SEL & School-Based Counseling vs. Therapy in Schools

Mindfulness Coloring

Improving mental health in children has been growing in conversation over the past few years, particularly during the Pandemic. Finally, politicians are being forced to engage in conversations about how the lack of mental health support for children in schools is impacting our society as children with mental health issues become adults. Of course, there have never been enough counselors, social workers, of school psychologists to meet every child’s need in schools. We are spread very thin, as you are probably aware. With the right tools, effort, and some creativity, however, we can still make a difference for many students through school-wide SEL, school-based counseling, and therapy.

The CDC indicates that 1 in 6 U.S. children aged 2–8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder. In addition, diagnoses of ADHD, anxiety, and depression become are more common with increased age. Behavioral problems are also increasingly common among children aged 6–11 years than younger or older children. For most parents, seeking outside, or private, mental or behavioral health treatments for their children is either not a possibility due to finances or extremely difficult to find. This is why it is so important that all schools provide all three types of social, emotional, and behavioral supports in their school.

Tiered Mental Health Interventions in Schools

In my experience, mental and behavioral health treatments in schools is set up in a tiered approach. Think upside down triangle or an umbrella. At the top of the umbrella, is a school wide system for Social and Emotional Learning. This may look like a mental health theme of the month, a program that the school is doing school-wide, classroom circles, or assemblies on topics, such as building self-esteem. School-wide mental health can benefit all students who may not know information on having a positive mindset, practicing mindfulness, or reducing stress. It helps students who have minor concerns from time to time, but who are not impacted regularly by their area of slight challenge.

Do counselors help with school-wide Social and Emotional Learning? Absolutely. Counselors can be involved as much or as little as their school needs to implement a school-wide system for supporting students. They can lead an already created program, create a new program, provide professional developments to teachers, provide classroom workshops, or send out a “SEL video of the week.” Your involvement as a counseling provider for school-wide SEL all depends on your school’s culture, needs, and leadership from your principal. It also depends, of course, on the counselor’s personal motivation an enthusiasm for doing school-wide support.

What is School-Based Counseling Exactly?

School Based Counseling Book

School-based counseling is often the next level of intervention for social, emotional, or behavioral concerns. It is a more narrow focus of support for students with specific areas of mental health challenges. For school-based counseling, a counselor or school psychologist will typically support students in a small group setting to address challenges in a more targeted way. This may look like a lunch bunch for teaching social skills, a grief group, a coping skills group, executive functioning skills, or an anger management group. As a school psychologist, I will try to group students on my counseling case load with a similar theme or topic, or I may group students by age to address more general social skills or behavioral concerns.

School-based counseling is more like being a teacher who is providing specific instruction and practice to improve a skill. School-based counseling can look like many things. It can look like using a specific, researched based program, having students complete a workbook, playing SEL games, art therapy activities, or showing videos on a specific topic. Of course, if you are seeing a group of students for six weeks or more, it is likely that you will use a combination of tools and activities in order to help your students improve in a specific area. It is also important to keep in mind that kids need novelty, variety, and engagement in order to want to participate and learn.

Here is an example of the activities that I would do if running a Small Group for Social Skills:

Week 1- Rapport Building Activity
All About Me Activity
Week 2- Social Skills Quiz Activity
Social Skills Quick
Week 3 – Videos on Specific Skill (Listening, Initiating Play, Manners Turn Taking, etc.)
SEL Videos
Week 4- Lessons, Worksheets, or Art Activities related to topic
Social Skills Activities
Week 5- Role Play Skill
The Conversation Game
Week 6- More Videos on new Social Skill of Focus
Mrs. Manners Says Counseling Game Video
Week 7- Game related to skill reviewed previous week
The Manners Game
Week 8- Consultation with teachers on progress and activity to practice skills and/or conclude group with fun activity
Emoji BINGO

What Does “Therapy” in Schools Look Like?

Therapy in schools is the highest level, also known as Tier 1, support to students with significant social, emotional, or behavioral needs. It is also provided by school counselors, school psychologists, and social workers. It is mostly individual counseling, that is much less instruction, and much more talking. It is usually for students struggling with more severe mental health concerns, such as depression, anxiety, anger control, or trauma.

It looks like engaging the student in conversation about their mental health, teaching a practicing skills individually, such as mindfulness, and making a support plan of people they can go to when feeling anxious or depressed. While more individualized than when in a small group setting, counselors can still use creativity and fun in their activities. Some therapy activities may include play therapy, videos, games, and coloring or painting. Because the therapy is in school, the focus should still generally be focused on the students functioning in the school environment.

When students needs go beyond the school environment to a significant degree, such as self-harm or suicidal attempts at home, it is time to support the student by helping parents seek a higher level of care through an outside agency or provider. School districts should have a relationship with community agencies, a list of community mental health resources, or a referral service for helping parents get therapists outside of school. While parents are seeking this higher level of care, it will be the counselor’s job to continue to support the student until their outside therapy begins. Usually outside therapists do not want students to also receive mental health support in the school. Too many cooks in the kitchen. But, sometimes they will be fine with the additional support of a professional who can support the student in a crisis.

Improving mental health in children has been growing in conversation over the past few years, particularly during the Pandemic. Finally, politicians are being forced to engage in conversations about how the lack of mental health support for children in schools is impacting our society as children with mental health issues become adults. Of course, there…

Improving mental health in children has been growing in conversation over the past few years, particularly during the Pandemic. Finally, politicians are being forced to engage in conversations about how the lack of mental health support for children in schools is impacting our society as children with mental health issues become adults. Of course, there…