Meeting the Needs of Children Where They Live

May 15, 2017

Christine Anderson, MA/CAGS ‘15 (left) and Danielle Vasserman, Clinical PsyD Student (right).

Interning as a school psychologist in Boston Public Schools, alumna Christine Anderson (MA/CAGS ’15) worked with a high school student from Haiti, who was significantly depressed and describing suicidal ideation. Her family had limited awareness of the resources available to help her, requiring Anderson to advocate for mental health care for the student’s safety. As a result, the student got the help she needed, graduated from high school, and is now attending community college.

We can play a unique role for students as child advocates... making sure kids’ mental health needs are met.” 
—Christine Anderson, MA/CAGS ‘15

That is a good example of the benefit of caring for kids where they are, which in this case was school, says Anderson, who is now a school psychologist in Salem Public Schools. “We can play a unique role for students as child advocates, bridging the gap of cultural understanding and making sure kids’ mental health needs are met. Having mental health clinicians in school settings makes mental health services accessible to all students, including low-income and historically under-served populations.” 

She notes that the school setting also facilitates a team-based approach, as teachers are often the first to identify behavioral changes. School teams can be composed of school psychologists, teachers, special education coordinators, social workers, and counselors.

“I built trust and became an ally between the medical team and the child... a crucial link that isn’t always there.” 
—Danielle Vasserman, Clinical PsyD Student

Another increasingly common location for mental health providers for children is the community health center. Danielle Vasserman, a student in William James College’sClinical Psychology PsyD program, is an intern at Lynn Community Health Center, where she works on a team with doctors and nurses.

She points to a recent case of a suicidal teenager with an eating disorder as an example of the importance of a team approach. In addition to Vasserman, the team consisted of a nurse, a nutritionist, a primary care doctor, and an interpreter, as the parents did not speak English. While the medical side worked to ensure the child was eating, Vasserman focused on stabilization and coping skills.

“I built trust and became an ally, essentially serving as the middle man between the medical team and the child. That is a crucial link that isn’t always there outside of this model,” she says.

Meeting a “Critical” Need

According to Bruce Ecker, PhD, Director of the Children and Families of Adversity and Resilience Concentration in the Clinical Psychology PsyD program at William James, these models are “critical” to increase children’s access to mental healthcare.

It can be a big step for families to acknowledge that kids need help, so it’s important to provide access in settings where stigma is minimized and physical access is maximized.
—Bruce Ecker, PhD

He explains, “When the famous bank robber Willie Sutton was asked why he only robbed banks, he said that banks are where the money is. This is how I feel about treating kids in schools and primary care practices. That is where they go for help and so that is where we should be.”

He points out that 46 percent of children have a mental health need at some point before they turn 19 (Merikangas et al., 2010). “At best, half receive any care, and of the care that is provided, it is often inadequate (Centers for Disease Control, 2014). That is partly due to lack of access. It’s also due to a lack of providers sufficiently trained to give the care and services families need. We work hard at William James College to meet that need and produce well-trained clinicians to help children, adolescents, and families where they live.”

Ecker notes that providing care in these settings helps overcome the challenge of stigma. “It can be a big step for families to acknowledge that kids need help, so it’s important to provide access in settings where stigma is minimized and physical access is maximized. That results in great access to care.”

Nadja Reilly, PhD, Associate Director of the Freedman Center for Child and Family Development and Co-Director of the Graduate Certificate in School Climate and Social Emotional Learning, observes that these settings can also mitigate cultural issues. “Families from other cultures may struggle with factors that limit their access to services. By working with them where they live, we can ensure they are heard, honor the strengths of their culture, and increase access to services.”

Preparing Students for a Changing Landscape

To prepare students to work with children in team-based models at schools and healthcare settings, the College is launching several new programs.

We want to think about how everyone who touches a child’s world can promote health and wellness.
—Nadja Reilly, PhD
As one of 30 sites in the country—and the only one in Massachusetts—to receive a $1.1-million grant from the Federal Health Resource and Services Administration, William James recently began an internship program to integrate behavioral healthcare with medical healthcare.

Placing students like Vasserman in underserved communities for hands-on experience, the grant will ultimately fund 31 internships.

Ecker points out that, while not new, the Clinical Psychology PsyD Program also offers a Health Psychology Concentration that trains people to work with medical providers, and the program is planning to integrate primary care skills into all clinical courses.

As part of the School Psychology Department, the Freedman Center for Child and Family Development at William James College is starting a Graduate Certificate in School Climate and Social Emotional Learning in September of 2017.

Reilly explains, “The goal is to train teams of administrators, teachers, and mental health care providers from different school districts to infuse social and emotional learning into every aspect of education. We want to think about how everyone who touches a child’s world can promote health and wellness rather than waiting for a crisis to find services. Trained teams can share that learning with others in the district to make a bigger systemic impact.”

Another new program at the Freedman Center is the Certificate in Pediatric and Behavioral Health Integration, which will launch next January. “We want to train pediatric medical providers and mental health practitioners interested in creating integrated models of care,” says Reilly.

School Psychology Department Chair Arlene Silva, PhD, notes there is a new program offered in her department: the MA in Applied Behavior Analysis. This program, which can be completed in a year while working full-time, combines instruction in behaviorism and learning theory with real-life application to prepare students to become Board Certified Behavior Analysts, many of whom will work in school settings.

The Children and Families of Adversity and Resilience (CFAR) concentration is also now available to students in the School Psychology MA/CAGS and PsyD programs. For school psychology students, an important component of the CFAR program will include working in settings where they are dealing with more complicated family needs and/or challenging environmental conditions, such as substance abuse, severe disabilities, and poor access to services.

“Well-trained school psychologists can be resources for families and schools. Our school psychology trainees understand school culture and how schools work. We work at various levels to maximize our impact,” Silva says.

Ecker adds, “We know that care works best when professionals work together and mental health providers are embedded in teams at schools and primary care settings. We seek to increase access of care for children through all of these programs.”