RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

TheUseofaTeamApproachtoInterventiontoImproveStudentAttitudesTowardsSchool ChristineE.Davis December8,2008 EDU690:ActionResearch UniversityofNewEngland

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

Abstract Thepurposeofthisstudywastoevaluatetheefficacyoftheacademiccomponentofanew programthatutilizesateamapproachtointerventionforstudentsdemonstratinganinabilitytobe successfulinatraditionalschoolsetting.Thestudyutilizedqualitativepostdatatogainclarityregarding thedominantstudentprofilesofthosereferredtotheprogramandtodeterminetheimpactthat participationintheprogramhadonschoolrefusalbehavioranditscomorbidsymptoms.Inaddition,the dataallowedfortheidentificationoftrendsinthereasonsforstudentreferralascomparedtooutcomes upondischargetodeterminethetypesofprogrammingthatcouldbemodifiedtobettermeettheneeds offuturestudents.Resultsshowedthatthemajorityofstudentswerereferredtotheprogramforschool refusal,failingorpoorgrades,symptomsofanxietyanddepression,andAttentionDeficitHyperactivity Disorder.Resultsalsoshowedagreatdealofinconsistencyintheoutcomesforstudents,andrevealed thesubjectivityofconclusionsdrawnandinconsistencyinthemonitoringofgoalsatintakesothatthey alignwithimprovementsuponstudentsdischarge.Theresearcherdeterminedthatadditionaland ongoingdataneedstobecollectedinanefforttoprovideamoreindividualizedacademicprogram alignedwiththeneedsofthestudentstoprovidemoreconsistentoutcomesforstudentsthatare specificallyalignedtotheirneedsatthetimeofreferral.

TableofContents

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

Introduction. .5 Rationalefor Study..5 Statementofthe Problem6 PrimaryResearchQuestions...7

Hypothesis7 Reviewofthe Literature..7

Introduction.7 Summary. .8 Analysis.. 19 Methodology.. 21 Research Design21 DataCollection Plan..22 Data Analysis.23 Sample Selection24 Results 25

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

Findings..25 ReasonsforStudentReferral25 SheehanAnxiety Index..26 BecksDepressionInventory28 GradePoint Average..30

Discussion..31 SpecificNeedsoftheStudentPopulation.32 BenefitsandDrawbacksofProgramParticipation...32 LearningDisordersandExecutiveFunctioning33

Limitations..33 SummaryofFindings...34 ActionPlan 35 ProposedAction ...36 SharingtheResults ...37 ActionPlanSteps ..38 FutureUse .39 Conclusions ...40 References

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

.42

Introduction RationaleforStudy Thelocationofthisstudyisaprivate,nontraditionalschoolthatservesstudentsagesthirteen

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

throughtwenty.Theschoolincludesbothanadventuretherapycomponentandastrongacademic component.Thefocusofthisstudywillbetoevaluatetheeffectivenessofanewprogramthatwas designedandimplementedoverthepastyearasanextensionofthecoreprogram,calledSummit Achievement,whichhasbeeninplaceforseventeenyearssincetheorganizationopened.Thispast AugustthecommitteewhoinitiallydevelopedtheTraverseprogrammettoreviewtheprogramasit currentlystoodandtomakerecommendationsforchangesmovingforward.Oneofthe recommendationsofthecommitteeincludedtheanalysisandpotentialrestructuringoftheacademic programmingforTraverse,andsotheexaminationoftheefficacyoftheprogramoverthecourseofits firstyearpresenteditselfasanappropriatemeansbywhichtoformrecommendationsforfuture changes.Thisdatawouldbegatheredthroughtheanalysisofstudentfileswhichcontainvaluablepost dataregardingreasonsforreferral,progresswhileintheprogram,andoutcomesofparticipationinthe program. Thisresearchisbeneficialaswebegintothinkaboutwhatwecandotomodifyand/orimprove theprograminthenextyear,specificallyinregardstostrengtheningandclarifyingthefocusandgoalsof theacademicprogram.Inthegenesisoftheprogramagreatdealofplanningandthoughtwasputinto developingthetherapeuticandprogrammaticstandardsandstructureofTraverse,andthedecisionwas madetoutilizethesameacademicprogrammingforbothAchievementandTraversedespitedistinct differencesinprogramgoalsandstructure.Asrevisionsaremadetotherestoftheprogram components,itisintegralthattheacademicportionoftheprogramalsobeevaluatedinaneffortto continueprovidingthebestpossibleservicestoourclients. StatementoftheProblem Initsinception,SummitTraversewasdevelopedasastepdownfromintensivetreatment

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

programstohelppreparestudentswhohaveformerlybeenunsuccessfulintraditionalsettingsto preparetotransitionbacktoalessintensivelevelofcare,ideallyatraditionalschool.Theprogram combinesfamilycenteredtherapeuticservices,ablendedlearningacademicprogram,andaresidential lifecurriculumthatstrengthensexecutivefunctioning,skillsforindependentliving,andselfmanagement ofleisuretimeandpursuits.Aswithanynewprogram,thereweremanyunanticipatedchallengesduring thefirstyearasTraversebegantoworktowardsbetterdefiningtheprogram,thestudentsitserves,and howtobestservethosestudents.Inthecommitteesreview,recommendationsforrevisionstothe programincludedbetterdefiningthestudentpopulationandmakingchangestotheresidentiallifeand academiccurriculumsinordertobettermeettheneedsofthestudentsweserve. Twospecificareasofneedemergedquicklythroughthecommitteesconversations.First,it wasnotedthatasignificantnumberofthestudentswhoenrollinTraversehaveexperiencedsymptoms ofschoolrefusalbehavior.However,theknowledgeofthecausesforthisbehaviorandapproachesthat canremediatethesebehaviorsinregardstoacademicprogrammingandsupportswaslimited.In addition,thequestionoftheefficacyofthetheblendedlearningstructureutilizedinthefirstyearwas raised.Initiallytheprogramhadbeenusedinanefforttomaintainconsistencyacrossthebranchesof theprogram,buttheabsenceofgoals,practices,andacurriculumspecificallygearedtowardstheneeds ofourstudentpopulationinTraverseappearedtobeapointforfurtherexplorationandrevision. PrimaryResearchQuestions Closeconsiderationofthecommitteerecommendationsallowedtheresearchertodrawthe conclusionthattherewasalackofclarityregardingtheacademicgoalsandintendedoutcomesof participationintheblendedlearningcurriculumbystudents.Beforemovingforwardwith recommendationsforprogrammaticchangesinregardstoacademiccurriculumsandlearninggoals,it

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

wasfirstnecessarytodevelopabetterunderstandingoftheprograminitscurrentstate.Asaresult,the followingresearchquestionsweredeveloped: 1. Whatarethemostcommonareasofneedforourstudents? 2. Inwhatareasdoweseethemostimprovement? 3. Howdoesateamapproachimproveselfimageandstudentmotivation? 4. Howwilltheteamapproachimpactacademicachievement? Hypothesis Participationinaninterventionprovidedthroughateamapproachthatincludesanacademic advisor,therapist,directcarestaff,parents,andstudentwillimprovestudentattitudestowardsschool andalleviatesymptomsassociatedwithschoolrefusal.Inaddition,participatinginablendedlearning modeldeliveredthroughanaccreditedonlinecurriculumsupervisedbyacademiccoacheswillhavea positiveimpactonstudentacademicachievement. ReviewoftheLiterature Introduction Asclasssizescontinuetogrowandresourcesdiminishinschools,identifyingandaddressing st schoolrefusalbehaviorhasbeguntofallthroughthecracks.The21 centurystudentisfacedwitha multitudeofchallengesthatareamplifiedbythepressuresimposeduponthembypeers,parents,and schoolpersonneltoperformbothsociallyandacademicallyinacompetitiveworld.Classsizesare growing,supportstaffareshrinkinginnumbers,andmandatesandmodificationsseemtobemultiplying, addingagreatdealmorestresstothosestaffwhoarethefrontlineprofessionalsresponsiblefor identifyingwhichstudentsmaybestrugglingandwhomightbenefitfrominterventions.Studentsare

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

feelingthesestressorsaswell,andcoupledwithincreasedsocietalpressuresandexpectationsto outperformtheirpeers,diagnosesofanxietyanddepressioninadolescentshaveincreased.Allofthese factorscontributetoalackofactioninregardstoaddressingschoolrefusalbehavior,whichincludes frequentabsencesortardinessorrefusingtoattendschoolforlongperiodsoftime.Thisbegsthe questionofwhatwecandobettertoidentifyandevaluateinordertointerveneincasesofschool refusal.Doesaselfpaced,blendedlearningcurriculumcoupledwithclinicalsupportinatherapeutic settingalleviatesymptomsassociatedwithschoolrefusalbehaviors? Summary InherarticleWhykidsrefusetogotoschoolandwhatschoolscandoaboutit,Wimmer definesschoolrefusalasanongoingconcernforadministratorsatthemiddleandhighschoollevel becauseoftheimpactithasonlearning,testscores,andsocialdevelopment.Shedefinesschoolrefusal asmissingdays,weeks,orevenmonthsofschoolandcitestheemotionbasednatureofschoolrefusal asaresultofanxietyofdepression.Sheiscarefultodistinguishbetweentruancyandschoolrefusal, statingthatstudentswhoaretruantdonotsufferfromemotionalchallengesordifficulties,whileSchool refusalbehavioroftenresultsfromacomplexmixoffactors,includingmentalhealthproblems,medical problems,familyissues,schooldifficulties,transitions,orstressfullifeevents(2008). Wimmergoesontodiscusshowstudentsstrugglingwithschoolrefusalalsoexhibitconcerns relatedtoschoolperformanceandachievement,selfefficacy,orcompetenceitiswhenthesetypesof feelingsbegintomanifestthatstudentsbegintoperceiveschoolasaplacewherefailureisathreat.

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

10

Wimmerassertsthatthegoalofinterventionshouldbetoincreaseattendanceandimprovesocialskills. OneofthemajorlimitationsofWimmersarticle,though,isitslackofempiricaldatatosupportthe suggestionsthatshemakesforinterventions.Shedoes,however,provideaplethoraofideasfor practicalinterventionstoaddressschoolrefusalbehavior. InhisarticleRespondingtochronicnonattendence:Areviewofinterventionapproaches (2003),Lauchlanmakesconnectionsbetweenschoolrefusalbehaviorsandlongtermproblems regardingtherefusersmentalhealth.Hearguesforafunctionalanalysisofnonattendanceversustrying todistinguishbetweencasesoftruancyandrefusal,asheseesdifferentiatingbetweenthetwotobe irrelevantwhenitcomestoaddressingtheissueofchronicabsenteeism.Lauchlansuggeststhatthe ultimategoalinaddressingschoolrefusalbehavioristolinktheassessmentofnonattendancebymeans ofthefunctionalanalysistospecificinterventionsthataddressthebehaviorsandproblemsthatledto refusal.Heofferstwoavenuesbywhichinterventionscanbedelivered:individualorgroup. Inindividualinterventions,practicessuchasrelaxationtraining,cognitiverestructuringor selfstatementtraining,exposure,and/ormedicationareusedonastudentbystudentbasis.Inagroup approachtointervention,socialskillstrainingandparent/teachertrainingareemployed.Lauchlan (2003),inhisreviewofstudiesbyLastetal.(1998)andKingetal.(1998)drawstheconclusionthat therearemixedresultsfromresearchinregardstotheeffectivenessofusingacognitivebehavioral interventionprogramtoaddressschoolrefusalbehaviors,butattributesthisdisparitytoalackof

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

11

empiricallycontrolledexperimentswheresystematicevaluationsofinterventionprogramshavebeen conducted,whichalsoservesasalimitationtohisownwork.Lauchlanconcludesbystatingthat developingindividualinterventionsbasedonfunctionalanalysisofstudentswherethereisa multisystemsapproachmaybethemosteffectivestrategyinaddressingissuesofnonattendance. KearnyandBates(2005),intheirarticleAddressingSchoolRefusalBehavior:Suggestions forFrontlineProfessionals,provideareviewofliteratureregardingschoolrefusalbehaviorsinan efforttoprovidesuggestionstoteachersandstaffwhoareseekinginterventionprocessesforaddressing schoolrefusalbehaviors.Theydescribeyouthwithschoolrefusalbehavioraspresentingwithboth internalizingandexternalizingbehaviorproblemsthatincludebehavioralissues,emotionaldisturbances, andfamilyconflict.Theyalsorecognizethatmanystudentsschoolrefusalbehavioriscomorbidwith anxietydisordersanddepression,whichfurthercontributetotheacademicunderachievementand medicalproblemscommoninthispopulation.Leftuntreatedoraddressed,theyassert,schoolrefusal behaviorscanhavebothshortandlongtermnegativeimplicationsforthestudent. KearnyandBates(2005)thengoontooutlineamultitudeofassessmentoptionsforidentifying andevaluatingschoolrefusalbehavior.Theseincludestructureddiagnosticinterviews,suchastheADIS forSMIV:C/P,theFearSurveyScheduleforChildrenRevised,theYouthSelfReport,the MultidimensionalAnxietyScaleforChildren,TheChildrensDepressionInventory,andtheSocial AnxietyScaleforChildrenRevised.Theyalsosuggestbehavioralobservationsasameansbywhichto

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

12

collectdetaileddescriptionsandratingsofchildrensbehaviorsthatcontributeorareconnectedto schoolrefusal.Thistypeofobservationincorporatesobservationsmadebyparentsandschool personnelwhointeractwiththestudent.Thistypeofassessmentdatacanthenbeusedtoeffectively determinetreatmentandinterventionoptions. Becausevariousstudieshaveshownthatateamapproach,inwhichparents,thechild,and schoolbasedpersonnelareinvolvedintheinterventions,KearnyandBates(2005)suggesttheuseof childbasedstrategies,parentbasedstrategies,andfamilybasedtreatmentmethodsbeusedasa comprehensiveapproachtoaddressingthebehavior.Inordertodevelopthemostappropriate interventionprocedure,itissuggestedthatschoolpersonnelaskthefollowingthreequestions:(1)What isthenatureoftheproblem?(2)Whatisthefunctionoftheproblem,orwhydoesitcontinuetooccur? (3)Whatisthebestinterventionfortheproblem?(KearnyandBates,2005).Whenthesequestions havebeenanswered,atreatmentprotocolcanthenbeputinplace.Thesetreatmentplansaresuggested toincludebothcontinuedmonitoringanddocumentationofbehavior,aswellasmoregeneral interventionssuchasmodifyingeducationalexpectations,providingtailoredinstruction,orfrequent assessmentoflearningneeds. ForStickeyandMiltenberger(1998),thepurposeoftheirstudyoutlinedinSchoolrefusal behavior:Prevalance,characteristics,andtheschoolsresponsewastocollectinformation regardingthewaysinwhichschoolsrespondtotheindividualsengaginginschoolrefusalbehavior.To

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

13

conductthestudya13itemsurveywasdevelopedtocollectdatafromK12publicschoolsinNorth DakotaincludingdemographicinformationaswellasthepresenceofSchoolRefusalBehavior(SRB) identificationandinterventionsystems.Resultsoftheirsurveyestablishedgradesasthosehavingthe highestpercentageofSRB,withgrades712having3.9%oftheirstudentbodyexhibitingSRB,a percentagewhichincreasedto4.5%whenjustthegrades912samplepoolwasexamined.Inmost casestheresponsibilityofidentifyingstudentsstrugglingwithSRBfellonthePrincipal. StickneyandMiltenberger(1998)deducedthatthemostcommonreasonforschoolrefusal wastheopportunitytoengageinmoreenjoyableactivities.Thesecondmostfrequentreasonforschool refusalwasdepression/emotionalproblems.However,despitetheprevalenceofemotionalproblemsor depressioninschoolrefusalbehaviors,therapeuticresourcesweretheleastfrequentlyutilizedreferral source,withonly11%ofcasesbeingreferredtotheschoolpsychologist,andonly4%ofcasesbeing referredtotheschoolpsychiatrist.Mostsurprisingwasthelackofinvolvementofparentsinaddressing schoolrefusalbehaviors,asparentswereonlynotifiedoftheconcernsin89%ofcases.Their suggestionforimprovingSRBidentificationandinterventionssystemsistoeducateschool administrators,socialworkers,counselors,andpsychologistsaboutthepotentiallongtermnegative effectsschoolrefusalaswellasappropriateanalysisandinterventionstrategiesforschoolrefusalsoas tobetterservetheirschoolsandstudents.Oneofthemajorlimitationsofthisparticularstudywasthat thedatacollectedthroughthesurveyhadahighpotentialforlessaccurateorbiasedreportingduetoa

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

14

limitedsampleofschoolsasevidencedbythefactthatonly46%ofschoolsrespondedtothesurvey. InthearticleTheriseofblendedlearning:Howanewtrendineducationrethinkstheroles ofcomputersintheclassroomandletseachstudentlearnatadifferentpace,Qyillen(2013) exploreshowusingonlinelearningprogramsallowsstudentstoworkattheirownskilllevel.Heasserts thatblendedlearningprogramsappeartobequitepowerfulsincefacetofaceinteractionbetween teachersandstudentsisstillpreferreddespitethegrowingavailabilityofeducationaltechnologies. Qyillenisalsocarefultodefineblendedlearningasasituationinwhichstudentshavesomecontrolover theirpaceandcontent.Thistypeofmodelisparticularlyimportantintodaysclassroom,where demographicshaveleadtowidedisparitiesinstudentabilitywithinaclassroom,whichestablishesa blendedlearningmodelaspotentiallybeneficial.WhileQyillendoesprovideanexcellentsummaryofthe purposeandbenefitsofblendedlearning,aswellasnarrativesofexemplarschoolswhereblended learningisbeingsuccessfullyimplemented,hedoeslittlemorethanoffertestimonythatachievement scoresintheStantonschooldistrictimprovedafterusingthismodeloflearningwithoutsubstantiating thoseassertionswithspecificdataorevidenceofdatacollection. LimandMorris(2009)outlinethefindingsoftheirstudyonblendedlearninganditsimpacton motivationinLearnerandinstructionalfactorsinfluencinglearningoutcomeswithinablended learningenvironment.TheysiteChungandDavis(2005)asreportingthatblendedlearningprovided studentsmoreautonomyinregardstocontent,paceoflearning,andtimemanagement,thereforemaking

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

15

blendedlearningmoreeffectiveinaddressinglearningstyledifferences.Forthepurposeoftheirstudy, blendedinstructionwasdefinedastheappropriatemixoffacetofaceinstructionalmethodsand variouslearningtechnologiestosupportplannedlearningandfostersubsequentoutcomes(Limand Morris,2009).Theysitelearnercontrol,interest,andfeelingsofselfefficacyashavingpositive correlationstolearnermotivation,andaimedtoexaminehowblendedlearningimpactslearner motivation. Agroupofundergraduatestudentswassurveyedbothbeforeandafterparticipatingina blendedlearningcurriculum.Theresultsofthestudyshowedthatindividuallearningdifferencesare importanttoconsiderindevelopinganeffectiveblendedlearningcurriculum.LimandMorris(2009) suggestthatidentifyingstudentslearningstylespriortothedevelopmentandexecutionofa blendedlearningcoursemaybebeneficialinmaintainingstudentmotivationthroughoutthecourse.In addition,theimportanceofstudentsseeingtherelevanceofthematerialtotheircourseworkisimportant sothattransferoflearningcanbepromoted. Norbergetal.(2011),intheirarticleAtimebasedblendedlearningmodel,outlinethe findingsoftheirresearchasitrelatestotheroletechnologyplaysinexpeditingthelearningprocess. TheyassertthatstudiesbytheUSMarketforSelfPacedLearningProductsandServicespredict declineinthenumberofstudentswhotakeexclusivelyfacetofacecoursesfrom14.4millionin2012to 4.1millionin2017.Thisprojected,andsignificant,increaseinthenumberofstudentstakingonline

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

16

coursespromptedNorbergetal.toevaluatewhetherblendedlearningisthenewnormineducation, whereinstructorsbecomefacilitatorsratherthantransmittersofinformation. Insuchamodel,Norbergetal.stresstheimportanceofmultimodaldeliverysystems,which includebothsynchronousandasynchronouselements.Thestudentsautonomyoverhowandwhenthey accesstheseelementssupportstheideasetforthbyBloom(1968),thatgivenenoughtimewithquality instruction,almostallstudentswilllearnthiswillnothappenwhentimeisalimitedresource.Itiswith thisunderstandingthatNorbergetal.stresstheimportanceofemphasizingthelearningprocessand masteryratherthanplacingtimeconstraintsonstudentsthatlimittheirabilitytolearnthematerial.The outcome,theyargue,ofteachersmovingintoamorefacilitativerole,willbestudentswhoaremore engagedwiththeirpeers,theirteachers,andmostimportantly,thecontent. InCoaching:Themissingingredientinblendedlearningstrategy,StevensandFrazer (2005)discusshowacoachingmodelintheclassroomcanbetterhelpstudentsmovefromthe comprehensionlevelofunderstandingtothemasterylevelofanalysisorapplication.Theyseethe absenceofcoachinginblendedlearningmodelscurrentlyasbeingpotentiallythedownfallofthismodel oflearning.StevensandFrazer(2005)aimtointroduceamodelforblendedlearningthatrealizesits potentialforimprovingcorporateperformancebyintegratingcoachingasanintegralcomponentof overallstrategy.Theyseethatwithoutcoaching,thedisparitybetweensuccessintrainingand/orskill acquisitionandsuccessinjobperformancewillgrowasaresultofthelackofconnectionbetweenwhat

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

17

waslearnedandhowtoapplythatknowledge.Theyidentifycoachingasameansbywhichtofacilitate continuousgrowthinemployeesandthereforeintheworkplace. StevensandFrazer(2005)illustratethewaysinwhichcoachingoccursintheblendedlearning process.Theyemphasizetheimportanceofworkingwiththestudentthroughoutthegrowthand enhancementprocess,aswellasappealingtothestudentbymatchingyourteachingstyletothe studentslearningstyle.Inthismodelthelearnerisnotsimplypluggedintothelearningmodules,but ratherarebeingcoachedthroughtheprocessbysomeonewhoismoreknowledgeableinthecontent andisabletohelpbridgethegapbetweenknowingtheinformationandusingit.Thisisdonethrough providingfeedback,demonstratingskills,andprovidingreinforcementbasedonstudentsachievements. Inorderforthissystemtobeeffective,itisimportantthatcoacheshaveregularandconsistentcontact withthelearner,andthatalongtermplanforgrowthandgoalsfortheindividualareestablishedand monitored. Synthesis WhileWimmer(2008),KearnyandBates(2005),andStickneyandMiltenberger(1998) notedtheimportanceofdistinguishingbetweentruancyandschoolrefusal,Lauchlan(2003)arguesthat distinguishingbetweenthetwoisirrelevantwhenitcomestoaddressingtheissueofchronic absenteeism.Ultimatelytheissuesassociatedwithfrequentorlongtermabsencesfromschoolhavean impactonstudentssuccess,andsothewaywelabelthesestudentsdoesseemsecondarytothe

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

18

importanceoffindingwaystoidentifyandintervenewiththebehavior.However,KearnyandBates (2005)furtheramplifytheimportanceofdefiningthecausalissuesofschoolrefusalbehaviorby concludingthatthereasonsforwhichstudentsexhibitthesebehaviorsshouldhaveadirectcorrelationto theinterventionstrategiesthatareutilized. OneoftheconsistenciesbetweenLauchlan(2003),KearnyandBates(2005),Stickneyand Miltenberger(1998),andWimmer(2008),wastherolethatanxietyanddepressionplayinthe manifestationofschoolrefusalbehaviors.Allfourarticlescitedschoolrelatedanxietiesasplayinga significantroleinschoolrefusalbehavior,andallarticlesalsostressedtheimportanceofconducting somesortoffunctionalbehavioralanalysistouncoverthecauseofthebehaviorbeforemovingforward withaninterventionplan.Oneofthemostcommonlyrecommendedinterventionswasmodificationof theschoolsettingorenvironment,aswellastheadjustmentofeducationalgoalsorexpectationsinan efforttorelieveschoolrelatedanxieties. Anothercommonalitybetweenthesefourarticleswasthelimitationsimposedduetoalackof empiricalevidencetosupportthesuggestionsforinterventionsincasesofschoolrefusalbehaviors. UnlikeLauchlan(2003),theworkdonebyKearnyandBates(2005),StickneyandMiltenberger (1998),andWimmer(2008)didnotincludethecollectionofdatatosupportsuggestionsregarding interventions.Rather,thesethreearticlesreliedonthereviewofstudiesalreadyconductedtooutline possiblestrategiesformodifyingschoolrefusalbehaviorinstudents.

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

19

OneofthegreatestunifiersamongthearticlesbyLauchlan(2003),KearnyandBates(2005), StickneyandMiltenberger(1998),andWimmer(2008)wastheemphasisonteambasedapproaches. Allofthearticlescitedtheimportanceofinvolvingthestudent,family,andschoolpersonnelinthe processofaddressingschoolrefusalbehavior.Itisclearthatinacasewhereastudentisstrugglingwith emotionalissuesthatimpacttheirabilitytofunctionintheschoolenvironment,providingateamthat includestherapeuticsupportinadditiontoteacherandparentsupportcanleadtogreatersuccesswhen interventionstakeplace. LimandMorris(2009),Norbergetal.(2011),Qyillen(2013),andStevensandFrazer(2005) allidentifyablendedlearningapproachasoneinwhichdigitaloronlineresourcesarecombinedwith facetofacetimewithateacherormentor.BothStevensandFrazer(2005)andLimandMorris (2009)suggestthatidentifyingandappealingtostudentslearningstylescanimprovethesuccessofthe studentinablendedlearningmodel.Allofthearticlesalsosuggestedthatablendedlearningmodelcan beeffectiveinimprovingstudentmotivationbyimprovingstudentsfeelingsofselfefficacy.Thiswas potentiallyachievedindifferentwaysaccordingtoeachoftheauthors,butincludedselfpacedlearning, selectionofcoursecontent,andthesupportofaknowledgeableinstructorwhocouldcoachthem throughthelearningprocess. Analysis Inconsideringthereasonsbehindschoolrefusal,itisclearthatanxietyanddepression,an

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

20

unsatisfyingschoolenvironment,andlackofparentalinvolvementcanallcontributetostudents participatinginschoolrefusalbehavior.Itisclearthattakingacomprehensiveapproachwhen addressingthebehaviorbyinvolvingschoolpersonnel,parents,thestudent,andtherapeuticresources contributestomorepotentialsuccessinremediatingtheschoolrefusalbehaviors.Oneoftheunderlying factorsthatwasnotaddressedspecifically,however,ishowschoolrelatedanxietiesthatcontributeto schoolrefusalbehaviormaybearesultofstudentsfeelingsoffrustrationordifficultyincompleting academictasksandthereforediminishedfeelingsofselfefficacy.Unfortunately,manyschoolsdonot havetheresourcesavailabletoaddressthesetypesofbehaviorseffectivelyduetofinanciallimitations thatresultinfewerstaffmembersandresources. Oneofthebiggestchallengesoftheresearchwasthelackofempiricaldataorresultsfrom studiesthatappliedtheinterventionssuggestedinthearticles.Thisdevelopsacompletelytheoretical insteadofresearchbasedstrategyforaddressingschoolrefusalbehavior.Whilethisstrategydoesseem appropriateinthatitinvolvesthoroughprocessesfortheidentificationandinterventionofschoolrefusal behavior,theinterventionsuggestionsseembeyondthereachesofpublicschooldistrictsthatare overwhelmedbygrowingstudentbodiesandareductioninthenumberofsupportstaffavailable. Inconsideringblendedlearningasameansbywhichtopromotestudentmasteryandimprove studentmotivation,itisclearthatthismodelisusedpredominatelyatthepostsecondarylevel, specificallyoncollegecampusesandincorporatesettings.However,thestudiesdoshowthatthe

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

21

selfpaced,multimodalnatureofsuchlearning,coupledwithstrongcoachingfromamentor,canresult inimprovedfeelingsofselfefficacyinstudents,thereforeimprovingmotivationandstudentengagement. Inconclusion,itisdifficulttoanswerthequestionofwhetheraselfpacedlearningprogram coupledwiththerapeuticsupportcouldalleviatethesymptomsassociatedwithschoolrelatedanxieties. Creatingalearningenvironmentthatincorporatessmallerclasssizesandtailoringthecurriculumtothe learnersneedsbyaccessinganonlineeducationalprogrammighthelptoalleviatetheanxieties experiencedbystudentsoverwhelmedbythetraditionalschoolenvironment.Inaddition,establishinga relationshipwithamentorwhocoachesandfacilitatestheinstructionwheretimeisavariableinsteadof theconstantmayleadtoimprovedfeelingsofselfefficacyastheemphasisistakenoffofachievement andplacedinsteadonmasteryofcontent.Finally,theinvolvementofatherapist,theparents,theteacher andthestudentinasharedprocessofgoalsetting,behaviormonitoring,andtherapeuticexperiencemay helptoalleviatetheanxietiesrelatedtoschoolandaidthestudentintransitioningslowlybackintoa traditionalschoolenvironment.Thiscombinationofbothindividualandgroupinterventionsalignswell withtheresearchthatsuggestshowacombinationofstructuredinterventionscontributetoincreased successinremediatingschoolrefusalbehavior. Methodology ResearchDesign Inordertodeterminetheefficacyofasemesterlongacademicprogramthatutilizesateam approachincludingacademicadvisors,atherapist,directcarestaff,parents,andthestudent,the

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

22

researcherassessedtheprogramoutcomesbyconductingcasestudiesofstudentfiles.Qualitativedata collectionwastheprimaryresearchmethodusedinthisstudy,althoughtheroleofparticipantobserver waslimitedduetotheteacherresearcheronlybeingpresentduringtheparticipationofapproximately 50%ofthesubjectsstudied.Researchalsoincludedthecollectionofminimalquantitativedatafrom surveysadministereduponstudentintakeanddischargethroughtheSheehanAnxietyIndex(Appendix A)andtheBecksDepressionInventory(AppendixB). DataCollectionPlan Qualitativedatawascollectedthroughthereviewofthefollowingdocuments: NeuropsychologicalEvaluationsadministeredpriortoenrollmentorduringstudentsenrollment. ParentreferralinformationincludingapplicationformsandaHopesandVisionsletter. NursePractitionerIntakeAssessmentgivenuponstudentenrollment. WeeklyTherapistprogressnotesoutliningstudentbehaviors,progressnotes,andstudents currentStageofChange. ClinicalDischargeSummarywrittenbystudentstherapistfollowingdischarge. EducationalDischargeSummarywrittenbystudentsAcademicAdvisorfollowingdischarge. EducationalTranscripts,includingthoseprovidedbythesendingschoolandthosedeveloped duringthestudentstimeintheprogram. Thisqualitativedatawascollectedinanefforttoidentifyareasofimprovementinindividualstudents, andtoidentifytrendsinthereasonsforstudentreferralascomparedtooutcomesupondischargeto determinethetypesofprogrammingthatcouldbemodifiedtobettermeettheneedsoffuturestudents. DataAnalysis ThefollowingDataCollectionMatrix(Table1)demonstratesthesourcesusedtocollectthe

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

23

datanecessaryforthisstudy. Table1. DataCollectionMatrix

Questions
Whatarethemost commonareasof needforour students? Inwhatareasdowe seethemost improvement? Howwilltheteam approachimprove selfimageand studentmotivation? Howwilltheteam approachimpact academic achievement?

DataSource1

DataSource2

DataSource3

DataSource4

Student Application

NursePractitioner WeeklyTherapist Intake Progress Assessment Summary Educational ClinicalDischarge Discharge Summary Summary

Becks SheehanAnxiety Depression Index Inventory Educational ClinicalDischarge Discharge Summary Summary Educational Transcripts Educational Discharge Summary

Eachofthedatasourcesreferredtoabovewerecompletedpriortothestudyandweredocumentedin thestudentscasefile.Informationwasrecordedbytheresearcherasitwasreportedineachofthese documentswithoutmodificationorinterpretation.

SampleSelection Thesubjectpopulationwasagroupof20males,ages1520,whoparticipatedinatransitional programatSummitAchievementbetweenJuly2012andSeptember2013.Thisprogramutilizesdaily milieutherapysessions,substanceabusegroups,weeklyindividualcounseling,servicelearning,

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

24

independentlivingskills,familytherapyconferencecallsandSkypesessions,andparticipationina programofsharedcommunityresponsibilitiesandchoresasintegralpartsofthetreatmentprovided. Studentprogressismeasuredbytheiradvancementthroughalevelsystem,whichdirectsthemto completeemotionalgrowthassignments,masterindependentskills,participateinonandoffcampus familysessions,andrespondtoacademicgoals.Thisprogram,calledSummitTraverse,offersstudents fivedaysofschoolandoffcampusbasedweekendactivity.Traverseisafamilycenteredprogramthat workstoestablishachievablegoalsthathelpstudentstransitiontomoretraditionalschoolenvironments. Themajorityofthestudentsenrolledduringthistime(Figure1)alsoparticipatedintheSummit AchievementprogrampriortoenrollinginSummitTraverse.Thistreatmentprogramutilizesaweekly routinesplitbetweenaresidentialandawildernessadventureapproach.Duringtheresidentialpartof theprogramstudentsspendthreedaysperweektakingclasses,andfourdayperweekarespenton adventurebasedexpeditions.Dailygrouptherapysessions,weeklyindividualcounseling,family conferencecalls,academicclasses,andparticipationinaprogramofsharedcommunityresponsibilities andchorescompriseintegralpartsofthetreatmentprovided.Astudentsprogressismeasuredbyhis advancementthroughalevelsystem,whichdirectshimtocompleteemotionalgrowthassignments, masteroutdoorskills,andrespondtoacademicgoals.

Figure1. StudentPlacementPriortoSummitTraverse

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

25

Results Findings Theteacherresearchercompileddatafromstudentfilestoevaluatetheimpactofa teamapproachonstudentattitudestowardsandbehaviorsinschool.Thisincludedevaluatingthe studentsimprovementsinregardstobehaviorsintheclassroom,beliefsaboutthemselves,anxietyand depressionlevelsuponenrollmentanddischarge,andimprovementsinstudentachievementinschool. ReasonsforStudentReferral TwentystudentswerereferredbytheirparentsorguardianstotheSummitTraverseprogram andenrolledbetweenJuly2012andSeptember2013.Studentswerereferredforavarietyofreasons, buttrendsemergedinsomeofthecommonreasonsforreferral.Morethanhalfofthestudentswere referredforthefollowingreasons:lowselfesteem,struggleswithbehaviorsresultingfromAttention DeficitHyperactivityDisorder(ADHD),poororfailinggrades,andschoolrelatedanxieties.While thesewerethemostcommon,thecomprehensivelistofrecurringreasonsforreferralcanbeseenin Table2. Table2. ReasonsforStudentReferral StudentBehavior PercentageofStudentsReferredfortheBehavior

FamilyConflict SchoolSuspension/Expulsion SubstanceAbuse LowSelfEsteem

30% 20% 40% 50%

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

26

AttentionDeficitHyperactivityDisorder SchoolRefusal NonverbalLearningDisability UnmotivatedAcademically PoororFailingGrades Anxiety

55% 45% 35% 30% 70% 50%

SheehanAnxietyIndex TheSheehanAnxietyIndexwascompletedbynineofthetwentyTraversestudentsduring enrollmentintheprogram.ThosewhocompletedtheIndexdidsouponarrivalandupondischarge. Thisdataprovidesinformationregardingthestudentslevelsofanxietyatthetimeofenrollment,and usesthesamemeasurementtool610weekslatertomeasurestudentanxietylevels.Thestudentswho weresurveyedshowedmoderatetohighlevelsofanxietyatthetimeofenrollment.Figure2displays boththeinitialscoreatenrollmentascomparedtothescoreafterthestudenthadcompletedthe Achievementportionoftheprogram. Figure2. SheehanAnxietyIndexResultsatIntakeandDischarge

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

27

Thereweremarkedimprovementsintheanxietylevelsofthemajorityofstudentsduringtheir timeintheprogram,withonlyonestudentexperiencinganincreaseinsymptoms.Amoredetailedview ofthechangesinanxietylevelsforstudentssurveyedcanbeseeninFigure3.

Figure3. ChangesinSheehanAnxietyIndexScoreBetweenIntakeandDischarge

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

28

Resultsindicatedthatstudentswhoenteredtheprogramwithmoderatetohighanxietylevels wereabletoalleviateanxietysymptomswhileintheprogram.ClinicalDischargeSummariesverifiedthat avarietyoftechniqueswereusedtohelpguidestudentsintheirabilitytomonitorandmanageanxious symptoms.Thesetoolsincludedweeklyindividualtherapysessions,theselfidentificationofcoping strategiesforanxiety,coachinginmeditationandbreathingexercises,andworkingwiththeirtherapistto developplansformonitoringandregulatinganxiousbehaviors. BecksDepressionInventory SimilartotheSheehanAnxietyIndex,theBecksDepressionInventorywasgiventostudents withpresentingsymptomsuponenrollmentandaftercompletionoftheSummitAchievementportionof theprogramming,usually610weeksafterintake.Figure4displaysthescoresoftheninestudentsto completetheinventoryuponarrivalandatdischarge. Figure4. BecksDepressionInventoryResultsatIntakeandDischarge

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

29

AsisseeninFigure4,themajorityoftheninestudentssurveyedpresentedmoderatetohigh levelsofdepressionatintake.Twoofthestudentssurveyedpresentedwithmilddepression,andoneof thesetwoexperiencedanincreaseofdepressivesymptomsduringtheirtimeintheprogram.Aclear pictureofthechangeindepressivesymptomscanbeseeninFigure5.

Figure5. ChangesinBecksDepressionInventoryBetweenIntakeandDischarge

AsevidencedbyFigure5,themajorityofstudentsexperiencingdepressivesymptomsupon enrollmentexperiencedareductioninthesesymptomsduringthecourseofprogramming.Clinical

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

30

DischargeSummariesandweeklyprogressnotesreferencetheuseofmoodjournals,moodrating scales,readingbooksandarticles,andfeedbackfrompeersanddirectcarestaffinthemilieuashaving animpactonstudentlevelsofdepression. GradePointAverage Thefinalpieceofdatacollectedservedtoprovideacomparisonofstudentachievementpriorto enrollmentinSummitTraverseascomparedtotheirachievementduringtheprogramwhereateam approachwasutilized.Datawascollectedforstudentswhosefilesincludedtranscriptsorgradereports fromthesendingschool.TheunitofmeasureusedtogaugestudentachievementwasGradePoint Average,orGPA.Table3providesadirectcomparisonofstudentGPApriortoenrollmentandduring theprogram,andalsoincludesthepercentilegaininGPA.

Table3. DifferenceinGradePointAverage
Student GPAPreEnrollment GPAPostEnrollment GPAPercentChage

1 2 3 4 5 6 7 8 9

2.23 2.6 2.17 3.13 1.9 1.71 1.9 3.2 2.4

3.6 3.67 3.16 3.23 3.75 3.16 3.14 3.71 3.75

0.61% 0.41% 0.46% 0.03% 1.85% 0.85% 0.65% 0.16% 0.56%

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

31

10 11

2.91 2.32

3.5 3.78

0.2% 0.63%

ThemedianGPApriortoenrollmentwas2.32,andtheaverageGPApriortoenrollmentwas 2.41.Atdischarge,themedianGPAforstudentswas3.6,andtheaverageGPAwas3.5.Themedian percentilegaininGPAforstudentsduringtheirtimeparticipatinginSummitTraversewas+0.56%,and theaveragepercentilegaininGPAwas+0.58%.NostudentsGPAdecreasedasaresultof participatinginSummitTraverse. Discussion Thefollowingthemesemergedfromtheanalysisofapplications,ClinicalDischargeSummaries, EducationalDischargeSummaries,WeeklyProgressNotes,Transcripts,NursePractitionerIntake Assessments,andStudentRatingScales. TheSpecificNeedsoftheStudentPopulation Initsinceptionin2012,SummitTraversewasintendedtoserveasatransitionprogramtohelp prepareadolescentmalestoparticipateandfindsuccessintraditionalschoolsettings,suchaspublic schools,privateschools,boardingschools,orindependentschools.Ofthetwentymaleyouthwho participatedintheprogram,eighteenwentontoparticipateintraditionalschoolsettings,onejoinedthe military,andonewentontoatherapeuticboardingschool.Overall,successwasfoundinprovidingthe structure,support,rehabilitation,andcoachingnecessarytoaidtheseyoungmalesinachievingtheirgoal ofreintegratingintoatraditionalschoolsetting. ThequestionoftheytypeofstudentSummitTraverseservesbestisoneofgreatdebateand discussion.Theresultsoftheanalysisofparentcompletedapplications,nursepractitionerintake

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

32

assessments,andtherapistsweeklyprogresssummariesshowedspecifictrendsinthetypeofstudent whoparticipatesintheprogram.Thefourmostcommonreasonsforreferralandobservationsincluded studentswithlowselfesteem,struggleswithbehaviorsresultingfromAttentionDeficitHyperactivity Disorder(ADHD),poororfailinggrades,andschoolrelatedanxieties.TheresultsofboththeSheehan AnxietyIndexandevaluationofimprovementsinGradePointAverageindicatethatparticipationinthe programallowedforreliefofanxietiesandanimprovementinschoolperformance. BenefitsandDrawbacksofParticipatinginSummitAchievementPriortoTraverse AllstudentsenrollinginSummitTraversemustmeettherequirementofhavingspentaperiodof timeinahigherlevelofcarepriortoenrollinginSummitTraverse.Ofthetwentystudentswho participatedintheSummitTraverseprogramfrom20122013,fifteenfirstparticipatedinSummit Achievement.TheanalysisofClinicalDischargeSummariesandWeeklyProgressNotesfilledoutby therapists,itwasobservedthatstudentswhofirstparticipatedinSummitAchievementratherthanan externalhigherlevelofcare,suchasafullwildernessprogramorhospitalization,sufferedfewer setbacks,foundmoresuccessintheclassroomandmilieu,andwerelesslikelytosufferrelapseintoold behaviorduringhomevisitsorpriortodischarge. LearningDisordersandExecutiveFunctioning 70%ofthestudentsenrolledinSummitTraversewereexperiencingpoororfailinggradesprior toenrollmentinSummitAchievementandSummitTraverse.Duringstudentsparticipationinthe program,fullNeuropsychologicalEvaluationsareoftenrequestedorrequiredinanefforttobetter diagnosethestudent.ManystudentswerefoundtohaveanundiagnosedNonVerbalLearning Disability(NLD)duringtheirtimeinSummitTraverse.TheidentificationofNLDduringtheprogram allowedforstudentstoparticipateincoachingaroundeducationabouttheirNLD,socialskillstraining,

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

33

andemotionregulationskillsspecifictotheirdisability.Inaddition,interventionsandaccommodations couldbemade,monitored,andadjustedintheclassroomduringthestudentsstayandappropriate recommendationscouldbemadeintheEducationalDischargeSummaryinanefforttosupportthe studentintheirnextschool.Studentsfoundgreatvalueinthiscoaching,withonestudentnotingthat, LearningIhadNLDsavedmylifeashefeltbetterknowingthathewasnotstupidorcrazy. Limitations Therewereseverallimitationstothedatacollectedinthisstudy.First,becausepostdatawas collectedusingstudentfiles,therewasalimitedavailabilityofinformation.Forexample,theBecks DepressionInventoryandSheehanAnxietyIndexwerenotadministeredtoallstudentswho participatedintheprogramandsotheresultsofcomparisonwerelimitedtothosestudentswho participatedinthesesurveys.Inaddition,duringthebeginningoftheprogramthevalueandnecessityof transcriptsfromsendingschoolswasunknown,andsodeterminingastartingGPAforallstudentswas notpossiblealthoughallstudentsparticipatedinacademicssuccessfullywhileenrolledinTraverse. Anotherlimitationofthestudywasthepotentiallysubjectivenatureofthedatacollected.The onlyinformationgeneratedbystudentsthemselveswasthroughthesurveys.Thereasonsforreferral, observationsofstudentswhileintheprogram,andconclusionsdrawnaboutstudentprogresswereall madebyadultsobserverswithouttheinputofthestudent.Whiletherapists,teachers,andthenurse practitionerallhadlengthyconversationswithandmadeprofessionalobservationsofthebehaviorsof eachstudent,ithastobeassumedthatallinformationrecordedwasunbiasedandofthemost professionalandobjectivequality. SummaryofFindings Theresearchprovidedacomprehensiveviewoftheimpactthatateamapproachcanhaveon

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

34

studentsstrugglingwithschoolrefusalbehaviorsthathavemanifestedasaresultofdepression,anxiety, orconflict(socialorfamilial).Itisclearthatprovidingstudentswithastructuredsupportnetworkthat includestheuseofchildbasedstrategies,parentbasedstrategies,andfamilybasedtreatmentmethods isthemosteffectiveinsuccessfullytransitioningstudentsbackintoatraditionalschoolenvironment (KearnyandBates,2005).ThequalitiesofprogrammingofferedbySummitTraverse,especiallythose intheclassroomwherestudentsreceivetailoredlearningplansandpersonalizedinterventions,are directlyalignedwiththosesetforthbyKearnyandBatesasbeingparamountinsupportingstudentsin reachingeducationalgoalsdespiteunderlyingfactorssuchasdepressionoranxiety. UnliketheschoolssurveyedbyStickeyandMiltenberger(1998),whereonly11%ofschool refusalcaseswerereferredtotheschoolpsychologist,allparticipantsinSummitTraverseparticipatein individual,group,andfamilycounselingonaweeklybasis.Studentsalsobenefitfromagroupofdirect carestaffwhoaretrainedandsupervisedinprovidingtherapeuticsupports.Inaddition,parentsare coachedbytherapistsaboutwaystosupporttheirstudentthroughtransitionintotheirnextsetting,and arealsoprovidededucationandcoachingregardingthespecificneedsoftheirstudent.Unlikemany publicschools,aprivateprogramlikeSummithastheopportunitytoprovidearoundtheclocksupport andsupervisiontostudentsastheylearn,practice,andmasterstrategiesfordealingwiththeir schoolrelatedstruggles. Whiletherearemanythingsthatarebeingdonewellcurrently,thereiscertainlyareafor improvementinSummitTraverseaswelearnmoreaboutourstudentpopulationsandtheactivitiesthat benefitthemmost.Movingforward,itwillbeimportanttoconsiderhowtheacademicprogramming offeredtostudentsmaybemodifiedoradjustedtobettermeettheirpersonallearninggoalsandneeds inastructuredway.

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

35

ActionPlan Theresultsofthisstudyshowedthattherewereimprovementsinstudentsanxiety,depression, andgradepointaverageduringparticipationinaprogramwithablendedlearningcurriculumand teambasedinterventionapproach.Theprogramisstillinplaceandcontinuestoadmitstudentsona rollingadmissionsbasis,butisnowunderthesupervisionofanewclinician.Itisexpectedthatdespite theshiftintherapeuticleadershipimprovementswillstillbeseenintheareasofstudentsattitudes towardsschoolandabilitytogainadmissiontoamoretraditionalschoolsettingafterparticipatinginthe program.Whileweseesteadyimprovementsinthegradepointaverageofstudents,consistent improvementsinclassroombehaviorsandacademicskillsremaininconsistentanddonotcorrelateto improvementsspecifictoallofthemostcommonreasonsforreferral. UponfurtherexplorationoftheacademicprogrammingforSummitTraverse,twoareasof weaknessbecameevident.First,whilewedoknowwherestudentsgoaftergraduatingordischarging fromSummitTraverse,wedonothaveanyinformationordatathatinformsusofwhetherornotthe studentissuccessfulinfuturesettings.ThepurposeofSummitTraverseistoprovidesupport,therapy andguidancetothestudentandtheirfamilyastheypreparetotransitiontoatraditionalschoolsetting, yetwedonotcollectanydatapostdischargetodeterminewhethertheprogramwasbeneficialin preparingthemforthattransition.Inaddition,weserveastudentpopulationthatwouldbenefitfrom moreexplicitinstructionintheareasofinterventionsandstrategiesthatmaybenefittheminthe classroom.However,thereisnospecificcurriculumorplanforteachingthesestrategiesor interventions.Inaddition,wedonotcollectanyconcretedatatomonitorstudentprogressduringthe courseoftheirstay,butinsteadrelyonanecdotaldataandthesubjectiveobservationsandreportsof oneteacher,theAdvisor,todetermineareasofgrowthandimprovementduringtheirstay.

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

36

ProposedAction TherecommendationsoftheresearchforfutureactionstoaddresstheneedsofSummit Traversearetwofold.First,itisrecommendedthataformatforcollectingmoreuniformdatatoinform instructionbedeveloped.Thereweremanyinconsistenciesinthedataavailableinthestudentfilesthat werereviewed.Forexample,manystudentsdidnotparticipateincompletingtheBecksDepression InventoryortheSheehanAnxietyIndexuponintakeanddischarge.Becauseschoolrefusal,anxietyand depressionwereallcommonreasonsforreferral,itseemsonlyappropriatetomorecloselymonitorthe evolutionofthestudentsdepressionandanxietysymptomsthroughoutthecourseoftheprogram.Itis anticipatedthatwewouldseesteadydecreasesinthesesymptomsinallstudents,butconsistencywould bebeneficialinthatitwouldprovidedatatosupportourcurrentassertions. Second,thereisnodataavailabletodeterminewhattheoutcomesofparticipationinSummit Traverseare.Asaprogramthatismarketedtoaidstudentsintransitioningbackintoatraditional environment,itisimportanttogainabetterperspectiveofwhattheexperienceofastudentisinthose environmentsafterdischarge.Withoutthisdataitisimpossibletocontinueconfidentlymarketingthis programasonespecificallyfocusedontransition.Havingdatatoconfirmthatparticipationinour programdoeshavelastingeffectsthattranscendthescopeofthestudentsstayintheprogramis importantandpotentiallybeneficialtothecontinuedsuccessoftheprogram.Itisanticipatedthatwe wouldfindthatourbeliefsareconfirmedthroughthistypeofsurvey,butwithoutconcretedataitis difficulttomakethisassumption. SharingtheResults ResultswillbesharedbyteacherresearcherwiththeResearchReviewBoardatSummit Achievementinanefforttoilluminateareasofweaknessandinconsistencyintheprograminitscurrent

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

37

state.TheteacherresearcherwillalsomeetwiththeClinicalSupervisorandinterimtherapistforSummit Traversetodiscussthewaysinwhichthisresearchcandriveinstructionalchangeswhilealsohonoring andaligningwiththephilosophyoftheorganization.Followingthismeeting,theresults,data,and recommendationswillbepresentedtotheteachingstaff,andupdatesonprogressinmeetingthegoals oftheactionplanwillbesharedasnecessaryatweeklyBoardofDirectormeetingsandmonthly teachermeetings. ActionPlanSteps TeacherresearcherwillestablishaProfessionalLearningCommunitywiththespecificintention ofdevelopingsupplementalacademicprogrammingfocusedonlearningstrategiesandinterventionsfor theSummitTraverseprogram.TheworkoftheProfessionalLearningCommunitywillbecollaborative innature,andwhenthecurriculumisdevelopeditwillbepresentedtotheteachingstaffthroughaseries ofprofessionaldevelopmentdays.Thiscollaborativeeffortwillusetheresearchtodrivefuture improvements,suchastheincorporationoftheexplicitinstructionofcomplexreasoningstrategies,study skills,andorganizationandfocustechniquesandinterventiontools. Inaddition,teacherresearcherwillformalizeasystemforcollectingconsistentdatabefore, duringandafterenrollmentintheSummitTraverseprogram.ThiswillincludeaLikertRatingScale regardingschoolattitudesandbehaviorsfilledoutbyparentsandstudentspriortoenrollment,duringthe transitionintoTraverse,afterthesecondhomeconnection,andfollowingdischargefromtheprogram, bothimmediatelyandafteroneyear.Theprocessofthisdatacollectionwillbeongoingandwillprovide anopportunityfortheteacherresearchertocontinueevaluatingtheefficacyofanycurrentandnew programminginSummitTraverse.Inaddition,duringthemeetingwiththeClinicalSupervisorand InterimTherapist,areviewoftheuseofcurrentindexesandinventorieswillbedone,anddecisionswill

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

38

bemaderegardingtheappropriatefrequencyandconsistenciesinusingthesesurveys. Teacherresearcherwilldevelopformsforthemorespecificcollectionofdatathroughteacher observation.Thiswillincludethecreationofaratingscalewithmorespecificcriteriaforobservation. Thegoaloftheseformswillbetomoveawayfromthemoresubjectiveobservationsmadebydifferent teachersinfavorofseekingconsensusandstructuringtheobservationmethods.Thiswillalsoencourage focusingonthestudentsspecificgoalswhiletheyareintheprogramtobetterdetermineifteacher observationsprovideinsightintotheprogressionofthestudenttowardsmeetingthosegoals,orto checkandadjusttheteachersapproachsothatthestudentmaybebetterabletomeetthosegoals. FutureUse Students,parents,teachersandtherapistsareallstakeholdersandwillallbenefitfromthe actionsthataretobetaken.Studentswillbenefitfromanimprovedandmoreindividualizedacademic program.Parentswillbenefitfromtheopportunitytoprovidefeedbackandparticipateintheevaluation oftheirstudentsexperience.Therapistswillhavemoreinvolvementintheacademiccomponentsofthe programandthereforebenefitfromamoresophisticatedteamapproach.Teacherswillbenefitfrom additionaltrainingandsupportindeliveringhighqualityinstructionalignedwithbestpractices,research, andobservation. Ienvisiontheoutcomeofthisactiontobemultifaceted.First,theprogramwillcontinuetogrow, develop,andberefinedinthecomingyearssothatwemaybetterserveourstudentsandtheirfamilies. Ialsoenvisionthatthedatathatwillbecollectedwillcalluponustocontinuereevaluateourpractices andgrowaseducatorsaswerespondtoit.Thelevelofcollegialitythatwillbeachievedthrough collaborationandhavingasharedvisionofimprovingtheprogramwillbeaplatformforcontinuous growthandimprovementintheyearstocomeforSummitTraverse.

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

39

Itistheteacherresearchershopethatthecontinueddevelopmentoftheprogramanddata collectionwillfurtherstrengthentheassertionthatateamapproachcanimprovestudentsattitudesand beliefstowardsschool.Intheeventthatfurtherresearchsupportsthishypothesis,itwouldbeofinterest totheteacherresearchertosharetheirfindingsatconferencesfortheIndependentEducational ConsultantAssociation,theNationalAssociationofTherapeuticSchoolsandPrograms,andthe NationalAssociationofIndependentSchools.Partneringwithothertherapeuticprogramsto incorporateacademiccomponentsintotheircurriculumwouldallowforcollaborationthatwouldbenefit theindustryonalargerscaleaswell. Conclusions Theprocessofexaminingaprogramstillinitsdevelopmentalstagesprovedtobeavery enlighteningexperienceprofessionally.Theimportanceofcarefulanddeliberatecurriculumdevelopment becameevidentthroughoutthecourseofthestudyhowever,italsobecameclearthattheabilityto developaneffectiveprogramrestsontheunderstandingofthetargetpopulationandtheirneedsand challenges.ItisnowmoreclearthatwhileSummitTraversehasaclearlydevelopedtherapeuticand residentiallifeprogram,theacademiccomponentremainsapointofweakness.Despiteimprovementsin traditionalmeasures,suchasGradePointAverage,thereremainsasignificantdisparitybetweenreasons forreferralandgoalswhileintheprogramandtheareasofimprovementreportedoutonatdischarge. Thisobservationisthedrivingforcebehindfutureaction,whereclarifyingthemissionandgoalsofthe academicprogramanddesigningamorestructured,cohesive,andconsistentmodelformonitoring studentprogressandmeetingstudentneedsisparamounttotheprogramscontinuedsuccess.This researchhasprovedinvaluableinrevealingsomeofthefallaciesbehindthebeliefthatthisprogramhas beenentirelysuccessfulinitsfirstyear.Whileitisimportanttohonortheworkthathasbeendonein

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

40

developingandimplementingthisprogram,itisalsoimportanttolookforwardandtoadoptamodelof continuousimprovementastheprogramevolves.Thisresearchwillprovideasoundfoundationfor furtherbuildingandadaptingtheprogram.

References

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

41

FernandoMorteraGutirrez.(2006).FacultybestpracticesusingblendedlearninginE learningandfacetofaceinstruction.InternationalJournalonELearning,5(3),313337. Retrievedfromhttp://search.proquest.com/docview/210334991?accountid=12756

Kearney,C.A.,&Bates,M.(2005).AddressingSchoolRefusalBehavior:Suggestionsfor FrontlineProfessionals.Children&Schools,27(4),207216.

Lauchlan,F.(2003).RespondingtoChronicNonAttendance:AReviewofIntervention Approaches.EducationalPsychologyInPractice,19(2),133146.

Lim,D.H.,&Michael,L.M.(2009).Learnerandinstructionalfactorsinfluencinglearning outcomeswithinablendedlearningenvironment.JournalofEducationalTechnology& Society,12(4),282n/a.Retrievedfromhttp://search.proquest.com/docview/1287037860?

Norberg,A.,Dziuban,C.D.,&Moskal,P.D.(2011).Atimebasedblendedlearningmodel.On theHorizon,19(3),207216.doi:http://dx.doi.org/10.1108/10748121111163913

Qyillen,I.(2013).Theriseofblendedlearning:Howanewtrendineducationrethinkstherole ofcomputersintheclassroomandletseachstudentlearnatadifferentpace.Smithsonian Magazine.Retrievedfrom:http://www.smithsonianmag.com/ideasinnovations/TheRise ofBlendedLearning214602391.htm

RunningHead:TEAMINTERVENTIONSANDSCHOOLREFUSAL

42

Stevens,G.H.,&Frazer,G.W.(2005).COACHING:Themissingingredientinblended learningstrategy.PerformanceImprovement,44(8),813.Retrievedfrom http://search.proquest.com/docview/237231909?accountid=12756

Stickney,M.I.,&Miltenberger,R.G.(1998).SchoolRefusalBehavior:Prevalence, Characteristics,andtheSchools'Response.EducationAndTreatmentOfChildren,21(2),

Wimmer,M.(2008).Whykidsrefusetogotoschool...andwhatschoolscandoaboutit. TheEducationDigest,74(3),3237.Retrievedfromhttp://search.proquest.com/docview/ 218201101?accountid=12756