Lesson Plan
Counseling Screener Plan
Use two 15-minute screeners—a teacher-completed tool for grades K–2 and a student self-report for grades 3–5—to rapidly identify social-emotional and behavioral needs, guiding the school counselor in planning targeted individual and group interventions.
Early identification of students’ social-emotional and behavioral needs enables timely support, improves well-being, and informs school-wide resource allocation and intervention planning.
Audience
School Counselors and Elementary Teachers
Time
15 minutes per screener session (K–2 teacher; 3–5 student)
Approach
Teacher observations and student self-reports followed by data analysis.
Materials
- K–2 Teacher Screener Form, - 3–5 Student Self-Screener Form, - Screener Data Review Template, and - Pencils and Clipboards or Digital Devices
Prep
Prepare Screening Materials
10 minutes
- Review the K–2 Teacher Screener Form
- Review the 3–5 Student Self-Screener Form
- Print paper copies or load digital forms on devices
- Familiarize yourself with the Screener Data Review Template
- Gather pencils and clipboards or ensure devices are charged
Step 1
Introduce Purpose
5 minutes
- Explain to teachers and students that the screenings help tailor support and services
- Emphasize confidentiality and honest responses
- Clarify that this is not a test but a tool to help them succeed
Step 2
Administer K–2 Teacher Screener
15 minutes
- Ask each K–2 classroom teacher to complete the K–2 Teacher Screener Form for their students based on recent observations
- For each student, rate key social-emotional and behavioral indicators
- Collect all completed forms and store securely
Step 3
Administer 3–5 Student Self-Screener
15 minutes
- Gather grades 3–5 students in a quiet space
- Read each question aloud and clarify as needed
- Have students complete the 3–5 Student Self-Screener Form independently
- Ensure completed forms are collected confidentially
Step 4
Collect and Organize Data
5 minutes
- Compile all completed screeners by grade and class
- Check that every student has a corresponding form
- Prepare data for review using the Screener Data Review Template
Step 5
Review Results & Plan Interventions
20 minutes
- Use the Screener Data Review Template to analyze responses and identify students needing Tier 2 or Tier 3 support
- Look for patterns (e.g., common stressors, behaviors)
- Group students with similar needs for small-group counseling
- Schedule 1:1 follow-ups and share summaries with teachers and support staff
Slide Deck
Counseling Needs Screener
Two 15-minute screeners:
• K–2 completed by teachers
• 3–5 completed by students
Identify needs for:
• Individual (Tier 3) counseling
• Small-group (Tier 2) interventions
• School-wide planning
Welcome everyone! Today we’re rolling out our new Counseling Needs Screener—two quick 15-minute tools to help us identify students’ social-emotional and behavioral needs at both the individual and school-wide level.
Objectives
By the end of this session, you will be able to:
- Describe the purpose of each screener
- Administer the K–2 Teacher Screener
- Administer the 3–5 Student Self-Screener
- Compile and review results using our template
- Plan targeted next steps based on data
Explain the learning goals so everyone knows what we’ll accomplish today.
Why Screen?
• Early identification of social-emotional & behavioral needs
• Tailor support for individual students
• Inform small-group and school-wide interventions
• Allocate resources effectively
Emphasize why early identification matters and connect it to better outcomes.
Confidentiality & Expectations
• All responses are confidential
• This is not a test—no right or wrong answers
• Honest feedback helps us provide the right support
• Results guide, not label, our students
Reassure teachers and students about confidentiality and set a positive tone.
Administering K–2 Teacher Screener
- Distribute the K–2 Teacher Screener Form
- Based on recent observations, rate each student on key indicators
- Allow 15 minutes for completion
- Collect and secure all forms
Walk through the steps for administering the K–2 screener. Highlight time limit and form link.
Administering 3–5 Student Self-Screener
- Gather grades 3–5 in a quiet space
- Read questions aloud; clarify as needed
- Students complete the 3–5 Student Self-Screener Form independently
- Allow 15 minutes; collect confidentially
Guide teachers on preparing the space and instructions for grades 3–5.
Compile & Review Data
• Organize completed screeners by grade & class
• Use the Screener Data Review Template
• Identify students needing Tier 2 or Tier 3 support
• Look for patterns (common stressors/behaviors)
Show how to organize and analyze data quickly using the template.
Next Steps & Intervention Planning
• Schedule small-group counseling for common needs
• Plan 1:1 follow-up sessions for Tier 3 students
• Share summary insights with teachers and staff
• Monitor progress and adjust plans monthly
Outline concrete next steps for individual and group interventions.
Questions & Contact
• Questions?
• Contact: [Your Name], School Counselor
• Email: your.email@school.edu
• Phone: (555) 123-4567
Thank you for your partnership!
Invite questions and remind participants how to contact you for follow-up.
Worksheet
K–2 Teacher Screener Form
Student Name: ____________________________________ Date: ___________________
Instructions: For each statement below, circle or write the number that best describes the student’s behavior over the past two weeks.
Scale: 1 = Rarely 2 = Sometimes 3 = Often
Anxiety Indicators
- Appears nervous, worried, or fearful without clear reason ____________
- Clings to adults or avoids new activities ____________
- Expresses worries about separation, routines, or events ____________
Anger Management Indicators
- Has frequent outbursts (yelling, hitting, kicking) ____________
- Struggles to calm down after being upset ____________
- Uses physical or verbal aggression when frustrated ____________
Social Skills Indicators
- Initiates positive interactions (greets peers, asks to join) ____________
- Takes turns and shares materials smoothly ____________
- Cooperates in group activities or play ____________
Friendship Indicators
- Plays appropriately with one or two peers ____________
- Maintains or seeks out friendships (invites/responds) ____________
- Shows empathy or concern for others ____________
Self-Regulation & Coping
- Follows classroom routines and transitions with minimal prompts ____________
- Uses age-appropriate coping strategies (deep breaths, asking for help) ____________
- Manages small disappointments without major upset ____________
Additional Observations / Notes
Please describe specific examples, patterns, or concerns that can guide grouping (e.g., “Strong empathy but high anxiety during free play.”):
Teacher Name / Signature: ________________________________________
Worksheet
3–5 Student Self-Screener Form
Student Name: ________________________________ Date: _______________________
Instructions: For each statement below, circle the face that shows how often you feel this way at school.
😊 = Often 😐 = Sometimes 😢 = Rarely
Anxiety Indicators
- I worry about trying new activities or changes. 😊 😐 😢
- I feel nervous or scared during group activities. 😊 😐 😢
- I get upset when routines or plans change. 😊 😐 😢
Anger Management Indicators
- I feel my temper rising easily. 😊 😐 😢
- I get upset when things don’t go my way. 😊 😐 😢
- I can calm myself down when I am angry. 😊 😐 😢
Social Skills Indicators
- I start conversations with classmates. 😊 😐 😢
- I join in group games or projects. 😊 😐 😢
- I take turns and share without being reminded. 😊 😐 😢
Friendship Indicators
- I have friends I enjoy playing with. 😊 😐 😢
- I invite others to join me when I play. 😊 😐 😢
- I feel accepted by other students. 😊 😐 😢
Reflection & Grouping
Which area do you think you need the most help with?
Circle one: Anxiety Anger Management Social Skills Friendship
Explain why or give an example:
Is there something or someone at school that helps you feel better?
Worksheet
Screener Data Review Template
Date: ______________________ Total Students Screened: ________
Use data from the K–2 Teacher Screener Form and the 3–5 Student Self-Screener Form to complete each domain tally and suggest group placements.
1. K–2 Teacher Screener Domain Tallies
Anxiety (Indicators 1–3)
| Rating | 1 (Rarely) | 2 (Sometimes) | 3 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Anger Management (Indicators 4–6)
| Rating | 1 (Rarely) | 2 (Sometimes) | 3 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Social Skills (Indicators 7–9)
| Rating | 1 (Rarely) | 2 (Sometimes) | 3 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Friendship (Indicators 10–12)
| Rating | 1 (Rarely) | 2 (Sometimes) | 3 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Self-Regulation & Coping (Indicators 13–15)
| Rating | 1 (Rarely) | 2 (Sometimes) | 3 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
2. 3–5 Student Self-Screener Domain Tallies
Anxiety (Indicators 1–3)
| Rating | 😢 (Rarely) | 😐 (Sometimes) | 😊 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Anger Management (Indicators 4–6)
| Rating | 😢 (Rarely) | 😐 (Sometimes) | 😊 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Social Skills (Indicators 7–9)
| Rating | 😢 (Rarely) | 😐 (Sometimes) | 😊 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
Friendship (Indicators 10–12)
| Rating | 😢 (Rarely) | 😐 (Sometimes) | 😊 (Often) |
|---|---|---|---|
| Count | ___ | ___ | ___ |
3. Suggested Group Placements
Use the tallies and individual student data to assign students to small-group or individual support.
| Group Focus | Students to Include |
|---|---|
| Anxiety Support | ____________________________________________ |
| Anger Management | ____________________________________________ |
| Social Skills | ____________________________________________ |
| Friendship Building | ____________________________________________ |
| Self-Regulation | ____________________________________________ |
4. Patterns & Observations
Note grade-level spikes, common stressors, or strengths that emerged:
5. Recommended Next Steps
Tier 2 Small-Group Focus:
Tier 3 Individual Counseling:
School-Wide Recommendations:
Script
Counselor Facilitator Script
Part 1: Introduction (5 minutes)
“Hello, everyone! Thank you for taking the time to help with our new Counseling Needs Screener. Our goal today is to gather information that will help us understand how our students are feeling and behaving at school so we can provide the right kind of support.
This is a quick, 15-minute process, and there are no right or wrong answers. Everything will remain confidential. We are not judging students—we are learning how best to help them.
Throughout the session, I will guide you step by step. Feel free to ask questions at any time.
Purpose:
• Identify individual students who may need one-on-one (Tier 3) counseling.
• Spot patterns for small-group (Tier 2) interventions.
• Understand school-wide needs to improve our overall support system.”
Part 2: Administering the K–2 Teacher Screener (15 minutes)
“Now, I will hand out the K–2 Teacher Screener Form. Please find the form that corresponds to your classroom.
- For each student, think about their recent behavior and emotions.
- Circle or write 1 (Rarely), 2 (Sometimes), or 3 (Often) for each indicator. Remember:
• 1 = Rarely
• 2 = Sometimes
• 3 = Often - Use the ‘Additional Observations’ section to note any context or concerns.
I will set a timer for 15 minutes. Work quietly. If you need clarification on any item, raise your hand and I will come over to help.
(Start timer)
(Five-minute check-in)
“Five minutes in—almost halfway there. Keep going! Let me know if something isn’t clear.”
(At 15 minutes)
“Please put down your pencils and pass your completed forms to me. Thank you!”
Part 3: Administering the 3–5 Student Self-Screener (15 minutes)
“Next, I invite our third- through fifth-grade students to join me here in a quiet space for a short survey.
- Students, take a seat and get ready with a pencil.
- In front of you is the 3–5 Student Self-Screener Form. This is not a test—there are no right or wrong answers.
- I will read each statement aloud. After I read it, circle the face that best shows how you feel:
😊 = Often 😐 = Sometimes 😢 = Rarely
“Let’s begin.”
(Read each item slowly. Pause for students to circle their answer.)
“Great! Now complete the three reflection questions at the bottom. You can write as much or as little as you like.”
(At 15 minutes)
“Pencils down. Please place your form in the basket on the table. Thank you for being honest and careful.”
Part 4: Collecting & Organizing Data (5 minutes)
“Thank you, teachers and students. I will now compile all of the forms by grade and class. Next, I’ll use the Screener Data Review Template to identify trends and highlight students needing extra support.
Please remember: results guide us—they do not label students.”
Part 5: Wrap-Up & Next Steps (5 minutes)
“Thank you all for your time and honesty today! Here’s what happens next:
• I will review the data and look for patterns.
• We will form small groups for Tier 2 support around common themes, such as managing frustration.
• I will schedule one-on-one (Tier 3) sessions with any students who need additional help.
• By the end of the week, I will share a brief summary of findings and recommendations with each teacher.
If you have any questions after today, please email me at your.email@school.edu or stop by my office. Thank you for partnering to support our students’ well-being!”