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Identifying and Assessing Students with Emotional

Disturbance

by Terry J. Tibbetts, Ph.D., J.D. San Bernardino, California

Baltimore • London • Sydney Excerpted from Identifying and Assessing Students with Emotional Disturbance by Terry J. Tibbetts Ph.D., J.D. Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2013 | All rights reserved

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Contents

About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii

1 Understanding Educational and Clinical Definitions of Emotional Disturbance: A Comparative Overview . . . . . . . . . . 1 2 Toward an Understanding of Educationally Based Emotional Disturbance . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3 The Educational Definition of the Student with Emotional Disturbance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 4 The Exclusionary Clause: Social Maladjustment and Behavior Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . 43 5 Psychoeducational Components of Assessment . . . . . . . . . . . . . . . . . . . . . . . . . 61 6 Clinical Considerations for Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 7 Response to Intervention: An Alternative Model of Assessment . . . . . . . . . . . 115 8 Placement Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

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Excerpted from Identifying and Assessing Students with Emotional Disturbance by Terry J. Tibbetts Ph.D., J.D. Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2013 | All rights reserved

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About the Author

Terry J. Tibbetts, Ph.D., J.D., is a licensed psychologist and educational attorney

who has worked in a variety of clinical and educational settings involving students with emotional disturbance, both as an administrator and as a psychologist. He currently works for the California Department of Corrections and Rehabilitation, where he is responsible for the psychoeducational evaluation of adjudicated adoles- cents. Dr. Tibbetts also holds a master’s degree in clinical social work and is both a registered art therapist and a board-certified behavior analyst. His most recent publication is on the use of short-term gestalt art therapy with adolescents who are emotionally disturbed. Dr. Tibbetts has testified as an independent evaluator and as an expert witness in multiple administrative due process hearings regarding the appropriate identification, assessment, and treatment of students with emotional disturbance. He resides in Southern California with his wife and two children.

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Placement Characteristics

The IEP team determines the most appropriate educational program for the student once identification and assessment have been completed and the student is found to be emotionally disturbed. Although the focus of the book has been on identifica- tion and assessment, this chapter provides a brief summary of typical educational settings for students who are emotionally disturbed, necessary staffing parameters and skills, successful classroom characteristics, and appropriate program charac- teristics for effective ED placements.

EDUCATIONAL SETTINGS AND SERVICES

Because no single program or service may be effective for every student who is emo- tionally disturbed, federal law requires that a “continuum of services” and programs must be considered for the student, with an emphasis on providing such services and programs within the LRE. This continuum is based on the individual needs of the student, and the services vary in the level and extent of the interventions provided to the student. A comprehensive and appropriate educational placement can be determined through matching the student’s characteristics and needs with various programs and services. RiSE (1991) defined these placements as either inte- grated settings or protective settings.

Integrated Settings

The special education teacher and the general education teacher work together in integrated settings to educate the student who is emotionally disturbed. The

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general education teacher typically provides most of the instructional services, whereas the special education teacher may provide instructional services and/or service in a support role to the general education teacher. These programs are typi- cally provided at the student’s home school site. All staff working in integrated set- tings should have extensive and specialized training in effective collaboration and in the educational needs of the student who is emotionally disturbed.

General Education Classroom Many students who are emotionally disturbed can be educated within a general education classroom setting with appropriate educational supports or related services such as counselors, specialized academic instruction (SAI) specialists, and other designated instructional services (DIS) sup- port staff. Using support staff allows the student to be educated within the LRE while reserving more restrictive resources for students who have more severe dis- abilities. Support staff can include a trained instructional aide assigned to assist the student in academic or behavioral activities. SAI services may occur within or outside the general education classroom.

Part-Day General Education Classroom The student who is emotionally dis- turbed is placed into a smaller and more intensive classroom setting for a part of the day. This smaller classroom setting is often referred to as a learning center, a resource room, or a specialized instructional classroom. Although the student continues to participate in the general education classroom to the maximum extent appropriate as determined by the IEP team, the student also receives services from the SAI specialist within the more individualized classroom setting. The emphasis is on moving the student who is emotionally disturbed to extended participation in the general education classroom as the student’s behavioral, social, and academic goals are increasingly met.

Protective Settings

Protective settings are considered when the student who is emotionally disturbed appears to need more intensive and extended services that require additional dis- trict staff support. These settings may be provided at a district school site, a segre- gated separate school site, a mental health site, a nonpublic school (NPS), or within a residential or hospital setting. The SAI specialist maintains the primary responsi- bility for the educational program within these settings. Advantages to such settings include the opportunity for greater individualiza- tion in instructional content, flexibility in the educational format, increased consis- tency within the classroom environment, and a smaller classroom population, which allows for a higher level of individualized attention and support. Disadvantages include reduced access to peers without disabilities and an increased exposure to students with severely disturbed behavior. All staff working in protective settings should have extensive and specialized training in the educational needs of the stu- dent who is emotionally disturbed.

Special Day Class A protective setting such as an SDC may be required when students fail to demonstrate progress in the general education classroom, even with supportive services from special education staff. For students with ED, these typically are students whose behavior is so significantly disruptive to the class or

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Placement Characteristics 129

dangerous to themselves or others that a self-contained educational placement is necessary. Such a class placement is designed to create a more controlled, therapeu- tic environment. The classes are generally smaller, typically 8–12 students with a teacher and 2 classroom aides. This allows each student to receive more consistent individualized and intensive instruction. The class often is focused on social and behavioral gains as well as academic improvement. The program is designed to pre- pare students to return to a more collaborative setting. A relatively new format involves collaborative agreements between the NPS site and local school districts, in which dedicated classrooms within a school site are leased or otherwise provided to the NPS. Students who would otherwise be placed into a segregated NPS site are provided with the more intensive services of an NPS but served within the school site itself. This arrangement allows students to partici- pate in social, academic, and recreational activities with peers without disabilities while providing focused services to students who are emotionally disturbed in a format that facilitates transition back to district programs.

Special Day Class: Day Treatment The behavioral and emotional severity of many students who are emotionally disturbed requires a coordinated response from both mental health and educational systems. Some of these students are placed in an SDC that incorporates mental health treatment as an embedded part of the day. Many of these programs are provided at a segregated district site, but they may also be provided at a district site, an NPS site, or a local mental health facility. Such a program generally consists of at least three program aspects: academic programs with individualized educational therapies, individual and group psychotherapy, and family-related therapy and/or other interventions (Sabatino & Altizer, 1998). The student typically participates in specialized instructional and clinical activities throughout the day. Structured instructional time provided by SAI staff is interspersed with individual and group psychotherapy activities managed by mental health staff. The focus is on providing a safe and therapeutic environment while maintaining a core educational program for the students. All-day treatment programs generally require a minimum of 3 hours per day of therapeutic activities. The programs also provide an opportunity for collaboration and teamwork between educational and clinical staff because the student is monitored and observed by all staff across the entire day. Immediate problem-solving strategies as well as long- term planning can be developed within an ongoing team format. Because the focus of intervention is on behavioral and emotional needs as well as academic needs, many programs have less opportunity and time to provide access to the core curriculum for students. Shepherd (2010) pointed out that this may lead to difficulties in making the transition back to a general education classroom set- ting when the student returns from the day treatment program.

Nonpublic School An NPS placement at a segregated site may be considered for students who are emotionally disturbed and who require a more restrictive set- ting. All NPS students are special education students who have been placed at the NPS program due to the severity and intensity of their emotional and behavior dif- ficulties. The instructional program typically involves a full-day classroom setting, with students transported to and from their homes each day. A n NPS prog ram rarely has a day treatment component. Suppor t sta ff are gener-ally well trained in working with students who are emotionally disturbed, however,

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and are available to a larger extent than in regular district classroom settings. Many NPS sites have a strong clinical component, and mental health activities are built into the educational day. The classrooms often have a low student–teacher ratio and offer fewer distractions. NPS teachers are often able to respond more appro- priately to bizarre or serious problems (e.g., physical aggression, sexual acting out, self-mutilation) that such students may demonstrate because of their experience with students who are emotionally disturbed. The cost to school districts is the major disadvantage of an NPS. Although some NPS programs are nonprofit, all NPS programs depend on keeping a sufficient number of enrolled students in order to financially survive. Many districts mistrust NPS recom- mendations regarding a student’s need for continued treatment and education in the program and may believe these recommendations lack validity. The most successful NPS programs are those that are able to create a sense of teamwork and collaboration with referring school districts so that both district and NPS staff recognize that they are working together for the best interests of the student who is emotionally disturbed.

Residential Residential placement may be considered when the intensity and severity of the student’s ED becomes so disabling that the student is unable to benefit from a public educational setting or the less restrictive settings previously described. The student who is emotionally disturbed typically lives on or next to the campus of a school site and receives educational services from teachers, along with individual, living unit, and group therapy from trained counselors, psycholo- gists, social workers, and/or psychiatrists. In addition, specially trained counselors often referred to as cottage staff or house parents work with the student on social and independent functional skills (living skills). A comprehensive treatment pro- gram is developed for each student and is monitored by the educational, thera- peutic, and residential staff team during periodic meetings. The emphasis is on stabilizing the emotional health of the student and returning him or her to the local district as soon as appropriate. The typical length of stay for a student who is emotionally disturbed in a residential facility varies but is generally in the range of 18–24 months.

Institutionalization The student is placed in a correctional facility or mental hospital and receives an educational program in conjunction with other institu- tional services. Hospital institutions may include private psychiatric hospitals and medical hospitals with psychiatric units, private community psychiatric hospitals with a local mental health contract, university psychiatric hospitals, or county hos- pitals with psychiatric units. Many hospital placements generally last less than 30 days, because of health insurance issues (RiSE, 1991). Juvenile justice correctional institutions serve students who have been commit- ted by the courts for violating the law. The length of incarceration varies, depending on court adjudication. State law generally mandates how educational services for such students will be provided.

Related Services

A special education student may also receive supportive related services (referred to in the law as designated instructional services [DIS]) as a supplement to the protective and collaborative education setting previously described. These ser- vices are determined by the IEP team and may include speech-language therapy,

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Placement Characteristics 131

occupational therapy, adaptive physical education, or even career development (vocational counseling) services. Counseling is the most common DIS service for students who are emotionally disturbed.

Speech-Language Therapy Students who are emotionally disturbed often demon s t rate a v a r iet y of com mu n icat ion d i ffic u lt ies a nd i mpa i r ment s (see C hapter 5). Speech-language services can be a highly effective part of the student’s IEP.

Occupational Therapy/Adaptive Physical Education Services provided by an occupational therapist or through adaptive physical education can significantly benefit students who demonstrate difficulties in physical movement or motor coor- dination by building visual-motor, coordination, motor planning, and fine and gross motor skills. Improvement in these areas can increase the student’s ability to successfully engage in physical and motor activities with peers and peer groups.

Career Development A comprehensive career development program for sec- ondary students who are emotionally disturbed is an important but often over- looked part of their educational program because more than half of all students who are emotionally disturbed drop out of school before graduation and an even higher number are unemployed up to 5 years after school ends. The teacher should be familiar with and work closely with regional occupational programs as well as with state agencies such as the Department of Rehabilitation and Employment Develop- ment Department to ensure that students who are emotionally disturbed are pro- vided with a meaningful opportunity to develop the skills to successfully make a transition from high school graduation to gainful employment. The lack of occupational social skills has been estimated to be the cause of almost 90% of job loss for students with disabilities (Elksnin & Elksnin, 2001). While there are many classroom-based social skills training programs avail- able, none address their relationship to obtaining and keeping specific employ- ment. Accordingly, secondary student IEP documents should address the issue of employment-related social skills training as an integral part of career development. The school psychologist and counselor are a useful starting point for career development services because they can administer vocational interest and social skills inventories to the student. The results can provide IEP goals that can lead to specific activities that will increase the student’s ability to 1) learn more about pos- sible career options and 2) how to obtain and keep jobs that will further his or her career. These goals and activities can be documented on the student’s individual transition plan and used to monitor the student’s progress in this area.

Individual Counseling Individual or small-group counseling is the most common supportive service provided to students who are emotionally disturbed. Federal law appears to generically refer to both psychotherapy and counseling as counseling; however, there is a significant difference between the two. Educational interventions to student’s emotional needs generally involve coun- seling, and most graduate educational programs in pupil personnel services teach skills in this area. Counseling is essentially concerned with the healthy personal- ity and its conscious, rational aspects, and helping students make productive life choices. It assists the student in working through specific, identified problems in sessions that generally last from a few weeks to several months.

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B y cont ra s t , mos t c l i n ic a l i nte r ve nt ion s u s e ps yc hot he rapy. Ps yc hot he rapy de a l s with the abnormal personality and its irrational aspects and with assisting students in resolving deep-seated, often unconscious emotional conflicts. Resolving such personality problems usually requires a significantly long period of time because the student requires time and repetitive working through of the conflicts in order to constructively resolve them.

Lions and Lambs

It is an unfortunate reality that the assessment process in many cases may be cir- cumvented by teachers and administrators who want students with behavior prob- lems removed from the general education settings (RiSE, 1991). This places pressure on the IEP team to find students who are socially maladjusted or behaviorally dis- ruptive as eligible for special education and often results in their subsequent, and inappropriate, placement in an ED classroom setting. Placing students who are socially maladjusted with students who are emotion- ally disturbed (referred to by many administrators as “placing the lions with the lambs”) does nothing but significantly dilute the effectiveness of the ED setting for both groups of students (Moran, 2012). The purposeful misbehavior of students who are socially maladjusted (e.g., physical and verbal aggression, classroom disruption, refusal to accept teacher authority) has little in common with students who are emotionally disturbed and whose disorder is rarely antisocial in nature. It provides students who are socially maladjusted with an opportunity to exploit and victimize students who are emotionally disturbed (Gacono & Hughes, 2004) while reducing their quality of education, violating their right to learn in a safe and protected envi- ronment, and providing them with inappropriate peer models. Not surprisingly, teachers and aides in ED classrooms are more likely to leave their positions or seek reassignment (Brooks & Farley, 1998). It is critical for the evaluator to participate in the IEP process to ensure that the IEP team does not make inappropriate or rushed judgments in what is often a very complex decision-making process. The evaluator should be a supportive and informational resource to the team in determining the most appropriate general education services and program modifications for noneligible students.

Entry Review Team Many school districts with ED classrooms and site pro- grams utilize a more formalized identification and entry process to ensure that students who are socially maladjusted are not inappropriately placed in an ED class- room and that all placements are educationally sound and appropriate for each indi- vidual student. This approach typically utilizes a committee or team that reviews the complete file for each student proposed for the ED program to ensure that an appropriate and meaningful educational program for that student can be provided. Coats (2006) identified five factors that such teams should look at in their review of each student being considered.

  1. LRE: What other treatment options or interventions have been attempted to this point? Have all other less restrictive options been exhausted?
  2. Safety concerns: Does the student present a significant danger to self or others? Is the student actively suicidal or homicidal? Excerpted from Identifying and Assessing Students with Emotional Disturbance by Terry J. Tibbetts Ph.D., J.D. Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2013 | All rights reserved

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. upport from all systems: What level of cooperation and support can be 3 S expected from the referring school district? What level of cooperation and support can be expected from the parents? Is there congruence of goals involving all parties?

  1. Goodness of fit: Is there space available in the program? How will the student respond to the current classroom dynamics and milieu?
  2. Staffing: Will there be appropriate staffing to meet the student’s needs and to ensure that the recommended educational services can be effectively provided? If the team is unable to answer these questions in a positive and confident way, then the placement of the student in the ED program should be declined.

STAFFING CHARACTERISTICS AND SKILLS

Staffing characteristics and skills play a key role in the development of an effective ED classroom program. These can affect dynamics ranging from classroom man- agement style and levels of student involvement and motivation to frequency of student misbehavior and time on academic tasks.

Classroom Size

Class size should be limited to 8–12 students and three supervising adults to give students more individualized attention and maintain effective classroom instruc- tion in crisis situations. All adult staff should have extensive training in effectively working with students who are emotionally disturbed (Mosier & Park, 1979).

Staffing Characteristics

Assisting students in learning to substitute socially appropriate behaviors and atti- tudes for those that have resulted in their exclusion from the general education setting is the main task of adults in the ED classroom. The task of teaching such self-regulatory behaviors to students who are emotionally disturbed requires a high level and variety of skills. Direct Instructional Staff As the lead instructional staff member, the teacher should have a demonstrated skill level and background in

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134 Tibbetts

•eloping and implementing behavioral goals and strategies Dev

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Placement Characteristics 135

Individualized Education Program Goal and Objectives

Writing effective goals and objectives for each student is another key domain for the ED teacher. Students who are emotionally disturbed are placed in special educa- tion programs because of their emotional or behavioral impairments, which need to be addressed when developing IEP goals. In addition to academics, the teacher should develop goals for behavioral, social, and emotional development as curricu- lum areas.

Managing Crisis Situations

The ability to effectively manage crisis situations in the classroom setting is another critical characteristic for the effective ED teacher. Several national orga- nizations provide formal training to teachers in this area, all of which focus on using nonverbal and verbal skills to deescalate a crisis event, physical principles of safety to avoid student and staff injury when behavior escalates to a physi- cal level, and subsequent resolution of the issues leading to the crisis situation (Caraulia & Steiger, 1997). No teacher should ever be requested to or ever should physically intervene with students without previous formal training in this area. Furthermore, every school should have a written policy regarding using physi- cal intervention with students who are out of control and who require physical holding or escorting. Key areas of effective training in crisis management should include, at minimum

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136 Tibbetts

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Placement Characteristics 137

Finally, it is important to keep comprehensive and thorough records of any crisis incidents involving physical intervention. Smith and Yell (2013) emphasize that documentation is important for three reasons: 1) to protect staff members if liability issues arise, 2) to ensure there is a record in case any false allegations are made by the involved student(s), and 3) to provide informational data to program adminis- trators and staff in evaluating the appropriateness of their responses to the incident. Some programs require that staff wear latex gloves if there is any potential for physical intervention in order to minimize any transfer risk of blood-borne patho- gens. It is interesting to note that one school program reported students who had been acting aggressively would become compliant when staff put on gloves in prep- aration for intervention. The program staff suggested that many students did not want to be touched by adults wearing latex gloves (Garrison School Staff, 1994). It may also have reflected the awareness of students that the donning of latex gloves was a discriminative stimulus indicating physical contact was about to occur if any further aggressive behavior was demonstrated.

Law Enforcement Intervention

Call the police if there is a crisis situation that involves assault or battery of another individual by the student who is emotionally disturbed. Law enforcement officers should be notified when there is any serious physical aggression committed by a student who is emotionally disturbed. Administrators who do not recognize crimi- nal acts committed in the school do a major disservice to students and the com- munity (Johns & Carr, 1995). Furthermore, they fail to ensure that the school site remains a safe environment for all students.

PROGRAM CHARACTERISTICS

A well-designed educational program should be structured, organized, predictable, and orderly (Epanchin, 1991). Many ED classrooms and settings, however, are poorly designed for students who are emotionally disturbed and often include unstruc- tured or overstimulating activities, lack of clearly delineated transition times, inconsistent use of rewards or punishments, frustrating or boring academic tasks, overly competitive games or tasks, unpredictable teacher behaviors or comments, unclear expectations, or poorly structured class time. An effective program for students who are emotionally disturbed must reflect a recognition that the teacher is concerned with each student’s mental health and emotional well-being, his or her academic achievement and success, and the welfare of the classroom, including the integrity of the environment and ongoing main- tenance of appropriate and supportive procedures and activities in that environ- ment. This means that an effective ED classroom must 1) provide a safe and secure environment in which learning can take place, 2) provide ongoing opportunities for students to learn how to follow rules and the consequences for choosing not to follow them, and 3) assist students in learning how to manage their behaviors by developing self-discipline and self-control skills (Shepherd, 2010). Frisby (1990) identified a problem-solving model of effective classroom disci- pline focusing on the ability of the teacher to demonstrate a thorough knowledge of four subsystems: instructional, behavioral, group management and dynamics, and human relationships.

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Instructional

T he effective ED teacher engages students in instr uction by different learning modal- ities, appealing to differing interests, and using varied rates of instruction along with varied degrees of complexity, ensuring that students compete only against them- selves while cooperatively learning with other students (Tomlinson, 1999). The curriculum content must be provided to students who are emotionally dis- turbed in a manner that is individualized and keeps motivation strong while still maintaining high academic standards. The teacher must clearly understand the curriculum content that the student must eventually learn in order to return to the general education setting. More elaborate and lengthy units of study will probably be relatively less effective because the course of instruction can be disrupted by behavioral outbursts, inconsistent attendance, and frequency of students entering and exiting the program. Coats (2006) recommended that the teacher consider using a shorter unit format with units clearly connected to each other as part of a more cohesive curriculum, accompanied by a clear set of expected student outcomes. Written assignments must be initially adapted to the student’s level of frustra- tion tolerance. Many students who are emotionally disturbed will look at an assign- ment and refuse to attempt it if it appears to be more than they believe they can do. Individual worksheets may need to have fewer problems; be printed in a larger font; or have critical words, operations, or functions color coded or otherwise empha- sized. The student can be shifted to independent practice once his or her initial competency is established. Review of previously mastered material should also be built into each student’s assignments to ensure long-term mastery and a sense of accomplishment through a high percentage of correct responses. Specific lesson plans need to be planned and developed in advance and focused to ensure that all assignments and activ ities support coverage of the core curriculum while corresponding to the student’s IEP goals and objectives. Lesson plans should include additional and/or alternative activities because lessons may often be com- pleted more quickly than anticipated or may be refused by students. Attempting to force students to complete an activity that is not working only creates open resis- tance and may result in escalating student defiance. The teacher needs to be sensi- tive to student frustration or boredom levels so that another activity can be quickly substituted. Furthermore, caref ul attention must be given to the amount of new information being presented at any given time. Directions should be clear and presented with appropriate vocabulary, and concrete or specific examples should be used whenever possible to introduce new concepts. The student should repeat the directions back to the teacher. A wide variety of specific curriculum approaches can be used that focus on the essential concepts and skills to be taught to each individual student.

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(20 0 9) i fferent iated bet ween behav iora l inter vent ions t hat a re prevent i ve d ( ke epi ng misbehaviors from occurring), supportive (assisting the student to regain self-control and return to task), and corrective (ensuring no further m isbehavior occurs). Effectively managing the inappropriate behaviors of students and providing a setting that will lead to developing more appropriate behaviors is critical for learn- ing to occur. This is particularly important because the behaviors of students who are emotionally disturbed are often disruptive to the organization and stability of the classroom program and, at times, dangerous to the health and safety of other students and adults. Teaching students new and increasingly complex rules and creating conditions in which self-control will be enhanced is one of the functions of the school setting. This is often a long and difficult process. The students’ behaviors did not start over- night and will not resolve themselves that quickly. The school psychologist should be a central part of the teacher’s efforts to cre- ate and maintain an effective behavior management system in the classroom. The school psychologist can provide individualized support and consultation to the teacher in developing a general behavior management system for the classroom and also for more individualized interventions with specific students. Many school districts have also begun to utilize the services of applied behavior analysts who are certified by the national Behavior Analysis Certification Board. These skilled indi- viduals can be an excellent resource for staff and sites that have exhausted their local resources without success. Staff who also desire written resources to increase their behavior management knowledge and skills are referred to Mayer, Sulzer-Azaroff, and Wallace (2012) or Cipani and Schock (2007). Most behavior management sys- tems utilize a blend of positive rewards for desired behavior (reinforcement) and negative responses to undesired behaviors (punishment).

Reinforcement Reinforcement refers to stimuli that increase the future prob- ability of the response they follow. Positive reinforcement involves providing a posi- tive reward to the child for performing a desired behavior. For example, a student may be given extra free time on the computer when he or she completes his or her math worksheet within a certain period of time. Negative reinforcement removes something negative or undesired as an outcome to the child for performing the desired behavior. For example, a student may be told he or she does not have to complete the remainder of the assigned math worksheet if the first 10 problems are correctly solved within a certain period of time. Reinforcement will be most power- ful to the student if it is immediately given following the desired behavior. Positive behavioral support (reinforcement of desired behaviors) is a key dynamic in class- rooms for students who are emotionally disturbed. S elec t i ng rei n forcers for a pa r t ic u la r s t udent shou ld be s ys temat ic a l ly conduc ted, starting with those that are most natural to a situation and moving only gradually toward more artificial ones (Mayer et al., 2012). If reinforcers typically include praise or other social rewards, then these should be tried first. If star charts or “classroom bucks” are naturally occurring, then begin with them. Classes of reinforcers gener- ally move from least naturally occurring to most naturally occurring as follows.

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Placement Characteristics 141

•ctivities: Free reading time, extra time on computer, special monitor assign A- ments, field trips

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40 inutes (e.g., sustained, on-task behavior), and the teacher wants to increase m the length of time that behavior is demonstrated, reinforcement should be provided when the student has demonstrated that desired behavior for 32 minutes. The desired behavior is reinforced every time it is exhibited during the initial stages of the behavior change process. The desired behavior needs to be consistently reinforced (continuous reinforcement) every time it occurs. The behavior needs to have the opportunity to become strengthened and established because the desired behaviors often increase gradually rather than dramatically. Many teachers become discouraged at this point and state that they are too involved in trying to keep the classroom program progressing to be able to moni- tor every instance of the student’s desired behavior across the day. The evalu- ator should emphasize to the teacher that the desired behavior does not have to be monitored across the day. The effort to provide continuous reinforcement for many behaviors should begin for a short time period. This may be for 10–15 minutes or for however long the teacher is willing to make a commitment to the behavior change effort. The initial purpose is to determine only whether the intervention process is effective. The time period can gradually be lengthened, once an effective reinforcer or set of reinforcers has been identified. At this point, a continuous reinforcement process can be shifted to an intermittent reinforce- ment schedule. When the desired behavior reaches a satisfactory level, it is reinforced intermit- tently. Continuous reinforcement is necessary to ensure that the desired behavior becomes established at a consistent level. Once this has occurred and the student is demonstrating the behavior at a consistently high level, ongoing reinforcement of that behavior should be gradually reduced to a level that will continue the behavior. For example, a student has been reinforced with a sticker whenever he completes a daily independent math worksheet. He now is consistently completing his work sheets. The teacher now rewards him with a sticker only every other day for com- pleting his worksheet (although she may continue to provide an appropriate natural reinforcer, such as praise) or involve natural objects or events in the classroom set- ting, such as extended access to computers or video games or classroom “helper” responsibilities. If tangible reinforcers are used, then social reinforcers should always be used with them. The purpose of all reinforcement is ultimately to place the control of the behavior under the contingencies of the natural environment (natural reinforc- ers). Because many of the reinforcers used in the classroom to build positive stu- dent behaviors do not occur in the real world, it is important to ensure that efforts are continually being made to gradually shift the reinforcers to those that would be found in the natural environment. Such reinforcers would tend to be social in nature (e.g., praise, compliments, attention). When more artificial reinforcers (e.g., tokens, food, stickers) are provided to the student, they should always be accompanied by a social reinforcer (e.g., praise, a pat on the shoulder). The teacher should gradually begin to replace these artificial reinforcers with the social reinforcers as the behavior program progresses. The key word here is gradually. If the replacement process begins to result in an increasing reoccurrence of the undesired behaviors, then it is most likely that the reduction of the artificial reinforcers has been too abrupt, and it will be necessary to slow the replacement process.

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Teachers sometimes fear that reinforcing one child might increase the nega- tive behavior of another child in order to get a reward. This concern is often voiced by teachers when a number of children in a class are on individual programs or only one child in a large class is receiving special rewards for increasing desired behavior. Although there has been little evidence to support this concern, one way to avoid this potential problem is to have the target child’s performance result in extra reinforcement for the entire group. Therefore, all of the children are rewarded for a child’s improved behavior, and they, in turn, are more likely to reinforce and encourage the child’s behaviors (Mayer et al., 2012). Sometimes it is more efficient to create group contingencies in a classroom set- ting in which students receive reinforcement based on the behavior of the group mem- bers. Group contingencies often result in students actively attempting to help each other reach the required level of performance so that all members of the group can receive the reinforcement, which can increase cooperative student behaviors: “These interventions are well suited to situations where a teacher wants to reinforce similar behaviors by all students in the class, such as on-task and good learning behaviors” (Smith & Yell, 2013, p. 127). Thorne and Kamps (2008) noted that group-oriented inter- ventions are relatively easy to implement, and students tend to enjoy them. However, the teacher needs to closely monitor such interventions, as peers may place inappro- priate pressure on group members to meet the group reinforcement criteria. There are three types of group contingencies—independent, interdependent, and dependent. The primary difference between the three involves how students are rewarded. A n independent g roup cont ingenc y involves set t ing t he s a me required response (and reinforcement) for all members of the group but rewards each student for indi- vidual performance. For example, the teacher may tell the students in the group that they are required to finish their math assignment and that each student who does so will receive five dollars in “class cash.” Ensure that the group membership is fairly homogenous because the ability levels of students who are emotionally dis- turbed are so varied. Alternately, the contingency for individual students may need to be modified to their ability level. An interdependent group contingency involves treating the group as if it were one single student. All members of the group receive reinforcement but only if all members of the group have demonstrated the desired behavior. For example, a group may be told that it will receive an additional 15 minutes of recess if every member of the group completes his or her math worksheet with less than three errors per student. This type of group contingency often results in more coopera- tive learning because helping another student meet the criterion results in a much higher probability of the helping students receiving the reinforcement. A dependent group contingency involves giving reinforcement solely based on the activity or behavior of one member (or a few members) of the group. For example, a group may be told that their reinforcement will depend on how much improvement the lowest performer in the group makes on a group math test. This contingency can lead to increased student support and cooperative behavior, but care should be taken to ensure that group members do not threaten or punish the student whose performance will determine whether anyone is rewarded. If students appear to become less responsive to specific reinforcers, then it may be necessary to create a new set of reinforcers. Reinforcer sampling and a reinforce- ment menu are two methods often used.

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Reinforcer Sampling Reinforcer sampling involves introducing the student to a novel stimulus that the student will find rewarding. This method is used to create new reinforcers for the student.

Ms. Reynolds reads the beginning of a new library book to the students. She does not finish reading the book but tells the students that when they complete their assigned work for the morning, they can borrow the book to find out its ending. The students are motivated to find out what happened next in the book and work to finish their assignments. When the students finish the book, Ms. Reynolds suggests other books that they might also like, and their motivation continues to remain high.

Reinforcement Menu The reinforcement menu involves determining a set or variety of reinforcers that the student had demonstrated an interest in and placing them into a menu format. The teacher presents the menu to the student when he or she has earned a reinforcer, and the student is allowed to make one selection from the menu. This method is particularly useful for students who quickly satiate on a specific reinforcer and keeps interest high because of the variety of desired reinforc- ers that are offered. It is critical to follow through on all consequences when students demon- strate undesired behaviors. This demonstrates a consistency on which students can depend. Students feel a sense of security in knowing that the teacher will always follow through with his or her commitments. Conversely, teachers who do not fol- low through create an insecure environment. Students cannot rely on them for con- sistency. Students who are aggressive or defiant will often misbehave because they know the teacher may not enforce the consequences for their inappropriate behav- ior. Teachers also leave themselves open to the accusation that they do not treat all students fairly, which can result in major problems in classroom management. Failure to follow through with stated consequences weakens the teacher’s ability to maintain an orderly classroom. Although extra rewards or incentives can help build a positive classroom cli- mate, avoid using a behavior management system that is difficult or complex. Also ensure that all students are able to obtain the positive reinforcers. A student who believes that it will be too difficult to obtain the offered rewards will easily become discouraged and fail to become involved in the behavioral system.

Token Economy Systems Many ED classroom programs use a form of rein- forcement for desired behaviors known as a token economy system. This format has been used as a means of promoting positive behaviors in a manner that is both effective and easy to use (Ayllon, 1999). A token is delivered to the student when the desired response occurs; these tokens are exchangeable at a later time for a reinforc- ing event, activity, or object. Many teachers utilize this system because of its relative ease of administration. A token is any object or symbol that that can be exchanged for a desired back- up reinforcer at a later time. A token can be a poker chip, a sticker, or even a “behav- ior buck,” depending on the age of the students in the classroom. The number or value of the tokens may be progressively decreased (inflation) as the desired behav- iors are more consistently demonstrated.

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Ms. Conlan utilized a token economy system in her classroom using “Conlan cash,” tokens that resembled currency. Students earned tokens by following the classroom rules, accurately completing their work and in a timely manner, and demonstrating appropriate social skills throughout the day. Students kept their tokens and could exchange them at the end of the day for a variety of desired activities, objects, or events (e.g., being first in line at recess, extra computer time, small toy cars, pictures of popular movie and television stars). To build her students’ capacity for delay of gratification and long-term planning, each student who earned a minimum number of tokens also earned a “savings bond” token. These tokens could be redeemed at the end of each week and included larger reinforcers (e.g., having a special lunch with the teacher, playing a board game with the principal).

The teacher should keep several considerations in mind to ensure that a token econ- omy system is maximally effective.

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146 Aversive consequences should generally be avoided in the ED classroom unless there are situations that arise in which there is an immediate danger of harm to others, significant destruction of property, or other severe consequences. Many resources are available to learn how to effectively use aversive interventions (e.g., Foxx, 1982). It is more effective to use a procedure referred to as differential rein-

forcement to significantly and permanently reduce or eliminate the number and duration of undesired behaviors in the classroom. Differential Reinforcement Differential reinforcement in the ED classroom can be defined as a two-part intervention in which a desired response to a stimulus is reinforced, while other responses to that same stimulus are not reinforced. The undesired behaviors will be reduced as the desired behavior is repeatedly rein-

The undesired behaviors will be reduced as the desired behavior is repeatedly reinforced over time (initially with continuous reinforcement) and all other behavioral responses to the stimulus are not. For example, there may be a classroom rule that students are to raise their hands before they will be called on for an answer or response. In addition to estab-

lishing an ongoing classroom routine that emphasizes this behavior, differential reinforcement may be used to ensure its effectiveness.

reinforcement may be used to ensure its effectiveness. eacher (to class): T Who knows when the Civil War began?

eacher (to class): T Who knows when the Civil War began? Joey (yells out): When they blew up Fort Sumter!

Teacher (ignoring Joey): Bobby, great hand raising! Do you know when the Civil War began?

began? Bobby: When the Confederate forces fired on Fort Sumter. Teacher: Excellent! Good job, Bobby. Now, who can tell me the capital

of the Confederacy? (Sees Joey raise his hand) Joey, do you

Group Management and Dynamics Research is very clear: The most effective ED teachers are those who set up a clearly defined and highly structured set of classroom rules and procedures that are integrated into a workable system that is carefully taught to the students (Marzano, Marzano, & Pickering, 2003). Teachers who understand group management and group dynamics are much more effective in their ability to implement a dynamic classroom program that provides educational benefit to students who are

know the answer? Joey: Richmond.

analysis and management (Cooper, Heron, & Heward, 2007; Mayer et al., 2012).

Teacher: Correct! Great answer, Joey! Now, let’s look at some of the other questions that we’ll need to answer on this worksheet. Many types of differential reinforcement can effectively be used by the teacher in

by Terry J. Tibbetts Ph.D., J.D.

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Placement Characteristics 147

(Jones, 2011). For example, Freiberg and LaPointe (2006) reported that a synthesis of more than 40 classroom management studies indicated that the most effective teachers engaged in a comprehensive set of behavioral standards, including the following.

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•equire students to complete one task before beginning another. R

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Placement Characteristics 149

Classroom rules should be periodically reviewed and practiced with the students, using specific examples, role-play ing, and other ways of prov iding concrete learning.

Transitions Students engaged in individual rather than group activities may finish at different times. This may lead to multiple individual transitions during the instructional period, causing confusion and lost time. When students become disengaged because a transition to another activity is extensive, it is often difficult to get them back on task (Smith & Yell, 2013). Some students may not know what to do, and others may become off task or deliberately avoid a new activity that is not preferred. More efficient transitions can be produced if the teacher is alert to help students who are between activities. The teacher should do the following to assist in this process.

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Human Relationships

The term human relationships refers to that part of the classroom program that is focused on feelings, emotions, support, and acceptance. This domain emphasizes the capacity of the teacher to create a sense of rapport with his or her students. Because students who are emotionally disturbed are often experiencing strong feel- ings and emotions, the way in which the teacher is able to respond to their anxiety, depression, or anger will determine the emotional quality of the classroom pro- gram and the student’s overall availability for learning. The teacher must be able to respond to problem situations in a manner that helps students to constructively deal with their emotions and to reduce further discomfort or distress. The degree to which teachers are able to develop caring and genuine relation- ships with their students is a significant dynamic in developing an effective ED classroom program. This requires that teachers provide a confluent environment for students—being able to shift between academic and emotional elements in learning, depending on the immediate needs of the student (Lederman, 1969). The teacher functions as a therapeutic support for the students in many ways, and the quality of this therapeutic dynamic is often the key to winning their cooperation. For example, this may require the need to adjust academic expectations if the stu- dent is having an especially bad day. A positive, supportive, structured, and pre- dictable environment is key to helping the student feel safe and accepted. Marzano et al. (2003) found that developing positive student–teacher relationships was the foundation of effective management and could reduce behavior problems in the classroom by 31%. Congruence, empathy, and unconditional positive regard are the necessary and sufficient conditions for creating an emotionally supportive classroom (Thompson & Rudolph, 2000). Congruence means that the teacher is honest and direct with students and maintains a clear sense of self-identity. Students clearly understand how the teacher is feeling, reacting, and responding to their classroom behaviors and actions. The teacher shows a willingness and ability to openly deal with prob- lems and conflicts. As a result, students come to trust the statements of the teacher. Unconditional positive regard refers to the fact that the teacher consistently behaves in a manner that respects student self-worth and dignity so that students feel that they are accepted for who they are, regardless of their behavior. The teacher and students regard each other positively. Students trust that their teacher will respect and accept their efforts and not ridicule or belittle them. Empathy is the capacity of the teacher to listen nonjudgmentally to the con- cerns, fear, and frustrations of the student and, by doing so, demonstrates that each student is worth hearing and understanding. Johns and Carr (1995) identified sev- eral specific strategies and teaching practices that can facilitate creating a support- ive therapeutic milieu within the classroom. Some of these include

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Placement Characteristics 151

•ompliment students for their success and accomplishments. C

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•ying: Ask questions to ensure that the teacher clearly understands the stu Clarif- dent’s concerns and to gather additional information regarding those concerns. As the student explains his or her concerns, the teacher restates and refocuses the issues as the student has identified them.

Social Skills Using formalized social skills training opportunities within the classroom can be an important part of the curriculum because many students who are emotionally disturbed lack an ability to demonstrate appropriate interpersonal relationships with others. Further, many behavior management problems have their foundation in social skills deficits. Evidence also suggests that building classroom social skills can lead to increased academic performance (Sugai & Lewis, 1996). Teaching social skills generally utilizes a cognitive-behavioral approach to building positive social abilities using a sequential and discrete format, most often including

  1. introducing the skill, 2) modeling the desired behavior, 3) peer involvement and role-playing of the skill by students, and 4) providing feedback and reinforcement (Shepherd, 2010). Key goals in the social skills training domain are (Skidmore, 2012)
  1. determine the probable outcome of each possible solution, 4) choose a solution, and 5) explain how the chosen solution worked out. Specific social skills are taught using a sequential step-by-step format in the structured learning approach. This is often the more favored approach by teachers because there are a multitude of commercial social skills programs available in the market from numerous publishers and more are being developed every year. These programs are easily adapted to the specific needs of the individual students in the classroom. A few of the more widely and currently used structured learning pro- grams include the following. Elementary A Children’s Curriculum for Effective Peer and Teacher Skills (ACCEPTS; Walker, 1983) is a behavioral-type program developed originally for students with learning handicaps (LHS) and ED that teaches the most basic social skills (e.g., making eye contact, giving compliments). Excerpted from Identifying and Assessing Students with Emotional Disturbance by Terry J. Tibbetts Ph.D., J.D. Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2013 | All rights reserved

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Getting Along with Others (Jackson, Jackson, & Monroe, 1983) is a very struc- tured curriculum teaching 17 basic social skills such as starting a conversation, responding to teasing, and so forth. It has been designed to be taught in either special or general education classes. The curriculum consists of lesson outlines in a book format with clear rationales and examples of how to teach them. Skillstreaming the Elementary School Child (McGinnis, Sprafkin, Gershaw, & Klein, 2011) is a sequential program designed for second through sixth grades in both special and general education. It is fairly comprehensive and can be extended upward or downward with the companion social skills programs.

Secondary ASSET (Hazel, Schumaker, Sherman, & Sheldon, 1995) is a video- based social skills training program that covers eight key social skills (e.g., giving and accepting criticism) in a clearly structured format and is specifically aimed at the LH SDC and ED secondary student population. The program is behavioral, structured, and clearly sequenced. Skillstreaming the Adolescent (McGinnis et al., 2011) is similar to the ele- mentary version. It is a well-designed program that is a good place to start with adolescents. Other social-emotional learning programs can be found online through pub- lishers such as PRO-ED, Research Press, or Aspen Publishers. A comprehensive review of social-emotional learning programs can also be found in An Educational Leader’s Guide to Evidence-Based Social and Emotional Learning, published by the Collaborative for Academic, Social, and Emotional Learning and available online at http://www.casel.org. The following questions should be asked when looking at a program’s application for a specific ED classroom.

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particular classroom intervention. Maag and Katsiyannis (2008) noted that an ED label “does not inform treatment. For example, a diagnosis of ADHD, oppositional- defiant disorder, or conduct disorder does not tell educators and clinicians appro- priate intervention strategies” (2008, p. 187). Although research has not specifically delineated effective strategies at this narrow-band level, some general intervention strategies can be identified, primar- ily with externalizing students. Some clinicians have indicated that three relatively effective strategies, particularly with younger students, include parent training, classroom behavioral interventions, and social skills training (Gimpel & Holland,

2003). These interventions primarily focus on the behavioral dimensions of the stu- dent’s emotional difficulties. It is more difficult to establish a clear link bet ween assessment and inter vention for internalizing problems, partly because of the nature of internalized problems. Most assessment data for internalizing students who are emotionally disturbed is descriptive rather than prescriptive. These types of behaviors exhibited by internal- izing students who are emotionally disturbed often involve subjective individual perceptions and states as well as the need for mental health intervention. It is not likely that there will be tangible and directly observable behaviors to consider for intervention. Furthermore, any intervention to address the behavioral concerns may or may not address any underlying emotional variables. Billy spends all of his free time in the boys’ bathroom, where he makes threatening statements to his reflection in the mirror. Although some behavioral interventions can be developed for this situation, it remains unclear whether a reduction in “mirror talking” would result in anything therapeutic having occurred for Billy. If a clinical evaluation reveals that a student feels excessive guilt and sadness and has an extremely low opinion of self, then everyone can agree that the student needs some therapeutic intervention. What is not as clear is what specific interventions might be most effective in resolving these specific concerns within this specific classroom setting. Although this lack of linkage can be frustrating, it should be noted that there are increasing efforts to develop such linkages between assessment and interven- tion. In 1993 the APA began efforts to establish a listing of psychological treatments whose efficacy has been demonstrated through clinical research (Jongsma & Bruce, 2010). These efforts to identify “evidence supported treatments (ESTs)” have contin- ued since that time, but there are multiple issues and concerns that remain unre- solved and have prevented the field from moving forward toward a more finalized resolution (Norcross, Beutler, & Levant, 2006). Individuals interested in additional information regarding the identification process for EST interventions and their current status should refer to Norcross and colleagues (2006). Individuals who are more specifically interested in additional information regarding EST interventions with youth may refer to Lonigan and Elbert (1998). Excerpted from Identifying and Assessing Students with Emotional Disturbance by Terry J. Tibbetts Ph.D., J.D. Brookes Publishing | www.brookespublishing.com | 1-800-638-3775 © 2013 | All rights reserved

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