Children/Families may be referred for traditional outpatient counseling. A Master’s level, licensed clinician provides this service in the office. The frequency of contact and intensity of service is determined by the person-centered plan. Treatment is provided from a family systems perspective using a short-term, strengths-based therapy model. This means that the focus of counseling is on the present-day concerns that families identify and the therapist looks to the strengths each family possesses for the resources to help families make the changes they desire.
Families may be seen conjointly, in subsystems of the family, or members of the family may be seen individually as determined in the treatment plan. A variety of brief therapeutic approaches may be used. These include Solution Focused Therapy, Structural Family Therapy, Strategic Family Therapy, Narrative Therapy, and CognitiveBehavioral Therapy. Consumers are provided opportunities to learn, improve, and demonstrate specific skills, which may include problem-solving, communication, and acceptable social interaction.
Community Living Supports (CLS) are used to increase or maintain personal self-sufficiency, facilitate an individual’s achievement of his/her goals of community inclusion and participation, independence or productivity. Services are those that assist, support and/or train primarily for activities of daily living, socialization and relationship building, participation in regular community activities and preserving the health and safety of the beneficiary in order that he/she may reside in the most integrated, independent community setting. It is anticipated that these services will encourage appropriate development, behavior, and independence.
The supports may be provided in the consumer’s residence or in community settings. The CLSaide, or home-based paraprofessional, acts as an adjunct to the primary service provider and provides active treatment as described by the services outlined in a family-centered plan. The intent is to assist, mentor and encourage the parent in taking an active role in the child’s outcomes. Therefore, parental involvement and active participation are expected unless it is determined that it is counter- productive or not necessary to the success of the child’s outcome.
Respite is provided to assist in maintaining a goal of living in a natural community home and temporarily relieves the unpaid primary caregiver. It is a part of the array of services available to support families in raising children with a serious emotional disturbance (SED) and/or developmental disability. Respite can be used by parents to conduct errands, keep appointments, go on vacation, spend time with their spouse or with their other children, handle emergencies, or simply to relax.
The rationale behind respite programs is to provide relief and revitalization of the family unit and to prevent family breakdown and the out-of-home placement of the child with SED and/or developmental disability. Respite has been shown to have positive benefits for all members of the family, reduce family members’ sense of isolation, and decrease the incidence of child abuse and neglect. Respite is an essential part of an overall system of support for families who want to care for their children at home. It is generally planned but can be arranged in crisis situations.
Families are eligible for a maximum annual amount of 640 units or 160 hours. Children’s Waiver consumers are exempt from this maximum number of units. Decisions regarding scope, amount, and duration within this guideline should be decided during Person Centered Planning. As services are provided, the primary provider is responsible for actively assisting the family in identifying natural supports. Only for emergent reasons, i.e. death in family, hospitalization, an additional allowance of up to 160 units or 40 hours may be made available. This must be authorized by the supervisor. Beneficiaries receiving respite services from other sources or programs funded by Medicaid such as the Medicaid Children’s Waiver, etc. do not qualify for care through this program.
Home-Based Services help children and families with a child between the ages of 3-17 that have many needs, and who require access to a comprehensive array of mental health services. The family unit is the focus of intensive, in-home treatment, which can include individual and family therapy, collateral contacts, case management, parenting education, child and family skill building, psychiatric services, coordination with the school system, and crisis intervention. The frequency of contact and intensity of service is based on the individual needs of each individual and family but at a minimum, the therapist will see the individual/family once per week.
A Home Based Clinical Specialist helps the child and family increase their interpersonal functioning, their functioning within the school and community and their overall quality of life. A family-centered treatment approach is used to help identify strengths, dreams, goals, and desires. The program is committed to helping family’s access community resources and to advocate for responsiveness from the community systems which impact the family’s ability to function.
Infant Mental Health Services provide mental health treatment to families with young Children Age Birth to 4 years old to help prevent the development of mental health issues in infants and toddlers. The focus of this home-based program is to provide services that will maximize the social, emotional, physical, and cognitive development of the infant and toddler. Nurturing the attachment between the parent and the child is a key component.
Services include Individual and Family Therapy, Parent-Child Psychotherapy, Case Management, Education on Child Development, Parenting Strategies, Strategies to handle common childhood problems and access to a psychiatrist for medication to treat mental health conditions when appropriate.
The Parent Management Training Oregon Model (PMTO) refers to a set of parent training interventions developed over forty years, originating with the theoretical work, basic research, and intervention development of Gerald Patterson and colleagues at Oregon Social Learning Center. PMTO can be used in family contexts including two biological parents, single-parent, re-partnered, grandparent-led, reunification, and foster families.
PMTO can be used as a preventative program and a treatment program. It can be delivered in many formats, including parent groups, individual family treatment in agencies or home-based and via telephone/video conference delivery, books, audiotapes, and video recordings. PMTO interventions have been tailored for specific youth clinical problems, such as externalizing and internalizing problems, school problems, antisocial behavior, conduct problems, deviant peer association, theft, delinquency, substance abuse, and child neglect and abuse. The individual parent or parent group interventions are appropriate for birth parents whose children have been removed because of maltreatment/neglect.
The Parent Support Partner (PSP) is the parent or primary caregiver of a child with emotional, behavioral and/or mental health challenges. The ideal PSP is sensitive, respectful and responsive to the values, cultural background and life experiences of each family. The Parent Support Partners’ focus should be to empower families to move toward independence through skill-building interventions. Parent Support Partners help empower families to access and obtain resources in the community, partner with service providers, and increase their confidence in parenting so that all family members can remain in the community.
The Parent Support Partner serves as an example and mentor to other parents. The Parent Support Partner engages family members and provides peer-to-peer support, education, and training to families who are receiving services. The Parent Support Partner is included in the service planning, implementing, and transition process, as delineated in the Individual Plan of Service. The Parent Support Partner utilizes personal experience and knowledge and expands opportunities for family choice and voice in matters affecting families and their children. The Parent Support Partner builds partnerships with parents and professionals and promotes an open, respectful attitude.
As its name implies is a form of cognitive behavioral therapy that addresses the specific emotional and mental health needs of children, adolescents, adult survivors, and families who are struggling to overcome the destructive effects of early trauma. Trauma-focused cognitive behavioral therapy (TF-CBT) is especially sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from abuse, violence, or grief. Because the client is usually a child, TF-CBT often brings nonoffending parents or other caregivers into treatment and incorporates principles of family therapy.
Anyone who has experienced a single or repeated experience of sexual, physical, or mental abuse or who has developed post-traumatic symptoms, depression, or anxiety as a result of the loss of a loved one or exposure to violence in the home or community can benefit from TF-CBT. If a child or adolescent also exhibits serious behavioral, substance-abuse, or suicidal-ideation problems, other forms of treatment, such as dialectical behavior therapy, may be more appropriate as an initial intervention and can be followed up with a trauma-sensitive approach.
Wraparound is a term used to describe a process by which service providers agree to collaborate to improve the lives of children, families, and adults by creating, enhancing, and accessing a coordinated system of support through a strengths-based, client-driven model. An emphasis is placed on identifying and enhancing the client’s natural and informal supports or to assist them in finding new informal supports. The client may be defined as an individual or as an entire family.
Wraparound is specifically designed to address crisis concerns and keep families together and in their home community. Wraparound is a voluntary process for families. The Medicaid guidelines for Wraparound specify that the Facilitator cannot have more than one role with any one family, thus the Wraparound Facilitator is not able to provide needed individual or family therapy. However, a therapist working with the child and family may be asked to join the Child and Family Team.
The Michigan Department of Health and Human Services (MDHHS) has implemented fidelity measures to ensure that Wraparound is being implemented in such a fashion that model fidelity is maintained. Additionally, MDHHS has outlined specific criteria for Wraparound eligibility, which is as follows:
The youth is involved in multiple child/youth-serving systems.
The youth has been served through other mental health services with minimal improvement in functioning.
The youth is at risk for out-of-home placement or is currently in out of home placement.
The risk factors exceed capacity for traditional community-based options.
Numerous providers are serving multiple children in the family and the identified outcomes are not being met.
