End of the Year Data Reports

It is very important in running an ASCA Model School Counseling Program to collect, analyze, and share data. I log all students referred for individual counseling (those seen 3 or more times that I get permission to see); I do not log every child who stops to ask me questions or is upset about a playground disagreement with a friend. If you log the details of referrals by date, grade, reason for referral, etc and do an intervention a change in referrals can be outcome data. For my SMART goal for my own teacher evaluation I was trying to get a reduction in the number of students I needed to see for individual counseling for anxiety. I did classroom lessons at two grade levels and groups for emotional regulation in grades 1st - 5th. Anxiety went from being the number one referral reason to number six and the data showed a 41% decrease. I log my individual referrals EVERY DAY before I leave the building. I look at the data at the end of each quarter to determine what interventions the counseling program should be offering. I share this data with staff, parents, my advisory council, and other elementary counselors in my district. Data is a great way to show how students are different as a result of a comprehensive, data-driven counseling program.

Healing the Long-term Effects of Childhood Adversity

Two thirds of people have experienced at least one adverse childhood experience, from the likes of bereavement and divorce to abuse and neglect. In The Deepest Well Dr Burke Harris reveals the science behind childhood adversity and offers a new way of understanding the adverse events that affect us throughout our lifetime. Based on her own groundbreaking clinical work and public leadership, Dr Burke Harris shows us how we can disrupt this cycle through interventions that help retrain the brain and body, foster resilience, and help children, families, and adults live healthier, happier lives. Listen to the NPR broadcast about this research and how schools are changing as a result https://www.npr.org/the-deepest-well-healing-the-long-term-effects-of-childhood-adversity 

I learned so much from this book especially "Living with the Bear" which causes a dysregulated stress response that can be a daily pattern for some students. Dr. Burke also talks about all the physical health risks for students with early trauma. I hope all school counselors will read this book.

Out of Your Mind

This noncompetitive game is a good resource for individual and small groups to get to know what students are thinking and teach social skills. Out of Your Mind from
 playtherapysupply fosters empathy and teaches communication, listening, and decision-making skills.

The game consists of four card decks and a Feel Wheel—a conversation-starting spinner featuring 24 emotions. Each card deck presents activities that engage the imagination and inspire creativity:

• Imagine That - Through guided imagery, these cards encourage players to visualize themselves dealing with novel situations.
• Picture This - Endorsing the idea that a picture is worth a thousand words, these cards feature 4 or 5 drawings that help players express themselves.
• Voice a Choice - Multiple-choice questions invite players to share things about themselves.
• Remember When - These cards ask players to recall a memory.

Out of Your Mind helps reluctant children communicate effectively.  I use this game with students in fourth and fifth grade and I think it is a worthwhile resource for a school counselor's office.

Back to School: Part 4 - Effective Strategies for Helping Students Reduce Anxiety

Helping students with anxiety is a topic I have researched, lived, and presented on extensively. I share most of my presentations in LiveBinders so if you want to see the PowerPoint from the ASCA webinar, my state conference presentation, or from the ASCA National conference on anxiety check them out on the Anxiety, Stress, and Worry tab livebinders.com/ The binder also has links to some good articles and resources about helping children reduce anxiety.

There are new resources being developed all time to help children manage anxiety. For individuals, I begin by assessing how big a concern anxiety is for them. I do this a variety of ways but one all the students seem to favor is selecting the stone that represents the amount of discomfort their worries are currently causing them daily. I have a small pebble, a 1-2 inch rock, and a 4-5 inch rock that I keep on my window sill and bring out. I say, "you could have a little anxiety and it fits in your pocket and you only notice it occasionally, a medium size rock in your pocket that you would notice every time you moved, and a heavy rock that would weigh down your backpack." Once I know how big a problem the child perceives their anxiety issues to be I start assessing their coping tools. What have they tried so far that works to reduce their anxiety when they are stressed? What did not work? If I do see a student for ongoing short term counseling we set a goal to reduce anxiety and quantify it (for K-1 to make it a pebble and for grades 2-5 to reduce it from a __ to below 5 on a 10 point scale). I have found that students who are highly perfectionist or compulsive do not like groups and will only agree to individual support.

If possible I try to have most students with anxiety issues participate in small group counseling. It has many advantages and students  help one another as much as I help them. For groups, especially in grade 2 my students love worrywoos The books in this series are great and the website offers some good materials to create activities.I have done a whole group based on the worrywoos.  For more resources check out my pinterest/worry--anxiety-stress board. Some of my favorite picture books on anxiety are: Hey Warrior, Caterpillar's Wings, The Huge Bag of Worries, and The Worry Glasses. I generally teach a strategy each session and provide members opportunities to practice (calming exercises, deep breathing, mindfulness, etc.)

Stress is so pervasive in my school I teach a class lesson on techniques to reduce stress in grades 3-5. I think this further helps normalize anxiety issues and gives all students a few tools to self-regulate when experiencing normal stress. Since we use Second Step I use their lessons in the classroom.

Back to School: Part 3 - Counselors Supporting Students with Anxiety

Last year I wrote an article for ASCA "Address Student Anxiety" it provides lots of details about how to help  https://www.schoolcounselor.org/address-student-anxiety It discusses how to work with parents, staff, and students in the school environment.

One of the most useful books for counselors on this topic is Working with Parents of Anxious Children: Therapeutic Strategies for Encouraging Communication, Coping, & Change. The author, Christopher McCurry, outlines the behaviors and symptoms to look for in children with anxiety disorders, and offers a guide for clinicians who work with their families.

When working with children who are reluctant to come to school I try to make a deal with the families, you get them in the building and I will keep them here. Many parents have told me how much they appreciated knowing that if they hung tough and got their child in the door I would work out a plan to make them feel safe inside.

If you have been a counselor very long you have probably had a child brought to you after the bell crying and clinging to a parent. Once you can get the parent to leave the building then you need to start your work with the child with the goal to get them in their classroom ASAP. I generally start by saying, "I am here with you and you are safe." Often I begin by acknowledging that right now their body does not feel OK. This begins the psycho-education of teaching them common body responses to anxiety and normalizing what they are feeling but correcting the misconception that they are "sick". Next I address their emotions and generally have them scale their unpleasant feelings. I have many scales readily available in my office from simple color coded and 1-5 scales for the young ones to 1-10 with a range of emotion vocabulary for older students. Finally their distorted thinking needs to be addressed. I acknowledge that they are telling themselves they are not safe in school (away from parent) but in reality they know they are - it is just their "worry brain" sending a false alarm. Once the student begins to calm down I try to get them to walk with me to class. 

I find small groups to be the most effective place to teach skills to students who need help with emotion regulation. I cannot possibly provide individual counseling to all my students with anxiety issues.  I offer groups for students who need to develop coping tools to students in grade 1-5 using both CBT and Mindfulness.  I typically start my first round of groups in late September or early October which means the first few weeks of school I am probably doing more individual counseling than any other month. Students with anxiety issues are my number one referral reason and this is typical for most school counselors from both elementary and secondary levels according to surveys conducted by ASCA.

Explain going to therapy to young children

When I need to refer a student for private therapy parents of young children frequently ask me, "How should I explain that I am taking my child to a therapist?" I was happy to find this simple children's book written by a few private psychologist which explains some things that typically happen in therapy, about confidentiality, and that it will take more than one session to help. I am sure I will be sharing this with several parents once school resumes.

Feelings Ladders

In order for children to regulate emotions they need to understand that all feelings are okay and there are many nuances to emotions especially the level of intensity. Children need to have a rich emotional vocabulary to label and express feelings. They need to be very aware of  how they are reacting to choose an appropriate strategy to manage the feeling. For anger counselors often use a thermometer but for other feelings like levels of "Afraid" I find a ladder is a better visual for most kids. After we brainstorm and discuss a particular "feeling family" like afraid or unsure they can select and write on a blank ladder handout low, medium, and high feelings in that category they experience. For example:
Anxious, Nervous, Uneasy, Frightened, Panicky, and Terrified. For some students it may be helpful to color the steps that are low green, medium yellow, and high red. Using Feelings Ladders helps students better understand emotions and then you can discuss appropriate coping tools for each level. For example if a student is anxious they may need to use take a movement break, if they are uneasy slow deep breathing, and if they are panicky seek help from an adult or self-talk.  They can write their go to strategy for each level on this handout to help them remember what might work for them. I have used Feelings Ladders both individually and in small groups from grades 2-5. You could also make a blank Feelings Ladder poster and laminate it to reuse.

Help Your Anxious Child: Tips from a Child Therapist

This child therapist specializes in helping parents whose children have excessive anxiety and/or OCD. I recommend her website anxioustoddlers.com to parents frequently. She makes it clear that parents should not over accommodate  anxiety behaviors and let children avoid challenges like sleeping in own room or going to school. She cautions parents that getting frustrated and asking them to something they clearly are not ready to handle like a sleepover party are the two extreme parenting styles. She has some simple practical suggestions for a balanced approach for parents to use in coaching children to "crush" anxiety. She starts by telling parents to discuss anxiety with the child and give it a name to externalize it and keep it from eroding the child's self-esteem. That is where I usually begin when doing individual counseling with students who have too much anxiety. She has some great articles and has published two books, This video addresses a question I get every week as a school counselor,"How can I help my anxious child?"

Feeling Families

I find it helpful to teach students there are 4 basic groups of feelings that have different levels of energy. This is a way of organizing emotions and helping students think about what emotion they are having, to what degree, and select an appropriate coping strategy. These are the same categories used in CBT Mixed Emotions activity that I wrote about previously for upper grade students with good vocabularies playtherapygames/mixed-emotions I used the feeling faces stickers from Conscious Discipline because those or ones I teach in the classroom in kindergarten and grade 1 so my students are familiar with them. This chart can be used to brainstorm additional feelings and they can be added with sticky notes or because it is laminated written on the chart with dry erase markers.

I keep the chart of the 4 families up in my office all the time because I use it frequently in individual and groups counseling sessions. For individual counseling this chart can be used as a check in by adding a scale. I ask (and record to determine patterns and hopefully progress) on a scale of ) to ten with 0=not having that category of emotions at all since our previous session to 10=Having that as strongly as I can remember having that category of emotions. So a client might be at 6/10 for happy and clam; 5/10 for anxious unsure feelings; 7/10 for angry frustrated; 4/10 for sad or left out. I then ask the student to tell me what happened that made them give that family each number.

For groups I am showing you some things I do reinforce and use feeling families with my self-regulation groups (where we work on controlling our bodies first, then our emotions, and finally our thoughts). For my emotion regulation groups, depending on the grade level, I do the activity sheets above. I make a word bank with a variety of grade level appropriate emotions and they write them in the correct house. This can be easily extended to reinforce I messages by having a member pick a feeling from the house and use it in an I message. These activity sheets go home so parents know what students are learning in group.

Using the Feelings Families has helped my students recognize, understand, label, and express their emotions with more clarity. It helps me tailor a discussion of coping tools that are sometimes effective dealing with each of the 3 unpleasant families of emotions. For example, take a break or walk away is a go strategy for anger but not for anxiety or sadness.

A Penny for Your Thoughts

These 80 hand-illustrated communication cards will bring new connection to your relationships with students. These cards help kids identify and talk about their feelings/experiences and teach skills that build confidence, help solve problems, and increase emotional connection.  Kids identify how they feel, who's involved, where something happened, and skills they can use to cope with challenging situations and big feelings.  This is a very open ended "game" that I have used students with a variety of presenting concerns. This game integrates social and emotional learning (SEL) skills, helping children to articulate their feelings and learn how to manage them in healthy and adaptive ways. It can be purchased at apennyforyourthoughtscards.com

Games for the Counseling Office

If you are still purchasing materials for your counseling office for next year and you don't have one of these bingo games. I have the entire set but if you can only afford one (they are $25) buy Empathy Counts childtherapytoys.com/products/empath You can play the game like regular bingo and have the students answer the question card that goes with the number on the tile they played. The Empathy Counts game offers and option to build a happy face or the letter E for empathy with the tiles which makes the game go faster and the students really like it. My students know a big part of my job is for them to understand their own feelings, understand the feelings of others, and act with compassion when another person is having unpleasant feelings. These games help facilitate this type of social emotional learning.

Individual Counseling Tool

My students love to play Totika but I don't usually use the card decks that the publisher makes because their questions narrow the focus. I have made category cards with broad topics that allows the student to share what they want. I select cards based on the reason I am seeing the child. For example, if the child's parent have just separated I will select the card with the category family. When the student pulls that color log they are invited to share something true or a belief they have about their family. Using categories also takes away the problem of reading because even first graders can use initial letter clues and quickly remember 1-2 word categories. I always have question as one category so I can ask what I want to know. When the student selects the question color log it is interesting what they ask me. I have learned a lot about students I see in counseling playing this open ended version of Totika.

Books about Depression for Kids

Like most school counselors I like to have a variety of books to share with students related to a specific concern or a strategy or skill to manage an issue or symptom.  Seeing characters in books going through something similar to the child normalizes it. Most children understand that is they write a book about it, then it must be pretty common. Here are some of the books on my bookshelf I use with students who feel depressed.

Bowden    I Just Want to be Me

Cook        Blueloon
Crist         What to Do When You Are Cranky and Blue (Grades 4-5)

Foley        Danny and the Blue Cloud

Jones        The Princess and the Fog

Malcolm   Meh: A Story About Depression
McIntyre   How Frederick Found His Light
McKee      Elmer and the Rainbow
Miles         Move Your Mood
Mundy       Sad Isn't Bad

Depressed Students

This year I have noticed that more of our students are depressed and we have already done more suicide risk assessments in mid March than we did each of the past 3 years. Some of these are students who were referred for services in the past for anxiety.  About half of people diagnosed with depression are also diagnosed with an anxiety disorder www.adaa.org Children with depression may display these symptoms:
Depressed, angry, or irritable mood
Difficulty sleeping or concentrating
Change in grades, getting into trouble at school, or refusing to go to school
Change in eating habits
Physical/somatic complaints
Mood swings
Feeling worthless or restless
Frequent sadness or crying
Withdrawing from friends and activities
Loss of energy
Low self-esteem
Thoughts of death or suicide
When symptoms last for a short period of time, it may be a passing case of “the blues.” But if they last for more than two weeks and interfere with regular daily activities and family and school life, a child may have a depressive disorder. This site is a good resource for parents www.dbsalliance.org

Teachers often overlook children with depression because it has internalizing symptoms not disruptive behavior with externalizing disorders, such as ADHD. Depressed children often don't ask for help at school because of negative thinking patterns: No one cares about my feelings, nothing can be done to help me, and so on (Cash, 2003). Younger students often lack the necessary language skills and self-awareness to report their depressed feelings. Even preschool age children can be depressed. Some students with depression will qualify for a 504 Plan and some may require an IEP.

School counselors can develop a positive relationship, provide emotional support, and teach students who are depressed coping skills.My go to goals for students with mood issues are: good sleep hygiene, healthy eating habits, and plenty of exercise (especially outdoors). There are not many resources for elementary counselors but these may be of some assistance schoolcounselor.org/students-with-depression  counselingyouthwithdepression

If a student has moderate to severe depression they should be referred out for cognitive behavior therapy and evaluation to see if medication is warranted.

Book to Explain Brain to Help Children Self-Regulate

Julie Mendenhall, School Counselor, has written and published another great resource for counseling. "Sunny Shifts His Brain". The book teaches students in grades Prekindergarten to Grade 3 a little about the brain and then explains to children how to use two simple strategies: 1 Check: Learn when I need to change my behavior. and 2) Crisscross and Shift: Learn how to cross arms/legs and "shift" to clearer thinking. Crisscross is a concept I have been sharing with students, teachers, and parents for years that I believe comes from Brain Gym (learn more at braingym.org). I have shared these strategies with several teachers of children who need help developing self-regulation. This book is very useful to some of my students who have OCD type symptoms if not a formal diagnosis. It is one of several terrific resources for explaining and teaching self-regulation available at youthlight.com
Julie has presented this brain-based research to counselors and her PowerPoint is available on her website juliemendenhall.com

Suicide Prevention Resource

"Tell Me More"

Tell me more... are 3 hard words to say but extremely important in assessing a student who has talked about committing suicide. Check out all the valuable resources at www.sptsusa.org

Teaching Life Skills to Children and Teens with ADHD

Teaching Life Skills to Children and Teens With ADHD (2016) describes the Life Skills Program created by author Vincent J. Monastra at his ADHD clinic. It features practical strategies for helping children and teens develop essential life skills at home, school, or in a support group setting.
Some of these skills include:
Engaging others in conversations
Seeking out confidence-building experiences
Responding appropriately to teasing
Establishing friendships and social networks
Trying group activities to avoid isolation
Developing healthy eating, sleeping and exercise habits
Solving problems and getting organized
Showing sensitivity to others' emotions
Each chapter includes exercises to help  teach, model, and guide children in trying out these skills. Interactive checklists, quizzes, and guided journal entries are provided as tools for reflection and for engaging children and teens in ways that are interesting and fun. I particularly like the Life Lesson "Kindness is Contagious" which fits in perfectly with my theme for February. This guide gives a counselor good activities to use in small groups. There are 12 life lessons that could easily be the format for a small tier 2 group. I have used many of the activities with individuals. The guide is a resource I recommend to most of the parents of my upper grade students who are identified as ADHD.

Four Simple Questions

Byron Katie uses the four questions and turnarounds to help children manage difficult emotions and fearful thoughts. To turnaround fear and stress challenge the irrational thoughts with 1) Is it true? 2) Can you absolutely know that it's true? 3) How do you react, what happens, when you believe that thought? and 4) Who would you be without the thought? I work with anxious kids every day and for my K-grade 3 students these 2 books are terrific to help them dispute their negative thoughts and uncomfortable emotions. There are many free resources on Katie's website  http://thework.com

Blocks with Clear Plastic Sleeves

I have bought and made cubes to use in groups for a variety of topics and issues over the year. I have feeling cubes and story cubes. I just got these 4 inch square cubes each have 6 clear plastic sleeves (from Amazon). These are so flexible I might use them in every group I lead. They could also be used in a classroom lesson as a hook for review or with individuals to get student talking. You just have to make 3-1/2 inch square cards to slip in the sleeves. There are activities you can use just one cube, two, three, or all four. This week I am using 2 of them (at a time) in a group with 3 students who are recent arrivals to the country. I am doing a version of an activity I do in kindergarten on the Smartboard. One cube will have pictures and labels of 6 animals (dog, bird, monkey, cow, bear, horse) and the other 6 feelings. The member roles both cubes and acts out whatever lands on top (like sad cat). These cubes are perfect to make tailored ice breakers like for a social skills group e.g., ask an open question about an activity, interest, entertainment, school, sports, and book or movie. They could be used in a new student or friendship group with just some basic get to know you questions. They could be used in a final session of a Study Skills group for a review session - give your best advice about homework, studying for tests, taking notes, group work, memorizing, and attention. Since I do all my groups in grades 3-5 these cubes have the advantage of being easy to wipe down in case they get food or germs on them.

Individual Counseling Check In Sheet

This is the sheet I use to determine how counseling is progressing with students I see individually. I record the date and meeting number then I ask "On a scale of 0-10 with 10 being outstanding and ) the pits, what number would you give School since we met last...Friends...Home..." For my students who shift between mom's and dad's home I note which place they are rating (and sometimes get 2 ratings). I love this scale that I download from R. Sabella's site  http://schoolcounselor.com/ I really believe in positive psychology and that we solve problems using our strengths so I then ask for 5 good things that have happened since out last meeting. It is good for students to focus on the positive because the ones I see individually already have plenty of negative thoughts. I try to use the term challenges rather than problems to determine what we need to discuss. Usually the challenges relate directly to the area of their life that is rated with the lowest number, but not always. If not that is something else I explore. I always have a stated goal students are working on with me and we jointly determine if that is still something they are willing to work on between sessions or if it needs to be revised. I do not show the students this sheet (its on a clipboard) but I would if asked. I want to see how their numbers and challenges change over the course of counseling. If a student would say all 10s for 2 sessions in a row and have no significant challenges, I'd be moving to terminate our work together in individual counseling.