Middle Level T3 Support System

T3 Overview


The T3 (or Tier 3) Program is a model of support for students with chronic or episodic mental health needs that interfere with daily school functioning and access to the general curricula. The goal of this program is to provide target students with multidisciplinary social, emotional, and academic support in the context of specialized instruction and in-class help.


Students will receive a combination of individual therapeutic interventions; specific in-class support for academic functioning; and specialized group instruction regarding social skills, emotional regulation, self-reflection, and coping skills for school-based stressors.


The goals of the supports offered through this program include decreasing absences/tardies, decreased “out of class time” during the school day (i.e. unscheduled visits with nursing or therapeutic staff), increased production of academic work, and a decrease in school-related symptoms as reported by students, staff, and parents/guardians. 


Middle School Level T3 Program Philosophy 

The T3 program embraces the philosophy of an inclusion-based structure. There are some populations of students who benefit from a substantially separate program design (i.e. students with significant neurodevelopmental challenges); however, students with mental health challenges do not benefit from a base educational model featuring exclusion from the general student population. In particular, mental health symptoms in youth may present as higher valence compared to peers at baseline, with acute symptoms presenting more episodically. As such, in the context of chronic needs, there is variance in how debilitating a student’s challenges may be, and thus variance regarding academic impact. In addition, mental health challenges do not inherently correspond with cognitive dysfunction, though there may be comorbidities. This means that many students struggling with mental health symptoms do not have barriers understanding grade level academic content or generating adequate academic products. Rather, they have difficulties with the academic context, such as academic pressures, social and relational demands at school, emotional regulation around management of responsibilities, etc. In contrast, there are students who struggle both with mental health challenges and other challenges, such as learning needs or executive dysfunction.  


The T3 Program design acknowledges the unique needs of this student population by providing a therapeutic wrapping around a student’s inclusive educational experience. Students maintain a regular schedule of courses, just like their peers, and also have designated academic support periods within which they receive therapeutic support, specialized instruction, and support for managing course work. The physical space and T3 staff operate as a ‘home base’ for students, and each student has a customized experience based both on their general, global needs as well as their present needs. As such, the program design accounts for variance in students’ symptom presentations and the corresponding variance in educational impact.  




Components of the Middle School Level T3 Program 








As each student enters T3, an assessment and outline of strengths and skills deficits will be done to inform the student’s goals.  


Emotional/Behavioral Supports: 


  • Individual Therapeutic Counseling Support: Each T3 student will receive individual therapeutic support to address defined goal areas related to their specific mental health challenges. 


  • Group Therapeutic Counseling Support: When it is appropriate and relevant to students’ needs, some students may engage in group-format therapeutic supports. 


  • Planned/Scheduled Therapeutic Support: These times will be used to provide individual and group therapeutic interventions as well as individual goal setting and progress monitoring. 


  • Unscheduled Support Time: These times include non-crisis emotional escalation that is contributing to reduced functionality and interventions for social/relational disruptions as they arise. Helping students reduce unscheduled support needs is included in their goals within the program. 


  • Crisis Intervention: APS mental health staff, including T3 staff, will provide crisis interventions for emotional escalation and safety related needs. In the case of the former, when escalation occurs outside the T3 space, the goal will be for the student to use the T3 space to deescalate, with the intention of preserving dignity and increasing their sense of safety and comfort, and then transition back into the general setting.    


  • General Setting Support: T3 staff will coach general building staff on how to appropriately support students’ needs, how to respond to escalations, and how to maintain connections with students who struggle relationally. 


  • Behavioral Assessment/Planning: When appropriate, T3 staff will facilitate behavioral data collection and the design of Behavioral Intervention Plans (BIPs) for students with maladaptive behavioral symptoms (i.e. escape/avoidance behaviors). 


Physiological Support: 


  • Environmental Considerations: The design of the T3 space will specifically regard sensory processing needs, have sensory-based de-escalation opportunities available, and have ‘carve-out’ personal areas accessible to students who need a defined, available personal space to feel safe. 




  • Individual Monitoring: Students with applicable needs may have access to technology-based supports that facilitate physiological measurement and cueing (i.e. biofeedback technology).  



Curriculum Modules 


T3 students will be supported via several layers of instruction featuring evidence-based interventions. 


Base Instruction: This level of instruction is for all T3 students and tied directly to entrance criteria, which all students will have in common. For example, instruction will feature curricula related to social and emotional awareness, regulation, and resiliency.  


Specific Modules: This secondary level of instruction relates to students’ specific needs areas and features briefer, targeted therapeutic interventions (i.e. anxiety management, coping with trauma, social skills training, etc.).  





Academic coordination includes a customized combination of academic support and communication with a student’s teachers to modify assignments and/or secure direct teacher support. 


T3 staff will work with other school staff to best support each student in their classrooms, receiving instruction alongside their peers. During periods in which T3 students require extended time in the T3 space, staff will work with teachers to create an academic plan relevant to the student’s needs.  


Data Collection 



Tracking student progress will include several methods of direct and indirect behavioral and emotional assessment, and both quantitative and qualitative methods: 


Quantitative Methods Examples: 


  • Tracking of absences/tardies/dismissals 


  • Academic performance 


  • Unscheduled out of class time, including use of the T3 space and other spaces for mental and behavioral health needs (i.e. nursing visits for somatic complaints, staff assisted unscheduled breaks) 


  • Pre/Mid/Post assessments of student functioning, such as validated parent, teacher, and self-report scales for screening and progress monitoring. 


Qualitative Method Examples: 


  • Student interview and self-report, such as feelings logs, coping skills logs, self-assessment of strengths and need areas. 


  • Observational data of the nature and frequency of behavioral prevalence. 


  • T3 Staff completed progress monitoring rubrics. 

Family Engagement 


Goal Setting: As a student enters T3, staff will communicate with the student’s parents to outline goals and describe how the student will be supported. 


  • T3 staff may work with families to obtain relevant biopsychosocial history, determine cultural considerations, and shape the needs assessment process.  


  • T3 staff will join with parents to outline the trajectory of interventions, explain proposed methods of interventions, and review curricula. 


Communication Planning: When a student enters T3, staff will design a communication plan with the student’s parent(s)/guardian(s): 


  • Identifying the preferred mode of communication (i.e. call, email) 


  • Identifying the type and frequency of routine communications (this may vary depending on the student’s symptom acuity).  


  • Identifying a method of urgent communication. 


Care Coordination 


Care coordination includes the identification of and collaboration with school staff (i.e. teachers, specialists, admin), as well as outside providers and clinical supports: 


The care coordination process will include: 


  • Identification of team members at the school who need to be informed of the student’s needs. 


  • Identification of supports outside of school: o therapeutic/healthcare related supports o familial resources/relationships 
  • Social/peer relationships 


  • Identification of gaps (i.e. supports outside of school that are needed but not in place) 


  • Identification of action steps for care coordination and who will follow through with those steps  


Middle School Level Program Branches


T3 identifies students as falling within one of three defined cohorts based on their presentations and needs, and is designed to serve students Group A students primarily, and Group B students secondarily.


Group A


Group A T3 students have a documented history of chronic, intensive mental health symptoms, such as debilitating mood disorders and severe anxiety. Many T3 students have required crisis or emergency evaluation followed by admittance into a higher level of clinical care, though that is not requisite for program entry. Students’ symptoms are primarily internalizing, contributing to a reduction in functional engagement within relationships and in situations. Students may struggle with sensitivity to emotional activation, poor emotional calibration, escape/avoidant behavior, and/or disinhibited behavior, primarily verbal. Group A students must be receiving Special Education for an Emotional Disability with an Individualized Education Program (IEP) featuring one or more goals related to emotional functioning. While students may have other Special Education needs, their Emotional Disability should be considered their primary disability or equivalent in impact to other disabilities.  


    • Entry: Students should have a history of social and emotional challenges that have affected their ability to access the curriculum, special education services, and IEP goals that address emotional regulation, socialization, and/or coping skills for stress management and general school functioning. Students should have a history of receiving therapeutic counseling support (i.e. individual or group sessions with social work staff), but require additional support to remain stabilized. Entry will be determined by a review of data related to school functioning (attendance, academic, use of mental health resources), which in aggregate, suggests a decrease in functional capacity, in conjunction with assessment of SPED service delivery options.


    • Exit: Students will exit T3 when they demonstrate consistency in completing academic work, consistent attendance, the ability to remain in class when stressed via use of coping strategies, and report of consistent symptom management (i.e. self, parent, and teacher ratings). Students will also have met most benchmarks on IEP goals related to social and emotional functioning. 


Group B


Students in this group may or may not receive special education support, and if not, may have a history of support through a 504 Plan. Their needs are understood to be episodic in that they would benefit from a shorter, defined period in which they had access to higher-level social and emotional supports. This group includes students with emerging symptoms or specific psychosocial stressors, as well as students re-entering school after absence due to psychiatric care needs. 


    • Entry: There are two points of entry for students in this group. 
      • First, students who demonstrate adequate school functioning at baseline, but demonstrate a deviance from their baseline as evidenced by a period of time in which their academic performance has decreased, attendance has decreased, and their need for mental health support has increased due to an escalation in symptoms. Consideration for a defined time in T3 will be contingent upon evidence of general supports having been implemented without success. 
      • Second, students who are reentering school after a period of absence due to psychiatric care needs (i.e. hospitalization). Entry will be based on the design of a concrete plan that supports their specific mental health needs and allows them to return to their pre-absence baseline functioning. 


    • Exit: Students will have reached their goals, as designed at entry, including the ability to attend classes, complete academic assignments, remain in class consistently, and demonstrate the use of coping skills.



Group C


Students in this group have chronic or episodic lower level mental health needs and are adequately supported by scheduled contact with social work staff. 



Type of Need

Support Design

Group A

  • Chronic high level
  • Designated schedule of specialized instruction

mental health needs

  • In-class support, curriculum support

  • SPED students
  • Scheduled group-based interventions + check-ins

Group B

  • Episodic needs
  • Time-limited with entry goal setting and exit criteria

  • School re-entry
  • Individual and group therapeutic intervention

  • Access to specialized instruction curricula from Group A

Group C

  • Chronic lower level
  • Individual and/or group therapeutic support 

mental health needs

with social work staff



T3 Staffing and Responsibilities 


The T3 team is comprised of a school psychologist, special education teacher, and social work staff. The team is additionally supported by nursing, guidance, and behavioral analytics staff. T3 support is also provided by building administration (Principal, Assistant Principals), district administration (APS Clinical Director, Social Work Coordinator), and other Student Support staff (i.e. SPED Coordinator and ETFs).  






  • Delivery of base curricula 



  • Delivery of targeted intervention modules 



  • Design of curriculum/module based instruction 



  • Therapeutic counseling support 



  • Crisis assessment 



  • T3 Data Oversight 



  • Organize family updates, care coordination  

SPED Teacher 


  • Academic and student skills support 



  • Delivery of base curricula 



  • Targeted in-class support 



  • Work tracking 



  • Teacher support/coaching 



  • Academic modification  



  • Oversee setting-based accommodations  

Social Worker 


  • Therapeutic counseling support 



  • Crisis assessment  



  • Community outreach  



  • Interventions for physiological symptoms 



  • Crisis triage for internalizing symptoms  



  • Alternative de-escalation space for internalizing symptoms