SUBMITTED PHOTO One of the teachers in Marshalltown Community School District Therapeutic Classrooms walks the hallway with a student, focusing on building a positive healthy relationship. The program has seen great success in combining education with therapy.

Mental health in students has been a growing concern in Iowa as the numbers of students struggling has increased. The Therapeutic Classrooms Program of the Marshalltown Community School District (MCSD) is striving to meet the needs of students.

Director of Special Services Matt Cretsinger refers to the program, which carries a key focus of addressing mental health while providing education, as the district’s “best kept secret.” The district created the program because so many students were facing mental health problems or some type of trauma.

Cretsinger said Iowa has the fourth largest increase of mental health problems in the nation. One in six kids have some kind of mental health condition, which equates to more than 830 Marshalltown students.

“When you think about kids with disabilities, you have to think about this whole spectrum of needs,” he said. “Within that, sometimes there are mental health conditions that relate to the behaviors concerning families and schools. When we talk about therapeutic programming, it really is how we are bringing together the educational service and the mental health service in one place so they can be successful in school.”

Cretsinger said there are a spectrum of needs when it comes to mental health. Thus, it is important to take Marshalltown’s history — the tornado, derecho and COVID-19 pandemic — into account when students are considered or admitted into the program.

For example, parents might believe their child is hyperactive, but it might be a result of trauma. The child might not think his or her environment is safe.

“How do you help a student understand their environment is safe so they can pay attention in class?” he said. “We’re blending that together, where they’re learning about their emotions and how their mind is working, and how it’s affecting their learning at the same time.”

The district has seen an increase in the rate of student mental health conditions since the program’s inception. In the beginning, Cretsinger said a student might have only been dealing with trauma or bipolar disorder. Today, students are more complex.

“They may be from situations where there are mental health conditions going on,” he said. “They also have different home situations. They have other learning disabilities, like reading or math. You have this really complex child who needs very thoughtful service and programming to make sure they have success in school.”

Outside interest

Since its inception 11 years ago, 86 students, 17 this year, have been served to great success. Therapeutic Classrooms have reduced the need for physical restraints by 90 percent; 78 percent of students have made academic progress and; 95 percent of the parents want their children to remain in the program due to the successes.

Cretsinger said the program has produced a lot of successful students. One in particular was a girl who staff did not think the student would succeed in comprehensive school.

“She has found through her relationships, and understanding how her mind works, understanding what leads to the behavior that is concerning, she can tell us when things are starting to go down that path,” he said. “Because of that, she is back in school, and we have found she is a gifted learner.”

The success of the program has inspired other public school districts in Iowa to implement a similar program. Crestsinger said officials from more than 40 school districts, all of the Area Education Agencies and Iowa Department of Education have requested visits or learning opportunities regarding the program.

“Really, they’re just trying to understand this blend of how we are providing high quality education and high quality mental health under the same umbrella,” he said.

On Monday, Cretsinger took a call from a small district one hour away.

“They had a special education student in the elementary level. They had been working with various agencies and identified those mental health conditions were the greatest concern going on,” he said. “They did not know a way to serve the student. They were curious if we would be able to serve the student for them.”

The program

Housed in the district’s administration building, Therapeutic Classrooms are for approved special education students in kindergarten through eighth grade. According to Cretsinger, the reason younger students are admitted to the program, rather than high school, is the earlier the program services are provided, the more likely positive differences are seen.

Students go through weekly therapy sessions which focus on skill building. Staff provide services such as medication management, parent education and real-time modeling of therapeutic stages.

A focus is placed on building healthy relationships. Each student’s therapy is blended into their education, and depending on each day, the staff make adjustments to meet the demands.

The program operates with the belief each student will do well if he or she can. If a student is not doing well, it is determined there are demands exceeding the student’s skills at that time. The staff then focus on what that demand might be, and help the student meet those demands.

So, therapy plays a big role. The program views therapy as helping students develop cognitive skills, understand trauma and how it affects behavior. Staff are able to understand how students perceive environments.

Getting a child in Therapeutic Classrooms is not done the traditional way. It is not like requesting a child go to a specific elementary facility. First, a student needs to be in special education, and have exhausted available services at his or her current school facility. Staff need to identify a student’s behavior as a concern driven by underlying mental health conditions, and speak to the parents about the possibility of program admittance. Approval is then provided by Cretsinger.

“This is a unique, special education only program,” he said. “It’s a school where, after the IEP process, we find there is a level of need here. Parents can always call me. I’m happy to talk about the program.”

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Contact Lana Bradstream

at 641-753-6611 ext. 210 or

lbradstream@timesrepublican.com.