Board of Trustees s7

Board of Trustees

2010-2011

Brett Springston Rolando Aguilar Superintendent President

Ruben Cortez, Jr. Joe Colunga Vice president Secretary

Rick Zayas Enrique Escobedo, Jr

Assistant Secretary Member

Minerva M. Peña Caty Presas-Garcia Member Member

TABLE OF CONTENTS

Page(s)

I. Foreword------1

II. What is a Crisis? ------2

 Description of Crisis Levels 1 – 3------2

 Examples of Crisis------3

III. Being Prepared------4

 The Purpose of Crisis Intervention------4

 The Campus Crisis Response Team Members------4

 Campus Crisis Response Team------5

 District Core Crisis Team Members------5

IV. Flow Chart to Address a Campus Crisis------6

 Plans A & B------6-7

 Proposed Campus Crisis Team Members------8

 Telephone Trees------9-15

 Roles & Responsibilities------16-19

 After the Crisis------19

 Debriefing & Conclusion------20-21

V. What is Grieving? ------22

 Warning Signs that indicate serious problems------22

 How children express Grief------23-27

 Suggestions for Helping Teachers------28

 Helping a Student Grieve After a Death in the Family------29

VI. Suicide Intervention Procedures------30-33

 Counselor Responsibilities------34-37

 Screening for Level of Suicide Risk/Assessment------38-40

 Student Suicide Safety Plan (Available in Spanish) ------41-42

 Notification of Emergency Conference (Available in Spanish) ------43- 44

 Need for Emergency Assistance------45

VII. Risky Youth Behavior------46-49

 Self-Harm Intervention Procedures------50

 Counselor Responsibilities------51-53

 Screening for Level Self-Harm/Assessment Form------54-56

 Student Suicide Safety Plan Form (Available in Spanish) ------57-58

 Notification of Emergency Conference Form (Available in Spanish) ------59-60

 Need for Emergency Assistance Form------61

VIII. School Phobia------62

 Warning Signs of School Phobia------63-64

IX. Drug Abuse and Addiction------65

 Five Myths about Drug Addiction and Substance Abuse------65-66

 Using Drugs as an Escape------66

 Signs and Symptoms of drug abuse and addiction------67

 Warning Signs------68 -69

X. Bullying and Cyber-Bullying------70-76

 Warning Indicators of Bullying------71

 Preventing Bullying------72-73

 Steps to Address Cyber-Bullying------74-76

XI. Eating Disorders------77

 What is Anorexia Nervosa? ------77

 What is Bulimia? ------77-78

 Warning Signs of Eating Disorders------78-79

 Eating Disorder Assessment Form------80

XII. Procedural Flow Charts------81-94

 Suicide Student Referral------81

 Suicide Outcry Response (When parents cannot be located)------82

 Suicide Outcry Procedures for Non-Counseling Staff------83

 Suicide Outcry Response Plan------84

 Self-Harm Student Referral------85

 Self Harm Outcry (When parent/guardian cannot be located ------86

 Self Harm Procedures for Non-Counseling Staff------87

 Self Harm Risk Level (when parent/guardian cannot be located) ------88

 Substance Abuse------89

 Child Abuse------90

 Cyber Bullying for Students-What to do------91

 Bullying and Cyber Bullying------92

 Eating Disorder------93

 School Phobia------94

XIII. Appendices------95-106

 Sample Letters addressing Death------95- 98

 Administrative letter for Administrator to Read to Staff------95

 Administrative letter for Teacher to Read to Students------96

 Letter to inform Parents (English) ------97

 Letter to inform Parents (Spanish) ------98

 Letter to Parents on Bullying------99

 Letter to Parents on Cyber bullying------100

 Record of Student Contact------101

 Student Activities on Grief------102-104

 Bibliotherapy for Grief and Bereavement------105-106

XIV.  References & Acknowledgements------107-110

FOREWORD

Brownsville Independent School District (BISD) is rich in cultural heritage and utilizes all resources to provide equitable opportunities for all students in order to produce well-educated graduates that pursue higher educational opportunities and go on to become responsible citizens in a changing global society.

The Guidance and Counseling Department is aligned with the mission and goals of

BISD in an effort to ensure a quality education that will prepare students for the future. BISD

Counselors encourage, enable, and empower the students they serve as well as intervene in situations and/or crisis in order to provide a safe learning environment. School crisis has been defined as a traumatic event that impacts a school. Such occurrences have a powerful tendency to ripple across the district.

For the reasons above, it is crucial that all school campuses follow the same protocol in any situation; thus, the BISD Crisis Manual will serve as an administrative guide framework based on a competency service program that will provide consistency while allowing flexibility.

A campus team working collaboratively to assist students is the basis for effective resolutions to any crisis. Counselors are trained individuals that exercise their professional judgment after careful examination of the problem; with the campus team members following suggestions provided in the District Crisis Manual.

This manual will also assist in establishing a network of guidelines for dealing with the shock, grief and healing process that follows a crisis. The BISD Guidance and Counseling

Department will continue to take the lead in providing administrators, counselors, staff and parents with information and resources needed to effectively serve the needs of all students and other individuals in crisis situations.

What is a Crisis?

A crisis is a situation that occurs as the result of a traumatic event and significantly alters the ability to carry on day-to-day activities by students and the school community. The word “crisis” implies that the individual’s usual coping mechanisms may not be sufficient to handle a particular situation. Situations that may generate traumatic stress and require crisis intervention include: “experiencing, witnessing, and/or learning about and event that involves the actual death or physical injury, and or threatened death or physical injury” (APA, 2000, p.463).

In the event of death of a classmate or teacher, a violent act witnessed by students and/or staff, suicide, a natural disaster, school invasion, or the anticipation of any such events, the risk of severe emotional upset and/or disorganization will always exist. In the B.I.S.D., each Campus Crisis Response Team (C.C.R.T.) will use the following "Crisis Levels" to determine the degree that their school is impacted by an event. If the need for services is beyond the scope of the C.C.R.T., the district Crisis Core Chairperson will be contacted to provide further services.

Crisis Level 1 – The event is not traumatic, or traditional school resources can manage the number of students affected and their crisis reactions. Intervention can be provided by the school counselor.

Crisis Level 2 – The event is traumatic; however, the number of students affected and their crisis reactions can be managed by the C.C.R.T. (administrator, counselor, and nurse) who temporarily discontinue traditional duties to provide crisis intervention.

Crisis Level 3 – The event is traumatic and the number of students affected and their reactions may overwhelm building-level crisis intervention resources. The Administrator requests assistance from the district Crisis Core Chairperson.

WE MUST BE PREPARED-It is not unusual for Crisis Levels 1 and 2 to escalate to Crisis Level 3.

What is a School Crisis?

A school crisis is a sudden, unexpected, or unanticipated critical incident that disrupts the school day. A school crisis involves short-term turmoil such as shock, confusion and fear. Although each student, teacher, parent or other school family member experiences each crisis differently, a school crisis can have a broad and immediate impact on many children and adults sufficient to interfere with teaching, learning, attendance and behavior. A school crisis can affect a single building or the entire district.

It makes a difference to a school community how a crisis and its effects are managed. Understanding the psychological consequences of a crisis situation and providing effective interventions can reduce the period of school disruption and restore safety and security to the school learning environment. 2

Examples of Crises

 Suicide attempt or ideation

 Stabbing

 Shooting

 Hostage situation

 Homicidal ideation/threats of Violence

 Death of a student, staff or family member

 Sexual assault

 Self-Mutilation/Self-Injury

 Terminal illness of a student or staff member

 Abuse: Sexual/Physical/Emotional/Verbal and Neglect

 Drowning

 Community violence

 Bullying/Harassment

 Eating Disorder

 School Phobia

 Substance Abuse

 Choking Game and other Risky Behaviors

BEING PREPARED

BEFORE A CRISIS

The Purpose of Crisis Intervention

The overall goal of crisis intervention is to restore the individuals involved to pre-crisis levels of functioning by:

 Assuring that tragic events or occurrences are not ignored.

 Assisting students, faculty, parents and other school staff in dealing with

emotional responses.

 Decreasing the proliferation of rumors through the sharing of facts.

 Securing and coordinating the services of community agencies as needed.

 Providing support and counseling to minimize the disequilibrium in the

school.

 Providing staff development to school personnel and parents on how to

cope with a crisis situation.

The Campus Crisis Response Team (C.C.R.T.) - Members include:

 Administrator  Counselor  Nurse  Security Officer/Police Officer  Administrator-appointed Staff

Campus Crisis Response Team (C.C.R.T.)

Assess the nature of the crisis and develop a comprehensive plan for responding to the needs of the students, faculty and parents. This is the foremost purpose of the C.C.R.T. The need for individual and/or group intervention should be determined and the target population should be identified.

Evaluate the needs of the students to determine the nature, length and duration of counseling services. If an outside agency is involved, the team should work in collaboration with the agency relative to the specific therapeutic involvement in each crisis. If students are in need of more intensive counseling, referrals should be made. Service providers will require clearly defined parameters to offer comprehensive services to students, faculty or parents.

Conduct an evaluation of services rendered to review the effectiveness of the plan and to develop recommendations for changes if needed (See Appendix D).

DISTRICT CRISIS CORE TEAM Members

 CHAIRPERSON ..…Program Administrator for Guidance and Counseling

 MEMBER……………….Rene Atkinson, M.Ed., L.P.C.

 MEMBER……………….. Lynn Black, M.Ed.

 MEMBER……………….. Dora Earl, M.Ed.

 MEMBER……………….. Bea Moyar, M.Ed.

 MEMBER………………. Monica Piña, M.Ed.

 MEMBER………………..Frank M. Treviño, M.Ed.

 MEMBER………………..Laura M. Treviño, M.Ed.

 MEMBER………………..Martha Walker, M.Ed.

 MEMBER………………..Bobette Williams, M.Ed.

 MEMBER……………….Susana Zapata, M. Ed.

ADMINISTRATOR’S PROCEDURAL FLOW CHART TO ADDRESS A CAMPUS CRISIS

Plan A: Crisis management is done by the C.C.R.T.

ADMINISTRATIVE PROCEDURAL FLOW CHART TO ADRESS A CRISIS ON CAMPUS

Plan B: Crisis management is done with the assistance of the District’s Crisis Core Team

PROPOSED CCRT MEMBERS

In the eyes of the community, the principal is the leader of the school. Many decisions that are made in response to a crisis cannot be delegated. Very often the principal is the one person the community holds responsible for action(s) taken or not taken. However, this does not mean the principal works in isolation; because every school has staff possessing expertise in various fields. It is important to utilize key people from the campus to serve on the C.C.R.T. in order to ensure that all aspects of the school environment will be addressed.

Each campus is responsible for creating an in-house team. This team is created to assess the situations to determine if the individual school can handle the crisis or if they need assistance from the District Crisis Core Team (DCCT). If assistance is needed, a DCCT will report to a campus at the request and approval of the campus principal.

Who should be included on the CCRT?

The strength of a school’s crisis plan lies in the selection of members to serve on the crisis team. It is important that the CCRT members possess certain qualities that will enhance the effectiveness of the team. Some of these qualities include, but are not limited to:

 A broad perspective on life  A willingness to work toward a solution  An ability to think clearly under stress  Flexibility  A familiarity with the school, the student body, and the community

Suggested Members:

Principal - This person is responsible for all decisions and actions taken and is familiar with District policies.

Principal’s Assistant or Designee - This person takes over in the absence of the principal.

Instructional Facilitator/Dean of Instruction - This individual is in an administrative role and is familiar with the faculty and staff.

Counselors - These individuals are trained to deal with reactions to crisis, grief, and group dynamics.

School Nurse - This individual can provide information and expertise about the physical symptoms of shock and/or physical reactions to grief. The nurse can also be instrumental in recommending the logistics for the care and removal of injured students to area hospitals, should a crisis require medical attention.

BISD Police Officer - This individual assists with crowd control, monitoring halls, campus entrances/exits and any other law enforcement duties assigned by the principal/ BISD Chief of Police. This officer also acts as a liaison between the school and other law enforcement officers in the community.

Special Assignment Person - Any supportive campus person designated by the principal and who has access to community resources.

Faculty Member - This individual should have the respect of co-workers and students and should be comfortable talking about death and crisis in extreme situations.

Receptionist/School Secretary - This individual is instrumental in screening campus telephone calls as instructed by the school principal or designee.

Custodian - This individual is assigned to open or close classrooms/gates and assist with other custodial/maintenance duties that may arise during a crisis.

It is highly recommended that substitutes for key members be identified in case of an absence.

***EACH CCRT HAS A DESIGNATED CHAIRPERSON (COUNSELOR) WHO WILL ASSIST IN COORDINATING AND CONTACTING CCRT MEMBERS.***

Telephone Tree

An accurate and up to date list of Cluster Response Team members with their home and work numbers must be kept easily accessible to the principal and/or his designee; however, additional Cluster Response Team members will be directly contacted by the District Crisis Core Team Chairperson. This will facilitate uniformity and efficiency in responding to the crisis. A calling tree for contacting faculty and staff should be formulated by the administrator. Each member of the CCRT should have an updated list with names and telephone numbers for the team and faculty. The team leader should also be identified. It is suggested that the telephone tree or crisis team notification list be reduced, made into a wallet-sized card, and laminated to ensure accessibility.

Roles and Procedures

Principal:

Principal is notified of the crisis and verifies that there is a crisis.

1. Principal notifies Area Administrator. At the discretion of the principal, the following may be notified/requested for their assistance.

A. BISD Crisis Core Team Chairperson - will coordinate BISD CRT’s, counseling procedures, and facilities.

B. Administrator for Health Services - will coordinate all health related issues

C. Public Information Officer - will handle all media issues.

D. Administrator for Security will handle all law enforcement information and safety measures, if needed.

2. Principal starts the telephone tree to alert the District Crisis Core Team Chairperson, if the crisis occurs after school hours or on the weekend. If the crisis occurs during the instructional day, the principal may consider having an emergency CCRT meeting. The faculty can then be personally informed of the crisis. This approach provides the greatest support, and if most effectively reduces rumors.

3. Principal prepares method of notifying and meeting with faculty and staff as soon as possible. If this is not possible, the principal should prepare a written statement which teachers will read to their class(es). Having this official message announced over the Public Announcement System (PA) is discouraged.

4. To avoid confusion and ensure consistency, the principal or designee needs to inform all faculty and staff members of the importance to what pertains to the media and to the administrator.

5. Principal should check frequently with CCRT members to ensure that all needs are being met.

Principal ensures that media staff does not go near the area where students/staff are being counseled.

Principal’s Designee:

1. Assists principal by contacting CCRT members if the crisis occurs after school hours or on the weekend.

2. Checks with the custodians/security guards to make sure that rooms and gates are opened or closed, depending on the need.

3. Assigns a staff person to log visitors in and out. This is a very important function and must be done efficiently.

4. Designates rooms that will be used for counseling, assesses the situation of CCRT members’ Debriefing, and formulates strategies for continuing services.

5. Makes arrangements, as needed, to ensure that faculty and staff can attend memorial/funeral services, and/or meetings addressing the crisis.

6. Performs other tasks assigned by the principal.

District Crisis Core Team Chairperson:

1. Checks with the principal that a statement concerning the incident has been written. (Refer to Sample Letters)

2. Directs CCRT members and District Crisis Core Team (DCCT) members to refer all media questions to the B.I.S.D. Public Information Officer to avoid confusion and ensure consistency.

3. Reminds CCRT and DCCT members of the need for confidentiality.

4. Has clip-on badges available for all team members so they can be easily identified. Badges will be uniform throughout the District and provided by the Department of Guidance and Counseling.

5. If needed, requests school floor plans/guides to classrooms.

6. Requests that rooms be designated and opened for counseling.

7. Formulates procedure for students needing counseling. Both group and individual counseling will be provided as needed.

8. Assesses special cases as needed (hysteria, physical malaise, etc.).

17 9. Directs CCRT to keep record of student contacts. These forms are to be passed on to student’s campus counselor.

10. In case of the death of a student, assign a person to follow the student’s schedule and spend time in the classroom, clean out locker, personal effects, etc. Consideration should be given in case of students sharing lockers.

11. Identifies students and personnel most affected by the crisis and assigns them to a DCCT member.

12. Determines the need for home visit(s) and assigns CCRT/DCCT members to go to the student’s home and talk with parents who may have needs with which the school can be helpful. (i.e., emotional support, etc.)

13. Makes sure that a detailed debriefing is held after the crisis for DCCT members.

14. Arranges for a Central Command Center (CCC) where DCCT members can meet to assess the situation, rest, debrief, and formulate strategies for continuing services, as needed.

15. Checks frequently with DCCT members to ensure that all needs are being met.

Special Assignment Persons - Home visitor/staff member, parent liaison (not a parent).

Assists the receptionist/school secretary with answering parent phone calls. A general statement should be available for this person to give the parents if they call the school.

Counselor(s):

1. Identifies and counsels with students and personnel most closely affected by the crisis.

2. Keeps accurate log of students and staff counseled. .

3. Works closely with administration in making necessary arrangements to address crisis management.

B.I.S.D. Employee Assistance Counselor:

Serves as the liaison between administration and faculty and provide support and assistance for teaching staff. Provides student assistance, if needed.

Security: Monitors entrance and exists, screens school visitors during the crisis management timeline.

School Nurse: Assesses special cases and serves as the contact for community services, as needed.

Custodian: Makes sure classroom doors and gates are opened or closed, as needed.

AFTER THE CRISIS

Principal:

Makes sure that a detailed debriefing is held after the crisis for the CCRT, faculty, and staff in order to provide closure on the crisis.

CCRT Team Chairperson:

Continues to monitor student reaction to the crisis and makes referrals and/or recommendations as needed to appropriate staff members.

DEBRIEFING

DEBRIEFING WITH THE FACULTY:

Within three school days of the crisis, the principal will set aside time for the faculty and staff to have a debriefing. Attendance at this process is voluntary and facilitated by the campus counselor and the principal. The CCRT members must attend.

Discuss individual’s reactions to the crisis and ask for suggestions for improvement in handling future crises. Allow each participant in the debriefing to share. (Size of group should be 10 or less, otherwise sharing will be incomplete).

The meeting should take about thirty minutes and will help to bring closure to the campus-wide incident.

DEBRIEFING THE CAMPUS CRISIS RESPONSE TEAM (CCRT): The principal, the CCRT members, and anyone else who was involved with the crisis activities need to debrief. This gives everyone the opportunity to re- evaluate the plan. Members should identify what worked well and what needs improvement or change. During the debriefing, those present should reconstruct actions taken by the team.

The second phase of debriefing is to share the emotional reactions with each other. While there might be some hesitation, this process ensures emotional readiness to return to normal working conditions and to be prepared, should there be another crisis.

SUGGESTED DEBRIEFING PROCEDURES

A. Information: * What happened? * What role did you play?

B. Idea: * What thoughts did you have when you heard about the crisis? * What thoughts have you had since the crisis?

C. Emotional: * How did you react at first? * How are you reacting now? * What impact has the crisis had on you? (Expressions of feelings may occur at this stage.)

D. Meaning: * What repercussions has the crisis had on you? On your life? * What symptoms are you experiencing? * How has this affected your family? School? Health? Friends? 20

E. Educational: . How have you coped with difficulties before? . What are you doing to cope now? . What are your strengths? . What are your difficulties? . It takes time to heal. . This is a team effort.

CONCLUSION

Remember that adults model appropriate behavior for students. They will learn how to express feelings and how to deal with sadness and loss. The process of allowing a class to explore their feelings of grief can be enriching, as well as a learning experience that will assist them in years to come.

What is Grieving?

Grief is your emotional reaction to a significant loss. The words “sorrow” and “heartache” are often used to describe feelings of grief. Whether you lose a beloved person, animal, place, or object, or a valued way of life (such as your job, going through separation/divorce, or good health), some level of grief will naturally follow. Even before the actual event occurs, anticipatory grief may present itself. Anticipatory grief is grief that strikes in advance of an impending loss. You may feel anticipatory grief for a loved one who is sick and dying. Similarly, both children and adults often feel the pain of losses brought on by an upcoming move or divorce. This anticipatory grief helps us prepare for such losses. Coping with Death When a family member dies, children react differently from adults. Preschool children usually see death as temporary and reversible, a belief reinforced by cartoon characters that die and come to life again. Children between 5 and 9 begin to think more like adults about death, yet they still believe it will never happen to them or anyone they know. A child who is frightened about attending a funeral should not be forced to go; however, honoring or remembering the person in some way is appropriate in order to begin the healing process. Once children accept the death, they are likely to display their feelings of sadness on and off over a long period of time, and often at unexpected moments. The surviving relatives should spend as much time as possible with the child, making it clear that the child has permission to show his or her feelings openly or freely.

Warning signs that indicate that students may be having serious problems with grief and loss:  an extended period of depression in which the child loses interest in daily activities and events

 inability to sleep, loss of appetite, prolonged fear of being alone

 acting much younger than their age for an extended period

 excessively imitating the dead person

 repeated statements of wanting to join the dead person

 withdrawal from friends

 sharp drop in school performance or refusal to attend school

How can Counselors Help?

1. Acknowledge a child’s grief through guide words, gentle actions and unconditional support. Whenever possible, coordinate with the family so that the child receives consistent messages. It is important to understand that protecting the child from the truth can have negative consequences like increasing confusion, fear and resentment. Help the child face reality by using simple, straight forward language like “He died,” not “He has gone to sleep,” or “She’s gone away.”

2. Show understanding by being compassionate and offering your calm, silent presence. If the child shares an emotion, reflect and validate it by reinstating the feeling. For example, say, “That was very sad.” Avoid saying “I know how you feel,” because one can never truly know the pain of another. Use books and workbooks which deal with loss in helpful ways.

3. Reassure the child that feelings of shock, sadness, loneliness, anger, anxiety, fear and guilt are normal reactions to grief.

4. Provide opportunities for the child to participate in activities designed to help in the healing process. These may include: writing, reading, telling stories, creating crafts, planting plants, making a memory book or treasure box.

5. Accept that each child’s experience with loss is unique; the reaction can be intense as well as sporadic. A grieving child often needs to take a break and engage in play activities since emotions concerning loss are so powerful.

6. Provide a support group for grieving children who are facing similar circumstances. The group can provide acceptance, companionship in an environment where emotions and concerns can be freely expressed.

7. If prolonged periods of change in a child’s temperament, eating, sleeping, and/or interest occur; additional professional attention may be required.

How Children Express Grief

The ways children express grief are usually different from the way adults express it. Children are not always able to use words to express their feelings. Instead, they often express them through behavior. Even children who are able to express themselves verbally may not always be able to express the many, sometimes conflicting, emotions they have.

Children May:

 become very quiet or very talkative

 they may become overactive

 have temper tantrums, angry outbursts, or refuse to obey adults

 have difficulty getting along with other children

 return to younger behaviors, such as wetting the bed after they have been dry for months or years

 cling to adults and want extra time and attention. 23

 have a drop in grades because of their difficulty completing school work

How children express grief usually depends on how they perceive the loss (including death). Each child’s perception of loss varies according to age and emotional development in general:

 Children younger than age 2 cannot understand the meaning of losses such as death of a family member. When a loss occurs, they know that something is different, but they do not know what it is.

 Children between the age of 3 and 6 often think that any major change in their lives is a result of their actions or wishes. This is called “magical thinking”. These children often feel responsible for any loss that occurs. If they see a loss or threat, they may think that they are being punished for something.

 Children between the ages of 6 and 10 do not always fully understand events that occur in their lives. They may understand only part of what is going on around them and they may invent conclusions or draw the wrong conclusions about things they do not understand. They may develop fears, such as the fear of death.

 Children between the ages of 10 and 12 start to understand loss (including death) the way adults do. They see death as permanent and irreversible. They are curious about what and how things happen.

Teens express their grief differently depending on their age and emotional maturity. The teen years can be divided into 3 developmental phases: the early, middle, and late teen years. Each group differs regarding the expression of grief:

 The early teen years (ages 12 to 14) are a time when teens search for the answer to the question, “Am I okay?” At this stage, teens are very concerned about fitting in and often act as if there is an imaginary audience watching everything they do. These teens may feel ill at ease when expressing grief. Since they usually are not concerned about what

other people think unless it relates directly to them, they may have a very difficult time understanding another person’s reaction to loss if it is not the same as theirs.

 The middle teen years (ages 14 to 16) are a time when teens believe that they are indestructible and that bad things will not happen to them. They cannot imagine their own death and they often think that they will live forever. These teens may express their grief by taking unhealthy risks such as driving too fast or drinking alcohol.

 The late teen years (ages 16 to 18) are a time when teens search for meaningful relationships. These teens are better able to understand complex relationships and are more interested in another person’s point of view. They have a better understanding of others’ thoughts and feelings. Teens of this age grieve as much as adults do.

Understanding the Special Needs of Special Education Students Dealing with Grief The Special Education student will most often follow the same development stages of the grieving process as that of the regular education student. It is possible, however, that he or she may or may not go through all the stages, and time involved in each stage could vary considerably. Significant factors which account for this difference are as follows:  Perceptual, cognitive, and emotional deficits.  Language capabilities, both receptive and expressive.  The ability to think abstractly and/or concretely.

Any traumatic experience that creates sudden change in the routine of the handicapped student is likely to influence how that student responds to that trauma. The following examples are to assist you in developing a plan of action in an attempt to reduce the stress and maximize the success of the handicapped student’s ability to deal with his or her grief following a crisis:

Student’s Reaction Teacher’s Response Anger “It’s OK to be angry.” “This is what you do when you are angry and it gets you into trouble.” This is what you can do which will NOT get you into trouble.” (Give specific examples which are age- appropriate.)

Aggression Repeat techniques recommended for anger, and substitute appropriate ways to release aggression.

During a crisis, manipulate the environment, rather than the student, to prevent potential student/staff injury.

Listlessness Keep the routine going as smoothly as possible with or without the student’s participation.

The manner in which the teacher chooses to react to these behaviors may influence how the handicapped student proceeds through the grieving process. If the teacher is not aware that the inappropriate behavior demonstrations are the only means the handicapped student has learned to convey his or her grief, the teacher may choose to respond with negative consequences, which in turn, may accelerate the inappropriate behavior, possibly creating a new crisis. It is critical for the teacher to acquire the skill of rational detachment, in order to separate the behavior from the student and provide pro-active alternatives which the student can effectively use to release anxieties brought on by the grieving process.

Things to Consider:

. Remember, it may get worse before it gets better. . Remain with the regular schedule as much as possible. . Be supportive.

Avoid comments which appear judgmental. “It’s not so bad.” “Don’t worry about it.” Remember that the teacher’s behavior is a model to the student on how to remain in control during a crisis. If the student gets extremely loud, the teacher should decrease his or her volume. If the student moves rapidly, the teacher should move slowly. If the student gets physical, the teacher should maneuver other students out of the way. Alter the environment, considering the safety factors. Be sure that what is communicated verbally coincides with what is communicated with body language.

RED FLAGS

(If any of these behaviors are observed, refer the student immediately to a counselor).

. Settling affairs . Giving away personal possessions . Inquiring about the hereafter . Inquiring about legal matters relating to insurance . Eating disorders . Sleeping disorders . Extreme or inappropriate emotions . Loss of concentration, confused thinking . Running away . High anxiety level . Very heavy smoking

. Verbalizations about suicide . Statements about revenge . Impatience or impulsivity . Depression, sadness . Lack of energy or restless over activity . Withdrawal from social activities . Loss of interest in hobbies, sports, job, or school . Increased risk-taking . Frequent accidents . Previous suicide attempts . Increase in substance abuse . Reporting that voices are telling them to kill themselves . Trouble with the law

Additional Suggestions for Helping Teachers

1. Be prepared for tears. Crying is a normal and healthy reaction, even though this can make you or some students uncomfortable.

2. Recognize that some students who are traumatized by this topic may be very quiet or seem to be in a daze. Be alert to this possibility and have someone bring these students to the counseling office.

3. Send grieving students to the counseling office. A counselor or student will be there to assist them.

4. During the day, let your students discuss this event or allow them to write about their feelings.

5. Just listening to students express their feelings and responding to the “hurt” is helpful. Supportive responses include:

“I can see that you are really hurting.” “It is very hard to accept the death of someone you know well.” “I know... it just seems unbelievable.” “It really hurts.”

The following types of responses are NOT helpful:

“You will feel better tomorrow.” “Don’t think about it now.” “A friend of mine died when I was your age and I got over it.” “Don’t be upset.” “You shouldn’t feel that.” “It could be worse, you still have……….” “I know how you feel.” “You are stronger because of this.” “It is God’s will” “It is probably for the best.”

28 HELPING A STUDENT GRIEVE AFTER A DEATH IN THE FAMILY

Literature indicates that during childhood, one in every twenty children in the United States will lose a parent to death. And by age 16, one in every five children will have lost at least one parent.

The following are some suggestions for helping students face such loss:

1. Remember that students can make a difference in helping students when they have problems with death, because most of them have faced the death of loved ones and other significant losses.

2. Listen and sympathize. Make sure you hear what is said (non-verbal response, facial, expressions, tone of voice, etc.).

3. Maintain a sympathetic, non-shaming attitude toward the students’ responses.

4. Respond with real feelings. Be willing to share your feelings.

5. Allow the student to cry by giving permission: “Go ahead and cry; it’s all right.” Permission may be necessary, since so many strong feelings are labeled as being publicly unacceptable and some students are taught to show only a stoic face in public.

6. Remember that ignoring grief does not cause it to go away. Research has indicated a relationship between antisocial behavior in adolescence and unresolved grief over the death of a loved one.

7. Assure students that they are not responsible for the person’s death because they might have had negative feelings about him or her at some time.

8. Refer students for help when necessary. This is a tricky area because sometimes normal grief looks very much like mental illness. When a teacher sees behaviors, such as regressive changes in bowel and bladder control, persistent sleep problems, excessive aggression, hyperactivity, extended loss of concentration, extended withdrawal, continued regression into lower developmental behavior levels, wild swings in emotions or thoughts that indicate a loss of contact with reality, it is time to refer that student.

9. Recognize that grief may last over an extended period of time. When grief is openly and deeply expressed, the first six months constitute the most stressful period, with recovery beginning during the first year and occurring more conclusively by the end of the second year.

29 Suicide Ideation/Risk

Students at risk for suicide have become increasingly more common and are being reported at even younger ages. Since suicide rarely happens without warning, school personnel need to take all comments about suicidal thought seriously, especially if details of a suicide plan are shared.

When a student is considered to be at risk for suicide, a parent or guardian must be contacted and involved from the onset. Anytime that the risk of suicide exists, an appropriately trained Campus Crisis Response Team (CCRT), composed of an administrator, counselor, and a nurse, must manage the situation. All assessments of threats, attempts or other risk factors of suicide must be left to an appropriate outside qualified clinical professional. In case of suicidal risk, the school should do the following:

 Escort student to a member of the Campus Crisis Response Team (Administrator, Counselor or Nurse)  Counselor will maintain a confidential record of all actions taken (screen form, safety plan, parent conference form, and follow-up conference form).  Place the student under the security/watch of an adult who will maintain constant supervision.  Counselor and Nurse will meet with the student.  Call parents/guardians to come to school and have them sign the “Notification of Crisis Intervention” form.  Utilize the “Screening for Level of Suicidal Risks: Interview Guidelines” form to provide an evaluation. This assessment will provide a guideline only before the student is further evaluated by an appropriate outside qualified clinical professional.  If a student refuses to answer the screening questions and/or sign the “Student Suicide Safety Plan”, he/she is considered a High Risk.  Campus Crisis Response Team (CCRT) will work with the parents/guardians in ensuring that they provide appropriate psychological/medical assistance for their child. Provide sources from Referral Agencies at Your Fingertips.  Conduct a follow-up conference and fill out the “Follow-up Conference”. Student must have psychological/medical clearance before being allowed to return to classes. A member of the CCRT will make direct contact with parents/guardians and the student.

In the event that the student’s parents/guardians cannot be contacted, and after a reasonable amount of time has elapsed, the school should then call the B.I.S.D. Police Department at 956-982-3085. They have the authority to transport the student.  If the parent or family members listed on records cannot be reached, call BISD Police at 956-982-3085.

 If a parent/guardian is uncooperative, then the Department of Family and Protective Services (DFPS) should be contacted at 1-800-252-5400 and a report should be made under medical neglect.

 If the student is a Ward-Of the-State, ensure that the DFPS caseworker is notified.  Maintaining a high level of confidentiality, notify the Program Administrator (Director) of Guidance and Counseling of developments and follow-up.

Suicide Warning Signs

 Suicide threats

 Previous suicide attempts

 Alcohol and drug abuse

 Statements revealing a desire to die

 Sudden changes in behavior

 Prolonged depression

 Making final arrangements

 Giving away prized possessions

 Purchasing a gun or stockpiling pills

Suicide Intervention Tip

Thoughts of suicide may be activated by:  Prior knowledge of intent of a friend’s suicide attempt

 Existence of a plan

 History of psychopathology and noncompliance

 Previous suicidal behavior

 Identification with the victim

 Academic failure

 Substance abuse

 History of family discord

 Loss of relationships

 Disciplinary crisis

 Exposure to a family/friend who has attempted/completed suicide.

 Marked changes in behavior and interpersonal relationships

 The availability of lethal means

Suicide Ideation includes:

 Threats to harm oneself

 Gestures

 Ideations – written/oral

SUICIDE INTERVENTION PROCEDURES

Suicide is a major cause of death among adolescents in the United States. A suicidal person experiences feelings of wanting to die or wanting to live. Both occur at the same time. This ambivalence is what makes suicide prevention possible.

To the pre-kindergarten child, suicide is not the fearsome reality that it is to older children. To the younger child, death and suicide can be turned on and off, just like a fantasy. The child uses the suicide threat to inform the parent of his need for greater attention. To the elementary school child, suicide threats or attempts are seen as a means to communicate anger or to punish parents.

Preadolescence and adolescence is the time of preparation for adulthood, for an evolving self, which includes developing life skills. Many troubled youngsters try to escape from reality with drugs; others see suicide as a solution to their problems. Keep in mind that suicide is a permanent solution to a temporary problem.

If the student approaches you to discuss suicide, assume that the student is interested in seeking help and is seriously considering harming him or herself.

All talk about suicide should be taken seriously and prompt attention should be given. If a student verbalizes, writes or discusses thoughts of suicide or harming him/her self, immediately accompany or escort the student to a counselor or administrator.

Under no circumstances should an untrained person attempt to assess the severity of the suicidal risk; all assessments of threats, attempts or other risk factors must be determined by the counselor.

TEACHER AND STAFF RESPONSIBILITIES:

1. Do NOT leave the student alone.

2. Escort the student to the counselor/administrator or call for security.

3. If counselor is not available, escort the student to the nurse.

4. Do NOT leave messages with the assumption that the situation will be dealt with.

5. Do NOT allow the student to leave the area or go to the restroom alone or to attend classes.

6. After school hours: If a teacher or staff becomes aware of a suicidal threat or action by a student, notify the on-site administrator. If no one is available, call Brownsville Independent School District Police at 956-982-3085.

COUNSELOR RESPONSIBILITIES: IF PARENT OR GUARDIAN CAN BE LOCATED

 Remain with the student.  Screen the student to assess the risk level using the form “Screening for Level of Suicidal Risk: Interview Guidelines”  Consult with the following Campus Crisis Response Team: Counselor, Nurse and Administrator and / or supervisor, if appropriate.

1. Complete the “Student Suicide Safety Plan” form with the student.

2. Contact parents or guardians and hold a parent conference, have “Notification of Emergency Conference” form signed and give a resource list from Referral Agencies at Your Fingertips to the parents.

3. Alert the assigned campus police officer to be aware of the situation, if appropriate.

4. Release the student to the family and obtain parent’s signatures on Notification of Emergency Conference form.

5. If the parents are willing to come to school but have no transportation, then contact the BISD Police Department at 956-982-3085 for assistance with transportation. 6. Follow-up the next day with Campus Crisis Response Team:  The student must provide clearance from a mental health provider/physician before being allowed to return to classes.

IF PARENT OR GUARDIAN CANNOT BE LOCATED:

Low Risk Students

 Administrator, Nurse or Counselor must remain with the student.  Screen the student to assess the risk using the form “Screening for Level of Suicide Risk: Interview Guidelines.”  Consult with the following Campus Crisis Team members: Counselor, Nurse and Administrator, if appropriate.

34 1. If the parents are willing to come to school but have no transportation, then contact the BISD Police Department at 956-982-3085 for assistance with transportation. 2. If the parents cannot be reached, these procedures will be followed: a. “Complete the Student Suicide Safety Plan” form, if appropriate. b. The Campus Crisis ResponseTeam may remain with the student, until the parent is reached. (Refer to Penal Code 20.02: Unlawful Restraint.) c. Call the adults listed on campus emergency information card. If no one can be reached, call the BISD Police Department for assistance at 956-982-3085. The campus staff will continue all through the evening to try and reach the parent, responsible adult or relative.

3. If the parent is unwilling to contact or come to the school and the staff member believes that the student’s physical or mental health or welfare has been adversely affected by abuse or neglect, call the department of Family and Protective Services At 1-800-252-5400 (emphasize that a team of three professionals have concerns about the parent’s unresponsiveness).

4. The Campus Crisis Response Team must follow-up with the following:

 The student must provide clearance from a mental health provider before being allowed to return to classes.  Make direct contact with student and parent/guardian.

Medium-Risk Students

 An administrator, nurse or counselor must remain with the student.  Screen the student to assess the risk using the form “Screening for Level of Suicide Risk: Interview Guidelines.” Consult with the following Campus Crisis Team members: Counselor, Nurse and Administrator. 1. If the parent or family members listed on the campus emergency card cannot be reached, the following procedures will be followed: a. Complete the “Student Suicide Safety Plan” form. b. The following Campus Crisis Team Members: Counselor, Nurse, or Administrator will complete the Need for Emergency Assistance form. c. Call the B.I.S.D. Police Department at 956-982-3085 to determine whether the student meets the criteria for an Application to Facility for Emergency Detention Without a Warrant for Preliminary Evaluation. d. The Administrator, Nurse or Counselor will remain with the student, until the parent/guardian or family member listed on the campus emergency card is reached. e. When the parent arrives, proceed with a parent conference, have the “Notification of Emergency Conference” form signed, and give the parent a list of resources from the Referral Agencies at Your Fingertips.

35 2. If the parent is unwilling to contact or come school and the Campus Crisis ResponseTeam Members believe that the student’s physical, mental health or welfare has been adversely affected by abuse or neglect, call the Department of Family and Protective Services at 1-800-252-5400. (Emphasize that a team of three professionals have concerns about the parent’s unresponsiveness). 3.The Campus Crisis Team must follow-up with the following:

 The student must provide clearance from a mental health provider before being allowed to return to classes.  Make direct contact with student and parent/guardian. 36High Risk Students

 An Administrator, Nurse or Counselor must remain with the student. Screen the student to assess the risk using the form “Screening for Level of Suicide Risk: Interview Guidelines” form.  Consult with the Campus Crisis Response Team, if appropriate.

1. If the parent/guardian is willing to come to school, but has no transportation, then the Counselor, Nurse or Administrator will contact the BISD Police Department at 956-982-3085 for assistance with transportation. Upon the parents arrival, the “Notification of Emergency Conference” form will be signed and a list with resources from Referral Agencies at Your Fingertips will be given. Parents will agree to arrange transportation to community/regional resource facility.

2. If a family member cannot be reached, the Campus Crisis Response Team (Counselor, Nurse, and Administrator) will complete the Need for Emergency Assistance form.

3. Call BISD Police Department to determine whether the student meets the criteria for an Application to Facility for Emergency Detention Without a Warrant for Preliminary Evaluation (Health and Safety Code Section 462.041)

4. If the student meets the criteria for Section 462.041, the student will be transported to a community facility for emergency assistance by the BISD Police or the Brownsville Police Department.

5. If the parent is unwilling to contact or come to the school and the staff member believes that the student’s physical, mental health, or welfare has been adversely affected by abuse or neglect, call Department of Family and Protective Services at 1-800-252-5400. (Emphasize that a team of three professionals have concerns about the parent’s unresponsiveness.)

6. The Campus Crisis Team must follow-up with the following:

 The student must provide clearance from a mental health provider before being allowed to return to classes.  Make direct student contact.  Make direct parent/guardian contact.

37 BROWNSVILLE INDEPENDENT SCHOOL DISTRICT Screening for Level of Suicide Risk: Interview Guidelines *Modify to student’s age

Name: ______ID :______Grade______

Campus: ______Date: ______

Instructions: Use the following questions to guide in interviewing the student.

Scoring Indicators: (Crisis Team Decision-Administrator, Counselor and Nurse)

H (High Risk) M (Medium Risk) Low (Low Risk)

I. Personal Information

H M L Are you thinking about hurting yourself right now?

______

H M L How long and how often have you been thinking about this?

______

H M L Do you have a plan that you can put into action now? Tell me the plan you had?

______

H M L Do you have access to anything that can hurt you?

______

H M L *Are you using alcohol or other drugs?

______

38 II. History

H M L Have you told anyone about what we’re talking about? Who?

______

H M L What happened that made you start thinking about hurting yourself?

______

H M L *Have you made any preparations (such as saving up pills, obtaining a gun, writing a note/online website, giving away special possessions, etc.)?

______

H M L Have you ever thought that hurting yourself was a way to hurt others? (example parents, boyfriend, girlfriend, etc.)

______

H M L *On a scale from 1 – 10, with 1 being low and 10 being high, what

number depicts the probability that you will attempt suicide?

______

H M L Is this the first time you’ve thought about this? When?

______

H M L Will you tell me about it? What happened?

______

H M L *Has anyone in your family ever committed suicide?

______

H M L Have you had any accidents or done anything reckless lately? ______

______

III. Significant Persons

H M L What is your biggest worry right now?

______

H M L What matters to you the most?

______

IV. Student Safety Plan

H M L Will you sign a Student Safety Plan? (If the answer is no, student qualifies

as a high risk student) ______

Note: Committee members should consider answers to the questions and overall demeanor of student when deciding risk level. Risk Factor Level:

Circle one: LOW MEDIUM HIGH

______

Committee Member Signature/Title Committee Member Signature/Title

______Committee Member Signature/Title

Brownsville Independent School District Student Suicide Safety Plan

I, ______, a student at ______, Name School agree not to harm myself in any way. I understand that if I am having suicidal thoughts that I agree to call ______at______. Family member’s name Phone I will also call ______at ______. Resource Phone

I know I can also call:

Family Outreach - (956) 541-5566 Palmer Drug Abuse Program – (956) 544-3333 Tropical Texas MHMR Children’s Unit (956) 546-2230 Girls/Boys Town National Hotline – 1-800-448-3000 Friendship of Women – 544-7412 BISD Guidance & Counseling Webpage – www.bisd.us/guidance

If I cannot reach them, I will call 911 and get help for myself.

Student Signature: ______

Counselor’s Signature: ______

Other: ______

Date: ______

Important: Students will need to provide clearance from mental health provider in order to come back to school.

BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities.

41 Brownsville Independent School District

Plan de Seguridad para el Estudiante

Yo,______estudiante de ______Nombre Escuela acuerdo en que de ninguna manera me haré ningún daño. Entiendo que si tengo

pensamientos de cometer suicidio, también convengo en llamar a la siguiente persona:

______al ______Nombre del familiar Teléfono

Yo sé que también puedo llamar a:

Family Outreach- (956) 541-5566 Palmer Drug Abuse Program- (956) 544-3333 Tropical Texas MHMR Children’s Unit (956) 546-2230 Girls/Boys Town National Hotline- 1-800-448-3000 Friendship of Women – 544-7412

BISD Guidance & Counseling Webpage – www.bisd.us/guidance

Si no encuentro a nadie, llamaré al 911 y pediré ayuda.

Firma del Estudiante:______

Firma del Consejero:______Otra firma:______

Fecha:______

IMPORTANTE: Se les requiere a los estudiantes que traigan documentación médica indicando que pueden regresar a la escuela.

BISD no discrimina a base de raza, color, origen nacional, sexo, religión, edad o discapacidad en el empleo en la provisión de servicios o actividades.

42 Brownsville Independent School District Notification of Emergency Conference I, or we ______, the parent/s of ______were involved in a conference on ______(date) with the school personnel at ______School. We have been advised that our child has made statements concerning thoughts of suicide to school personnel. We have been further advised that we should seek psychological/psychiatric consultation immediately. We have been provided with a list of agencies and emergency numbers. I understand that if no help is sought for my child, state and federal law requires school personnel to notify Department of Family and Protective Services.

Check One: ( ) I, or We, agree to follow through with the recommendations made. ( ) I, or We, disagree with the recommendations made and take full responsibility for the welfare of my child and any outcome of this crisis. ______Parent or Legal Guardian Parent or Legal Guardian ______Principal Counselor ______Date FOLLOW UP: [Counselor will verify and follow up with parent by ______(date). Steps taken by Parent: ______Student Status:______Date: ______Signature: ______Important: Students will need to provide clearance from mental health provider in order to come back to school.

BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities

Aviso de Conferencia de Emergencia

Yo (ó Nosotros)______, padres de______

Fuimos participes de una conferencia el ______con el personal de la escuela Fecha ______. Se nos ha informado que nuestro hijo/hija ha hecho comentarios al personal de la escuela sobre cometer suicidio . Además, se nos ha indicado que debemos buscar ayuda psicológica/psiquiátrica inmediatamente. Se nos ha

proporcionado una lista de agencias y números de emergencia. Entiendo/entendemos que si no se busca ayuda para mi hijo/hija, las leyes federales y estatales requiren que el personal de la escuela notifíque a la Agencia de protección a menores (Dept. of Family and Protective

Services). Marque uno:

( ) Estoy/estamos de acuerdo en seguir las recomendaciones que se han hecho.

( ) No estoy/estamos de acuerdo con las recomendaciones que se han hecho y acepto/aceptamos la responsabilidad por el bienestar de mi hijo/hija y del resultado de esta crisis. ______

Padre ó Tutor Padre ó Tutor ______

Director Consejero ______

Seguimiento: Consejero verificará y dará seguimiento con el ó los padres para ______. Fecha Medidas tomadas por los padres: ______Estado del estudiante: ______Fecha: ______Firma: ______IMPORTANTE: Se les requiere a los estudiantes que traigan documentación médica indicando que pueden regresar a la escuela.

BISD no discrimina a base de raza, color, origen nacional, sexo, religión, edad o discapacidad en el empleo en la provisión de servicios o actividades. 44 Brownsville Independent School District

NEED FOR EMERGENCY ASSISTANCE

We, the undersigned, make this statement of concern regarding ______, (Name) On this ______day of ______, 201____, at ______a.m./p.m. at

______. (Campus) Emergency assistance is sought for the following reasons:

(1) We have reason to believe that the student evidences a risk of serious harm to himself or others which is described as follows: (specify and describe the risk or harm that the person presents)______

______

(2) We have reason to believe that the risk of harm is imminent, unless intervention measures are immediately taken.

______

______Counselor’s Signature Date

______Nurse’s Signature Date

______Administrator’s Signature Date

My signature certifies that I received this report. ______Signature of Peace Officer

______Title Date Time

BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities.

45 “Risky Youth Behavior” ... Strangulation

Strangulation is a dangerous activity that older children and early adolescents sometimes play to get a brief high. They either choke each other or use a noose to choke themselves; hence, this activity has become known by the nation’s youth as ‘the choking game’. However, in spite of its title, this common activity is far from a game due to the fact that after just a short time, children can pass out; which may lead to serious injury or even death from hanging or strangulation.

What is the choking game? The choking game is a dangerous activity that older children and early adolescents sometimes play to get a brief high. They either choke each other or use a noose to choke themselves. After just a short time, children can pass out, which may lead to serious injury or even death from hanging or strangulation. Who is most at risk for death from playing the choking game?  Boys were much more likely to die from the choking game than girls; 87% of victims were boys.  Most of the children that died were 11-16 years old (89%).  Nearly all of the children who died were playing the game alone when they died.  Deaths have occurred all over the United States; the choking game is not limited to one area of the country. What are the warning signs to look for that a child is playing the choking game? Parents, educators, health-care providers, or peers may observe any of the following signs that can indicate a child has been involved in the choking game:

 Discussion of the game or its aliases  Bloodshot eyes  Marks on the neck  Wearing high-necked shirts, even in warm weather  Frequent, severe headaches  Disorientation after spending time alone  Increased and uncharacteristic irritability or hostility  Ropes, scarves, and belts tied to bedroom furniture or doorknobs or found knotted on the floor  The unexplained presence of dog leashes, choke collars, bungee cords, etc.  Petechiae (pinpoint bleeding spots) under the skin of the face, especially the eyelids, or the conjunctiva (the lining of the eyelids and eyes)

46 What are some of the other names used for this risky behavior?  Pass-out game  Choking game  Space monkey  Suffocation roulette  Scarf game  The American dream  Fainting game  Something dreaming game  Purple hazing  Blacking out/blackout  Dream game  Flat liner  California choke  Space cowboy  Airplaning  Purple dragon  Cloud nine How quickly can someone die after performing this stunt? Someone can become unconscious in a matter of seconds. Within three minutes of continued strangulation (i.e., hanging), basic functions such as memory, balance, and the central nervous system start to fail. Death occurs shortly after. Are there non-fatal, long-term consequences? • Loss of consciousness and death of brain cells due to oxygen deprivation in the brain; coma and seizures may occur in severe cases • Concussions or broken bones (including jaws) from falls associated with the act • Hemorrhages of the eye How can the choking game be prevented? Research is not available on the best strategies to prevent the choking game. However, parents, educators, and health-care providers should be made aware of this public health threat and the warning signs that adolescents may be experimenting with this risky behavior.

47 Self Harm

One common classification of pathological self-mutilation concerning middle and high school educators is Repetitive Self-Mutilation Syndrome (RSM). RSM is referred to by many terms, such as self-injurious behavior, parasuicidal behavior, and deliberate self- harm. Forms of RSM include cutting, scratching, burning, head banging, preventing wounds from healing, picking, poking, and hair pulling. Of these, cutting is by far the most common behavior. RSM behaviors differ from many culturally sanctioned behaviors-such as ritual tattooing and piercing-that typically are intended as ornamentation or for established cultural, spiritual, or social purposes. Experts generally consider RSM to be an impulse disorder. This group of disorders includes alcohol and substance abuse, suicide attempts, shoplifting, and eating disorders. Impulsive behaviors have two factors in common: First, they occur episodically, meaning that a student will not harm herself everyday but intermittently and usually following some precipitating event. Second, there is some gratification achieved by the behavior, which is why it becomes addictive and repetitive. As the adolescent cuts or burns herself, the brain secretes endorphins that are natural antidepressants. This is one of the disconcerting aspects of the behavior that makes it difficult for the observer to understand. It is a natural instinct to ask, "Doesn't that hurt?" but the answer is usually no. A student who is actively self-mutilating often does not report feeling pain, but rather a sense of relief, release, calm, or satisfaction. They also often feel isolated and ashamed afterward.

48 Is it a Suicide Attempt?

RSM is a recurrent failure to resist impulses to harm one's body physically without conscious suicidal intent. In fact, these students are self-mutilating so they do not kill themselves. Although the suicidal student seeks to end his or her life and painful feelings, the student who self-mutilates seeks to feel better and, usually, is crying out for help. The wounds are typically not life threatening-for example on the inner thighs, forearms, and torso-as opposed to fully slitting the wrists. This does not mean that suicide is not a concern. Although the self-mutilator may not be driven by suicidal intention during the act, he or she may be actively traveling down a very self-destructive path. At some point, self-mutilators may have considered suicide or tried to harm themselves more seriously-or may do so in the future. For many of these students, RSM behaviors surface at a time of crisis when their coping skills are poor. They are at a particularly dangerous turning point when their negative thoughts evolve into harmful behavior. Educators must stay vigilant in identifying and referring students who display RSM behaviors to provide appropriate interventions and assess suicide risk.

Intervention Recommendations – Handle Initially as a Suicide Risk

The best role is to identify students who self harm; refer them to and coordinate with community mental health resources; and offer safe, caring, and nonjudgmental support. Most students who self-mutilate, however, are better off attending school and knowing that they have the option to leave the classroom if they become overwhelmed. The school psychologist's or counselor's office may be the only safe place that a student struggling with the impulse to self-mutilate can go during the school day. These students need to connect with someone who cares and understands their plight; who is comfortable letting them talk, cry, or rant without criticism; and who can help them employ alternative coping mechanisms.

49 SELF HARM INTERVENTION PROCEDURES

If the student approaches you to discuss self harm, assume that the student is interested in seeking help and is seriously considering harming him or herself.

All talk about self harm should be taken seriously and prompt attention should be given. If a student verbalizes, writes or discusses thoughts harming him/her self, immediately accompany or escort the student to a counselor or administrator.

Under no circumstances should an untrained person attempt to assess the severity of the self harm risk; all assessments of threats, attempts or other risk factors must be determined by the Campus Crisis Response Team composed of the Administrator, Counselor and Nurse.

TEACHER AND STAFF RESPONSIBILITIES:

1. Do NOT leave the student alone.

2. Escort the student to the Counselor/Administrator or call for security.

3. If Counselor is not available, escort the student to the nurse.

4. Do NOT leave messages with the assumption that the situation will be dealt with.

5. Do NOT allow the student to leave the area or go to the restroom alone or to attend classes.

6. After school hours: If a teacher or staff becomes aware of a self harm threat or action by a student, notify the on-site administrator. If no one is available, call Brownsville Independent School District Police at 956-982-3085.

50 COUNSELOR RESPONSIBILITIES: IF PARENT OR GUARDIAN CAN BE LOCATED

 Remain with the student.  Screen the student to assess the risk using the form “Screening for Level of Self Harm Risk: Interview Guidelines.”  Consult with the following Campus Crisis Response Team: Counselor, Nurse and Administrator and / or supervisor, if appropriate.

1. Complete the “Student Safety Plan” form with the student.

2. Contact parents or family and hold a parent conference, have “Notification of Emergency Conference” form signed and give parents or family a list of resources from Referral Agencies at Your Fingertips.

3. Alert the assigned campus police officer to be aware of the situation, if appropriate.

4. Release the student to the family and obtain parent’s signatures on “Notification of Emergency Conference” form.

5. If the parents are willing to come to school but have no transportation, then contact the BISD Police Department at 956-982-3085 for assistance with transportation.

6. Follow-up the next day with Campus Crisis Response Team: a. The student must provide clearance from a mental health provider/physician before being allowed to return to classes. b. Make direct contact with student and parent/guardian.

IF PARENT OR GUARDIAN CANNOT BE LOCATED:

Low Risk Students

 Administrator, Nurse or Counselor must remain with the student.  Screen the student to assess the risk using form “Screening for Level of Self Harm Risk: Interview Guidelines.”  Consult with the following Campus Crisis Team members: Counselor, Nurse and Administrator, if appropriate.

1. If the parents are willing to come to school but have no transportation, then contact the BISD Police Department at 956-982-3085 for assistance with transportation.

2. If the parents cannot be reached, these procedures will be followed: a) Complete the “Student Safety Plan” form, if appropriate. b) The Campus Crisis Response Team may remain with the student until the parent is reached. Call the adults listed on campus emergency information card. If no one can be reached, call the BISD Police Department for assistance at 956-982-3085. The campus staff will continue all through the evening to try and reach the parent, responsible adult or relative. 51 3. If the parent is unwilling to contact or come to the school and the staff member believes that the student’s physical or mental health or welfare has been adversely affected by abuse or neglect, call the Department of Family Protective Services at 1-800-252-5400.

4. The Campus Crisis Response Team must follow-up with the following:

 The student must provide clearance from a mental health provider before being allowed to return to classes.  Make direct contact with student and parent/guardian.

Medium-Risk Students

 An administrator, Nurse or Counselor must remain with the student.  Screen the student to assess the risk using the form “Screening for Level of Suicidal Risk: Interview Guidelines.”

1. Consult with the following Campus Crisis Response Team members: Counselor, Nurse, and Administrator. 2. If the parent or family members listed on the campus emergency card cannot be reached, the following procedures will be followed: a) Complete the “Student Safety Plan” form. b) The following Campus Crisis Response Team Members: Counselor, Nurse, or Administrator will complete the “Need for Emergency Assistance” form. c) Call the B.I.S.D. Police Department at 956-982-3085 to determine whether the student meets the criteria for an Application to Facility for Emergency Detention Without a Warrant for Preliminary Evaluation. d) The Administrator, Nurse or Counselor will remain with the student, until the parent/guardian or family member listed on the campus emergency card is reached. e) When the parent arrives, proceed with a parent conference, have the “Notification of Emergency Conference” form signed, and give the parents a list of resources from the Referral Agencies at your Fingertips. 3. If the parent is unwilling to contact the school or come to the school and the CCRT members believe that the student’s physical or mental health or welfare has been adversely affected by abuse or neglect, call the Department of Family and Protective Services at 1-800-252-5400. Emphasize that a team of three professionals have concerns about the parent’s unresponsiveness.

4.The Campus Crisis Team must follow-up with the following:

 The student must provide clearance from a mental health provider before  being allowed to return to classes.  Make direct contact with student and parent/guardian.

52High Risk Students

. An Administrator, Nurse or Counselor must remain with student. Screen the students to assess the risk using the form “Screening for Level of Self Harm Risk: Interview Guidelines.” . Consult with the Campus Crisis Response Team, if appropriate.

1. If the parent/guardian is willing to come to school, but have no transportation, then the Counselor, Nurse or Administrator will contact the B.I.S.D. Police Department at 956-982-3085 for assistance with transportation. Upon the parents’ arrival, the “Notification of Emergency Conference” form will be signed and a list of resources from Referral Agencies at Your Fingertips will be given to the parents. The parents will arrange transportation to community/regional resources facility.

2. If a family member cannot be reached, the Campus Crisis Response Team (Counselor, Nurse, and Administrator) will complete the “Need for Emergency Assistance” form.

3. Call B.I.S.D. Police Department to determine whether the student meets the criteria for an Application to Facility for Emergency Detention Without a Warrant for Preliminary Evaluation (Health and Safety Code Section 462.041)

4. If the student meets the criteria for Section 462.041, the student will be transported to a community facility for emergency assistance by the B.I.S.D. Police or the Brownsville Police Department.

5. If the parent is unwilling to contact the school or come to the school and the staff member believes that the student’s physical or mental health or welfare has been adversely affected by abuse or neglect, call Department of Family and Protective Services at 1-800-252- 5400. (Emphasize that a team of three professionals have concerns about the parent’s unresponsiveness.)

6. The Campus Crisis Response (CCRT) Team must follow-up with the following:

 The student must provide clearance from a mental health provider before being allowed to return to classes.  Make direct student contact.  Make direct parent/guardian contact.

53 BROWNSVILLE INDEPENDENT SCHOOL DISTRICT Screening for Level of Self Harm Risk: Interview Guidelines *Modify to student’s age

Name: ______ID:______

Campus: ______Date: ______

Instructions: Use the following questions to guide in interviewing the student.

Scoring Indicators: (Committee decision-Administrator, Counselor and Nurse)

H (High Risk) M (Medium Risk) Low (Low Risk)

I. Personal Information

H M L Are you thinking about hurting yourself right now?

______

H M L How long and how often have you been thinking about this? ______

H M L Do you have a plan that you can put into action now? Tell me the plan you had?

______

H M L Do you have access to anything that can hurt you?

______

H M L *Are you using alcohol or other drugs?

______

54 II. History

H M L Have you told anyone about what we’re talking about? Who?

______H M L What happened that made you start thinking about hurting yourself?

______

H M L *Have you made any preparations (such as saving up pills, obtaining a gun, writing a note/online website, giving away special possessions, etc.)?

______

H M L Have you ever thought that hurting yourself was a way to hurt others? (example parents, boyfriend, girlfriend, etc.)

______

H M L *On a scale from 1 – 10, with 1 being low and 10 being high, what number depicts the probability that you will attempt suicide? ______

H M L Is this the first time you’ve thought about this? When?

______

H M L Will you tell me about it? What happened?

______

H M L *Has anyone in your family ever committed suicide?

______

H M L Have you had any accidents or done anything reckless lately?

______

III. Significant Persons H M L What is your biggest worry right now?

______

H M L What matters to you the most?

______

IV. Student Safety Plan

H M L Will you sign a Student Safety Plan? (If the answer is no, student qualifies

as a high risk student) ______

Note: Committee members should consider answers to the questions and overall demeanor of student when deciding risk level.

Risk Factor Level:

Circle one: LOW MEDIUM HIGH

______

Committee Member Signature/Title Committee Member Signature/Title

______Committee Member Signature/Title 56 Brownsville Independent School District

Student Safety Plan

I, ______, a student at ______, Name School agree not to harm myself in any way. I understand that if I am having self harming thoughts, I agree to call ______at______. Family member’s name Phone I will also call ______at ______. Resource Phone

I know I can also call:

Family Outreach - (956) 541-5566 Palmer Drug Abuse Program – (956) 544-3333 Tropical Texas MHMR Children’s Unit (956) 546-2230 Girls/Boys Town National Hotline – 1-800-448-3000 Friendship of Women – 544-7412 BISD Guidance & Counseling Webpage – www.bisd.us/guidance

If I cannot reach them, I will call 911 and get help for myself.

Student Signature: ______

Counselor’s Signature: ______

Other: ______

Date: ______

Important: Students will need to provide medical release to come back to school.

BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities. 57 Brownsville Independent School District

Plan de Seguridad para el Estudiante

Yo,______estudiante de ______Nombre Escuela acuerdo en que de ninguna manera me haré ningun daño. Entiendo que si tengo

pensamientos de hacerme algún daño, también convengo en llamar a la siguiente persona:

______al ______Nombre del familiar Teléfono

Yo sé que también puedo llamar a:

Family Outreach- (956) 541-5566 Palmer Drug Abuse Program- (956) 544-3333 Tropical Texas MHMR Children’s Unit (956) 546-2230 Girls/Boys Town National Hotline- 1-800-448-3000 Friendship of Women – 544-7412

BISD Guidance & Counseling Webpage – www.bisd.us/guidance

Si no encuentro a nadie, llamaré al 911 y pediré ayuda.

Firma del Estudiante:______

Firma del Consejero:______Otra firma:______

Fecha:______

IMPORTANTE: Se les requiere a los estudiantes que traigan documentación médica indicando que pueden regresar a la escuela.

58 Brownsville Independent School District Notification of Emergency Conference

I, or we ______, the parent/s of ______were involved in a conference on ______(date) with the school personnel at ______School. We have been advised that our child has made statements concerning thoughts of self-injury behavior to school personnel. We have been further advised that we should seek psychological/psychiatric consultation immediately. We have been provided with a list of agencies and emergency numbers. I understand that if no help is sought for my child, state and federal law requires school personnel to notify Department of Family and Protective Services. Check One: ( ) I, or We, agree to follow through with the recommendations made. ( ) I, or We, disagree with the recommendations made and take full responsibility for the welfare of my child and any outcome of this crisis. ______Parent or Legal Guardian Parent or Legal Guardian ______Principal Counselor ______Date

Follow-up: [Counselor will verify and follow up with parent by ______(date).] Steps taken by Parent: ______Student Status: ______Date: ______Signature: ______

Important: Students will need to provide medical release to come back to school. BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities. 59 Brownsville Independent School District

Aviso de Conferencia de Emergencia Yo(Nosotros)______, padres de______Fuimos participes de una conferencia el______(fecha)Con el personal de la escuela______.Se nos ha informado que nuestro hijo/hija ha hecho comentarios al personal de la escuela sobre cometerse daño a si mismo/a . Además, se nos ha indicado que debemos buscar ayuda psicológica/psiquiátrica inmediatamente. Se nos ha proporcionado una lista de agencias y números de emergencia. Entiendo/entendemos que si no se busca ayuda para mi hijo/hija, las leyes federales y estatales requieren que el personal de la escuela notifique a la agencia de protección a menores (Dept. of Family and Protective Services). Marque uno:

( ) Estoy/estamos de acuerdo en seguir las recomendaciones que se han hecho.

( ) No estoy/estamos de acuerdo con las recomendaciones que se han hecho y acepto/aceptamos la responsabilidad por el bienestar de mi hijo/hija y del resultado de esta crisis. ______

Padre ó Tutor Padre ó Tutor ______

Director Consejero ______

Fecha Seguimiento: Consejero verificará y dará seguimiento con el ó los padres para ______Fecha Medidas tomadas por los padres: ______Estado del estudiante: ______Fecha: ______Firma: ______Importante: Se les requiere a los estudiantes que traigan documentación médica indicando que pueden regresar a la escuela.

NEED FOR EMERGENCY ASSISTANCE

We , the undersigned, make this statement of concern regarding______(Name) On this ______day of ______, 201____, at ______a.m./p.m. at______. (Campus)

Emergency assistance is sought for the following reasons:

(1) We have reason to believe that the student evidences a risk of serious harm to him/her self which is described as follows: (specify and describe the risk or harm that the person presents)______

(2) We have reason to believe that the risk of harm is imminent, unless intervention measures are immediately taken.

______

______Counselor’s Signature Date

______Nurse’s Signature Date

______Administrator’s Signature Date

My signature certifies that I received this report.

______Signature of Peace Officer

______Title Date Time

BISD no discrimina a base de raza, color, origen nacional, sexo, religión, edad o discapacidad en el empleo en la provisión de servicios o actividades. 61

School Phobia: Recommendations for School Counselors

School phobia, school avoidance and school refusal are terms that describe an anxiety disorder in children who have an irrational or persistent fear of going to school. Their behavior is different from children who are truant. The majority of children who refuse to attend school are between 8 and 13 years old. Children who have school phobia want to be in close contact with their parent or caregiver, whereas truants do not. School phobic children are often insecure, sensitive and may not know how to cope with their emotions. The most important thing to understand about phobias is that they are not rational. A child who is afraid of dogs is not going to be talked out of it, scolded out of it or punished out of it. Not wanting to go to school may occur at any time, but is most common in children 5 to 7 and 11 to 14, when children are dealing with new challenges of elementary and middle school. These children may suffer from paralyzing fear of leaving the safety of parents at home. The onset of school phobia symptoms usually is gradual. Symptoms may begin after a holiday or illness. Some children have trouble going back to school after weekends or vacations. Research indicates that when a child has difficulty separating from their parents, the best strategy is to inform the child calmly that the parent will return and that the child needs to stay and for the parent to leave quickly. Children typically have more difficulty separating if the parents hover, linger, become upset, wait for the child to calm down, or attempt to reason with the child. A firm, caring and quick separation is usually better for both parent and child.

Differences Between School Phobia and School Truancy:

School Phobia Truancy Severe emotional distress about attending Lack of excessive anxiety or fear about school; may include anxiety, temper attending school. tantrums, depression, or somatic symptoms. Parents are aware of absence; child often Child often attempts to conceal absence tries to persuade parents to allow him/her to from parents. stay at home. Absence of significant antisocial behaviors Frequent antisocial behavior including such as juvenile delinquency. delinquent and disruptive acts (e.g. lying, stealing), often in the company of antisocial peers During school hours child usually stays During school hours, child frequently does home because it is considered a safe and not stay home. secure environment. Child expresses willingness to do school Lack of interest in school work and work and complies with completing work at unwillingness to conform to academic and home. behavior expectations. 62 Warning Signs of School Phobia:

 frequent stomach aches and other physical complaining such as nausea, vomiting, diarrhea, exhaustion and headaches that cannot be attributed to a physical ailment.

 clinginess tantrums, and/or panic when separating from a parent or caregiver.

 fear of the dark or being in a room alone

 trouble going to sleep and/or having nightmares

 constant thoughts concerning safety of self or others

 exaggerated fears of animals, monsters, school, etc.

Home Issues:

A child may:  be experiencing a family change like a move, illness, separation, divorce, death, depression, or financial problems

 have been absent from school due to a long illness

 enjoy a parent’s undivided attention when not in school

 be allowed to watch television, play video games or with toys rather than complete school work

 have an overprotective parent who reinforces the idea that being away from him or her could be harmful

 be apprehensive of an impending tragedy at home

 fear an adult at home might hurt a family member while the child is at school

 be afraid of neighborhood violence, storms, floods, fires, etc.

School issues:

A child may:  fear criticism, ridicule, confrontation or punishment by a teacher or other school personnel

 have learning difficulties- for example, afraid to read aloud, take tests, receive poor grades, be called on to answer questions or perform on a stage

 be afraid of not making perfect test scores 63  be sensitive to a school activity such as singing a certain song, play a specific game, attending a school assembly, eating in a lunchroom, or changing clothes for physical education in front of peers

 exhibit poor athletic ability, being chosen last for a team or being ridiculed for not performing well

 fear teasing due to appearance, clothes, weight, height, etc.

 feel socially inadequate due to poor social interaction skills

 be a victim of peer bullying during school, walking to or from school, or on the school bus

 receive threats of physical harm

Drug Abuse and Addiction Signs, Symptoms, and Help for Drug Problems and Substance Abuse

Understanding drug addiction Addiction is a complex disorder characterized by compulsive drug use. People who are addicted feel an overwhelming, uncontrollable need for drugs or alcohol, even in the face of negative consequences. This self-destructive behavior can be hard to understand. Why continue doing something that causes personal harm? Why is it so hard to stop? The answer lies in the brain. Repeated drug use alters the brain—causing long-lasting changes to the way it looks and functions. These brain changes interfere with one’s ability to think clearly, exercise good judgment, and control behavior. These changes are also responsible, in large part, for the drug cravings and compulsion to use that make addiction so powerful. Five Myths about Drug Addiction and Substance Abuse MYTH 1: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to. Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will. MYTH 2: Addiction is a disease; there is nothing you can do about it. Most experts agree that addiction is a brain disease, but that does not mean he or she is a helpless victim. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments. MYTH 3: Addicts have to hit rock bottom before they can get better. Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Do not wait to intervene until the addict has lost it all. 65

MYTH 4: You cannot force someone into treatment; they have to want help. Treatment does not have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly- resistant addicts decide they want to change. MYTH 5: Treatment did not work before, so there is no point trying again; some cases are hopeless. Recovery from drug addiction is a long process that often involves setbacks. Relapse does not mean that treatment has failed or that you are a lost cause. Rather, it is a signal to get back on track, either by going back to treatment or adjusting the treatment approach. The far-reaching effects of drug abuse and drug addiction. While each drug of abuse produces different physical effects, all abused substances share one thing in common. They hijack the brain’s normal “reward” pathways and alter the areas of the brain responsible for self-control, judgment, emotional regulation,motivation,memory, and learning. Whether someone is addicted to nicotine, alcohol, heroin, Xanax, speed, or Vicodin, the effect on the brain is the same: an uncontrollable craving to use that is more important than anything else, including family, friends, career, and even the person’s own health and happiness. Using drugs as an escape: A short-term fix with long-term consequences

Many people use drugs in order to escape physical and emotional discomfort. They may have started drinking to numb feelings of depression, smoking pot to deal with stress at home or school, relying on cocaine to boost your energy and confidence, using sleeping pills to cope with panic attacks, or taking prescription painkillers to relieve chronic back pain. Instead of treating the underlying problem, the drug use simply masks the symptoms. Take the drug away and the problem is still there, whether it be low self-esteem, anxiety, loneliness, or an unhappy family life. Furthermore, prolonged drug use eventually brings its own host of problems, including major disruptions to normal, daily functioning. Unfortunately, the psychological, physical, and social consequences of drug abuse and addiction become worse than the original problem you were trying to cope with or avoid.

Risk factors that increase a person’s vulnerability to substance abuse addiction include:  Family history of addiction  Abuse, neglect, or other traumatic experiences in childhood  Mental disorders such as depression and anxiety  Early use of drugs

Signs and symptoms of drug abuse and drug addiction Although different drugs have different physical effects, the symptoms of addiction are the same no matter the substance. Common signs and symptoms of drug abuse  You are neglecting your responsibilities at school, work, or home (e.g. failing classes, skipping work, neglecting your children) because of your drug use.  You are using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.  Your drug use is getting you into legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.  Your drug use is causing problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of old friends. Common signs and symptoms of drug addiction  You have built up a drug tolerance. You need to use more of the drug to experience the same effects you used to have with smaller amounts.  You take drugs to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.  You have lost control over your drug use. You often do drugs or use more than you planned, even though you told yourself you would not. You may want to stop using, but you feel powerless.  Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, and recovering from the drug’s effects.  You have abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.

 You continue to use drugs, despite knowing it is hurting you. It is causing major problems in your life—blackouts, infections, mood swings, depression, paranoia—but you use anyway. What drugs are most commonly abused and what are the signs and symptoms? Almost all drugs have the potential for addiction and abuse, from caffeine to prescription medication. However, the majority of non-alcohol related addictions are due to a short list of drugs including sleeping pills, painkillers, cocaine, marijuana, methamphetamine, and heroin. Warning signs that a friend or family member is abusing drugs Drug abusers often try to conceal their symptoms and downplay their problem. If you are worried that a friend or family member might be abusing drugs, look for the following warning signs: Physical warning signs of drug abuse  Bloodshot eyes or pupils that are larger or smaller than usual.  Changes in appetite or sleep patterns. Sudden weight loss or weight gain.  Deterioration of physical appearance and personal grooming habits.  Unusual smells on breath, body, or clothing.  Tremors, slurred speech, or impaired coordination. Behavioral signs of drug abuse  Drop in attendance and performance at work or school.  Unexplained need for money or financial problems. May borrow or steal to get it.  Engaging in secretive or suspicious behaviors.  Sudden change in friends, favorite hangouts, and hobbies.  Frequently getting into trouble (fights, accidents, illegal activities). Psychological warning signs of drug abuse  Unexplained change in personality or attitude.  Sudden mood swings, irritability, or angry outbursts.  Periods of unusual hyperactivity, agitation, or giddiness.  Lack of motivation; appears lethargic or “spaced out.”  Appears fearful, anxious, or paranoid, with no reason.

Warning Signs of Teen Drug Use There are many warning signs of drug use and abuse in teenagers. The challenge for parents is to distinguish between the normal, sometimes volatile, ups and downs of the teen years and the red flags of substance abuse.  Being secretive about friends, possessions, and activities.  New interest in clothing, music, and other items that highlight drug use.  Demanding more privacy; locking doors; avoiding eye contact; sneaking around.  Skipping class; declining grades; suddenly getting into trouble at school.  Missing money, valuables, or prescriptions.  Acting uncharacteristically isolated, withdrawn, or depressed.  Using incense, perfume, or air freshener to hide the smell of smoke or drugs.  Using eye drops to mask bloodshot eyes or dilated pupils Finding help and support for drug addiction  Call 1-800-662-HELP to reach a free referral helpline from the Substance Abuse and Mental Health Services Administration. 69

Bullying

Every day in our schools and communities, millions of students are teased, threatened or tormented by bullies. Bullying is a problem that creates a climate of fear, that affects the whole school, and in some cases, the entire community. When we fail to recognize and stop bullying behavior as it occurs, we actually promote violence. We are saying to the bully, “You have the right to hurt people,” and to the victim, “You are not worth protecting.” Safe schools are everyone’s responsibility and everyone can help keep our schools safe. Bullying is a form of abuse. It comprises repeated acts over time that involves a real or perceived imbalance with the more powerful individual or group abusing those who are less powerful. The effects of bullying can be serious and even fatal. Victims can suffer from long term emotional and behavioral problems. Bullying can cause loneliness, depression, and anxiety leading to low self-esteem and increased susceptibility to illness. The victim of bullying is sometimes referred to as a target. In 2002, a report was released by the U.S. Secret Service concluded that bullying played a significant role in many school shootings and that efforts should be made to eliminate bullying behavior. New legislation related to bullying was passed during the 79th regular session and went into effect on September 1, 2005. The law represents an acknowledgement by the Legislature that every year, countless Texas children are victims of classroom bullying, which impedes student learning. The new law allows a victim to transfer to another classroom or school within the district in order to create a stable learning environment for the victimized student. School districts are now required to address the problem of bullying in the discipline management plan that is included in the district improvement plan.

70 Bullying

 Involves repeated acts of physical, emotional or social behavior, evident as early as two years of age.

 Can be either direct or indirect. Direct bullying usually is seen and felt readily. Indirect bullying (deliberate exclusion, name calling, etc.) is much more difficult to identify and is often more difficult to remedy

 Is defined by a power imbalance between the bully and the target. A bully’s power can be derived from physical size, strength, verbal skill, popularity or gender. A bully’s target feels tormented, helpless and defenseless.

 Can include hitting, name-calling, threatening, intimidating, kicking, spreading rumors, teasing, pushing, tripping, excluding someone from a group, or destroying someone’s things.

Bullying may lead to increased absenteeism and dropout rates. Students feel less safe and less satisfied in school when there are high levels of bullying in the school. Bullying children may become bullying adults and are more likely to become child and spouse abusers. The longer bullying lasts, the harder it is to change. Bullying may be linked to other delinquent, criminal and gang activities, such as shoplifting, drug abuse and vandalism. Bullies may bully because they themselves have been the victim of bullying. The targets of bullies grow socially insecure and anxious with decreased self-esteem and increased depression rates, even into adulthood.

Warning signs Indicating a Bully

 Seeks to dominate and/or manipulate others.

 Enjoys feeling powerful and in control (whether real or not).

 Is both a poor winner (boastful and arrogant) and a poor loser.

 Seems to derive satisfaction from other’s fears, discomfort, or pain.

 Is good at hiding behaviors or doing them where adults cannot notice.

71  Is excited by conflicts between others.

 Blames others for his/her problems.

 Displays uncontrolled anger.

 Has a history of discipline problems.

 Displays a pattern of impulsive and chronic hitting, intimidating, and aggressive behaviors.

 Has a history of violent and aggressive behaviors.

 Displays intolerance and prejudice towards others.

 May use drugs, alcohol or be a member of a gang.

 Lacks empathy towards others.

PREVENTING BULLYING

 Increase the awareness of everyone at school (students, staff and parents) toward bullying problems.

 Assess the scope of the problem.

 Identify both the children who are bullying and the children who are being bullied.

 Intervene in a timely manner with clear and consistent consequences for the child who is bullying and with support and protection for the child who is being bullied.

 Encourage by-standers to intervene appropriately to help stop the bullying.

 Reward pro-social behavior of all students.

Preventing your Child from Becoming a Victim:

 Instill self-confidence in your child.

 Help your child establish good social skills.

 Teach your child to speak out for him or herself.

 Teach your child to seek help, if harassed, from you and other caring adults.

72 Preventing your Child from Becoming a Bully:

 Present yourself as a model of non-violent behavior.

 Clearly state that violence is not acceptable.

 Assist your child in finding non-violent strategies for anger management and conflict resolution.

 Seek help from mental health/school counselors to help stop bullying and aggressive behavior.

Cyber bullying Cyber bullying is the use of e-mail, instant messaging, chat rooms, pagers, cell phones, or other forms of information technology to deliberately harass, threaten, or intimidate someone. Cyber bullying is often done by children, who have increasing access to these technologies. However, it is by no means confined to children. The problem is compounded by the fact that a bully can hide behind an electronic veil, disguising his or her true identity. This makes it difficult to trace the source, and encourages bullies to behave more aggressively than they might face-to-face. Cyber bullying can include such acts as making threats, sending provocative insults or racial or ethnic slurs, gay bashing, attempting to infect the victim's computer with a virus, and flooding an e-mail inbox with nonsense messages. If you are a victim, you can deal with cyber bullying to some extent by limiting computer connection time (not being always on), not responding to threatening or defamatory messages, and never opening e-mail messages from sources you do not recognize. More active measures include the blacklisting or whitelisting of e-mail accounts, changing e-mail addresses, changing ISPs, changing cell phone accounts, and attempting to trace the source. In some cases, it may be advisable to inform the local police department or consult an attorney. It is not recommended that you retaliate in kind because such behavior can lead to civil actions or criminal charges against you. Cyber bullying  Can occur anytime of the day or night.

 Distributes messages and images quickly to a very wide audience.

 Can be anonymous making it difficult, sometimes impossible to track.

If you are a victim of a Cyber bully:  Do not reply to messages from cyber bullies- even though you may really want to, this is exactly what cyber bullies want. They want to know that they have you worried or upset. They are trying to mess with you and want to control you, to put fear into you. Do not give them that pleasure.

 Do not keep this to yourself, you are NOT ALONE and you did not do anything to deserve this. Tell an adult you know and trust.

 Inform your Internet Service Provider (ISP) or cell phone/page service provider.

 Inform your local police.

 Do not erase or delete messages from cyber bullies- you do not have to read it, but keep it as your evidence. You may unfortunately get similar messages again, perhaps from other accounts. The police and your ISP, and /or your telephone company can use these messages to help you. You might notice certain words or phrases that are also used by people you know. These messages may reveal certain clues as to who is doing this to you, but don’t try to solve this on your own, remember, tell an adult you know and trust. GET HELP!

 Protect yourself-Never arrange to meet with someone you met online unless your parents go with you.

ACTIONS STEPS TO ADDRESS CYBERBULLYING:  Notify parents of victims and parents of suspected cyber bullies.

 Notify police if known cyber bullying involves a threat.

 Closely monitor the behavior of affected students at school for possible bullying

 Talk with all students about the harms caused by cyber bullying.

 Investigate to see if the victim(s) could use support from school counselor/school-based mental health professional.

75  Contact the police immediately if the known or suspected cyber bullying involves acts such as:

1. Extortion

2. Obscene or harassing phone calls or text messages

3. Harassment, stalking or hate crimes

4. Child pornography

5. Threats of violence

76 Eating Disorders: Recommendations for School Counselors

School counselors are in daily contact with the highest risk group for developing eating disorders- children and adolescents. According to the American Psychological Association (APA), ten million people in the United States struggle with anorexia and bulimia.

Eating disorders are a group of conditions characterized by abnormal eating habits that may involve either insufficient or excessive food intake that harms a person's well-being, including an individual's physical and emotional health. Although we all worry about our weight sometimes, people who have an eating disorder go to extremes to keep from gaining weight. There are two main eating disorders: anorexia nervosa and bulimia.

What is anorexia nervosa?

People who have anorexia are obsessed with being thin. They do not want to eat and they are afraid of gaining weight. People usually think they are fat even though they are very thin. It results in starvation and an inability to stay at the minimum body weight considered healthy for the person's age and height. If untreated, anorexia can cause the following health problems:

• stomach problems • heart problems • irregular periods or no periods • fine hair all over the body, including the face • dry, scaly skin

What is bulimia?

Bulimia is eating a lot of food at once (called binging), and then throwing up or using laxatives to remove the food from the body (called purging). It is an illness in which a person binges on food or has regular episodes of significant overeating and feels a loss of control. The affected person then uses various methods -- such as vomiting or

77 laxative abuse -- to prevent weight gain. They may hide food for binges and they are usually close to normal weight, but their weight may go up and down. If untreated, Bulimia can cause the following health problems:

• stomach problems • heart problems • kidney problems • dental problems (from throwing up stomach acid) • dehydration (not enough water in the body)

Individuals with eating disorders are highly competitive and worry excessively about what others may think of them. Many times, eating disorders are in response to coping with challenges, stressful situations, family conflict and school pressure. A struggle with self- esteem can be so tortured that a person with an eating disorder can starve themselves or become so obese as to incur in serious medical problems.

Controlling Food

Controlling food is used as a coping mechanism to either soothe or punish; weight becomes the symbolic proving ground for worth or worthlessness. People with eating disorders may also suffer higher rates of other mental disorders- including depression, anxiety disorders, and substance abuse- than other people. Eating disorders most often begin in adolescence or early adulthood, and the key to helping a person with a potential eating disorder is to recognize the signs.

According to the American Academy of Family Physicians, eating disorders need to be taken seriously because they are potentially life-threatening conditions that affect an individual's physical, emotional, and behavioral growth and development, and they may lead to premature death.

What are the warning signs of an eating disorder?

• emaciated appearance • dry brittle nails, skin and hair, and or hair loss • dizziness • lack of energy • low blood pressure • dehydration • constant dieting or obsession with food • perfectionism

78 • competitiveness • sense of over responsibility • emotional distress • criticism of self and others • low self esteem • mood swings • complaining of “feeling fat” • inability to express emotions • demonstrate ”black- and- white” thinking • Isolation • withdrawal from friends and family

More serious warning signs are harder to notice because people who have an eating disorder try to keep it secret. Watch for these signs:

• throwing up after meals • refusing to eat or lying about how much was eaten • fainting • over exercising

79 Informal Checklist

Eating Disorder: Assessing the Situation An overall assessment needs to be done in the behavioral, psychological and medical areas, but meanwhile, an informal checklist can be conducted to assist with the referral process.

Checklist of observable and non-observable signs of an eating disorder:

_____Does anything to avoid food even when hungry _____Is terrified about being overweight or gaining weight _____Is obsessive and preoccupied with food _____Eats large quantities of food secretly _____Counts calories in all foods eaten _____Disappears into the bathroom after eating _____Vomits and either tries to hide it, or is not concerned about it _____Feels guilty after eating _____Is preoccupied with the desire to lose weight _____Must earn food through exercising _____Uses exercise as punishment for overeating _____Is preoccupied with fat in food and on the body _____Increasingly avoids more and more food groups _____Eats only non fat or “diet “foods _____Becomes a vegetarian (in some cases will not eat beans, cheese, nuts, and other vegetarian foods) _____Displays rigid control around food: in the type, quantity, and timing of food eaten (Food may be missing later) _____Complains of being pressured by others to eat more or eat less _____Weighs obsessively and panics without a scale available

_____Complains about being too fat even when being at normal weight or thin, and at times isolates socially because of this. _____Always eats when upset _____Goes on and off diets (often gains weight each time) _____Forgets nutritious foods on a regular basis and prefers sweets or alcohol _____Complains about specific body parts and asks for constant reassurance regarding appearance _____Constantly checks the fitting of belt, ring, and “thin” clothes to see if any fit too tightly _____Checks the circumference of thighs particularly when sitting and space between thighs

From: Assessment of an Eating Disorder- Healthy Place, America’s Mental Health Channel .

80 Suicide Student Referral Flowchart Suicide Outcry Response According toRisk Level

When Parent/Guardian Cannot Be Located Suicide Outcry - Procedures for Non-Counseling Staff Suicide Outcry Response Plan

Self-Harm Student Referral Flowchart Self Harm Student Referral Flowchart

Self Harm Risk Level Flowchart

(When Parent/Guardian Cannot Be Located) If parent/guardian cannot be reached, call Parental Involvement for home visit. Risk is Medium

Self-Harm Procedures for Non-Counseling Staff

(Self-mutilation, and/or Other Risky Behaviors) Self- Harm Response Plan

Cyber Bullying for Students What to Do: Bullying & Cyber Bullying Flowchart

LETTER TO STAFF SAMPLE ONLY

(DATE)

Dear Staff,

There are times when it is necessary to communicate news that is painful for all of us. During those times we must be prepared to support each other as we deal with the many feelings that we begin to experience. It is with great sorrow that I inform you that (teacher/student/friend) ______Name from ______has died. School Name

We all share the shock and sadness that overcomes us at a time like this. Death can be difficult for us to understand, especially when it is sudden. We will begin to feel different emotions: shock, sadness, confusion, even some anger. What is most important is that we care for and support each other.

Please know that we care for you, your feelings, and all that you may be experiencing as a result of (NAME)’s death. The School Crisis Response Team will be available to lend support and refer you to appropriate agencies for further help, if needed. Please let us know if there is anything we can do to help you.

In memory of (NAME), the flag will be flown at half-mast for the remainder of the week.

Sincerely,

(Principal’s name) 95

LETTER FOR TEACHERS TO INFORM STUDENTS ABOUT THE DEATH ON CAMPUS SAMPLE ONLY

TO: All Faculty

FROM:______, Principal

RE: Announcement Concerning a Death

Please read the following announcement to your first period class after the pledge to the flag, on ______. Date

“We are saddened to learn of the death this weekend of ( Name of student )____student, at ( School Name) who died late Saturday afternoon. The complete details of his death are not available at this time. I know that these news may be upsetting to some students. If you need to talk with a counselor, please request a pass to the Counseling Office.

************************************************************************************************ Note:

If you have students who seem unduly upset after the announcement or during the school day, send them to the Counseling Office. However, you can be of assistance to students just by listening and letting them express their feelings. 96

Suggested letter to parents on the death of a teacher, staff member, or student/English

SAMPLE LETTER ONLY: (Letterhead) (Date) Dear Parents or Guardians: We are all saddened this week by the death of______, one of our teachers. We have had additional counselors from the district present at our school to assist the students and faculty with the questions and grief which accompany a situation such as this. Experiencing, witnessing, or even hearing of a traumatic incident may affect a child or adult in a variety of ways; therefore, it is very important that children be given ample opportunities to ask questions and to talk about their reactions. When reacting to a traumatic incident, a child may display behaviors such as the following:  Clings closest to adults

 Displays regressive behaviors

 Appears not to be affected

 Thinks about it privately

 Asks a lot of questions

 Appears frightened

 Appears agitated and angry

 Displays difficulty sleeping

 Stomach aches and/or head aches

Below are some suggestions that parents may find useful in helping your child:  Be a good listener.

 Provide physical closeness. Spend extra time putting your child to bed. Talk and offer reassurance.

 Encourage children to ask questions and to discuss, write or draw their feelings.  Provide play and fun experiences to relieve tensions.

Please call (Teacher’s name) o send a note if you have any questions or if you wish that your child speak with the school counselor. If you do not want your child to talk about this event or you would prefer your child not to see or hear any of the materials dealing with grief, please let us know. You and your child are important to our school community and we want to do what is best for the children. Sincerely, 97

Death of a Teacher or Staff Member- Sample Only

Letterhead Fecha

Estimados Padres: Lamento mucho informarles del fallecimiento de: (Name of deceased person and assignment) quien falleció ______. La familia nos ha informado que: ______Los servicios funerarios estarán a cargo de: ______En situaciones tan difíciles como esta, nuestros niños necesitan nuestro apoyo. Ya hemos dado comienzo a servicios de consejería y apoyo en la escuela. Si necesitan contactarnos, favor de llamar a la escuela al: ______. Sinceramente,

Director 98

Letter to Parents on Bullying Sample Only

Dear Parent or Guardian: Let me introduce myself. I am your child’s counselor and I will be conducting a lesson on the subject of Bullying. Let me start by giving you a definition of bullying. Bullying involves repeated acts of physical, emotional or social behavior. Bullying can be either direct or indirect. Direct bullying usually is seen and felt readily. Indirect bullying (deliberate exclusion, names calling, etc.) is much more difficult to identify and is often more difficult to remedy. Bullying is defined by a power imbalance between the bully and the target. A bully’s power can be derived from physical size, strength, verbal skill, popularity or gender. A bully’s target feels tormented, helpless and defenseless. Bullying can include hitting, name-calling, kicking, spreading rumors, teasing, pushing, tripping, excluding someone from a group or destroying someone’s things.

Recommendations to stop Bullying are: I believe that parents are the most important partner that we have in education. As such, I look forward to working with your children and you to open up conversations and dialogs that strengthen our understanding of one another and to have communication between school and home to ensure the safety of all students.

Sincerely 99

Letter to Parents on Cyber Bullying Sample Only

Dear Parent or Guardian: Let me introduce myself. I am your child’s counselor and I will be conducting a lesson on the subject of Cyber bullying. Let me start by giving you a definition of cyber bullying. It is a form of bullying that relies on the use of Internet-connected devices to bully and harass others. Sadly, research and experience have taught us that this form of bullying has grown enormously in the last few years. For many of us it is a new form of harassment that we just have not thought too much about. For your children, however, it is an everyday piece of their life. Cyber bullying is the use of e-mail, instant messaging, chat rooms, pagers, cell phones, or other forms of information technology to deliberately harass, threaten, or intimidate someone. Cyber bullying is often done by children, who have increasing access to these technologies. However, it is by no means confined to children. Recommendations to stop cyber bullying are: 1. Do not respond to cyber bullies. 2. Tell your children to inform an adult about the cyber bullying. 3. Inform your Internet Service Provider. 4. Inform the local police department. 5. Do not erase messages from cyber bullies as they may be evidence.

I believe that parents are the most important partner that we have in education. As such, I look forward to working with your children and you to open up conversations and dialogs that strengthen our understanding of one another and to have communication between school and home to ensure the safety of all students.

Sincerely

100 RECORDS OF STUDENT CONTACT

CAMPUS: ______

NAME OF STUDENT: ______S.S.# ______

DATE AND TIME OF CONTACT WITH STUDENT: ______

OTHERS NOTIFIED : ______

COMMENTS: (Brief summary of counselor-student session; referral, if offered; recommendations; other information, as necessary)

______

Recommended Follow up: ______yes ______no

Forward this report to (Student’s Counselor Name):

______

______CRT Counselor’s Signature Date

101 IF YOU FEEL LIKE IT, THIS MIGHT BE A GOOD TIME TO WRITE A LETTER SAYING GOOD-BYE

______

102 WHAT ARE SOME MEMORIES YOU HAVE OF A DEAD OR DYING LOVED ONE?

______

103 ACTIVITIES FOR CHILDREN TO DO -DEALING WITH GRIEF-

o Writing an eulogy o Designing a yearbook page commemorating the deceased o Honoring the deceased by collecting memorabilia for the trophy cabinet, with permission of the family. o Writing stories about the victim or the incident o Drawing pictures of the incident o Debating controversial issues o Investigating laws governing similar incidents o Creating a sculpture o Creating a class banner in memorial o Building a fitness course, a sign for the school, or a bulletin board in memory o Discussing ways to cope with traumatic situations o Discussing the stages of grief o Conducting a mock trial if laws were broken o Starting a new school activity such as a MADD unit if a child was killed by a drunk driver o Encouraging students to keep a journal of events and of their reactions, especially in an ongoing situation o Placing a collection box in the class for notes to the family o Urging students to write the things they wish they could have said to the deceased o Practicing and composing a song in memory of the deceased o Discussing alternatives for coping with depression, if suicide is involved o Analyzing why people take drugs and suggesting ways to help abusers, if substance abuse related o Writing a reaction paper o Writing a “Where I was when it happened” report o Discussing historical precedents about issues related to crisis o Reading to the class (bibliography in the appendix) o Encouraging mutual support o Discussing and preparing children for funeral (what to expect, people’s reactions, what to do, what to say) o Directing energy to creative pursuits, physical exercise, or verbal expression when anger arises o Creating a class story relevant to the issue

104 Bibliotheraphy

After a Murder The Dougy Center. A book full of journaling and activities to help children after a murder. Focuses on helping them feel safe, talking to police, the media, friends and family, going back to school, remembering the victim and more.

After a Suicide The Dougy Center. This is a colorful book of activities to help children after the suicide of a loved one. It touches on how they feel, how to express feelings, how to talk to people about their loved one and their grief, going back to school, dreams and nightmares, and more. A very valuable tool to help a child work through his grief and feelings.

Stinky Stern Forever Michelle Edwards. Stinky Stern, not well-liked by his peers, is hit by a car and killed. The students of his class are faced with how to deal with his death. This moving story is certain to resonate with anyone who has experienced the loss of a classmate or friend.

The Next Place Warren Hanson. Warren Hanson helps put fear of death to rest in this reassuring book about the afterlife. Set against a soothing sky-blue background, he examines death, providing hope to those terminally ill while reassuring those that remain that there is a “next place.”

Tear Soup P. Schweibert and C. DeKlyen. A recipe for healing helps Grandy work through a big loss in her life. Mixing a pot of tears, together with a dash of Bitter, good friends, comfort food, and plenty of exercise, Grandy finds that she is sometimes able to laugh and smile again.

Tenth Good Thing About Barney Judith Viorst. A boy’s pet dies, and his family holds a funeral for the cat. Issues include the afterlife, grief, loss, and finding the positive in loss.

Tough Boris Mem Fox. Boris was the toughest, meanest pirate ever, but when his parrot dies, Boris cried. Issues include morning, and giving boys permission to cry.

Love You Forever Robert Munsch. A young mother holds her newborn son and sings him a song of endearment. As he grows older, he becomes an active two-year-old, a rebellious teenager, and an adult. Throughout, the mother holds him while he sleeps and sings him the same song. When she grows old and becomes sick, it’s the son’s turn to hold her and sing it to her-just as he now does with his own baby. This simple story is about the enduring nature of a parent’s love and how it crosses the generations. 105

Brave Bart Caroline H. Sheppard. Bart the Cat learns that his thoughts, feelings and behavior after a trauma are common. Traumatized children relate to Bart as symptoms of post traumatic stress disorder are paralleled. Issues include PTSD triggers, peer relationships, getting professional help, trust, reassurance, group support and hopefulness. Published by the TLC Institute

What on Earth Do You Do When Someone Dies? Trevor Romain. Answers the questions that kids have about death, saying goodbye, and understanding feelings.

From: Dr. Cheryl Sawyer, University of Houston Clear Lake 106

References

Assessment of an Eating Disorder- Healthy Place, America’s Mental Health Channel.

Burby, L. (1998). Bulimia nervosa: The secret cycle of bingeing and purging. New York: The Rosen Publishing Group, Inc.

Crisis Intervention Services Procedural Manual – Chicago Public Schools Office of Specialized Services Coordinated School Health

Davis M. Ed. , Leah, Overcoming School Phobia

E.T.H.S. Crisis Manual

Garner, D. M., Omstead, M., Polivy, J. Development and Validation of a Multidimensional Eating Disorder Inventory for Anorexia Nervosa and Bulimia. International Journal of Eating Disorders 2:15-33, 1983.

Kaminker, L. (1998). Exercise addiction: When fitness becomes an obsession. New York: The Rosen Publishing Group, Inc.

Principal Leadership Magazine, Vol. 4, Number 7, March 2004, Counseling 101 Column

Russel, S., Ryder, S., & Marcoux, G. (2001). BRIDGE: A resource collection for promoting healthy body image, grades 7-9, grades 10-12. Available from Alberta Mental Health Board, www.amhb.ab.ca Sawyer, Cheryl, University of Houston Clearlake-From Workshop “When Death Comes to School.”

References online: Academy of Child and Adolescent Psychiatry www.aacap.org American Family Physician www.aafp.org

About Face: Combating Negative and Distorted Images of Women www.aboutface.org Anorexia Nervosa and Related Eating Disorders www.anred.com Calgary Regional Health Authority: School Health and Eating Disorders www.crha-health.ab.ca/schoolhealth/eating.htm 107

Chicago Public Schools http://www.oism.cps.k12.il.us/pdf/Crisis_Manual_2008.pdf

Eating Disorders: Real Life Teens www.tmwmedia.com (Teachers Guide Available for this program) www.iVillage.com http://www.oism.cps.k12.il.us/pdf/Crisis_Manual_2008.pdf http://www.tcta.org/legal/newbullyinglaw.htm

Understanding and Responding to Students Who Self-Mutilate http://www.nasponline.org/resources/principals/nassp_cutting.aspx

Crisis Management Dealing With Psychological Trauma Utilizing School Teams La Joya ISD

Crisis Management Fourth Edition Developed By San Antonio-Mental Health Association United Way of San Antonio Colonial Hills Hospital of San Antonio

DISD Crisis Management Plan Resource Manual Dallas Independent School District Dallas, TX 75204 (1992-1993)

Suicide Intervention Plan McAllen Independent School District McAllen Texas 78501

“School Crisis Response Manual” Healthy Kids-Healthy San Francisco Department San Francisco Unified School District (91/93) San Francisco, CA 94115

School Crisis Survival Guide Suni Peterson, Ron L. Straub The Center For Applied Research West Nyack, New York 10995 (1992)

Yellow Ribbon Suicide Prevention Program: www.yellowribbon.org 108

American Association of Suicidology : www.suicidology.org

The Virtual Office of the Surgeon General: www.surgeongeneral.gov

American Academy of Pediatrics: www.aap.org/

National Youth Violence Prevention: www.safeyouth.org/

Suicide Awareness-Voices of Education (SA/VE): www.save.org 109

Crisis Intervention Procedural Manual Revision Committee

Under the Direction of

Mrs. Lucy Green, Interim Director for Guidance and Counseling

MEMBER……………….. Dora Earl, M.Ed.

MEMBER……………….. Pilar Janis, M.Ed.

MEMBER……………….. Bea Moyar, M.Ed.

MEMBER………………. Monica Piña, M.Ed.

MEMBER………………..Frank M. Treviño, M.Ed.

MEMBER………………..Laura M. Treviño, M.Ed.

MEMBER………………..Martha Walker, M.Ed.

MEMBER………………..Bobette Williams, M.Ed.

MEMBER……………….. Susana Zapata, M. Ed. 110