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The BI Experience

In 2015, across the 11 designated agencies across the state of Vermont, there were approximately 686 full-time behavioral interventionists (BIs) employed.  At Washington County Mental Health Services (WCMHS) alone, there are 130 behavioral interventionists employed in the Children, Youth, and Family Services (CYFS) division presently.  WCMHS far out serves any other designated agency in the youth reported on in the annual BI report. The BIs across the designated agencies supported more than 300 students in 2014 in accessing their education in their least restrictive environment. This number does not include BI support that is being provided in environments other than the public schools, such as residential placements, indicating that this is a low estimate. 

BIs support children throughout their school days and beyond, depending on the program model. BIs may also provide support in the community or in residential placements.  The types of youth that are served are diverse. The challenges which youth are experiencing who are coordinated with behavioral intervention services range from those with developmental, neurological, psychological, and/or behavioral disorders. Those with diagnoses that involve strong outward behavioral expressions are more often represented than those with inward behavioral expressions. These children are often being supported in school with an individualized education plan (IEP).children mental health

Behavioral intervention services and programs have come a long way in the last twenty years. In 1995, CYFS Director, Dr. Michael Curtis, and Dr. Ed Sbardellati, Board Certified Behavior Analyst (BCBA) supervised the very first BI in the state, Tiffiny Hubbard, who is now the Director of School Based Services at WCMHS. Behavioral intervention supports have gained notoriety and momentum since that time and continue to be valuable services in the state of Vermont and other states as well. Today, Michael Curtis, Tiffiny Hubbard, and Ed Sbardellati continue to be pivotal leaders in the world of behavioral intervention supports and beyond.  

The BI model is supported by funding from the Success-Beyond-Six initiative in Vermont. This initiative provides an avenue for providers and schools to work together in order to meet the needs of students in their school-aged years to proactively prevent more intense needs or negative outcomes as these children age. While the reporting of outcome data has continued to progress year by year, there are still gaps to fill in terms of expressing the value of this service in a meaningful way. Based on the data that had been collected for the 2014 report, approximately half of the youth who had two assessment scores to compare showed significant effects reducing the presence of internalizing and externalizing behaviors. Sometimes the goal may be to maintain the same level of behaviors. This may be because a client has reached a high level of success or because a client is experiencing significant stressors in their lives, and an absence of an increase in negative behaviors actually demonstrates that the client is using their acquired coping strategies effectively.

Behavioral interventionists are an extremely diverse group of individuals, as are their clients! Age, experience, credentials, specializations, and skills are impossible to generalize! One trait that is shared among behavioral interventionists is the willingness to support youth in a genuine and evidenced- based way: through the therapeutic relationship. Behavioral interventionists implement a prescribed behavior plan written by the behavioral consultant, but the element of the relationship between BI and client is of equal importance to the behavior plan.

children mental healthWhen one witnesses the great work that BIs are doing across our agency, what is often noted is the touching relationship the child and BI have.  Like all relationships, these therapeutic relationships ebb and flow; they are challenging at times and effortless at others. In the behavioral intervention world we talk a lot about ‘fit’. The fit has got to be there! Yet, often a skilled interventionist can build a therapeutic relationship with any client, at times instantaneously. WCMHS is proud to employ a great many amazing behavioral interventionists that can do just this! One such BI is Wendy Abare; lead BI at Barre City School for the last 10 years. Wendy previously worked at CDS for the previous 10 years with adult clients. She is an amazing role model for other BIs and brings “IT” to work each and every day: fun, caring, energy, laughter, clinical expertise and almost as important, amazing baked goods! Staff and students alike realize the power of Wendy’s skilled and positive interventions.

There are many ways in which BIs build these therapeutic relationships with children. BIs offer structure, consistency, empathy, and understanding.  BI duties can also be quite wide-ranging.  During the school day BIs often provide encouragement and prompting in order for the youth to access their education and their social environment to the best of their abilities. This can involve breaking assignments into manageable pieces, helping them build bonds with peers, teaching them how to advocate for themselves, and helping them to implement coping strategies to manage their emotions. BIs also communicate with and educate school staff on the needs of their specific client and the philosophies that drive behavioral intervention. They work to bridge general expectations and their client’s specific behavior intervention plan.  This means that not only does the fit need to be there with the youth and the BI, but also to be most effective, the BI, teacher, and school also need to come together to create an effective and efficient working collaboration daily.

 Outside of school hours BIs facilitate community activities with youth. This may include swimming, horseback riding, after-school programs, summer camps, or exercising which only skims the surface of the recreational and extracurricular activities that BIs may engage in with their assigned youth.  Community time can be a great perk of the job!  During this time BIs help their youth realize their interests and help to facilitate their success in chosen activities! In addition, BIs are able to integrate their own interests into their client’s treatment such as outdoor education, gardening, music, and even Star Wars in some cases!

Today across programs and the agency as a whole, there are former and current BIs who take pride in their behavior interventionist days!  Being a strong behavioral interventionist means that you are, or have become skilled in patience, empathy, managing emotions, and anticipating needs. These experiences and relationships can have an impact for youth, their families, and their schools both in the short term and long term; regardless, they have an impact that is immeasurable.

 

Written 5/2016

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