- Social and Emotional Supports
- Multi-Tiered System of Supports
- System of Care
- The Three Models
- Tools & Resources
Colorado Framework for School Behavioral Health
All In: Using Advisory to Transform School Climate
Multi-Tiered System of Supports
The Colorado Framework for School Behavioral Health Services melds a System of Care within a Multi-Tiered System of Supports. The Framework includes three models of service delivery for students with high behavioral health needs;
1.) Co-located services, where a district or school has a school-based health center that includes behavioral health and primary care
2.) A school-based therapist, where a therapist from the community comes to the district or school to deliver group and individual based therapy
3.) A referral to a community based therapist, where a district or school has a strong relationship with a Community Mental Health Center (CMHC) and has a streamlined referral process with the center to create a seamless service delivery model for children, adolescents, and their families.
The following Framework and best practices guide provide the key elements required to implement comprehensive school behavioral health systems in districts and schools across Colorado. As part of a tiered system of supports, school staff must realize that individual students’ needs are not fixed at one of the tiered levels; instead, students may move fluidly between tiers—up or down—at any time, depending on circumstances. While the pyramid is fixed, students’ needs are not.
Click on the pyramid icons for more information on each tier.
Tier 1-Universal Supports for ALL STUDENTS
Positive behavior supports are implemented across the district.
Rather than focus on control and punishment, schools should focus on creating positive classroom environments that focus on social, emotional, and behavioral health skill building with clear and consistent expectations.
Evidence-based/practice based social, emotional learning opportunities are included across classes and curriculum.
Districts and schools should include evidence-based or practice-based social and emotional learning throughout the curriculum, across content, and across grade levels.
Schools include universal behavioral health screening.
Currently, very few schools in Colorado use formal measures to screen students for behavioral health needs. Instead, too often, students’ behavioral health needs are addressed only from a reactionary and punitive approach rather than a preventative one, and internalizing students’ needs are overwhelmingly not addressed.
Districts and schools have a formal referral process in place.
School leaders must work with all school staff and behavioral health experts outside of the school to create a streamlined referral system for students with Tier 2 and Tier 3 needs. Additionally, schools must ensure they have adequate systems in place so that students who are referred for Tier 2 and 3 interventions have the support they need.
Tier 2 – Secondary or Targeted Interventions for SOME STUDENTS
Schools offer evidence-based group and/or individual interventions.
School behavioral health professionals and local behavioral health experts should work together with the school and the team guiding the behavioral health work to ensure the interventions they are using are effective.
Progress monitoring is integrated into the school day.
Progress monitoring is most effective when it occurs in natural settings throughout the school day and when it includes multiple measures, including those from the home and community.
Tier 3 – Tertiary or Intensive Interventions for FEW STUDENTS
Schools offer opportunities for individual and group counseling/therapy during the school day.
Students who have tertiary needs will struggle to learn without the proper support in place. Schools need to include opportunities throughout the school day for students to receive the therapy and counseling services they need.
Schools have a re-entry program for students transitioning back from hospitalization or residential treatment.
Districts and schools should have a thorough plan in place that supports students and their families transitioning back to school from hospitalization or residential treatment.
Schools have a crisis response plan in place.
Schools must establish a crisis response protocol and have a plan in place for events that affect multiple students and that address the need for grieving and coping.
View the following tab to learn more about how tiers 2 & 3 link to specialized service delivery models.
Schools ensure adequate information sharing between the behavioral health professional, other youth-serving agencies, families, and necessary school staff.
For many districts and schools, the lack of adequate information sharing has kept students from receiving the services they need in school and has made progress monitoring of school’s behavioral health efforts difficult.
Constant and effective communication loops exist between the behavioral health professionals and the team leading the behavioral health work.
As part of a comprehensive school behavioral health system, schools need a strong communication loop with the behavioral health professional(s) serving the school and other youth-serving systems.
Schools ensure opportunities exist for “warm hand-offs” between school staff and behavioral health professionals.
A warm hand-off is an empathetic process where an educator, school social worker, school psychologist, school counselor, or school nurse introduces a student to the local behavioral health specialist and helps that student navigate the process of care coordination between the behavioral health professionals within and outside of the school.
Wraparound services are available for students with Tier 3 needs.
Wraparound services are individualized, community-based services that bring multiple systems together with the child or adolescent and their families to provide a highly individualized plan to meet the unique needs of the student.
School leaders ensure youth-guided services and family partnerships for students with Tier 2 and Tier 3 needs.
As part of the System of Care principles, youth-guided services and family partnering are integral to the success of student interventions.
Click on the icon above for more information on the System of Care.
Three Models for Specialized Delivery
There are three models that Colorado districts and schools use for specialized services within a comprehensive school behavioral health system. Depending on location, resources, and need, the three models include delivering early intervention and intervention evidence-based services through:
1. Co-located services within a school-based health center
2. A school-based therapist who comes to the school to deliver services
3. A community-based therapist who delivers services in a Community Mental Health Center. In the following section, there are best practices and spotlight stories about each model in Colorado. While the three models vary in setting, they have common best practices.
Click on the image for a best practices overview of the models.
Click on each model for more information on the Three Models for Specialized Service Delivery.
Colorado Framework for School Behavioral Health Services Tools and Resources
Click here to download the complete Colorado Framework for School Behavioral Health Services
BB (Building Bridges Resources)
1) CLF – Created Additional Resources
3) BBAnxiety Disorder
4) BBBiPolar Disorder
5) BBConduct Disorder
8) BBSubstance Use Disorder
10) BBScripts for Calling Parents
11) BBManaging Challenging Behaviors for Parents and Teachers
12) BBMandated Reporting
13) BBSchool Transitions for Teachers
14) BBBuilding School Team
15) BBFamily Driven Care
16) BBImplementing ESW Standard
17) BBAssessment Tool for Capacity Building
18) BB Legal Memo
19) CEI- Created District Needs Assessment
20) CEI- Created School Needs Assessment
21) CDE Family Partnering Toolkit
22) SACPIE Suggested Family School Partnering Resources
23) CEI- Created Gaps and Barriers Analysis
24) Information Sharing Tip Sheet
25) State of Colorado Consent to Release Information
26) CASBHC Understanding Minor Consent and Confidentiality in Colorado
27) West Virginia Sample Parental Consent
28) CEI- Created Mental Health Stigma Reduction
29) MOU Final School Based Pueblo City Schools
30) School-Based Mental Health Services Contract Spanish Peaks and Pueblo
31) PACE Program for Students Transitioning Back to School from Residential Treat..
32) BRYT One-Pager
33) CWRMH Inc. Outpatient Referral Form
34) CWRMH Inc. Referral Instructions
35) West Virginia Sample Referral Form
36) CDE School Readiness Assessment Guidance
37) CEI- Created Social Emotional Learning Guide
38) Social Emotional Continuum preK- 3rd grade- Mesa County Valley
39) Social Emotional Continuum 4th- 8th grade- Mesa County Valley
40) Social Emotional Continuum 9th- 12th grade- Mesa County Valley
41) CEI- Created Staff Self Care Tip Sheet
42) System of Care Concept and Philosophy
43) CEI- Created Colorado Context
44) CEI-Created National Context
45) CEI- Created Trauma Sensitive and Culturally Responsive Classrooms
46) Responding to Traumatic Events
47) CEI- Created Universal Screening Toolkit