Question 1

How is Cartwheel’s Big Behaviors, Big Feelings Program different from the support schools already provide?

Accepted Answer

School counselors and teachers play an important role in helping students work through big emotions and behavior challenges. Cartwheel offers additional clinical support when those challenges begin to affect a student’s emotional well-being, relationships, learning, or school engagement. Our clinicians provide individualized care, caregiver guidance, and coordination with school teams, building on the support students already receive at school.

Question 2

How quickly can students begin receiving support?

Accepted Answer

Students typically begin care within 7–10 days of referral after completing an initial assessment. Care is tailored to each student’s developmental needs and may include individual therapy, parent guidance, family therapy, or psychiatric care when appropriate. For younger children, support may focus primarily on working with parents and caregivers.

Question 3

What kinds of big feelings and behavior challenges can Cartwheel help with?

Accepted Answer

Cartwheel supports students experiencing a range of challenges, including frequent outbursts, difficulty calming down or handling frustration, escalating conflicts with peers or adults, and strong reactions that affect learning and relationships. Students don’t need a specific diagnosis or severe symptoms to benefit from support. Our program also helps students build skills for managing big emotions and helps families respond in ways that support their child’s well-being.

Question 4

Does telehealth work well for students with big feelings and big behaviors?

Accepted Answer

Yes. Virtual appointments make it easier for families to participate, and clinicians work with students and caregivers on practical strategies they can use in everyday life, including responding when emotions run high and building calmer routines. For younger children, clinicians work especially closely with parents and caregivers, who play a central role in care.

Question 5

How do you measure whether the program is working?

Accepted Answer

We use targeted screening at the start of care and throughout treatment to track changes in emotional and behavioral challenges and daily functioning. Clinicians also work with students and families to identify meaningful goals, such as calmer responses to frustration, fewer conflicts, or smoother days at school and home. School teams receive appropriate updates on engagement and progress.

Question 6

What if a student may need medication?

Accepted Answer

When clinically appropriate, students can receive a psychiatric evaluation with a Cartwheel child psychiatrist or psychiatric nurse practitioner. Medication management is also available when indicated, with coordination across the student’s care team.

Question 7

What is expected of families?

Accepted Answer

Family involvement is an important part of the program. Depending on the student’s age and needs, caregivers may participate in parent guidance, family sessions, or other aspects of treatment. Families can also access optional caregiver training to learn practical strategies for responding to big emotions at home.

Question 8

How much coordination is required from school staff?

Accepted Answer

Cartwheel manages scheduling, family communication, clinical care, and ongoing progress monitoring. School staff may participate in brief check-ins to share observations and align on strategies, but the program is designed to provide additional support without adding significant work for school teams.

Question 9

How can school counselors identify students who might benefit from this program?

Accepted Answer

Big feelings and big reactions can look different from student to student, and students don’t always show distress in ways that are easy to recognize. Staff might notice frequent outbursts, difficulty calming down after a frustrating moment, escalating conflicts with peers or adults, or recurring concerns from families about behavior at home. These can be opportunities to explore whether additional support could help.

Question 10

How does the program work with IEP or 504 supports?

Accepted Answer

Cartwheel’s clinical care can complement a student’s existing IEP or 504 plan. With appropriate consent, clinicians collaborate with school teams to help align treatment strategies with supports already in place.

Question 11

What does the district pay for, and what costs are covered by insurance?

Accepted Answer

Cartwheel’s clinical services are primarily covered by insurance, including Medicaid and most major private insurance plans. Districts invest in access and coordination, allowing students and families to receive clinical care without schools having to fund each treatment session directly. Financial aid is also available for uninsured and underinsured students.

Question 12

What ages does the program serve?

Accepted Answer

Big Behaviors, Big Feelings is available to students across all grade levels. Care is tailored to each student’s age and developmental needs. For younger children, treatment may focus primarily on parent guidance and helping caregivers build calmer routines at home.

Question 13

Is this a discipline program?

Accepted Answer

No. It is clinical care for individual students and families, not a discipline system or a school policy initiative. It works alongside the supports a school already has.

Question 14

Does a screening result mean a student has a diagnosis?

Accepted Answer

No. Screening helps clinicians understand what may be driving a child’s reactions and track progress. It is not a diagnosis. Clinicians use it together with what they learn from the child and family.

Question 15

What if a student could fit more than one Care Program?

Accepted Answer

Schools can refer as usual based on the best fit program for the student’s need. Cartwheel works with the family to choose the Care Program that fits best.

Big Feelings Are Normal. Some Students Need More Support to Manage Them.

A Mental Health Solution That Helps Students Work Through Big Feelings

Why Districts Are Asking About Big Behaviors, Big Feelings

Explore resources on big feelings, behavior, and student wellbeing

Webinar: Connection, Co-Regulation, and Coping Skills: Helping Kids and Teens Navigate Big Feelings

Parent guide: Big Feelings, Big Reactions

Parent guide: Friendships, Fitting In, and Big Feelings

Webinar Recap: Helping Kids Handle Big Feelings and Build Confidence

Upcoming Family Webinars

Why This Matters for Districts

[Quote from Juliana Chen, MD, pending]

What the Program Includes

Students and Families We Can Support

Care That Fits Families’ Needs

Explore Our Other Care Programs

Frequently Asked Questions

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