Expert answer:School and Crisis Intervention

Solved by verified expert:The Term Paper: no more than 10 pages -It should include historical and background issues as well as information on pertinent crisis intervention strategies and tactics. -Must be type written and spell-checked. -Spelling, punctuation, grammar, originality, and appropriate use of citations are essential. -Creativity and innovation are encouraged in term paper development. -Must use APA style for the bibliography section.************ -8.5 inch x 11 inch paper. -The paper requires a “cover sheet” with a) title of the paper, b) the student’s name and the c) department’ name and d) course number. -The paper must have five to ten primary references. (I have already provided you with 6 sources, you may add more as needed).Suggested format: -Abstract (a paragraph about 5 lines will be enough)-Intro and background. (should include why the topic is chosen)-Statistics. (can include a specific case if passable).-Body.-Conclusion-References *I was only able to upload 5 files, so the sixth one is this: https://ac-els-cdn-com.proxy-bc.researchport.umd.e…
27_exploring_benefits_of_school_based_crisis_intervention_programs_a_preliminary_study.pdf

an_integrated_model_of_school_crisis_preparedness_and_intervention.pdf

are_school_social_workers_prepared_for_a_major_school_crisis_indicators_of_individual_and_school_environment_preparedness.pdf

crisis_intervention_and_crisis_team_models_in_schools.pdf

effectiveness_on_mental_health_of_psychological_debriefing_for_crisis_intervention_in_schools.pdf

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NEW RESEARCH POSTERS
6.25 – 6.27
Methods: Charts were reviewed of patients seen by a psychiatric consult
service in a major children’s hospital over 3.5 years. Seventeen patients
received dexmedetomidine for severe anxiety, agitation/aggression, and
delirium. Demographic information, presenting problems and reasons for
consultation, medical and psychiatric diagnoses, psychotropic medications
before, during, and after consultations, complications, and duration of
treatment with demedetomidine were considered.
Results: Seventeen patients, age range 6.1 to 33.75 years (average 17.76
years), 13 females and 4 males, received dexmedetomidine for non-procedural, psychiatric reasons. Nine were treated for agitated delirium who had
medical contraindications to antipsychotics (QT prolongation, drug interactions). Of these, five had combined profound neurodevelopmental
disorders and deliria due to sepsis, two were post cardiac surgery, one had
anti-NMDA receptor encephalitis, and one had E. coli sepsis. Of seven patients with cystic fibrosis, all were treated while on ventilators, including four
with severe anxiety before they expired, and three who survived but had
difficulty weaning from the ventilator due to severe anxiety. A 21-year-old
severely agitated, aggressive autistic male on numerous psychotropic medications and requiring medical care received dexmedetomidine to permit
weaning of unnecessary polypharmacy and to keep self and others safe while
medical issues were addressed. Finally, a 15-year-old male with aggression
secondary to a drug induced intoxication delirium and dangerous autonomic
instability due to “spice” and “kratom” also was treated with dexmedetomidine with a good outcome.
Conclusions: Dexmedetomidine is a useful agent for use in medical and
critical care settings for time-limited treatment of severe anxiety, agitation, or
delirium associated with multiple conditions for which usual psychotropic
medications are ineffective or contraindicated.
ANX CON PYI
Supported by Nationwide Children’s Hospital Division of Pulmonary
Medicine
http://dx.doi.org/10.1016/j.jaac.2016.09.344
6.25 PREVALENCE RATES AND DETERMINANTS OF
ELEMENTARY SCHOOL-BASED SERVICES FOR
EXTERNALIZING BEHAVIOR PROBLEMS OVER A
THREE-YEAR PERIOD IN GIRLS
Pierrette Verlaan, PhD, Psychoeducation, University of
Sherbrooke, 2500 Boulevard Universite, Sherbrooke, QC J1K 2R1,
Canada; Michele Dery, PhD; Jean Toupin, PhD; Jean-Pascal Lemelin, PhD
Objectives: Externalizing Behavior Problems (EBP) are frequent causes of
referrals to school-based psychological services. Studies suggest that girls
with EBP may have more unmet needs, present more severe impairment,
and receive less prolonged treatment than boys. In addition to these concerns, little is known about referral determinants for school-based services
for girls. The aims of this study were to examine gender differences in: 1) the
severity of EBP and in prevalence rates of service reception, and 2) child,
family and school-related determinants associated with maintaining (>12
months) school-based services.
Methods: The data are part of an ongoing longitudinal study on gender
differences in trajectories and service use for children with EBP in Canada.
Eligible children (372;149 girls) were those receiving school-based services for
emotional and behavior problems aged less than 10 years at recruitment.
Guided by an ecological approach, determinants for EBP in child, family and
school contexts were collected from parent and teachers initially and at each
follow-up points (12, 24 and 36 months). Multilevel Generalized Estimating
Equations (GEE) models were used to identify the determinants most likely to
account for girls and boys maintaining services over time.
Results: Prevalence rates indicated that more girls than boys were experiencing clinical levels of EBP and fewer remained in services at each follow-up
points. Inversely, more boys than girls presented subthreshold levels of EBP
at each follow-up points and were more likely to maintain services. GEE
models indicated that along severity of EBP, dysfunctional relationships with
parents, teachers and peers increased significantly the likelihood of girls
maintaining school-based services (R2 ¼ 0.253, p < 0.001). A larger set of determinants emerged as important for boys, they included comorbid S212 www.jaacap.org internalizing problems and ADHD, family instability and pathology, as well as dysfunctional teacher-child and peer relationships (R2 ¼ 0.338, p < 0.001) Conclusions: The higher rates of service reception, the lower threshold of EBP and the larger set of determinants found for boys, suggest a greater sensitivity of adults to boys’ difficulties than for girls. To be noticed, girls may have to present severe disruptive behaviors and conflicting interpersonal relationships with adults and peers. CD EDUC RF Supported by the Canadian Social Sciences and Humanities Research Council (SSHRC-37890/SSHRC-326706) and the Canadian Institutes of Health Research (CIHR-82694) http://dx.doi.org/10.1016/j.jaac.2016.09.345 6.26 PREDICTION OF IMPAIRMENT IN SCHOOL FUNCTION OVER ONE SCHOOL YEAR IN SPECIAL EDUCATION STUDENTS WITH PSYCHIATRIC DISORDERS Richard E. Mattison, MD, Pennsylvania State University, Department of Psychiatry, H073, Hershey Medical Center, Hershey, PA 17033 Objectives: Functional impairment in school is routinely measured by grade point average (GPA), absenteeism, and suspensions. The purpose of this study was to determine for students with psychiatric disorders those variables that could predict the worst dysfunction on these measures over a school year, thus identifying the most at-risk students to school staff, and suggesting more specific targets for interventions. Methods: A cohort of 196 students in a self-contained public school for secondary special education students with psychiatric disorders was followed over one school year. By the end of the first marking period the following information was available: demographics, IQ, reading and math achievement, and teacher ratings of psychopathology. Logistic regression analyses were then used to identify predictors for the worst final dysfunction in GPA, absenteeism, suspensions, and psychiatric inpatient/partial hospitalization during the school year. Results: The most dysfunctional groups were established for each area: GPA of <70 (29.6 percent), absenteeism of >24 days (33.2 percent), any suspension (36.2 percent), and any psychiatric inpatient/partial hospitalization (28.6
percent). The resultant significant predictors for each most impaired group
were: GPA (non-Caucasian, low Verbal IQ, and high ADHD-Inattentive scale;
concordance ¼ 76.7 percent); absenteeism (older and high Social Anxiety
scale; 71.3 percent), suspension (high Conduct Disorder scale; 75.7 percent),
and hospitalization (younger and high Depression scale; 67.5 percent).
Conclusions: Information that child psychiatrists can easily obtain for their
special education students with psychiatric disorders can produce practical
results that can benefit both their patients and school staffs to whom they
consult. For example, academically, non-Caucasian students with decreased
language skills and attention appeared to be most at-risk for poor GPA.
Consequently, clinicians and school staffs could ensure optimal treatment for
such students in any ADHD, language disorders, and accompanying learning
disorders in reading and/or writing. The results further model how practical
research can be conducted in schools, as well as increase the limited evidence base that school consultants can use to assist their patients and
special education colleagues.
CON EDUC LD
http://dx.doi.org/10.1016/j.jaac.2016.09.346
6.27 EXPLORING BENEFITS OF SCHOOL-BASED
CRISIS INTERVENTION PROGRAMS:
A PRELIMINARY STUDY
Ji min Cha, MD, Child and Adolescent Psychiatry, Kyungpook
National University, 45, Deulan-ro 78-gil, Suseong-gu, Daegu,
42010, The Democratic People’s Republic of Korea
Objectives: In Korea the most common cause of death for teenagers is
suicide and this occupies a major part of school crisis. The adolescents who
J OURNAL
OF THE
AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY
VOLUME 55 NUMBER 10S OCTOBER 2016
NEW RESEARCH POSTERS
6.28 – 6.30
have experienced the trauma like peer suicide may be vulnerable to suicide
intentions or attempts due to negative psychological symptoms (Cougle et
al., 2009). Policy initiatives to reduce the negative psychological impact of
peer suicide have been conducted since 2012 in Korea. However, there is
little research to verify the effectiveness of interventions carried out. The
purpose of this study is to investigate the effectiveness of school-based
crisis intervention for students who experienced peer suicide in the same
school.
Methods: For 188 high school second year students experienced the peer
suicide in October 2012, education composed of contents concerning the
promotion of normal grief reaction and coping was conducted for 40 minutes
one week after the accident. A total of 188 adolescents joined all the followup study for twelve months and measured demographic features, experience
in trauma(LITE), degree of depression(CDI), post-traumatic symptoms(CROPS) and post-traumatic stress symptoms(UCLA-PTSD-RI) at one week,
two, six and twelve months. For statistical analysis, the SPSW Statistics 18.0
program was used.
Results: As a result of conducting one-way repeated measures ANOVA for
before-and-after comparison, significant changes were derived in the scale of
CDI (F¼22.81, p¼.00), STAI-X-I(F¼43.01, p¼.00), CROPS(F¼13.61, p¼.00),
UCLA-PTSD-RI(F¼14.22, p¼.00). It was revealed that there was a significant
decline in depressive symptoms and post-traumatic stress symptoms of the
students. Among demographic variables, low economic status group has
more depressive and post-traumatic symptoms than high and middle economic status group. In high risk group with the high score of CDI and CROPS
at one week, it showed significant decline in both symptoms at twelve-month
follow-up.
Conclusions: Our data indicate that school-based crisis intervention can
significantly reduce posttraumatic psychological symptoms among students
who experienced traumatic event of peer suicide. This implies that schoolbased crisis intervention can have preventive effect of spreading suicide.
Also, the results show that careful attention are more necessary in the case of
adolescents with low economic status.
CC PTSD SC
Supported by the Ministry of Education in Korea
http://dx.doi.org/10.1016/j.jaac.2016.09.347
6.28 EFFECTIVENESS OF URGENT OUTPATIENT
SERVICES AT REDUCING SCHOOL-REFERRED
EMERGENCY ROOM MENTAL HEALTH VISITS
Douna Montazeralghaem, MD, Psychiatry, Maimonides Medical
Center, 4802 10th Avenue, Brooklyn, NY 11219;
George Alvarado, MD; Anne Buchanan; Logan Hegg, PsyD;
Theresa Jacob, MPH, PhD
Objectives: The objectives of this study aimed to: 1) examine the effectiveness of a clinic-based intervention at reducing ER utilization; 2) explore demographic and clinical features of patients referred to the service; and 3)
help guide decisions about community-based service planning and
implementation.
Methods: School-based support teams from 15 local schools (identified as
high ER utilizers) were invited to a 2-hour in-service to review referral data
and procedures, and to launch the UES, an outpatient same-day service for
school-referred youth which started in 2014. Comparison was made between
the number and characteristics of school ER referrals for pediatric psychiatric
evaluation and those of UES outpatient visits over three consecutive school
years, 2013 (prior to the start of UES) and 2014 and 2015 (post UES
initiation).
Results: School ER Referrals [44% of all consults in 2013, n¼185] dropped by
46 percent in 2014 (32 percent of total, n¼100): t (672) ¼ 3.5678, p <0.0004, d ¼ 0.27. A comparable drop was not observed from other sources. Cases seen in UES increased from 73 to 87 in 2014 vs. 2015, with the majority sent for evaluation of suicidal ideation or self-injurious behavior. 84.4 percent of patients evaluated in UES during the analyzed period had no current outpatient treatment at the time, and only 1 case required further care in the J OURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 55 NUMBER 10S OCTOBER 2016 ER. Data for the 2016 school year has also been collected and is currently under analysis. Conclusions: A same day, clinic-based, urgent evaluation service appears to be a promising alternative to the ER for schools faced with students in crisis. Aside from the immediate impact on ER utilization, there is potential for other qualitative gains such as cross system communication, direct contact, and patient engagement. Further, parents and children benefit from being seen in an outpatient setting in many ways more appropriate and less threatening than a general pediatric ER. Urgent care evaluations can be an effective intervention in reducing ER visits and meeting the mental health needs of students, families, and their schools. Our data is vital to informing and structuring future policy, funding, and service implementation efforts, with the specific goal of preventing unnecessary ER visits, enhancing access to care and reducing stigma. CC QA SC http://dx.doi.org/10.1016/j.jaac.2016.09.348 6.29 THE MEDIATING EFFECT OF COPING ON STRESS REACTIVITY IN A PREVENTIVE INTERVENTION Meredith A. Gruhn, MA, Vanderbilt University, Peabody #552, 230 Appleton Place, Nashville, TN 37203; Rex Forehand, PhD; Bruce Compas, PhD Objectives: In a randomized clinical trial with 180 families of parents with a history of major depressive disorder, levels of stress reactivity were examined as a mediator of the effects of a family group cognitive–behavioral (FGCB) intervention on adolescent’s use of coping skills. Methods: Families were either randomized to a written information (WI) condition, or a FGCB intervention condition. The FGCB intervention is a manualized 12-session program designed to teach parenting skills to parents and facilitate the development of adaptive coping responses to stress in youth (see Compas et al., 2009). The Parental Depression version of the Responses to Stress Questionnaire (RSQ; Connor-Smith, Compas, Wadsworth, Thomsen, & Saltzman, 2000; Jaser et al., 2005, 2008) was used to assess self-reported levels of stress reactivity and three factors of coping in youth: primary control coping (e.g., problem solving), secondary control coping (e.g., positive thinking), and disengagement coping (e.g., avoidance; Connor-Smith et al., 2000). Stress reactivity, the hypothesized mediator, was assessed at 2 months, and adolescents’ primary control, secondary control, and disengagement coping skills were measured at a 6-month follow-up. Results: Stress reactivity mediated the effects of the intervention on primary control coping skills (t ¼ ¼2.12, p < .05) and secondary control coping skills (t ¼ -7.90, p < .001) after adolescents completed the intervention, accounting for approximately half of the effect of the intervention on the outcomes. No significant mediating effects were found for stress reactivity and disengagement coping. Conclusions: The present study provides the first evidence of stress reactivity as a mediator within a family group cognitive–behavioral preventive intervention for families of parents with a history of major depressive disorder. Further investigation of the relations between stress reactivity and coping is vital to implementing preventive interventions targeting the reduction of mental health problems in children of depressed parents. COPI DDD PRE Supported by NIH grants R01MH069940 and R01MH069928 http://dx.doi.org/10.1016/j.jaac.2016.09.349 6.30 A META-ANALYSIS OF ANXIETY DISORDER COMORBIDITY IN PEDIATRIC BIPOLAR DISORDER Sarper Taskiran, MD, Psychiatry, Koc University, Koc Universitesi Tip Fakultesi, Davutpasa Caddesi No 4, Topkapi, Istanbul 34010, Turkey; Hale Yapici-Eser, PhD; Tuba Mutluer, MD; Ozge Kilic, MD; Aslihan Ozcan, MA; Isil Necef, MA; Merve Yalcinay, MA; Dost Ongur, MD, PhD www.jaacap.org S213 An Integrated Model of School Crisis Preparedness and Intervention A Shared Foundation to Facilitate International Crisis Intervention SHANE R. JIMERSONa, STEPHEN E. BROCKb and SARAH W. PLETCHERa a University of California, Santa Barbara, California, USA and b California State University, Sacramento, California, USA ABSTRACT In an effort to promote the social and cognitive competence of youth, school psychologists must be prepared to address a multitude of contextual factors and life events that impact children’s performance and adjustment in school and subsequent developmental trajectories. The domain of crisis preparedness and intervention has received increased attention during the past decade (as evidenced by a growing school crisis intervention literature) and is currently a training standard for school psychologists in some parts of the world. Crisis situations may emerge following natural disasters such as floods, fires, tornadoes or earthquakes and also from human generated situations such as bombings and school shootings. Each of these events is likely to affect the children and families in schools and communities by presenting them with problems that will be challenging to cope with. There are a variety of crisis preparedness and intervention models and strategies available to address crisis situations. Without a shared foundation for crisis intervention, responding to crisis situations may be further complicated, especially in situations where international colleagues are collaborating. Therefore, a shared foundation that includes both preparedness and intervention while emphasizing both developmental and school considerations will be invaluable in our efforts to facilitate collaboration among diverse colleagues across multiple contexts. The purpose of this article is to Please address correspondence to: Dr Shane R. Jimerson, University of California, Santa Barbara, Gevirtz Graduate School of Education, Counseling, Clinical, and School Psychology, Child and Adolescent Development, 2208 Phelps Hall, Santa Barbara, CA 93106-9490, USA. Email: Jimerson@education.ucsb.edu School Psychology International Copyright © 2005 SAGE Publications (London, Thousand Oaks, CA and New Delhi), Vol. 26(3): 275–296. DOI: 10.1177/0143034305055974 275 School Psychology International (2005), Vol. 26(3) incorporate several models and frameworks in order to provide a shared foundation for school psychologists and other educational and mental health professionals regarding crisis preparedness and intervention. To establish a shared foundation for international crisis collaboration, it is also necessary to review the original works discussed in this brief overview and participate in relevant workshops. KEY WORDS: integrated model; international collaboration; intervention; preparation; response; school crisis The area of crisis preparedness and intervention has emerged as an important domain of knowledge and skills for many school psychologists and other mental health professionals (Brock and Jimerson, 2004a; Brock et al., 2002b; Rosenfeld et al., 2004; Whitla, 2003). There are numerous adverse outcomes associated with the experience of a crisis event. As emphasized by Brock and Jimerson (2004b): Interventions will be needed to (a) prevent and/or mitigate common stress reactions, (b) identify those who may develop psychopathology (e.g. posttraumatic stress disorder), (c) prevent and/or mitigate dangerous coping behaviours (e.g. suicidal and homicidal behaviours, depression) and (d) provide appropriate referrals to mental health professionals. In addition, school crisis interventions need to address problems that are relatively unique to the school setting. 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