Stephanie Taylor on Teletherapy and How Schools Should Approach Mental Health

Okay, so now it’s 12 o’clock in the afternoon. You can see I have a You can see I have a You’re listening to the Getting Smart podcast. I’m Shawnee Carruthers and today I’m joined by Stephanie Taylor, Director of Clinical

Innovation at Presence. Stephanie has worked in education since 2002 as a special education teacher slash case manager, a school psychologist and director of special education. She is currently working in the private sector to help schools gain access to needed related services through teletherapy.

Stephanie, thanks so much for being here and joining me today. I’m very excited to be here. So thank you. I’m super excited to have you. And this is, I want to say a hot topic, but hot, it means like it’s just something that

we’re only talking about for a moment. But in reality, this is something that we need to continuously talk about because it’s such an important issue. And so as we think about teletherapy, as we think about mental health, the first thing I want to discuss is that mental health isn’t always noticeable.

And we see that everywhere. And specifically as we talk about in schools, it’s not something that people can always easily identify. So how can we as parents and educators and friends do a better job of noticing? And are there any key stakeholders that I’m forgetting?

So a couple of things. I do want to start out by saying that I’m, I mean, I’m pretty passionate about really reframing or I guess framing the fact that, yes, we need to put a real microscope on mental health needs right now. And we need to talk about them separately and kind of elevate their visibility in the

world. But I think there’s actually a step before that, that is the primary way that we address these, this everyone’s needs, which is we start remembering that mental health is just part of health. There are so many invisible diseases.

There are so many physical ailments that you don’t know when people walk around and you see them in public, like you don’t know that they’re going through something. You don’t know that they have some other physical ailment. And mental health is no different, meaning it’s all invisible or it’s often invisible. The main difference is that people accept and while you’re aware that a physical problem

is somehow out of my control, right? It happened to me and it’s nothing I can do about it. So there’s no shame attached with it. And we have, as everyone knows, this is nothing new. We talk about the stigma of mental health all the time.

But there still is just this idea that mental health is different. It’s different than physical health. And it’s something that, although there are so many people now who are talking more and more about the struggles they’re going through, and it really is sort of like desensitizing us all to this idea, but there is this underlying portion still to this day where we should somehow

be ashamed or we should somehow feel that we could have prevented it or we could do something about it. And so I do want to just acknowledge that and take a step back to say that the more we can do to, I guess it’s my goal, it’s my hope one day that we stop having to call out mental health as a separate thing and we can just talk about health in general.

And it’s just understood and acknowledged or it’s known that the mental health is included in that overall definition of health because then we’ll have our general practitioners, we’ll have, you know, all those bases of, or foundational pieces of healthcare will also include mental health. And the way that I feel like that really impacts the education space is, you know, when we

talk about academics, for example, or really what most people think is the main function of a school, it is to teach, you know, academic subjects. That’s what the main priority is. And because of that, we’ve got, you know, the main courses, main classes, the general education that teachers teach.

And then we’ve got built in ways of what if a student’s struggling and they’re not being able to read at grade level, then what do we do with them? And then if they still struggle, then what do we do? And there is like an escalation path built into how schools function when it comes to academics.

But there’s not always that same foundation when it comes to mental health skills. There’s often an escalation path, but there’s almost a invisible forgetfulness about the fact that there has to be some type of foundational service provided for mental health as well, just like we’re doing for all the academic subjects. And I think that if talking to, you know, all those stakeholders, so teachers, administrators,

parents, really any, I would say, invested community member too, because sometimes it’s actually like coaches and sometimes it’s paraprofessionals. Because everyone that really interacts with that school system is remembering that there has to be some universal acceptance that mental health needs to be part of an overall child’s experience in the school setting and not something that’s called out in special little segments

once there’s already an issue. So I think one of the things you were mentioning was just like when it comes to academics, in addition to the escalation path, there are like these tiered interventions that aren’t necessarily as available when we’re talking in this mental health space. But there has to be a culture of learning for all involved because you’re correct that

they, students interact with so many people each day from the bus driver to the janitorial staff to the coaches to the lunchroom people, everyone. So how do you go about building a culture of support in the school? So it’s not just always embedded in the curriculum, but like we said, since they interact with so many, it has to be a culture of understanding.

How do you build that? So I think it’s important to acknowledge what you just said, which is that a research shows that it’s actually not super effective to be able to set aside little snippets of time to explicitly teach social emotional skills or mental health skills or whatever you want to call them in that broader context.

That feels very arbitrary and it’s hard for kids to generalize that. So even if I can give you an answer in the middle of this, like a lesson, like let’s say you’re giving me a lesson on social skills. And then it’s hard for me to take that and go out and generalize that too in actual situation with my peers.

And it’s more effective to actually just support these more authentic interactions with all adults. And the way to go about that is to really support the adults in saying, and like you said, this is everybody, this is not just teachers, this is everybody in a school system, to have some professional development for them to be able to say, hey, this is kind of how, if an opportunity

presents itself, this is how you can catch that moment. These are some of the ways in which you can also show your own vulnerability or the things you’ve been through and give examples of your resiliency because that’s really what kids need. They need to know they’re not alone.

They need to see examples of resiliency and they need to know that anything that happened to them, that there is a trauma-informed approach. And that’s whether that’s, I mean, trauma can be described pretty broadly, meaning trauma is not always very specific and horrific. There are a lot of different ways to define trauma and most of us define them by whatever

we have experience with. So whatever is the most traumatic thing that’s happened to us at that time, not comparing to anybody else or what anybody else has gone through. So I think there’s a level of just being able to talk to other human beings and to adults and for kids to be able to see that this is okay.

We’re all going through life’s experiences. We’re all dealing with some of the same things and we’re all finding our way. And the power of that example is pretty amazing and remarkable in what it does for children and their own thoughts about their own resiliency. And then you’ve also got to think about, just like for academics, for those kids that don’t

respond to that foundational level. And also maybe don’t have the same level of support from other adults outside of the school setting as other children as well. Sometimes you have students that need a little bit more and this is where we get into those tiered interventions.

And I feel like the thing that’s super important to recognize here is that I would never ask for, like say, like you mentioned the janitorial staff, right? I would never turn around and ask them, so, hey, we need somebody to come in and teach calculus today. Can you jump in and do that for us, please?

Because that’s not what their training is, right? That’s not their expertise. And so just in that same vein, asking teachers to become mental health professionals, no amount of professional development is going to make them be mental health professionals, nor should they.

And I think that’s something that is super important for administrators, especially to hear is that if we’re really wanting to do what is going to be most effective for children, letting teachers be the experts in their subjects like they are, but again, showing that they are human beings, having those times for open and honest communication and examples of resiliency with children.

But when there are students who need extra that are either struggling, you can see maybe their parent has recommended, maybe they’re on your radar from a teacher that says, you know what, they’ve been acting a little differently than usual. That is when it’s time to really look at what do you have in their system to be able to accommodate or meet the needs of those children and not have it be somebody who is also responsible

for every other thing that’s going on in that classroom. It’s just holistically unreasonable. Yeah, no. So building that foundation is critical. And then like you said, just teaching like the conversation pieces, the how to have empathy

toward others. So just basically the skills that you would extend to anyone as an adult in that building is really necessary. And so you’ve kind of described what mental health looks like today in like the first part of the conversation and then what it looks like sometimes in school buildings.

But what should it look like in the future? I think although sorry, I actually do want to jump back really fast for one thing, how to help teachers recognize or how to help people recognize when children need something extra. So I want to just jump on that for one second.

I think and so going to even go more on what I was saying about I really think about those interactions with the adults in the school setting can have with the children and some of those like authentic relationships, having developing authentic relationships, that’s actually the best way to recognize when something is a little bit off or out of place. And sometimes it’s because a child is interacted historically in one way and now it’s a little

bit different. But also sometimes it’s that you realize that there are some children who are always against interaction, right? They’re not ever wanting to engage and they always seem withdrawn and some of those things because mental health can display itself as nothing at all, right?

You don’t even notice. They seem happy. They seem great. They seem like nothing’s wrong. It can also be total withdrawal.

It can be erratic. It can be just a little bit of different. So I think that it’s more about looking around at what general interaction looks like for that age group and then specifically the history of that child’s interactions. That’s really the best way to notice when something’s happening.

And if you’re not having regular interactions with that student, it’s really hard to know. Yeah. No, I mean, it’s just like if you know, if you’re a parent, you notice when your child might be acting a little differently than how they might typically act. And so that’s when you kind of start some interventions, start to dig a little bit deeper

and the same is true with students in terms of building those authentic relationships. And so as we going back to the other question about moving mental health forward, what are the innovative things that are happening out there? What does the future look like? What should it look like?

The first thing is that not only do we have to really focus on these authentic interactions and building relationships, which I’m talking about, but there does need to be a little bit more of a focus on a quantifiable science of mental health. Like I said, just like we have general checkups at the doctor every year and they are looking at very specific indicators, the same can be said for mental health.

So one of the things that schools and a lot of schools are putting this in place, but this really needs to become standard going forward, which is universal screeners for mental health issues. So it’s literally they’re typically questionnaires and they go out to all the teachers in the school, to the parents as well.

And then depending on the age of the child, they might do a self screener. Right. They are a questionnaire and that also can just put it towards the science. So most of those screeners are normed. So meaning like, of course, there is a national population of like, here’s what’s the typical

range and here’s a little below or above. And so being able to have something that is standard that way that also helps with the longitudinal right is this is this child different than they were. Or for those children who maybe seem like nothing’s happening, like they have no no warning signs of being at risk at all.

A lot of times when you actually sit down and ask individual questions that are on those questionnaires, then then the information comes to light and you’re like, Oh, you know what, I never noticed that. But also some of the time the children will self identify through those questionnaires as well.

And you’ve given them the opportunity to give that information, which is essential in a very non threatening way of filling out a piece of paper. So the first thing is universal screening and benchmarking. So benchmarking those screening needs to be redone three times a year at minimum to be able to track overtime.

Second is really again, I this is this is now that I’m going to get on to a little like philosophical, you know, horse for one second. But I feel like schools are in a really, really hard place. And by that I mean, they are responsible for children’s education. Right.

So think about the way that schools are judged. They’re judged on testing scores. They’re judged on graduation rates and things that are very specifically tied to academics into credits. But on the other hand, they also are the one place that most children will go, right?

Most children attend school. And so if you really want to provide a service to schools or to children, schools is a good place to do it because that’s where you can get them. Schools are not given the funding nor the preparation to be able to become more holistic providers of mental health.

In, in my world, we call this like the educational model versus the medical model. Right. If I have an ailment and I go to the doctor, they’re going to go, yep, you have an ailment. You, you can get treat, you know, you can get whatever you need. But if I, in the school end, everything has to be very much tied to academic performance

to be able to really, I guess, meet the needs of a lot or meet the requirements of some of the funding sources. And so schools are kind of like, we know we need to do more. We know that we could be really instrumental in providing this to, to students, but we’re not doctors.

We’re not a medical model. We are an educational model and we don’t have the same funding, the same ease of treatment like determinations of treatment that you would if you go to a doctor. So I think that in the future, the most important thing that we can do is sort of get rid of that idea of like that bilateral thinking that it’s, it’s got to be a medical model

or an educational model and we can’t do, we got to have to keep them separate. I think it’s really setting up schools to be in a position where not only funding wise and resources wise, but just their whole approach, I guess, just really being bought into the idea that schools can be the one stop shop for all of children’s needs that they, we need them to be if we approach it correctly and set it up the way that it needs

to be set up. So as you think about that one stop shop, because I agree, you definitely have to have the right resources in place. And I appreciate the fact that more schools are doing, you said like the universal screenings for all the, all the indicators for lots of things.

So not just like vision and hearing, but also thinking like you said, just very holistically about health and it’s great that students are being a part of that conversation because we often talk about students co-authoring their learning and like creating these journeys and these pathways, but we don’t always talk about like kind of their health as a part of that because you’re right, they’re all, they’re all kind of ref together the school and health

component. But when students do identify maybe some challenges they might be having or teachers are able to identify and because this is all happening in this one place, it can be very easy sometimes for students to feel like very ostracized or different because you know, they’re saying I’m struggling with this and I identify this at my school and now in this place where I

have to be and I’m here for this, you know, amount of time now doesn’t feel like a safe space for me anymore. So how can students be assessed for these challenges, whether I’ve identified or not or someone else does without feeling so ostracized or different? This is one of the places where I actually feel that teletherapy plays a huge role and

so well, let me take a step back. Doing a screening usually happens on a computer. So a lot of the screeners now, everybody likes it, everybody in the whole school goes and sits down in front of their computer. They answer a couple of questions and then that information goes and their mind goes

out into the ether from there, right? But as we get that information and say, okay, now what do we want to do for this? What are the steps we want? Who are the children that are doing our ride and are meeting their emotional benchmarks and then who are the ones that maybe need a little extra?

And even though, again, we’ve all got to work on getting rid of the, again, stigma that still exists around mental health, I think the more important thing right this moment is just making sure that students get the services they need and that they will engage in them in the way that they need to because that’s the other part. Even if you put them with somebody like a counselor or a psychologist, if they don’t

actively participate because of the reasons that you’ve mentioned, it might as well not be happening. And so in teletherapy, there’s a couple of things I feel like are really, really important here. Number one, nobody sees them going into the counseling office.

Nobody sees them talking to a known mental professional. They will go to a room with a computer. That’s basically what happens. And it’s different. Also that child usually will engage a little bit more because they don’t know that person,

which seems counterintuitive, but it’s actually really effective because they’re not going to see them in the hall later. They’re not going to say hi to them at lunch. It’s not anybody who knows their parents. It’s not anybody who knows their older brother necessarily.

So there’s that comfort of anonymity, which even the youngest children respond to now. And then there’s also the ability to have some flexibility. So if I, most schools have one singular counselor and maybe one singular school psychologist. And sometimes it’s not even a dedicated, like what’s very common is as a school psychologist, I had three schools that I was covering.

So I was just like traveling around to different schools during the day or one day each week. And it’s really hard to be able to give a school what it needs with that kind of schedule. But in this case, let’s say I am again, a female and I really need to speak to a female counselor, but the only person that is on site at my school is a male. That’s problematic.

And what is the school supposed to do about that? They’re not going to hire another, you know, they’re not hiring a second counselor. Like that’s just not how that works. And also what if there is a certain time of day that is the best time of day to be able to like carve out some of this intervention time for students to be able to all go get

some mental services at once. Again, how is one or two people supposed to see all the kids in the school at that time? And so utilizing teletherapy and some of that teletherapy staffing is actually a really great way to give students the, you know, kind of like multiply your staff, if you will, in the in the time that you need it, which is a big deal.

And also students feel more comfortable so they engage more. And it’s also a little bit better to find specialists if need be. So if you do have children that have identified like very more significant identified needs, what we call low incidence needs. A lot of times then teletherapy is a way to connect them with someone who is a little

more specialized where they can still get that in a school setting and from somebody that is, you know, understands what the school world is like. But it just provides a little bit of flexibility. Yeah. And I kind of mentioned pathways earlier, but as we were talking about just getting smart

in general, I was talking about new pathways, one of the pillars is around the support and guidance and how and this would fall right under that. Because like you said, schools don’t always have the resources for all the support and guidance that a student may need. However, there are items out there like teletherapy that creates accessible, equitable access

to support without a student feeling like, oh, they’re just kind of calling me out. And now everybody kind of knows what my challenges are. Therefore, I don’t want to engage in getting the support that I know I really need. Exactly. And that’s what we see over and over again across the nation is that lack of engagement.

Right. Yeah. And parents, I know, play a central role or guardians and in providing just this all around support. So it is the notion of it.

It takes a village to to make sure that, you know, kids or students have what they need and the adults in their lives know how to support them throughout. So I’ll just kind of finish out with having you finish this line. Positive mental health. Finish the sentence.

Positive mental health. Positive mental health is productive behavior put into action. So in the, I guess, like I’ve been talking so much about trauma informed and resiliency here. And one of the most important things in that is that we don’t, you know, nothing is right or wrong.

Nothing is good or bad. Nothing is, you know, even positive or negative. Things are just productive or unproductive. And the more that we can look at saying, am I doing things that are productive for me, that are moving towards my good mental health, moving towards good interactions, moving

towards meaningful life, then that means I am going to have positive and good mental health and not worrying about judgment words, right? Like, is that a good thing to do or a bad thing to do? And it’s like, no, you don’t have to be mean to yourself. You don’t have to say, like, oh, that was horrible.

I shouldn’t have done that. We can just take a step back and say, was it productive or was it unproductive? And if it was unproductive, I should probably just not do it again. But it’s OK. It’s like no harm no foul. So I think that’s why I want, I choose that is because I want people to understand that

it’s just productive or unproductive. It’s not good or bad and nobody is bad. Yeah. And it’s and it’s not mental. It’s just health and you continue to to push us on that. And I really appreciate it because just what you just described is just what we all should be doing

just for good health and mental and physical or just components of that good health. So thank you for taking the time to talk to us today, Stephanie. And and really giving us more information about how to best support all students so that they are seen and they all feel a great sense of belonging through relationships

and knowledge building in a great culture of care. So we appreciate you being here today on the Getting Smart Podcast. Thanks for tuning into the Getting Smart Podcast today. We want this podcast to be actionable and insightful and a great way to learn about what’s next in learning. In order to stay on the cutting edge, we need people in the field to tell us what they’re hearing,

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Thanks so much.