pals
Students in grades 6-8 from the nearby middle school do mentoring, reading, and tutoring with the students at J.T. Brackenridge.
The initial funding for the program was provided by the Hogg Foundation at $50,000 per year for five years. Other funding has been provided by a variety of agencies and organizations at the District, city-wide, state, and federal levels. More specifically, J.T. Brackenridge's Hogar Program is funded by Americorps, the Transitions Program is funded by the District through the McKinney Act, Los Ninos Program is funded by the Texas Commission on Alcohol and Drug Abuse, and the After-School Program is funded by the City of San Antonio. In addition, various agencies and businesses donate their services through programs such as the Conflict Resolution Program, provided by the Innercity Agency and the Mentoring Programs, provided by local private businesses.
Teachers at J.T. Brackenridge were initially very supportive of the concept of the School of the Future Program. However, because the program involved a tremendous amount of change, there was also a great deal of apprehension on their part. For example, with respect to the Parent Volunteer Program, teachers were somewhat apprehensive about regularly having parents in their classrooms.
When Hogg Foundation funding had run out, a couple of agencies (Metro Alliance and Communities Organized for Public Service) got involved. They got parents to rally the district, and brought in corporations to advocate to the school board to continue supporting the School of the Future initiative.
Decisions regarding the integration of services at J.T. Brackenridge are mainly made by the Campus Social Worker in consultation with the school Principal, who has the final decision. According to the Campus Social Worker, the Principal has demonstrated a great deal of confidence in his ability to determine if an agency or service is inappropriate for the students. Coordination of the services occurs primarily through the Campus Social Worker, the Student Support Coordinator, and the Therapist, who meet with agencies, screen them for participation, discuss the needs of the community, and review the curriculum for the service to be provided. Agencies often approach the school to provide the services and the school sometimes engages in outreach to recruit specific services. However, the Campus Social Worker, the Coordinator, and the Therapist are so overwhelmed with other duties that they have little time to devote to outreach. According to the Social Worker, there is no coordination and collaboration between the agencies/services themselves; only between each agency and the school. He suggests that more coordination probably needs to occur but there is simply no time to facilitate this.
For the most part, there have been no power dynamic problems among workers in the school ("we are all working for the same thing") and interaction between professionals is positive. However, the Campus Social Worker has encountered a conflict of interest with his other role as coordinator of integrated services. For example, he has found himself in the position of reporting teachers who are harsh, rude, and somewhat abusive towards the children. This has resulted in loss of their support for some of the programs and changes he has attempted to implement. In addition, conflict tends to arise when the Campus Social Worker is trying to bring about change and he sometimes finds himself unsupported in these endeavours.
With respect to resolving disputes with teachers, the Campus Social Worker adheres to a personal rule that one must always attempt to speak to the person about the concern twice. He explains that this takes into account the possibility that someone has had a bad day or was too busy with another commitment to discuss the problem when approached the first time. After this, he insists on providing the person with written documentation concerning the conflict. The next step is to approach the Principal with the concern. However, the Campus Social Worker admits that he will sometimes let things go if he needs that teacher's cooperation for something else within the school. He explains that it is important for him to choose his battles wisely and that sometimes, he must ignore a particular concern or conflict with a teacher in order to maintain support for an important initiative.
With respect to the agencies involved, the Campus Social Worker always discusses his concerns with the Principal. He then approaches the agency workers and expresses his concerns. The next step may involve writing a letter to the agency to express his concerns further. If the problem remains unresolved, he and the Principal may make the decision to terminate the collaboration and let the agency go. They have not had to let any agency go, thus far. However, a situation did arise where an agency was circulating a research survey without having first informed the school. In addition, they wanted information from the school which could not be provided because of confidentiality issues. The school asked that the agency stop circulating the survey and instead, worked with the agency to help them get the information they wanted. They suggested that the agency draft a letter to the families which requested permission to do home visits. The students brought the permission letters back to the school and the school then forwarded these to the agency. Although such a process can be very time consuming, the cooperation between the agency and the school is seen as beneficial to the integration of services.
One major challenge which faces the school with respect to the integration of services is the transitory involvement of some of the service providers. Agencies and businesses may provide services for one cycle or one year but may choose not to make a long-term commitment. The lack of continuity and consistency impacts on the children's ability to continuously develop their relatedness skills and make long-lasting connections to the adults providing the services. The Campus Social Worker explains that "it's great that we get agencies in, but it doesn't have the same effect as having the relationship and trust a consistent person in the school is able to build with the kids. Ideally, we need more consistency for some of the critical services."
There is currently no formal evaluation process in place to evaluate the benefits of the Family Student Support Program (FSSP) at J.T. Brackenridge. The Coordinator of the FSSP at the District level has gathered information from the school for the past four years with the goal of investigating any correlations between a student's grades and the services that the student is receiving. However, the school has yet to be informed of any results. There is concern that statistics on which to assess their success does not exist. At this point, the school evaluates based on what it sees and what the students say in order to determine whether or not an agency should return. The Campus Social Worker has strongly recommended that an outside agency do the research and evaluation and the school has asked the universities to engage in such research. However, the universities say that professors would be needed to supervise students pursuing this research and maintain that they would have to charge for this service. They suggest that the school solicit funding which would help pay for this supervision. In the past five years, a few PhD programs have been initiated at the universities and although these programs are not heavily grounded in research, there is hope that students may become involved in evaluation efforts at J.T. Brackenridge for dissertation research purposes.
A number of benefits of integration have been identified at J.T. Brackenridge Elementary. First, there is a major benefit to having social workers in the school because the children have the opportunity to build a relationship with an adult who is consistently present in their lives. The children know that there is someone they can turn to when something negative or positive happens in their family and many of them do not have someone else to fill this role.
A second major benefit is the learning that develops on the part of the social workers and teachers. By being in the school, the social workers are forced to become more aware of how the school system works. They are able to witness the obstacles and challenges the teachers face first hand. Conversely, the teachers have become more sensitive and aware of the problems the children have through interaction with the social workers. If a teacher holds the opinion that "I don't want to know what problems the children have, it's my job to teach them", he/she is less likely to feel this way after hearing from the social worker that the child was abused last night.
Additional benefits of the integration are related to the services being provided by the numerous agencies and businesses involved. The children are benefitting from the attention they are receiving through the various programs and are using the terminology they are learning from the services. For example, children can be heard making comments such as "I have good self-esteem".
The major challenge to the integration of services at J.T. Brackenridge has been the lack of financial support. The Campus Social Worker remarked, "I have a potential caseload of 550 kids (ie. the entire school). This causes major stress. The stress is not due to the types of problems presented, but to the amount you have to do. A social worker per grade would be more effective". Money is wasted when it is not used (i.e., when it is left over at the end of the year). With proper planning, this money could be used to fund someone else, even part-time. Furthermore, the school is always lacking financial support and yet, money seems to appear when a cause is important enough to the District. An example of this is the Texas Assessment of Academic Skills (TAAS) that all the children have to take. As explained in the interview, money appeared to come out of nowhere in order to hire consultants and get resources in order to teach this test. He suggests that "if someone would say that social workers are important enough, I imagine that the funding would miraculously appear. The bottom line for schools is academics. If you can't show that what you're doing is benefitting academically, you won't get the funding. You have to show fast results."
Improvement in the delivery of services for students at J.T. Brackenridge is contingent upon the provision of more staff. One related suggestion is to employ people who are teachers/case workers. These individuals could teach for half the day and do case work and home visits for the other half of the day, allowing them to be better informed about the challenges facing the students in their classrooms. In addition, it is recommended that agencies are ahead of schools in terms of recognizing the need to provide services. An increased number of parents and a strong administrator on the board are needed to advocate for these services in schools. A final suggestion for the future involves the need to evaluate and document more in order to demonstrate the effects of integration. Focus group interviews and feedback from parents and older students who have since left the school, are recommended.
Overall, however, the Campus Social Worker has a positive outlook on the provision of mental health and social services through J.T. Brackenridge Elementary. He states that "the school is the perfect place to do services. We're right in the school so we don't have to chase down clients. The kids are here every day and we can just pull them right out of class. I am hoping that this will happen more and more in schools. Administrators are becoming more aware in the district."
EDUCATION, PRIMARY AND SECONDARY PREVENTION PROJECT
(PROGETTO EDUCATIVO E DI PREVENZIONE PRIMARIA E SECONDARIA)
Reggio Emilia, Italy
The city of Reggio Emilia, situated in the province of Reggio Emilia in northwest Italy, has a population of 438,500. Compared to the rest of Italy, this province is characterized by its high socio-economic status and advanced industrialization (comprised mainly of small and medium sized enterprises). Further, Reggio Emilia is recognized for the importance it places on the presence of women in the workforce. This in turn contributes to the low rate of unemployment in this region. This city is diverse in the number and extent of social services available, and is recognized world-wide for its innovative preschool educational practices.
The Education, Primary, and Secondary Prevention Project (herein referred to as the Project) began as a result of changing social conditions. For instance, emotional difficulties, psychological violence, scholastic problems, the increasingly fragmented reality of the family, and a large population of immigrant school-aged students (primary and secondary) contributed to the rapidly changing social climate of this area. The Project's aim is to enhance the educational experience of students, with specific intervention designed to combat disabling situations that are a result of these new social realities.
This initiative focuses on developing networks among the various services existing in a particular Territory and operates with the belief that communication must be frequent between both traditional agencies of socialization (schools and families) and less traditional associations. Originally established in 1990 in Circoscrizione IV, the Project has gradually expanded to support students aged 8 to 14. It is also now linked to the legal system (number 309 in 1990 and number 216 in 1998) to promote drug and crime prevention.
Two elements characterize this initiative: the Territory and Prevention. The first step in the construction of the Project is the identification of the Territory and an activation of the resources that the Territory can deploy. Once the Territory has been identified, resources available can be linked and reallocated. Both primary and secondary prevention are the focus of intervention. Individual case plans are developed that consider the children as an integral part of a larger social and environmental context. The location of the Project depends on the school; for example, the number of rooms available at the school. The level of integrated service delivery depends on the school and its willingness to restructure systemically to work collaboratively with the partners of the Project. Specifically, the goals of the Project are:
· to break the vicious circle of disabling conditions,
· to help with the evolution of the person and of the group,
· to increase involvement of adults/guardians with youth,
· to build collaborative relationships based on trust and respect,
· to research the potential of children,
· to comprehend and celebrate the norms of the different cultures represented in the school and in the community, and
· to support school-based competencies.
The services offered and coordinated through this Project are extensive and vary from case to case, but the focus on education remains constant. Those assigned as 'responsible' (i.e., Project Coordinators) to the school and to the services involved, develop an 'individual project' based on the needs of the student. For this reason, the Project Coordinator acts as a link among the services, the community, and the school. A special collaborative relationship exists between the Educational Group of the Territory and the Clinical and Social Psychologist. The term 'Educational Staff/Group' includes social workers, mediators, teachers, and any other individuals or groups involved in the education of children. The following example depicts how intervention by the Educational Group of the Territory is uniquely tailored to meet the needs of the student. This example concerns a nomadic child who has stolen from a store. The Educator from the Territory initiated conversation with the Judge involved and negotiated an alternative discipline strategy. These conversations resulted in enabling the student to attend the Educational Group of the Territory as opposed to serving a criminal sentence, and therefore, the learning needs of the student could be met simultaneously.
Important to the success of this collaboration is low staff turn-over of teachers in the schools. Currently, 13 people staff this Project, specifically, one person linked to the Territory and another as the Coordinator of the Project. The notion of one expert figure is decreasing as an increasing number of educators have gradually acquired more expertise in a specific area. Hence, the pool of experts is increasing, thereby allowing responsibility to be shared.
The Project has always been supported, both financially and ideally, by the Town Council of Reggio Emilia. Today, sixty percent of the Project is financed by the Town Council of Reggio Emilia (the Minister of the Family, the Minister of the Interni) and the remaining is funded by the region of Emilia Romagna. These resources are considered adequate. The Town Council institutionalized the Project and has established indicators of quality. The collaborators involved include:
· the Town Council administration, the Educational and Assistance services and the Centre for Families;
· different schools in the area;
· the Health Local Unit, Social Area of the Minors (area social dei Minori) , Neuro-psychiatry service for children, Clinical and Social psychological services;
· the Provincial Education Office, different primary and secondary schools, the Teacher's college;
· the Social Prevention Centre (CPS);
· a project called POLO (on work orientation);
· the province - Polaris, Professional Orientation Service;
· the service centre called Prometeo - resources on immigration;
· the Emilia Romagna region; and
· the Headmastership of the council of the Minister - Minister for the Family and social business.
The teachers and educators involved were trained over a two year period. The focus of the training at the beginning of the Project was more narrowly defined. However, now it has expanded and evolved to incorporate issues surrounding relationship building among organizations. The general focus of the training is on educational communication; socialization; and systemic, global, and socially relevant intervention, for students and their families. Input from the family is viewed as paramount in the development of an 'individual plan'. Depending on the need, training can be organized once or twice a month and can also be facilitated by educational staff. Usually for this purpose, professors from the University of Bologna (for eg. professors of educational sciences and psychology) are frequently invited to deliver training in their field of expertise.
Meetings are organized at different levels. Meetings every year with the Provincial Education Office are organized in order to share information about the development of the Project. Annual meetings are held with all the teachers and the educators involved, and monthly meetings between the Principal of the school and the coordinator of the Project are also organized. Moreover, in order to analyze a case individually, meetings are planned regularly, and as needed with families, teachers, and with educational staff. The Project Coordinator also regularly meets with particular teachers in order to create an 'individualized project' for the student immediately after concerns for the students have been expressed.
The clients, usually referred to the Project by the school, generally have learning challenges. A high percentage of these referrals are immigrant students whose families have immigrated mainly from the south Italy. The families' relationship with the Project vary on a continuum from formal to informal. Intervention based on informal relations and intervention are cited as more conducive to affecting change. Intervention methods also differ. They include: meeting at the students' home, meeting at the location of the service, and telephone or written communication. The family is also encouraged to be involved in the preparation and development of an intervention.
In the last two years, the Project has evolved from being an instigator linking services, to the position of working collaboratively with those services in partnership to develop an 'individual plan'. Social and clinical psychological services, Neuro-psychiatry, the Centre of the Adult Education, the Centre of Social Prevention, and the Centre for the Family are examples of new services that have entered into partnership with the Project. Over the years, the Project's relationship with the school has increasingly become more interdependent and integrated. This is attributed partially to the development of common goals shared among each partner of the Project and the school.
All the services involved are linked to the school and the school is therefore considered central to the Project. Originally, the aim of the Project was collaboration, where each partnering agency did their respective job independently without any meaningful structural change in the delivery of services. However, this approach was not extremely effective as it did not fully meet the needs of the community and the demands introduced as a result of the changing social conditions of this region. Distinct approaches to service delivery increased levels of confrontation among service providers and administrators on technical and cultural issues. These conflict- inducing confrontations are seen as positive and necessary responses, needed to provoke growth. Conflicts are handled by maintaining a focus on the child, studying the student's case, and creating an 'individualized plan' to break the cycle of disabling situations.
Trust is an important factor in the success of this Project, especially among the Project staff and the Principal of the school, who originally had authority over final decisions and resource allocation. Development and refinement of the Project have empowered teachers to be responsible in the execution of tasks and decision-making. Regular communication, with practical and concrete information that is readily available and accessible for all stakeholders, was cited as critical to the relationship and trust building processes. Many professional groups, each with their own orientations and approaches to service delivery are involved with the Project. Hence, as a lesson learned, it is necessary to build an environment that is void of cultural prejudices and that is conducive to being open to alternative viewpoints. Relationships and trust are also nurtured with increased inter-disciplinary contact.
Restructuring systems of service delivery and interpersonal relationships among service providers are directly related to, and reflective of, the changes in the social condition of Reggio Emilia. Services that were formerly self-centered, now work interdependently with each other. Underlying this shift is an awareness of the scope and limitations of each service and the benefits of combining resources and organizing a network among the various services. Today, the aim has moved beyond working collaboratively, to creating 'individual plans' for students that are case specific, and that are not limited by defined responsibility. Hence, a shift from developing collaborative relations to including shared responsibility is evidenced.
A similar service does not exist elsewhere in Italy, and for this reason it is difficult to compare this Project with any other. Thus, this service uniquely documents changes in, and benefits to, the student and the school's ability to deal with the changing social reality. The success of the service is measured by the results of the child's overall progress. Moreover, the work done by the student outside the school is evaluated at the end of the year. These developments are seen as indicative of the changes in this exemplary school's approach to education. Given the Project's success, there is a willingness to extend this effort in order to establish stronger and more extensive links between communities and schools.
FINDINGS AND CONCLUSION
This study yielded some potentially important findings regarding characteristics of mature attempts to link schools with health and social services. These results are subsumed under the headings goals, structure, evolution, resources, and power.
Although no one model of school-linked services exists, a consistent finding in all the exemplary programs reviewed was that they were all explicitly child centered. This is in keeping with the assertion that to integrate a program you must have an integrating idea. In the cases presented here a wholistic child-centred focus was consistently evident. Increasing the educability and improving the life chances of children were the general aims of the integration efforts.These goals provided a dual focus for both service delivery and system of service delivery improvements. The former provided a tangible and concrete day-to-day feedback, while the latter was more abstract and unavailable to assess. These two dimensions have differential appeal to managers and front line workers. The more abstract goal, the implementation of policy, was the focus of managers. In contrast, front line workers sought input around whether or not their collaborative efforts had paid off in terms of improved service for children and their families.
None of the services reviewed were mandated. That is, all were formed on a voluntary basis. Moreover, both institutional and community based programs were originally impelled by groups outside of schools.
Structure refers to the organizational forms by which schools are linked to health and social services. These forms both illustrate and illuminate the persisting question, "if school-linked services are such a good idea, why is it so difficult to achieve?". The preceding case presentations suggest that even in mature school linking structures, issues of funding, turf, and autonomy remain tenacious and pervasive. Crowson and Boyd (1993) point to the need for the creation of an institutional climate that will be supportive of linking efforts. Leadership and trust are both personal and organizational qualities that need to be addressed in creating the kind of climate that will enable integration to catch fire. As they argue, "people cannot be separated from the 'iron cages' of their separate employing organizations". Evident in the cases reviewed here are the policies and funding opportunities that make organizations susceptible to change. Also evident is the use of the new academic organizational knowledge base now available in this area (Morgan, 1998).
School linking tends to take on one of three organizational forms, a ring, spoke, or spiral. Some linking arrangements involve agencies and individuals sharing common goals that each work on collaboratively. Problems are shared and they tend to have impact on all participants. This organizational form is like a ring or a circle, involving frequent and intense interaction. A substantially different form of linking is spoke-like interactions that have a primary agency acting as a hub to connect other agencies. These agencies interact with one another as specific needs arise to form spokes. These spokes are often coordinated to meet shared goals. Spiral organizations have multiple services that cohabit in the school. In time they may become absorbed by the larger system. An important example of this is day care, which may have arisen through a social service agency, but which comes under the control of a school.
In general, state level programs tend to be like rings, and local level programs are more like spokes. The implication of this observation is that large top-down programs tend to function best as rings and smaller, service-focused programs work best as spokes (i.e. as small, problem- focused dyads).
Our third generation programs showed evidence of progressive change. Moreover, in keeping with modern perspectives on development, these changes were not linear. Multiple paths, along with sidetracks and regressions, were evident. Context played a major role in shaping the emergence of organizational forms. Funding and governance changes caused disruptions and often transformations. The rate and pace of changes often hinged on political-ideological events and alterations in physical environments.
Guidance through the implementation phase of program development was also extremely important in shaping what organizational forms emerged. This period was often underestimated in terms of the length of time needed and the amount of effort that would be required. These features highlight the need for effective leadership by both management and service providers.
Leadership along with funding must be counted as program resources. Almost all forms of school linking recognize the importance of community/business, political, educational, and service leaders. Moreover, the extremely important involvement of families often appears as part of community leadership. Consequently, leadership appears to be intimately related to financial support. Business, government, and foundation financial resources result from an array of partnerships that are expressed through leaders.
Power is rarely shared. Strong leadership consistently plays a role in the maintenance and evolution of programs. School principals play a crucial role by virtue of their role authority. Rarely was the ball for integrating services picked up and run by schools. Most initiatives for the linking of services occur through the instigation of outside agencies.
These leaders tend to be well experienced professionals who guide the linking efforts with their own visions, zeal, understandings, passion, and knowledge. Three types of leadership are evident: The Wheeler/Dealers, Paternal/Maternal, and Democratic. The Wheeler/Dealer is usually there at the beginning of the program and then fades into the background. He/She often continues to play a major 'behind the scenes' role. The Paternal/Maternal leader is usually a community member that is the head of a family foundation or a retired business executive. The Democratic leader is usually a government official or legislator with a particular interest in reform or educational or community systems change.
This final section will highlight emerging themes, trends,
and issues that have arisen from the previously reviewed cases.
This discussion will be grounded in lessons learned from these
exemplary programs. Lessons learned from these sustained efforts
will be framed in terms of facilitators to success.
In examining program rationales three developments consistently provide program impetus. The first is the wholistic child-centred view that has come to dominate thinking in education and human development. Second, is the fruit of numerous long term studies that show the multiplicity of paths to positive life outcomes. Third, is an expanded definition of risk that incorporates both personal and societal features. Each of these developments highlights the importance of seeing problems in living as complex and in need of supports and services that are at the same time multifaceted and coordinated. School-linked programs that are effective are the product of service offerings, specific personal needs, and local conditions. Consequently, no one preferable model of service delivery has emerged. Rather, innovative school-linked initiatives illustrate the dynamic nature of education and human service delivery.
This report's examination of relatively mature programs has enabled us to discern evolutionary changes as these undertakings have taken hold in schools. Most important among these changes is a shift from an emphasis on risk to protective factors, a shift from focusing on negative personal and environmental features to inherently more positive achievements and strengths. These shifts can be seen in a change in focus expressed in describing children in terms of promise as opposed to risk.
Funding changes have created a new mind set for many programs. Moving beyond a pilot or demonstration phase has grounded many providers and facilitated their becoming a school fixture. Funding is often as eclectic as the programs themselves. This is both a result and benefit of greater cooperation between schools, other services, and funding sources. Most programs began as foundation or privately funded initiatives and moved to more secure government support.
Through years of internal and external evaluation, constant justification, and intense competition these programs have become more able to articulate their practice visions and service delivery models. In many cases this has made it possible for more recent growth to be more purposive and coherent instead of a patchwork of opportunistic add ons.
REFERENCE LIST AND SELECTED BIBLIOGRAPHY
Adelman, H. S., & Taylor, L. (1997). Addressing barriers to learning: Beyond school-linked services and full-service schools. American Orthopsychiatric Association, Inc.
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PARTICIPANTS, KEY INFORMANTS AND RESOURCE LIST
FIVE STATE INITIATIVES FOR MENTAL HEALTH IN SCHOOLS
Center for School Mental Health Assistance
Department of Psychiatry, University of Maryland at Baltimore
680 West Lexington Street, 10th Floor
phone: (410) 706-0980
fax: (410) 706-0984
Howard Adelman and Linda Taylor
School Mental Health Project at UCLA
Center for Mental Health in Schools
Department of Psychology, University of California, Los Angeles
405 Hilgard Avenue
Los Angeles, California
phone: (310) 825-3634
School Mental Health Project at UCLA
Center for Mental Health in Schools
Department of Psychology, University of California, Los Angeles
405 Hilgard Avenue
Los Angeles, California
phone: (310) 825-3634
THE INTEGRATED RESOURCES IN SCHOOLS INITIATIVE (IRIS)
The Integrated Resources In Schools Initiative (IRIS)
C/o DMH, 275 E. Main Street
phone: (502) 564-7610
fax: (502) 564-9010
Family Connections Coordinator
601 Foust Avenue
Phone: (502) 686-1114/1125
SCHOOL-LINKED SCHOOL-BASED MENTAL HEALTH SERVICES PROJECT
State Project Coordinator
School-Linked Mental Health Project
University of Southern Maine
295 Water Street, 2nd Floor
phone: (207) 626-5274
fax: (207) 626-5210
Student Health Center Coordinator
Maranacook Student Health Center
Community School District #10, Maranacook Community School
P.O. Box 177
Readfield, ME 04355
Phone: (207) 685-4923 x318
Fax: (207) 685-9597
Dr. John Yasenchak
Clinical Supervisor and Program Director, Counseling Services,
Penobscot Nation Health Department
5 River Road
Indian Island, ME
phone: (207) 827-6101
fax: (207) 827-5022
THE CHILDREN'S AID SOCIETY'S COMMUNITY SCHOOLS AND
TECHNICAL ASSISTANCE CENTER
Washington Heights Community School, New York, New York
Associate Executive Director
The Children's Aid Society
105 East 22nd Street
New York, New York
Phone: (212) 949-4936
Fax: (212) 477-3705
Children's Aid Society Technical Assistance Center, IS 218
New York, NY
phone: (212) 569-2880
fax: (212) 544-7609
TRAINING AND INFORMATION CENTER FOR THE EDUCATION OF
CENTER DE FORMATION ET INFORMATION POUR LA SCOLARISATION
DES ENFANTS DES MIGRANTS (C.E.F.I.S.E.M.)
Coordinator of the CEFISEM of Montpellier
Phone number: office: 0467915007 // 0467618303 /04679150011
Fax number: office: 0467618312 // 0467914953
31 rue de l'Université,
34064 Montpellier CEDEX 2
THE URBAN LEARNING CENTERS
A NEW AMERICAN SCHOOLS DESIGN
Los Angeles, California
Urban Learning Centers
Los Angeles Educational Partnership
315 West 9th Street, Suite 110
Los Angeles, California
phone: (213) 622-5237
fax: (213) 629-5288
Karen V. Bading
Organizational Development Consultant
2010 Fair Oaks Avenue
South Pasadena, California
phone: (626) 799-7659
fax: (626) 799-7055
Foshay Learning Center
3751 S. Harvard Blvd.
Los Angeles, California
phone: (323) 735-0241
fax: (323) 733-2120
Corona Avenue Elementary School
3825 Bell Avenue
phone: (323) 771-6667
New American Schools Development Corporation
1000 Wilson Blvd., Suite 2710
phone: (203) 908-9500
DALLAS INDEPENDENT SCHOOL DISTRICT
OFFICE OF INTERAGENCY COLLABORATION
YOUTH AND FAMILY CENTERS
Office of Interagency Collaborations
Youth and Family Centers
phone: (214) 951-8669
fax: (214) 951-9035
Dr. Wayne Holtzman
Hogg Foundation for Mental Health
Lake Austin Center, 4th Floor
3001 Lake Austin Boulevard
phone: (512) 471-5041
fax: (512) 471-9608
SAN ANTONIO INDEPENDENT SCHOOL DISTRICT FAMILY SUPPORT PROGRAM
San Antonio, Texas
Fred Cardenas, Campus Social Worker
Family Student Support Program
J.T. Brackenridge Elementary
San Antonio, Texas
Phone: (210) 224-4916
Fax: (210) 224-4933
EDUCATION, PRIMARY AND SECONDARY PREVENTION PROJECT
(PROGETTO EDUCATIVO E DI PREVENZIONE PRIMARIA E SECONDARIA)
Reggio Emilia, Italy
Comune di Reggio Emilia
Assessorato Educazione e Formazione Università
Via Guido da Castello 12
421000 Reggio Emilia
Phone number: +39 0522 456422
Fax number: +39 0522 456198
EUROPEAN HUMAN RESOURCES
RISORSE UMANE EUROPEE
Walter De Liva
Coordinator of the project on the social integration and the cultural difference of the foreign minors and their families in the province of Udine
c/o ITI "A. Malignani", Viale L. Da Vinci 10
33100 Udine (Italy)
Phone : +39 0432 46361
Fax: +39 0432 545420
5 ACTION PLAN
CSDM COMMISSION SCOLAIRE DE MONTRÉAL
Conseillère pédagogique en Coordination et développement pour l'intervention en milieu defavorisé de la CSDM Commission Scolaire de Montréal
Service des ressources éducatives
3737, Rue Sherbrooke Est
Phone #: 514/ 596-6398
Fax# : 514 / 596-6340
Marie Martin Dimitri
50 30 Rue Jeanno-Mance
Phone # 514/ 596-4195
Phone # 514/ 596-3379
JEWISH FAMILY AND CHILDREN'S SERVICES
Jewish Family and Children's Services
School Partnership Project
1600 Scott Street
San Francisco, California
phone: (415) 561-1208
HEALTHY START AND AFTER-SCHOOL PARTNERSHIPS
Healthy Start and After-School Partnerships Office
721 Capitol Mall, Room 556
phone: (916) 657-3558
Sheridan Way Elementary School
573 Sheridan Way
phone: (805) 641-5081
fax: (805) 641-5392