Middle Level T3 Support System
The T3 (or Tier 3) Program is a model of support for students with chronic or episodic mental health needs that interfere with daily school functioning and access to the general curricula. The goal of this program is to provide target students with multidisciplinary social, emotional, and academic support in the context of specialized instruction and in-class help.
Students will receive a combination of individual therapeutic interventions; specific in-class support for academic functioning; and specialized group instruction regarding social skills, emotional regulation, self-reflection, and coping skills for school-based stressors.
The goals of the supports offered through this program include decreasing absences/tardies, decreased “out of class time” during the school day (i.e. unscheduled visits with nursing or therapeutic staff), increased production of academic work, and a decrease in school-related symptoms as reported by students, staff, and parents/guardians.
Middle School Level T3 Program Philosophy
The T3 program embraces the philosophy of an inclusion-based structure. There are some populations of students who benefit from a substantially separate program design (i.e. students with significant neurodevelopmental challenges); however, students with mental health challenges do not benefit from a base educational model featuring exclusion from the general student population. In particular, mental health symptoms in youth may present as higher valence compared to peers at baseline, with acute symptoms presenting more episodically. As such, in the context of chronic needs, there is variance in how debilitating a student’s challenges may be, and thus variance regarding academic impact. In addition, mental health challenges do not inherently correspond with cognitive dysfunction, though there may be comorbidities. This means that many students struggling with mental health symptoms do not have barriers understanding grade level academic content or generating adequate academic products. Rather, they have difficulties with the academic context, such as academic pressures, social and relational demands at school, emotional regulation around management of responsibilities, etc. In contrast, there are students who struggle both with mental health challenges and other challenges, such as learning needs or executive dysfunction.
The T3 Program design acknowledges the unique needs of this student population by providing a therapeutic wrapping around a student’s inclusive educational experience. Students maintain a regular schedule of courses, just like their peers, and also have designated academic support periods within which they receive therapeutic support, specialized instruction, and support for managing course work. The physical space and T3 staff operate as a ‘home base’ for students, and each student has a customized experience based both on their general, global needs as well as their present needs. As such, the program design accounts for variance in students’ symptom presentations and the corresponding variance in educational impact.
Components of the Middle School Level T3 Program
As each student enters T3, an assessment and outline of strengths and skills deficits will be done to inform the student’s goals.
T3 students will be supported via several layers of instruction featuring evidence-based interventions.
Base Instruction: This level of instruction is for all T3 students and tied directly to entrance criteria, which all students will have in common. For example, instruction will feature curricula related to social and emotional awareness, regulation, and resiliency.
Specific Modules: This secondary level of instruction relates to students’ specific needs areas and features briefer, targeted therapeutic interventions (i.e. anxiety management, coping with trauma, social skills training, etc.).
Academic coordination includes a customized combination of academic support and communication with a student’s teachers to modify assignments and/or secure direct teacher support.
T3 staff will work with other school staff to best support each student in their classrooms, receiving instruction alongside their peers. During periods in which T3 students require extended time in the T3 space, staff will work with teachers to create an academic plan relevant to the student’s needs.
Tracking student progress will include several methods of direct and indirect behavioral and emotional assessment, and both quantitative and qualitative methods:
Quantitative Methods Examples:
Qualitative Method Examples:
Goal Setting: As a student enters T3, staff will communicate with the student’s parents to outline goals and describe how the student will be supported.
Communication Planning: When a student enters T3, staff will design a communication plan with the student’s parent(s)/guardian(s):
Care coordination includes the identification of and collaboration with school staff (i.e. teachers, specialists, admin), as well as outside providers and clinical supports:
The care coordination process will include:
Middle School Level Program Branches
T3 identifies students as falling within one of three defined cohorts based on their presentations and needs, and is designed to serve students Group A students primarily, and Group B students secondarily.
Group A T3 students have a documented history of chronic, intensive mental health symptoms, such as debilitating mood disorders and severe anxiety. Many T3 students have required crisis or emergency evaluation followed by admittance into a higher level of clinical care, though that is not requisite for program entry. Students’ symptoms are primarily internalizing, contributing to a reduction in functional engagement within relationships and in situations. Students may struggle with sensitivity to emotional activation, poor emotional calibration, escape/avoidant behavior, and/or disinhibited behavior, primarily verbal. Group A students must be receiving Special Education for an Emotional Disability with an Individualized Education Program (IEP) featuring one or more goals related to emotional functioning. While students may have other Special Education needs, their Emotional Disability should be considered their primary disability or equivalent in impact to other disabilities.
- Entry: Students should have a history of social and emotional challenges that have affected their ability to access the curriculum, special education services, and IEP goals that address emotional regulation, socialization, and/or coping skills for stress management and general school functioning. Students should have a history of receiving therapeutic counseling support (i.e. individual or group sessions with social work staff), but require additional support to remain stabilized. Entry will be determined by a review of data related to school functioning (attendance, academic, use of mental health resources), which in aggregate, suggests a decrease in functional capacity, in conjunction with assessment of SPED service delivery options.
- Exit: Students will exit T3 when they demonstrate consistency in completing academic work, consistent attendance, the ability to remain in class when stressed via use of coping strategies, and report of consistent symptom management (i.e. self, parent, and teacher ratings). Students will also have met most benchmarks on IEP goals related to social and emotional functioning.
Students in this group may or may not receive special education support, and if not, may have a history of support through a 504 Plan. Their needs are understood to be episodic in that they would benefit from a shorter, defined period in which they had access to higher-level social and emotional supports. This group includes students with emerging symptoms or specific psychosocial stressors, as well as students re-entering school after absence due to psychiatric care needs.
- Entry: There are two points of entry for students in this group.
- First, students who demonstrate adequate school functioning at baseline, but demonstrate a deviance from their baseline as evidenced by a period of time in which their academic performance has decreased, attendance has decreased, and their need for mental health support has increased due to an escalation in symptoms. Consideration for a defined time in T3 will be contingent upon evidence of general supports having been implemented without success.
- Second, students who are reentering school after a period of absence due to psychiatric care needs (i.e. hospitalization). Entry will be based on the design of a concrete plan that supports their specific mental health needs and allows them to return to their pre-absence baseline functioning.
- Exit: Students will have reached their goals, as designed at entry, including the ability to attend classes, complete academic assignments, remain in class consistently, and demonstrate the use of coping skills.
Students in this group have chronic or episodic lower level mental health needs and are adequately supported by scheduled contact with social work staff.
Type of Need
mental health needs
mental health needs
with social work staff
T3 Staffing and Responsibilities
The T3 team is comprised of a school psychologist, special education teacher, and social work staff. The team is additionally supported by nursing, guidance, and behavioral analytics staff. T3 support is also provided by building administration (Principal, Assistant Principals), district administration (APS Clinical Director, Social Work Coordinator), and other Student Support staff (i.e. SPED Coordinator and ETFs).