Matt Crestsinger, District Administration, Director of Special Services in Marshalltown, IA, shares how the school district has implemented Collaborative Problem Solving and the results they are seeing.

Transcript:

How did you become interested in Collaborative Problem Solving?

I was reading some of the works by Bruce Perry, and at the end of the most recent edition of his book, The Boy Who Was Raised as a Dog, it actually speaks a little bit to the Collaborative Problem Solving (CPS) process. I love the book, you know, it made a lot of sense to me. It was highly engaging. And so when I hear this, I'm like, well, I need to learn more. I found some materials online and did just some general reading about it. And then, I found some of the YouTube videos that were published. One in particular, it's a little more than an hour long, and it's Dr. Ablon just doing a general overview about Collaborative Problem Solving.

Well, I wanted to learn even more. So, at the time, there was an online opportunity to take essentially an online course. And I brought myself and a group of principals, some of my school counselors, we have these kind of social work type positions, and we all enrolled, and we took these classes. And we got done, and I sat around the table and said, "What do you guys think?" And they absolutely said, "We love it. That's exactly what we were talking about. We need to learn more." So, then I decided I need to get a group of people who are actually through the training. I'd been reading the literature online. Let's see where we have a Tier 1 training and how many people I can send. And after that completed, they came back, and I said, "What did you hear? What did you learn? What are the things you're excited about?" And they continue to promote of, "yes, the more we hear about this, the further we get into it, the more we agree, it's a necessary fit for us."

What makes Marshalltown, IA, a unique community and school district?

We're about 5,300 kids. We have 11 attendance centers. 71% of our kids this year are eligible for free or reduced lunch, which is the ninth highest in our state. 31% of our kids are within the continuum of the English Language Proficiency Scale, which is the third highest in Iowa, and third most saturated in the state. Culturally, about 54% of our kids identify with Hispanic/Latino. 30% of our kids identify as White or Caucasian. 7.5% of our kids identify as Asian. About three and a half percent of our kids identify as Black or African American. And then everyone else will identify in a multi-categorical way.

So, we were trying to figure out “How do we work with this unique population to Iowa?” And I went with the principals, I went with our intermediate agency, they're called AEA or Area Education Agencies, and a group of like 20 went to a summer Tier 1. And we all came back with just our minds spinning of, “This is our missing piece. What do we need to do?”

And then fate happened. About two weeks later, an EF3 tornado came through our community. And in a community like ours, that is really a very blue-collar community, it devastated things. It hit through some of our major businesses and residential area. And so, many of our families were displaced, and they were dealing with trauma. So, we decided to bring Dr. Ablon in and address all of our staff for the first day of school, as well as then ask him to do some parent groups in the evenings. We got such tremendous feedback off of it that we thought, this is something that makes sense here in Marshalltown. This is something we need to develop and grow. And since 2017/18, we've been working to do that as systematic as we can.

What has changed since implementing Collaborative Problem Solving in Marshalltown?

I would say we're still early in, and we definitely have people who have bought into it and understand it and see the result. And we still have people that we're trying to onboard because it's just such a different way of thinking about supporting kids and families. Those who have really bought into it. It has changed the focus of the discussion. It's moved from things like, "Well, they would if they wanted to," or kind of those dead-end ideas of "This family's always been this way. I've worked with other kids," or "I was a teacher for the parents, and they were this way when they were that age." To a reframing of "What's happened to this kiddo? What about this situation is so difficult for them that I've seen them do this before, but today they can't."

And it's really made our conversations in those situations more solution focused, and it also improves the relationship. Checking in with kids and letting them feel like they have a voice and they have a choice. You just can't put money in the bank quick enough that way so that when you have those days where you have to really hold to your own expectations, that relationship is in a place where you can get some buy-in from the kids as well. And they don't always feel like you're imposing your will on them. So, we're seeing in settings where people are really invested in it, good relationships, ability to have difficult conversations, and really a problem-solving philosophy.

What are some of the results you are seeing in Marshalltown?

So, the first I'll talk about is one of our elementary schools. Its name is Woodbury Elementary, and it's a preschool through fourth-grade school. Before we began our work in Collaborative Problem Solving, we tracked many of the things most schools do: How many kids go to the office? How many kids are so aggressive that they require physical restraint? How many kids are in a situation where safety is such a big issue that we have to use exclusionary timeout? What are the factors that make the learning environment safe? Which our state of Iowa has a universal survey they do. At Woodbury, which has really internalized this work, we've seen a decrease since 2018/19 to last year: office referrals are down over 36%. The number of students who have two or more office referrals are down 49%. The need to use seclusion and or restraint is down by 28%.

And most importantly, so our state of Iowa has what they call the Conditions for Learning Survey. Then it's a survey that goes out to our staff members, our kids, and our families that asks about the well-being and the learning environments, really around SEL. Before this, that survey showed that Woodbury Elementary was 7% below the state average on emotional safety, how safe did kids feel in that school. Last year they were 7% above the state average. So, we've seen this significant swing in kids are feeling connected, regulated, and that it's a safe learning environment. I guess the other unique thing about Woodbury Elementary is that it is a dual-language school. So, our families who go there they learn in Spanish for half a day, and then they learn in English for half a day. And the general population of that school is really those families who are moving into Iowa that are completely Spanish speaking, coming from Mexico and other countries.

The last, and probably my favorite story a few years ago, we identified that there are, there are kids in schools that have serious underlying mental health conditions. And those create the behaviors that we see that are unsafe and that we really worry about. In Iowa, there's not a lot of facilities to work with kids who are beyond what most schools can work with. So we tried to create our own, and we call it the therapeutic classrooms. And in there, we have integrated CPS as our primary model into a trauma-informed approach. And we work with kids that usually would be placed in residential treatment or day school programs, or out-of-state kind of psychiatric facilities. And we are seeing success with 96% of the kids in there. And they range from kindergarten through ninth grade.

And I mean by success is if they were in their comprehensive schools, on average, they may have four, five, six behavioral incidents a day. They may have two to three behavioral incidents a month now. They're not running out of school; they're not destroying property. They're engaged in their learning. In fact, on our most recent state-required literacy academic assessment, every one of our 18 students made growth in literacy. And they're excited to come to school. Their attendance is way up. Their families who we had a really difficult relationship with for a variety of reasons. We don't have that kind of difficult situation anymore. They love our teachers; they love our little program. They love that there's a place that their kids can grow and learn and get their needs met. So those are the places I would talk about as a system. We're doing it and doing it well and seeing those great outcomes.

How does Collaborative Problem Solving support students with disabilities?

I want to share a couple things thinking through the special education lens. So federal law around special education really does dictate a variety of things that seem very prescriptive on how you have to think and approach supporting kids who may have behavioral challenges. Collaborative Problem Solving has been a game changer in a lot of our situations with kids with disabilities who have those behavioral struggles because not only does it address some of those underlying conditions that we never thought about, but it helps us then create a pretty clear way to do checks and balances along the way. A Plan B conversation is a great way to see how are things going in this element of the instructional skill-building that you're trying to do.

How does Collaborative Problem Solving integrate with SEL and PBIS in your schools?

So, our district is really committed to providing a full continuum of services to our families on social-emotional learning. And as part of that, then, my job as the director who oversees it was to gain as much knowledge and skills as possible. So first, I've been through the inaugural cohort of CASLE, the Collaborative for Academic Social-Emotional Learning, and have completed their fellows program. I've also completed two cohorts with the National Superintendents Associations, both mental health work as well as their SEL cohort. So, working with these folks has provided me with a really strong foundation about what is evidence-based, research-based, social-emotional learning across the continuum. What happens at school-wide, what happens within the classrooms, what happens within the teacher's mindsets. And having that together, we have created an infrastructure to support our needs of our kids.

Foundationally, we had to get on the same page about what are our common beliefs about kids. Many school districts will talk about Positive Behavioral Interventions and Supports (PBIS). And what we've learned about PBIS is that first, it's very regulating to kids to know what's expected of them across settings. Many times their life is a little bit out of control at home, and there's a lot of chaos. But knowing that when I walk into this school, if I'm in the cafeteria, here's what's expected of me. If I'm in the classroom, here's what's expected. That brings down some of the anxiety, to begin with. Our next piece, though, is ensuring that everything we do is based on our thinking with Collaborative Problem Solving, is relational. So, we've moved away in many of our locations from that, that token economy system, that reward system when kids are meeting expectations, to those relational interactions.

How does Collaborative Problem Solving fit with other approaches?

I would also ask people to look carefully at the components of the other approaches that they're using. Within our district, we think about a multi-step process. And so I talked a little bit about PBIS as a regulating system for all kids across all settings. We also use classroom approaches. Responsive Classroom is something we use at the elementary, and we have found that CPS has such a great companion component to that Responsive Classroom model that they go hand in hand. It's not, "Are we doing this? Are we doing that?" We're supporting all kids under a common framework, and the language compliments each other. With our older kids, Capturing Kids' Hearts has been an approach that we've found really beneficial. And again, as the language of CKH and the language of Collaborative Problem Solving, they support each other and the framework and the thinking behind it. So, I would say within an integrated system, there are going to be a number of components. You know, you're, you're making a stew here, and you've got a bunch of ingredients in this stew. And I've found that CPS is integrated very well into our stew that also has evidence-based and research-based behind every piece of it.

How does Collaborative Problem Solving build future-ready skills?

When I went to high school, and I'm not going to say how old I am, but when I went to high school, the idea was, Matt, if you go to high school, you need to go to college. And if you can complete college, you will get a good job, and your job skills will be taught to you on-site. Many of the things that I thought were skills back then, now I can learn from YouTube, or there's a video somewhere to teach this. The things that weren't taught to me that now we're hearing kids need to have are conflict resolution skills, problem-solving skills, critical thinking skills, and an internal drive to be successful in something with a level of independence. And so, as we think about now, those are our umbrellas or goals for those soft skills; Collaborative Problem Solving lends itself perfectly to it. You know, it's teaching kids how to deal with difficult situations in not getting upset, essentially, staying regulated. Something has happened that I wasn't predicting, and so I'm going to get upset about it. Let's pause; let's keep ourselves regulated and start problem-solving. How do we address this issue, whether it's with a task, a situation, or another person? It's a very generalizable set of skills, I would say, across all those soft skills for employability.

How are you engaging families in this work?

So, we have been working on engaging parents in learning about Collaborative Problem Solving through what we call either watch parties or community wellness nights that we're doing once a quarter. And families can come into our schools and see and learn more about it. I think the most engaging part about all of this is not only are we continuing to try to teach them about it, but now when we have school board meetings, we have families showing up saying, "I absolutely love that my child that I was getting phone calls on all the time for whatever reason. The phone calls I get now are positive phone calls, and that I'm seeing that my child, when I'm having difficulty with him or her at home, I can kind of engage in that process and generally work through it. And even sometimes my kids are coaching me, even elementary kids so that we can try to work through this conversation in a regulated way for a mutually agreed upon solution."

What has been a challenge in implementing Collaborative Problem Solving?

The other thing, and I'm excited and also a little bit embarrassed to say this, the kids take to it well and quickly. The implementation delays are really about the adults and dealing with our own internal conflicts of how we were raised, what we believe should and shouldn't be behavioral strategies, classroom management, or just innate skills that any adult or child should have at some age. But for the kids, when we do this and do this well as an approach, they pick it up like that. As I work with kids or talk with some of the buildings that work with kids regularly in this approach, three or four conversations in the kids can start to tell you what that next component is. What's that next step that you're going to talk to them about? And they actually engage in it as long as they see it's successful for them being heard and feeling like they have some choice; they will take you there if you let them. So that was another real surprise, of it's the kids that this is, you know, going super easy with. It's the adults that we're going to have to work through a variety of different things to try to get their neurocognitive skills, skills aligned with what we're doing here.

What has been most powerful about Collaborative Problem Solving?

I'd begin with just a philosophy. Not only do I love that they have a philosophy, but when you hear, you know, Kids Do Well if They Can, if kids could do well, they would do well. And so, our job is to figure out what are the things getting in the way of them doing well, like just that general umbrella of thinking to every situation. It was an a-ha moment for so many of us who went through either the online training or went in person to Tier 1. Because, like so many, it wasn't our thinking was what happened to this child or what is getting in the way for this child? It was, oh, they're just being lazy or, what is the bigger carrot or stick I can wave at them to get them motivated to do this? What do I need to do to compel them to move forward? Instead of, "What do I need to do to lift them up and support them so they can move forward?" So that first part was just amazing a-ha for so many of us. And it's so simple. Yes, it is skill problems. You're right. If I look at them, they are trying harder than most other kids that these skills are already there for, and it happens easy.

The Value of Implementation Frameworks: Using Active Implementation Frameworks to Guide System‐wide Implementation of Collaborative Problem Solving

Alisha R. Pollastri Ph.D., Lu Wang Ph.D., Soo Jeong Youn, J. Stuart Ablon Ph.D., Luana Marques

In the last decade, many implementation frameworks have emerged that consolidate the research on implementation science, guiding purveyors and service agencies in improving implementation of evidence‐based practices (EBPs). In this paper, we describe how Think:Kids utilized the active implementation frameworks (AIFs) to define and standardize strategies for site‐wide implementation of Collaborative Problem Solving. We illustrate what implementation looked like before and after using AIFs to understand implementation, as well as some ways in which using the AIFs helped the purveyor identify, and then overcome, barriers to implementation. This paper provides a model for others who seek to use AIFs to guide their implementation practices, or more broadly, an illustration of how to use any implementation framework to ensure best practices in implementation.

Are you interested in bringing Collaborative Problem Solving to your organization? We follow Implementation Science best practices as we work with organizations, institutions, and schools to implement CPS.

Learn More

Crossroads Children's Mental Health Centre is a community leader developing and delivering a range of individualized mental health services solely for children under the age of 12 and their loved ones in Ottawa, Canada. They are committed to developing and delivering a wide range of mental health services to help children and families struggling with severe emotional, behavioral, and social challenges. No case is too complicated, complex, or severe, and they never give up on a child.

In 2008, Crossroads, and the larger mental health community in Ottawa, decided to explore different treatment approaches to better serve their hardest to help children. Think:Kids had the opportunity to look back at Crossroads’ journey and use of Collaborative Problem Solving with its Executive Director, Michael Hone.

Clinicians Do Well If They Can (especially during COVID-19)

Traci McCarty, LISW-S, Clinical Director at The Village Network, a multi-discipline behavioral health organization in Ohio.

The COVID-19 crisis has demanded that we shift our practice in many ways, and staff have responded differently to those demands. I have found it helpful to remember that it is skill, not will, getting in the way for some staff, and to practice Plan B when problems arise.

Two weeks ago, upon order from Ohio’s Governor to shelter in place, our agency, like many, started the transition to telehealth; providing clinical services to youth and families remotely through use of technology. This process required our clinicians to learn how to use a new software application quickly and then immediately shift to the role of “teacher” to their clients.

Within a 5-day period, clinicians were trained in the new software application, state regulations, and best clinical practices to support the change to telehealth.

Simultaneously, these same clinicians were adjusting to working from home while also navigating through their own fears about community spread, home-schooling, and limited access to practical necessities like toilet paper.  Many clinicians wondered whether they could be successful counseling clients by phone or laptop when they typically depend on using sensory regulating tools and relational-based interventions to capture and maintain children’s attention. It seemed that the conditions of telehealth appointments would make it likely that challenges and challenging behaviors would arise. The transition to telehealth meant that each clinician’s own emotional regulation and cognitive flexibility skills were being put to the test.

I noticed that one clinician in particular had not signed on to any of the required telehealth webinars or to the new software application. Zero clients were on the clinician’s schedule for telehealth.

Now, prior to our recent focus on implementing the Collaborative Problem Solving approach into our agency’s supervision philosophy, my response to this clinician would likely have been very “Plan A.” I might have assumed that this staff member was simply being uncooperative; avoiding the transition to telehealth to avoid having to put in extra work.  My response might have included performance-based tracking forms and corrective actions.

However, since we have implemented Collaborative Problem Solving into both our clinical model and into our supervisory practices, we hold tightly to the philosophy that it is skill, not will getting in the way when our youth or our staff aren’t meeting expectations. I turned to Plan B to find out what was getting in the way of this clinician delivering services via telehealth to clients.

I started the Plan B conversation neutrally. “I noticed that you haven’t attended the telehealth webinars or started transitioning your clients to telehealth. What’s going on?”

In rapid fire, the clinician immediately expressed several concerns that were getting in the way of being able to transition to telehealth. First, they felt anxiety around using any new technology, and they were not able to find the necessary software application on the desktop. The clinician also cited doubts that elementary-school aged clients, most of whose families had limited financial resources, would be able to engage via telehealth, due to lack of access to WiFi, computers, and mobile phones; even the libraries where many clients and parents typically accessed internet are closed due to state orders. Finally, the clinician was very concerned that telehealth sessions would not be clinically useful, and that they would instead result in the clinician staring at carpet and ceiling fans via webcam. (Any aunt, uncle, or grandparent who has tried to face-time with a 6-year-old can probably relate to this!)

Wow, I thought. That’s a lot. And every one of those concerns was valid. In asking for this staff member’s perspective, I learned something new that would likely help me be a more effective leader in the confusing wake of COVID-19. I surmised that other clinicians were likely experiencing the same challenges. I made a mental note to follow up with others.

The calming effect of the first ingredient created the safety for the second ingredient: I expressed two concerns. First, our agency wanted to avoid contributing to a community spread of the virus. Second, continued contact with clients could be helpful to maintain the clinical relationship, to check for worries or other mental health needs related to the virus, and to keep an eye out for critical needs or the need for crisis intervention.

With both sets of concerns on the table, the clinician and I brainstormed several solutions. Some of the solutions were quick and easy. As it turned out, there was a technology glitch that impacted the software application from displaying on the clinician’s desktop. We solved it with just one email to the IT department. Once the clinician could actually see the software application, the novelty of the application became much less intimidating.

The clinician identified several other flexible strategies to provide consistent services during this time.  One idea was using a hybrid model of phone calls and the web application, depending on the client’s level of access to the internet. In addition, the clinician requested permission to still provide face-to-face sessions when truly in the best interest of the client, utilizing all physical distance protocols and personal protective equipment. Finally, the clinician suggested that it would be helpful to have a plan for accessing technology support or a supervisor for quick troubleshooting if (and when) technology failed.

All of the solutions posed by the clinician were reasonable and do-able, and they met both of our concerns. In fact, the flexible options for using hybrid methods to connect, and the reminders of how to access supervisors and tech support were rolled out to every clinician to assure that no client was left behind in our shift to telehealth.