Episode 29 – Mental Wellness and Behavioral Health in Public Schools
Hello, and welcome to The Behavior Education Connection, the podcast that works to connect the world of behavior analysis and the world of education. We focus on topics important to behavior analysts who work in the public schools, and those who support them. Join us and spend time gaining insights and ideas as our host talks with fellow behavior analysts, as well as other experts in the field. [Selena Layden] Hello and welcome to our newest episode of The Behavior Education Connection. I’m your host, Dr. Selena Layden, and I am fortunate enough today to be joined by two guests, um, Emily and Anne. So Emily, if you don’t mind introducing yourself? [Emily Muise] Sure. Uh, so I am Emily Muise. I am a behavior analyst, and I’m also the project manager for the Cooperative for Effective Behavior Intervention and Supports. [Selena Layden] Thank you. Welcome, Anne. [Anne Perrotti] Hi. Yes, it’s nice to be here. Uh, my name is Dr. Anne Marie Perotti, and I am a certified speech language pathologist with a PhD in special education, and I work as an associate professor at Old Dominion University. [Selena Layden] Well, thank you so much both for being here, and I am excited about this topic. I think it’s something that school-based behavior analysts are dealing with more and more, um, whether by choice or just by circumstance. And so today we are talking about mental health, mental wellness, behavioral health, the intersection, and where it doesn’t intersect kind of thing. Um, so let’s go ahead and jump in. So, um, Anne and Emily, tell me a little bit about what we mean by these terms, because mental health, mental wellness, behavioral health, it’s not exactly the same thing. So what do we mean by this? [Emily Muise] Sure. Um, one of the things that we found as we together kind of dug into this topic is that the way that these terms get used depends a little bit on who you ask. Um, different organizations like the World Health Organization, the American Psychological Association, um, other groups along that line kind of add and subtract components of these definitions, but there are some common themes. Um, so mental health generally refers to a current definable describable mental, social, or emotional state, whereas mental wellness is more of a concept of a resource that each person has that can be developed and can be improved over time. And then to add into the mix behavioral health, according to the American Medical Association, that generally refers to mental health, substance use disorders, life stressors and crises, and stress related physical symptoms. And that is a quote from their website. Um, but the most important thing I think to keep in mind when we talk about these terms is to remember that mental health and mental wellness are not the same as mental illness. Um, there is, we feel and, and kind of came across as we were diving into this area, that sometimes those get a little bit mixed up in everybody’s minds. And, um, especially when we start to think about public schools and where does everybody fit in, um, it can be a little bit daunting, um, because sometimes we always assume that we’re talking about the same thing, when in fact we’re not. So I, the big takeaway would just be, you know, mental health, mental wellness, different concepts entirely from mental illness. [Selena Layden] Yeah. And I, I do think it’s important because, and, and part of what I think about, we all have mental health, we all have mental wellness and behavioral health. Um, we may or may not all have mental illness, and so mm-hmm. Yep. Good point. So what does this have to do with schools? Why, why would we even need to talk about this as school-based behavior analysts? [Emily Muise] I’m gonna kick this one to Ann, I’ll let Ann jump in here. [Anne Perrotti] So I think it’s important for educators in the school system to be aware of mental health, mental wellness, and behavioral health, um, because are, these are the, um, precipitating factors that can, uh, guide student behavior with regards to being successful or not being successful in the classroom. Um, and those successes can be related both to, uh, social, social success, academic success, um, as well as, um, the ability to, um, generate and solve problems. [Selena Layden] So what kind of impacts are we seeing right now on students with regards to mental wellness and behavioral health? [Emily Muise] So definitely mental wellness and behavioral health are very much more in the public eye, I think, at the moment than perhaps they have been in years past. Um, but that’s not just a perception. That’s supported by like reporting data as well. School divisions are reporting a higher incidence and prevalence of mental wellness, behavioral health concerns, educators are reporting a higher level of concern surrounding it. Um, and it’s also, we’re starting to see kind of across the board some of these topics that maybe were perceived as like, well, school doesn’t really deal with that, or school can’t really support that. Uh, like Anne was saying, school has to support that because it’s impacting student success in the classroom academically, and it’s impacting their success socially as well. [Selena Layden] So as BC, as school-based BCBAs, you know, I, I don’t know that historically we have always seen this as our role, right? Like we tend to say, we tend to focus on observable behavior, we tend to focus on things that we can change in the environment. Um, so as we think about mental wellness and behavioral health, what are some of those barriers other than just, I don’t see it as my role, which we need to break through that. Um, what are some of the barriers that we need to think through and try to work to overcome a little bit? [Emily Muise] So I can say as a behavior analyst, um, I don’t recall a whole lot of my pre-service training, uh, really focusing on the subject of mental wellness or behavioral health, other than maybe a cursory mention here and there. Um, and any subsequent professional development surrounding those topics have been things that I had to seek out for myself. So definitely a barrier is, for lack of a better way to put it, the ability to establish this as part of your practice area. Um, sometimes you have to do a little bit more homework, uh, and a little bit more self-study and seek out resources than perhaps you would with some other areas that are very commonly, in public schools, perceived to be part of the scope of practice for behavior analysts. Um, and because we need to practice in our scope of competency, that’s absolutely, you know, not open for debate. Sometimes the result can be that BCBAs are left out of the conversation a little bit when it’s time to talk about, um, how can we address these problems? How can we build our systems in a more effective way? Sometimes these conversations happen and BCBAs we’re just not included in them. [Selena Layden] Yeah. So Anne, I would actually love to hear your thoughts about this being a speech language pathologist and not a BCBA. Um, you know, we have talked about the importance of collaboration a lot and as a school-based BCBA, um, well, let me back up as BCBAs for a long time, I don’t know that collaboration was as strong a part of our training programs as it is growing to be now. And, you know, the coursework has changed over time, and hopefully supervisory practices are really emphasizing this need for collaboration, because especially in a school setting, we can’t do it by ourselves, nor should we be trying to do it by ourselves. And so how do we think about collaboration, um, particularly with people from, from different fields that are not necessarily trained in behavior analysis. [Anne Perrotti] Um, so I think that’s a great question and a really important topic is this idea of how do we work, um, with others in order to improve changes, uh, and what might be, um, a discipline specific goal. So for, um, in the world of BCBAs, it might be that you are working on a goal specific to observable behavior as mentioned, however, the team approach might be extremely important if we consider that those observable behaviors may be manifested as a function of, um, something within the realm of mental wellness, um, mental health or behavioral health, as Emily had to find those, those terms earlier. So having said that, I think that in the school system right now, if we’re talking primarily about school-based BCBAs, um, there are forms of collaboration that go on all the time, whether that that be called be whether those terms that are used, um, multidisciplinary teaming collaboration or teamwork. I do think that there is, um, this effort to try to talk with others, to try to, um, make sure that services are being delivered in a comprehensive manner. However, if we want to take lead, um, from, uh, uh, the World Health Organization, uh, we can think we can start thinking about collaboration in this realm as much more of a synthesis and integration of approaches, uh, in, according to the framework as outlined, uh, by the WHO organization called Interprofessional collaborative practice. And so, interprofessional collaborative practice really offers us a more dynamic and purposeful, uh, way to interact at the same time as other professionals towards the same goals. So this is much less, you know, working in silos and then coming together at individual points during the process. And this is much more working together simultaneously from beginning to end through the process of, uh, intervention remediation, uh, skill development in using interprofessional collaborative practice. It’s much more directed and purposeful at every point in the intervention approach that you are seeking. Uh, and, um, responding to the input of other professionals, uh, and the World Health Organization re uh, recognizes interprofessional collaborative practice as effective and necessary not only to improve client outcomes, patient outcomes, but also to generate increased, uh, uh, professional reward. Um, increasing the professional’s ability to feel fulfilled in their role, um, increasing the use and, uh, of resources so it elevates and leverages resources that are already in place. Um, and it allows for professionals to really work in a dynamic fluid type of relationship to improve outcomes and to improve outcomes for the long term. Um, in the world of speech language pathology, we might call that generalization through generalization and transfer, um, so that these are skills that can be practiced outside of the therapeutic setting. [Selena Layden] Yeah, and I think being systematic in our collaboration is really important. I think it’s more than just we ended up in the same room together and somehow we have to make this work out. And I think in education, unfortunately, that happens a lot. We don’t necessarily get to pick our teams. We don’t necessarily get to decide I’m going to be part of this team and I’m not going to be part of that team. We kind of get assigned. Um, and a lot of times it’s based on geographical location and role rather than, um, who people are and how they work together. And so I think having a systematic framework for what that looks like can be really helpful. So what are kind of some of those first steps that our BCBAs could think about to have a more systematic approach to collaboration, such as interprofessional practice? [Anne Perrotti] Well, the, the, one of the pre steps to interprofessional collaborative practice is interprofessional education. And this is something that, um, I find is very rewarding and helpful. Um, and interprofessional interprofessional education really refers to when groups of professionals come together to learn with from and about one another. So if we’re talking about a really true precursory step, it would be the opportunity for BCBAs in their environment to seek out other professionals that they know would be integral on the team and start to learn with from and about that professional. Um, interprofessional collaborative practice, uh, assumes that the everybody is on the same tier, right? There’s no level of hierarchy within that framework. And so, um, starting with some really, um, healthy conversations between other professionals with regards to, okay, what, you know, where is your perspective? How do you view observable behavior? What are your primary, what are your primary, uh, what is your primary scope of practice? And how do you engage the client to achieve the goals within that scope of practice? And really learning about where you can elevate one another, support one another, or extend one another’s skills and abilities, uh, I think is one of the precursor steps. And then, um, as you generate a, a, a better understanding of the profession that that professional represents and how the, the link between that profession and, um, the BCBA and what they are trained and skilled to do, I think then you’re able to start making decisions that are client specific about who you would want on your interprofessional team, how you would bring those people together, um, and then how you would stay together from the assessment through the intervention and outcome phases. [Selena Layden] Yeah. Emily, you brought up scope of competence, which I think is really important, particularly when we’re talking about mental health, mental wellness, and behavioral health, because I don’t, I don’t know how many BCBAs would say Yep. My scope of competence absolutely includes mental wellness, behavioral health. I feel really good about this and I, I know what to do. Um, with 99% of the cases, I don’t feel that way. I don’t feel like as a BCBA I got a lot of training on mental wellness and behavioral health, and I think, um, there’s moments where I’ve had to really seek out resources and mentors and other people to help support my professional growth in this area. So I, I think, um, I would love to get your perspective on how interprofessional practice might be a way to help support our growing, the growth of our self competency and, and what, and our scope of competency, particularly in this area. [Emily Muise] Definitely. Um, something that I think it’s important to keep in mind is that, um, sometimes we forget about the things that we are competent in, um, things that are very much within our scope of competence. And one of them, especially for behavior analysts, is to kind of take a look at the environment in totality and identify, okay, so something here isn’t working, we’re not sure what it is. We have to gather more information, we have to assess what is happening, but we can agree that this situation, something needs to change. And that might be a potentially uncomfortable place sometimes for BCBAs to be in, especially in schools. And we’ve talked a lot through VAPSBAN and through other events about how BCBAs sometimes get called in as the last resort or as the firefighter. Um, and interprofessional collaborative practice is a way to kind of step outside of that firefighter role where you may not be the person that has the solution, and that’s okay, but what you might be is the person who says, we have to bring some other folks with different expertise to bear because like we said, something in this scenario isn’t working. So I think being able to stay curious, but also use the competencies that we do have in identifying and defining behaviors, identifying, um, other stakeholders who could be really, really beneficial and whose voices might need to be amplified in support of the students is a really great way to get started without falling into that kind of circular thinking of, I can’t address this because it’s mental wellness and behavioral health, or if I had more training, I would be able to do this. See, sometimes we have to start where we are with the skills that we have, and that might mean setting up the environment where we can pass the microphone to someone else who absolutely has the training and the support and the resources, and is just really waiting for the opportunity to share them. [Selena Layden] Yeah, I agree. And I think, you know, sometimes I think we get caught up in language, right? Like, oh, that’s not behavioral, because they’re not using the same language that I’m using. But at the end of the day, I think sometimes we need to take, take a step back and say, actually they’re saying something very similar or even the same of what I’m saying. They’re just not saying it the same way. And so how can we as a team come together to produce better outcomes for the kids that we’re supporting? So, um, well, I want to, we’re, we’re reaching the end of our time, but I really do appreciate your, your time today, both of you. Any last minute thoughts that you wanna share before we sign off? [Emily Muise] I think we got it. Just, you know, again, stay curious and keep trying and it is okay to connect with and support others in the best interest of our students. [Selena Layden] Great. Well, again, Anne and Emily, thank you so much for being with us today. I really appreciate your time. [Emily Muise] Thank you so much for having us. [Anne Perrotti] Thank you for having, yes, thanks. It was my pleasure to be here. [Selena Layden] Well, again, appreciate your time and your expertise. Um, and thank you to our listeners for joining us today. We will see you on our next episode. Thank you for joining us on this episode of The Behavior Education Connection. Join us next time for another great conversation about behavior analysis in the schools. And don’t forget to subscribe so you don’t miss out on an episode Sending out a special thanks to the Virginia Department of Education for supporting our work. We look forward to connecting with you all again soon.
Welcome to the Behavior Education Connection!
In this episode, we’re talking about school-based behavior analysts supporting mental wellness and behavioral health in public school settings. We discuss how behavior analysts can cultivate relationships and level up their practices to expand their scope of competence to include this vital area.
Our guests for this episode are Emily Muise from the Cooperative for Effective Behavior Intervention and Supports and Dr. Anne Perrotti from Old Dominion University.
We’ll discuss:
-Mental health, mental wellness, and behavioral health- what’s the difference?
-Why supporting students in these areas can be daunting for school based behavior analysts
-How interprofessional collaborative practice can help bridge the gap
And more!
Link for WHO behavioral health definition: https://www.ama-assn.org/delivering-care/public-health/what-behavioral-health
For more information, check out the Virginia Public Schools Behavior Analyst Website: https://sites.google.com/odu.edu/vapsban/home
Guest Speakers: Emily Muise is the Project Manager for the Cooperative for Effective Behavior Intervention and Supports (CEBIS) through Old Dominion University, and Dr. Anne Perrotti is an Associate Professor and certified speech-language pathologist at Old Dominion University.
Host:
Selena J. Layden, Ph.D., BCBA-D, LBA is an Assistant Professor in the Department of Human Movement Studies and Special Education at Old Dominion University. Dr. Layden earned her doctorate degree from the College of William & Mary in Education Policy, Planning, and Leadership with an emphasis in Special Education Administration and her master’s degree in Applied Behavior Analysis from St. Cloud State University in Minnesota. Prior to joining the faculty at ODU, Dr. Layden worked in multiple school divisions focusing on challenging behavior and children with autism spectrum disorder. She was also the Assistant Director of Training at the Autism Center for Excellence at Virginia Commonwealth University. Dr. Layden’s research interests focus on providing effective professional development for school personnel, improving the implementation of evidence-based practices in schools, particularly for students with autism spectrum disorder, and school-based behavior analysts.
Music:
Finding Peace by Remember the Future, from Shutterstock Music