Intensive, In-School Clinical Support

Many districts are struggling with a growing number of students with intensive mental health challenges. Often these students are at risk of being placed in an outside therapeutic placement. ESS’ Tier 3 Intensive, In-School Clinical Support program introduces a better option: embedded, state-of-the-art clinical care offered within the four walls of your school building.

What is Intensive, In-School Clinical Support?

  • Programming for students with the most intensive mental health challenges
  • Highly structured, longer in duration and “wrap-around” in nature
  • Meant to return students from out-of-district placement (ODP), avoid ODP or serve as a preventative support for gen ed students
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What does ESS provide?

  • Tier 3 Intensive In-School Clinical Program
  • Tier 3 Dual Diagnosis Program
  • Customizable Program Options


Intensive, In-School Clinical Support

With our flagship offering, ESS brings together clinical staff, proven programming, sound oversight, and a mature system of quality and risk management to give teachers and schools confidence that the needs of their students with emotional and behavioral challenges are being met in the most careful and cost-effective manner, all while avoiding ODPs and maintaining students in the least restrictive environment. Additionally, the core ESS Tier 3 Intensive, In-School Clinical Support program can be customized for each individual district based on the clinical needs of its students, their age range, and the ideal level of the implementation.


Dual Diagnosis Program

For neurologically diverse students such as those on the Autism Spectrum (ASD), ESS offers a specialized version of its Tier 3 programming. The Dual Diagnosis Program is specifically for the 83% of intellectually, developmentally, and neurologically diverse students who also carry one or more psychiatric diagnoses such as anxiety, depression, or trauma. Our flexible approach to meeting the needs of diverse students includes evidence-based treatment modalities such as:

• Social-emotional learning approaches

• Mindfulness

• Therapeutic play

• Cognitive behavioral therapies

• Relationship based interventions

10 Elements of Unique Clinical Programming for K-12 Students

The ESS Tier 3 wrap-around approach has been proven effective for over a decade of serving thousands of students. Our model is built around the following 10 Key Components:

Comprehensive Program Protocols

ESS is not simply a clinician placement service; ESS clinicians work with highly structured, proven clinical protocols to support at-risk students most effectively. As a result of experience, data, and new research, our comprehensive protocols are constantly improving, creating an inclusive framework that accommodates each student individually.

School Avoidance Interventions

ESS reduces school avoidance through specialized assessments for students and parents, parent coaching, morning phone check-ins and same-day home visits, as well as a supportive re-entry to the school environment.

Behavioral Student Programming

ESS has developed specialized programming that allows students who consistently “act out” to be safely and successfully educated within their public-school. The Trauma-Attuned Model® includes daily group skills training in emotional regulation for students, family therapy, and ongoing professional development with teachers to ensure classrooms remain non-reactive.

Family Support

ESS provides ongoing family therapy with flexible scheduling, as well as a monthly parent support program that follows a detailed and adaptable psycho-educational protocol. ESS also distributes Solutions, a monthly newsletter that provides useful information and practical parenting tips for all ESS parents.

Multiple Layers of Supervision

ESS on-site clinicians receive the most comprehensive supervision possible from their ESS Regional Clinical Director, who maintains frequent communication with school and district leadership. Executive Clinical Directors provide oversight for each region, and report directly to ESS’ Chief Program Officer.

Clinical Documentation

ESS on-site clinicians maintain detailed student records that meet FERPA standards, a system of documentation akin to that found in structured psychiatric treatment programs. For classified ESS students, student records reflect IEP goals and initiatives, ensuring proper and well-documented care.

Quality and Risk Management

The ESS Quality Management team provides ongoing monitoring of each student record to ensure the services provided are consistent with ESS protocols and rigorous safety standards. ESS on-site clinicians regularly participate in IEP meetings, while ESS leadership attend mediation meetings as requested by the district.

Professional Learning and Psychoeducation for Educators

ESS regularly conducts professional learning for district teachers, and provides all-day off-site conferences for selected teaching staff. ESS also distributes Insights, a monthly newsletter for educational professionals who work with students with emotional and behavioral challenges.

Objective Measurement of Performance

ESS regularly evaluates the impact of our programming on a district’s students, sharing those results with the district several times a year. Receiving hard data that demonstrates dramatic improvements in grades, attendance, and discipline provides comfort to school leadership that ESS is working for their district.

Highly Experienced, Highly Qualified Clinicians

ESS guarantees the quality of its on-site clinicians, only employing highly experienced, licensed mental health professionals who have specific expertise in working with students with significant emotional and behavioral challenges.

1 Comprehensive Program Protocols

2 School Avoidance Interventions

3 Behavioral Student Programming

4 Family Support

5 Multiple Layers of Supervision

6 Clinical Documentation

7 Quality and Risk Management

8 Professional Learning and Psychoeducation for Educators

9 Objective Measurement of Performance

10 Highly Experienced, Highly Qualified Clinicians

Program Customization Options

Working in partnership with each school district, ESS can customize our Tier 3 program across multiple dimensions, including student clinical need, student age range, and intensity of implementation setting.

High Concentration of Behavioral Students

For schools with a higher frequency of behavioral challenges, ESS utilizes the Trauma-Attuned Model®, focusing more of the elements of our Tier 3 program on the specific needs of behavioral students. TAM®’s emotional regulation strategies are taught and reinforced in daily skills groups and weekly individual therapy so students can consistently practice alternatives to acting-out behaviors. Family sessions, a monthly parent psychoeducation group, and frequent phone-coaching help parents better manage their child and support positive behaviors at home.

ESS has developed specialized clinical protocols for school avoidant students and their families. Services begin with a highly specific assessment questionnaire for both students and parents that helps identify the underlying causes of the problem and shape the strategies used to overcome it. The protocols also incorporate several therapies, including Dialectical Behavior Therapy (DBT) and Cognitive Behavior Therapy (CBT).

The ESS Tier 3 model was originally developed for middle school and high school settings, but specific customizations now allow ESS to work with districts in supporting the mental health needs of elementary age students as well. This customization adds the following to the core ESS model:

  • Individual therapy at least once per week
  • Group therapy at least twice a week
  • Clinical services, including play therapy, children’s yoga, mindfulness exercises, a grade-level curriculum for behavioral situations, and an interactive five-level reward system.

The most common implementation of Tier 3 is our wrap-around model, wherein students participate in the clinical components of ESS programming, while still attending classes alongside the broader student body. However, for districts who desire a more self-contained environment to meet the needs of their students with greater behavioral challenges, the ESS Tier 3 program can also form the clinical foundation for a self-contained or partially self-contained In-District Therapeutic School.

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The ESS staff works tirelessly and collaboratively with our staff on behalf of our students to provide immediate therapeutic interventions to students. I often wonder how we were ever able to manage these students without the ESS program in our school. ESS provides necessary support services for students, staff, and parents to enable students to remain in a mainstream educational setting with their peers.
-John Pascale, High School Principal, Mahwah, NJ

Learn More About Tier 3

Speak with our experts to learn how your district can improve outcomes and reduce costs

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Learn more about Funding Sustainable School-Based Mental Health Programs

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Our Unwavering Focus on Data Collection

At ESS, we have an unrelenting focus on data, measuring results, and communicating to our partners the proven impact our programming has on mental health, school outcomes and financial sustainability.

With every ESS partner, we will:

• Set data driven goals at the beginning of every implementation

• Have regular “Report Card” meetings in which we share the impact of ESS services

• Monitor data along the way to look for potential risk areas so that these can be proactively addressed

Learn more about our Will to Wellness 6 Step Framework

Complete this form to discuss best practices for districts, states, and federal policymakers that will reinvent mental health in schools over the next five years.

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