Each Tier 2 Team has a written process outlining how students are identified for Tier 2 interventions. 

This will include decision rules describing when students are identified using counselor notes, attendance, or Panorama Survey data (consider self assessment scores in the area of Hope  for this intervention). Additionally each site has a formal process for Staff, Students, and Caregivers to nominate students for Tier 2 supports. 

• Query for Counseling Notes

  • • • LIST STU LOC CNF STU.ID STU.NM STU.GN STU.GR STU.SC LOC.NM CNF.DT CNF.CD CNF.CD? CNF.CU CNF.CO BY STU.GR STU.NM CNF.DT IF CNF.DT >= 08/01/2023 AND LOC.NM ; SUMMER AND LOC.DNR = 0 AND STU.TG # "*" AND STU.TG # "N" AND STU.TG # "W" AND ( CNF.CO : "ANXIETY" OR CNF.CO : "DEPRESSION" OR CNF.CO : "MENTAL HEALTH" )

      • Remember to change the terms in quotes to match the terminology used by your school counselor when documentating student concerns related to mental health, anxiety or depression

Students should be considered for the Trails to Wellness intervention as teams review data from each of the above screening processes. Consider the following as part of the selection criteria:

• Select students who could benefit from learning skills to manage stress and symptoms of depression and/or anxiety. No formal diagnosis is required. 

• CBT groups utilize some written materials. Students with significant cognitive impairment may struggle with these materials and the concepts taught in group.

Please note: Students with active suicidal ideation or serious self-harming behaviors are not appropriate for this group and need to be served by a higher level of care such as the SBCUSD's HEART/ERMHS therapy teams or VCSS. 

Tier 2 Teams should refer back to TFI 2.3 and TFI 2.4 for more information.

Tier 2 Teams will use the Functional Assessment Checklist for Teachers  and Staff (FACTS) to complete a brief Functional Behavior Assessment (FBA) on each student identified to receive Tier 2 interventions. This information will help the Team to determine which coping strategies will be taught and hypothesize what the student is getting/gaining and/or escaping/avoiding by engaging in the behaviors that result from symptoms of anxiety and/or depression. 

tieResponding to Problem Behaviors in School pg. 131

When analyzing the FACTS consider students for the Trails to Wellness intervention whose:

• The primary behavior of concern is internalizing behaviors (i.e., social withdrawal, unexplained physical symptoms (headaches and stomachaches not due to a medical condition), not talking to or interacting with others, sadness, nervousness, irritability, fearfulness, etc.

• The hypothesized function is Avoiding - events, tasks, activities, peers, staff, over stimulation, etc.

On-Demand Trainings: Functional Assessment Checklist for Teachers & Staff (FACTS)

Form: Functional Assessment Checklist for Teachers & Staff (FACTS)

Tier 2 Teams should refer back to TFI 2.7 for more information.

Prior to enrolling a student in the Trails to Wellness group intervention, it is best practice to get caregiver consent as well as provide a brief description of the intervention in consideration.

An Opt-in intervention form along with a brief overview of the intervention is provided for Tier 2 Teams to use as a guide - Sample: 

Trails to Wellness overview for families: Caregiver Overview, Opt-In Consent Form

Prior to enrolling students into the Trails to Wellness intervention, the Facilitator should meet with each student. Below is a sample agenda which includes possible discussion points:

Pre-Group Meeting Agenda grades 6-12

Pre-Group Meeting Agenda grades 3-5

During the pre-meeting the faciliator should review the following with each student, individually:

1. Provide an overview of the intervention

2. Review confidentiality

3. Gain student consent

4. Establish a need - PHQ-9/GAD-7 (grades 6-12) 

"Best practices in mental health care entail using assessment information to inform service delivery. Assessment data also helps evaluate the impact of programming on student outcomes"(trailstowellness.org). 

Note to Facilitators: Consider group placement based on GAD7/PHQ9. For example, on the PHQ9 students who score 0-9 have minimal to mild depression, as opposed to students scoring 10-27 indicating moderate to severe depression - should Facilitators put them all in the same group?

5. Deliver the Trails to Wellness - Elementary Reflection Assessment, Secondary Reflection Assessment

NOTE: The pre-reflection assessment can be conducted at the pre-meeting or during the first session with the whole group.

Role of Tier 2 Team

• Review data monthly - 

1. Number of students in intervention, 

2. Students response to the intervention: positive, questionable, poor

3. Next steps: fade, continue, intensify

4. Success rate of participants

•  Discuss possible new students

• Provide intervention updates to staff and parents/guardians

Role of the Coordinator/Facilitator

• Coordinator Role - person overseeing the intervention, supporting the facilitator and the teacher(s)

• Facilitator Role - person delivering the content to the group

Intervention Procedures 

• Establish Group Expectations: create with the input of group members; align to school-wide expectations; ensure they are - easily observable, positively stated, developmentally appropriate, representative of the shared values of the cultures and lived experiences in the group

• Select an Ideal Location: confidential space, phone/walkie-talkie, sufficient seating, proper ventilation

• Determine min./max. number of students (Elementary: 2 - 6 with 1-2 facilitators; Secondary: 2 - 8 with 1-2 facilitators)

All of  this data will be used to determine if a student's response to the Trails to Wellness intervention is Positive, Questionable, or Poor.

If the student's response was found to be questionable or poor teams should consider the following:

• Was the intervention implemented with Fidelity

• Did the student attend >80% of the Sessions

• Did the student complete >80% of the DPRs/Homework

If no, consider reteaching - another group or 1:1

If yes, to the above consider referring the student for further support - ERMHS, HEART, VCSS

TFI 2.12 recommends that fidelity checks be conducted regularly and include the following: Review of products: lesson plans; DPR - points awarded, parent signature, etc.; Direct Observation: Associate instruction, teacher feedback, data entry, etc.; Review of goals, intervention elements, and outcomes to ensure they are socially relevant; Surveys or interviews with program graduates or current participants.

For the Trails to Wellness intervention, Teams will consider the following:

Review documents

• Data-base: Students’ data entered weekly - Attendance, DPR, Homework

• DPRs: Facilitator is collecting DPRs daily and/or weekly

• DPRs: >80% of the students are completing - daily

• Homework: Facilitator is collecting homework weekly

• Homework: >80% of the students are completing homework - weekly

Direct Observation

• Lessons are being taught as designed

• Students appear to be engaged - active participation 

Social Validity Survey

• Completed by >80% of student participants per group

• Results Reviewed by Facilitator/Coordinator and brought back to Tier 2 Team for review

• The Tier 2 Team uses the Social Validity Survey to adapt group procedures/routines