better together
School Edition — Licensed Counselor-Led Group Support
Business Overview v1.0
T.C. Hilton Foundation · March 2026
Confidential — For School District Review
The Student Mental Health Crisis

The school pays nothing.
And saves everything.

9.7 million K-12 students are actively using school-based mental health services — and demand is rising faster than any school can staff for it. Better Together brings licensed counselor-led group support to students at scale, on the topics that matter most to them, at zero cost to the district for Medicaid-eligible students. The counselor is always in the room. The AI is always in a supporting role.
Students in Crisis
9.7M

K-12 students using mental health services

18% of all 54.1 million K-12 students. Demand increased at 58% of schools this year alone. A 61% surge in staff concerns about student anxiety, depression, and trauma.

System Capacity
52%

of schools cannot effectively meet student mental health needs

Recommended counselor-to-student ratio: 250:1. Most schools are nowhere close. Federal pandemic relief funds have ended. The gap is widening.

Annual Cost
$89B

spent annually on K-12 student mental health services

$9,150 per student receiving services. One individual counseling session per week for a school year. Group therapy delivers the same clinical benefit at a fraction of the cost.

The Three Walls Schools Hit

Why existing mental health programs fall short — and why Better Together doesn't

Wall 1 — Staffing

There aren't enough licensed counselors.

Schools report a counselor-to-student ratio of 1 per 408 students on average — nearly double the recommended 1:250. When a licensed professional is working 1-on-1, they can serve 4-6 students per day. In a group of 8-10, they serve them all in the same hour.

Wall 2 — Topics

Students face issues counselors can't address at scale alone.

Anxiety. Social media pressure. Substance use. Grief. Identity. Peer conflict. Academic pressure. These aren't episodic — they're chronic, shared, and ideal for peer group work under licensed supervision. No 1-on-1 schedule can reach every student who needs it.

Wall 3 — Documentation

Paperwork consumes clinical time.

A licensed counselor running 4 group sessions per day faces hours of post-session documentation — notes, progress records, referrals. Better Together's AI generates draft documentation for counselor review immediately after each session. Clinical time stays clinical.

The Better Together Solution for Schools
Licensed counselor-led group support — at the scale schools actually need
How It Works

One counselor.
Eight to ten students.
One session.

A licensed school counselor or therapist leads a structured group session for 8-10 students on a shared topic — anxiety, peer pressure, substance use, grief, or any of dozens of student-centered areas. The session runs on Better Together's secure platform.

The AI supports — but never leads. It monitors engagement, flags risk signals for immediate counselor attention, and generates draft session notes for counselor review post-session. The counselor is the author of record for every document.

  • FERPA-compliant — student data handled to federal education privacy standards
  • Parental consent workflow — built into onboarding
  • Crisis protocol — any risk signal → immediate counselor alert
  • Age-appropriate — content and interaction designed for K-12 students
The Capacity Math

One counselor can reach 40× more students in the same week.

A counselor running 4 individual sessions per day reaches 20 students per week. The same counselor running 4 group sessions per day — 8 students each — reaches 160 students per week in the same hours.

That's not a marginal improvement. That's a transformation in what a single licensed professional can accomplish for a school's student population.

  • 4 sessions/day × 8 students = 32 students per day
  • 160 students per week from one counselor
  • AI documentation means no after-hours paperwork burden
  • Group cost per student: a fraction of individual therapy
Student-Centered Group Topics

What students actually need help with — and what group therapy is specifically designed to address

😰
Anxiety & Stress

Academic pressure, test anxiety, social anxiety — the leading presenting concern among K-12 students today.

📱
Social Media & Identity

Body image, online comparison, cyberbullying, FOMO — a generation-defining pressure point.

💊
Substance Use

Peer pressure around alcohol, cannabis, vaping, and prescription misuse. Group settings are clinically proven for early intervention.

🤝
Peer Relationships

Conflict resolution, belonging, friendship dynamics, social exclusion — issues that affect academic performance directly.

💔
Grief & Loss

Bereavement, family disruption, loss of relationships — experiences that cluster in student populations and respond well to shared group processing.

🏠
Family & Home Stress

Parental conflict, economic stress, food insecurity, housing instability — issues that arrive at school with the student every day.

🌈
Identity & Belonging

LGBTQ+ support, cultural identity, belonging and acceptance — areas where peer group connection is therapeutically central.

📚
Academic Pressure

Performance anxiety, perfectionism, college admissions stress — increasingly a mental health issue, not just an academic one.

The Economics — For School Districts
How districts fund Better Together — at zero or near-zero cost
Funding Path 1
$0

District cost for Medicaid-eligible students

Nearly 4 in 10 K-12 students have Medicaid coverage. Medicaid reimburses for medically necessary school-based mental health services. For these students, Better Together sessions are billed through Medicaid — the district pays nothing. No budget approval required. No vendor procurement process.

Funding Path 2
Title IV-A

Federal grant funding covers the rest

Title IV-A (Student Support and Academic Enrichment grants) explicitly covers mental health services. State mental health grants — including the $208M+ in recently re-allocated federal mental health grants — are directly applicable. Most districts already have access to funding that can cover Better Together today.

Funding Path 3
$15

Per-student per-session — where direct billing applies

For students without Medicaid and where grant funding isn't available, a modest per-session student fee applies — far below the $175+ cost of individual therapy. At 8 students per session, the session is fully funded. No session requires district subsidy once enrolled students are identified.

How It Works — From Referral to Session

Six steps from counselor referral to student support — no district procurement required

1
Counselor identifies student

School counselor refers a student for group support in a specific topic area. Parental consent obtained.

2
Intake & safety screen

Student completes structured intake. Mandatory crisis screen first. Any crisis signal → counselor notified immediately. Group placement suspended.

3
Smart group matching

AI matches student to an appropriate group by topic, age, and school year. Counselor reviews and approves all placements.

4
Licensed counselor leads session

8-10 students per group. Counselor facilitates. AI monitors engagement and flags any risk signals. Counselor has full authority at all times.

5
AI generates draft notes

Post-session, AI produces draft session notes per student for counselor review. Counselor edits and approves. Counselor is author of record.

6
$0
District cost for Medicaid students

Medicaid-eligible students billed through Medicaid. Grant-funded students covered by existing Title IV-A allocation.

Four wins — every time a group meets

The Student

Gets the support they need — finally.

Peer group therapy for the specific issue they're carrying. Licensed professional supervision. An environment where their peers share their experience. Research-backed outcomes for anxiety, substance use, grief, and social difficulties.

The Counselor

Multiplies their reach without burning out.

Reaches 160 students per week instead of 20. AI handles documentation. No billing, no prior authorizations. Clinical time is 100% clinical. The 4-hour documentation burden becomes a 15-minute review.

The District

Solves the mental health mandate at zero or near-zero cost.

Medicaid covers eligible students. Title IV-A covers the rest. No procurement process for pilot schools. Documented student outcomes for district reporting. Reduced absenteeism and behavior referrals tied to unaddressed mental health.

The Parent

Their child gets real support — not a waitlist.

Licensed professional in every session. Parental consent at every stage. No driving to appointments. Sessions available during or after school hours. Crisis protocol with immediate notification if risk signals arise.

Patent-Pending Technology — BTGX Provisional Patent Filed March 2026

Better Together's school edition operates on the same patent-pending BTGX platform covering five novel inventive elements: per-participant thread isolation ensuring each student's session data is handled independently; four-pass iterative note synthesis from individual audio streams; the Session Interaction Overlay producing a group-level clinical view for counselor review; First-Visit Therapeutic Area Determination with mandatory crisis safety screen; and the Counselor Authority Layer ensuring all AI outputs require licensed counselor review before finalization. The counselor is always the author of record. The AI is always in a supporting role.

Page 2 — Better Together Schools · Hard Questions · Go-to-Market · ROI Appendix
The Hard Questions — Addressed Directly
Six real challenges any superintendent, principal, or school board will raise. Our honest answer to each.
Parental Consent & Privacy
Can a school offer group mental health sessions without parental consent? How is student data protected?
FERPA requires parental consent for disclosure of student education records. Mental health services in schools require parental notification and often consent. Group settings add complexity — a parent's child is in a group with other students whose parents have also consented.
Our answer
  • Parental consent is built into the onboarding flow — no student joins a group without documented parental approval
  • FERPA-compliant data architecture — student records handled to federal education privacy standards throughout
  • Group confidentiality protocols modeled on best practices for school-based group therapy — counselor sets expectations at session outset
  • No student is identifiable to another student's parent — group composition is not disclosed outside the session
Crisis & Safety
What happens when a student discloses self-harm, suicidal ideation, or abuse in a group session?
Mandatory reporting requirements apply to licensed counselors regardless of setting. A group disclosure in front of peers adds complexity — managing the disclosing student, the group, and mandatory reporting obligations simultaneously.
Our answer
  • Mandatory crisis safety screen at intake — any crisis signal halts group placement and routes to counselor and crisis resources immediately
  • Real-time AI monitoring flags risk language for immediate counselor attention — zero-tolerance policy
  • Counselor has private channel to any student, ability to pause session, direct crisis protocol activation at all times
  • Mandatory reporting remains counselor's responsibility — the platform supports, not substitutes, professional judgment
Licensure & Scope
Can school counselors lead these groups — or does it require a licensed clinical therapist?
Licensure requirements for group therapy vary by state. School counselors (Licensed Professional Counselors, Licensed Clinical Social Workers) may or may not be authorized to conduct clinical group therapy sessions depending on their credential and state rules.
Our answer
  • Better Together is designed for licensed professionals — LPC, LCSW, LMFT, psychologist credentials all qualify depending on state rules
  • For schools with licensed counselors on staff, those credentials are typically sufficient for school-based group support
  • Where school counselors are credentialed for support but not clinical therapy, Better Together's platform is configurable for peer support groups — supervised, structured, counselor-led, but not clinical therapy billing
  • Sara's clinical partner network can provide licensed therapist coverage where school staff credentials are insufficient
District Procurement
Our district procurement cycle is 18 months. How does Better Together get into schools faster?
School districts are notoriously slow-moving procurement environments. Vendor approval, IT security review, school board approval, budget cycles — a platform evaluation can take two years before a single student is served.
Our answer
  • Medicaid billing model bypasses district procurement entirely — for Medicaid-eligible students, no district purchase order is required
  • Title IV-A funds are typically already allocated — a principal with discretionary grant spending authority can pilot without board approval
  • 90-day pilot generates documented student outcomes before any district commitment is required — the district approves a free trial, not a platform contract
  • Entry through the school counselor or principal — a clinical outcomes conversation, not a vendor evaluation
Student Adoption
Will students actually show up — and engage — in a virtual group therapy session?
Adolescents are skeptical of mental health programs, resistant to anything that feels stigmatizing, and accustomed to dismissing school-mandated programs as performative. Attendance and genuine engagement are not guaranteed just because a program is offered.
Our answer
  • Peer group format reduces stigma — students are not singled out; they're joining a group of peers with similar experiences
  • Topic-matched groups increase relevance — a student with social anxiety joins a group specifically about that, not a generic "wellness" session
  • Students are digital-native — video-based group sessions are a natural format, not a foreign one
  • Counselor-led provides the trusted adult anchor students actually respond to
Outcomes & Evidence
What evidence exists that group therapy works for adolescents — and how will outcomes be measured?
Districts and school boards increasingly require evidence-based programs. "We believe this helps" is not sufficient. Documented clinical outcomes, attendance data, and academic impact metrics are required for any program that wants to survive past pilot phase.
Our answer
  • Group therapy has 50+ years of clinical evidence for adolescent anxiety, substance use, grief, and peer difficulties — this is not experimental
  • Better Together generates session-by-session counselor-reviewed notes for every student — a documented longitudinal record of participation and progress
  • 90-day pilot metrics: attendance rate, student-reported wellbeing (pre/post), counselor assessment of student progress, absenteeism comparison
  • Sara's clinical partner brings research methodology expertise — pilot can be designed as a publishable outcome study
Go-to-Market — Schools

Three entry points. One of them doesn't require district approval at all.

01
School counselor direct — bypass procurement entirely

A licensed school counselor with Medicaid billing authority can pilot Better Together for their Medicaid-eligible caseload without district procurement approval. Sara's conference network reaches school counselors directly — the same clinical credibility that opens hospital doors opens school counselor doors. One counselor. One school. 90 days. Documented outcomes.

02
District Title IV-A grant pilot — principal-level decision

A principal with discretionary Title IV-A spending authority can fund a Better Together pilot for their school without board approval for amounts under their authorization threshold. Target: principals in high-need Title I schools where mental health need is highest and grant funding is most accessible. The pitch: documented student outcomes in 90 days at zero additional budget.

03
State mental health grant recipients — immediate fit

States receiving the $208M+ in re-allocated federal mental health grants are actively seeking platforms to deploy those funds. Better Together is purpose-built for exactly what those grants require — licensed professional supervision, documented outcomes, scalable reach. State education agency contacts are the highest-leverage entry point for multi-district scale.

Appendix — Better Together Schools · Detailed Economics · Funding Model
Appendix — School Economics Detail
Per-session cost architecture · Medicaid & grant funding model · 90-day pilot ROI
Per-Session Cost Architecture — 8 Students
ComponentCostBasis
Counselor session fee$120.00Licensed professional, 60-min group session
AI documentation (all 8 students)$0.65Draft notes + session overlay, confirmed cost
Platform / WebRTC / infrastructure$6.40Video hosting, session management, FERPA storage
Payment processing (2.9%)$3.48On $120 student fee revenue
Total cost per session$130.538 students · 60 minutes
Revenue per session (8 × $15 Medicaid/grant)$120.00Medicaid rate or grant-funded
Revenue per session (8 × $15 direct fee)$120.00Where direct billing applies

Note: The Medicaid reimbursement rate for school-based mental health group services varies by state — typically $15-$30 per student per session. Counselor fee is intentionally set to be attractive to licensed school counselors supplementing district income or operating independently through the Better Together network.

90-Day District Pilot ROI — 500 Referred Students
MetricValueAssumption
Students referred to pilot500Mid-size district, one school
Students with Medicaid coverage20040% Medicaid rate (national average)
Sessions per student per 90 days6Weekly group attendance
Total group sessions in pilot375500 students ÷ 8 per group × 6 sessions
Individual counseling sessions displaced3,000500 students × 6 sessions
Counselor time freed per week~32 hrsFor counselors now running groups vs. 1-on-1
District direct cost (Medicaid students)$0Billed through Medicaid
District net cost — 90-day pilot$0–$9,000Medicaid covers 40%; Title IV-A covers most of remainder
Counselor capacity multiplierStudents reached per counselor hour
Documentation hours saved per counselor/week8–12 hrsAI draft notes vs. manual documentation
Why group therapy specifically? Decades of clinical research confirm that group therapy produces outcomes equivalent to individual therapy for adolescent anxiety, substance use, grief, and social difficulties — at 20-30% of the cost. The peer element is not a compromise; for many adolescent presentations, peer group context is clinically preferable to 1-on-1.
Why is district cost effectively zero? For Medicaid-eligible students (40% nationally), Medicaid reimburses for medically necessary school-based mental health services — no district budget required. For remaining students, Title IV-A and state mental health grants cover the fee. A district that cannot fund Better Together has not explored its existing grant allocations.
FERPA vs. HIPAA — what's the difference? Schools operate under FERPA (Family Educational Rights and Privacy Act), not HIPAA. Better Together's school edition handles student data under FERPA standards — distinct from the HIPAA-compliant architecture used for the clinical BTG platform. Parental consent and record access rules follow FERPA throughout.
Sara's clinical validation role. Sara brings 15 years of statistical and government project background — and is actively validating the Better Together platform through women's health conferences. The school edition benefits from the same clinical validation framework, adapted for school-based group therapy outcome measurement and designed to produce publishable pilot results.