BIT/ CARE teams require membership expertise in mental health care and treatment. This position provides general insight into mental health-related behaviors as well as specific information and coordination for those cases either currently participating in counseling services or for those cases where there is a need to offer counseling services as part of an intervention. Tire counseling member is also trained in more advanced violence risk and threat assessment tools and can participate as needed in these mandated assessment activities. When possible in higher education, this position is a licensed administrator from the college’s counseling center staff, such as the Director or an Associate/Assistant Director who has access to the center's complete client load. Licensed counseling positions on the team may come from a variety of clinical perspectives: psychologists, licensed mental health counselors, marriage and family therapists, licensed social workers or addiction specialists. If the college or university does not staff licensed counselors, then the position would be filled by a faculty or staff member with a background in psychology, a community member who can consult and work with the team or local community mental health specialists. Given that 7S% of the cases that come to a typical team involve mental health issues (Schiemann & Molnar, 2019), it is critical to have some expertise in this area. In К-12 schools, the position is typically occupied by the school counselor or Dir ector of Counseling and supplemented with regular or as needed involvement from a licensed school psychologist.

Because of the unique aspect of haring both licensed and non-licensed counseling staff in these roles, it is critical to clarify two issues related to this membership: 1) is the member licensed to practice mental health care in the state, and 2) is the member hired by the school to provide mental health treatment? If the answer to both of these questions is yes, tills team member has a higher level of confidentiality that shifts how they share information with the team about clients. Most other team members use privacy standards established by the Family Education Rights and Privacy Act (FERPA) (20 USC § 1232g; 3+ CFR § 99). Confidentiality in a client/provider relationship requires either a specific release of information or meeting certain exceptions in order to share information outside of the professional relationship. FERPA-protected information can be shared regularlv with other team members under the legitimate educational interest aspect of the statute (FERPA, 2020). This means psychologists, psychiatrists and professional clinicians will more often than not be botmd by confidentiality unless an information release is in place, but school counselors or non-licensed aca- demic/personal counselors or advisors are able to communicate more freely.

When it comes to the risk assessments completed by the team, the counseling staff are often the only team members who have extensive knowledge and course- work in differential diagnosis. To tills end, diagnoses should be avoided in BIT/ CARE documentation, but rather focus on behavioral descriptions of the concerns shared with the team. Unless everyone on the team has a license and can


TABLE 7.3 Behavioral Language for Diagnostic Terms

Diagnostic term

How to Document on the BIT/CARE

Asperger's/Autism Spectrum Disorder

  • • The student has difficulty attending to and understanding social cues when talking to other students about dating.
  • • The student has a sensitivity to light and loud noises in the classroom.
  • • The student asks off-topic questions and becomes frustrated when they are not answered immediately.


  • • The student talks often about odd and strange topics that other students and staff have difficulty understanding.
  • • The student mumbles to themselves and often talks out loud in response to voices that only they can hear.
  • • The student does not seem to be caring for themselves in the areas of hygiene and dress; they wear strange objects such as a white feather or are wrapped in tinfoil.


  • • The student is often tearful and distracted in class. They do not respond to redirection.
  • • The student talks about "not wanting to be alive anymore" to other students and has shown self-inflicted cuts to others in class.
  • • The student often falls asleep in class, expresses feelings of hopelessness and has lack of appetite. They are socially isolated from others.

discuss diagnostic criteria, this language should be avoided. A brief table of examples is provided in Table 7.3.

Student Conduct/Discipline

While the BIT/CARE team approaches cases from a perspective of support and care as opposed to a punitive mindset, there is still the need to coordinate team activities with a progressive and educational discipline or conduct process, hi fact, one of the most common mistakes a team makes is skipping standard disciplinary actions for BIT cases, thinking they are being thoughtful and supportive. Unfortunately, this can create inconsistent standards across the educational community, and the team loses the opportunity to reset expectations and document patterns of concerning behaviors. In higher education, this position on the team is most often filled bv the Director of Student Conduct, and in K-12 schools, this is usually the Assistant Principal responsible for discipline. This position is able to share information on conduct historv of cases and information about reoccurring behaviors. They are also able to inform the team about typical conduct processes related to the presenting behaviors and coordinate with the team as these processes occur. This can mean coordinating when a student is going to be suspended or selecting disciplinary conditions that complement the team’s selected interventions. The student conduct or discipline team member should also be trained in mandated assessment processes and advanced threat assessment tools in order to support the team when this need arises.

Law Enforcement

BIT/CARE teams should include representation from on-campus, sworn law enforcement for the college or school. For schools that do not have sworn law enforcement, campus safety, security or local law enforcement may be a reasonable substitute. This individual is the expert on criminal offenses and processes. Thev are able to consider the criminal nature of behaviors as well as share infor-


mation related to criminal history or police contact/reports with the team. They should be trained in advanced threat-assessment tools and be able to participate as needed in violence risk and threat assessments. This position should also act as a liaison with other local, state or federal law enforcement agencies. In higher education, this is often the Chief or Assistant Chief of the campus law enforcement imit. In K-12, it mav be a School Resource Officer.


Case Manager

More frequently in higher education and K-12, teams are using case manager positions to support the work of the team by providing flexible and creative support to the various cases through intervention activities, monitoring and coordinating access to care and resources and providing holistic oversight to the case. Approximately +0% of teams now include case management membership (Scliiemann & Van Brunt, 201S). This can be either a clinical or non-clinical case manager. Non-clinical case managers are the most frequent and often work closely with the chair of the team to support the team functions as a primary aspect of their job responsibilities. Clinical case managers may also be members of the team, but they are often representing a counseling or health unit and serving similar roles to those descr ibed under the counseling member section. Case managers are uniquely situated to interact directly with students of concern, build relationships with them and provide longer-term management of at-risk situations. These positions are also well-suited to be tr ained in violence risk and threat assessment tools.

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