Applying the ASCA National Model to elementary school students who are homeless: a case study.

This case study of an African American elementary school female who is homeless illustrates how ASCA's National Model meets the needs of students who are homeless. The needs of children who are homeless and the rationale for school counseling interventions--including assessment, classroom guidance, group play therapy, and consultation--are described. Outcomes reveal a decrease in the child's anxiety and behavior problems and an increase in self-concept. Implications and recommendations for school counselors are discussed.

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School counselors must meet the challenge of providing the American School Counselor Association (ASCA) National Model for a rapidly growing diverse student population, including children who are homeless (Strawser, Markos, Yamaguchi, & Higgins, 2000). According to the Institute for Childrcn and Poverq, (2002), more than 1 million U.S. children per year are homeless. The number ofchildrcn and families who are homeless continues to grow because of limited affordable housing, shortages in jobs that pay a living wage, and welfare reform (National Coalition for the Homeless, 1999b). Families with children are the fastest growing segment of the homeless population, currently representing 40% of people who are homeless (National Coalition for the Homeless, 1999a).

The Stewart B. McKinney Act (1994) mandates that school counselors provide services for children who are homeless. A review of the professional literature reveals guidelines and interventions for school counselors to address the barriers and needs of children who are homeless. Strawser et al. (2000) described legislative provisions, current barriers, effects of homelessness on children, and strategies such as accessing basic needs and malting referrals to medical and social agencies. Walsh and Buckley (1994) recommended addressing the social stigma of homelessness through developmental counseling. Daniels, D'Andrea, and Morioka (1991) and Daniels (1992) identified developmental needs and barriers of children who are homeless and recommended strategies such as providing food to satisfy children's hunger and creating a sense of safety within a developmentally based counseling group. Later, Daniels, D'Andrea, Omizo, and Pier (1999) described a group counseling approach designed to reduce conflicts and enhance problem-solving skills for adolescents who were homeless.

In addition, two empirical research studies have validated effective interventions that school counselors should consider. Nabors, Proescher, and DeSilva (2001) found significant improvement in parents' perceptions of their children's positive behavior and grades after participation in the Empowerment Zone project, which provided parent training, children's small groups, and classroom-guidance mental health prevention activities for elementary school-aged children who were homeless. Perry (2000) found that children who were homeless and received structured problem-solving training significantly improved in problem solving and coping flexibility and had lower anxiety than did children in control and comparison groups.

Although previous literature has provided guidelines for addressing the general needs of children who are homeless, a detailed, personalized description of a child who is homeless has not been provided. In addition, school counselors are now encouraged to apply the ASCA National Model, a comprehensive approach to program foundation, delivery, management, and accountability, for every student (ASCA, 2002). Thus, school counselors must conceptualize interventions for students who are homeless in light of ASCA's National Model.

In this article, we will (a) discuss the rationale for providing school-based counseling to children who are homeless; (b) provide a detailed, personalized description of a child who is homeless; (c) describe an application of ASCA National Model interventions for this child; (d) report and discuss results; and (e) provide recommendations, identify implications in light of ASCA's National Model, and give future directions.

RATIONALE

Elementary school-aged children who are homeless are confronted with a variety of unique challenges. Socially, children living in a homeless shelter are hindered in the development of their social skills due to the shame of their homelessness and frequent family moves (Buckner, Bassuk, Weinreb, & Brooks, 1999; Walsh & Buckley, 1994). Children who are homeless were found to have less social support and coping behaviors than children who were either never homeless or previously homeless (Menke, 2000).

Emotionally, children who are homeless tend to experience more depression and anxiety than children who are housed (Buckner et al., 1999). Approximately 47% of children who were homeless were found to have clinically significant internalizing problems, such as depression and anxiety, compared to only 21% of children who were housed (Buckner et al.). Menke and Wagner (1997) also found depression and anxiety were significantly higher in children who were homeless compared to children who were never homeless. Other researchers (Homeless Children, 1999) found that one fifth of children who were homeless had severe emotional difficulties that warranted clinical intervention, although these children seldom received the interventions. Many children who are homeless have experienced domestic violence. Approximately 80% of mothers who were homeless compared to 66% of mothers who were housed reported domestic violence (Buckner et al., 1999).

Behaviorally, children who are homeless tend to exhibit more externalizing problems, such as delinquent and aggressive behavior, than the normative sample (Buckner et al., 1999). Increased behavioral problems of children who were homeless compared to children who were not homeless were identified as early as preschool (Koblinsky, Gordon, & Anderson, 2000).

Academic achievement problems also have been reported for children who are homeless (Masten et al., 1997). Rubin et al. (1996) found elementary school children who were homeless performed significantly more poorly on academic tests than children who were not homeless. Biggar (2002) found that a lifetime history of homelessness negatively predicted students' academic performance as measured by grade point average. Other research indicates children who were homeless were diagnosed with learning disabilities at double the rate of children who were not homeless (Homeless Children, 1999).

Given the impact of homelessness on children, there are three reasons for providing school-based counseling to children who are homeless. First, as described above, the intense social, emotional, behavioral, academic, and familial problems of children who are homeless hinder their ability to achieve success in school (Buckner & Bassuk, 1997). Second, parents who are homeless have difficulty obtaining counseling and psychological services due to limited energy., and resources (National Law Center on Homelessness and Poverty, 1995; Torquati & Gamble, 2001). Third, the McKinney Act mandates that state and local education agencies remove barriers to school success of children who are homeless (National Coalition for the Homeless, 2002). Therefore, it is incumbent upon school counselors to implement school-based mental health interventions to promote the academic, career, personal, and social success of children who are homeless.

CASE DESCRIPTION OF A CHILD WHO IS HOMELESS

Regina (alias) was a 7-year-old African American female who resided with her mother and 10-year old brother in one dormitory-like room at a homeless shelter in a southeastern metropolitan city. After several months in the shelter, Regina's mother married and her new stepfather moved into the room with the family. Regina's mother reported a family history of homelessness and poverty, frequent moves, past domestic violence, and a lack of recent contact with the children's biological father.

Regina was enrolled in the first grade in a general education K-2 classroom at the on-site charter school in the homeless shelter where they resided. Her mother and the school cumulative folder provided only a small amount of useful family and academic background information. Regina's mother suggested her daughter had no known academic deficiencies but did have social and behavioral problems. Her teachers reported Regina's academic performance in the classroom was on grade level, despite learning gaps in basic achievement skills (e.g., reading, writing, and math).

According to her teachers and mother, Regina's problem behaviors at home and school included excessive dependency and attention seeking from adults (e.g., repeatedly asking, "Do you love me?" and constantly approaching and interrupting); peer difficulties (e.g., making and keeping friends); low frustration tolerance (e.g., raising voice and talking out of turn); and stealing, lying, and denying responsibility for her actions. In addition, her teachers reported a history of somatic complaints, poor self-concept, impulsivity, depressed mood, distractibility, oversensitivity, anxiety, and irritability. Regina's strengths included being friendly, helpfulness, an attractive appearance, and an active energy level.

COMPREHENSIVE SCHOOL COUNSELING PROGRAM PROCEDURES

The following four program components of ASCA's National Model, based on Gysbers and Henderson's (1994) Comprehensive School Counseling Program (CSCP), were provided to Regina.

Education/Prevention

For large-group classroom guidance, a weekly social skills training program entitled "Stop and Think" (Knoff; 1999) was implemented in Regina's class. The major components of the "Stop and Think" model are (a) discussion of social skills, (b) modeling, (c) role playing, (d) performance feedback, and (e) transfer of training via application in an everyday environment (Knoll). During weekly large-group guidance lessons, a part-time school psychology graduate assistant presented the following "Stop and Think" steps (Knoff): (a) identify a problem and verbalize "stop and think"; (b) activate decision making by asking, "What are my choices?"; (c) evaluate options and ask, "Do I want to make a good choice or a bad choice?"; (d) select an option and state "just do it"; and (e) conduct a self-evaluation and encourage self by saying "good job." The teachers reviewed these steps on a daily basis with Regina and other students in her classroom.

In addition, the school psychologist encouraged teachers to implement a classroom-wide behavior management system that entailed a token economy using a behavior monitoring chart with written stars as a secondary reinforcer (Cooper, Herron, & Heward, 1987). If Regina tact her individualized behavior goals of being honest rather than lying, asking to borrow items rather than stealing, cooperating with teachers by raising her hand or waiting her turn rather than interrupting, and completing her assigned tasks, then she was rewarded with a star on her behavior monitoring form at the end of each day. At the end of the week, if she earned 5 stars, she received a primary reinforcer of a grab-bag toy or school supplies. In addition, teachers were encouraged to give her frequent praise and to reward her with extra stars for positive behavior.

Individual Student Planning

To assess Regina's behavioral and emotional progress, the following three assessment instruments were administered. These instruments were selected based on prevalent use in other studies of children who are homeless (Buckner et al., 1999) and based on availability, which was limited by the homeless shelter's budget.

The Child Behavior Checklist Parent Report Form (CBCL-Parent Report), developed by Achenbach (1991), is a 113-item scale through which parents rate their child's behavior. Results are described in two domains, Internalizing Behavior and Externalizing Behavior, and nine subscales. This instrument was chosen because it has good test-retest reliability, of .89 for internalizing behavior problems and .93 for externalizing behavior problems and good construct validity with analogous scales on the Conners Parent Questionnaire (Conners, 1973) and the Quay-Peterson Revised Behavior Problem Checklist (Quay & Peterson, 1983).

The Child Anxiety Scale (CAS), developed by Gillis (1980), is a 20 item questionnaire specifically designed to measure anxiety in children ages 5 to 12 years old. It was chosen because it has good test-retest reliability ranging from .82 to .92 and good construct validity of .81 (p < .01) with Krug, Schcier, and Cattall's (1976) Institute for Personality and Ability Testing Anxiety Scale.

The Joseph Pre-School and Primary Self-Concept Screening Test (JPPSST), developed by Joseph (1979), is a 1 S-item test that measures the self-concept of children ages 3 to 9 years old. Scores are based on the child's identification with either a negative or positive picture of a child doing different activities. The child's self-concept is rated on a global index scale of 0 (low) to 30 (high) and is categorized as "High Risk Negative," "Poor," "Watch List," "Moderate Positive," or "High Positive." The JPPSST has good test-retest reliability' of .87, good internal consistency ranging from .59 to .81 with a medium correlation of .73, and good construct validity of .51 (Joseph).

Responsive/Intervention Services

Based on Daniels (1992) and Walsh & Bucklev's (1994) recommendations for a developmental counseling approach with children who are homeless, the responsive service intervention selected for Regina was play therapy, due to its proven effectiveness with children (Bratton & Ray, 2000; Ray, Bratton, Rhine, & Jones, 2001). When play therapy was applied to children who were homeless, Hunter (1993) reported that it empowered children to manage family crises, resolve conflicts, make sense of their world, and develop strength for long-term growth. Baggerly (2003) identified perspectives and procedures of child-centered play therapy with children who were homeless as well as their unique play themes of "eviction" and "I am rich!" Because group work with children who are homeless was recommended (Daniels et al., 1999; Davey and Neff; 2001; Nabors et al., 2001; Strawser et al., 2000), group play therapy was implemented for the extra benefit of helping children assume responsibility in interpersonal relationships (Landreth, 2002).

The first author, who is a Licensed Mental Health Counselor Supervisor and a Registered Play Therapist Supervisor, provided 10 weekly sessions of child-centered group play therapy to Regina and Twanda (alias), another female student in her class. We followed basic child-centered play therapy principles of following the child's lead; avoiding judgmental statements; creating a safe, accepting atmosphere; reflecting feelings; facilitating decision making; enhancing self-esteem; and setting therapeutic limits (Landreth, 2002). We conducted sessions in a private room with play therapy tote-bag toys such as a doll family, plastic dishes, handcuffs, toy soldiers, an inflatable plastic punching toy, Play-Doh, paper, and crayons (Landreth).

We provided another responsive service, parent consultation, based on recommendations by Nabors et al. (2001). Through parent consultation, we provided Regina's parents with positive feedback about her, such as, "Regina responds well when limits are set in a friendly but firm way and when she is given choices." In addition, we encouraged the parents to use a more effective, democratic parenting style of encouragement and problem solving within flexible limits rather than an authoritarian parenting style of harsh commands and corporal punishment (Steinberg, Lamborn, Darling, Mounts, & Dornbusch, 1994). Unfortunately, Regina's mother and stepfather were distracted by meeting more basic needs and thus did not choose to implement a more positive approach to parenting at that time.

Program and System Support

Because teacher training in mental health prevention activities was suggested by Nabors et al. (2001), we provided consultation to Regina's teachers. We encouraged the teachers to consistently implement the behavior management system for Regina and provided them with an alternative understanding of her behavior, such as, "She is motivated by a desire to please peers and adults."

RESULTS

After implementation of these CSCP interventions during the 12 weeks that Regina attended the charter school and the family resided at the homeless shelter, the following results were noted in Regina's assessment scores and behavior.

Regina's preassessment on the CBCL-Parent Report revealed a total t score of 74, which indicated clinical significance of behavior problems. Her internalizing score (t = 66) and externalizing score (t = 74) also were in the clinically significant range as they are a standard and a half deviation above the norm. Specifically, the anxious/depressed subscale score (t = 69) was in the borderline clinical range whereas thought problems (t = 73), attention problems (t = 78), delinquent behavior (r = 71), and aggressive behavior (t = 76) subscale scores were in the clinically significant range. On this preassessment, specific concerns reported by Regina's mother included "not understanding that she have [sic] to stay in her seat," "always writing notes because she knows she be [sic] wrong," "hides her food as if someone going [sic] to take it," "wants to grow up to [sic] last," and "wants to be the boss." To determine the integrity of the mother's responses, we reviewed individual items on the protocol and found no pattern of extreme ratings and found that scores were not skewed in either direction.

Although Regina's mother was asked to complete the postassessment CBCL-Parent Report, she did not comply, as she stated that she was preoccupied with moving out of the homeless shelter. However, Regina's mother did give a verbal report that her daughter's behavior improved in that she demonstrated less dependency, lying, and stealing in the last few weeks of treatment. Since the post-CBCL-Parent report was not completed, the validity of Regina's behavior change is questionable.

Anxiety

Results measured by CAS indicate a decrease in Regina's anxiety. Regina's preassessment standard Sten score of 10 on the CAS placed her in the 99th percentile for a child of her age, indicating that she experienced more anxiety than 99% of the normative group. Her postassessment standard Sten score of 8 on the CAS placed her in the 91st percentile. Although Regina's posttest Sten score of 8 still indicates a significant departure from the norm, her anxiety score was a full standard deviation lower than her pretest score.

Self-Concept

Results measured by JPPSST indicate an increase in Regina's sell-concept. Her JPPSST pretest global self-concept score was 4, which is in the "High Risk Negative" category, whereas her posttest global self-concept score was 22, which borders on the "Poor" category. Specific questions reveal improvement in Regina's self-concept. For the question, "One of these girls is a bad girl and the other girl is a good girl. Which one are you?" Regina answered "I'm a bad girl" in the pretest but "I'm a good girl" in the posttest. For the question, "One of these girls is smiling and the other girl is crying. Which one do you do the most?" Regina answered "cry" in the pretest but "smile" in the posttest.

Behavior

Based on reports from Regina's teachers and review of behavior monitoring charts by the school psychology graduate assistant, Regina demonstrated substantial improvement in her classroom behavior by the end of treatment. Unfortunately, due to personnel changes within school staff; behavior monitoring charts were misplaced at the end of the school year and thus specific data are not available to indicate when and at what rate Regina's behaviors changed. However, teachers verbally reported that Regina's lying, stealing, and interrupting had decreased and that she completed more of her weekly assignments by the end of treatment. Teachers also verbally reported that several days before Regina and her family were to move out of the shelter and away from the school, her behavior regressed back to stealing and lying once a day.

Observations of Regina's behavior during group play therapy sessions suggest that Regina understood and integrated the concepts of the behavior management system. For example, during session 7, she played teacher and said, "Don't do that. Sit down. Good. You earned a star." Hence, she appeared to associate behavior with the reward of earning a star on the behavior monitoring chart. Regina also began to integrate social skills such as "stop and think" into her daily routine. For example, during one play session while trying to make a decision, she verbalized, "Stop and think. What are my choices? Do I want to make a good choice or a bad choice? Just do it. Good job!" She demonstrated the accompanying hand signs for each step. She also stated frequently, "I'm supposed to make good choices."

In addition, Regina demonstrated more collaboration with Twanda during the last few play sessions. For example, instead or insisting that she be the boss, she was more likely to yield to Twanda's suggestions for play. In the classroom, Regina's teachers and the school psychology graduate assistant anecdotally observed Regina exhibiting less attention getting and dependent behavior. They observed Regina demonstrating more appropriate social skills to gain attention, such as volunteering in role plays, and increased her participation in peer activities.

Group Play Therapy Behavior and Themes

Variations in Regina's play therapy themes throughout the 10 sessions were observed by using the Benedict Play Theme Analysis System (Benedict et al., 1995). During the first four play sessions, Regina's play themes predominantly entailed nurturing themes, such as feeding the baby doll, and dependency themes, such as repeatedly asking "How do you do this?" Beginning at session 6, Regina began displaying mastery themes, such as adding restaurant prices on her own and stating "let me do it," and positive power themes, such as playing an encouraging teacher. In addition, observations of Regina's play revealed a shift toward positive self-perception throughout the sessions. For example, in group play therapy session 3, Regina wrote, "I'm sorry for doing bad," while in session 6 she wrote, "I'm being a good star." During the last session, Regina maintained play themes of mastery and positive power but also displayed conflict related to moving out of the shelter.

Parent and Teacher Response

Before program interventions began, Regina's parents and teachers expressed frustration and exasperation with her dependency, lying, and stealing. Both her parents and her teachers attempted to address her behavior with an authoritarian discipline approach of harsh words and punishment. Although neither her parents nor her teachers consistently implemented a more positive, democratic approach to discipline, both parents and teachers verbally indicated satisfaction with the group play therapy and social skills training and decreases in their own frustration. They also reported decreases in Regina's dependency, lying, and stealing toward the end of treatment.

DISCUSSION

As ASCA (2002) suggests, school counselors must answer the question, "How is Regina different because ASCA's National Model was implemented?" The difference in Regina after the implementation of the National Model is noted on several counts. Regarding her personal and social development, Regina's anxiety decreased and her behavior and self concept improved. Each CSCP intervention appeared to have contributed to Regina's personal and social development in a unique manner. Classroom guidance of social skills training seemed to help increase Regina's acceptance by peers and adults and thus made collaboration for learning more likely. The classroom behavior management system appeared to help Regina regulate her own behavior, be more attentive to schoolwork, and be less disruptive to other children's learning.

Responsive services of group play therapy seemed to help Regina identify and sort through intense feelings, evaluate old and new social skills in light of immediate peer responses and therapeutic feedback, gain a sense of mastery over troubling experiences, and enhance her self-concept. These findings were consistent with Hunter's (1993) report of group play therapy empowering children who were homeless and with Holmberg, Benedict, & Hynan's (1998) report of nurturing and mastery themes in children with traumatic histories. Parent consultation appeared to increase her parents' awareness of a more positive approach to discipline and perhaps increased the likelihood of their implementing a positive approach in the future. System support of teacher consultation seemed to facilitate teachers' acceptance of and positive persistence with Regina.

Regarding academic development, Regina's improvement in personal and social dimensions would likely reveal increases in her academic achievement, although Regina's abrupt move from the school prevented the verification of this hypothesis. However, because teachers reported that Regina was less disruptive, more attentive, and more cooperative, her readiness to learn appeared to have increased. Regarding career development, Regina's career exploration was facilitated in group play therapy when she played various occupations such as storekeeper, restaurant manager, and teacher. Play therapy interventions of encouragement, esteem building, and facilitating responsibility during her career-related play may have increased her self-concept related to having a successful career.

Recommendations

Based on this case study, we make the following four recommendations for improving interventions for students who are homeless. First, school counselors should train teachers on behavior management rationale, concepts, objectives, procedures, and record keeping. Second, school counselors should help create a positive, democratic school environment by securing administrators' support and providing training to all staff on specific skills such as encouragement, positive communication, active listening, and conflict resolution. Third, school counselors should enhance community resources by offering training to homeless shelter staff and recruiting parent mentors to guide and encourage parents who are homeless. Fourth, school counselors should regularly meet with school psychologists, parents, and teachers to monitor the progress of students who are homeless, adjust intervention strategies as needed, and reinforce positive approaches.

Implications for School Counselors

When this case study is considered in light of ASCA National Model: A Framework for School Counseling Programs (ASCA, 2002), several implications for school counselors as they work with homeless students are salient. First, school counselors can demonstrate the qualities of leadership, advocacy, and collaboration to lead systemic change for students who are homeless by (a) informing teachers about the intense needs of students who are homeless, (b) leading school staff and community members in developing a systematic plan to meet those needs, and (c) collaborating with homeless shelter staff; community leaders, and parents in leveraging resources.

Second, school counselors can promote academic achievement, career planning, and personal/social planning of students who are homeless through the integrated components of ASCA's National Model. The foundation of beliefs and philosophy as well as mission should include promoting students' success, whether or not they are homeless. The delivery system, as described in this case study, should include guidance curricula such as social skills training; individual student planning of academic, behavioral, and emotional assessments; responsive services such as group play therapy and parent consultation; and systems support of teacher consultation and resource referrals. The management system should include agreements between school administrators and homeless shelter staff; the use of data on the academic, social, and emotional progress of students who are homeless compared to those who are not homeless; and action plans to accomplish expected results of students who are homeless. Accountability should be demonstrated by results reports that link program interventions with the achievement of students who are homeless and a program audit to guide future action for students who are homeless.

Finally, ASCA (2002) student competencies of knowledge, attitudes, and skills for academic development, career development, and personal/social development should be maintained for students who are homeless. Communicating these expectations to students, parents, and teachers will help prevent a lower expectation for students who are homeless and will ensure appropriate effort on everyone's part. In so doing, students who are homeless will be encouraged to develop to their full potential in academics, career, and personal/social issues, thereby giving them the needed skills to help break the cycle of homelessness.

Limitations of the Case Study

Like all case studies, this one has several limitations (Heppner, Kivlighan, & Wampold, 1998). The lack of experimental control prevents the findings from being generalized to other children who are home less. It is possible that the student, her teachers, and her parents felt compelled to indicate positive changes in an effort to please the counselor. The student's improvements may have been temporary, and conditions other than the interventions described may have caused the changes.

Future Directions

Due to these limitations, future empirical research studies are needed. A quasi-experimental study applying the above described interventions with recommended revisions to a larger sample size is warranted. An experimental study that compares treatment groups' and control groups' academic scores, anxiety, depression, and behavior problems also is needed. Finally, comparison studies between the interventions described in this article and other approaches will provide further direction in effective interventions for children who are homeless.

Although it is imperative for school counselors to focus on interventions that improve academic achievement and behavior for the majority of students (Brigman & Campbell, 2003), we must not forget the individual student. Corsini and Wedding (2000) identified a common counseling mantra as "what specific therapeutic interventions produce specific changes in specific patients under specific conditions" (Strupp & Bergin, 1969, p. 20). This reminder will motivate school counselors to provide responsive intervention services such as child-centered play therapy for a few students with numerous needs, such as those who are homeless.

Fortunately, the ASCA National Model (ASCA, 2002) provides the framework so that counselors can deliver interventions of classroom guidance for large groups of students and additional responsive services for individual students. This case study "puts a face on" the individual student who is homeless and compels us to provide the powerful four components of the ASCA National Model (ASCA, 2002). (Those components are education/prevention through large-group guidance, individual student planning through assessment, responsive/ intervention services through child-centered group play therapy, and system support through teacher consultation and resource development.) In doing so, school counselors will become advocates and change agents (Kiselica & Robinson, 2001) for students who are homeless. School counselors should implement the ASCA National Model (ASCA) to provide interventions to improve the personal, social, and academic achievement of students who are homeless, thereby helping to break the cycle of homelessness.

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