Day Treatment Handbook


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While our programs are designed to provide individual care, many of our programs share basic commonalities. We are unified by an organization-wide philosophy evolved from the essential belief that “every child is a program.” Our Philosophy of Care focuses on positive approaches, individualized services and effective programming. This philosophy is our commitment to you and your family. We believe this is what makes Devereux special.

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Day Treatment Handbook

  1. 1. Day Treatment Handbook for Families and Providers Devereux Colorado Devereux Cleo Wallace 8405 Church Ranch Blvd. Westminster, CO 80021 8405 Church Ranch Blvd., Westminster, CO 80021 (800) 456-CLEO (303) 466-7391 (800) 456- CLEO (303) 466-7391
  2. 2. Devereux Colorado Mission StatementThe mission of Devereux Colorado, the Cleo Wallace Center is to inspire growth and fosterhuman potential in the lives of those we serve. By utilizing positive dynamic approaches toindividualized, evidence-based services, we promote health and success. Our programs arerecognized nationally as models of excellence in the provision of compassionate HumanServices.Our MantraWe inspire growth.We foster human potential.We promote health and success with compassion.A Better LifeDevereux Colorado is part of the Devereux Foundation, one of the nation’s oldest non-profitproviders of behavioral health care services. Considered a leader in the field of mental health,Devereux Colorado serves children and adolescents ages 8 to 21 with psychiatric treatmentneeds. At Devereux Colorado, we are devoted to making a difference by enhancing the lives ofour clients - Opening doors for a better life.General InformationDevereux Colorado is the Rocky Mountain region’s premier facility for the treatment ofpsychiatric, emotional and behavioral difficulties in children and adolescents. We offer a widerange of treatment programs including residential and day treatment services. While intreatment, your child will be involved in a highly structured schedule with clearly defined goalsfor tracking progress.Each student will be involved in weekly individual therapy and family therapy as needed. Eachstudent will be taught the skills needed to change maladaptive behaviors. Devereux Coloradotreats “the whole child,” and each student, in addition to formal therapy, will have theopportunity for age-appropriate school, recreational and social activities.Every activity is planned to enhance the physical, emotional and mental well being of thestudent.Our role in helping students and families improve the quality of their lives has made us a trustedresource for medical professionals and community agencies. All of our programs and activitiesreflect an abiding respect for children and great care is taken to ensure the safety, security, andcomfort necessary for personal growth. It is our continued commitment to carry on the vision ofour founder,"...that each child might realize his full potential as a human being." Cleo SpurlockWallace, 1948  Devereux Colorado 1 
  3. 3. Devereux’s Philosophy of CareWhile our programs are designed to provide individual care, many of our programs share basiccommonalities. We are unified by an organization-wide philosophy evolved from the essentialbelief that “every child is a program.” Our Philosophy of Care focuses on positive approaches,individualized services and effective programming. This philosophy is our commitment to youand your family. We believe this is what makes Devereux special.1) Positive ApproachesOur primary goal is to help you develop the plan of care that best meets your needs and mostcritically, the needs of your child. We are committed to serving, focusing on and strengtheningyour family. We strive to provide your child with the knowledge, guidance and resources he orshe needs to live a fulfilling and meaningful life.2) Individual ServicesAlthough our programs are rooted in effective, evidenced-based practices, Devereux Coloradoremains an organization focused on innovation. We seek new solutions to help our studentsrealize positive results and are dedicated to doing what is right for those we serve.3) Effective ProgrammingWe are continually working to ensure the effectiveness of our programs. We are developingways to measure outcomes, all the while focusing on the safety and stability of the students inour care, nurturing their individual potential and helping them to develop their resilience to leadfulfilling, productive and rewarding lives.CommunicationCommunication is a crucial aspect of treatment and is the most effective way to ensure lastingchange within the student. In other words, home and school can work together to help yourfamily achieve your goals. For example, if your child has a very difficult night at home, it isimportant that school knows this information so they may talk to your child about this.Conversely, if your child has a difficult day at school, it is important that you know so you cantalk at home. Most importantly, rewards, incentives and privileges need to remain constantthroughout both environments. The Devereux Colorado School utilizes many avenues ofcommunication to ensure all information is exchanged between school and home. The mostcommon ways are “back and forth” books, emails and voicemails. Please talk with your child’steacher about which method is preferred.  Devereux Colorado 2 
  4. 4. Positive Behavioral Support (PBS)Positive Behavioral Support (PBS) is a research-based program created to define and teachexpectations to students in a proactive and supportive manner. Students are explicitly taughtexpectations in all environments on campus in an effort to address difficult behavior before itoccurs. When challenging behavior occurs, it is utilized as a learning opportunity for staff,families and providers to create proactive strategies to teach appropriate behaviors andinteractions. Students receive a variety of positive reinforcement and rewards when theydemonstrate the expectations to increase the likelihood of positive behaviors occurring in thefuture. The program has a three-tier approach to allow students to receive universal, targeted andindividualized levels of support when appropriate. The Positive Behavior Support program has shown tremendous success in numerousschools around the nation including over 540 schools in more than 60 school districts inColorado alone. Devereux Colorado looks to continue the success of PBS as a pilot PositiveBehavioral Support residential program with the Colorado Department of Education. We beganthe first steps of implementation in February 2008 and are excited about the growth and potentialthis program will continue to offer us.Cougar PawsA student receives a hole punch in their Cougar Paw Card when they demonstrate: Care about self and others Are responsible Respect people and property Encourage safetyOnce all twelve holes of a card have been hole-punched, students turn them into staff that thenlogs twelve dollars into the student’s token store account. Students spend theses dollars once aweek during their classroom’s scheduled token store time. Staff also places the card into a bin forweekly classroom drawings. After the weekly drawing, everyone’s tickets will go into a largerbin for our two month assembly with larger prizes.  Devereux Colorado 3 
  5. 5. Care about self Are Respect people Encourage Education and others responsible and property safety Classroom  Actively  Be prepared  Raise your  Address participate  Be a positive hand concerns with  Work peer  Be an active staff cooperatively  Use materials listener  Take space if  Strive for for their  Keep an arm’s you are excellence intended length between frustrated purpose yourself and  Follow others directions Transition Time  Work as a  Follow the  Move quietly  Stay with the cooperative person in front to your group group of you destination  Follow  Be a positive  Keep an arm’s directions peer leader length between yourself and others Structured  Actively  Treat equipment  Display  Stay with staff Activity participate with care positive  Take space if  Strive for  Clean up area sportsmanship you are excellence and put  Keep an arm’s frustrated equipment away length between  Play safely yourself and others  Include others Library  Work together to  Return items in  Use a quiet  Use materials find materials a timely fashion voice tone for their  Care for intended materials purposes Teicher  Wash your hands  Stack your tray  Practice  Stay with your  Eat a well  Clean and wipe positive table group balanced diet your area manners  Turn in  Push in your  Say please and utensils chair thank you Bathrooms  Wait your turn  Throw trash in  Use the toilet  Wash your the trash can and sink for the hands  Turn off the intended  Have staff sink and lights purpose check the  Flush the toilet bathroom before and after use Medication Time  Take your meds  Complete a  Wait your turn  Stay in mouth check  Be kind designated areas during med time  Devereux Colorado 4 
  6. 6. Prosocial Support SystemDevereux Colorado trains its staff to establish and maintain a safe and warm therapeuticenvironment. Our treatment process works to encourage positive social behavior. This isachieved by increasing positive behavior, decreasing negative behavior and teaching newbehavior. Staff responds to behavior by using positive feedback and predictable consequences.When providing feedback, the staff focuses on reinforcing positive behavior. Forms of positivefeedback include: Verbal Praise: It is crucial to notice and acknowledge when students are doing well. Staff is trained to acknowledge and praise positive feedback when a student is successful. This motivates the student to do well more often and in turn, decreases problematic behavior. Making “time-in” matter: It is very important to create an environment where students are motivated and excited about their treatment. This includes providing activities that are therapeutic and fun, encouragement to maintain appropriate and meaningful relationships with others and feeling respected and supported by staff members. Earning points through the level system: Points earned through Devereux Colorado’s level system, students have opportunities to earn additional privileges and advance levels. Positive behaviors are reinforced and students are awarded for participation in treatment.Additionally, staff utilizes predictable consequences to decrease the likelihood that negativebehaviors will be repeated. Forms of consequence include:  Reduction in privileges  Restrictions from preferred activities  Suspension of levels  Loss of earned pointsIf a student’s behavior is escalating and/or out of control, Behavior Management Strategies areused which may include one or more of the following: Verbal Warning/Prompt: If a student says or does something considered to be inappropriate, they will be “prompted” on the unacceptable behavior and given suggestions on alternative behaviors. Time Out: Students are shown how to use time out to regain personal control and eliminate reinforcement for disruptive behavior. If a student cannot use time out appropriately, continues the negative behavior or escalates, he/she will be asked to remove himself/herself from the situation to a designated space determined by staff. This is done to reduce environmental stimulation and provides the student with a safe place to regain control. Time out may be taken by sitting away from the group, being in their room or by being in a Quiet Room, depending on the severity of the student’s behavior. The door is not locked during a quiet room session. Quiet Room: A quiet room is a designated room free of personal belongings or materials. It is typically used following a time out or when a student becomes dangerous to him/herself. Physical Restraint: Physical management is a trained procedure for containing the behavior of a student who is physically out of control or who poses a danger to themselves or others. This is to be used as a last resort when verbal and less restrictive interventions have been proven unsuccessful and the student is presenting a danger to themselves or others. This procedure is done by extensively trained staff as well as routinely reviewed by licensing agencies.  Devereux Colorado 5 
  7. 7. Medication Policy for Day Treatment Students1. Will I be informed if my child is put on a new medication?The need for medication is assessed carefully by the Devereux Colorado psychiatrist.Medications are prescribed only after careful evaluation and only after a parent/guardian hasbeen consulted and has given written permission. Should your child need medication, thepsychiatrist will discuss with you the medication in detail and answer any questions you mighthave. Medication handouts are also given to parents. Psychiatrists closely monitor how themedication and specific dosage are affecting the child and if any changes are needed, they willconsult the parent/guardian for their consent before any adjustments are made.2. How do I get my prescriptions filled?Call your pharmacy directly. Your pharmacy will contact our nursing department. If you arehaving difficulties getting a prescription filled, please call residential nursing at: (303) 438-2206.3. What if my child is taking a medication that is given during school hours?If your child is being cared for by one of the psychiatrists at Devereux Colorado, the medicationgiven on Devereux Colorado premises will have a separate written prescription than those youwill give at home. Please bring the medication to the Devereux Colorado nursingdepartment in the bottle it was dispensed in. We can no longer accept medication unless itis in the original prescription bottle.If your child is being seen by a psychiatrist outside the Devereux Colorado facility, themedications that are given during school hours should be brought into the nursing department ina bottle labeled correctly by the pharmacy with the student’s name, the pharmacy name,medication name, the date the medication was issued and the expiration date. The nursingdepartment cannot accept medications in unlabeled containers, incorrectly labeledcontainers or containers of which the label has expired.4. What if my child needs blood drawn?A prescription needs to be written by your doctor or psychiatrist. We may provide theprescription but we DO NOT draw blood on the Devereux Colorado campus. This has to bedone by an outside office. The results need to be faxed to the nursing department at (303)438-2442 or a copy may be brought directly to the nursing department.Reminders:Please call your Pharmacy 7-10 days in advance when supply is low.For medication distributed during school hours, nursing will contact you when the medicationsupply is low and needs to be re-filled. You then contact the pharmacy and the new medication(with bottle) needs to be brought to Devereux Colorado and given to the nursing department.Students are not permitted to bring their own medication to school. All medications are tobe dispensed ONLY through the nursing department.We do not accept medications that parents/guardians “hand off” to transportationproviders to bring to Devereux Colorado’s nursing department.  Devereux Colorado 6 
  8. 8. The Academic ProgramEducation staff work as members of the treatment team and support each student’s treatmentplan. The program provides individualized education for students from elementary through highschool and is in session daily. Classes are taught by certified teachers and paraprofessionals. Insmall classes (approximately 12 students each), instruction is tailored to each student’s academicskills and strengths.During the school day, students receive whole class, small group and individualized instruction.Please contact your child’s teacher if you have any questions regarding your child’s educationalprogram.Educational screening is done for each student and an Education Plan is completed for studentswho do not qualify for special education services. An Individualized Education Plan (IEP) iscompleted within 30 days of admission for students receiving special education services.Educational testing is conducted as needed.Within 72 hours of discharge, students receive a report card, which summarizes theirparticipation in the school program. An educational liaison is also available to help with thetransition when your child returns to public school. Please contact the educational liaison,clinician or teacher if you need this assistance.  Devereux Colorado 7 
  9. 9. 2012-2013 School Year CalendarTerm #1: August 14, 2012 – October 19, 2012August August 14: First Term begins First Day of school for day treatment students in Gilpin School District August 17: Report cards due from Summer Term August 20: First Day of School for day treatment students in the following school districts: Adams 12, Jeffco, Clear Creek, and PlatteSeptember September 3: No school - Labor DayOctober October 22 : No School – Teacher professional Day October 23 :Term 2 beginsTerm #2: October 23, 2012 – January 4, 2012November November 2: Report cards due from Term November 29 and 30: No school - Thanksgiving BreakDecember December 24 and 25: No School – Christmas December 28: Term 2 ends December 31: No school- New Years EveTerm #3: January 2, 2013 - March 15, 2013January January 1 : No School- New Years Day January 7: No School – Teacher Professional Day January 11: Report cards due from Term 2FebruarySchool Calendar Continued on Next Page  Devereux Colorado 8 
  10. 10. Term #4: March 19, 2013 – May 24, 2013March March 18: Monday No School - Teacher Professional Day March 22: Report Cards Due March 20: Term #4 beginsAprilMay May 27: No School - Memorial DaySummer Term #5: May 28, 2013 – August 16, 2013June June 3: No School - Teacher professional Day June 7: Report Cards Due from Term 4July July 4: No School – 4th of JulyAugust August 16: Summer Term #5 ends August 19: No School - Teacher Professional Day August 23: Report cards due from Summer Term  Devereux Colorado 9 
  11. 11. Campus RulesThe following rules are intended to provide standards forevery student to follow. There should never be a deviationby any student, even if they are on a higher level.Dress Code:The following items are not permitted to be worn: tank tops, spaghetti straps, half shirts, anyclothing showing excessive body exposure, hats, bandanas, caps, inappropriate logos, accessorieswith writing or pictures that demean others in any way or depicts illegal or illicit themes such asdrugs, alcohol, violence, or sexual references, and clothing or jewelry that could be dangerous tothe wearer or others such as spiked items or certain body piercings (tongue, lip, nose or anyfacial piercings). Up to 2 earrings are permitted in each ear ONLY. Shorts and skirts must belonger than the student’s arm length. Students must have proper footwear.Examples of how students should demonstrate C.A.R.E.:  RESPECT – we expect you, as well as your peers and the staff, to respect others. This includes respecting others privacy, personal boundaries, property and treatment issues.  Follow staff directions.  Only one person in the bathroom at a time.  Use appropriate language.  Chairs and tables are only to be used for their intended purposes.  Gum and sunflower seeds are to remain off campus.  Running and gymnastics are only permitted in an outdoor setting.  Unless used to label your own property with your initials, writing utensils should only be used on paper and for school related purposes.  Refrain from passing notes.  Avoid lending, borrowing, trading or gift giving.  Personal information such as phone numbers, email addresses, or mailing addresses should be kept privately to yourself.  Abstain from gang-related writing, drawing, talking, signs or glorifying.  Abstain from drug-related writing, drawing, talking or glorifying outside of prescription drug education or related therapy groups.  Food, drink and hygiene products are to remain outside of the classroom unless given staff permission.  Avoid communication with peers in “time-out” or at a desk working on “treatment refocus.”  Electronic equipment such as iPods, Gameboys, radios, CD players, small televisions, cell phones and beepers are to be checked upon arrival.  In the event that a student commits a crime, law enforcement may be contacted.  Devereux Colorado 10 
  12. 12. TransportationWe do not provide transportation for our Day Treatment students. It is your responsibility toarrange transportation plans, which is usually done at intake with your school district. If yourchild is unable to attend for some reason, you must notify their transportation and classroomby 10 a.m. Generally speaking, Day Treatment students are not permitted to use their own formof independent transportation (cars, any type of motorized vehicle, bikes, and etc.)If there is a safety issue and your child is suspended from or not allowed to take the districttransportation arranged, for any reason, you will be responsible for dropping/picking them up.District Phone Numbers:Adams 12: 720-972-4300Boulder: (303) 447-5125Clear Creek: (303) 597-3865Gilpin: (720) 562-3155Jefferson County: (303) 982-2324Logistic Care: 1(800) 284-5150Platte: (303) 838-7666 ext. 1270St. Vrain: (303) 682-7228Discharge PlanningDischarge planning starts the first day a student arrives on campus. You will be working closelywith the entire treatment team to determine what services are available in your community soyour child will be successful upon discharge. Support in the community has shown to be asignificant factor in a student’s continuing success once leaving our program. An outpatientpsychiatrist and therapist to your liking can be difficult to find, and often psychiatrist’s schedulesare full up to three months for new students. Please plan ahead of time so your child may startthe relationship with a new psychiatrist and a new therapist before discharge. Also, pleaseremember to address what type of support you as a parent may need. When students leave ourprogram, it is one of the most vulnerable parts of the treatment process. Transition meetingsshould be held with the student, parent, school district (including the school where the studentmay be attending), Devereux Colorado staff and all other outside agencies well before a studentis discharged.If a Day Treatment Student Makes a Suicidal CommentWhen a student makes a suicidal comment, a Suicide Assessment will be completed by a trainedDevereux Colorado professional. Regardless of the outcome of the Suicide Assessment, thestudent cannot go home until family/guardian has been contacted to inform them of the ideationor gesture. To ensure a safe transition home, a responsible family member must be at home toreceive the student. If a responsible family member is unavailable to receive the student, thestudent will remain at Devereux Colorado until arrangements can be made. Please remember, ifclinically indicated, you may be required by Devereux Colorado to come to campus to pick upyour child and to meet with their primary clinician.Students cannot leave campus or go home without a cleared Suicide Assessment.  Devereux Colorado 11 
  13. 13. Questions and Answers1. What is a “treatment team?”The treatment team is a group of mental health professionals who work together with the studentand the family to assess and evaluate the student, set treatment plan goals and provide treatment.Every member of the treatment team brings their perspective and specialized skills to develop anindividual treatment plan for each student. The team usually includes the following people: Parents: You are a pivotal member of the treatment team. You will be ask to participate in all treatment related decisions and your opinions are very valuable. No one knows your child as well as you do. Clinician: Your child will be assigned a clinician who will be your child’s primary therapist and will work with the psychiatrist to lead the treatment team. The therapist is a Master’s level clinician or a psychologist and will be one of your family’s main contacts with Devereux Colorado. Case Coordinator: The case coordinator coordinates discharge planning and acts as a liaison between family and community resources. The Case Coordinator is responsible for the management of and is involved in all areas of the child’s treatment. Psychiatrist: A specially trained Medical Doctor, the psychiatrist will have overall responsibility for the psychiatric management of your child’s treatment. Nursing Staff: Consists of a Nurse Manager, registered nurses, medical technicians and a medication coordinator. This group of professionals attends to your child’s medical needs in coordination with both the psychiatrists and the pediatrician. Pediatrician: A Medical Doctor who is specially trained to treat the medical needs of students to age 21. Mental Health Worker/Paraprofessional: Team members who are responsible for providing a safe and therapeutic milieu in accordance with the student’s treatment plans. They may also assist the teacher in the classroom throughout the day. Teaching Staff: Under the supervision of the Principal, the teaching staff consists of an educational liaison, certified teachers and paraprofessionals. School District: The school district representative helps guide the treatment while in Day Treatment, and is also a pivotal member of the team for a successful transition plan.2. Can we use our own psychiatrist or are we required to utilize Devereux Colorado’s?We understand that finding a psychiatrist is a difficult task and if you already have a psychiatristthat you and your child prefer, please continue utilizing their services. During the intake process,you will work with your intake clinician to determine whether or not you wish to use DevereuxColorado’s psychiatrist.  Devereux Colorado 12 
  14. 14. 3. How can the family help? Support your child’s treatment. Many students are fearful of treatment and may deny that theyneed it. Your support and encouragement can be very helpful in overcoming your child’s fear. Inaddition, you can help by becoming familiar with your child’s treatment needs and by learningthe warning signs, which may indicate problems in the future. Lastly, ensure that your child takesmedication according to the schedule provided by your doctor.4. How often do I meet with the Treatment Team?You will be invited to meet with the Treatment Team once per month at the Treatment PlanReview (TPR). Your case coordinator, clinician, psychiatrist and teachers/paraprofessionals willbe present at that time and all questions about treatment and educational progress can beaddressed at that time. However, if there are urgent matters you wish to discuss before or afterthe TPR, arrangements may be made by contacting the treatment team member directly.Individual therapy takes place with your child and the clinician weekly. Family therapy occurson an as needed basis and will be arranged with your primary clinician.5. When I have a question, whom should I call?We want you to know as much as possible about Devereux Colorado and the care we provide.For general inquiries about the program, you can call our front office and they will connect youto the person who can best answer your question. If it is a specific question relating to your childand their treatment program, we recommend that you directly contact their case coordinator,clinician, psychiatrist or teacher. We encourage you to learn about our programs and your child’sprogress.6. Who do I call when my child will be missing school?Please notify your child’s homeroom teacher when your child is out sick, leaving early orarriving late to school, no later than 10 a.m. You are also responsible for notifying the Districttransportation if they no longer need a ride to/from school.7. What can my child bring to school?We realize that some students have long bus rides and need various forms of entertainment.Therefore, students are permitted to bring items such as cell phones, personal music players(iPods, CD players, etc.) and personal gaming systems (Nintendo DS, Gameboy, etc.) to schoolbut they will be checked in upon arrival. No student is permitted to have money with them unlessneeded for transportation. School materials such as books, writing utensils, notebooks, paper, etc.will be provided by Devereux Colorado. All checked items will be placed in a locked roomthroughout the duration of the school day. Devereux Colorado will not be held responsible forany lost, stolen or damaged items.8. Where does my child get dropped off/picked up at school?If you are dropping off or picking up your child at school, please do so at the East end of schoolat the loading zone. If you need to drop off your child late or pick them up early, please stop bythe front entrance and notify administration.  Devereux Colorado 13 
  15. 15. 9. Is Devereux Colorado a year–round program?Yes. However, in order to attend our program throughout the summer term, your child must beapproved by the school district for extended school year services through the IEP process.  Devereux Colorado 14 
  16. 16. Contact InformationDevereux Cleo Wallace8405 Church Ranch Blvd.Westminster, CO 80021(303) 466-7391(800) 456-CLEOFax (303) 466-0904Nursing: (303) 438-2206Intake: (303) 438-2208Campus Support: (720) 272-6835Teacher____________________________________________________________________ Name Phone # EmailCase ______________________________________________________________________Coordinator Name Phone # EmailClinician___________________________________________________________________ Name Phone # EmailPsychiatrist________________________________________________________________ Name Phone # Email  Devereux Colorado 15