With the return from the Thanksgiving weekend, we already seen an increase in the number of risk assessments. Four of them in three days. I wonder if the trend is going to continue.
So with this as a preface, I had a risk assessment, the fourth of the week so far. A middle school student with reports of suicidal ideation. I spent quite a long time on this one and didn't really come to a conclusion until I obtained collateral information from family members. In the end, it was what the student didn't tell me and their family did that led to my decision.
So I was thinking about the role of a school psychologists and how it relates to the risk assessment. During the assessment the thought crossed my mind, "I should just send the student out and be done with it." Within the confines of the school, it seems to me that the general feeling is that we are to decide whether another mental health professional needs to assess the student rather actual determining whether the student is at risk.
Part of this feeling may come from the fact that we don't actually have any power outside the school. We are only able to say that the student can't return to the school until they have been cleared by someone with the authority and license to do so. So does that absolve us from investigating further? Does it mean that we should just CYA (or COA)?
I don't think so. In my district, we have a relationship with the local screening center where we complete a report (a much briefer report than my actual in-district write up) and fax it to the center, as well as giving them a heads up call. So by digging deeper and asking more questions and seeking further information, we may end up getting information that won't be given to the professionals at the hospital. Either because the student/family may change their story on the way there or just refuse to discuss certain issues that may have been discussed in the school.
I'll also reiterate another piece of advice that I have picked up from the people that really trained me in risk assessment. Some excellent people indeed. That advice is: take your time. Don't let anyone rush you. Not the student; not the guidance counselor; not the principal. If you have questions, make sure you ask them. Don't feel like you have to fill the silence. You can take your time and think of your next question. And don't feel silly for asking the same question again, particularly if you something is bothering you about the first answer.
Like I said, it was what the student didn't tell me and their evasiveness that led me to ask further questions and seek out other sources of information that ultimately led to my decision.
Showing posts with label risk assessment. Show all posts
Showing posts with label risk assessment. Show all posts
Wednesday, December 1, 2010
Friday, October 2, 2009
The Road to Hell...
As I stated in my first post, it was my intention to do a post a day...well so much for that this week. Ah well. Here is the week in a nutshell.
Tuesday
After a three day weekend, it was like I never left. There were a number of paperwork and organizational issues to take care of which is nothing unusual. Then the big one came: a risk assessment. A student had spoken about killing herself. I went over and met with the student, guidance counselor, the district counselor, and the guidance counselor's intern. It was very crowded in the very small office. In the end, it was determined that the student needed to be screened at a local psychiatric screening center for a number of reasons that are too confidential to place on a blog. The whole situation was made more murky due to a question of guardianship.
Wednesday
I got a chance to meet with students that have counseling in their IEP. Some were the same students that I had seen last year. Some were new. Counseling in a school is not psychotherapy, although many teachers and other school staff think that it is or should be.
Following this, I had to make final arrangements for a meeting with some teachers on Thursday. Arrangements included making sure one of the teachers, who had a class scheduled the period of the meeting, was able to send her students to another class. After that it was back to my office for a quick lunch before a student showed up for testing.
Testing: I completed the psychological evaluation. It was composed of a cognitive assessment, some projective drawings, a behavior rating scale, visual motor coordination test, and an interview.
This was the one day of the week that the majority of the work was actually related to being a school psychologist and not a case manager.
Thursday
I got into work and had a voice mail message from a guidance counselor that a student had seen her during back to school night and had asked her to change a class to another period because the atmosphere in the class was too distracting. The guidance counselor was going to change the class from period 4 to period 1. I checked the high school master schedule to make sure that the class was an in-class support teacher and discovered that not only wasn't the period 1 class supported but neither was the class that he was currently assigned. Crap.
I took a closer look because a similar issue had occurred with another class about two weeks before. And I found that not only was this student in an unsupported class but so was another student. Then I got a sinking feeling. I called one of my co-workers who is deeply involved in scheduling the special education high school students. She stated looking at the various sections of this subject (physical science; I don't know why I'm being so mysterious about it) and discovered that 5 other students were impacted in the same way. Double crap.
We then started looking other courses and student schedules. One of my students who was supposed to have all in-class support classes wasn't in any in-class support classes. Then we discovered that it wasn't just freshmen (my caseload). This impacted students across the grades, mostly in the sciences. So the high school case managers had to check each students schedules against the services in the IEPs. This took a fair amount of time and raised the blood pressure of everyone involved because, thanks to computers, we were able to look at when the classes were changed from in-class support classes to unsupported classes. Without casting blame, the only explanation that we were able to come up with was that more sections of certain subjects were created and the scheduling program was allowed to balance the class numbers but no one ever looked to see if special education students were where they should be when it was over. And since it was guidance that created the new sections and did the redistribution of students...And that is one of those situations that leads to the Us vs. Them feelings.
In the midst of this, one of us gets a call that there is a student in crisis over at the high school and since I'm the school psychologist, off I go. It didn't end in a referral to the psych screener but it did involved about an hour and a half of counseling and working on coping skills. It was a textbook case of someone in the process of developing a generalized anxiety disorder. Fortunately the student was about to enter outside treatment and, in the end, the student was able to return to class for the rest of the day, which was good because I was concerned that this might lead to school avoidance.
I made it back in time to be a part of the second half of a conference call with the company that provides us with the special education information system. The district had just purchased the services of this company toward the end of the '07-'08 school year and there are still kinks in the system, particularly in having this system communicate with the school information system. It was a good meeting because we learned about some capabilities of the program that we didn't know about.
Then it was off to the meeting I mention under Wednesday. It involved the teachers of a particular student and to answer any concerns regarding that student. It is an involved case and a number of the teachers were passionate in their positions, which is a good thing. Especially since none of them seemed passionate for selfish reasons. I did spend about 40 minutes after the meeting debriefing one teacher who had been particularly heated.
Friday
The day started with the aftermath of the scheduling debacle from Thursday. All the schedules were corrected and we had to call the students down and give them their new schedules and explain the change. Some students were cool about, some didn't necessarily want the change. In the case of the latter, I told the students to speak with their parents and if they felt the same, the parents should give me a call. By the time this was done, it was time for the Friday staff meeting.
The theme of the meeting: monitoring of course. Following a brief discussion, we were broken down by school and told to review charts for monitoring. My group put together a list of names and then we split up to go through charts. And that is how the day ended.
See you next week.
Tuesday
After a three day weekend, it was like I never left. There were a number of paperwork and organizational issues to take care of which is nothing unusual. Then the big one came: a risk assessment. A student had spoken about killing herself. I went over and met with the student, guidance counselor, the district counselor, and the guidance counselor's intern. It was very crowded in the very small office. In the end, it was determined that the student needed to be screened at a local psychiatric screening center for a number of reasons that are too confidential to place on a blog. The whole situation was made more murky due to a question of guardianship.
Wednesday
I got a chance to meet with students that have counseling in their IEP. Some were the same students that I had seen last year. Some were new. Counseling in a school is not psychotherapy, although many teachers and other school staff think that it is or should be.
Following this, I had to make final arrangements for a meeting with some teachers on Thursday. Arrangements included making sure one of the teachers, who had a class scheduled the period of the meeting, was able to send her students to another class. After that it was back to my office for a quick lunch before a student showed up for testing.
Testing: I completed the psychological evaluation. It was composed of a cognitive assessment, some projective drawings, a behavior rating scale, visual motor coordination test, and an interview.
This was the one day of the week that the majority of the work was actually related to being a school psychologist and not a case manager.
Thursday
I got into work and had a voice mail message from a guidance counselor that a student had seen her during back to school night and had asked her to change a class to another period because the atmosphere in the class was too distracting. The guidance counselor was going to change the class from period 4 to period 1. I checked the high school master schedule to make sure that the class was an in-class support teacher and discovered that not only wasn't the period 1 class supported but neither was the class that he was currently assigned. Crap.
I took a closer look because a similar issue had occurred with another class about two weeks before. And I found that not only was this student in an unsupported class but so was another student. Then I got a sinking feeling. I called one of my co-workers who is deeply involved in scheduling the special education high school students. She stated looking at the various sections of this subject (physical science; I don't know why I'm being so mysterious about it) and discovered that 5 other students were impacted in the same way. Double crap.
We then started looking other courses and student schedules. One of my students who was supposed to have all in-class support classes wasn't in any in-class support classes. Then we discovered that it wasn't just freshmen (my caseload). This impacted students across the grades, mostly in the sciences. So the high school case managers had to check each students schedules against the services in the IEPs. This took a fair amount of time and raised the blood pressure of everyone involved because, thanks to computers, we were able to look at when the classes were changed from in-class support classes to unsupported classes. Without casting blame, the only explanation that we were able to come up with was that more sections of certain subjects were created and the scheduling program was allowed to balance the class numbers but no one ever looked to see if special education students were where they should be when it was over. And since it was guidance that created the new sections and did the redistribution of students...And that is one of those situations that leads to the Us vs. Them feelings.
In the midst of this, one of us gets a call that there is a student in crisis over at the high school and since I'm the school psychologist, off I go. It didn't end in a referral to the psych screener but it did involved about an hour and a half of counseling and working on coping skills. It was a textbook case of someone in the process of developing a generalized anxiety disorder. Fortunately the student was about to enter outside treatment and, in the end, the student was able to return to class for the rest of the day, which was good because I was concerned that this might lead to school avoidance.
I made it back in time to be a part of the second half of a conference call with the company that provides us with the special education information system. The district had just purchased the services of this company toward the end of the '07-'08 school year and there are still kinks in the system, particularly in having this system communicate with the school information system. It was a good meeting because we learned about some capabilities of the program that we didn't know about.
Then it was off to the meeting I mention under Wednesday. It involved the teachers of a particular student and to answer any concerns regarding that student. It is an involved case and a number of the teachers were passionate in their positions, which is a good thing. Especially since none of them seemed passionate for selfish reasons. I did spend about 40 minutes after the meeting debriefing one teacher who had been particularly heated.
Friday
The day started with the aftermath of the scheduling debacle from Thursday. All the schedules were corrected and we had to call the students down and give them their new schedules and explain the change. Some students were cool about, some didn't necessarily want the change. In the case of the latter, I told the students to speak with their parents and if they felt the same, the parents should give me a call. By the time this was done, it was time for the Friday staff meeting.
The theme of the meeting: monitoring of course. Following a brief discussion, we were broken down by school and told to review charts for monitoring. My group put together a list of names and then we split up to go through charts. And that is how the day ended.
See you next week.
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