UsingPCOMSwithYouthandFamilies:Parkinson

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Dr. Pamela Parkinson, Certified Trainer, recently presented the webinar, "Using PCOMS with Couples, Youth, and Families II." This webinar addressed the issues that come up in using PCOMS with multi-stressed families.

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UsingPCOMSwithYouthandFamilies:Parkinson

  1. 1. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 1 The Heart and Soul of Change The Heart and Soul of Change Delivering WhatDelivering WhatDelivering WhatDelivering WhatDelivering WhatDelivering What Works With KidsWorks With Kids and Familiesand Families Delivering WhatDelivering What Works With KidsWorks With Kids and Familiesand Families Pamela Parkinson, Ph.D., LCSW ParkinsonP2@comcast.net Developer: Barry Duncan, Psy.D. Website: Heartandsoulofchange.com Pamela Parkinson, Ph.D., LCSW ParkinsonP2@comcast.net Developer: Barry Duncan, Psy.D. Website: Heartandsoulofchange.com Welcome!Welcome! Who am I?Who am I?
  2. 2. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 2  I am a licensed Clinical Psychologist and a Licensed Clinical Social Worker in the S.F. Bay Area of California  I am a licensed Clinical Psychologist and a Licensed Clinical Social Worker in the S.F. Bay Area of CaliforniaArea of California.  I run the Bay Area Family Institute of Training and travel around helping individuals, programs, and organizations get unstuck in their work with kids and families. Area of California.  I run the Bay Area Family Institute of Training and travel around helping individuals, programs, and organizations get unstuck in their work with kids and families.  I specialize in training/consultation using the one-way mirror.  I started off working as a residential counselor in intensive residential treatment.  I specialize in training/consultation using the one-way mirror.  I started off working as a residential counselor in intensive residential treatment. The Kids and Families Struggling the Most! The Kids and Families Struggling the Most!  My whole career has focused on kids in the f t t th j il j ti t  My whole career has focused on kids in the f t t th j il j ti tfoster care system, the juvenile justice system, the mental health system and those labeled as emotionally disturbed within the Special Education System.  These are the “high end” kids that are referred foster care system, the juvenile justice system, the mental health system and those labeled as emotionally disturbed within the Special Education System.  These are the “high end” kids that are referredThese are the high end kids that are referred to the private non-profit CBO’s who attempt to do a good job with few resources and very little funding. These are the kids we will be talking about today. These are the high end kids that are referred to the private non-profit CBO’s who attempt to do a good job with few resources and very little funding. These are the kids we will be talking about today.
  3. 3. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 3 Here are some Questions that I will focus on today regarding PCOMS in our work with Kids and Families! Here are some Questions that I will focus on today regarding PCOMS in our work with Kids and Families!  Does everyone in the family need to Does everyone in the family need to Does everyone in the family need to complete the ORS? It can be so chaotic!  How do I know where to start reviewing the scores on the ORS when they are all low? E i ll i h l f f il b i  Does everyone in the family need to complete the ORS? It can be so chaotic!  How do I know where to start reviewing the scores on the ORS when they are all low? E i ll i h l f f il b iEspecially with a lot of family members in the room. Especially with a lot of family members in the room. More Questions!More Questions!  Should I start in mid-treatment with these Should I start in mid-treatment with these tools? If feels like I should only use these from the beginning of treatment.  How do I handle all high scores from kids and even all 10’s? tools? If feels like I should only use these from the beginning of treatment.  How do I handle all high scores from kids and even all 10’s?and even all 10 s?  Is it helpful to include some of the referring folks like County Social Workers, Probation Officers, Teachers, etc.? How? and even all 10 s?  Is it helpful to include some of the referring folks like County Social Workers, Probation Officers, Teachers, etc.? How?
  4. 4. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 4 More QuestionsMore Questions What do I do with the ORS during the summer if school is the big issue? What do I do with the ORS during the summer if school is the big issue? I am not a therapist so can I use these Tools? I am not a therapist so can I use these Tools? Your Questions!Your Questions! More Questions can be asked inMore Questions can be asked inMore Questions can be asked in the last 10-15 minutes of this Webinar so write them down so you don’t forget! More Questions can be asked in the last 10-15 minutes of this Webinar so write them down so you don’t forget! If we don’t get to them, email me and I will answer them! If we don’t get to them, email me and I will answer them!
  5. 5. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 5 Here we go!Here we go! As you all know, PCOMS standsAs you all know, PCOMS stands for: Partners for Change Outcome Management for: Partners for Change Outcome ManagementOutcome Management System Outcome Management System Why do I Like PCOMS?Why do I Like PCOMS?  Tons of evidence that it helps clients to Tons of evidence that it helps clients to have successful outcomes!  Strength-based, client-directed, outcome- informed.  Can be used with ANY theoretical way of have successful outcomes!  Strength-based, client-directed, outcome- informed.  Can be used with ANY theoretical way ofCan be used with ANY theoretical way of thinking so you don’t have to abandon what you love doing (CBT, family systems, psychodynamic, humanistic, etc., etc.). Can be used with ANY theoretical way of thinking so you don’t have to abandon what you love doing (CBT, family systems, psychodynamic, humanistic, etc., etc.).
  6. 6. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 6 Why do I Like PCOMS?Why do I Like PCOMS? Works for clients of all agesWorks for clients of all agesWorks for clients of all ages, diagnoses, ethnicities, etc.: Barry calls this “one size fits all” and I call it your “umbrella policy”. Works for clients of all ages, diagnoses, ethnicities, etc.: Barry calls this “one size fits all” and I call it your “umbrella policy”. Very affordable Compatible with other EBP’s so it can overlay with anything! Very affordable Compatible with other EBP’s so it can overlay with anything! The Importance of Client FeedbackThe Importance of Client Feedback to Positiveto Positive OutcomesOutcomes The Importance of Client FeedbackThe Importance of Client Feedback to Positiveto Positive OutcomesOutcomes  Whether an approach is a good fit for Whether an approach is a good fit for a client can only be determined by the client’s response to what is delivered.  It is the client’s feedback regarding progress in therapy (ORS) and the a client can only be determined by the client’s response to what is delivered.  It is the client’s feedback regarding progress in therapy (ORS) and theprogress in therapy (ORS) and the quality of the alliance (SRS) that will tell us if what we are doing is helpful to the client! progress in therapy (ORS) and the quality of the alliance (SRS) that will tell us if what we are doing is helpful to the client!
  7. 7. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 7 Cli tCli t’’ ti f thti f th Starting WithStarting With the Predictorsthe Predictors Change and the AllianceChange and the Alliance ••ClientClient ss rating of therating of the alliancealliance is the best predictoris the best predictor of engagement andof engagement and outcome.outcome. ••ClientClient’’ss subjectivesubjectiveClientClient ss subjectivesubjective experience of changeexperience of change earlyearly in the processin the process is the bestis the best predictor of success for anypredictor of success for any particular pairing.particular pairing. Who drops out? Reminder about the Trajectory of Change A B •The bulk of change occurs sooner rather than Howard, K. et al. (1986). The dose-effect response in psychotherapy. American Psychologist, 41, 159-164. rather than later
  8. 8. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 8 Some clients do take longer, but the mythology never diesdies N=4676; 77% attended 8 or less, and 91% 12 or less Note that even for the Baldwin, S., Berkeljon, A., Atkins, D., Olsen, J., & Nielsen, S. (2009). Rates of change in naturalistic psychotherapy: Contrasting dose-effect and good-enough level models of change. Journal of Consulting and Clinical Psychology, 77(2), 203-211. clients who take longer, change starts early…just is flatter It Just Makes SenseIt Just Makes Sense Since early change and the client’s bj ti i f th lli Since early change and the client’s bj ti i f th llisubjective experience of the alliance, predict treatment outcome, it seems to make sense that having an early warning system in place could be very helpful! subjective experience of the alliance, predict treatment outcome, it seems to make sense that having an early warning system in place could be very helpful!system in place could be very helpful! Maybe we can identify clients at risk of dropping out and not benefitting from services! system in place could be very helpful! Maybe we can identify clients at risk of dropping out and not benefitting from services!
  9. 9. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 9 PCOMS provides us with this Early Warning System PCOMS provides us with this Early Warning System When we see thatWhen we see thatWhen we see that outcome is bad, you can make it better by changing something about When we see that outcome is bad, you can make it better by changing something aboutsomething about the work to turn things around! something about the work to turn things around! Here are our Early Warning System Tools Here are our Early Warning System Tools ORS Outcome RatingORS Outcome RatingORS – Outcome Rating Scale ORS – Outcome Rating Scale SRS – Session Rating Scale SRS – Session Rating Scale
  10. 10. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 10 ••Give at theGive at the Becoming Better Measuring Outcome Becoming Better Measuring Outcome ••Scored to theScored to the nearest millimeter.nearest millimeter. ••Add the fourAdd the four scales togetherscales together ••Give at theGive at the beginning of thebeginning of the visit; Clientvisit; Client places a markplaces a mark on the line.on the line. ••Each line 10Each line 10 (100 ) i(100 ) i scales togetherscales together for the total score.for the total score. cm (100 mm) incm (100 mm) in length.length. •Reliable, valid, feasible CORSCORS
  11. 11. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 11 •Under 6 •Involves all members of the family even thefamily, even the youngest •Have crayons and places to color ready Children and Adolescents Clinical Cutoff Children and Adolescents Clinical Cutoff The dividing lineThe dividing line between a clinical & non-clinical population for adults (25) For childrenKids Adolescents (25). For children (32); adolescents (28); caregivers (28). Kids Adolescents & Caregivers
  12. 12. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 12 Kid t lf d lt tKid t lf d lt t Who, What, When, Where,& Why  Kid rates self; adults rate kid; siblings rate themselves  Spoiler Alert! Sometimes Th A B t M t  Kid rates self; adults rate kid; siblings rate themselves  Spoiler Alert! Sometimes Th A B t M tThey Agree But Most Times They Don’t!  When They Don’t Agree, Don’t Sweat It! They Agree But Most Times They Don’t!  When They Don’t Agree, Don’t Sweat It! Some Points to be Aware of with the ORS and CORS Some Points to be Aware of with the ORS and CORS  Little kids (YCORS) have no scores to input as d t h till i th th f  Little kids (YCORS) have no scores to input as d t h till i th th fdata, however, we still give them the form because it is good clinical work.  Some kids will not understand the form, despite your best efforts to help them with it. In these rare cases, you would continue giving them the data, however, we still give them the form because it is good clinical work.  Some kids will not understand the form, despite your best efforts to help them with it. In these rare cases, you would continue giving them therare cases, you would continue giving them the ORS/CORS but you would not enter their data.  We are lucky that, with kids, we have another source of data: the caregivers. rare cases, you would continue giving them the ORS/CORS but you would not enter their data.  We are lucky that, with kids, we have another source of data: the caregivers.
  13. 13. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 13 More Points to be Aware of with the ORS and CORS More Points to be Aware of with the ORS and CORS  If an older kid wants to do the CORS or a younger If an older kid wants to do the CORS or a younger kid is insulted by the faces and wants to do the ORS, this is fine.  While this is usually not an issue, if it becomes one, go with the flow. kid is insulted by the faces and wants to do the ORS, this is fine.  While this is usually not an issue, if it becomes one, go with the flow.  Since the scoring is the same, it does not matter, however, your cut-off scores will still be those for the actual age of the child/youth regardless of which form they complete.  Since the scoring is the same, it does not matter, however, your cut-off scores will still be those for the actual age of the child/youth regardless of which form they complete. The Session Rating Scale Measuring the Alliance The Session Rating Scale Measuring the Alliance ••Give at the endGive at the end of session;of session; ••Score in cm toScore in cm to the nearest mm;the nearest mm; ••Each line 10 cmEach line 10 cm in length;in length; •Reliable, valid, feasible ••Discuss withDiscuss with client anytimeclient anytime total score fallstotal score falls belowbelow 3636
  14. 14. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 14
  15. 15. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 15 Using Paper Graphing: A Helpful Visual Using Paper Graphing: A Helpful Visual  Adds a visual component another way  Adds a visual component another waycomponent—another way to focus treatment  At a glance tells the story of the client’s progress. ll d f component—another way to focus treatment  At a glance tells the story of the client’s progress. ll d f Allows you to dispense of the previous measures.  Allows you to dispense of the previous measures. •Indispensable with youth and families. Using Graphs With Families families. •Can comment on other’s scores in relation to own •Invites family discussion about the next steps •A visual indication of the need•A visual indication of the need for changing approach, continuing, or ending. •You can let them plot their own scores in different colors. Very interactive!
  16. 16. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 16 Let’s Address Those Questions!Let’s Address Those Questions! The thing that I find most interesting about MOST of the questions that folks ask is that The thing that I find most interesting about MOST of the questions that folks ask is thatMOST of the questions that folks ask is that they already know the answers! You have skills and already do good work so why not show it?! You also want to improve, of course! MOST of the questions that folks ask is that they already know the answers! You have skills and already do good work so why not show it?! You also want to improve, of course! Before you ask your question at the end of the Webinar, see if you can answer it using your own clinical judgment. I bet you can! Before you ask your question at the end of the Webinar, see if you can answer it using your own clinical judgment. I bet you can! A Simple ExampleA Simple Example Let’s take this question:  Should I start in mid-treatment with Let’s take this question:  Should I start in mid-treatment with Should I start in mid treatment with these tools? If feels like I should only use these from the beginning of treatment.  I bet that you would know how to introduce anything meaningful that might be helpful for your clients into k t i t ld d thi i th  Should I start in mid treatment with these tools? If feels like I should only use these from the beginning of treatment.  I bet that you would know how to introduce anything meaningful that might be helpful for your clients into k t i t ld d thi i thyour work at any point so you would do this in the same way with PCOMS!  If the scores are above the cutoff, use the tools but don’t enter the data. your work at any point so you would do this in the same way with PCOMS!  If the scores are above the cutoff, use the tools but don’t enter the data.
  17. 17. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 17 PCOMS does not replace your work! PCOMS does not replace your work!  It enhances your work by keeping you focused It enhances your work by keeping you focusedy y p g y on the most important aspects of the work! Aspects of which you are already aware !  It is meant to help you get to where you and the client are headed so don’t be distracted or confused by the tools y y p g y on the most important aspects of the work! Aspects of which you are already aware !  It is meant to help you get to where you and the client are headed so don’t be distracted or confused by the toolsconfused by the tools.  Nothing about PCOMS derails the treatment or interferes with it. It is to help you and the client do what you are trying to do anyway! confused by the tools.  Nothing about PCOMS derails the treatment or interferes with it. It is to help you and the client do what you are trying to do anyway! Does everyone in the family need to complete them? It can be so chaotic! Does everyone in the family need to complete them? It can be so chaotic! Yes, administer them every time you meetYes, administer them every time you meet in most settings. It is important for everyone to be included – it is a family session and the balanced lli i i f il k! in most settings. It is important for everyone to be included – it is a family session and the balanced lli i i f il k!alliance is necessary in family work!  Also, remember that doing anything new takes a little practice. alliance is necessary in family work!  Also, remember that doing anything new takes a little practice.
  18. 18. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 18 Chaos ContinuedChaos Continued Don’t worry about the time it takes to giveDon’t worry about the time it takes to give out the tools or your scoring. Just talk with the family about what you are doing and maybe ask their help: measuring or plotting their own scores on a graph etc out the tools or your scoring. Just talk with the family about what you are doing and maybe ask their help: measuring or plotting their own scores on a graph etcplotting their own scores on a graph, etc.plotting their own scores on a graph, etc. Into the home, Into the ChaosInto the home, Into the Chaos  Believe it or not, this can actually help in chaotic situations which we experience all the  Believe it or not, this can actually help in chaotic situations which we experience all thechaotic situations, which we experience all the time in work with families.  Using the ORS can help create a kind of focused space for families. It sets the stage f h i f i l i h chaotic situations, which we experience all the time in work with families.  Using the ORS can help create a kind of focused space for families. It sets the stage f h i f i l i hfor the importance of our special time together and family members find it interesting. After all, it is about their opinions and observations so they will like it. for the importance of our special time together and family members find it interesting. After all, it is about their opinions and observations so they will like it.
  19. 19. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 19 Chaos ContinuedChaos Continued  Spread the scored forms out on the kitchen table or the floor, or wherever, so that  Spread the scored forms out on the kitchen table or the floor, or wherever, so that everyone can see them together. Doing this creates a focus and communicates that this is a collaborative process in which everyone has an important role and the clinician is not the everyone can see them together. Doing this creates a focus and communicates that this is a collaborative process in which everyone has an important role and the clinician is not thean important role and the clinician is not the holder of some kind of private information.  Review them all briefly but you can focus on the IP and the caregiver’s ORS for data input. an important role and the clinician is not the holder of some kind of private information.  Review them all briefly but you can focus on the IP and the caregiver’s ORS for data input. Chaos ContinuedChaos Continued  Remember, all that the ORS does is help to identify “ ”  Remember, all that the ORS does is help to identify “ ”better what is already “in the room”. It does not create what is happening in the room, or make it worse, it focuses and contains the issues so that we are less likely to “miss them” in the chaos. better what is already “in the room”. It does not create what is happening in the room, or make it worse, it focuses and contains the issues so that we are less likely to “miss them” in the chaos.  The ORS gives everyone a voice. If they have some scores in which they agree, this is wonderful.  If not, it is important to get their differences out “on the table” so why not have a tool to help with this?  The ORS gives everyone a voice. If they have some scores in which they agree, this is wonderful.  If not, it is important to get their differences out “on the table” so why not have a tool to help with this?
  20. 20. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 20 How do I know where to start reviewing the scores on the ORS when they are all low? Especially with a large family in the room! It can feel a bit overwhelming especially if How do I know where to start reviewing the scores on the ORS when they are all low? Especially with a large family in the room! It can feel a bit overwhelming especially ifIt can feel a bit overwhelming especially if all the scores are quite low. I like to start with the lowest score. Since these 4 domains are not discrete entities It can feel a bit overwhelming especially if all the scores are quite low. I like to start with the lowest score. Since these 4 domains are not discrete entities and distress is what ties them together, talking about one usually spills into all of them. and distress is what ties them together, talking about one usually spills into all of them. Low Scores (Con’t.) If they have all indicated low scores, this Low Scores (Con’t.) If they have all indicated low scores, this is a strength in the family because they are in agreement about the distress, or pain, that they are in even if their reasons for the distress are different (and you can is a strength in the family because they are in agreement about the distress, or pain, that they are in even if their reasons for the distress are different (and you canfor the distress are different (and you can BET that they ARE). for the distress are different (and you can BET that they ARE).
  21. 21. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 21 Low Scores (Con’t.)  Look for ways to help folks experience each th ’ i f di t i iti Low Scores (Con’t.)  Look for ways to help folks experience each th ’ i f di t i itiother s expression of distress, in a positive direction. For example, a caregiver might indicate their lowest score as 3.4 in the family domain and the kid’s lowest score could be other s expression of distress, in a positive direction. For example, a caregiver might indicate their lowest score as 3.4 in the family domain and the kid’s lowest score could be 8.5. Seemingly, these would be very different opinions on how things are going. However, have they both selected this as the lowest domain? If so, this could be a place to start. 8.5. Seemingly, these would be very different opinions on how things are going. However, have they both selected this as the lowest domain? If so, this could be a place to start. How do I handle all high scores from kids and even all 10’s? How do I handle all high scores from kids and even all 10’s?  Wait a minute! This is one that you know the Wait a minute! This is one that you know the answer to! Often, at first, kids will say that everything is perfect and they have no problems.  Just handle this in the same way you would without an ORS. answer to! Often, at first, kids will say that everything is perfect and they have no problems.  Just handle this in the same way you would without an ORS.  First, don’t challenge them! Acknowledge that they are indicating that they are “just fine”. Let them save face!  First, don’t challenge them! Acknowledge that they are indicating that they are “just fine”. Let them save face!
  22. 22. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 22 All high scores and 10’s (con’t.)All high scores and 10’s (con’t.)  If the scores are all high, but not all 10’s, start with the lowest score (maybe it is 9 2) and find out more  If the scores are all high, but not all 10’s, start with the lowest score (maybe it is 9 2) and find out morethe lowest score (maybe it is 9.2) and find out more about it and what would make it be a 9.3.  If they are all 10’s, just reflect this. Remember, the number just reflects what the kid would say anyway so don’t worry about it the lowest score (maybe it is 9.2) and find out more about it and what would make it be a 9.3.  If they are all 10’s, just reflect this. Remember, the number just reflects what the kid would say anyway so don’t worry about itso don t worry about it.  Now, use your very well honed and creative skills to facilitate a therapeutic process that will allow folks to speak from the heart. so don t worry about it.  Now, use your very well honed and creative skills to facilitate a therapeutic process that will allow folks to speak from the heart. All high scores and 10’s (con’t.)All high scores and 10’s (con’t.)  When the kid then opens up in this way, they When the kid then opens up in this way, they When the kid then opens up in this way, they will often be able to talk about something they would like to be different, refer back to the ORS and let them reflect it on the form. They can change their mark!  When the kid then opens up in this way, they will often be able to talk about something they would like to be different, refer back to the ORS and let them reflect it on the form. They can change their mark!can change their mark!can change their mark!
  23. 23. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 23 Is it helpful to include some of the referring folks like County Social Workers, Probation Officers, Teachers, etc.? How? Is it helpful to include some of the referring folks like County Social Workers, Probation Officers, Teachers, etc.? How?  Definitely! In fact, they will be impressed Definitely! In fact, they will be impressed that you are looking so closely at how THEY see the issues.  This also gives you a chance to help them understand how these tools are used and that you are looking so closely at how THEY see the issues.  This also gives you a chance to help them understand how these tools are used and how it is going to help you to work in a manner that is likely to increase positive outcomes. how it is going to help you to work in a manner that is likely to increase positive outcomes. What do I do with the ORS School Scale over the summer if school is a big issue? What do I do with the ORS School Scale over the summer if school is a big issue?  Remember, the School scale on the CORS parallels the corresponding "Socially" item on the ORS—The School  Remember, the School scale on the CORS parallels the corresponding "Socially" item on the ORS—The Schoolp g y scale covers the child's social world including peer relationships, academics, and behavior. Thus, over the summer, it will reflect the child’s or caregiver’s perceptions about their peer friendships and social-based activities that they are involved in over the summer: jobs p g y scale covers the child's social world including peer relationships, academics, and behavior. Thus, over the summer, it will reflect the child’s or caregiver’s perceptions about their peer friendships and social-based activities that they are involved in over the summer: jobsactivities that they are involved in over the summer: jobs, lessons, sports, scouts, church groups, things like that.  However, always check with the child after any ratings are completed to make sure that we are clear on what the mark means to the child. activities that they are involved in over the summer: jobs, lessons, sports, scouts, church groups, things like that.  However, always check with the child after any ratings are completed to make sure that we are clear on what the mark means to the child.
  24. 24. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 24 ORS School Scale (Con’t.)ORS School Scale (Con’t.)  In my world, it is typical that most kids struggle in In my world, it is typical that most kids struggle in more than one domain and really need support over the summer so that they can get off to a good start in the next school year.  Thus, the scale would represent the ongoing work more than one domain and really need support over the summer so that they can get off to a good start in the next school year.  Thus, the scale would represent the ongoing work done to address the social relationships outside of school in the context of what happens over the summer. done to address the social relationships outside of school in the context of what happens over the summer. ORS School Scale (Con’t.)ORS School Scale (Con’t.) However, If the struggle is academic orHowever, If the struggle is academic orHowever, If the struggle is academic or behavioral issues that are strictly related to school (which I have found to be quite rare), then have the child rate where he or she was when the school year ended as a starting However, If the struggle is academic or behavioral issues that are strictly related to school (which I have found to be quite rare), then have the child rate where he or she was when the school year ended as a startingwas when the school year ended as a starting place. Then connect what can be done over the summer to continue to address these concerns. was when the school year ended as a starting place. Then connect what can be done over the summer to continue to address these concerns.
  25. 25. https://heartandsoulofchange.com September, 2013 Pamela Parkinson parkinsonp2@comcast.net 25 I am not a therapist so can I use these Tools? I am not a therapist so can I use these Tools?  This is sooooo important! Since most service id i th fi ld NOT th i t b t  This is sooooo important! Since most service id i th fi ld NOT th i t b tproviders in the field are NOT therapists, but offer just as important services to clients, it would be extremely important for anyone doing direct service to use these tools! providers in the field are NOT therapists, but offer just as important services to clients, it would be extremely important for anyone doing direct service to use these tools!  There is only one place that uses the word therapist (Approach/Method domain on the SRS) and you can easily use your own title.  There is only one place that uses the word therapist (Approach/Method domain on the SRS) and you can easily use your own title. Your Questions?Your Questions?Your Questions?Your Questions?

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