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Prevent Bullying At School

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How to Prevent Bullying in Schools a group project for Broward College.

How to Prevent Bullying in Schools a group project for Broward College.

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  • :'( im 12 years old and i cut myself 32 times just now because of a bully
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  • Any harmful things happened has a definite reason and a solution. And bullied cases nowadays were rapidly increasing due to lack of communication from parents to their kids. And as a mother, I am preparing myself to deal with this issue, to avoid my kids from being bullied and to help them deal as well from any bullies.Thus, I was searching sites that will help me know what to do about bullying issues and an Apps that can guard my loved ones in case of any emergencies. Then I found this link http://safekidzone.com/ that talks about securing every family in modern way. You can also check that link for your own good.
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  • This slides are very good and i found it useful for me.
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  • Very good slide but I can not copy it!!! Give me your advise? PLease?!!!!!!! dear my friends, I hope you will help me?!!!!!!!!!!!!!!!!!!!!!!!!!
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  • 1. Prevent Bullying at School Broward College EPI Institute The Teaching and Learning Process EPI 0004 Professor Charlotteaux A Group Project by Amy Mayberry, Susan Foltz, Carol Aleguas and Kedisha Daley
  • 2.
    • When asked for advice on how to deal with bullying, Barbara Coloroso often quotes an anonymous Holocaust survivor who said, "Pay attention, get involved, and never, ever look away." The lessons we must take from school tragedies over the past several years are the same. Pay attention—bullying occurs in all schools. Get involved—with the bully, the bullied, and the bystander; each has a role. And never look away—grown-ups tend to dismiss bullying, which according to Coloroso is a grave mistake
    • http://cfchildren.org/issues/bully/coloroso
  • 3. Bullying Affects Learning:
    • Students can learn and achieve at optimal levels ONLY if they know they are both physically and psychologically safe at school. Furthermore, if they don’t feel safe they are more likely to drop out before high school graduation.
    • (Rumberger, R.W. (1995) American Educational Research Journal, 32, 583-625)
  • 4. What is Bullying?:
    • “ Bullying” means systematically and chronically inflicting physical hurt or psychological distress on one or more students or employees.
    • It is further defined as: unwanted purposeful written, verbal, nonverbal, or physical behavior, including but not limited to any threatening, insulting, or dehumanizing gesture, by an adult or student, that has the potential to create an intimidating, hostile, or offensive educational environment or cause long term damage; cause discomfort or humiliation; or unreasonably interfere with the individual’s school performance or participation, is carried out repeatedly and is often characterized by an imbalance of power.
    • www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 5. Bullying Includes:
    • Unwanted teasing
    • Threatening
    • Intimidating
    • Stalking
    • Cyberstalking
    • Cyberbullying
    • Physical violence
    • Theft
    • Sexual, religious, or racial harassment
    • Public humiliation
    • Destruction of school or personal property
    • Social exclusion, including incitement and/or coercion
    • Rumor or spreading of falsehoods www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 6. Statistics:
    • 17% of students in grades 6-10 report being bullied
    • 23% of students in grades 4-6 have been bullied
    • 20% of students in grades 4-6 report bullying others
    • http:// www.olweus.org/public/bullying.page
  • 7. Bullying is not going away:
    • Bullying appears to be on the rise. A follow-up study by Dan Olweus in 2002 showed the percentage of victimized students had increased by 50%. Serious bullying by degree and frequency was up by 65%.
    • The number one reason adolescent boys and girls gave for being targeted for abuse is “I don’t fit in”.
    • Approximately 160,000 school children stay home each day out of fear, often without telling their parents why.
    • http://www.mass.gov/Eeohhs2/docs/dph/com_health/violence/bullying_prevent_guide.pdf
  • 8. Facts About Bullying:
    • Of second graders identified as bullies, 65% had felony convictions by age 24 (Johnson Institute 1996)
    • Of boys identified as bullies in middle school, 60% had at least one conviction and 35-40% had three or more convictions by age 23 (Limber, National School Safety Center, 1996)
    • Bullies are more likely to abuse their wives, use harsh physical discipline to punish their children and raise children to be bullies (Hodges & Perry, National School Safety Center, 1996)
    • 28% of Public School Teachers report being verbally abused, 15% have been threatened with injury and 3% reported being physically harmed . (Johnson, LD, 1993)
    • www.unf.edu/dept/fie/sdfs/notes/bullying.pdf
  • 9. Did you know?:
    • A national study of 15,686 students in grades six through 10, published last year in the Journal of the American Medical Association (Vol. 285, No. 16) is among the most recent to document the scope of bullying in U.S. schools.
    • The journal cited that 17 percent of students reported having been bullied "sometimes" or more frequently during the school term. About 19 percent reported bullying others "sometimes" or more often. And six percent reported both bullying and having been bullied.
  • 10. What makes someone into a Bully?:
    • Research has shown that those who bully may live in families that teach their children that those in power are also the decision-makers. This can sometimes lead to an external locus of control, and can lead children to believe that their behavior is appropriate unless they encounter someone more powerful.
    • Students also sometimes become bullies in part through an osmosis of violence from their surroundings. They can learn this violent behavior from their home, their friends, or even the media, though that last is the subject of some debate .
  • 11. What are the Characteristics of a Bully?:
    • People of any age, gender, or background can be both the bully and/or the recipient of bullying behavior
    • Males are more likely to be bullies and victims of bullying than females. Males are more likely to be physically bullied, while females are more likely to be verbally or psychologically bullied.
    • Bullies and victims of bullying have difficulty adjusting to their environments, both socially and psychologically. Victims of bullying have greater difficulty making friends and are lonelier.
    • Bullies are more likely to smoke and drink alcohol, and to be poorer students.
    • Bully-victims who are both bullies and recipients of bullying--tend to experience social isolation, to do poorly in school and take part in smoking and drinking .
    • www.edgov/admins/lead/safety/training/bullyingT
  • 12. What are the Characteristics of a Target?:
    • Bully Targets tend to be the same kids year after year. The only physical feature which is predictive of victimization is physical weakness .
    • Chronic abuse from peers is linked to a wide variety of adjustment problems and negative behavior including depression, anxiety, low self esteem, loneliness, chronic disruptiveness, violence towards others and suicide.
    • Many targets:
    • Eternalize problems
    • Can be argumentative, pushy, disruptive and irritating
    • Are quick to blame others
    • React to bullying through anger and violence
    • May bring weapons to school
    • www.unf.edu/dept/fie/sdfs/notes/bullying.pdf
  • 13. How Girls and Boys Differ:
    • Girls:
    • Girls bully by using emotional violence. They do things that make others feel alienated and alone.
    • Some of the tactics used by girls who bully include:
    • anonymous prank phone calls or harassing emails from dummy accounts
    • playing jokes or tricks designed to embarrass and humiliate
    • deliberate exclusion of other kids for no real reason
    • whispering in front of other kids with the intent to make them feel left out
    • name calling, rumor spreading and other malicious verbal interactions
    • being friends one week and then turning against a peer the next week with no incident or reason for the alienation
    • encouraging other kids to ignore or pick on a specific child
    • inciting others to act out violently or aggressively
    • http://teenadvice.about.com/od/violencebullying/a/girlbullies.htm
    • Boys:
    • In contrast to girls, boys of any age and ethnic group tend to be physically aggressive Also, research shows that physical abuse tends to occur more often among boys than girls at all educational levels.
    • Some of the tactics used by boys who bully include:
    • Physical attacks
    • Name calling, insults
    • Extortion (frequently of lunch money, and handheld game systems)
    • Threats
    • Unwelcome touch
    • www.unf.edu/dept/fie/sdfs/notes/bullying.pdf
  • 14. 3 Reasons for Bullying:
    • According to Olweus, a bullying prevention program associated with Clemson University, there are three reasons why students demonstrate bullying behavior:
      • being rewarded in some way for their behavior with either material or psychological rewards
      • a strong need for power and (negative) dominance
      • satisfaction in causing injury and suffering to other students
  • 15. Bullying in the Information Age:
    • Unfortunately, while technology has provided us with the ability to do a lot of things more efficiently, it has also provided bullies with new tools and provided their bullying behavior with a wider audience. Community networking sites like Myspace and Facebook have provided a new platform for bullying behavior, and cell phones and text messages have made it possible for rumors, true or not, to spread like never before through a school or peer group.
  • 16. Cyberbullying:
    • Cyberbullying can include the following:
    • Sending mean, vulgar, or threatening messages or images
    • Posting sensitive, private information about another person
    • pretending to be someone else in order to make that person look bad
    • Intentionally excluding someone from an online group
    • (http://stopbullyingnow.hrsa.gov/adults/cyber-bullying.aspx)
    • Cyberbullying can take place in any or all of the following platforms:
    • Chat rooms or discussion posts
    • Emails
    • Instant messaging •
    • Cell phones
    • Webpages
    • Blogs
  • 17.
    • “ Courage is fire, and bullying is smoke.” - Mark Twain
  • 18. Creating a Safe School:
    • There must be long term support from all levels at the school, from classroom teachers to administrators, to guidance, and all other employees
  • 19. A Culture of Bullying:
    • Bullying is a behavior that can spread. If one student is bullied and adults in charge fail to step in to help resolve the issue, other students may learn that such behavior will be tolerated. Some of these other students will themselves become bullies, and others will become victims. The culture of the school as a whole can be affected for the worse when bullying is condoned by a lack of action by adults in charge
  • 20. How to Create an Environment of NonViolence:
    • School wide commitment to supporting all students academic and social success
    • Challenging and engaging curriculum
    • Caring, trusting faculty-student relationships
    • Genuine and equal respect for students and teachers of diverse backgrounds, races & ethnicities
    • Clear guidelines for behavior, consistently enforced
    • Instruction in social interaction and problem solving skills
    • student participation in school decision making
    • Mechanisms for communication without fear of reprisal
    • Emphasis on pro-social behaviors
    • Close working relationships with community agencies and families
    • Open discussion of safety issues
    • (Ormrod p. 506)
  • 21. Tools for Prevention:
    • Training for bystanders on how to be an ally to the target
    • Support for targets (self-empowerment, assertiveness skills and social skills)
    • One on One counseling for bullies and targets as needed
    • Re-channeling bullies need for power into more positive directions (leadership skills training, cross-age peer mentoring)
    • Effective involvement and training of parents
    • Breaking the code of silence to encourage reporting to both school staff and parents
    • Structural changes that reduce the risk of bullying (increased supervision in places where students are vulnerable, policies such as buddies for bathroom trips)
    • Community involvement
    • http://www.mass.gov/Eeohhs2/docs/dph/com_health/violence/bullying_prevent_guide.pdf
  • 22.
    • “ The challenge of leadership is to be strong, but not rude; be kind, but not weak; be bold, but not bully; be thoughtful, but not lazy; be humble, but not timid; be proud, but not arrogant; have humor, but without folly.”
    • - Ralph Waldo Emerson
  • 23. Creating a Safe Classroom Environment:
    • Teach students what bullying behavior is, and alternate tools for solving their problems or addressing their issues of concern.
    • Encourage a good relationship and open communication between students and their parents, teachers, and administrators.
    • Parents should be encouraged to notify school officials and seek help if bullying is a concern.
  • 24. 3 Simple Rules for Everyone:
    • Respect Yourself
    • Respect Others
    • Respect Your Environment
  • 25. Create a Cooperative Classroom:
    • Teachers should establish clear ground rules for student behavior:
    • Listen to others politely and attentively
    • Make sure that everyone has an equal chance to participate
    • Make sure that everyone understands the material
    • Ask clear, precise questions when confused
    • Give encouragement and assistance to others
    • Address differences of opinion amiably and constructively
    • (Ormrod p. 468)
  • 26. Encourage Bystanders to:
    • Include students who are excluded
    • Not join in when others are being targeted
    • Join together with other students to stand up for the target or report incidents to adults
    • http://www.mass.gov/Eeohhs2/docs/dph/com_health/violence/bullying_prevent_guide.pdf
  • 27. Early Intervention:
    • Perhaps 10 to 15 percent of our students will need some sort of intervention to help them interact effectively with peers and teachers. Such intervention cannot be a one-size-fits-all approach but must instead be tailored to students' particular strengths and needs.
    • Regardless of their nature, interventions are more effective when they occur early in the game - before students go too far down the path of antisocial behavior - and when they are developed by a multidisciplinary team of teachers and other professionals who bring various areas of expertise to the planning table.
    • Research shows that when a child reaches age 8 aggressive tendencies may already be firmly in place
    • (Ormrod p. 507)
  • 28. Can Bullies Change?:
    • Research shows that prevention and intervention can make a difference. We can teach bullies alternate ways to meet their needs by:
    • Intervening immediately with constructive discipline.
    • Creating opportunities for bullies to feel powerful in positive ways (e.g. making a difference in the lives of others, protecting more vulnerable youth).
    • Nurturing empathy.
    • Teaching pro-social skills (e.g. communication, expression of feelings, problem solving, nonviolent communication.
    • http://www.mass.gov/Eeohhs2/docs/dph/com_health/violence/bullying_prevent_guide.pdf
  • 29. Signs of Violent Behavior:
    • Experts have identified numerous warning signs that a student may be contemplating violent actions against others. Any one of them alone is unlikely to signal a violent attack but several of them in combination should lead us to consult with school administrators and specially trained professionals about the student(s) of concern
    • (Ormrod p.508)
    • Social Withdrawal
    • Excessive feelings of isolation, rejection, or persecution
    • Rapid Decline in academic performance
    • Poor coping skills
    • Lack of anger control
    • Sense of superiority, self-centeredness and lack of empathy
    • Lengthy grudges
    • Violent themes in drawings and written work
    • Intolerance of individual and group differences
    • History of violence, aggression and other discipline
    • Association with violent peers
    • Inappropriate role models
    • Excessive drug or alcohol use
    • Inappropriate access to firearms
    • Threats of violence
  • 30. Signs a Child is Being Bullied:
    • All types of bullying may have a tremendous impact on targeted children. They may :
    • feel depressed,
    • anxious,
    • eat or sleep less or more,
    • have difficulty concentrating on school work,
    • have trouble making friends with others,
    • Lie or steal,
    • run away from home,
    • avoid school
    • consider suicide.
    • Children may not want to tell anyone if they feel they deserve this type of treatment, caused it, or that telling would make it worse (which the bully may have threatened).
    • http://www.education.com/reference/article/difference-between-boy-and-girl-bullies/?page=2
    • Other Signs a child may be a bully’s target:
    • Avoids activities that used to be fun
    • Unexplained cuts and bruises
    • Asking for stolen property to be replaced
    • Losing lunch money
    • Falling out with previous friends
    • Suddenly moody and bad tempered
    • Suddenly quiet and withdrawn
    • Refusing to talk about what happens at school
    • Aggression with siblings
    • Doing less well with schoolwork
    • Talking about not having friends
  • 31.
    • “ When a resolute young fellow steps up to the great bully, the world, and takes him boldly by the beard, he is often surprised to find it comes off in his hand, and that it was only tied on to scare away the timid adventurers.”
    • - Harvey Firestone
  • 32. What to do if Bullying Occurs in Your Classroom:
    • "As teachers our frequent interactions with students put us in an ideal position to identify those who may need intensive intervention.... Although we must be ever vigilant about indicators that a student may be planning to cause harm to others.. we must never use the warning signs as a reason to unfairly accuse, isolate or punish a student"
    • (Ormrod p. 507)
  • 33. Teacher Responsibilities:
    • As with most situations, teachers need to keep accurate and detailed records of each bullying incident they observe. This can help to not only keep any conferences on track with just the facts and prevent difficulties involving hazy memories, but can also help the school differentiate between an isolated incident and a pattern of behavior.
  • 34. Demonstrate Leadership:
    • Your role is to perpetuate the tone set by the school as a strong leader for young people. A leader does not always have the answers to a problem but rather poses the questions. They make it safe for others to make mistakes and help them learn from them. A leader treats the classroom as a stage for learning rather than a platform for performing.
    • Take the necessary steps to make your classroom a model for cooperative learning.
    • http://www.mass.gov/Eeohhs2/docs/dph/com_health/violence/bullying_prevent_guide.pdf
  • 35. What to Do…
    • Report all bullying immediately. Guidance counselors and administrators should be made aware of these situations.
    • Ensure that students understand not only what traditional bullying is, but what cyberbullying is as well.
    • Ensure that school and district rules and policies adequately address bullying, and that those policies are enforced.
    • Know the policies and procedures in place at your school
  • 36.
    • Destructive behaviors develop in part from a complex web of familial, economic and cultural circumstances. These factors are part of the fabric of life and difficult to attack. Yet strategies that help children develop the resilience to cope adaptively with modern day stresses can be effective and it is there schools need to focus their efforts.
    • -Collaborative for the Advancement of Social and Emotional Learning.
  • 37. Broward County School District Policies and Procedures on Bullying:
    • By August 2011, each school will have a designated school violence and safety liason. This individual will be trained in and will be responsible for disseminating threat prevention training, prevention methods, intervention, and curriculum, for bullying and other issues that impact the school.
    • At each school, the principal/designee is responsible for receiving oral or written complaints alleging violations of this policy, as with all infractions from the Student Code of Conduct. All District faculty and staff are required and must report, in writing, any allegations of bullying or violations of this Policy to the principal/designee or appropriate area/district administrator. Failure to report will result in discipline, consistent with the collective bargaining agreement provisions, up to and including termination of employment.
    • www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 38. Incident Reporting Requirements:
    • The procedure for including incidents of bullying in the school’s report of safety and discipline data is required under F.S. 1006.09(6). The report must include each incident of bullying and the resulting consequences, including discipline, interventions and referrals. In a separate section, the report must include each reported incident of bullying or harassment that does not meet the criteria of a prohibited act under this policy, with recommendations regarding said incident. recorded on the specified data system, as with other infractions from the Code of Student Conduct.
    • www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 39. Student Complaints:
    • Any student (and/or the parent on that complainant's behalf if the complainant is a minor) who believes he/she is a victim of bullying (or any individual, including any student who has knowledge of any incident(s) involving bullying of students) is strongly encouraged to report the incident(s) in writing to a school official.
    • Anonymous reports may be made utilizing the Broward County Public Schools Anonymous Bullying Report Form. This reporting form can be found on the School District’s website www.browardschools.com (click on special investigative unit; click on report anonymous tips), at each school’s front office, or at each area/district/department site. Anonymous reports may be delivered to the school administration’s front office, put in the school’s reporting box, or through the Special InvestigativeUnit via their internet website www.broward.k12.fl.us/siu or Emergency/Silence Hurts Tipline at (754) 321-0911.
    • Complaints should be filed as soon as possible after the alleged incident and noted on the specified data system, but must be filed within ninety (90) school days after the alleged incident
    • www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 40. Bullying Complaints and Resolution:
    • The investigation of a reported act of bullying of a student, school-based employee, or other persons providing service to the school is deemed to be a school-related activity and begins with a report of such an act. The principal will document all complaints in writing and through the appropriate data system to ensure that problems are addressed in a timely manner.
    • www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 41. Referral for Intervention:
    • Referral of a student to the collaborative problem-solving team for consideration of appropriate services is made through the school problem-solving process by school personnel or parent. Parent notification is required. When such a report of formal discipline or formal complaint is made, the principal will refer the student(s) to the collaborative problem-solving team for determination of need for counseling support and interventions.
    • School-based intervention and assistance will be determined by the collaborative problem-solving team and may include, but is not limited to: 1. counseling and support to address the needs of the victims of bullying. 2. counseling interventions to address the behavior of the students who bully (e.g., empathy training, anger management). 3. intervention which includes assistance and support provided to parents. 4. analysis and evaluation of school culture with resulting recommendations for interventions aimed at increasing peer ownership and support.
    • www.browardschools.com/schools/pdf/bully/anti-bullypolicy
  • 42.
    • “You must be the change you wish to see in the world”
    • -Mohandas Gandhi
  • 43. Innovative Anti-Bullying Programs:
    • The Olweus Bullying Prevention Program was initially developed in Norway, and has shown some success in preventing bullying in scientifically designed tests administered in the United States. This school wide program includes conducting regular, usually weekly, classroom meetings in which the class focuses on bullying and other peer relations. This is one reason the program has had limited implementation, as teachers are under pressure to use all the time available to them for content instruction. In order for meetings to be successful, teachers should be skilled in facilitating discussions about student behavior. http://www.clemson.edu/olweus/
  • 44. STEPS TO RESPECT:
    • Teachers often shrink back from the idea of adding one more curriculum to their list of initiatives, but the STEPS TO RESPECT program helps support some of the critical needs that schools already face: "We have to relate to one another—let's do it consciously. We have to read books—let's get kids reading conscience-raising books [that deal with] getting along with others and problem solving.“ says Barbara Coloroso, (author of “The Bully, The Bullied and The Bystander”).
    • www.tooter4kids.com/bullying.htm
  • 45. Don’t Laugh at Me:
    • Operation Respect: Don’t Laugh at Me , founded by Peter Yarrow of the folk group Peter, Paul and Mary, the organization disseminates educational resources such as the Don’t Laugh at Me (DLAM) programs; one for grades 2-5, another for grades 6-8, and a third for summer camps and after school programs. Through music, video, and classroom activities, the "Don't Laugh at Me" (DLAM) programs help sensitize children to the painful effects of behaviors that too often are accepted as necessary rites of passage in childhood - ridicule, disrespect, ostracism and bullying.
    • Available through www.dontlaugh.org
  • 46. Two Prevention Ideas:
    • One school in Gloucester, MA has an adult greet every bus each morning to see if there were any incidents needing following up. This approach has proved extremely effective in reducing bullying on the bus.
    • In Lowell, MA a teacher died after sustaining injuries breaking up a student fight on school grounds. Now after reciting the pledge of allegiance all student members recite this poem:
    • I shall use my hands for peace, not pain
    • I shall use my heart for love, not hate
    • I shall use my voice for song, not slurs
    • I shall strive each day to grow and learn
    • I shall live my life so all will gain
  • 47. What Works to Prevent Bullying?:
    • Fairly consistent evidence suggests that children's bullying behavior can be significantly reduced by well-planned interventions. The chance of success is greater if the intervention incorporates a whole-school approach involving multiple disciplines and the whole school community. The school staff's commitment to implementing the intervention also may play a crucial role in its success. The use of curriculum or targeted social skills groups alone less often results in any decrease in bullying and sometimes worsens bullying and victimization. Caution should be exercised in supposing that antibullying interventions invariably produce the intended results.
    • http://archpedi.ama-assn.org/cgi/content/full/161/1/78
  • 48.
    • “ Never be bullied into silence. Never allow yourself to be made a victim. Accept no one's definition of your life, but define yourself.”
    • - Benjamin Disraeli
  • 49. Web Resources:
    • http:// www.olweus.org/public/bullying.page http:// en.wikipedia.org/wiki/Megan_Meier http:// cfchildren.org/issues/bully/coloroso www.tooter4kids.com/bullying.htm http:// thinkexist.com /quotes/with/keyword/bullying www.browardschools.com/schools/pdf/bully/anti-bullypolicy www.edgov/admins/lead/safety/training/bullyingT
    • http://teenadvice.about.com/od/violencebullying/a/girlbullies.htm
    • www.unf.edu/dept/fie/sdfs/notes/bullying.pdf
    • http://www.education.com/reference/article/difference-between-boy-and-girl-bullies/?page=2
  • 50. Books & Articles:
    • Books:
    • Espelage, Dorothy L. and Susan M. Swearer. Bullying in American Schools. New Jersey: Lawrence Earlbaum Associates, 2004.
    • Roberts, Walter B. Working with Parents of Bullies and Victims. California: Corwin Press, 2008.
    • Barton, Elizabeth A. Bully Prevention, Second Edition. California: Corwin Press, 2006.
    • Besag, Valerie E., Ian Rivers, and Neil Duncan. Bullying. Connecticut: Praeger, 2007.
    • Bean, Allan L. Protect Your Child from Bullying. California: Jossey-Bass, 2008
    • Ormrod, Jeanne Ellis Educational Psychology, Fifth Edition. Ohio: Pearson, 2006
    • Articles:
    • Laura Parker-Roerdan, David Rudiweck and Donald Gorton, Direct From the Field; A Guide to Bullying Prevention Sponsored by the Commonwealth of Massachusetts http://www.mass.gov/Eeohhs2/docs/dph/com_health/violence/bullying_prevent_guide.pdf
    • Rachel C. Vreeman MD and Aaron E. Carroll MD, MS, A Systematic Review of School-Based Interventions to Prevent Bullying , Archives of Pediatric and Adolescent Medicine, Vol 161(1) 2007