Solution Shop: a solution-focused counseling and study skills program for middle school

Professional School Counseling, Dec, 2003 by Jonathan B. Cook, Carol J. Kaffenberger

APPENDIX A

Student Referral Form

1. Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Motivation / Organization/

Other: --

2. Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Motivation / Organization/

Other: --

3. Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Motivation / Organization/

Other: --

4. Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Motivation / Organization/

Other: --

5. Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Motivation / Organization/

Other: --

Alternate Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Self Motivation / Organization/

Other: --

Alternate Student Name: --

Homeroom Teacher: --

Main Concern(s): Circle the items that apply.

Being Prepared / Classwork / Homework / Behavior / Self Motivation / Organization/

Other: --

APPENDIX B

Daily Monitoring Chart

The main purpose of this daily monitoring sheet is to help you to develop a greater awareness of how well you are doing at school each day. In order to be successful you must be self-disciplined, accept responsibility and take charge of your learning. In life there are consequences for not meeting our responsibilities. Consequences for not meeting your school responsibilities will be instituted at the point totals listed below:

                    Home    1st    2nd    3rd    4th    5th    6th
Dates:              room

On-Time in seat
when bell rings
Prepared
assignment book,
binder, supplies
Homework
assignment
complete
Class work--
attentive &
on-task
Appropriate
behavior
Actual
Total
Goal
Total
Teacher's
Initials

                    7th     Goals
Dates:

On-Time in seat             1 2 3 4 5 6 7 8
when bell rings
Prepared                    1 2 3 4 5 6 7 8
assignment book,
binder, supplies
Homework                    1 2 3 4 5 6 7 8
assignment
complete
Class work--                1 2 3 4 5 6 7 8
attentive &
on-task
Appropriate                 1 2 3 4 5 6 7 8
behavior
Actual                            /38
Total                           Compare
                                  /38
Goal
Total
Teacher's
Initials

y = 1 Point   N = 0 Points   Z = Not Applicable (1 Point)   (1/2 = .5)

Parent Signature --

38 points = (Perfect Score) Success

36-37 points = Success

31-35 points = Satisfactory

26-30 points = Warning

Table 1. Solution Shop Results

               Grade Point Average Change at the End of the First Year

                    Students in
                    Solution Shop
                    Program          Lower GPA    Maintained GPA

8th Graders         16 (100%)        1 (6.25%)     4 (25%)
7th Graders         19 (100%)        1 (5.26%)     9 (47.37%)

Totals              35 (100%)        2 (5.71%)    13 (37.1%)

               Grade Point Average Change at the End of the First Year

                                    Improved GPA

8th Graders                         11 (68.75%)
7th Graders                          9 (47.37%)

Totals                              20 (57.1%)