Two children with arms around their shoulders and smiling

3 ways the Therapeutic Teaching Model helps kids with severe emotional and behavioral disorders heal

10/3/22 by Alma Marquez

Four years ago, Dr. Benita Amedee and I helped develop an intensive mental health program called the Therapeutic Teaching Model for young children who were referred to federal setting IV special education services for severe emotional and behavioral disabilities.

Setting IV schools are separate schools for children who have disabilities that require more intensive services than their home schools can provide. A student with an emotional or behavioral disability might come to a setting IV school after hitting people, throwing desks, and running from school buildings because their brains are flooded by trauma. Their behavior likely overwhelmed them, their classmates, teachers and their families. Parents were likely called to pick up their child frequently and may have even lost jobs as a result.

The Therapeutic Teaching Model blends individual, family and group therapy into special education classes for students in kindergarten-third grade who are referred to Intermediate District 287, which supports unique learners for 11 school districts in the West Metro. Over the years, children have been referred to Intermediate District 287 at younger and younger ages, and they are disproportionately kids of color. We created the Therapeutic Teaching Model in partnership with Intermediate District 287 because we believe that healing is possible.

So far, in our small program, seven children have leveled down, meaning they returned to their home schools and lowered their special education needs. We are so proud of our kids and their families for their achievements!

As schools, communities and families work to understand how to support the mental well-being of children, here are three things to know about the Therapeutic Teaching Model.


1. We work in schools that are sometimes called the “provider of last resort” for children with severe emotional and behavioral challenges.

Our mental health system is often not meeting the needs of children with severe emotional and behavioral challenges, particularly children who are aggressive to others – the children who respond to trauma with “fight” behaviors rather than “flight” or “freeze” behaviors. Many day treatment programs, partial-hospitalization programs and other intense mental health services cannot accept children with aggressive behaviors. But students with severe emotional and behavioral challenges must still go to school and are often referred to setting IV special education services.

Children with a wide array of disabilities use setting IV special education services. The innovative, specialized services at schools like Intermediate School District 287 help many students thrive for the duration of their entire education. The Therapeutic Teaching Model focuses on young students who are in setting IV schools because they have severe emotional and behavioral challenges that have not been addressed. Our goal is to help children and families get better.

2. The Therapeutic Teaching Model offers high-quality, intensive  services for students and their families.

The Therapeutic Teaching Model includes:

  • A full-time mental health clinician in the classroom with the full-time classroom teacher and educational assistants. Our role in the classroom is to use a trauma-based approach to help kids understand and manage their emotions so that they can learn. By being present when kids are struggling, we can provide therapy in brief, consistent, and predictable interactions.  Doing this with repetition helps the whole classroom feel more regulated.
  • A therapist who provides both individual therapy for students and therapy for their families. With family therapy, we can partner with parents to think with us about their kids, how we understand the children’s behavior together, and talk through challenges they are experiencing.
  • Support navigating systems and connecting families with resources. Sometimes our families are not ready to talk about their children’s mental health because the whole family is in crisis. We work with families to connect them to services until they are stable and able to focus on their children’s mental health.

3. Our work doesn’t stop when students are ready to transition to their home schools.

Returning to a home school can be frightening for students, their families and the school district. The student may remember that adults at their home school were not able to help them and that they didn’t like that feeling. They may be scared about what other kids will think of them when they return. Parents also remember the experience and may feel afraid of taking the risk. 

Our role in the Therapeutic Teaching Model is to help students and families feel ready. Therapists plant the seed of returning to school long before a potential transition so that we can help process the feelings that may surface. As a transition nears, we may meet with the child’s home school, tour schools with families. We may provide ongoing consultation to teachers, special education staff, therapists and others at the home school, and we can even continue to provide therapy for the child for up to six months after they transition to a new school.

The process is different for each family. Improvement in a child’s mental health symptoms is just a fraction of what needs to be considered for an effective transition.

The work is intense, and these kids are worth it. Investing in children’s mental health has the power to shape the lives of children, families and the community for years to come. Healing is possible.

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