Mental Health Support Services for Educators

[00:01] Announcer:

Welcome to Principal Center Radio, helping you build capacity for instructional leadership. Here's your host, Director of the Principal Center, Dr. Justin Bader. Welcome everyone to Principal Center Radio.

[00:13] SPEAKER_00:

I'm your host, Justin Bader, and I'm honored to welcome to the program, Diana Parafinik. Diana is a speech therapist and the founder of eTherapy, and she's the winner of a Women's Achievers Award from the Capital Times of Arizona for her work in connecting students with the therapy services that they need.

[00:31] Announcer:

And now, our feature presentation.

[00:34] SPEAKER_00:

Diana, welcome to Principal Center Radio.

[00:36] SPEAKER_01:

Thank you so much. Looking forward to being here today.

[00:40] SPEAKER_00:

Well, I'm excited to talk about a concept that a lot of people might just never have thought of because it doesn't necessarily seem like it would be possible. But your company, eTherapy, provides a variety of different therapy services to students remotely. Is that right?

[00:55] SPEAKER_01:

That's correct.

[00:56] SPEAKER_00:

Tell us a little bit about how that works. I have some speech therapists in the family, and of course, as a principal, worked with a variety of speech and occupational and physical therapists to provide services for our students who needed them. How did you get into providing services remotely through the e-therapy platform, and how does that work?

[01:15] SPEAKER_01:

Great. That's a wonderful question. Thank you for asking. I started about a dozen years ago and I began in the rural areas of the Navajo and Hopi reservations. where I had to travel long distances, traverse through different mud and weather and snow. And so consistent therapy was really a challenge for these particular populations of where they were located.

[01:38] SPEAKER_00:

Right. And this is a part of the country where often school districts have airplanes just for context, right?

[01:43] SPEAKER_01:

Exactly correct. So the challenge there was how to see the students and get them the consistent therapy that they needed. And this was in 2008. in 2009. So this was at a time where there were challenges or, or with streaming and loading pages. And at this point in time, the only thing that really existed, let's say was Skype was kind of had been released and it was for all intents and purposes, a bit challenging.

[02:10]

So you had to get creative on how to provide therapy. And there was no particular person or group to look to. And so really the innovation came within. What we decided to do was put together a platform for ourselves and have it be interactive. So At that point in time, there actually was no video system where you could see your videos at the same time and also share your screen unless you built the system yourself. And so we were able to use some, get really crafty and scrappy.

[02:39]

And we hustled and we put together, utilizing some different platforms, the ability to share the screen and see the students at the same time. And we could have six video windows. simultaneously, which in 2009 was a big deal because that didn't exist. And I had no idea how it was going to go. There had been different studies that had been done, Kent State, Omni Project, things like that. There were individual therapists that were doing case studies and with static video conferencing systems, such as Tanberg and Polycom and the district, they're really expensive and the districts had to have one on their end and therapists had to have one on their end.

[03:18]

And But the interactive capabilities were not similar to what we experience today. And I just couldn't believe it when I had the kids full attention, which, you know, at that point in time, I had runners. You know, I had kids that would hide under the desk or I had kids that would I'd have their attention for five minutes and then they would scramble and you bring them back to center. And those kids particularly, when we did our telepractice, I had their full attention and I thought to myself, oh man, I didn't prepare for this full 30 minute session. And it was extraordinary. And the success was beyond anything that I could have possibly imagined.

[04:02]

And it started with speech and then moved into quickly occupational therapy, physical therapy, behavioral mental health, BCBA, ABA, and psychic services that we do for our students. I think at this point in time, we've really gotten to a place where and probably due to the pandemic where educators have leaped into the platform of virtual education in a way they had not expected that they were going to be able to do successfully. And that's actually been a blessing because the open mindedness now with administrators in the educational space and what it is that we do, knowing what we can bring consistently for teletherapy and therapeutical practice really allows them to have access to therapists for their students instead of being stuck in a quagmire of not being able to find those therapists for their services.

[05:01] SPEAKER_00:

I wanted to just put on the table a question that's kind of the elephant in the room, and that is just kind of what types of services are even possible to do remotely? Because obviously, anything that's like a phone call or a Zoom meeting can happen remotely if it involves talking and listening and things like that. Doesn't seem like too much of a stretch, but at the same time, there are some hard limits. Like obviously dentistry is probably never going to become a telemedicine or primarily a telemedicine. You know, there are things that we just have to be there in person for. So, you know, speech therapy, take us through the different types of therapies because, you know, traditionally we're used to all of these being done in person.

[05:37]

What works really well virtually and what are some of the things that really do need to be done in person?

[05:44] SPEAKER_01:

Right. That's a wonderful question. A dozen years ago, I would have probably had a different answer for you. But now having seen the gamut of different services that we can actually facilitate and provide and carry over has really evolved over all of these years of time. And we really are able to work with myriad different disabilities and challenges that people have successfully. There are a few, you know, barring, of course, maybe a video for us, which I think they actually do.

[06:18]

They can do via telehealth these days, but there are some challenges, maybe having to actually see the viscosity of food and things like that, you know, but truly the. With speech therapy and thankfully at this point in time, because of technology and all of the different devices that we have at our fingertips, we actually can incorporate those into therapy relatively well in terms of document cameras and being able to facilitate the ability to see the fine motor and the gross motor movements for the students for occupational and physical therapy. Incorporation of actually hard manipulatives, which we do incorporate within our therapy practices. So there are facilitators on the side of the student and of course the therapist. So we make sure that we have uniform materials and we have a plan in place where we're able to provide that therapy

[07:11]

successfully because we have the plan before the therapy actually takes place. So there's expectation and understanding of what's going to be involved when that therapy does happen and what the requirements are from the facilitator and from the student and from the therapist so that there's a level set of expectations there and the achievement of success for those goals that the students are working on is possible.

[07:33] SPEAKER_00:

Right. And that's what it ultimately comes down to, right, is the student achieving their goals that are set out in their IEP or whatever type of plan is being worked toward. Because if it can happen, if the student is making progress toward their goals, then we're not inclined to be especially picky about the exact format in which services are delivered.

[07:52] SPEAKER_01:

There's a facilitator. So depending on what the goals are for the student and what is needed, we incorporate an additional facilitator or sometimes we don't need that at all, right? So you have the gamut from mild to severe to profound. And even in the circumstances, I mean, we work with nonverbal students. We work with students who are on the autism spectrum who have a severity and are quite profound. And what we're able to do, if you kind of take it from an out of the box approach, We are still always able to work with a student regardless because we can work through a consult model, which is a really important aspect of therapy that you kind of have to remember to incorporate when you are experiencing different challenges through a teletherapy or telerehab practice.

[08:38]

And or modality. And with that being said, there's lots of modeling and lots of carryover and counsel that we can do with the people who are on site or within the district themselves if they don't have access to an on-site therapist, which is, which is huge. because they're not operating in the dark. And we do have the gift of observation and being able to see everything that's taking place. So with the utmost challenges that we would face with 0.01% of the population that we couldn't serve, maybe in the traditional sense, as you're thinking, we do have these other options of being able to incorporate the service and set them up for success.

[09:17] SPEAKER_00:

Very cool. And I, you know, thinking about the students that I've worked with who did have more profound disabilities, often they're working with a classroom aid or they have even a one-on-one aid who kind of travels with them throughout the days. Is that often the case that their aid is working with them during their therapy session as well?

[09:32] SPEAKER_01:

Exactly. We want to make sure that they're incorporated, that they're doing the carryover and generalization of the skills that we are providing. We want all hands on deck for that team, for that support for the students.

[09:44] SPEAKER_00:

Let's talk a little bit about some of the scenarios where this is an option that makes the most sense, because obviously there are schools that have one or multiple full-time therapists on site. Larger schools in urban areas often do have full-time therapists on staff. I think in my school, when I was an elementary principal, most of our therapists traveled to multiple schools. I think we had one speech therapist who was full-time in our school, but the occupational and physical therapists traveled to different sites. And you mentioned that in your work on the Navajo and Hopi reservations, just the geography, the distances that you would have to drive was a challenge and really was the impetus for starting e-therapy. In addition to geography, just being in a rural area or being in a very small school that can't justify full-time staffing for some of these positions, what are some of the other scenarios that lead people to reach out and work with you?

[10:36] SPEAKER_01:

So it used to be this concept of, you know, we just sort of service the rural industry and the educational space because they are the ones that struggle the most. And what kind of gets overlooked are also those inner city and really populated dense school districts and being able to recruit the therapists that they need to have onsite, right? And so what's really important is to know that we fit within every type of setting for brick and mortar, virtual, charter, for the districts that have homeless populations where they need to be able to facilitate homeschool groups, one-on-one, outside carryover, case management, we really fill that gap in service. So even for the districts who have onsite, there's just never enough, right? Or maybe there's a need to be able to support that staff that already exists for onsite and they just need one or two kids taking off their caseload or they need some evaluations done where their entire staff isn't drowning.

[11:35]

And what's beautiful about what it is that eTherapy does, in all honesty, I think that kind of sets us apart is for me, the idea was to reach all the students, whenever we can, however we can do it. And so we don't have a minimum caseload concept or, hey, you have to give us 20 kids. It's one student, right? And for however that facilitates your onsite staff or whatever that means for them to be able to be successful. So we want to be leaned on in that regard. And school districts, I think, really struggle with having the amount of therapists that they need.

[12:13]

even when they have their own onsite therapists. And we work in tandem. We are not just somebody that comes in and you don't see us. And so we just are this enigma that floats in space and we have no connectivity, right? I mean, we are thoroughly connected. It's a full implementation program.

[12:33]

That works with the onsite therapists that are already there because our job is to be part of the team and to make everybody's lives easier, right? And solve some of those pain points. that we know administrators and special education directors and principals and onsite therapists are experiencing. Because we've all had it. I started in the space of working within districts where I had a caseload of 110 kids or more. And I had to travel within the district, like you mentioned.

[13:01]

One of my schools was 50 miles from the district schools that I worked at. And I was the translator as well for all of the additional speech therapists and the psychologists. So... With that being said, we do multiple.

[13:17]

It's not just coming in and serving in isolation, right? So we want to hear what the school administrators are struggling with and what their onsite therapists are struggling with. And we want to be able to fill that gap in that particular space that makes it so that everybody can function with 100% success.

[13:35] SPEAKER_00:

I'm thinking of the decimal problem, you know, that often funding for therapists comes in 0.6 FTE, full-time equivalent. Great. We get 0.6 occupational therapists this year. We get 0.9 speech therapists or even worse.

[13:50]

Cause you know, sometimes people want to work 0.9. They like the schedule even worse. You need a 1.2 or a 1.3 and like good luck finding a 0.3 person who wants to work.

[14:00]

Three mornings a week and then leave at 10 a.m. This is just a very, very hard position to fill or to keep someone in because of those fractional kinds of staffing patterns that we have. So I appreciate you mentioning that working alongside of, not necessarily instead of, but just to supplement, to fill in, to be part of the team. and to help deal with often either the unpredictability of the student numbers, you know, if your population blooms overnight and you have to serve far more students than you're anticipating, or if you have staffing challenges. And I know many, many schools are having staffing challenges in all types of positions now just having a teacher in every classroom has been a great challenge for many schools this year.

[14:39]

Let's talk a little bit about who is actually doing the therapy, because obviously these are professions that have pretty stringent licensing requirements, right? And I remember many discussions as to the difference between occupational and physical therapy, and you can't try to get the occupational therapist to do something that's physical therapy and vice versa. So tell us a little bit about how the licensing and qualification works and who actually provides the services.

[15:05] SPEAKER_01:

You have to be licensed where you reside and you have to be licensed where you work. So we have therapists that have multiple licenses that can work across the country. So if they live in California, but they work in New York, they have to be licensed in New York. They have to be licensed in California. They have to be licensed with all the departments of education that require it per state. We do follow all of the individualized state regulations and licensure requirements that are necessary to be able to provide the therapy.

[15:32]

All of our therapists have many years experience providing therapy. So we also do supervision. So that's something that I did want to mention for the school districts that have therapists or assistants and things that they need additional supervision for, but exactly fills in that gap that you're talking about. We only need somebody to supervise for four hours a week. And so where are we going to get that? And the therapists that we already have on site are completely strapped of time.

[15:58]

And it's just that last ask where you know that you're just not going to ask that person to do it because they're going to walk out the door.

[16:05] SPEAKER_00:

Yeah, that's huge because I remember, you know, I was in a large school district, Seattle Public Schools, and our therapists did have their own supervisors there. through the district, which I was grateful for, because obviously, I don't have that background. If I walk in and observe a therapy session, for one thing, I'm kind of disrupting it, you know, just by being there, it kind of changes the dynamic to increase the number of people in the room by 50%. But also, I just don't know what I'm looking for. It's just such a different setting than teaching a classroom full of students. So you actually can, upon request, observe the therapist at work and do their evaluations.

[16:39] SPEAKER_01:

Yeah, we can do that as well, which is great and has been really beneficial. And it's come in usually a last minute request, right? As everybody's scrambling. So we're happy to do that as well.

[16:50] SPEAKER_00:

So all the therapists are conventionally trained and licensed both where they live and where their students live. They have to be licensed in both places.

[16:58] SPEAKER_01:

And we use continuing education as well in professional development. That's an additional thing that eTherapy provides for our therapists. And we are constantly creating and generating resources and materials for our own therapists to be able to utilize within their therapy. So the reason why I bring that up that that's so important is because I want the therapist to focus on the therapy practice and working with what they need to instead of doing a heavy lift for themselves of constantly researching and figuring out what am I going to do? Where am I pulling my resources from? How do I do this?

[17:32]

And so we create a full comprehensive platform for called STAR that eTherapy operates from, that our therapists are able to provide the best therapy that they can with a click of a button. They're able to schedule all their sessions. They're able to see everything that they're doing at a glance with a click for themselves. And then they're also able to find any resource assessment screening, material, therapy activity right at their fingertips so that they don't lose time in when they need to actually provide the therapy to the student.

[18:06] SPEAKER_00:

So Diana, I understand you also provide a variety of wellness and mental health services as well. Tell us a little bit about that.

[18:14] SPEAKER_01:

Yes. We have a wonderful program that we have developed and are offering for our districts, for administrators and educators, and it's called EQIP. And it is Engaging Environments, Quality Connections, Understanding, Interpersonal Interactions, and Personal Wellness and Professional Development. And with those five verticals comes a few different options for school districts to be able to fill those gaps in terms of service that they can do and provide support for their own educators and staff. And so with that being said, we have professional development seminars that we provide on-site live, or we can do them over Zoom or whatever works best for the district. That is a foundations mental health seminar providing all of the fundamentals for mental wellness for anybody that comes in contact with students and how to manage their own personal wellness and their professional wellness when interacting online.

[19:17]

with students to be able to identify for themselves and the students who might need additional support and really providing those tools and materials for them. So that's our professional development foundations that we offer. And second, we have a platform, a mental health platform, Equip, which is a on-demand modules that breaks down section by section with resources, PDFs, materials, and tools For teachers in their classroom and the modules are between five and seven minutes, you know, so we know that teachers, we want to maximize their time. We know that there's so many different requirements asked of them. But what's most important is that they can on their own time be able to log in. and get quick information on how to work with challenging students and how to support themselves and then actually give them low-tech materials to be able to incorporate in the classroom when working with these challenging students.

[20:17]

So that's second. And then lastly, we do live professional and personal wellness coaching and support for educators based on the flexibility of the district of what works for them. So if they know that they want... their staff to be able to have access to a licensed professional counselor, to be able to receive coaching and modeling for increased professional and personal wellness.

[20:41]

They can have a 60-minute or 30-minute session once a week. They can do it monthly. They can do it bimonthly. They can break it down however they want so that it facilitates the burnout and the stress. We often say, okay, we know what the students need, right? We're for them through social emotional learning or through this additional direct service.

[21:07]

But what about the teachers? And how do we support them? And at this point in time, I think in pandemic, and we needed it beforehand, right? Is that additional support where they can reach out on demand and be able to be receiving that information and support for how they work and what they need to do so that they come to work prepared and feel better about themselves and their own personal wellness and professional wellness is taken care of. Yeah.

[21:33] SPEAKER_00:

And again, to make a big district connection, I think when I was in Seattle, we had something called the Employee Assistance Program, where you can be connected with resources or, you know, as a principal, if you had a staff member who was struggling, maybe in their personal life, that could be a good resource for connecting with various different services that would go beyond what, you know, as a supervisor, I, you know, like there are just plenty of things that I'm not equipped as a supervisor to help individual staff members through. So this serves in that, that same kind of way. Is that right?

[22:00] SPEAKER_01:

Yeah, it can be used in that capacity. So we could provide a direct counseling session for the educators in that same capacity. Or we can work within a group capacity. So you could have a group of educators who come together who just need additional support for themselves within their classroom and their strategies that they want to implement, but they're really struggling. And so it's negatively impacting themselves and how they feel about their own success and their own wellness in terms of working with their students. And so where do you reach out for that?

[22:30]

And how do you get the support for that? And who's going to provide you the materials and resources? But we can, right? And we can do that as often as needed based on what the administrators feel that would be beneficial for their educators and staff. So we could do a group of five to seven educators at a time. And we work through all of the issues that they're facing, right?

[22:52]

Because it's an outlet for them. It's a channel for them to say, hey, this is what I'm experiencing in my classroom. This is how it's negatively impacting me. This is how I feel when I show up to work in the morning and I don't know what to do about it. And how is that going to carry over to my students? And how can I make that a more successful experience for my own self, which will carry over to my students, right?

[23:13]

And I think that's the piece that doesn't exist. But in terms of the employee assistance program, that in itself, there's always a wait time. So I do want to kind of address that too, where the... Educators can sign up with us directly for a counseling session.

[23:32]

There's not an eight-week delay in terms of getting that scheduled. It can be an immediate experience and they can get the help they need with that as well. So that is really important. And we're seeing that more and more with the districts and the school administrators that we're talking to, where they just need the additional help for their teachers and their educators and their staff. So that's really important as well.

[23:57] SPEAKER_00:

Is this a service that's available to individual administrators as well? So if somebody is dealing with just a lot of stress, which I know is endemic in our profession, would that be available to individual administrators who just say, hey, look, I need somebody to talk to to get me through this week or to keep me on the job and keep me at my best for students?

[24:14] SPEAKER_01:

Exactly. And the licensed professional counselors that we have on staff are education specific and focused. So they really do and are able to hone in on those challenges and pain points that they're experiencing. And it's relatable. And I think that's a really important wraparound for that.

[24:31] SPEAKER_00:

I wonder if you ever work with schools that have a therapist already, but would like to enable that therapist to work remotely, again, either due to geography or maybe due to a partial leave, or maybe we had somebody go out on maternity leave and we want them to come back point two and they would love to come back point two, but we really need the technology to do that. How can that work with e-therapy?

[24:53] SPEAKER_01:

Yes. So when the pandemic hit, I think one of the most important things that we fielded was we need your help. We need your help. We need your help. And with that being said, it was for the on-site therapists that then were needing to do teletherapy and learn about how to do teletherapy, how to be successful, learn about the practice and how to implement it. And so we did a deep dive.

[25:16]

We created a platform called eSmart where districts can license that for themselves. It comes with a complete comprehensive training component for therapists that work within the district themselves. So not utilizing our therapists, but having the expertise of our therapists because we train them and they have all the access to the professional development, our webinars, our resources, our activities, our therapy modules, everything that we have. is included within eSmart. And what that does for the administrator as well is they're able to see now that their program may be hybrid or their onsite therapists may be working in a hybrid fashion and they aren't used to that experience in terms of being able to track it, right? or being able to monitor all of the progress because everybody's focused on how do we do this and what's the modality and where do I put in my information and how do I know you actually scheduled the therapy with the student?

[26:18]

And what's really wonderful is eSmart is a pre-session, in-session, post-session experience for all the stakeholders. So for the onsite therapist, for the school administrator and for the student. And it's with complete and total ease. So if that student is on-site and working with their therapist on-site, the on-site therapist can still utilize the platform for scheduling their session and tracking and entering in all their clinical data notes. And then let's say that student then gets sick with COVID or the therapist does. And then there's a change in service type.

[26:54]

They have eSmart right there and they're able, the students able to log on from home and the therapist can be at school and be able to still see that student without them missing a beat. Same thing, vice versa. The therapist has to be at home and quarantine, but still wants to be able to see the students. They can see them that way as well through eSmart. If you don't want to use the teletherapy virtual component in terms of video conferencing, but you want to be able to maintain your entire program, the Platform allows for complete transparency of when the students were seeing all the clinical data notes. And then all progress is charted real time.

[27:32]

So we're not waiting for quarterly progress reports. You see after every session, the achievement that the student has made towards their goal post that session having taken place. And that's all exportable into documentation form and hard copies. So we see charted graphs that monitor how the student's working on after each session that takes place. And that is for districts and their own therapists. And we're here to train them so that they have a positive experience and that the students have a positive experience.

[28:03]

But with that being said, then the success within tele-rehabilitation, telehealth, digital health, health therapy, the entire space, everybody's having a positive experience and feels comfortable with it moving forward because that's what we want, right? I want to make sure that not just my therapist with my company know what they're doing. I want to make sure that everybody working in this space is successful.

[28:27] SPEAKER_00:

So kind of a learning management system for therapists, but also backed by the expertise. And of course, if people need the actual therapists or aren't bringing their own, then that's available too. Well, it sounds like in almost every case, the first step is for people to just kind of reach out and talk about their situation, right? Because everything's very customized and scaled specifically to their situation. So if people want to get in touch with your team and find out how to bring e-therapy possibly to their school or district, what's the best place for them to go?

[28:59] SPEAKER_01:

They can go to our website. They can reach out to me directly. So our website is www.electronic-therapy.com. They can email me at dianap.com.

[29:11]

D-I-A-N-A-P at electronic-therapy.com. Everything is within our website as well. So we actually have a button called the easy bell and they can ring the easy bell and just put in their information and we will be in direct contact with you about whatever works best for your school. And it's exactly that, Justin. So thank you so much because we are completely flexible and whatever the school district needs, we look to adapt our services to that and not the other way around, right?

[29:44] SPEAKER_00:

Well, Diana, thank you so much for joining me on Principal Center Radio. It's been a pleasure.

[29:47] SPEAKER_01:

Same. Thank you very much for having me.

[29:49] Announcer:

Thanks for listening to Principal Center Radio. For more great episodes, subscribe on our website at principalcenter.com slash radio.