Education Section Insert 2 The NASAP Newsletter
Template for Behavior Plan -- Middle School Version
Developed by Mollie M. Thorn, M.Ed., L.C.P.C.
Many students who have difficulty with self-control could benefit from a formalized behavior plan. A plan that
is organized and coordinated by the Student Assistance Team could guide all the adults in preparing the student
to manage his/her own emotions. With clear goals, and a coordinated effort on the part of everyone connected
to the student, including the parents, the student feels the support that a healthy structure can offer. In this
way, without being punished, the student can be held accountable and can hold him/herself accountable for
his/her actions. In addition, over time the student will be able to modify his/her actions in order to contribute
in the school productively with social interest.
Below is a template for developing such a plan in a middle school. Elementary and high school teams could
revise this plan for use in their unique settings.
1. Provide a general pass excusing student from class when he/she feels, or an adult in charge feels, that he/she
could benefit from some time to “chill out.”
• Provide several laminated copies of the pass so the student has one in his/her backpack, one in his/her
locker, etc.
• Provide one copy of the pass for each of the student’s teachers.
• Provide a copy of the pass to be included in each teacher’s substitute teacher file.
2. Encourage the adult in charge to direct the student to calm him/herself on the spot (i.e. there, in the
classroom) when he/she just begins to become agitated. If he/she has difficulty accepting direction, or continues
to be agitated, the adult then should insist that he/she take the pass and leave the classroom to go to his/her
designated “chill out” place.
3. When the student leaves the classroom to “chill out” he/she should have a specific place to go. One example
could be for the student to go to the counseling center, stay for 10 minutes, and then an adult excuses him/her
to return to class.
• If no counselor or other adult is available to supervise (not necessarily to counsel with or talk to the
student) then the student goes to the main office, the resource room, or some other designated location,
where an adult is part of the “chill” team.
• If longer than 10 to 20 minutes is required to regain composure, consider calling a parent for help.
• If more than 2 “chill” times are needed in the same class period, provide for longer time out of class, or
plan to call parent to pick student up.
4. Ensure that the student does not feel punished if a “chill out” time is taken or needed.
• Provide a buddy in each class to offer copies of notes or assignments given while student is out of the
classroom for a “chill” time.
• Ask teacher to provide the information or assignment missed.
• Ask the Resource teacher to provide this accommodation.
5. If the student is uncooperative in accepting the direction to leave the room, provide a non-punitive strategy
for ensuring compliance (e.g. at least two other persons to be “on-call” to help, by coming to the classroom to
escort the student out).
6. Ensure that the student is on board with the plan.
Education Section Insert 3 The NASAP Newsletter
7. Update and re-evaluate the plan regularly, revising as necessary.
8. Encouragement: A student could be assigned a mentor in the school who would be the contact person
for ensuring he/she is offered many opportunities to be successful and receive encouraging feedback. Some
students can be assigned a regular important job, such as working in the TV studio, delivering mail throughout
the building, or assisting in a classroom of younger children. Ideas for providing encouragement are plentiful
and only limited by the imagination of the people in the school.
After the “Chill”
After a student has been to “chill out” for 10 minutes, it is helpful to make him/her aware of the feelings of being
calm, cool and collected, which the “chill” time offers. A checklist could be provided so the student is sure he/she
is ready to return to the classroom.
Here is a possible checklist:
The “Chill Out” Checklist
Yes No I am calm.
Yes No My breathing is normal and natural.
Yes No I can smile at the world.
Yes No My hands, arms, and legs are relaxed.
Yes No The tension is gone from my body.
Yes No I can explain to myself, and others, the trigger that brought on my stress.
Yes No I am ready to return to work.
________________________________________ ______________________________
Student’s Signature Date
________________________________________ ______________________________
Supervising Adult’s Signature Date
(credit to Jill Pickett, M.A., for consultation on developing this plan)
Education Section Insert 4 The NASAP Newsletter
Name of Student ___________________________________________________________________________
School Name______________________________________________________________________________
Date ___________________________________________
I, ________________________, agree to the following terms/conditions if I am feeling frustrated or anxious in my class:
(Student’s Name)
• I agree that I will practice my “strategies” if I am feeling agitated or anxious while in the classroom or if my
teacher sees that I may be overwhelmed.
• If I cannot calm myself using my strategies in the classroom, or if the teacher feels that I may need to leave the
classroom for a breather, I will ask the teacher to leave the classroom. I will use the pass that has been given to
me to go to the Guidance Office so that I can regain my composure.
• I will go to the Guidance Office and speak with my counselor, (counselor’s name) regarding my frustrations. I will
practice my breathing if (counselor) is not available to meet with me. If I feel like I need to speak with someone
while she is unavailable, I will go to see (another teacher’s name, ex. Special Educator) or to the main office.
• After a 10-minute “chill out,” I will return to my classroom.
• If I need to return to Guidance because the 10-minute “chill out” was not enough for me to regain my composure,
I understand that my parent will be called.
The above strategies are not to be seen as a punishment, but only as a way for me to gain control of my feelings and the situation in which I feel
agitated.
____________________________________ ____________________________
Student Signature Date
____________________________________ ____________________________
Special Educator’s Signature Date
____________________________________ ____________________________
School Counselor’s Signature Date
____________________________________ ____________________________
Parent Signature Date
____________________________________ ____________________________
Administrator’s Signature Date
Developed by Kristen DeRose, M.Ed.
Permission is granted to photocopy this contract for the purposes of using it in an education setting. This is copyrighted information.
November/December 2004 Volume 37, No. 6
Newsletter of the North American Society of Adlerian Psychology
Education Section
Insert
A Message from the Co-Chair
Dear Education Section Colleagues,
I sure hope you are having a happy and productive school year. Although I no longer work in a school, I continue
to have many contacts with schools in my role as a private practice family therapist. When families bring
children to my office, you know that we will be discussing and handling issues related to school. I think my most
satisfying professional accomplishments are ones in which there are opportunities to cooperate with other
adults on behalf of a child.
I would like to share a wonderful collaborative experience I have had recently. I had the pleasure of working
with a middle school team at the initiation of the school counselor, Ms. Kristen DeRose. Kristen, who works at
Matthew Henson Middle School in Charles County, Maryland, is the counselor for a sixth grade student who is
my client in my private practice. The student, let’s call him Tyler, has been diagnosed for many years with ADHD,
as well as bipolar depression. Luckily for Tyler, his parents are proactive, supportive, and very encouraging
people. As a team, Kristen, Tyler, his parents, his teachers, an administrator, and I all met to develop a support
plan for Tyler to help him with emotional and behavioral management.
I wrote up a proposal and presented it to the team. Then, Kristen adapted my notes and wrote a contract for
Tyler and the adults to sign. Kristen and I offer you our plans, which are presented here in a generic form. It is
such a pleasure to work as a collaborative team on behalf of a child and his family. I feel fortunate to have this
opportunity…and to have Kristen as my colleague.
I hope you, too, will have similar opportunities this school year. When we have Adler and Dreikurs as our
mentors, the coordination goes so much more smoothly, don’t you think?
Encouragingly,
Mollie M. Thorn, M.Ed., L.C.P.C.