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Thinking Outside the Box

A visit with Jim Koller and Karen Weston, Department of Educational, School, and Counseling Psychology

By LuAnne Roth
Published: - Topics: mental health psychiatry psychology mental illness pathology
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We began this interview with the intent of focusing, as we usually do, on one person’s research. However, this query soon became—like the collaborative work it highlights—a joint project involving James R. Koller and Karen Weston of the Department of Educational, School, and Counseling Psychology in the College of Education, two individuals working together to “think outside the box.” For much of his three decades at MU, Koller’s research has concerned child and adolescent psychopathology as well as developmental disorders including learning disabilities and ADHD (Attention Deficit Hyperactivity Disorder). Like many licensed psychologists, his early work focused on “abnormal development,” that is, diagnosing and treating various disabilities including mental illness.

When he was invited by the American Psychiatric Association and the Missouri Department of Mental Health to attend the APA’s national conference, where these escalating mental health problems were to be addressed, Koller was challenged to create a new model. He considered the World Health Organization’s 1991 study comparing the top fourteen industrial countries in the world in terms of such problems as suicide, depression, anxiety, substance abuse, and eating disorders. As he reports, “sure enough, the good old U.S.A. was first in almost everything. We had the highest divorce rates, we had the highest depression and anxiety rates, and so forth.” This study, moreover, focused only on adults, not taking children and adolescents into consideration. “Until fairly recently, it was felt by some, for example, that kids don’t get major depression, bipolar disease, or any kind of serious affective mood disorders. It was unheard of,” he explains. “Well, we know that’s not true. We’re seeing massive escalation rates occurring earlier and earlier with children.” And the sooner those problems start, the more likely they will become ingrained habit patterns. When these kids grow up to be adults, Koller cautions, the problems are perpetuated and lead to greater dysfunction – that is, “unless they are dealt with proactively and early.”

In that regard, he continues, “I realized that we have to do something different to stop the escalating incidence of mental illness vis-à-vis mental health problems in the country.” And so it happened that in 1999, “a light bulb had turned on,” and he decided to radically shift his approach, with the assistance of the Missouri Department of Mental Health, the Missouri state legislature, the College of Education, and the MU Department of Educational, School, and Counseling Psychology. Instead of attacking the problem of mental illness from the point of diagnosis and treatment, he began focusing on positive prevention-based mental health intervention strategies. It was at that moment that Koller conceived the Center for the Advancement of Mental Health Practices in the Schools, now affectionately called “the Center” by its members.

“The Center was created in response to the rising number of students in need of mental health services today,” states its homepage. It was initiated “as a paradigm shift that recognizes prevention as a fundamental element in supporting our nation’s youth facing developmental challenges, psycho-social issues, and environmental stressors within the school system and community . . . with the whole thrust being a paradigmatic shift from mental illness to mental health.” Of course, “you’re never going to get away from mental illness,” admits Koller, “but instead of waiting until pathology occurs, the question posed to me was how we can do something different. How can we better prepare consumers at all levels to be better informed so that we can create a positive learning environment for each learner and increase her or his self-concept, while academic learning flourishes?”

Understandably, academics must remain the primary focus in schools, but the Center seeks to cast light on that focus, encouraging schools “to develop a humanistic and proactive position in which mental health is integral to the learning and development of all students through the enhancement of positive systems, environments, and relationships.” To put it simply, says Koller, “the Center’s goal is to emphasize ‘what is right,’ not just what is wrong, with each child and enable every child’s success academically, socially, and within the family context.”

Karen Weston joined the Center in 2002 and serves as its co-director. Her applied background as an educator has informed her research interests in developmental psychology, leaning processes, and effective teaching practices. With her leadership, the Center has grown in many ways and given shape to a number of hope-inspiring projects. The Center’s overall mission is to convince lay people and the professional community of the importance of nurturing mental health. Just as the body’s physical health requires the right amount of nutrition, exercise, and rest, Weston explains that communities need to build awareness “around children’s mental health and to promote mental health. We take a preventative approach, arguing that we should be paying attention to children’s social and emotional development, that we should be promoting mental health the same way we promote physical health.” In the same vein, Koller adds, “Mental health doesn’t occur by osmosis; you have to teach it. You have to be active consumers in acquiring it. You have to be cognizant of being able to recognize when something is awry so that you can instigate some sort of early intervention.”

In the spirit of that mission, the Center has been working within MU’s College of Education to target nascent teachers and other school personnel, so that by the time they actually begin teaching or working in the school they have a better understanding of how to promote mental health, how to recognize early “red flags,” and how to intervene quickly when a child begins to struggle with mental health issues. In order to develop more effective educators, administrators, and health-services professionals, the Center has also developed an online program. Housed inside the Department of Educational, School and Counseling Psychology, it is the first and only sanctioned online graduate degree program in the country with a focus on mental health issues in schools and has been recognized as a national model. Students pursuing this emphasis can take individual courses based on their unique needs for continuing education, or work toward degrees at the Masters or Education Specialist levels. The program currently has over 100 degree-seeking students and has already graduated 47 from around the world.

Focused on evidence-based practice and current, practical application-driven principles and test theories, educators and other health care professionals can now take coursework in areas with which they are being confronted professionally. For example, some of these courses involve how to deal with a bully, how to recognize possible drug use, how to respond when someone has a medical emergency in class, how to teach resiliency, and how to help a community address major trauma. “Our whole curriculum deals with identifying strengths-based, prevention-driven strategies that have an empirical bent to them,” says Koller, who emphasizes the benefits of the multidisciplinary cast of participants, ranging from physicians, psychologists, and mental health caseworkers to teachers, principals, speech and language pathologists, and occupational therapists. As he observes, “it creates a terrific environment for these professionals to converse back and forth online.”

“What we’re doing now is a paradigmatic shift,” Koller explains. Knowing that “your ability to succeed in life is a function of not just what you know from a content perspective, but your ability to get along with people, your ability at self-reflection, your ability to adapt, and the strategies you’ve learned to accommodate stress,” he and Weston like to think of mental health as “the superstructure on which people operate.” That is, nurturing mental health is crucial in order to have healthy children, effective parents, good employees, active consumers, and productive citizens.

One of the biggest obstacles in their work, Koller remarks, is getting people to do more than just nod and agree that mental health is important. “Of course, it’s important: but what are we willing to do to encourage it in our youth?” he asks. Many people see symptoms in children and think, “It’ll go away” or “They’ll outgrow it.” But Koller sees things differently: “I think the only thing children really outgrow is their pants,” he counters. “If you let something go to the point where it becomes a habit, it’s darn hard to get rid of because then you have to de-condition the habit in order to get the person on the right track. We have to do something that’s more proactive than reactive. Mental illness is continuing unabated in our society in particular. It’s an ethical and moral responsibility. What can we do about it?” Reflecting on his own efforts to intervene, he concludes: “When you have a chance to do something about it, when you have people who are willing to look outside the box at a different world, why not take it? At least you can’t be judged that you didn’t try.”