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Counseling Services

School Based Counseling Services Include

Consulting with parents and school staff regarding social-emotional/behavioral functioning, offering information and resources on how to support the school, class, and individual students.

Checking in with students on an as needed basis (e.g. during times of crisis, adjustment and or transition, etc.)

Goal-based, focused counseling services to students:

Social Skills Development

504 Plans (as specified on individual plan)

IEP Related Service (as specified on IEP)

Parent permission/informed consent must be provided for students receiving counseling services. Although the School Psychologist may assist a student in need (e.g. situational, such as when in crisis) on-going services require parent/guardian consent.

Name of Student:

Your Name:

Relationship to Student:

The school's problem-solving team may wish to contact you to discuss your referral concerns. Please provide your contact information and the best time to reach you.

Phone number:

Email address:

Best time to contact:

Does this Student have an individualized education plan (IEP) or 504 Plan?

Yes No I don't know IEP 504

Area(s) of concern:

Academic Concerns Physical Health Concerns Emotional/Behavioral Concerns Social Concerns Family Concerns Other:

Please describe your concern(s):

Behavioral concerns (mark all that apply):

Exposed to violence or trauma Sad, depressed or irritable mood Hopelessness Nightmares, intrusive thoughts Low self-esteem, negative self-statements Anxious, fearful or irritable mood Difficulty concentrating Jumpy or easily startled Dininished interest in activities Avoids reminders of trauma Low or decreased motivation Aggressive Sexualized play or behaviors Worries excessively Talk excessively Restless or on edge Gets out of seat and moves constantly Specific fears or phobias Interrupts and blurts out responses Difficulty sleeping Inattentive, distractible, forgetful Clingy behavior Disorganized, makes careless mistakes Appears distracted Angry toward others, blames others Fights Argumentative and defiant

How long have these behaviors been occurring?

To your knowledge, what interventions have been tried?

Please describe any known interventions that have previously been tried:

To your knowledge, what interventions are currently in place?

Please describe any known interventions that are currently in place:

What do you think will help the student to experience success?

Confirmation email

Today's Date:

My Name:

My Grade:

My Teacher:

Who needs help with how they are feeling?

Myself Another student at school

The school's care team may want to contact you to understand your concerns better.

Yes, it's okay to contact me No, please don't contact me

Please check the box next to the reason you or someone else needs help:

home (family or siblings a friend/another student at school school/teacher another problem

Confirmation email

Counseling Services

School Based Counseling Services Include

Consulting with parents and school staff regarding social-emotional/behavioral functioning, offering information and resources on how to support the school, class, and individual students.

Checking in with students on an as needed basis (e.g. during times of crisis, adjustment and or transition, etc.)

Goal-based, focused counseling services to students:

Social Skills Development

504 Plans (as specified on individual plan)

IEP Related Service (as specified on IEP)

Name of Student:

Your Name:

Relationship to Student:

The school's problem-solving team may wish to contact you to discuss your referral concerns. Please provide your contact information and the best time to reach you.

Phone number:

Email address:

Best time to contact:

Does this Student have an individualized education plan (IEP) or 504 Plan?

Yes No I don't know IEP 504

Area(s) of concern:

Academic Concerns Physical Health Concerns Emotional/Behavioral Concerns Social Concerns Family Concerns Other:

Please describe your concern(s):

Behavioral concerns (mark all that apply):

How long have these behaviors been occurring?

To your knowledge, what interventions have been tried?

Please describe any known interventions that have previously been tried:

To your knowledge, what interventions are currently in place?

Please describe any known interventions that are currently in place:

What do you think will help the student to experience success?

Confirmation email

Today's Date:

My Name:

My Grade:

My Teacher:

Who needs help with how they are feeling?

Myself Another student at school

The school's care team may want to contact you to understand your concerns better.

Yes, it's okay to contact me No, please don't contact me

Please check the box next to the reason you or someone else needs help:

home (family or siblings a friend/another student at school school/teacher another problem

Confirmation email

Anti-Bullying

What is Bullying?

Stopbullying.gov defines bullying as:
Bullying is unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Both kids who are bullied and who bully others may have serious, lasting problems.

In order to be considered bullying, the behavior must be aggressive and include:

An Imbalance of Power: Kids who bully use their power—such as physical strength, access to embarrassing information, or popularity—to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.
Repetition: Bullying behaviors happen more than once or have the potential to happen more than once.

Report Bullyiing

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Counseling Services

Counseling Services

Anti-Bullying

What is Bullying?

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