Mindfulness and Yoga in Schools A Guide for Teachers and Practitioners

30 • PART i: A ModEl foR SElf-REgulATion And EngAgEMEnT

The first tier is known as the primary prevention level, intended for the promotion of
health and well-being and to provide specific protection against the onset of disease (Cook-
Cottone & Vujnovic, in press). The primary prevention level includes the implementation
of procedures (i.e., screening) to identify potential risk and to intercept such risk prior to
the need for classification (Cook-Cottone & Vujnovic, 2016). Subsequently, secondary
prevention is intended for early detection and timely treatment to prevent or limit pro-
longed disability, or lack of academic success for the individual (Cook-Cottone & Vujnovic,
2016). Finally, the tertiary level of prevention is considered for the treatment of symp-
toms, rehabilitation, and the reduction of further developmental disruption and disorder
(Cook-Cottone & Vujnovic, 2016; Leavell & Clark, 1953, 1958, 1965). Notably, in the 1990s,
the field of prevention adopted the terminology endorsed by the Institute of Medicine
(IOM): universal, selective, and indicated (Cook-Cottone & Vujnovic, 2016).
Over the past few decades, the field of education has increasingly embraced the
prevention model framework for a number of reasons, including the increased development
of research documenting the efficacy of evidence-based interventions; an emphasis on the
promotion of well-being; acknowledgment of the increasing levels of need among students;
recognition of the limitation of resources; and a need for a cost-effective approach (Cook-
Cottone & Vujnovic, 2016). In 2010, the three-tier model was outlined by the National
Association of School Psychologists explicating a multitier model, school-based academic
support and special education classification system (Cook-Cottone & Vujnovic, 2016;
Shin & Walker, 2010). Applied within the school framework, the three-tier model is incred-
ibly effective for providing services to all students, especially as school personnel are fre-
quently the first line of defense against emerging academic, behavioral, and mental health
problems (Cook-Cottone, Tribole, & Tylka, 2013).
Tier 1, the universal level, is conceptualized as the core instructional or social- behavioral
program. Tier 1 programs are research supported and aim to meet the needs of 80% to
90% of students (Cook-Cottone & Vujnovic, 2016). Accordingly, the majority of students,
including those who may be at risk for concerns, respond sufficiently to this level of
programming (Stoiber, 2014). Tier 2 is the targeted level, intended to serve a smaller group
of students who require increased support to enhance the core programs at the Tier 1 level
(Stoiber, 2014). Tier 3 is the intensive level, designed to be individualized and strategically

Tier 2: Targeted

Interventions and

Programs

(10%–15% of students)

Tier 1: Universal

Interventions and Programs

(80%–90% of students)

Tier 3

Tier 3: Individual

Interventions

(1%–5% of students)

figuRE 2.2 Three-tier model of interventions in schools.