Douglas Gotel understands trauma and its crushing consequences; when he was 21, his 11-year-old cousin was murdered. He recalls feeling helpless watching his cousin’s mother suffer, in anguish without access to a grief therapist in the small town where they lived.
Today, Gotel approaches trauma from a clinical perspective as a Licensed Clinical Social Worker and a Registered Play Therapist Supervisor. And as a Program Manager with the District of Columbia Public Schools Mental Health Team, he and his colleagues support the efforts of school-based social workers who deliver Evidence-Based Treatment (EBT) interventions. The interventions support the eight to eleven percent of all children in DC who have signs, symptoms or diagnosable emotional and mental health conditions, including those related to trauma.
Here, Gotel speaks with EdSurge about the impact EBT interventions have on DCPS students. He also shares how the district uses case management technology to track these interventions, support clinicians and help assess when students need help—and when they don't.
EdSurge: Tell us about your Evidence-Based Treatment interventions.
Douglas Gotel: DCPS has 49,000 students, and more than 4,100 of those students are receiving ongoing, prescribed behavioral support services through our comprehensive service delivery model. We've been offering EBT interventions as part of that model since the 2011-2012 school year. Our ultimate goal is to strengthen kids’ coping capacity and resilience. We also want to reduce disproportionality—where minority students (specifically, black and Latinx students in our district) are overrepresented in special education and discipline referrals.
DCPS School Mental Health providers currently use 13 targeted EBT interventions that focus on supporting children who have social and emotional needs. They help reduce the symptoms of issues such as ADHD, ASD and chronic exposure to trauma or adverse childhood experiences (ACEs), among other things.
For example, we use child-centered play therapy intervention in our elementary schools where kids learn how to solve their problems and work through relational difficulties.
Providers use puppets, wooden houses, animals and people figures to facilitate symbolic play. Children get to retell the story of physical abuse, or even of having a difficult time with being placed in foster care, in a way that restores power and mastery to them. While it looks like play, there's real work happening with the child.
Why did you decide to adopt special education case management technology?
We needed a better system to capture—and then use—the immense amount of data we were collecting through our EBT interventions. We collected data around the frequency of certain behaviors, who was receiving treatments, how much treatment and then the outcome of the treatment.
Initially, we used bubble forms to collect those details, but the process took months. We had to package up the data and send the forms to a vendor for scanning. Then an analyst had to aggregate the raw data and put it into some usable form for us.
We needed to get the data much faster to tell each student's story and show the impact of their treatment at multi-disciplinary team meetings. That ultimately led us to adopt AcceliPLAN in 2017, a customizable special education management system. We already had a contract with Accelify for Medicaid billing, and we needed to replace our previous data system for provider management and 504 compliance, so it made sense.
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How does special education management technology support your district's mental health services?
We can customize AcceliPLAN, so it aligns with our workflow and policies. For each intervention, the system is programmed to expect our school-based clinicians to complete particular behavioral or symptom scales for all of our students, both general education and special education. That’s helped us enforce our progress-monitoring policy.
Within a multi-tiered system of supports, using this technology, clinicians can easily collect and use anecdotal and hard data to substantiate a statement of progress or a statement of regression.
And then there are time savings.
For example, a critical support we provide is school crisis response. When a crisis event, such as a staff death, takes place, we organize and deploy mental health providers from our campuses to provide support at the school. With Accelify, we created a custom crisis response manager. We can see where these events are happening and how many staff and students received crisis counseling. The system also populates the data entered on response details into a downloadable narrative report.
That saves us hours in productivity because we don't have to create charts from raw data in a spreadsheet. Those are hours we can spend ensuring students receive quality mental health services.
With more accessible data, what have you learned about how interventions impact students?
The national data overwhelmingly demonstrates that children of color are disproportionately represented in special education services. But how do we right-size services for a student whose IEP may exceed the demonstrated need and functioning of that student? This tool quickly puts behavioral data, intervention-specific data and outcomes data into providers’ hands. Now they have quantitative data to justify and advocate for reducing services or exiting kids from special education services where appropriate.
We've also been able to consistently demonstrate that participating in trauma-focused interventions significantly reduces PTSD (Post Traumatic Stress Disorder) symptoms. For example, on average, students who received the Grief and Trauma Intervention for Children (GTI) had an initial score of 20 on the Child PTSD Symptom Scale, indicating moderate symptoms associated with post-traumatic stress. The average score of students after receiving the intervention was 12, which tells us their symptoms were significantly improved. This type of mental health outcomes data is unprecedented for a school district.
Those numbers aren't just stats; they represent our children’s emotional well-being. For instance, we had a high school student who used to cut herself. She wasn't suicidal; she would cut to manage stress. After completing the SPARCS intervention (Structured Psychotherapy for Adolescents Responding to Chronic Stress), that student no longer needs to harm herself; she learned better ways to cope with sadness through SPARCS.
These interventions help children heal so they can go out into the world and live their dreams.
Evidence has shown several times over that students cannot learn if their social-emotional needs aren’t being met. The data we collect from Accelify supports this.
