metal health in school

Solution-Focused brief conversations in schools provide a practical tool for educators, administrators, school nurses, parents, and the myriad of professionals involved in the lives of youth to help address their social, emotional, and mental health needs. Solution-focused brief conversations are trauma-informed and can be taught to transdisciplinary teams within diverse educational systems fostering success for all our collective children.

At its core, Solution-Focused Brief Therapy (SFBT) is a conversation and can happen in everyday conversations when applied with positive intention and training. People who can talk, not just those trained in counseling, can practice this approach. Solution-Focused conversations foster hope by building agency and a plan. Agency is the capacity to do something to act and exert power over a situation. Activating an individual or group’s agency can instill hope and confidence that they can do things that will make a difference in their lives. Developing a plan fosters hope by knowing there are actions that can be taken to improve their situation. Teachers, children, educators, principals, parents,  administrators, lunchroom staff, bus drivers, and many others involved in children’s education can learn the essential elements to build fluency in solution-building conversations. 

Solution-focused brief therapy (SFBT), an evidenced-based practice, has been successfully applied to many real-world challenges (Beyebach et al., 2021). SFBT research has grown over the past ten years and is accepted as an evidence-based intervention in the United States (Kim et al., 2019; Kim & Franklin, 2009). Working on What Works, WOWW, a classroom intervention based on SFBT, is a practical intervention to use in schools and can be implemented across classrooms in both public and private schools (Wallace et al., 2020). Evidence of the effectiveness of solution-focused child welfare practices in child protection settings demonstrates how solution-focused practices can be disseminated at a low cost and provide cost-efficient treatment (Medina et al., 2022).

Solution-focused practitioners follow in the footsteps of Steve de Shazer and Insoo Kim Berg, who recognize that although problems may have complicated causes, the solutions may be much less complex. In other words, a solution can be separate from the cause of the problem to be effective and sustainable. SFBT addresses day-to-day issues that may hinder educational achievements, such as the relationship with the teacher, attendance, transportation, and academic, peer, or family challenges. Teachers and student support teams may deliver interventions that assist in practical solution-building.

Solutions thrive in schools. Children talk excitedly about their teachers and friends. Parents volunteer their time. Teachers invest their creativity and energy daily to make a positive difference in the lives of children. Insoo Kim Berg and Lee Shilts were the pioneers of bringing solution-focused practices to schools. In 2002, they were asked to observe a student in a classroom whose behavior was creating difficulties for the class (Berg & Shilts, 2005). They observed the child in the class to be respectful, able to focus at times, and polite. They sent him a letter complimenting what they noticed. The following week, the teacher noticed that the student was doing better. This idea of noticing and providing positive feedback had a noticeable helpful effect. This profound small intervention was the first seed of bringing solution-focused practices into schools called Working on What Works (WOWW), a solution-focused classroom management strategy. WOWW focuses on positive actions and interactions by observing the whole class and classroom teacher in their natural environment.WOWW is an inclusive classroom intervention through language and collaborative observation with children and teachers. Since this time, many outstanding practitioners, researchers, and educators have collectively continued this vision of solution-focused practices in schools.

Harnessing Hope In Everyday Conversations

What is possible in brief conversations? How can we harness hope in even short interactions that happen on a daily basis? In schools that run at a fast pace with ever-changing dynamics and crises, brief may present as a 2-minute conversation with a student in the hallway who appears distressed from a recent peer conflict as chaos ensues during period changes. It may mean a 5-minute conversation with a parent concerned their child is making poor decisions and failing academically. It may mean a 10-minute conversation between two teachers figuring out how to manage curriculum demands while feeling pressured to complete numerous college recommendations, grade volumes of assignments, and prepare for the next class while dealing with the pressures of the administration’s demands to address rising achievement gaps with fewer available resources. It may mean a 5-minute classroom conversation about how confident students are that they are prepared for an exam from 1-10 (10 being the most confident). It may include a conversation about students’ best hopes for the class so they can say it was fun and they learned something.

One of the most important features of life is conversation. Some conversations enhance hope and possibility, while others diminish it. How can educators, parents, clinicians, nurses, coaches, lunchroom staff, and others who care for our children foster hope, agency, confidence, and success? How can they help cultivate conversations that nurture positive change, harness new knowledge and meaning, and encourage children to make choices that create positive differences in their lives?

Consider the following brief conversations.

Conversation One:

Mr. Jones was working with a group of 2nd-grade students and felt frustrated with how to help one boy who frequently refused to do his work and complained about stomachaches and his need to go to the nurse. Mr. Jones kept a stack of index cards on his desk and observed his students for things the class and students were doing well each day. Perhaps it was the 5 minutes Damien was able to sit and focus on a math lesson, or the time Sarah, who was often shy and reclusive, had a conversation with a peer for a few minutes, or the time Jimmy got his notebook out and did some of his work. Mr. Jones would write these observations on individualized notecards, place them quietly on the students’ desks, thank them for their hard work, and ask them to write how they did those things on the card. At the end of the week, he would talk with the students about the week’s successes and inquire how they were accomplished. He would then scale with them from 1-10 how satisfied they were with school for the week from 1-10 (10 being the most satisfied), whether that was good enough, what kept the number from being lower, and what they could do to keep up the good work and increase the number if it was not good enough.

Conversation Two:

Mrs. Smith, a middle school math teacher, was teaching a lesson on geometric figures. The class presented with varying abilities, making meeting all of their needs challenging. Mrs. Smith made a point that when a shy student raised their hand and asked a question to appreciate what a good question they had, many other individuals likely had a similar question and curiously asked what they knew about the concept they were inquiring about appreciating their prior knowledge.

Conversation Three:

Mr. Snow, the school guidance counselor, was asked by the French teacher to meet with Destiny. Destiny is a 10th-grade student who was chronically late for class, missed several days of school a week, and was constantly on her phone when she did come. She was failing French. Her French teacher was concerned she appeared depressed, so she referred her to the counseling office. She would often miss school entirely due to significant anxiety following the loss of her grandmother, her primary caregiver, during the COVID-pandemic.

Mr. Snow acknowledged that it must have been challenging for her to make it to French class and asked her how she decided to come to school today. Destiny responded, “I don’t know – I was forced to.” Mr. Snow was curious and asked her who was concerned about her that thought her coming to school was this important. Destiny responded that it was her aunt. Mr. Snow asked what her aunt knows about her so that she can be successful at school. Destiny stated, “ I don’t know – ask her?” Mr. Snow stated that, of course, her aunt knows best, but she knows her aunt well and asked her gently again what her aunt knows about her and that she will be successful in school.

Destiny ignored the question and proceeded to only focus on her phone, understandably causing some frustration in Mr. Snow; however, Mr. Snow was able to ask a few more solution-focused questions to keep the conversation productive. Mr. Snow asked Destiny her “good reason” to be on her phone. She stated that she wasn’t good at French and it wouldn’t make any difference in her life. Mr. Snow appreciated how frustrating this must be for her and asked her how she has been able to tolerate French, given how annoying it is for her to be here. Destiny stated she knew that she had to pass French to graduate. Mr. Snow asked Destiny what else she knows she needs to do to graduate. Destiny responded by stating to get a D or above in French and showing up enough times to meet the requirements. Mr. Snow appreciated her candor about the requirements to graduate, as well as how frustrating this must be for her to take a class that she does not think will make a difference in her life.

He then asked her what her best hopes are after she graduates. Destiny stated she already was working part-time for her uncle, creating graphic design promotional material for his business, and wanted to pursue doing more graphic design. Mr. Snow asked her about the graphic designs she had created, and Destiny went on to show him the artwork she had created to advertise her uncle’s upcoming promotional event. Mr. Snow asked her how she learned all these artistic skills, and she talked about going to “YouTube University” and spending hours learning art skills during COVID while dealing with the chaos in her home. Mr. Snow appreciated these skills and then asked if she would be willing to share her designs at the end of the week with the class after tolerating French in a good enough way to pass so she could fulfill her goal of graduating.

Mr. Snow asked her how confident she is from 1-10 (10 being the most confident) that she will be able to do what is needed this week to reach her goal of passing French class. She stated a 5. Mr. Snow asked if this was a “good enough” number for now, and she said yes. Mr. Snow asked her what keeps the number from being lower, and Destiny stated knowing that she has had success with her uncle’s business and that graduating would help her with her goals moving forward. They agreed that Mr. Snow would do a “scaling check-in” weekly, or more often if needed, to monitor how confident she is from 1-10 that she is doing what she needs to do to graduate. 

Benefits of Solution-Focused Brief Conversations in Schools

Children spend more time in school than anywhere else except at home. Educators are well-positioned to identify and address student mental health concerns and are at the frontlines of the child mental health pandemic. School staff typically engage with students 6 hours/day, five days per week for 30 weeks a year, while also placing academic demands on them daily. They are ideal for recognizing struggles among their students. Although teachers are not mental health clinicians, they are often the professionals helping youth manage stress, problem solve, and manage daily challenges and frustrations. Schools provide structure, routine, peer interactions, social connections, support, and opportunities to engage in fun, stimulating social, emotional, physical, and cognitive activities. Solution-Focused techniques assist in delivering mental health services to youth and could be adapted and scaled sustainably while prioritizing equitable access across diverse populations.

Solution-focused conversations can help identify and support indigenous persons and resources with schools, as they are the critical agents needed to sustain positive change. The most obvious change agents in schools are teachers, who influence the classroom climate, nurture relationships, and are critical to children learning. Training teachers in solution-focused conversations can effectively improve classroom management, which strongly predicts children’s future success.

Solution-Focused Techniques and Comprehensive School Mental Health

Teacher and behavioral health workforce shortages combined with an increased demand for services for children have required educators, schools, mental health professionals, health care providers, parents, and communities to devise innovative service delivery and training strategies. Qualified teachers are the backbone of education that drive schools and classrooms. Few issues threaten the nation as seriously as the growing teacher shortage ( Zhang, G., & Zeller, N. (2016). Unfortunately, fewer people are enrolling in this career, and new teachers are quitting at an alarming rate. A nationwide teacher shortage exists, and reports indicate that there are 250,000 teaching vacancies annually across the United States, and teacher education enrollments have declined by 35% (Sutcher, L. et al. 2019). Teacher shortages exacerbate the inequitable distribution of qualified teachers to schools serving low-income individuals and individuals of color (Sutcher L. et al., 2019).

In the United States, comprehensive school mental health systems are emphasized. These include universal mental health promotion activities for all students, early intervention services for at-risk students, and treatment for students with severe impairments. This requires collaborative partnerships between school systems and community partners. In education, this is referred to as a multi-tiered system of support (MTSS). Multi-Tiered Systems of Support (MTSS) include universal schoolwide support, known as Tier 1, 2, and 3. Solution-focused brief conversations can be incorporated into all levels of a multi-tiered system of support.

Solution-focused conversations can be implemented within the naturalistic school environment without adding yet another requirement for teachers to add to their already overwhelming demands. There is a need to optimize and enhance educational goals rather than superimposing a new set of programs and responsibilities on beleaguered schools. Mental health staff can be considered “educational enhancers” who assist teachers in providing effective instruction by embedding them within natural settings such as classrooms. ( Atkins et al. 2010).

Many federal and state agencies have adopted the concepts of competencies within their definition of a mental health condition. Solution-focused conversations facilitate identifying and assessing children’s functioning and competencies in their natural settings. Focusing on improved functioning rather than symptom reduction cultivates a child’s agency and aptitudes, creating a better alignment between educational and mental health policy. This includes enhancing interactions between teachers and students, teachers and parents, educators and peers, and providing an effective model for integrating social-emotional learning within the school environment.

The Solution-Focused Approach and Social-Emotional Learning

The COVID-19 pandemic has highlighted the importance of social and emotional learning and schools’ critical role in supporting other aspects of children’s development beyond numeracy and literacy. Social and emotional learning (SEL) refers to the process by which youth and adults acquire and apply intrapersonal, interpersonal, problem-solving, and decision-making skills essential for school success. Social-emotional learning (SEL) generally captures three broad areas, including the ability to regulate and manage one’s emotions, the ability to set and achieve goals, and the ability to develop interpersonal skills that are essential for school, work, and success in life (Yorke et al., 2021). SEL has been shown to influence an individual’s achievement and outcomes, including the level of education, academic progress, pathways beyond education, entry into the labor market, and future earnings.

Students engaged in social-emotional learning demonstrate an increase in academic test scores and promote students’ social and emotional competence (Durlak et al., 2011). Educators trained to implement SEL curricula report lower depression and job-related anxiety, higher quality interactions with students, and greater perceived job control than those not trained in SEL (Schonert-Reichl, K. A. (2017). Training in SFBT provides a practical approach that educators can use to promote SEL. This includes building the capabilities of students to collaborate with others, developing their agency, responsibility, empathy, critical and creative thinking, navigating conflict, and addressing prejudice and bias. Solution-focused conversations can assist educators in bonding with their students, facilitating positive peer experiences, and promoting respectful relationships and equality, all of which can promote SEL (International Commission on the Future of education, 2021).

Solution-Focused Conversations are Trauma-Informed

Solution-focused conversations (SFC) are trauma-informed and support people in crises by providing a safe and reassuring therapeutic relationship. They enhance an individual’s resilience, decrease distress and minimize the potential risk of re-traumatization. Trauma-sensitive schools refer to a schoolwide approach to understanding and addressing trauma. Solution-focused conversations can assist in creating safe, supportive, and culturally responsive schools that prevent school-related trauma and foster thriving and transformative learning opportunities. SF conversations assist in counterbalancing intense emotions, collaboratively supporting people in developing meaningful coping strategies, cultivating competencies, and navigating gradual next steps for the immediate future. This belief in the client’s resilience and capacity is harnessed throughout the conversation and can be productively utilized to help cope with the aftermath of a crisis and build a healthy, satisfying future (Dolan, 1998; Froerer et al., 2018).

This belief in client resilience has the added benefit of educators experiencing vicarious resilience instead of vicarious trauma. Vicarious trauma (secondary trauma) has been defined as the transformation that occurs in the inner experience of the worker that comes about as a result of empathic engagement with the trauma material (Pearlman & Saakvitne, 1995, p.31). Vicarious resilience is a complex collection of elements contributing to the empowerment of workers through interaction with stories of resilience (Hernandez et al., 2007). These elements of witnessing and reflecting on human beings’ remarkable capacity to heal can result in the worker reappraising the significance of their own challenges and generating new possibilities and hope on the part of the worker. Integrating solution-focused conversations within a school’s organizational context can increase vicarious resilience.

Solution-Focused Conversations are Strength-Based and Student-Centered

Solution-focused conversations are individualized and adaptable in differing contexts within and across schools. Educators must collaboratively create yearly goals for students, including those with complex needs on Individualized Educational Plans (IEPs). Solution-focused conversations afford a practical approach that can assist educators, parents, and students in writing goals that can be integrated successfully into the student’s educational plan. Identifying incremental goals through scaling questions can be integrated within IEPs. Solution-focused conversations in schools may be delivered in a variety of different modalities, including individual, group, family, and even organizational-level interventions, and has the potential to serve universal, secondary, and tertiary prevention purposes (Metcalf, 2021). Solution-focused conversations can help educators enhance active parent involvement while providing tools to provide strategic support for families, such as specialized outreach programs.

Providing resources and skills for teachers and other school staff to manage high-need children, especially in high-poverty communities where student-to-staff ratios are high, and technology or other resources are scarce, is critical. Solution-focused techniques can be embedded within classroom-wide programming for normal events, such as transitions through the school day or class-wide routines.

Solution-focused conversations can be applied within academic counseling, college applications, sports and coaching, and group interventions with individuals with academic and emotional challenges. Regardless of the setting, several specific techniques are used in an SFBT intervention or programs that are universal to the therapeutic model.

Solution-Focused Techniques Can Enhance a Positive School Climate

School climate has a profound impact on students’ mental and physical health. Solution-focused conversations can contribute to a positive school climate by enhancing feelings of safety, social relationships, and teaching and learning practices. Enhancing individuals’ academic mindsets and confidence in their ability to learn and develop skills in decision-making, relationship-building, and self-management can foster a student’s well-being and confidence. These skills can improve students’ willingness to engage, attend, and remain in school and improve their academic achievement. Interventions that promote a positive school climate may reduce the risk of victimization and adverse mental health outcomes in lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Research has highlighted high levels of perceived school connectedness as an essential protective factor for mental health (Parodi et al., 2022).

The Urgent Need for Comprehensive School-Based Mental Health

One in five children is adversely impaired by a mental health condition (Merikangas et al., 2010). However, less than half of these children will receive treatment (Kataoka et al., 2002), and of those who do, most receive fewer than four sessions of care in community mental health settings. For youths living in poverty or racial-ethnic minority groups, access to mental health treatment is even more limited, with many of these youths being managed in the juvenile justice system (Skowyra & Cocozza, 2007).

Schools are an optimal setting to identify, manage and sustain progress for children with mental health needs increasing access, adherence, and participation in treatment, decreasing stigma, and promoting positive effects on academic and social-emotional functioning. Approximately 75%-80% of youth receive mental health services in schools (Masonbrink & Hurley, 2020). School mental health models provide a context to provide transdisciplinary teams of support for children in their natural developmentally appropriate context and the opportunity to provide universal support in an accessible and comfortable environment. Comprehensive school mental health systems integrate education, mental health resources, and expertise to improve youth’s academic and social-emotional outcomes (Hoover & Bostic, 2021). Brief evidence-based interventions can help as they can be delivered widely.

Schools have many competing demands and forces with changing priorities, administrations, and mandates. There is strong evidence that school mental health positively influences students’ academic and social functioning, but sustaining the resources in these changing contexts can be very challenging. For many reasons, implementing evidence-based, sustainable, cost-effective mental health prevention and interventions still lag within schools. Schools often are driven by competing and changing priorities and not informed by data. Education and mental health systems have operated in separate silos, partly because of youth and families concerns about seeking mental health in schools. Mental health systems do not easily navigate the delivery of school services, including reimbursement. Unfortunately, the impetus for school mental health arises in crises such as school shootings, suicide, natural disasters, and other incidents of violence.

Teacher and behavioral health workforce shortages combined with an increased demand for services for children have required educators, schools, mental health professionals, health care providers, parents, and communities to devise innovative service delivery and training strategies. Qualified teachers are the backbone of education that drive schools and classrooms. Few issues threaten the nation, as seriously as the growing teacher shortage ( Zhang & Zeller, 2016). Unfortunately, fewer people are enrolling in this career, and new teachers are quitting at an alarming rate. A nationwide teacher shortage exists, and reports indicate that there are 250,000 teaching vacancies annually across the United States, and teacher education enrollments have declined by 35% (Sutcher, L. et al. 2019). Teacher shortages exacerbate the inequitable distribution of qualified teachers to schools serving low-income individuals and individuals of color (Sutcher L. et al., 2019).

Looking at the results of children not attending schools during the COVID-19 pandemic demonstrate with great clarity how critical teachers and schools are for children and families. The COVID-19 pandemic created the largest disruption of education systems in human history, affecting nearly 1.6 billion learners in more than 200 countries. Closures of schools, institutions, and other learning spaces impacted more than 94% of the world’s student population (Pokhrel & Chhetri, 2021). There is clear evidence of a negative effect of COVID-19-related school closures on student achievement. The effects of remote learning were similar to those achieved when no teaching was implemented during summer vacation. Younger children and children from low-SES families were disproportionately affected by COVID-19-related school closures (Hammerstein et al., 2020). A systematic review and meta-analyses of 23 studies and a total of 57,927 participants provide evidence that 28.6%, 25.5%, 44.2%, and 48.0% of children and adolescents experienced depression, anxiety, sleep disorders, and posttraumatic stress symptoms, respectively, during the COVID-19 pandemic (Ma et al., 2021).

An estimated 5 million to 7.5 million US students miss nearly a month of school yearly. This lost instruction time exacerbates dropout rates and achievement gaps. Students who reduce absences can make academic gains (Ginsburg et al., 2014). Students who miss more school than their peers score lower on educational progress testing, which holds true for all social-economic groups.

The USA has had 57 times as many school shootings as all other major industrialized nations combined (Rowhani-Rahbar & Moe, 2019). Guns are the leading cause of death for children and teens in the USA, with children ages 5–14 being 21 times and adolescents and young adults ages 15–24 being 23 times more likely to be killed with guns compared to other high-income countries. Furthermore, Black children and teens are 14 times, and Latinx children and teens are three times more likely than White children to die by guns (Muir, M.S.P., 2021). Children exposed to violence, crime, and abuse face a host of adverse challenges, including abuse of drugs and alcohol, depression, anxiety, post-traumatic stress disorder, school failure, and involvement in criminal activity (Cabral et al., 2021; Everytown Research and Policy, 2022b; Finkelhor et al., 2016).

Technological tools are used for various purposes in many areas of daily life, such as connecting to the internet, accessing social media, listening to music, playing games, shopping, taking photos, and navigating. Using a smartphone is a characteristic feature of today’s youth. Smartphones are nearly ubiquitous among younger adults, with 92% of Americans aged 18-29 owning one (Pew Research Center report, 2017). Cellphones and tablets have become more frequent at schools and universities in their spare time and during class. Multi-tasking in technology (emailing, texting, and Facebook) negatively correlates to the capability to learn effectively, as demonstrated by lower test scores (Wood et al., 2012). Students often overestimate their ability to multitask. There is clear evidence of the negative relationship between smartphone usage and academic performance, are a source of distraction in classrooms and other settings dedicated to studying, and that, on average, the difference between reported use of phones and the actual rate may be as high as sevenfold (Felisoni & Godoi, 2018).

Although many features of smartphones can positively affect human life, their excessive and uncontrolled use can cause social, physical, and psychological problems. The term NOMOPHOBIA or NO MObile PHone PhoBIA describes a psychological condition when people fear being detached from mobile phone connectivity (Bhattacharya et al., 2019). It has been described as an “over-connection syndrome” as it reduces the number of face-to-face interactions adding additional challenges to youth health. Studies among high school students have shown that with the increase in smartphone use, the degree of nomophobia increases, leading to increased anxiety and loss of self-control over their life (Bartwal & Nath, 2020).

The US Surgeon General’s Advisory acknowledges that our healthcare system is ill-equipped to support our children and youth’s mental health and well-being. The advisory exhorts us to reimagine addressing, managing and preventing mental health challenges. It urges recognizing the need for trauma-informed care with youth facing adversity and educating a wide range of professionals who work with children, such as schools, child care, justice, social services, and public health sectors. Solution-focused brief therapy and conversations can successfully be applied in schools dissolving conventional disciplines’ boundaries to foster children’s mental health.

Coming Soon: Solution-Focused Conversations in Schools: An Integration of Education and Mental Health

This course, Solution-Focused Conversations in Schools: An Integration of Education and Mental Health, attempts to reimagine how solution-focused brief trauma-informed practices can be practically implemented in a transdisciplinary way within schools. Our goal is to make a positive difference in the lives of children, families, and the myriad of dedicated professionals working daily to foster success for all our collective children. This course includes a written component, video lectures, demonstration videos, case examples, and individual and group practice exercises demonstrating how Solution-Focused conversations are developed. Multiple classroom exercises are included within the course to assist teachers with practical tools for embedding social-emotional learning in their daily work. Our best hope is that at the end of this course, you can implement these skills in your daily life, classrooms, educational settings, and all the contexts that support children’s educational, academic, and social-emotional success.


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