The Doctor is IN.

Recently, the edublog world has been talking about how teacher accountability might be measured in much the same way doctors are measured—by professional standards, not client outcomes (such as test scores). The argument has been made that doctors are not punished for undesired outcomes; they are accountable for doing what professionals should do given their client’s circumstances. Eduwonkette summarized the position nicely.

Ok, so if teachers are the doctors who do the best they can under the circumstances with all the professional tools and data-based decision making skills, what would that make school psychologists?

I’d argue in the medical model, we would like to be the Wellness Coordinators or Early Childhood Primary Care Physicians who focus on prevention. At least in the world of urban education, I think we are more like Emergency Room Psychological Triage Doctors. Whose life is in danger? Who is in the most pain? Who is a danger to others? Who is quietly suffering in the waiting room? Go! Go! Go! Oh, and we are also understaffed, don’t have phones or offices, have to share our equipment with 40 other doctors, and drive between 3-5 different “hospitals” in a given week. As one dear reader and fellow school psychologist wrote me the other day, “The pure lack of space and resources makes for sometimes disabling inefficiency. Do I have to go to private practice to get a working phone and a door that closes?” And she’s in a fancy school district.

It is difficult to sustain one’s self in such an environment. The burnout rate for school psychologists is alarming. Half of the profession sees themselves leaving within 5 years. I see people coming to my blog with search terms like, “Hate my Job and School Psychologist.” It's sad. The problem with the current system of service delivery is that it is set up to wait until the child is so “ill” that they have to be tested to see if they have suffered enough to be called "disabled" and get some services. I don't usually get to work with kids until they have failed out enough to possibly warrant special education. And if they are only minor learning injuries, you'll have to just wait. Come back in a year when there's a statistically significant drop in your academic performance though!

The rewards of this job are intangible. Once your students are stable and feeling better, they go away and the next 5 traumas are there waiting for you. You are left with, “Huh. Wonder how much I helped that kid?” and you have to move on. By and large, you work intensely with a child for a few months and then are left to wonder what interventions or words of encouragement “stuck.” Did they end up taking their prescription? Did they change their behavior? They left feeling better and didn’t come back, so is that good news? Did the parents and teachers leave the IEP meeting or counseling conference thinking about the child’s needs in a different way? Did their behavior change to help the child? Does the child feel better about his/her learning?

Before you get out the Kleenex box for me, I still love my job. There are days that I am so encouraged and empowered after seeing a kid I’ve been working with finally make a break through. There are days where I am Debbie Downer and am angry at the inequities. It is a job of extremes.* You have no choice but to hold yourself to the standards of best practice and do your best every day. You may not have a working phone, but you have kindness, knowledge, research, and clinical experience, and hope you have made a difference.** You take the small victories. Every so often you get a student come back to you and say things like, “You made me feel smart for the first time!” or “I miss our talent group!” and it makes it worth it. Somehow I think a standardized test about their feelings wouldn't quite capture that.

It would be so much better if school psychologists could be Wellness Coordinators or at least Primary Care Physicians who follow children through their development to prevent school failure and provide anticipatory guidance. Instead, we put on our best psychological bandage, give our prescription for learning, and hope that healing occurs.

Oh, and can someone tell Lucy to talk to the school board about increasing our time at our school sites to do prevention work? It may cost slightly more than 5 cents, but I think we're worth it.

*It might be so extreme I’d leave out the “e,” make spelling errors, and create a recruitment poster for the neXt generation that said: “R U Ready to be Xtreme!?! Think of a career where U get Skooled every day! School Psychology!” We would have competitions about who could last the longest in an urban school with no resources. Kind of like Survivor. Only you could vote yourself off when you couldn’t take it anymore.

**Hope. So hot right now.

Are you Playing Around on the Job Again???

"We can be sure that all happenings, pleasant and unpleasant, in the child’s life, will have repercussion on her dolls” -Jean Piaget

I have said before that school psychologists wear many hats, above and beyond being “that special ed lady.” The past few weeks I have also worn a wizard hat, a beret, a firefighter hat, a cowgirl hat, and a bridal veil,* all in the spirit of play therapy. I have to say that at times, I can’t believe how lucky I am to get paid for my job.

But what exactly is “Play Therapy” and how can that be therapeutic? Parents sometimes ask, what do we DO in there? Teachers have said, “I don’t see how playing UNO all year can help.”

Play therapy provides an opportunity for children to work through adjustment problems in a supportive, child-driven setting. I don’t set out the teacher doll and the kid doll and a fake gun and say “show me what happened!” I set out the materials and let the child play. If they want to “talk” about what happened, they will, when they feel comfortable. Making them talk about it is the equivalent of an adult sitting down for therapy wanting to talk about their job and the therapist making them talk about their family, because the therapist feels that’s more pressing. What’s pressing for a child is what they will play. You go with it. And then the relationship builds and the child feels supported because you are interested in their world.

Let’s put it this way. Adults find relief in talking about their difficulties with an understanding therapist. Usually children cannot express their thoughts and feelings in words, but can find release through various forms of play. Play therapy can offer a child a unique relationship with an objective and accepting adult who is not in a position to “use” any of his or her disclosures in any way.

Like any other form of therapy, Play Therapy takes time. The first few sessions are rapport-building. I tell the child that he or she will be coming every week to talk with me, and there are a lot of toys s/he can play with. I explain that it seems to help children to have someone that they can talk to and play with all alone. I ask the parents not to “quiz” the child after the session about what they did or what their piece of art means. It is important for the child not feel it necessary to give an accounting of the events that occur in the playroom, because this reinforces that the time is private and will build trust and cooperation. If the child wants to share what s/he did or show a painting s/he made, that’s okay. It’s best to say something like “thank you for sharing what you did/made.”

In the school setting, I work mostly with 11-14 year olds, so the schpeal is different. I have also heard people wonder if play therapy is too babyish for teenagers. Au contraire. While there is more talking involved with middle schoolers, if there is play going on simultaneously, you will get a lot more opening up. In my earlier years as a therapist, I would keep kids in the four-walls and do only drawing or games. I was amazed at how kids, especially boys, opened up when we went on the basketball court or walked around the school. The wonderful side effect is for anxious or hyperactive kids, they get out some energy in a productive way.

Sometimes you have to “sell” the idea of coming to talk with some lady you don’t know about something you are pretty sure you don’t want to talk about in the first place. My schpeal is something like, “This time is “chill time” from your class. It is a chance to take time out of class to talk about anything that is going on, or to just to relax for a while.” I always add, “You’re not in trouble!” because most of my counselees have had the experience that someone coming to get you out of class is probably not because you’re getting the Best Student Award. In general, counseling is not a hard sell if you find a class they hate and suggest you meet during that time.

Oh, and by the way, I highly encourage you to play around on the job today. It is Friday, after all.

*Unrelated to my own pending nuptials. It was an arranged marriage. A child wanted me to marry Barney.

Resources: I like Garry Landreth’s Play Therapy: The Art of the Relationship.It is one of the few “Nuts and Bolts” kind of books on how to improve your play therapy techniques. One chapter is dedicated to the “What to do if…” kind of situations. As in, “What do I do if the child steals a toy?” or “What do I do if the child leaves the playroom?” I also like School-Based Play Therapy edited by Drewes, Carey, & Schaefer. It provides some adaptations of play therapy in the school with both individuals and groups.

Kids Say the Darnedest Things

Sometimes, when I tell people I work in middle schools, the listener’s face turns to that of someone smelling something bad. As one of my readers told me after my series on middle school students, “The tweens freak me out. I don’t know how you do it.” What can I say? I love the drama of it all.

There is something to be said for the little ones though. I recently had the opportunity to work with a Kindergarten student.* With adolescents, you can have a straight talk, but with a 6 year old, it’s all about the drawings. She was referred because she had a recent loss in her family and I was checking in on her. Unprompted, she began drawing a rainbow and there was a giant pot of gold at the end.

Dr. B: You’ve used so many colors! And what’s that at the end?

Tiny: That’s a pot of gold.

Dr. B: Ooh! What would you do if you had a pot of gold?

Tiny: I would buy an African child.

Dr. B: ??? (moment to recover) Um…tell me more!

Tiny: Well, African children have dirty water and that’s yucky. I’d buy an African child.
Dr. B: Oh, so you would buy an African child with your pot of gold?

Tiny: If you act now, you can get your very own African for less than $1 a day!

Dr. B: It sounds like you like to help others!

Tiny: Yeah! And did I tell you that my daddy is in jail and he will get out when I’m 13 years old?

In the midst of her crisis, she still had this inner drive to help others. In a community where most of our kids are “helped” and not the “helpers,” it struck me how powerful and possibly transformative it would be to have such students in helping roles. And then I remembered there is a strong body of research in the field of Service Learning (learning academics through community service) that I used to be involved with as a graduate student. I will have to dust off my old research from when I worked at the Service-Learning Center at UC Berkeley and do a post on this educational pedagogy.** Until I find it, check out this website for an overview of what Service Learning is: Service Learning Clearinghouse

*She was so tiny compared to my gawky adolescent student population. She might have fit in my pocket. I wanted to put her on a shelf next to a doll collection that I don’t have.

**I will spare you the year long project I did that could have been published in the Journal of Duh in which I made the landmark assertion that in order for Service-Learning programs to be successful, one must have administrative support and money.

The Little Engine that Could

I started out my day in an AttorneyPoloozaFest 2008 IEP meeting in which everyone blames everyone else for the child’s difficulties. Not exactly the Monday I was looking for after last week's desire for early retirement.

But in the afternoon, the School Psychology Gods shone upon me and infused me with some hope that I can do this for 25 years.

I used to work with this little 2nd grade boy last year who was having major behavioral difficulties. He would yell out profanity, trip other kids, refuse to do work, call the teacher names, and rip up his work. I don’t think he ever earned recess all year. I observed him in his 3rd grade class this afternoon and he was a different child. He was engaged with his small group and doing well. His teacher reported she didn’t have any concerns about him.

At recess, I asked him how he was doing, and he said, “Great!” with a glowing face o’ enthusiasm for learning. He said, “Guess what? I don’t play video games anymore, I like to study and learn a lot now. I want to be the first 3rd grader to take classes at UC Berkeley! Do you think I can do that?” I told him that it was great to see him so excited about learning. When I asked what helped him like school so much, he said, “Every day, even at recess, I just told myself, don’t be bad at school, don’t be bad at school, don’t be bad at school. Then I got on the honor roll and my dad took me to Marine World and it was the best day of my life!”

Holy cuteness, batman. It’s worth a try. I can do this for 25 years, I can do this for 25 years, I can do this for 25 years…

Time for Retirement?

Apparently, the shining exuberance generated from a restful spring break has faded to a lackluster flickering light. A few posts ago, I talked about how a well-rested employee is a happy employee. I came down with a little something this week and have been trudging through this week like my feet are in molasses. I did everyone a favor by self-quarantining myself in my office away from potentially infecting others with my sniffle because I’m nice like that. Only now at the end of the week I realized I was doing the opposite of the very same thing I was proselytizing to others to do in my last post: to take care of yourself.

SO I would like to acknowledge how difficult it is to stop the hurried rush to meet deadlines, test students, write reports, do counseling, meet with that parent, do the survey with the teacher, meet the supervisor for the evaluation meeting, go to the new charter school and do an observation, call the hospital to see if a kid has been discharged, call the parent and butcher the Spanish language in the name of a obscenely overdue triennial assessment (e.g. “I have terminated the assessment of your child. Oh, and to you I give the paper of the many questions? You to me bring that paper of the many questions?*) Etc etc.

In retrospect, a day off in the beginning of the week would have made the end of my week less painful. I know I’m feeling run down because of the conversation I had with a colleague Friday. She is retiring at the end of this year. I ran into her and asked her for tips on the state retirement fund because it is so hard to think that far down the road, but I know I should:

Me: Congrats on your retirement! Only a few more months left. Any advice?

Colleague: I would advise going on the state retirement website and putting in how many years of service you have and what age you plan to retire. So you would put in 25 years more of service and…are you okay?

Me: Um, I just threw up in my throat a little thinking about doing this for another 25 years.

Colleague: Rough week?

Me: You could say that I'm running on empty.

Colleague: Please go home now.


And I did. And here’s to resting up this weekend! Sniff, sniff.


*If anyone knows how to say "Rating Scale" or "Behavioral Survey" in Spanish, do let me know!

New Resource for RtI

For those of you just joining Notes From the School Psychologist, Welcome!

For those who have been reading for a while, you know that I have been going down a professional shame spiral at my lack of Response to Intervention (RtI) posts.

I will proudly defer to the National Association of School Psychologists' new website on RtI. It has some theory, some practice, and some chances to connect to others about what they are doing.

Discuss.

The Audacity of Help

I have been on Spring Break, which for me, included my first road trip with fiancée. We drove down the coast to look at wedding sites and spent a good amount of time in the Santa Barbara hills being extraordinarily lost. We probably drove by Oprah hanging out at her house in Montecito and never noticed because we were looking at the crappy tourist map that has left out entire roads or were trying to get reception on our iPhones for google maps. My point is, we were lost and needed to ask for directions.

Ha! You think this story is headed in the direction (no pun intended) about how men don’t ask for directions. But you are wrong. I am the one who will drive around for 45 minutes rather than stop and ask. My name is Rebecca, and I hate asking for directions. I made my poor fiancée waste our preciously expensive gas because I am too stubborn to ask for help.

Now I have written before about how people in the helping field are sometimes over-helpers. Myself included, I’ve noticed another trend among my fellow educators of not asking for help when it is clearly needed. For example, I was at a school once on a crisis call in which an entire yard of students had witnessed a shooting. The platoon of psychologists came in and tried to see which students were the most affected to provide counseling. Turns out, most of the students see this kind of thing all the time, and they were coping just fine (with the exception of those who were close to the victim, of course). It was the teachers that needed the help.

I remember this one teacher who was being so strong for her class that she shoved down all her own feelings to take care of her students. At the end of the day, she was still determined to run a previously scheduled curriculum meeting, even though it would have been perfectly appropriate to reschedule it. She was stressed out because she didn't have her handouts made yet. We met with her and convinced her that she needed to go home and take care of herself. As they say on airplanes, “In case of emergency, please put oxygen mask on yourself before assisting others.” I would go so far as to say that most urban educators I know who have left the field did so because they didn’t care for themselves as much as they cared for their students. As a result, they were left with little oxygen to continue.

And do you know what I noticed today on my first day back from Spring Break today? Happy rested teachers, happy kids. Well, mostly happy kids. As happy as a bunch of middle schoolers are to go back to school. I found myself and staff members laughing at their antics, rather than getting annoyed they were off-track.*

Ultimately, we did end up pulling over for directions. And we ended up meeting a teacher whose son was getting married and she gave us some local tips on where to find good caterers and wedding sites. And my fiancée didn’t say “I told you so” once. And that is why the wedding is still on.

*Let’s face it, how can 8th graders NOT make jokes during a properties of matter lesson about gas? Can a 7th grader really let it slide when the teacher talks about the planet Uranus? It’s just not possible.