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2020 FALL B SEMESTER - Dysfunctional Behavior EDG-6327 Dr. Lyons

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2020 FALL B SEMESTER - Dysfunctional Behavior EDG-6327 Dr. Lyons

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Diagnosis & Assessment - What's Appropriate for My Role?

Before examining the different types of dysfunctional behaviors in depth, you should understand the nature of the role of the school counselor in serving students with mental health concerns.

Professional school counselors are in a unique position within schools to implement comprehensive guidance programs that provide prevention and early intervention strategies, education and support for students, staff, parents, and the community, and collaboration with mental health professionals to ensure that needs are met.

While school counselors are in a position to recognize signs and symptoms of emotional disturbances, because their certifications do not include expertise in the area of diagnosis and treatment of disorders, it is not appropriate for school counselors to diagnose these behaviors or carry out long term counseling or therapy in the school setting to address these disorders. For a quick chart of appropriate and inappropriate activities for school counselors, see the attached PDF below created by the American School Counselor Association (ASCA). There are also resources available in the reading list to help you understand your role.

When working to recognize dysfunctional behavior / emotional disturbance, a school counselor must be able to identify the appropriate entity for referral, such as a licensed professional counselor (LPC), a licensed specialist in school psychology (LSSP), a medical practitioner (doctor), or a psychiatrist. Counselors can support students' mental health needs by appropriately referring, acting as a supporting connection between the student and parent, family and mental health referral, and mental health professional and school personnel, and by ensuring the school environment and staff is equipped to best serve the student. As we explore the different behaviors in this course, you will be provided with resources to help you solidify your understanding of your role in serving students with dysfunctional behaviors. For this introductory module, you may find the resource  What Do Mental Health Professionals Do in Schools? helpful.

In addition, you will see several resources referring to the Diagnostic and Statistical Manual, 5th ed. (DSM-V).  It is important that you understand how diagnoses are made and what information is available in the DSM.  You may see this information in ARD/IEP meetings, as well as on information from private counselors or others.  Several resources have been included with this information and it would behoove you to become familiar with it, knowing that it is not for you as a school counselor to make diagnoses. The resource  ASCA Appropriate Activities for School Counselors may also help you understand some of the basic activities appropriate for school counselors.

Lyons, K. (2020). Module 1: Intro to dysfunctional behavior. https://blackboard.angelo.edu/webapps/blackboard/content/listContent.jsp?course_id=_67112_1&content_id=_2695047_1&mode=reset

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The Special Education Referral Process. Because of the  federal laws and regulations that govern the education of students with disabilities, a process has evolved over time that governs the special education referral process. The purpose of this module is to provide an overview to the “Special Education Process” so that the learner may understand the global procedures for providing a student with disabilities a free and appropriate education (FAPE).PHASE ONE: Recognitional that all  students begin their educational careers with needs. For many, it is the need for guidance by a professional educator who can expand their knowledge and understanding of the world around them. While each student brings a different level of knowledge and skills to his or her first class, the individual’s needs are typically met by a highly-qualified educator. However, there are children who have unique needs that are atypical for children of their age and may not be within the expertise of the general education classroom teacher. It is during this time that the teacher (or parent, administrator, or counselor) recognizes a consistent need or problem exhibited by the student. The recognition of a discrepancy in the student’s academic, social/emotional, behavioral, and/or physical ability and his or her age may signal the need for additional academic or behavioral supports. During this phase, it is important to call a meeting with the parents or guardians. The teacher should provide examples of the student’s work and/or anecdotal classroom notes regarding the student’s needs. In the meeting, the teacher and the parent/guardian should explore the following: Is the issue a recurrent problem or new? The parents will be best able to present invaluable insight into the knowledge, skills, and needs of their child. The teacher should document when they recognized an issue. Is the issue constant? All children may exhibit unique needs or problems at some point but it may only be an isolated episode for that day. The teacher should document any issue that is constant, providing dates and information about the behavior of concern or skill deficit exhibited by the student. Is the issue appropriate for children of this age? How many kindergarten students have been seen crying the first days of school? This behavior is a typical occurrence and should not be confused with an atypical behavior. The teacher should have a strong understanding of the cognitive, behavioral, and physical development levels of typical students they teach. It is possible that the problems that are being exhibited by the student may be “solved” with the careful execution of a cooperative plan of action between the teacher and the parents. The teacher and the parent should document their plan of action, strategies utilized with the student, and progress. The teacher should continue to collect student work samples and keep assessment data relevant to the student’s unique needs. It is critically important that the teacher document all actions and strategies used in the classroom and the impact on the student. The student’s parents/guardians should be kept informed of any changes in the student’s progress. If the teacher, after a period of time, determines the problem cannot be controlled with simple classroom interventions, then the teacher should notify the parents/guardians that they will be asking for outside help from a school-based pre-referral team.PHASE TWO: Pre-referral The pre-referral step in the special education process is more formal than providing simple and temporary accommodations for students. Pre-referral intervention is to identify, develop, and implement alternative education strategies for students who have recognized problems in the classroom before the student is referred to special education. Pre-referral intervention is typically conducted by a Student Centered Team (also called early intervention team, intervention assistance team, student support team, teacher assistance team, or instructional support team). The pre-referral team usually consists of the teacher, the parents/guardians, an administrator, other general education teachers, nurse, guidance counselor, and any other adult involved in the education of the student. The general education teacher provides background information regarding the problem exhibited by the student and the team works together to develop possible solutions. Because of changes to IDEA in 2004, many states and independent school districts have begun using a more formal and systematic pre-referral process called response to intervention (RTI). “RTI is a model designed to address the needs of all children through a continuum of services, which include: High-quality instruction and tiered evidence-based or practice-based intervention strategies aligned with individual student needs; Frequent monitoring of progress to make results-based academic or behavioral decisions; and Application of child response data to important educational decisions (such as those regarding placement, intervention, curriculum, and instructional goals and methodologies)” (TEA, 2007).RTI provides three levels of intervention for students who are experiencing problems. Generally, the first level (sometimes referred to as Tier 1) is focused on utilizing high-quality general education instruction in the core curriculum with all students. RTI theorizes that around 80% of all students will respond positively to core curriculum and behavior systems. The second level (or Tier 2) provides targeted group instruction or some form of group remediation to improve performance. The RTI model believes that second level services will improve performance for approximately 15% of all students. If performance does not improve in the second level, then students are moved to the third level which consists of intensive, individualized interventions. Whether the school uses pre-referral teams or the more formal RTI process, the intent is to provide interventions that will help the student achieve success without entering special education. However, if these interventions do not improve the student’s performance, then the student will be referred for an assessment to determine possible eligibility for special education services. PHASE THREE: Referral for Special Education Evaluation If, after interventions in the general education classroom, the student continues to experience difficulty, school personnel may refer the child for a special education evaluation. Referrals for determination of eligibility for special education services may be initiated by: School personnel (including general education teachers, special education teachers, counselors, administrators, etc.);Child’s parent(s) or legal guardian(s);Any other person involved in the education or care of the child. The official referral begins the formal process of determining eligibility for special education services. Once a referral is provided, the school must obtain consent from the parent(s) or legal guardian(s) to begin the evaluation phase of the referral process. PHASE FOUR: Special Education Evaluation IDEA requires that students referred for special education services receive a nondiscriminatory multi-factored evaluation. The school district is required to complete the evaluation within 60 days of the referral date. The evaluation is to be conducted by a multidisciplinary team that will consist of individuals who can bring different perspectives and expertise to the evaluation. Some examples of team members include: Educational Diagnostician (also called Psychometrist) or School Psychologist: These professionals are qualified to conduct all types of educational assessments including intelligence (IQ), achievement, behavior, etc. Special Educators: These individuals are qualified to conduct some types of achievement and behavior evaluations as well as informal observations. General Educators: These individuals provide documentation of the problems of the specific student. Parent(s) or Legal Guardian(s): The parents or legal guardians provide valuable insight into the student’s behavior and personality in other environments.*Related Service Providers (Physical Therapist, Occupational Therapist, Audiologist, Orientation and Mobility Specialist, etc.): These specialists provide information pertaining to specific areas of concern that have been assessed. Medical Doctors (including psychiatrists, ophthalmologists, and optometrists): Depending on the disability of the student, medical records can also be used in the determination of eligibility for special education services.* Parents of students with developmental disabilities must decide whether to complete the legal process to become the legal guardian once their child reaches 18 years old, the age of majority. According to Texas state law, this process is separate from the required school transition planning process. The evaluation must be comprehensive and use evaluation tools and strategies that are technically sound and accepted. Most students receive a battery of formal evaluations that measure:, informal observations and documentation of the student’s past work should also be used during the eligibility determination meetings. Assessments may not be biased in regard to race, culture, language, or disability. The materials and procedures must be administered in the language and form most likely to provide accurate information on what the child knows and can do. PHASE FIVE: Eligibility (FAPE)IDEA states that each child is entitled to a Free Appropriate Public Education (FAPE.) Special education services are one way to accomplish that requirement for some students with disabilities. Within 30 days of the completion of the evaluation, the individuals that took part in the process thus far will meet to determine eligibility. In simple terms, a student is considered eligible for special education services if (1) the child has a disability as defined by IDEA which negatively impacts his/her educational performance, and (2) the child needs special education services in order to benefit from education. Not all students are determined to be eligible for special education services. There are multiple reasons why a student may not qualify for special education services including not having a disability that negatively impacts his or her education. However, these students may need help to access the academic curricula. In these situations, the school will need to work out a plan to provide other services for the student. If the team determines that the student is eligible for special education services, then a formal Individualized Education Program (IEP) team will be formed to develop a plan of special education services for the student. PHASE SIX: IEP Meeting (IEP and LRE)The Individualized Education Program (IEP) is a legal contract between the parents and the school district that describes the special education services to be provided by the local education agency which is the local school district. While IEP documents vary, the basic parts of an IEP include: A student profile that provides background information about the student. The profile will include strengths and weaknesses of the student, information regarding performance in the classroom and on formal assessments, and the reason he or she is receiving special education services. IEP initiation and duration dates: the goals expressly stated in an IEP begin on the date, stated in the IEP meeting, and are in effect until the date stated in the IEP. These IEP goals are reviewed, monitored and updated based on student progress. For most students, IEP goals are in place for one academic year. A statement of “special instructional factors” (such as the need for assistive technology, braille, or transition services). If the student requires any of the special instructional factors, they should be addressed in the IEP.A statement of special transportation needs; A statement of opportunities to participate in nonacademic and extracurricular activities with their non-disabled peers. A statement of the frequency and method of reports of goal attainment for parents or guardians. Benchmark pages are included and focus on specific areas that need special education services (such as reading, math, PE, etc.). The benchmark pages include: Present Levels of Academic Achievement and Functional Performance (PLAAFP) statements, Measurable Annual Goals, Evaluations used to measure annual goals, Benchmarks to be achieved to meet the annual goals, Special education and related services needed to achieve the annual goal (includes frequency of services, amount of time, location, and responsible agencies).A Behavior Intervention Plan (BIP) if the student’s behavior is a concern and a functional behavioral assessment has been done or needs to be conducted, For students 16 years and older; the plans and activities for the student’s transition from high school will be addressed The signature page which provides a statement of least restrictive environment (LRE) and has the signatures of all members present at the meeting. The benchmark pages are the “meat” of most IEPs and can be developed by any member of the team. Typically, these pages are developed by the special education teachers in collaboration with the parents, general education teachers, related service providers, and behavioral specialists. IN some school districts, the IEP meeting may be referred to as the ARD meeting. ARD stands for Admission, Review, and Dismissal. The IEP team (also called IEP committee or ARD committee) is formed for the purpose of 1) developing the IEP, the formal plan of special education services; 2) overseeing the implementation of the plan, 3) evaluating the effectiveness of the plan annually, and 4) developing future plans as needed. The IEP team can also meet as needed when unique issues present themselves during the academic year (such as with behavior issues).The IEP team is composed of the following: The parent(s) or legal guardian(s) of the student with a disability; At least one general education teacher of the student if the student is or may be participating in the regular education environment for any classes; At least one special education teacher of the student or a special education provider of the student; A representative of the local educational agency (LEA) who is (1) qualified to supervise the needs of the student, (2) is knowledgeable of the general curriculum, (3) is knowledgeable about the availability of resources of the public agency, and (4) has the authority to commit agency resources; This person is frequently a principal or assistant principal of the student's campus. An individual who can interpret the instructional implications of evaluations (typically an educational diagnostician, school psychologist, or specially-trained special education teacher);The student, when appropriate; and Other individuals asked to attend at the discretion of the school or the parent who have knowledge or special expertise regarding the student (such as related service providers and/or family members or family friends maintaining a close relationship with the student). Parents also have the right to invite an advocate if they so desire. Depending on the age of the student, other individuals may be included in the meeting including rehabilitation or transition service providers or early intervention representatives. PHASE SEVEN: IEP Implementation Once the IEP is developed and signed by members of the IEP team it is the responsibility of the entire IEP team to ensure that the IEP is implemented. The IEP team may meet as frequently as needed to discuss the implementation of the IEP. School personnel are required to provide documentation of the mastery of benchmarks and annual goals. The IEP document is a “living” document and can be altered during the school term if needed. The IEP goals and benchmarks provide the objectives for the education of the student and prescribe what services will be provided by the local school district and school campus to achieve those objectives. However, it must be understood that school agencies are not required to meet all the goals within the school term, but they must provide evidence of a “good faith effort” toward achieving the goals. PHASE EIGHT: Reevaluation each year, the IEP team is required to meet for the dual purpose of evaluating the implementation of the current IEP and to develop the next annual IEP. During these annual meetings, the IEP team should discuss the positive and negative elements of the special education services provided and determine, based on any new assessment data, what services should be provided in the upcoming school year. While the IEP is redeveloped each year, the IEP team does not have to conduct the battery of assessments each year. At a minimum, the IEP team is to determine if formal evaluation is required every three years. However, the IEP team can ask that formal evaluations be conducted more frequently if needed. There are times when, after the reevaluation takes place, it is determined that the student does not need special education services. One example of this might be young children who are provided speech and language services and have developed the ability to speak without problems. In this case, the IEP team will need to file appropriate documentation to support the fact that the student no longer is eligible for services and the IEP team will disband for this student.

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The Special Education Referral Process. Because of the  federal laws and regulations that govern the education of students with disabilities, a process has evolved over time that governs the special education referral process. The purpose of this module is to provide an overview to the “Special Education Process” so that the learner may understand the global procedures for providing a student with disabilities a free and appropriate education (FAPE).PHASE ONE: Recognitional that all  students begin their educational careers with needs. For many, it is the need for guidance by a professional educator who can expand their knowledge and understanding of the world around them. While each student brings a different level of knowledge and skills to his or her first class, the individual’s needs are typically met by a highly-qualified educator. However, there are children who have unique needs that are atypical for children of their age and may not be within the expertise of the general education classroom teacher. It is during this time that the teacher (or parent, administrator, or counselor) recognizes a consistent need or problem exhibited by the student. The recognition of a discrepancy in the student’s academic, social/emotional, behavioral, and/or physical ability and his or her age may signal the need for additional academic or behavioral supports. During this phase, it is important to call a meeting with the parents or guardians. The teacher should provide examples of the student’s work and/or anecdotal classroom notes regarding the student’s needs. In the meeting, the teacher and the parent/guardian should explore the following: Is the issue a recurrent problem or new? The parents will be best able to present invaluable insight into the knowledge, skills, and needs of their child. The teacher should document when they recognized an issue. Is the issue constant? All children may exhibit unique needs or problems at some point but it may only be an isolated episode for that day. The teacher should document any issue that is constant, providing dates and information about the behavior of concern or skill deficit exhibited by the student. Is the issue appropriate for children of this age? How many kindergarten students have been seen crying the first days of school? This behavior is a typical occurrence and should not be confused with an atypical behavior. The teacher should have a strong understanding of the cognitive, behavioral, and physical development levels of typical students they teach. It is possible that the problems that are being exhibited by the student may be “solved” with the careful execution of a cooperative plan of action between the teacher and the parents. The teacher and the parent should document their plan of action, strategies utilized with the student, and progress. The teacher should continue to collect student work samples and keep assessment data relevant to the student’s unique needs. It is critically important that the teacher document all actions and strategies used in the classroom and the impact on the student. The student’s parents/guardians should be kept informed of any changes in the student’s progress. If the teacher, after a period of time, determines the problem cannot be controlled with simple classroom interventions, then the teacher should notify the parents/guardians that they will be asking for outside help from a school-based pre-referral team.PHASE TWO: Pre-referral The pre-referral step in the special education process is more formal than providing simple and temporary accommodations for students. Pre-referral intervention is to identify, develop, and implement alternative education strategies for students who have recognized problems in the classroom before the student is referred to special education. Pre-referral intervention is typically conducted by a Student Centered Team (also called early intervention team, intervention assistance team, student support team, teacher assistance team, or instructional support team). The pre-referral team usually consists of the teacher, the parents/guardians, an administrator, other general education teachers, nurse, guidance counselor, and any other adult involved in the education of the student. The general education teacher provides background information regarding the problem exhibited by the student and the team works together to develop possible solutions. Because of changes to IDEA in 2004, many states and independent school districts have begun using a more formal and systematic pre-referral process called response to intervention (RTI). “RTI is a model designed to address the needs of all children through a continuum of services, which include: High-quality instruction and tiered evidence-based or practice-based intervention strategies aligned with individual student needs; Frequent monitoring of progress to make results-based academic or behavioral decisions; and Application of child response data to important educational decisions (such as those regarding placement, intervention, curriculum, and instructional goals and methodologies)” (TEA, 2007).RTI provides three levels of intervention for students who are experiencing problems. Generally, the first level (sometimes referred to as Tier 1) is focused on utilizing high-quality general education instruction in the core curriculum with all students. RTI theorizes that around 80% of all students will respond positively to core curriculum and behavior systems. The second level (or Tier 2) provides targeted group instruction or some form of group remediation to improve performance. The RTI model believes that second level services will improve performance for approximately 15% of all students. If performance does not improve in the second level, then students are moved to the third level which consists of intensive, individualized interventions. Whether the school uses pre-referral teams or the more formal RTI process, the intent is to provide interventions that will help the student achieve success without entering special education. However, if these interventions do not improve the student’s performance, then the student will be referred for an assessment to determine possible eligibility for special education services. PHASE THREE: Referral for Special Education Evaluation If, after interventions in the general education classroom, the student continues to experience difficulty, school personnel may refer the child for a special education evaluation. Referrals for determination of eligibility for special education services may be initiated by: School personnel (including general education teachers, special education teachers, counselors, administrators, etc.);Child’s parent(s) or legal guardian(s);Any other person involved in the education or care of the child. The official referral begins the formal process of determining eligibility for special education services. Once a referral is provided, the school must obtain consent from the parent(s) or legal guardian(s) to begin the evaluation phase of the referral process. PHASE FOUR: Special Education Evaluation IDEA requires that students referred for special education services receive a nondiscriminatory multi-factored evaluation. The school district is required to complete the evaluation within 60 days of the referral date. The evaluation is to be conducted by a multidisciplinary team that will consist of individuals who can bring different perspectives and expertise to the evaluation. Some examples of team members include: Educational Diagnostician (also called Psychometrist) or School Psychologist: These professionals are qualified to conduct all types of educational assessments including intelligence (IQ), achievement, behavior, etc. Special Educators: These individuals are qualified to conduct some types of achievement and behavior evaluations as well as informal observations. General Educators: These individuals provide documentation of the problems of the specific student. Parent(s) or Legal Guardian(s): The parents or legal guardians provide valuable insight into the student’s behavior and personality in other environments.*Related Service Providers (Physical Therapist, Occupational Therapist, Audiologist, Orientation and Mobility Specialist, etc.): These specialists provide information pertaining to specific areas of concern that have been assessed. Medical Doctors (including psychiatrists, ophthalmologists, and optometrists): Depending on the disability of the student, medical records can also be used in the determination of eligibility for special education services.* Parents of students with developmental disabilities must decide whether to complete the legal process to become the legal guardian once their child reaches 18 years old, the age of majority. According to Texas state law, this process is separate from the required school transition planning process. The evaluation must be comprehensive and use evaluation tools and strategies that are technically sound and accepted. Most students receive a battery of formal evaluations that measure:, informal observations and documentation of the student’s past work should also be used during the eligibility determination meetings. Assessments may not be biased in regard to race, culture, language, or disability. The materials and procedures must be administered in the language and form most likely to provide accurate information on what the child knows and can do. PHASE FIVE: Eligibility (FAPE)IDEA states that each child is entitled to a Free Appropriate Public Education (FAPE.) Special education services are one way to accomplish that requirement for some students with disabilities. Within 30 days of the completion of the evaluation, the individuals that took part in the process thus far will meet to determine eligibility. In simple terms, a student is considered eligible for special education services if (1) the child has a disability as defined by IDEA which negatively impacts his/her educational performance, and (2) the child needs special education services in order to benefit from education. Not all students are determined to be eligible for special education services. There are multiple reasons why a student may not qualify for special education services including not having a disability that negatively impacts his or her education. However, these students may need help to access the academic curricula. In these situations, the school will need to work out a plan to provide other services for the student. If the team determines that the student is eligible for special education services, then a formal Individualized Education Program (IEP) team will be formed to develop a plan of special education services for the student. PHASE SIX: IEP Meeting (IEP and LRE)The Individualized Education Program (IEP) is a legal contract between the parents and the school district that describes the special education services to be provided by the local education agency which is the local school district. While IEP documents vary, the basic parts of an IEP include: A student profile that provides background information about the student. The profile will include strengths and weaknesses of the student, information regarding performance in the classroom and on formal assessments, and the reason he or she is receiving special education services. IEP initiation and duration dates: the goals expressly stated in an IEP begin on the date, stated in the IEP meeting, and are in effect until the date stated in the IEP. These IEP goals are reviewed, monitored and updated based on student progress. For most students, IEP goals are in place for one academic year. A statement of “special instructional factors” (such as the need for assistive technology, braille, or transition services). If the student requires any of the special instructional factors, they should be addressed in the IEP.A statement of special transportation needs; A statement of opportunities to participate in nonacademic and extracurricular activities with their non-disabled peers. A statement of the frequency and method of reports of goal attainment for parents or guardians. Benchmark pages are included and focus on specific areas that need special education services (such as reading, math, PE, etc.). The benchmark pages include: Present Levels of Academic Achievement and Functional Performance (PLAAFP) statements, Measurable Annual Goals, Evaluations used to measure annual goals, Benchmarks to be achieved to meet the annual goals, Special education and related services needed to achieve the annual goal (includes frequency of services, amount of time, location, and responsible agencies).A Behavior Intervention Plan (BIP) if the student’s behavior is a concern and a functional behavioral assessment has been done or needs to be conducted, For students 16 years and older; the plans and activities for the student’s transition from high school will be addressed The signature page which provides a statement of least restrictive environment (LRE) and has the signatures of all members present at the meeting. The benchmark pages are the “meat” of most IEPs and can be developed by any member of the team. Typically, these pages are developed by the special education teachers in collaboration with the parents, general education teachers, related service providers, and behavioral specialists. IN some school districts, the IEP meeting may be referred to as the ARD meeting. ARD stands for Admission, Review, and Dismissal. The IEP team (also called IEP committee or ARD committee) is formed for the purpose of 1) developing the IEP, the formal plan of special education services; 2) overseeing the implementation of the plan, 3) evaluating the effectiveness of the plan annually, and 4) developing future plans as needed. The IEP team can also meet as needed when unique issues present themselves during the academic year (such as with behavior issues).The IEP team is composed of the following: The parent(s) or legal guardian(s) of the student with a disability; At least one general education teacher of the student if the student is or may be participating in the regular education environment for any classes; At least one special education teacher of the student or a special education provider of the student; A representative of the local educational agency (LEA) who is (1) qualified to supervise the needs of the student, (2) is knowledgeable of the general curriculum, (3) is knowledgeable about the availability of resources of the public agency, and (4) has the authority to commit agency resources; This person is frequently a principal or assistant principal of the student's campus. An individual who can interpret the instructional implications of evaluations (typically an educational diagnostician, school psychologist, or specially-trained special education teacher);The student, when appropriate; and Other individuals asked to attend at the discretion of the school or the parent who have knowledge or special expertise regarding the student (such as related service providers and/or family members or family friends maintaining a close relationship with the student). Parents also have the right to invite an advocate if they so desire. Depending on the age of the student, other individuals may be included in the meeting including rehabilitation or transition service providers or early intervention representatives. PHASE SEVEN: IEP Implementation Once the IEP is developed and signed by members of the IEP team it is the responsibility of the entire IEP team to ensure that the IEP is implemented. The IEP team may meet as frequently as needed to discuss the implementation of the IEP. School personnel are required to provide documentation of the mastery of benchmarks and annual goals. The IEP document is a “living” document and can be altered during the school term if needed. The IEP goals and benchmarks provide the objectives for the education of the student and prescribe what services will be provided by the local school district and school campus to achieve those objectives. However, it must be understood that school agencies are not required to meet all the goals within the school term, but they must provide evidence of a “good faith effort” toward achieving the goals. PHASE EIGHT: Reevaluation each year, the IEP team is required to meet for the dual purpose of evaluating the implementation of the current IEP and to develop the next annual IEP. During these annual meetings, the IEP team should discuss the positive and negative elements of the special education services provided and determine, based on any new assessment data, what services should be provided in the upcoming school year. While the IEP is redeveloped each year, the IEP team does not have to conduct the battery of assessments each year. At a minimum, the IEP team is to determine if formal evaluation is required every three years. However, the IEP team can ask that formal evaluations be conducted more frequently if needed. There are times when, after the reevaluation takes place, it is determined that the student does not need special education services. One example of this might be young children who are provided speech and language services and have developed the ability to speak without problems. In this case, the IEP team will need to file appropriate documentation to support the fact that the student no longer is eligible for services and the IEP team will disband for this student.

# data[].attributes.body
https://www.parentcenterhub.org/

https://www.parentcenterhub.org/emotionaldisturbance/

https://www.parentcenterhub.org/emotionaldisturbance/

http://www.worrywisekids.org/

https://childmind.org/

# data[].attributes.body
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Sophia F. Dziegielewski. (2015). DSM-5 in Action. Wiley.

Renée M. Tobin, & Alvin E. House. (2016). DSM-5® Diagnosis in the Schools. The Guilford Press.

James Morrison. (2014). DSM-5® Made Easy : The Clinician’s Guide to Diagnosis. The Guilford Press.

Sarah Edison Knapp, Arthur E. Jongsma, J., & Catherine L. Dimmitt. (2014). The School Counseling and School Social Work Treatment Planner, with DSM-5 Updates, 2nd Edition: Vol. Second edition. Wiley.

Sophia F. Dziegielewski. (2015). DSM-5 in Action. Wiley.

Renée M. Tobin, & Alvin E. House. (2016). DSM-5® Diagnosis in the Schools. The Guilford Press.

James Morrison. (2014). DSM-5® Made Easy : The Clinician’s Guide to Diagnosis. The Guilford Press.

Eating disorders : mind, body, and society. (2009). Films Media Group.

Eating Disorders : The Hunger Within. (2010). Films Media Group.

Eating Disorders. (2012). Films Media Group.

Carney, J. M., & Scott, H. L. (2012). Eating Issues in Schools: Detection, Management, and Consultation With Allied Professionals. Journal of Counseling & Development, 90(3), 290–297. https://doi.org/10.1002/j.1556-6676.2012.00037.x

Bob Palmer. (2015). Helping People with Eating Disorders : A Clinical Guide to Assessment and Treatment: Vol. Second edition. Wiley-Blackwell.

Sarah Edison Knapp, Arthur E. Jongsma, J., & Catherine L. Dimmitt. (2014). The School Counseling and School Social Work Treatment Planner, with DSM-5 Updates, 2nd Edition: Vol. Second edition. Wiley.

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Anxiety on the Rise: A survey of campus counseling centers finds increased demand for services, as well as additional positions and more diversity in hiring. More than half of the college students who visited their campus counseling centers during the 2015-16 academic year reported symptoms of anxiety, according to a survey by the Association for University and College Counseling Center Directors. This marks the seventh year in a row that anxiety has been the top complaint among students seeking mental health services. This year, 51 percent of students who visited a counseling center reported having anxiety, followed by depression (41 percent), relationship concerns (34 percent) and suicidal ideation (20.5 percent). Many students reported experiencing multiple conditions at once. Since 2009, when anxiety overtook depression as the No. 1 concern among college students, the number of students experiencing anxiety has steadily increased. This survey was conducted between September 2015 and August 2016. In total, 529 counseling center directors representing that many institutions responded to the survey, with an even split between public and private institutions. The majority of respondents came from four-year colleges, but community colleges, professional schools and art schools were also included. IN an effort to reflect the makeup of their student bodies, counseling centers have diversified their clinical staff members. Of new hires, 62.2 percent are white, 15.3 percent black, 7.5 percent Latino and 10 percent Asian. This compares to current clinical staff, who are 70.9 percent white, 10.1 percent black, 7.3 percent Latino and 7.9 percent Asian. "Student populations have become more diverse,” said Micky Sharma, president of the AUCCCD and director of counseling and consultation services at Ohio State University. “Counseling services work to create a staff that represents their student bodies. "At Ohio State, for example, the counseling center now offers clinical services in nine different languages to meet the needs of their international students, who make up about 12 percent of the student body, Sharma said. Regardless of race, ethnicity, gender or sexual orientation, “anyone could show up with anxiety or depression or a relationship issue,” Sharma said. “A university counseling center is charged with providing help for everybody. "Another key finding in the survey is that 41.6 percent of counseling centers hired additional staff members in the last academic year, compared to about 26 percent in 2011 and 36 percent in 2016.College counseling centers continue to grow to match the demands of their students, according to David Reetz, the lead researcher and coordinator for the 2016 survey and director of counseling and psychological services at the Rochester Institute of Technology. "More students are seeking services because we continue to be more and more aware that a student’s health and well-being have a lot to do with their success in their academic programs and the quality of their student life experience,” Reetz said. IN fact, of the students surveyed, about 72 percent who used counseling services said it helped their academic performance in some way. As more students continue to seek out mental health services and campus counseling centers try to keep up with new hires, the question of student wait times becomes key. For the first time, this year’s survey asked counseling center directors about average wait times for students based on the number of business days between when the appointment was scheduled and when it occurred. The survey team found that, on average, students waited between six and eight business days for counseling services. However, as might be expected, institutions with a lower ratio of professional staff to students saw shorter wait times.Reetz noted that the wait-time average is a “tricky number,” given that some students opt to schedule their first appointment farther out to accommodate their own schedules. "Students don’t necessarily want to be seen right away,” Reetz said, adding that, generally, “the more staff a center has, the shorter that wait time is between initial contact and first appointment

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Anxiety on the Rise: A survey of campus counseling centers finds increased demand for services, as well as additional positions and more diversity in hiring. More than half of the college students who visited their campus counseling centers during the 2015-16 academic year reported symptoms of anxiety, according to a survey by the Association for University and College Counseling Center Directors. This marks the seventh year in a row that anxiety has been the top complaint among students seeking mental health services. This year, 51 percent of students who visited a counseling center reported having anxiety, followed by depression (41 percent), relationship concerns (34 percent) and suicidal ideation (20.5 percent). Many students reported experiencing multiple conditions at once. Since 2009, when anxiety overtook depression as the No. 1 concern among college students, the number of students experiencing anxiety has steadily increased. This survey was conducted between September 2015 and August 2016. In total, 529 counseling center directors representing that many institutions responded to the survey, with an even split between public and private institutions. The majority of respondents came from four-year colleges, but community colleges, professional schools and art schools were also included. IN an effort to reflect the makeup of their student bodies, counseling centers have diversified their clinical staff members. Of new hires, 62.2 percent are white, 15.3 percent black, 7.5 percent Latino and 10 percent Asian. This compares to current clinical staff, who are 70.9 percent white, 10.1 percent black, 7.3 percent Latino and 7.9 percent Asian. "Student populations have become more diverse,” said Micky Sharma, president of the AUCCCD and director of counseling and consultation services at Ohio State University. “Counseling services work to create a staff that represents their student bodies. "At Ohio State, for example, the counseling center now offers clinical services in nine different languages to meet the needs of their international students, who make up about 12 percent of the student body, Sharma said. Regardless of race, ethnicity, gender or sexual orientation, “anyone could show up with anxiety or depression or a relationship issue,” Sharma said. “A university counseling center is charged with providing help for everybody. "Another key finding in the survey is that 41.6 percent of counseling centers hired additional staff members in the last academic year, compared to about 26 percent in 2011 and 36 percent in 2016.College counseling centers continue to grow to match the demands of their students, according to David Reetz, the lead researcher and coordinator for the 2016 survey and director of counseling and psychological services at the Rochester Institute of Technology. "More students are seeking services because we continue to be more and more aware that a student’s health and well-being have a lot to do with their success in their academic programs and the quality of their student life experience,” Reetz said. IN fact, of the students surveyed, about 72 percent who used counseling services said it helped their academic performance in some way. As more students continue to seek out mental health services and campus counseling centers try to keep up with new hires, the question of student wait times becomes key. For the first time, this year’s survey asked counseling center directors about average wait times for students based on the number of business days between when the appointment was scheduled and when it occurred. The survey team found that, on average, students waited between six and eight business days for counseling services. However, as might be expected, institutions with a lower ratio of professional staff to students saw shorter wait times.Reetz noted that the wait-time average is a “tricky number,” given that some students opt to schedule their first appointment farther out to accommodate their own schedules. "Students don’t necessarily want to be seen right away,” Reetz said, adding that, generally, “the more staff a center has, the shorter that wait time is between initial contact and first appointment

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. By Emily Tate, March 29, 2017

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Lifetime Prevalence of Mental Disorders in US Adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A) 

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Lifetime Prevalence of Mental Disorders in US Adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A) 

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Lifeline of Prevalence of Mental Disorders in us Adolescents

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How to Help a Child With an Anxiety Disorder

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How to Help a Child With an Anxiety Disorder

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When worrying gets in the way of a child’s functioning, parents need to get help rather than arranging the child’s life to avoid the occasions of anxiety.

Anxiety disorders, the most common mental health problems in children and adolescents, often go untreated while children suffer, even though there are effective treatments available, according to a new report on anxiety in children and adolescents from the Child Mind Institute in New York. Anxiety may be missed because it doesn’t necessarily declare itself with attention-getting disruptive behaviors; in fact, symptoms may keep some children quiet and inhibited, though in other children, alternatively, anxiety may be misunderstood as oppositional behavior.

Adults may also assume that anxiety in a child is just a phase to be outgrown. A certain amount of anxiety is a normal aspect of development for young children — consider separation anxiety, for example — and it can even be protective, since children need to learn to keep themselves safe and anticipate certain kinds of dangers. But when worrying or avoiding possible threats gets in the way of a child’s functioning or a child’s enjoyment, it should be a signal to parents that help is needed, not just watching and waiting, not arranging the child’s life to avoid the occasions of anxiety.

Kathleen Merikangas, the senior investigator and chief of the Genetic Epidemiology Research Branch at the National Institute of Mental Health, said, “To me, anxiety is one of the most underrecognized or under-treated conditions of childhood and adolescence.” These children can get missed, she said, because they may seem to be functioning well; many don’t have the kinds of developmental problems or attention issues that draw attention in school, though they may be suffering.

Consider the child whose anxiety about speaking in public gets in the way of participating in class. The child may be silent out of a fear of being laughed at or otherwise rejected, Dr. Merikangas said, but to the teacher, it may look like the child is just not interested. Environmental modifications can really help these children thrive in school, she said; for example, working in small groups with children they know.

The new report, released in September, summarizes the evidence that early temperament in children predicts their later behavior patterns around anxiety; toddlers who show what are called “behaviorally inhibited” behaviors, which parents are likely to perceive as extreme shyness, or anxiety around new people, are more likely to develop social anxiety later on. That doesn’t mean that shyness is pathological (as with all varieties of temperament, there’s a wide range of function), but it does suggest how important it is to help a child with this temperament who develops difficulties.

The tendency toward anxiety — and toward some specific forms of anxiety, like phobias — may persist throughout childhood and adolescence and into adulthood. And anxiety is closely tied to depression, Dr. Merikangas said. Although there have been reports that anxiety rates among American teenagers have soared, she cited evidence that the international rates of the underlying disorders had stayed consistent from 1998 to 2013; there is no global “epidemic” of clinical anxiety disorders, she said.
But with rates of suicide and suicidal ideation on the rise, it’s particularly important to provide information to schools and to parents about recognizing anxiety and getting children help.

Dr. Harold Koplewicz, the president of the Child Mind Institute, said that when anxiety disorders in children are left untreated, anxiety can inhibit their lives, making standard daily activities difficult, from attending school to sleeping in their own beds, and lead to many extra visits to the school nurse or the pediatrician.

But beyond that, he said, “people underestimate that this is a gateway disorder.” If children don’t get help with these disorders, they may be at risk to develop other mental health problems; the child with severe separation anxiety may develop panic disorder, he said; the child with untreated general anxiety may be at greater risk for depression.

Dr. Merikangas was a co-investigator on a national study of mental disorders in adolescents, which has shown both that anxiety disorders were the most common mental health problems in adolescents in the United States, and also the problems that showed up earliest in those children’s lives — the mean age of onset for anxiety disorders was 6. But many adolescents had never received treatment. That makes it essential to get the word out, Dr. Merikangas said, that anxiety is “one of the most treatable symptoms and syndromes, we can really change their lives with minimal intervention.”

“All these disorders are remarkably treatable,” Dr. Koplewicz said. There are highly effective behavioral and psychosocial therapies, including cognitive behavioral therapies, to help children cope with the demands of daily life. For children who don’t respond to psychosocial therapies, he said, medications can be added.

But perhaps because anxiety is a normal response, parents often believe that even severe and disabling anxiety symptoms are just a phase, and on average, there is a two-year lag between the time children develop anxiety and the time they get help. “It’s bad for these children’s brains,” he said. “Having your brain’s thermostat miss-set is not good for your brain.”

“Anxiety can manifest itself along a continuum,” said Rachel Busman, the senior director of the anxiety disorders center at the Child Mind Institute. The report shows that there is some overlap with physical illnesses, such as chronic headaches or stomach aches, often coordinated with school. “That could be a kid’s way of saying, ‘I’m anxious,’” she said.

And when a child who is having a lot of difficulty with separation gets into the classroom, Dr. Busman said, that child may start throwing things, or running and hiding, and that “bad behavior” may represent the fight or flight response of anxiety. “We’ve also seen kids who have intense social anxiety and their way of managing it is to be class clown,” she said.

Treating children with anxiety always means working with their parents. Jerry Bubrick, senior clinical psychologist at the anxiety disorders center of the Child Mind Institute, said that when children are little, it’s normal for parents to operate in “fix-it mode,” blocking the staircase so a toddler doesn’t tumble down, averting problems before they happen.

As children get older, parents normally pull back, helping children find solutions of their own. “But anxious parents of anxious children remain in fix-it mode,” he said, helping their children avoid the situations that make them anxious. Therapy involves exposing children to those situations and helping them develop strategies to manage them; with treatment, Dr. Bubrick said, parents can “let the child experience the anxiety and learn to tolerate and overcome it on their own.”

“If you see things you’re not sure about, talk to the preschool, talk to the pediatrician, be open to the idea that maybe there is anxiety,” even in a young child, Dr. Busman said. Separation anxiety can be a problem even in children who are able to go to school, she said. Parents should pay attention if a child can’t be left with a babysitter, a child can’t sleep alone at home.  “These are the kids, they go into the bathroom, and they’re like, are you still there?” she said. “We do see really young anxious children.”

“If your child is suffering distress and dysfunction, reach out to your pediatrician,” Dr. Koplewicz said. When you get to a mental health professional, “make sure you ask the right questions,” he said, including asking whether that person has specific experience with treating anxiety and how long the treatment is expected to take.

“You want a professional who understands what they’re doing and can explain to you what they’re doing.”

By: Klass, P. (2018). https://www.nytimes.com/2018/10/01/well/family/how-to-help-a-child-with-an-anxiety-disorder.html

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IDEA 2004 Definition of Emotional Disability/Emotional Disturbance

A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

An inability to learn that cannot be explained by intellectual, sensory, or health factors.

An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

Inappropriate types of behavior or feelings under normal circumstances.

A general pervasive mood of unhappiness or depression.

A tendency to develop physical symptoms or fears associated with personal or school problems.

Emotional disability includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.

General Characteristics of Emotional Disturbance vs. Social Maladjustment

A student who receives special education services under the category of Emotional Disability has emotional problems of some kind that are adversely affecting his/her educational performance. Usually schools look at grades, discipline records, and performance on achievement tests to quantify educational impact. In determining eligibility for Emotional Disability, several evaluations are typically completed. A school will conduct psychological testing by a school psychologist, which will include cognitive testing and social/emotional measures (rating scales, interviews, observations). Educational testing is typically completed to determine current levels of achievement in reading, writing, math, and other educational areas. Additionally, a Sociocultural evaluation or interview by a school social worker is typically completed with a parent to rule out environmental factors and obtain a developmental history. (See SPED testing for more information)

Often, the most difficult part of determining eligibility for special education services in this category is determining if the student has an emotional disability or social maladjustment. The following is adapted from a chart that was shown at a training I attended by Bruce Bracken. He adapted it from Social Maladjustment: A Guide to Differential Diagnosis and Educational Options (Wayne County Regional Educational Service Agency – Michigan, 2004).

Behavior Area | Emotional Disturbance | Socially Maladjusted
School Behavior | Unable to comply with teacher requests; needy or has difficulty asking for help | Unwilling to comply with teacher requests; truancy; rejects help
Attitude Toward School | School is a source of confusion or angst; does much better with structure | Dislikes school, except as a social outlet; rebels against rules and structure
School Attendance | Misses school due to emotional or psychosomatic issues | Misses school due to choice
Educational Performance | Uneven achievement; impaired by anxiety, depression, or emotions | Achievement influenced by truancy, negative attitude toward school, avoidance
Peer Relations and Friendships | Difficulty making friends; ignored or rejected | Accepted by a same delinquent or socio-cultural subgroup
Perceptions of Peers | Perceived as bizarre or odd; often ridiculed | Perceived as cool, tough, charismatic
Social Skills | Poorly developed; immature; difficulty reading social cues; difficulty entering groups | Well developed; well attuned to social cues
Interpersonal Relations | Inability to establish or maintain relationships; withdrawn; social anxiety | Many relations within select peer group; manipulative; lack of honesty in relationships
Interpersonal Dynamics | Poor self-concept; overly dependent; anxious; fearful; mood swings; distorts reality | Inflated self concept; independent; underdeveloped conscience; blames others; excessive bravado
Locus of Disorder | Affective disorder; internalizing | Conduct disorder, externalizing
Aggression | Hurts self and others as an end | Hurts others as a means to an end
Anxiety | Tense; fearful | Appears relaxed; �cool�
Affective Reactions | Disproportionate reactions, but not under student’s control | Intentional with features of anger and rage; explosive
Conscience | Remorseful; self critical; overly serious | Little remorse; blaming; non-empathetic
Sense of Reality | Fantasy; naïve; gullible; thought disorders | �Street-wise�; manipulates facts and rules for own benefit
Developmental Appropriateness | Immature; regressive | Age appropriate or above
Risk Taking | Avoids risks; resists making choices | Risk taker; �daredevil�
Substance Abuse | Less likely; may use individually | More likely; peer involvement
Adapted from Social Maladjustment: A Guide to Differential Diagnosis and Educational Options (Wayne County Regional Educational Service Agency – Michigan , 2004)

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Behavior Disorders: Definitions, Characteristics & Related Information

Information about Emotional/Behavioral Disorders

Definition
IDEA defines emotional disturbance as follows:

“…a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems.”

As defined by IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.

Characteristics
As is evident in IDEA’s definition, emotional disturbances can affect an individual in areas beyond the emotional. Depending on the specific mental disorder involved, a person’s physical, social, or cognitive skills may also be affected. The National Alliance on Mental Illness (NAMI) puts this very well:

Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Some of the characteristics and behaviors seen in children who have an emotional disturbance include:
◾Hyperactivity (short attention span, impulsiveness);
◾Aggression or self-injurious behavior (acting out, fighting);
◾Withdrawal (not interacting socially with others, excessive fear or anxiety);
◾Immaturity (inappropriate crying, temper tantrums, poor coping skills); and
◾Learning difficulties (academically performing below grade level).

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings.

Many children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.

Causes
No one knows the actual cause or causes of emotional disturbance, although several factors—heredity, brain disorder, diet, stress, and family functioning—have been suggested and vigorously researched. A great deal of research goes on every day, but to date, researchers have not found that any of these factors are the direct cause of behavioral or emotional problems.

According to NAMI, mental illnesses can affect persons of any age, race, religion, or income. Further:

Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.

Frequency
According to the CDC (Centers for Disease Control and Prevention), approximately 8.3 million children (14.5%) aged 4–17 years have parents who’ve talked with a health care provider or school staff about the child’s emotional or behavioral difficulties. (6) Nearly 2.9 million children have been prescribed medication for these difficulties.

Specific Emotional Disturbances

As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders. Let’s take a brief look at some of the most common of these.

Anxiety Disorders

We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder.

As with the term emotional disturbance, “anxiety disorder” is an umbrella term that actually refers to several distinct disabilities that share the core characteristic of irrational fear: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias.

According to the Anxiety Disorders Association of America, anxiety disorders are the most common psychiatric illnesses affecting children and adults. They are also highly treatable. Unfortunately, only about 1/3 of those affected receive treatment.

Bipolar Disorder

Also known as manic-depressive illness, bipolar disorder is a serious medical condition that causes dramatic mood swings from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood.

For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment.

Conduct Disorder

Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. (14) This may include some of the following behaviors:
◾aggression to people and animals;
◾destruction of property;
◾deceitfulness, lying, or stealing; or
◾truancy or other serious violations of rules.

Although conduct disorder is one of the most difficult behavior disorders to treat, young people often benefit from a range of services that include:
◾training for parents on how to handle child or adolescent behavior;
◾family therapy;
◾training in problem solving skills for children or adolescents; and
◾community-based services that focus on the young person within the context of family and community     influences.

Eating Disorders

Eating disorders are characterized by extremes in eating behavior—either too much or too little—or feelings of extreme distress or concern about body weight or shape. Females are much more likely than males to develop an eating disorder.

Anorexia nervosa and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging. Both of these disorders are potentially life-threatening.

Binge eating is also considered an eating disorder. It’s characterized by eating excessive amounts of food, while feeling unable to control how much or what is eaten. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives.

According to the National Eating Disorders Association:

The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or counseling, coupled with careful attention to medical and nutritional needs. Some medications have been shown to be helpful. Ideally, whatever treatment is offered should be tailored to the individual, and this will vary according to both the severity of the disorder and the patient’s individual problems, needs, and strengths.

Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder (which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called “rituals,” however, provides only temporary relief, and not performing them markedly increases anxiety.

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. Treatment for most people with OCD should include one or more of the following:
◾therapist trained in behavior therapy;
◾Cognitive Behavior Therapy (CBT);
◾medication (usually an antidepressant).

Psychotic Disorders

“Psychotic disorders” is another umbrella term used to refer to severe mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder. There are others as well.

Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy (a type of counseling).

Source Material
National Institute of Mental Health (NIMH)
Code of Federal Regulations, Title 34, §300.8(c)(4)
National Alliance on Mental Illness
U.S. Department of Education
Anxiety Disorders Association of America
American Academy of Adolescent and Child Psychiatry
National Mental Health Information Center
National Eating Disorders Association
National Dissemination Center for Children with Disabilities

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Trauma exposure and posttraumatic stress disorder among incarcerated men.

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Resource Guide for Bipolar Disorder and Depression Services and Referral II