Demographics and staffing:

The primary role of the Clinical Counselor is to foster safe and supportive relationships to mitigate risk factors and trauma that negatively impact academic success. Overall, the Clinical Counselor proactively addresses the social and emotional needs of students through on-site interventions. These include school-based individual and group counseling, peer mediation, crisis management, community outreach and collaboration, as well as general consultation and support for students, families and teachers geared at fostering student health, wellness, and academic success. Currently, the Clinical Counseling FTE is 3.5 to support CHS/Palm, CMS, Village/ECDC and Silver Strand Elementary Schools.

In addition to Clinical Counseling service for each school site, program data collection is also collected monthly.  Historic data for the 2015/16 school year as well as 2016/17 is listed below:

Table 1, below, illustrates a breakout of the student/parent/community contacts made by the Clinical Counselors from the 2015/16 and 2016/17 School Years.  

The following narrative provides a brief description of the services listed in Table 1.

• Classroom and Staff Presentations:  Classroom and staff presentations for students are being provided at all school sites in the areas of: character building; Up-Stander Education (anti bullying curriculum); transition between grade levels and school site, academic support, and healthy coping skills. To date, the Clinical Counselors have provided three hundred twenty-one (321) of these presentations in our schools.

• Individual Clinical Services:  Each Clinical Counselor maintains a caseload of students for ongoing services based on developmental, social, and emotional needs impacting school functioning. New “open” cases, opened for ongoing counseling with parental consent, are monitored by grade and referral sources.  “Closed” cases, that are closed due to student’s progress with treatment goals, matriculation to a different school site, transfer to Educationally Related Mental Health Services (ERMHS), or transfer to an outpatient therapist for ongoing services, are also monitored until consent is withdrawn. Currently sixty-six (132) students and their families are receiving counseling monthly from our Clinical Counselors.

• Walk-In:  On a case-by-case basis, students access the Clinical Counselor to address stressors in their life. These may range from bullying concerns requiring peer mediation, to problem solving skills, to social/emotional or academic concerns. Thus far, seven hundred seven (707) students have been seen on a Walk-In basis across the district.

• Risk Management:  Here Clinical Counselors address mental health and related behaviors including anxiety, depression, self-harm, self-esteem, eating or body image concerns, suicidal or homicidal ideation. In cases of suicidal ideation, a risk assessment is completed to include a school wellness contract and follow up services are provided. Research indicates positive relationships with a safe and supportive adult is a primary ameliorating factor for at-risk behavior/suicidality.  At this time, the Clinical Counselors have provided interventions for one hundred ninety-four (194) district students.

• Parent Consultation:  Provides on campus consultation as needed for a student’s academic, social, and emotional wellbeing.  Six hundred seventy (670) parents have received consultation from the Clinical Counselors this school year.

• Group Counseling:  Specifically designed therapeutic groups are formulated to engage at risk students. Groups are designed by Clinical Counselors, which may include, social skills building, communications skills, coping skills and anger management. The Clinical Counselors have provided Group Counseling to three hundred thirty-six (336) students thus far and students are now referring their peers for this service. 

Continuum of Services:

Referral, Eligibility Determination, and Continuum of Care

Student Identification

Students undergoing excessive stress and/or at risk of psychological distress are identified at each site for referral.  Students in crisis are identified and connected with clinical counseling both in crisis and not in crisis.  Teachers and counselors collaborate both systematically at grade level meetings and informally daily to discuss student concerns and observations.  Teachers and school staff are trained to recognize academic, behavioral, and appearance changes as warning signs that may indicate psychological distress. These including failing grades, habitual missed/late or incomplete assignments, diminished attendance, and participation as well as social withdrawal/isolation, statements about feeling low and hopeless, and changes in hygiene, appearance and/or drastic weight gain/loss.  

Referral and Assessment

Students may be referred for clinical counseling by themselves, a parent/guardian, through their grade level team or SST process, or otherwise identified by counselors.  To refer a student for clinical counseling, a referral is completed to capture a student’s behavioral presentation, social/emotional concerns, academic progress, and other risk factors and school based interventions attempted.   To follow up on a referral, clinical counselors will contact a student within 7 days for an initial screening meeting.   The clinician will determine the need for ongoing counseling.  Should ongoing counseling be indicated, the clinical counselor has a responsibility to contact student’s parent/guardian, connect each student with appropriate counseling support, and will consider both the continuum of counseling services available on site, including the MFLC (military family life counselor) and Educational Related Mental Health Services (ERMHS) discussed through a student’s IEP team, as well as community resources.

Informed Consent

FERPA (Family Educational Rights and Privacy Act) laws state that until a student is 18, the parents have the right to give or deny consent for counseling services in schools.   In order to initiate ongoing clinical counseling, the clinical counselor must obtain a signed form from the student’s parent or guardian that indicates informed consent as well as understanding of the limits of confidentiality.  Should a student live in foster or kinship care, clinical counselor must obtain consent for counseling from the student’s county social worker or legal guardian.  Should a student’s parents or guardians be divorced/separated and maintain joint legal custody, clinical counselor is responsible to make reasonable efforts to obtain consent from all parties holding legal custody.  

If informed consent is NOT obtained, individual clinical counseling services cannot be initiated.  Based on clinician’s assessment of student’s need, clinical counselor will maintain oversight and monitoring of students as indicated in the school setting, to include crisis management, problem solving support and peer mediation, and general check-ins regarding welfare and academic success.    

Treatment planning and Duration

The clinical counselor is able to provide crisis management, peer mediation, and general check-ins regarding welfare and academic success as well as ongoing group and individual mental health counseling for academically related social and emotional needs.    After informed consent is obtained, the clinical counselor completes biopsychosocial assessment, develops a diagnostic impression and treatment plan and defines goals and services based on developmental, social, and emotional needs impacting school functioning. Clinical counselors are responsible to follow APA guidelines   Although students may discuss a variety of issues in the assessment, the clinician gages the impact of problems as well as the student’s motivation to address them and selects a few of the most significant challenges impeding learning on which to focus the treatment process.  Clinical counselors establish broad treatment goals and well as short term objectives for treatment and define these objectives in behaviorally measurable language.  In the course of services, the clinical counselor designs interventions from a broad range of therapeutic approaches, including cognitive, behavioral, family systems, and solution focused brief therapy.  Frequency, type and duration of services is determined on a case by case basis and re-evaluated regularly, a minimum of every 3 months, based progress with counseling goals. Based on treatment goals, services for a student may include group, individual and family sessions.   

Exit Criteria and Closing

Clinical counselors hold an ongoing caseload of students for individual counseling at each school site.  As goals are meet, services may be redefined and frequency of services may be reduced in preparation for termination.  Cases may be closed due to a student’s progress with treatment goals, withdrawal of parental consent for treatment, moving or school matriculation to a different school site, transfer to an ERMHS, or transfer to an outpatient therapist for ongoing services.  Clinical Counselors monitor treatment goals and seek to reduce services based on progress.   As students transition between schools, clinical counselors facilitate transition meetings with clinical counselors at new school site to ensure continuity of care.  

The role of the Clinical Counselor is essential to supporting the social emotional needs of our students, families and community.  The Clinical Counseling team at CUSD are the foundation of the mental health supports provided in our schools.