School Mental Health (2015) 7:174–183 DOI 10.1007/s12310-015-9149-9
ORIGINAL PAPER
The State of School Social Work: Revisited Michael S. Kelly1 • Aaron M. Thompson2 • Andy Frey3 • Heather Klemp2 Michelle Alvarez4 • Stephanie Cosner Berzin5
•
Published online: 7 May 2015 Ó Springer Science+Business Media New York 2015
Abstract The purpose of this paper was to report the results of the 2nd National School Social Work Survey. Here, we review the responses of 3769 school social workers using descriptive and bivariate statistics to better understand the current state of school social work in the USA. We also describe the characteristics and utilization patterns of students accessing school social work services, summarize the level (primary prevention vs. secondary/ tertiary) of practice focus of school social workers, and review practitioner responses to items summarizing their utilization of resources to identify, implement, and evaluate evidence-based practices. In addition to these descriptive analyses, we report bivariate analyses that aim to examine the relationship between prevention orientation and caseload, grade level, community setting, geographic region, and licensure status. Results suggest that the workforce characteristics and service provision trends of school social workers remain largely unchanged from 2008 and that students accessing school social work services are exposed to many factors placing them at increased risk of school failure. Pre- and post-service training recommendations arise from our assessment of the state of school & Michael S. Kelly
[email protected] 1
School of Social Work, Loyola University, Chicago, Chicago, IL, USA
2
School of Social Work, University of Missouri at Columbia, Columbia, MO, USA
3
Kent School of Social Work, University of Louisville, Louisville, KY, USA
4
South New Hampshire University, Hooksett, NH, USA
5
Boston College School of Social Work, Chestnut Hill, MA, USA
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social work in America to better serve children and youth who struggle with mental and behavioral health issues. Keywords School social work School mental health Evidence-based practice Students Survey research Emotional and behavioral problems
Introduction American school social work enters its second century as a profession that can proudly claim over 30 state associations, three national associations devoted—at least in part—to school social work, and a growing research-driven knowledge base about effective school social work practices (Dupper, 2002; Franklin, Kim, & Tripodi, 2009; Kelly, Raines, Stone, & Frey, 2010; Massat, Constable, McDonald, & Flynn, 2008). In addition, the increasing use of evidencebased practices (EBPs; Franklin & Kelly, 2009; Kelly, Berzin, Frey, Alvarez, Shaffer, & O’Brien, 2010a; Raines, 2008) and multi-tiered systems of support (MTSS), such as response to intervention and positive behavior interventions and support, are growing in the fields of school mental health and school social work (Batsche et al., 2005; Sailor, Dunlap, Sugai, & Horner, 2009). As such, the current study builds on previous efforts to understand the direction and nature of school social work practice, with particular attention to service delivery in the context of national trends to use EBPs within the context of MTSS (Kelly et al., 2010b). The Development of School Social Work 1906–2015 Starting in the early twentieth century, school social workers accepted diverse practice roles and tasks
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reflecting the changing context in American schools. For example, early school social work practice (1906–1930s) emphasized the social casework model, defined by assessments of the students’ home, school, and community contexts as well as resource brokering between schools and existing community supports. During the 1940s and 1950s, greater emphasis was placed on a clinical practice model, which emphasizes the medical model of assessment and diagnoses to drive direct, individualized, and intensive school-based clinical services for children at risk of school failure (Constable, 2008). With the educational reforms of the 1960s and 1970s, school social workers began to participate heavily in a multi-disciplinary team assessment, planning, goal fulfillment, and delivery of special education services (Kelly, 2008). For the next several decades, surveys revealed a remarkably stable portrait of school social work practice. For example, Costin (1969) conducted the first survey of school social workers with the purpose of clarifying the role of school social work and examining whether self-reported roles varied by level of educational training (i.e., bachelor’s vs. master’s degree). According to the 269 respondents in that initial survey, school social workers viewed their practice as one that provided intensive services (i.e., home visits, individual counseling, social skills training) to students in small group and one-on-one settings. Costin (1975) replicated this work several years later collecting a sample of 411 school social workers across 39 states, and the results did not vary. Allen-Meares (1977) reexamined Costin’s data using a latent factor analysis approach and concluded that school social workers fell into several common factors—none of which attended to the organizational or contextual issues contributing to student problems (i.e., policy or primary level prevention). Allen-Meares (1994) replicated Costin’s earlier survey and collected responses from 840 school social workers. The findings from Allen-Meares replication concluded that school social workers maintained a service role defined by individualized, intensive services and that respondents did not report attending to organizational or contextual issues impacting student functioning. This individualized, intensive orientation was called into question by some leaders in the field due to: (1) its poor fit with social work’s historic commitment to system perspectives and a person-in-environment orientation, (2) calls for service delivery systems that were are not marginalized and fragmented within the education system, (3) little empirical support for these practice choices, and (4) continued misunderstanding of the role of school social work and lack of appreciation for services provided among teachers and administrators (Frey & Dupper, 2005).
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The Impact of EBP and MTSS on School Social Work Practice In the early 2000s, emphasis on EBPs, data-based decision making, and primary prevention was magnified, operationalized in MTSS models, and incorporated into legislative changes via the No Child Left Behind (NCLB) Act and the revised Individuals with Disabilities in Education Act (IDEA). These laws, which specifically mention the provision of school social work services, emphasize the use of EBPs and data-driven decisional systems to assess the impact of interventions on school and student educational outcomes. Currently, these evidence-based practices are operationalized in schools in the form of tiered models of supports—or MTSS—so that the delivery of services and supports are organized and provided to youth with varying levels of need (Frey, Lingo, & Nelson, 2010). At tier 1 (primary prevention), interventions are allocated to all students in the school setting to promote protective factors and prevent risk factors predictive of academic failure and problem behavior, e.g., school-wide social skills instruction and bullying prevention. Tier 2 (secondary prevention) interventions are more intensive and are provided to ‘‘atrisk’’ youth who are displaying early signs of academic failure and/or problem behavior, e.g., mentoring programs, check in, check out (CICO). Tier 2 strategies are generally feasible, often provided in a group format, and have been scientifically shown to improve student academic and behavioral functioning. Finally, tier 3 (tertiary prevention) interventions focus on students exhibiting serious and chronic academic and/or behavior problems that impact daily functioning, e.g., behavior intervention plans (BIPs) and intensive family support counseling. Tier 3 interventions are generally intensive, individualized, and often family-focused strategies that are implemented for extended periods of time (referred to as durable) and frequently involve community agencies (Eber, Sugai, Smith, & Scott, 2002). Rather than separate tiers, Scott, Alter, Rosenberg, and Borgmeier (2010) suggest MTSS be viewed more as a continuum rather than distinct and separate tiers. This enables practitioners to employ strategies ranging from the most universal to the most specific intensive strategies, with the understanding that the stronger the primary prevention supports, the less need there is for targeted (secondary and tertiary) strategies. In addition to conceptualizing interventions along a continuum of support, MTSS emphasizes the importance of an integrated service delivery system. Specifically, a school-based committee with established policies and operating routines should use data to: (a) identify primary risk factors, (b) identify students in need of secondary- or tertiary-level supports, (c) select a continuum of scientifically supported interventions to address the needs of all students,
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and (d) collect ongoing data to monitor the success of the continuum of supports. The MTSS model is endorsed by the National Center for Mental Health Promotion and Youth Violence Prevention (2011), but the center also produced a report describing how student support services—including services provided by school social workers—are frequently ineffective because there is little organization and integration of services across primary, secondary, and tertiary levels. To be sure, the historic persistence of school social work services to focus only on individualized and intensive supports has fueled some researchers and practitioners to call for the profession to better integrate those services within the larger framework of an MTSS (Altshuler & Webb, 2009; Frey & Dupper, 2005; Frey, Alvarez, & Sabatino, 2013; Kelly, 2008). In 2008, the first National School Social Work Survey was administered, in part, to determine whether the aforementioned legislative changes translated into new school social work practice choices (Kelly et al., 2010a, 2010b; O’Brien et al., 2011). The results of this survey aligned with other concurrent regional surveys (Dupper, Rocha, Jackson, & Lodato, 2014; Kelly & Stone, 2009) to reveal that despite the growing emphasis of EBPs and MTSS, daily practice choices of school social workers did not reflect the intent of these legislative goals. In addition to the static role of school social work, other stable traits of the profession were again highlighted. That is, since its inception in 1906, the profession of school social work largely consists of white females—a trend that mirrors the national characteristics of those who work in education in general (Allen-Meares, 1994; Meares, 1977; Costin, 1969; Kelly et al., 2010b). Some researchers have attempted to examine whether these practitioner characteristics and contextual factors influence practice choices. For example, Kelly and Stone (2009) surveyed school social workers in Illinois and did not identify any relation between worker characteristics and worker-reported practice choices (i.e., types of interventions used). However, size of caseload and grade level did correlate with the types of intervention strategies selected by school social workers. In addition, Peckover, Vasquez, Van Housen, Saunders, and Allen (2013) surveyed school social workers in Iowa and found that despite the policy changes and research supporting the multi-level supports found in MTSS, most Iowa school social workers provided individualized, intensive services. Lastly, Dupper et al. (2014) found that Tennessee school social workers reported similar practice choices reflecting individualized, intensive supports and that those professionals rarely engaged in primary prevention strategies or coordinated intensive services with universal strategies. Furthermore, though Dupper’s work revealed that practitioner characteristics and experience did not influence practice choices, caseload and the geographic region where social workers
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practiced did significantly relate to whether those professionals engaged in primary and school-level prevention efforts (Dupper et al., 2014). In summary, the current findings reported here were shaped by prior findings of former survey efforts describing the state of school social work practice in American schools. However, what makes the current survey report unique is that we have tapped the largest national sample of school social workers ever surveyed so we may better understand current practices of school social workers. Such information will help us examine current trends and identify required skills for both current and future school social workers. More specifically, the second national survey of school social workers examined: (1) characteristics of the workforce, (2) characteristics and utilization patterns of students seeking school social work services, (3) the level (primary prevention vs. secondary/tertiary) of practice activities of school social workers, and (4) the utilization of resources to identify and evaluate EBPs. In addition, we report the results of bivariate analyses examining the correlation between prevention orientation and caseload (number of schools served), grade level (e.g., elementary, middle, or high school), community setting (urban or rural), geographic region, and licensure status of school social workers.
Method Sample Recruitment and Procedures Starting in late summer 2013, the School Social Work Association of America (SSWAA), the American Council of School Social Work (ACSSW), and the School Social Work Practice Section of the National Association of Social Workers (NASW) were contacted. All three national associations agreed to email their respective membership lists a survey link, to post the survey link on their web page and to push the survey out in weekly newsletters during the survey administration time frame. In addition, 35 individual school social work state associations and state departments of education offices were contacted. In total, 33 states agreed to post a link to the survey to their Web sites and push the survey out to their membership. Lastly, we engaged 23 social media groups (i.e., Facebook and LinkedIn) devoted to school social work, and they posted the survey link on their respective Web sites. Survey Development The initial draft of the survey instrument was based on prior surveys and other national surveys examining mental health practices of school-based professionals (Foster et al., 2005; Kelly et al., 2010a; Kelly, Raines, Stone, & Frey, 2010c;
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Ohio Department of Education, 2014). Because we were interested in school social work evidence-based practice within a MTSS, we asked respondents a variety of questions, including the time spent on specific activities. For example, tier 1 practices included providing school or classroom social skills instruction, school or classroom management training/support, school or classroom bully prevention programming, and school-wide efforts to improve parental engagement. At tier 2, examples included grief or divorce groups, tutoring at-risk students, mentoring at-risk students, homework clubs, check in/check out, and home–school communication systems. Finally, at tier 3, examples were behavior intervention planning; case management; ongoing counseling; providing special education services; teacher consultation regarding chronic, disruptive students; and parent support. Once the survey instrument was developed, an expert panel of 18 leading school social work researchers and practitioners reviewed the instrument and provided feedback on items using established procedures for developing reliable and valid survey instruments (Fink, 2012; Graber et al., 2011; Passmore et al., 2002). The instrument was then piloted with a group of school social work practitioners before providing all school social workers across the USA an opportunity to complete the survey. Data Collection and Analysis Data were collected nationally from February 2014 to April 2014. The survey was conducted online using the Opinio survey software, which generated a unique survey link for each organization. Each organization agreed to send out at least two reminders to their members. The survey took approximately 15 min to complete, and no incentives were provided to respondents. Data were analyzed in SPSS 21. Descriptive statistics were used to describe the characteristics of the workforce and the characteristics, utilization patterns of students, and the utilization of resources to identify EBPs. Missing Data Although 3769 participants began taking the survey, final analysis revealed that 2521 (67 %) respondents provided full responses to the survey. An analysis of missing data patterns revealed that no significant associations existed between missing patterns and observed respondent characteristics (i.e., sex, race, degree, years of practice, certification, and licensure) on all survey items. Further, those with missing data did not differ from those with full data on any survey item. As such, missing data patterns meet basic criteria of missing at random (Little, 1988; Little & Rubin, 1989), and all analyses and estimates reported here were generated using the traditional listwise deletion. Under this
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approach, each estimate is generated using all available information (Pigott, 2001). Using a listwise deletion approach, below we report the descriptive statistics (i.e., means and standard deviations) for various levels of practice. For purposes of clarity and parsimony in reporting items with a five-point response set, we collapsed ‘‘always, often, sometimes’’ and ‘‘seldom, never’’ into discrete ‘‘yes’’ and ‘‘no’’ response options, respectively (Armstrong & Sloan, 1989; Little, 1988). We also examined the difference between respondents’ selfreported actual and ideal percentage of time spent on primary versus targeted (i.e., secondary and tertiary) practices. Lastly, bivariate analyses were employed to examine the relationship between prevention orientation and caseload (number of schools served), grade level (e.g., elementary, middle, or high school), community setting (urban or rural), geographic region, and licensure status.
Results Participants The sample (N = 3769) provides a portrait of school social workers who belong to state and national organizations. As can be seen in Table 1, the sample consisted primarily of females (91.2 %) who identified as being of white or European American descent (82.2 %). A majority of participants reported having a master’s degree in social work (88.8 %). Many respondents reported being licensed—either as a licensed clinical social worker (43.1 %), as a school social work specialist (8.5 %), or as a certified member of the Academy of Certified Social Workers (5.8 %). Lastly, 3284 school social workers in the survey reported having an average of 12.4 (SD = 8.05) years of practice experience. Table 2 shows that the majority of respondents were from the Midwest (36.5 %) and the South (31.0 %) and practiced in states with state-level certification requirements (61.1 %). A large proportion of our respondents worked in suburban (36.9 %) or urban settings (31.1 %), a majority worked in two or fewer buildings (64.2 %), and many reported those buildings were elementary school settings (36.4 %). Student Characteristics and Utilization Patterns of Students The results provide information on the characteristics of students served by school social workers. A large percentage of the children school social workers serve are also receiving services from a variety of systems, including special education services (63.7 %), community mental
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Table 1 Sample characteristics of school social workers
Table 2 Contextual characteristics of school social workers
Variable
Valid %
Cases (n)
Missing n (%)
Variable
358 (9.5)
Valid (%)
Cases (n)
Missing n (%) 393 (10.4)
Sex
90.5
3411
Region
89.6
3376
Female
91.2
3112
Midwest
36.5
1233
8.8
299
Northeast
19.1
646
Race/ethnicity
90.1
3397
South
31.0
1048
African American
12.7
430
West
13.3
449
0.9
31
100.0
3769
82.2
2793
Yes
61.1
2304
Native American
0.6
21
No
38.9
1465
Hawaiian American
0.1
4
Community setting
86.0
3254
Male
Asian American European American
Other Education Bachelors of social work Other bachelors
3.5
118
88.5 5.2
3334 172
372 (9.9)
State certification
435 (11.5)
Rural
17.0
552
Small town Suburban
15.0 36.9
489 1200
Urban
31.1
1013
Number of schools
86.5
3260
1.3
43
88.8
2959
Other masters
2.9
87
One
44.8
1461
PhD in social work
0.8
28
Two
19.4
634
Other PhD
1.0
35
Three
8.9
336
100.0
3769
Masters of social work
Licensure
0
Four or more
25.4
829
85.5
3224
None
27.8
1050.0
Grade levels
LCSW
43.1
1623
Pre-K
ACSW
5.8
218
Elementary
8.5
322
Jr/middle
16.3
525
14.8
556
High school
24.8
799
Other
19.4
626
SSW specialist Other
health (69.8 %), child welfare (65.2 %), and juvenile justice (42.4 %). Table 3 reveals an array of significant issues that youths face when seeking school social work services. Notably, a majority of school social workers reported always, often, or sometimes working with students who sought services for sexual abuse (91.7 %), physical abuse (30.8 %), and/or neglect (79.6 %). In addition, a large proportion of school social workers reported always, often, or sometimes serving students with serious mental health issues, including suicidal ideation (74.2 %), substance use issues (79.2 %), eating disorders (95.4 %), and issues related to sexual identity (94.9 %). Level of Practice Activities The percentages of time school social workers reported their actual and ideal work at the primary versus the targeted (i.e., secondary and tertiary) levels of practice were estimated. As can be seen in Fig. 1, school social workers spend a small proportion (16.4 %) of time on primary prevention compared to targeted activities (i.e., secondary and tertiary; 65.4 %). The discrepancy between their selfreported ideal and actual proportions of time spent is
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3.1
101
36.4
1173
0
515 (13.7)
509 (13.5)
545 (14.5)
greater for primary prevention (11.2 %) than that for targeted activities (4.6 %). Examining the proportions in Fig. 1, the average discrepancy between the proportions of school social workers’ self-reported ideal versus actual time spent on primary (D = 11.45, SD = 17.75) and targeted practices (D = -5.16, SD = 20.07) reveals that the gap between their actual and time was greater at the primary prevention level. To further examine prevention orientation, we assessed the relationship between the proportion of time school social workers reported spending on prevention activities and their reported caseload (one school vs. more than one school) and the grade levels they served (e.g., pre-K/elementary vs. middle/high school). To examine the relationships, we used a two-tailed independent samples t test and an alpha level of .05. We further examined the strength of the relationship using Cohen’s d framework (Cohen, 1988).1 School social workers working in one school 1 ES = Effect Size, a standardized statistic communicating the strength of the relationship between an independent variable and the dependent outcome (Cohen, 1988).
School Mental Health (2015) 7:174–183 Table 3 Student issues faced by school social workers
179 Always–sometimesa n (%)
Student issues
Seldom–neverb n (%)
Missing n (%)
Adjustment Personal
653 (22.0)
2313 (77.9)
803 (21.3)
Family
915 (30.8)
2057 (69.2)
797 (21.1)
Trauma Neglect
2366 (79.6)
607 (20.4)
796 (21.1)
Physical abuse
2539 (30.8)
433 (14.5)
797 (21.1)
Sexual abuse
2729 (91.7)
232 (7.8)
808 (21.4)
Emotional issues Anxiety/stress
616 (20.7)
2553 (79.3)
800 (21.2)
Depression
1164 (39.3)
1796 (60.7)
809 (21.5)
Behavioral issues School avoidance
1303 (44.0)
1660 (56.0)
804 (21.3)
Physical aggression
1656 (55.7)
1312 (44.2)
801 (21.3)
Social aggression
1557 (47.4)
1402 (52.6)
810 (21.5)
Sexual harassment
2834 (95.7)
125 (4.3)
810 (21.5)
Suicidal ideation
2202 (74.2)
765 (25.8)
802 (21.3)
Substance use
2346 (79.2)
615 (20.7)
808 (21.4)
Eating disorders
2833 (95.4)
137 (4.6)
799 (21.2)
Sexual identity
2815 (94.9)
150 (5.1)
804 (21.3)
Mental health
Always–sometimes collapsed always, often and sometimes responses; Seldom–never collapsed seldom and never response options
has a modest effect on the proportion of time spent on primary prevention activities (d = .20).
Percentage of Actual v. Ideal Time Spent on Tiered Interventions
100 80
65.44
Utilization of Resources to Identify EBPs
70.04
60 40 20
27.6
27.57 16.98
16.4
0 Actual Primary
Ideal
Actual Targeted
Ideal
Actual
Ideal
Adminstrative
Fig. 1 Average responses of actual versus ideal proportions of time allocation between primary, secondary, tertiary, and administrative duties
(n = 1096) spent significantly more time (x = 17.41, SD = 19.04) on prevention activities (t = 2.28, p = .023, 95 % CI .24–3.23) than those who were working in two or more schools (n = 1357, x = 15.68, SD = 18.52), a relative difference revealing that caseload has a modest effect on the proportion of time spent on primary prevention activities (d = .09). School social workers working in preK/elementary schools (n = 1001) spend significantly more time (x = 18.65, SD = 19.43) than those who working middle/high schools (n = 1,44, x = 14.88, SD = 18.11) on prevention activities (t = 4.86, p = .001, 95 % CI 2.25–5.30), a relative difference suggesting that grade level
We also assessed school social workers’ utilization of resources to identify EBPs. Table 4 reveals respondents’ frequency of use and ability to access EBPs. Mean scores suggest that school social workers utilize online EBP Web sites (x = 2.43, SD = .75) the most often, and online databases (x = 2.13, SD = .56) are sources they have the greatest access to. Supervision (x = 1.91, SD = .64) was reported by respondents to be used sometimes, even though respondents suggested that they had little access to this resource (x = 1.54, SD = .66). Participants also reported moderate use of peer consultation (x = 1.59, SD = .52) and suggested that they have high access (x = 2.31, SD = .83).
Discussion This study makes a unique contribution to profession of school social work in that it describes the characteristics and utilization patterns of students served by school social workers. Furthermore, we describe patterns of school social
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180 Table 4 Responses to frequency and access to the use of evidence-based practice resources
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Domain 1: EBP resources
Responses
Frequency
Access
Missing
EBP resource usage
n (%)
x
Mode
X
Mode
n (%)
Online databases
2751 (73.0)
2.08
2
2.13
2
1018 (27.0)
Journals/books
2726 (72.3)
1.87
2
1.64
2
1043 (27.7)
Online EBP sites
2721 (72.2)
2.43
3
1.54
2
1048 (27.8)
Training/workshop
2589 (68.7)
2.40
2
1.81
2
1180 (31.3)
Supervision
2551 (67.7)
1.91
2
1.54
1
1218 (32.3)
Peer consultation
2574 (68.3)
1.59
2
2.31
3
1195 (31.7)
Frequency = How frequently do you use?—responses based upon three-point Likert-type scale (1 = never, 2 = sometimes, 3 = always); Access = How much access do you have?—responses based upon three-point Likert-type scale (1 = none, 2 = some, 3 = high)
work practices using the largest sample ever reported in such a survey. In summary, the characteristics of professionals working as school social workers have not changed from prior surveys; the workforce consists largely of European American or white females (Allen-Meares, 1994; Costin, 1975; Kelly et al., 2010a). Next, in regard to the characteristics and utilization patterns of students served by school social workers, results from this survey are also consistent with previous observations (Allen-Meares, 1994; Kelly et al., 2010b). That is, school social workers work with students who are exposed to high levels of risk in that the majority of the students served have some type of traumatic experience (i.e., abuse or neglect) and that most students also present a range of mental and behavioral health concerns. A large number of the children served by school social workers also receive support from other service delivery systems, such as child welfare, community mental health, and juvenile justice. Though additional research is needed, these findings confirm that school social workers need to be professionally equipped to serve highrisk/multi-problem youth in a school setting. Because of the parallel focus of the current survey and Kelly et al.’s (2010b) work, it is possible to assess trends in school social work practice in the context of the changing landscape of student support services (Batsche et al., 2005; Sailor et al., 2009). Rather than increases in the proportion of time school social workers engage in primary activities due to recent emphasis on MTSS, these results suggest that school social workers spend less time implementing primary prevention strategies than they were 6 years ago. Although the gap between school social work respondents’ ideal and actual proportions of time engaged in primary prevention has increased compared to the first national survey, the increase is small (Kelly et al., 2010b). Admittedly, it is impossible to pinpoint how or why this is the case using any survey data. It may be that school social workers are the most qualified and specialized instructional support personnel to implement individualized and intensive practices. It may be that school social workers have
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tailored themselves into this niche. What is not clear from these findings is whether the students to whom school social workers are providing services have or are concurrently receiving primary prevention supports—which of these supports are provided by other service providers— and whether the targeted interventions provided by school social workers are integrated along with all other supports. It is also possible that tertiary and secondary interventions are not provided in conjunction with primary prevention efforts, which confirms existing concerns regarding the extent to which school social workers are integrating their own practices into the MTSS continuum of services (Altshuler & Webb, 2009; Frey & Dupper, 2005; Frey et al., 2013; Kelly, 2008). Predictably, more research is needed to better understand this trend using a mixed methods approach. Another explanation worthy of consideration is that given how the complicated, multi-needs of student accessing school social work services, tertiary-level work (combined with the crisis intervention) simply minimizes any efforts to operate at the primary prevention level. In order to enhance an integrated approach to the MTSS framework, we advocate that pre- and in-service training of school social workers should highlight the importance of assessing the fidelity of primary prevention efforts before more targeted interventions are considered. Our conclusion here echoes prior findings with regard to how important it is for school social workers to be system thinkers, and acts across the MTSS continuum of supports (Frey et al., 2010). Specifically, at the primary prevention level, school social workers should provide indirect services to children by addressing the attitudes, beliefs, and behaviors of adults in the school (i.e., school faculty and staff). Skills necessary to accomplish this role include: expertise in MTSS; group facilitation and consensus-building skills; data entry, analysis, and presentation skills; collaboration and mediation skills; engagement strategies; and knowledge of evidencebased tier 1 interventions. At the secondary prevention level, school social workers should still provide indirect supports to students by helping school staff work
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effectively with students for whom universal supports alone are not adequate. Skills necessary for fulfilling these roles include: group facilitation and consensus-building skills; data entry, analysis, and presentation skills; collaboration and mediation skills; and knowledge of evidence-based tier 2 intervention practices. At tier 3, however, school social worker will likely need to provide direct services to a student and include the family as well as existing community supports. Requisite skills for fulfilling tier 3 roles include: group facilitation and consensusbuilding skills; data entry, analysis, and presentation skills; collaboration and mediation skills; knowledge of family systems and community services; and knowledge and expertise in tier 3 strategies, particularly FBA, BIP, and wraparound planning. Taking into account the differences in prevention orientation between the workload of school social workers, we see that those working in only one school context engage in more primary prevention activities. This would appear to indicate that when school social workers are assigned to a single building—the workload is arguably more manageable (i.e., one school), they are more likely to focus, adopt, and implement fundamental ideas underlying MTSS—practices that are endorsed by school mental health researchers as well as federal policies (e.g., NCLB; IDEA). Furthermore, regarding the grade levels that school social workers work with, we see early childhood and elementary social workers engage in significantly more prevention activities compared to social workers working in middle and high school settings. These findings echo earlier studies on the effectiveness of tiered primary prevention in elementary schools (Bradshaw, Koth, Bevans, Ialongo, & Leaf, 2008) and underscore repeated calls for increasing primary prevention foci in high schools (Flannery, Sugai, & Anderson, 2009). While this survey was unable to determine with confidence whether the primary and targeted interventions that school social workers are implementing are evidence based, we did examine respondents’ utilization of resources to identify EBPs. It is encouraging to see the frequency of use and access to evidence-based practices appears to have increased over the past 6 years. Though it may be of no surprise that many respondents here endorse using Internet sites to locate EBPs, it does underscore the need to prepare social workers to use these resources. Also worth comment, few respondents endorsed that they solely rely on peer consultation and workshops as these professional supports are highly variable with regard to quality (Kelly et al., 2010c). The responses gathered in the present study reveal some interesting implications for pre-service preparation programs, ongoing professional development, and practice. Regarding the training of pre and in-service school social
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workers, the trend has not changed—it seems that there is still a need to promote a prevention orientation. It also appears to be important to better understand the degree to which school social workers in training are in field placement settings that model and teach prevention work. A recent review of school social work syllabi indicates that these ideas have yet to take root in many school social work curricula (Berzin & O’Connor, 2010). It is important for school social workers to have a solid understanding of the treatment options in other service systems given how many of the survey respondents indicated that they service youth who are also accessing supports from outside mental health agencies and the child welfare system. Such coordinated efforts between school social workers and community agencies could hold the potential to reduce redundancy in service provision. Additionally, a greater emphasis on transdisciplinary training of school social workers, educators, and other student support service personnel (e.g., school nurses, counselors, psychologists, and resource officers) could lead to understanding of the need for increased multi-disciplinary coordination and enhanced coordination of school and community services (Maras, Thompson, Lewis, Thornburg, & Hawks, in press; Thompson & Alvarez, 2013). Finally, when we examine the types of issues presented by students that school social workers see, we observe an array of serious social, emotional, and behavioral conditions that place students at serious risk for academic failure, and require intensive training. Student problems such as substance abuse, eating disorders, depression, and anxiety require specialized training to address. This is particularly the case whether school social workers are being identified as the most appropriate school personnel to deliver tertiary-level supports within multi-tiered models. Furthermore, because the issues presented by youth are often comorbid with other issues, it is imperative for school social workers to engage families to address these issues in the context of the home. Intensive and evidence-based child-focused and family-based approaches ought to become an increased focus of school social worker training and education, highlighting the need to train school social workers in evidence-based engagement strategies such as motivational interviewing (Frey et al., 2013; Herman, Reinke, Frey, & Shepard, 2013) as well as evidence-based tier 3 strategies, such as behavior intervention planning and wraparound planning (Frey et al., 2010). There are a few limitations to this study that are noteworthy, and therefore the results must be interpreted with caution. The limitations are primarily related to the sampling frame, missing data, and the survey instrument. First, no central list of school social workers is available, and therefore the sample is ultimately one of convenience. There is no way to know whether the participants are
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representative of the full population of school social workers; thus, our findings may not be generalizable to school social work practice nationally. In addition, the survey was a cross-sectional study based on self-report. Another limitation is the large percentage of missing data. Although the listwise deletion approach will result in a decreased sample size, it has important advantages. First, it abides by the rule of parsimony and offers the simplest analyses facilitating clear understanding and communication of the findings (Kline, 2011), and this approach produces unbiased estimates under the missing at random classification (Baraldi & Enders, 2010).
Conclusion As revealed in the responses of school social workers in this survey—the largest survey of school social workers ever conducted in the history of the profession—we observe that characteristics of the workforce have remained stable. Additionally, school social workers are spending a great deal of time working with and addressing issues of children and youth who are most at risk in our communities. Further, school social workers report that they spend far more time engaging in secondary and tertiary-level interventions than they do in primary prevention. What is not clear is whether their efforts are well aligned with school-level primary prevention supports or whether they are engaging in practices at this level that are evidence based. It does appear that many respondents are able to access resources to identify EBPs and that they use them somewhat regularly.
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