We have come a long way from traditional therapy, still evoked in memes, that included a couch and psychologist analyzing our thoughts a la Freud. Conversations about mental health and wellness have gained increasing momentum over the past decade or so. Perhaps we can even thank the pandemic – or the increased social media footprint sweeping the world – for thrusting these conversations into the forefront of policy and practice, and raising mental health awareness in the process.
Regardless of how the conversation gained momentum, one important outcome was the increased focus on supporting children’s mental health and wellness. Schools across the country began adding programming both across groups and individuals. This included the implementation of perspectives such as trauma-informed care and social-emotional learning. Programming emerged providing mental health education school-wide, focusing on age-specific curriculum such as anti-bullying, healthy relationships, social skills, mindfulness strategies, emotion regulation and more. With that came the idea of bringing individual therapy into the school setting.
To best understand what school-based outpatient programming can provide, let’s first review what exactly it is and is not.
What school-based outpatient programming IS:
- Traditional outpatient programming in school environment: School-based outpatient programming utilizes the practices of traditional outpatient clinic settings. This includes providing individual, group, family and even collateral family therapy (you read that correctly: therapy in schools can and should include parent involvement!). Sessions are between 30-45 minutes and conveniently coincide with bell schedules. Therapists still meet with the client and families to identify treatment needs and develop goals for the client to work towards. Additionally, therapists assess risks to safety and help develop a safety plan as needed.
- Access to psychiatry and medication management: Students and families who choose to receive school-based outpatient therapy still have the opportunity to collaborate with traditional outpatient programming to request psychiatric evaluations, diagnoses, and medication management if clinically appropriate.
- Low or no cost to families: School-based outpatient programming can be billed like traditional outpatient programming in which insurance pays for services rendered. Sites like those of KidsPeace’s school-based outpatient are licensed mental health clinics within the schools and as such, students with Medical Assistance have all costs covered during treatment.
It is also important to understand what school-based outpatient is NOT:
- It is not a service for schools to have unchecked access to students’ mental health services. Protected by HIPAA, students who are clients have the right to privacy regardless of setting.
- It is not a replacement for Individual Education Plans, 504s, or other educational supports.
- It is also not a replacement for higher levels of care such as school-based partial programs, acute partial programs or other support services.
- Lastly, and above all else, it is not an interference to the education of the student client. For a student to learn best, they have to feel safe, secure and mentally healthy.
Benefits to School-Based Mental Health Programs
Perhaps what makes school-based outpatient programming such an intriguing and appealing concept is the simplicity in implementation, low cost to programs and districts alike, and the significant impact it has on both clients and the student body as a whole.
After spending the past five years in our school-based outpatient program, I have noticed exciting benefits to providing outpatient therapy in the school setting:
Accessibility to Mental Health Treatment: There are significant barriers to traditional outpatient mental health treatment at times, which include transportation, work schedules, childcare, and school absence. The ability to offer school-based outpatient programming in schools eases the burden for families and students. With the ability to pull a student from one class during the day and then return them back to their scheduled day, the students miss minimal work, and parents avoid obstacles to care.
In-Vivo Skill Practice: Students get opportunities to practice and use the skills they learn in therapy in real time throughout their school day. The students then also have immediate feedback from the skills they used.
Bridging Communication & Connecting Systems: By bringing mental health support into the school setting, guidance teams and therapists can collaborate on the most effective support for the student clients. Again, they can focus on real-time communication and immediate adjustments to address student needs.
Supporting Families: Schools and school-based outpatient services have been able to link together as a cohesive unit to support families. Having these services in the school allows families to attend meetings and therapy sessions, communicate concerns quickly and efficiently, and brainstorm strategies for mental health and behavioral support in the classroom.
Normalizing Mental Wellness and Self Care: Therapists have a unique opportunity to be a presence in the school culture. They create a visibility among the student population that normalizes their presence within the schools. Students (whether a client or not) frequently stop by therapists’ offices as they would other school supports, and this starts the conversation about the importance of mental wellness. Rather than avoidance, what we see are students in groups, popping in to say “Hi”, borrow fidgets, and ask about therapy. This is how barriers are broken down!
With the integration of school-based outpatient therapy into schools, we have developed the opportunity to prioritize student mental wellbeing, normalize mental health care, and break down barriers to accessibility to a service that should be available to anyone in need.
