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re-education

Community Mental Health – in an alternative school, in the public schools, and in the kitchen!

Cindy Long, John Page, Beth Hail, Tifffany Davis and Len Mitchell

Centerstone Community Mental Health, a private nonprofit agency based in Nashville, Tennessee, has responded to community needs by establishing new service programs to address them with whatever funding is available. Three described here are: an alternative school far students who cannot “make it” in public schools, school-based mental health services, and a community kitchen combined with a culinary school. These are examples of the ecological models of Re-EDucation (Re-ED) as developed by Nicholas Hobbs (1994).

Weems Academy: An alternative school for special children and youth
Cindy Long

Weems Academy is a private, therapeutic alternative school in Clarksville, Tennessee, that serves 75 boys and girls, ages 5 to 19, in four Tennessee counties and Fort Campbell, Kentucky. Weems students enter the academy as referrals from the local school system through the Individual Education Plan (IEP) processor, as residents in one of Centerstone’s two residential group homes referred because their behaviors interfere with their ability to be maintained in public school regular or behavioral classes. Many of these students exhibit aggressiveness, poor coping skills, truancy problems, depression, anxiety, or poor impulse control. The goal of the staff at Weems is to help the students acquire the knowledge and skills they need to contribute as responsible citizens. Staff work closely with families to increase their effective communication in order to deal positively with their children's behaviors. Students participate in daily pro-social skills training groups, vocational training opportunities, and a daily character education class. Highly individualized educational plans are designed for each student. Community involvement is strongly encouraged through school-sponsored community service projects. These projects start on campus and then move out to the community as the students demonstrate self-control and responsible behaviors.

Staff Training, and Ongoing Evaluation
Weems – 9 teacher/counselors and 11 associate teacher/counselors work closely with both a principal who is certified in special education and a master’s degree level psychologist. The principal is the administrator responsible for the program, and the psychologist/therapist supervises clinical services. All staff members are creative, caring, highly motivated adults who work together using their strong communication skills to interact with each other in providing the safe, caring environment needed for success with troubled children.

Although there is a therapist, all members of this team are trained to work with clinically sound interventions to facilitate students” behavioral improvement. We believe that all good teaching and all good interventions are therapeutic; successful living is healing. All staff members are trained in the Crisis Prevention Institute’s (CPI) Nonviolent Crisis Intervention program, as well as Life Space Crisis Intervention (LSCI). Each month, every staff member attends and participates in inservice training sessions dealing with relevant subjects, such as documentation, DSM-IV (Diagnostic and Statistical Manual) diagnosis, LSCI refreshers, IEP writing and programming, first aid, and communication.

Satisfaction surveys are completed each month by parents, students, and staff members. Surveys are also sent to contracting agencies twice a year. In addition, the school tracks key indicators of student progress such as attendance, grades, achievement scores, incident reports, and behavior and academic goal accomplishment. The staff meets every morning to evaluate the school’s progress, share problems, and celebrate successes, both large and small.

Programming for Successful Living
In addition to a strong academic and vocational program, there are five other outstanding components of the school program. Students are strongly encouraged to become an active part of a club, and perhaps take part in a pet training group. They take an active part in decreasing violence by participating in a peer mediation program that helps them to find peaceful solutions to their problems. Finally, a family enrichment group has been a successful intervention for many students whom we serve and for their families.

Clubs
Each staff member brings to the school some special talent around which they can develop and facilitate a club. Students are expected to join a club as a way to help them learn to belong and cooperate in a group. The clubs vary in content. Students can be a member of the school newspaper staff, draw or sculpt in the art club, play softball, build crafts or model trains, or become involved in a community or school-wide cause. Weems students are publishing their own yearbook this year. They can sing in a chorus or join a more health-oriented walking group. In clubs, students learn to master a skill, become more competent, and receive opportunities to experience some joy in each day.

Pets
In the pet training group, students work closely with a local rescue and pet therapy group to help rehabilitate abused and displaced animals. They are taught by professional dog trainers to train the dogs to do simple tasks. These tasks may help the dogs acquire more acceptable behaviors, which may help place them in permanent homes. While in training, the students teach the dogs to overcome fears and begin to trust and accept people in their lives. Students often accompany the dog they are training to nursing homes and assisted living facilities in the area. Students who participate in this project are gaining new skills, increasing their empathy for animals as well as people, and learning how to work cooperatively with others.

Community Service
Community service opportunities are built into the Weems program. As the students progress through the behavioral program, they are expected to give back to the school and to the community. The first opportunities they experience are on campus – serving as aides to teachers, helping out in the kitchen, planting flowers or weeding the landscaping, and decorating the bulletin boards. As they progress through the steps, they are encouraged to do community service for people and organizations off campus. They have worked on the United Way campaign, assisted the Red Cross, and visited nursing homes. While students greatly enjoy this activity, they are also learning about the intrinsic rewards of community involvement.

Peer Mediation
The students take an active part in decreasing violence in their school. As trained members of the peer mediation board, students are given the task of helping their peers solve conflicts in a peaceful manner. Students learn how to help identify problems, how to have empathy for others, how to listen and give counsel, and how to develop appropriate solutions. In addition, peer mediators have also been instrumental in rewriting the behavior management program.

Family Enrichment
The families of Weems students are a key component to success. Each month, staff members participate in the Family Enrichment Night, where the families bring dinner to share with each other. They sit down as a family and share food and conversation. After eating, games are provided to encourage camaraderie. The therapist then leads a communication-oriented group activity to end the evening. Families are encouraged to eat, play, and problem-solve as a group.

The clubs, the peer mediation, pet training, and the strong emphasis on improving academics relate directly to developing a sense of competence in the students. The staff understand that there should be some joy in each day, and they attempt to provide a variety of fun and challenging experiences in their daily classes and clubs. Many of the students have not had an opportunity to have hobbies and interact with adults in a loving and trusting fashion. Students become involved in many rituals and ceremonies. Staff members understand that many of the families do not have the time to sit and eat with each other. Family Enrichment Night is an attempt to help the families establish some family rituals centered around sharing dinner and playing games together. Peer mediators help their peers realize that they can learn to have self-control. All staff members are trained in the principles of Re-ED and find that these wonderful principles provide them with creative, exciting ways to help Weems students realize their potential and gain the confidence they will need to be successful adults.

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School-Based Mental Health Services
John Page, Beth Hail, and Tiffany Davis

Centerstone provides school-based mental health services in both public and private schools in middle Tennessee, currently serving 35 schools with 45 case managers for 1,200 boys and girls, ages 8 to 18. Teachers and guidance counselors refer students with a wide variety of problems, including withdrawal and isolation, excessive anxiety truancy or running away from home, aggressiveness with peers and teachers, destruction of property, poor impulse control, and the inability to develop self-enhancing and! or self-sustaining behaviors. Case managers work with students, teachers, families, courts, extended family members, and others in the child's ecology to help each student gain control over problematic behaviors, learn positive behaviors in response to negative feelings, and improve their relationships with others. In addition, case managers help teachers gain a more effective understanding of positive ways to work with the student and family, as well as help parents to increase their understanding of their child's behavioral strengths and weaknesses, and increase their skills in addressing behavior problems.

There are clear advantages in providing this type of service in the school setting. First the student is more willing to accept help from someone at the school than from someone at the mental health center because of the stigma associated with receiving mental health services. Our review of service data indicates a dismal 50% no-show rate for clinical appointments at the center, in spite of the average 90% client satisfaction ratings given our clinical workers. Second, the parents are also more willing to receive the services at school than at home or at the clinic. Case managers tell us the best way to get the parents into school for a family appointment is often to attempt scheduling a home visit as an alternative. It is as important for the family to receive support and guidance as it is for the child to receive this help.

Staff and Training
Staff hold a master’s degree in social work, counseling, or psychology and have one or two years of experience in counseling troubled and troubling youth. They are independent self-starters with excellent communication skills, able to mix well with students, parents, teachers, and school administrators. They are also creative in developing effective treatment plans and able to juggle demands for completing assessments and treatment plans while maintaining communication with a wide variety of lay and professional staff.

Staff receive specific training on a wide range of topics needed to help children and adolescents with significant emotional and behavioral problems. From Life Space Interviews to crisis intervention and prevention, staff learn how to interact with clients to teach self-control and pro-social competencies. Direct and purposeful training makes them aware of the principles of Re-ED. In every aspect of their work, each staff member has flexibility and choices about how to interact with clients and family members. When given a philosophical basis in which to carry out their duties, staff become able to demonstrate the spirit of Re-ED concepts. For example, they understand that in order to develop trust with students, they must develop positive relationships. In addition, staff emphasize teaching functional skills to students rather than providing psychotherapy. By helping students to learn more effective problem-solving skills, we demonstrate that “intelligence can be taught,” “competence does make a difference,” and “self-control can be learned.”

Skill-Building Groups in the Classrooms
Building on the Re-ED principle that the group is very important to young people, the school-based program provides a weekly group for students who have demonstrated behavior problems. Behavioral Adjustment Achievement Program (BAAP) is a curriculum we developed to specifically teach students more pro-social skills for use in the school environment. This group gives students a chance to model specific behaviors and evaluate their performance. In the group, students follow predictable steps: check-in, review group rules, complete the structured activity, evaluate their performance, and earn points. As the students gain more experience in this procedure, they become more comfortable and seem to learn more. This practice is directly related to the Re-ED principle that ceremony and ritual give order, stability, and confidence.

Often the group members who exhibit aggressive and antisocial behavior leave the group meetings and are able to turn to a peer and ask, “How are you feeling today?” and “Why are you feeling that way?” This way of greeting is a skill they acquire in group and one that they may not even observe in their own home environment. This daily “check-in” ritual, ascertaining how each one is doing, also encompasses the Re-ED principle that feelings should be nurtured.

The weekly continuity of a structured group time together builds trust between students and group leaders, helping build community within the classroom. The point system encourages students to monitor their own behaviors and to develop self-control. Evaluating themselves in front of peers helps the student be accountable to the group.

Life is to be lived now
Even if students performed poorly in group the week before, they are encouraged to start fresh and try to earn more points this week. Time is an ally; since students are in school all day, this is an excellent time to provide prosocial skill-building instruction. Finally, since we want this to be a fun experience for students, we developed the group exercises to provide opportunities for students, teachers, and group leaders to laugh and to play. We firmly believe that we all need to experience some joy each day.

Responsive Evaluation
Every teacher and principal has an opportunity to evaluate school-based services two times per year. We also ask for feedback from the parents/caregivers and the students; Are we meeting their needs as hoped in their plans? Feedback is discussed with the staff so they can make any needed adjustments to their approach. In addition, evaluations serve as an important tool to help supervisory staff determine training needs of case managers.

To see if all of the parties agreed regarding the child's progress, we compared the overall ratings given by the parents, teachers, and clients. We were pleased to find they tended to agree with each other. As indicated in the table below, the percentiles show the overall rating given by each of the groups:

Overall, it appears that students are making progress with the support and guidance they receive from their school-based case manager or therapist.

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A Community Kitchen: Teaching Job Skills to Change Problem Behaviors
Len Mitchell

The Wallace Academy Community Kitchen was developed to address two needs: preparing troubled teens for jobs and feeding the hungry in Nashville. The project was based on funding from Phillip Morris Companies, Inc., through Foodchain's Community Kitchens, with matching support from Centerstone Community Mental Health Centers, Inc., the program’s parent organization. It is a prepared food / job-training program that teaches culinary skills to Wallace Academy students while providing meals to Nashville citizens in need of help. The program completed its first year of operation, having produced 5,156 pounds of food with 10,271 meals distributed to 16 recipient community agencies. At the current rate, the program is projected to feed 60,213 hungry people this year through close collaboration with Nashville’s Table and Second Harvest Food Bank. We recently learned from a national Community Kitchens Conference that ours is the only project of its kind in the United States, one worth replicating. The project also is closely connected to the community through a strong and diverse advisory council and is fully endorsed by the Metropolitan Health Department.

Operating within Centerstone’s commitment to creating and sustaining behavioral health services that champion individuals, families, and communities, the Wallace Academy Community Kitchen program helps students, ages 16 to 19, re-adjust to society in order to lead a self-sustaining life. This is being accomplished by providing students with valuable vocational training, life skills, and job placement through the delivery of a chef training program and a student-operated grille. The Wallace Academy Community kitchen program collaborates with local food rescue operations to address the needs of the hungry, needy, and homeless populations through the operation of a community kitchen. The program also involves the community through establishing partnerships with key organizations that have shared missions and interests. The program’s manager testified last year before a bipartisan Senate! congressional hearing on hunger held in Washington, DC. Through this meeting, the project was designated as a model to be implemented in school systems across the nation. With collaboration between America’s Second Harvest, DC Central Kitchen, Sodhexo Marriott, and the American Schools Food Service Association, the key elements of Wallace Academy’s Community Kitchen project will be made available in schools nationwide.

Program Staff
Program manager for culinary operations and chef training, Len Mitchell, has extensive experience as a professional chef and in designing and implementing educational training programs for use in many different settings. Mr. Mitchell holds degrees in restaurant management and business administration and has taught successfully for six years in business, technology, and culinary arts. Since coming to Wallace Academy, he has designed the new commercial teaching kitchen, created the instructional culinary program, and implemented comprehensive kitchen systems.

As Wallace Academy principal and grant write; Dr. Sidney Levy originally conceived of beginning a chef training program at the Wallace Academy in collaboration with other local professionals. His extensive experience in health care administration, special education, and vocational program design and delivery facilitated securing program support. Coincidentally, Dr Levy served on the faculty of Vanderbilt University’s Peabody College with Dr Nicholas Hobbs.

Assistant chef/trainer Willie Jemison has 20 years of successful experience in the restaurant business and holds a degree in culinary arts. He has made several valuable contributions to our operation and has become an integral part of the Wallace Academy Community Kitchen.

Food service supervisor Sherrie Baker has 15 years of successful experience in food service and 7 years experience working with special education students. She holds a key role in the program.

Line chef Jason Anderson is the first Wallace Academy student to achieve full-time employment with our agency. Mr. Anderson recently graduated from high school and completed the 14-week chef training program and an 8-week culinary arts internship. He demonstrates a strong desire to help students to succeed and to enhance his community.

Re-Inventing Re-ED in the Community Kitchen
Creating a program such as this is a challenging and even daunting task. The 12 principles of Re-ED (Hobbs, 1994) serve as a viable and essential framework for creating and delivering an effective program. Even though all twelve are integrated into the development of the program, the key principles that have impacted the program most are: trust, competence, and community.

Trust between the child and adult is essential.
The value of trust can be demonstrated by allowing students access to something tangible, intrinsically valuable, traditionally off-limits, and greatly desired. The construction process for the full-scale, commercial/teaching kitchen began at the start of the school year. Many of our students became interested in participating in the program right away and derived great satisfaction from knowing that we were “building something for them.” Our students also recognized the extensive investment involved and began to feel a sense of belonging. One of our most oppositional and withdrawn students appeared at the kitchen door one morning, smiled, and said, “Well, Mr. Mitchell, it’s really coming along in here, isn’t it?” His continued visits assured him that adults were doing something specifically for the youth there.

Competence can be considerably enhanced.
We re-invented culinary education by focusing on helping our kids to be good at something. A traditional culinary arts curriculum focuses on teaching the prospective chefs a lot of information in a short period of time. In 20 years of professional cooking experience, I have worked with many graduates of information-based programs, and their competence as chefs was not enhanced. Indeed, they knew many, many things about food, but had to be retrained for skill and performance. This is an unfortunate consequence for the individual in terms of their self-esteem, career potential, and value perception of their culinary training. We knew at the onset that our kids needed something specially designed for them in terms of their needs, their prospective employers' needs, and their learning acquisition modes. The choice was to teach them to do a few essential things well, instead of merely exposing them to a grand milieu of food knowledge that is not really useful in production. In addition, and even more importantly, learning about something does not provide anywhere near the level of personal growth and joy that being able to be good at something provides. When this philosophy was put together with the fact that experiential learning and repetition is the preferred learning method for our students, designing a lesson plan any other way would have been tragic. Once the students achieved a level of competence, we were able to allow them more independence in the kitchen. You could see their self-esteem rise right before your eyes. The kids took the process a step further by bringing in special recipes from home to cook for school functions. One student decided that he most enjoyed baking and brought in his grandmother’s recipe for apple pie. It sure tasted good'some joy in each day.

Communities are important.
The very idea of being directly involved with helping people is a thrill to our students. People often ask me why I am a chef. I tell them, “Generosity – when I find something wonderful, I want to share it with the whole world.” Our chef training program graduates have similar feelings. To have the opportunity to feed people who are homeless, survivors of domestic violence, or physically challenged is its own reward. By participating in the Feed the Hungry program, our students learn firsthand the joy of being a help to others. It teaches them community responsibility, as well as increases their empathy for others. The important lessons learned through this exercise will enhance our students' lives far beyond the milestone of self-sufficiency.

The discoveries we have made in designing this program are surprisingly simple. Maintaining our focus on these elegant simplicities and continuing to integrate the basic principles of Re-ED will be a great challenge. We must maintain and enhance our commitment to student empowerment. We must allow them responsibility for the decisions and experiences of their lives. We can only continue to provide opportunities and model success for them. It must be part of everything that we do.

References

Hobbs, N. (1994). The troubled and troubling child. Cleveland: AREA.

This feature: Long, C., Page, J., Hail, B., Davis, T., and Mitchell, L. (2003). Community Mental Health “in an alternative school, in the public schools, and in the kitchen!" Reclaiming Children and Youth, Vol. 11 No. 4 Winter 2003. pp. 231-235.