Michelle L. Monnat, LMHC Jeremy Felice. Founded as an orphanage in 1859 Transitioned to a...
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Transcript of Michelle L. Monnat, LMHC Jeremy Felice. Founded as an orphanage in 1859 Transitioned to a...
Therapeutic Crisis Respite ProgramMichelle L. Monnat, LMHCJeremy Felice
“Creating Opportunities to Enhance Lives, One Relationship at a Time”
Children’s Home of Jefferson CountyFounded as an orphanage in 1859 Transitioned to a Residential Treatment Center in 1970sExpansion of Foster Care in 1990s and 2012Addition of several community based services through the 1990s and 2000sUpdated Residential Model of Care in 2009Establishment of OMH Article 31 Mental Health Clinic in 2011 – Community Clinic of Jefferson CountyBalancing Incentive Program 2014
Therapeutic Crisis Respite Program
Tri-County InitiativeYouth ages 10* through 17Short Term Respites Aftercare
Respite PhaseCANS Assessment Referral to Mental Health ServicesSchool Partnership and AdvocacyFamily Support and Supported VisitationPsychiatric Assessment and NeurofeedbackPsychological EvaluationConnection to Community Services
Ongoing ServicesClinical GroupFamily Support GroupParenting EducationLife Skills Crisis InterventionTherapeutic Recreation
Yoga, Meditation, Deep Breathing, etc.PsychoeducationAcademic Support including tutoringSupported Visitation
Family EngagementParenting Group
Six Week ProgramTopics Include:
Three C’s: Caring, Consistency and ConsequencesDiscipline Versus PunishmentParent and Youth Relaxation TechniquesSelf-CareBehavioral Support TechniquesRules and RoutinesParenting Styles
Treatment Team Meetings InitialReturn HomeFinal Discharge
Aftercare Phase
90 Day Connection to ServicesPhase Out “Warm Hand Off” MethodContinuous Crisis Intervention Services
Staffing ModelProgram DirectorCare Coordinator – Outreach and Engagement24/7 Awake Staff
Bachelor’s or Master’s degree in psychology, education or a related fieldMinimum of two staff per shift at all times
Registered NurseLicensed CliniciansPsychiatristPsychologist
Staff On-Boarding and TrainingThree Week Intensive Training
Week One:Team Building – Project AdventureClinical Training - Building Positive AttachmentsClinical Training - Working with Traumatized ChildrenClinical Training – Why It Matters – Advanced attachment trainingChild Sexual AbuseMedication TrainingSupported Visitation TrainingBehavior Management Training
Training Cont’d
Week TwoTherapeutic Crisis Intervention
Week ThreeStaff Observations Columbia –Suicide Severity Rating Scale (C-SSRS) training
Ongoing TrainingContinuous staff development at least monthly
Neurosequential Model of Therapeutics (NMT)
Child Trauma Academy (CTA)Trauma Informed “Way of thinking about youth”Brain MappingInformed Clinical Practice
Community ConnectionsCommunity Services BoardsLocal Departments of Social ServicesLocal Probation DepartmentsSt. Lawrence Psychiatric Center (SLPC) and Mobile Integration TeamCommunity Clinic of Jefferson CountySamaritan Medical Center and Carthage Area HospitalNorthern Regional Center for Independent Living (NRCIL)YMCA and SoZo Teen CenterNorth Country Family Health CenterSchool DistrictsNorth Country Prenatal/Perinatal CouncilVolunteer TransportationCommunity Action Planning Council (CAPC)Single Point of Access (SPOA)Cornell Cooperative ExtensionMany More…
Data-Driven Decision Making
Feb Mar Apr May Jun Jul Aug Sep Oct Nov02468
101214161820
Data by Month
Referrals
Admin
CCJC10%
CHJC11%
JRC1%School
13%TLS /Waiver4%Probation
1%
Danser&Knudsen1%
SMC13%
DPAO1%
LDSS13%
Parent/Guardian30% Other
3%
Referral Source
Data-Driven Decision Making2/
1/20
152/
7/20
152/
13/2
015
2/19
/201
52/
25/2
015
3/3/
2015
3/9/
2015
3/15
/201
53/
21/2
015
4/4/
2015
4/10
/201
54/
16/2
015
4/22
/201
54/
28/2
015
5/4/
2015
5/10
/201
55/
16/2
015
5/22
/201
55/
28/2
015
6/3/
2015
6/9/
2015
6/15
/201
56/
21/2
015
6/27
/201
57/
3/20
157/
9/20
157/
15/2
015
7/21
/201
57/
27/2
015
8/2/
2015
8/8/
2015
8/14
/201
58/
20/2
015
8/26
/201
59/
1/20
159/
7/20
159/
13/2
015
9/19
/201
59/
25/2
015
10/1
/201
510
/7/2
015
10/1
3/20
1510
/19/
2015
10/2
5/20
1510
/31/
2015
11/6
/201
511
/12/
2015
11/1
8/20
1511
/24/
2015
0
5
10
15
20
25
Respite / Aftercare Roster
ACS TCRP
Data-Driven Decision Making
Feb Mar Apr May Jun Jul Aug Sep Oct Nov0
5
10
15
20
25
Respite / Aftercare Gender Stats
Female RespiteMale RespiteRespite AverageFemale After CareMale After CareAfter Care Average
Project Outcome MetricsGoal 1: Assist families in identifying their strengths and needs through administration of the Child and Adolescent Needs and Strengths (CANS) assessment tool:
Performance Target Compliance Rate
Staff Training 100% - Target Met
CANS-NY Utilization at admission 93% - Target Met
Benefit of CANS-NY to family 100% - Target Met
Project Outcome MetricsGoal 2: Decrease recidivism of emergency room and preventable hospital utilization:Performance Target Compliance Rate
Client specific historical data collected
92% - Target Met
Youth will be offered intensive intervention/ youth participation
100% offered / 100% Participation - Target
Met
“High Risk” youth offered aftercare services
100% - Target Met
“High Risk” youth aftercare participation
86% - Target Met
Post Discharge Emergency Room Visits
7% - Target Met - Therefore 93% of
youth have not had a mental health
emergency encounter with the ED.
Project Outcome MetricsGoal 3: Decrease symptoms and behaviors, family stress and functional impairment from the time of admission through discharge:
Performance Target Compliance Rate
Offering of family engagement services 100% - Target Met
Family participation in family engagement services
89% - Target Met
Demonstration of improved behaviors at discharge
90% - Target Met
Success Stories
“What a simple idea!”
We brought our son to you and you cared for him as we would, and you may very well have saved his future. I could see my son heading towards a darker place - maybe self harm or rebelling into deeper trouble. We were able to participate in the two week respite program. I'm unsure of your official verbiage for the program but I call it a savior! By allowing our family time to decompress, we were able to reset. What a simple idea!”
In the words of a youth…
“TCRP helped me with my addiction to tobacco products. It helped me realize there is more to life then being a mess up. TCRP helped with my depression by doing rec and activities. TCRP helped me with my social skills because I made multiple friends there and it helped my life at home with my parents. My parents and I get along much better now.”
“Consolation, Validation and Support”“When the behaviors started, I often felt isolated, embarrassed and helpless. I didn't know who to turn to for help. The Children's Home Respite staff offered me consolation, validation and support. I was given several agencies and professionals to contact and seek help from. I was able to share information with the rest of my family providing comfort and a direction for us all to move in.”
“Well-Planned”
“The Care Coordinators and staff kept excellent contact with our family and pointed us in the right direction for psychological assessments, medical attention and counseling. The transition back into our home was well planned beginning with short supervised home visits and then an occasional overnight until our family could regroup.”
Lessons Learned
FAMILY ENGAGEMENTIncorporate Groups Initial AssessmentsRemain flexible - but never lose site of the vision!
QUESTIONS?