Meghan Franklin, MSW<br />Catholic Community Services<br />Family Preservation Systems<br />Bridging the Gap<br />Between ...
Overview<br />Treatment Process<br />CSS in the treatment process<br />Progress Notes<br />
Treatment Process<br />Youth is referred to services either by a mental health organization (Washington, Clackamas, Multno...
Treatment Process Continued…<br />Qualified Mental Health Professional assesses youth / family<br />Current risks<br />Dev...
Where do CSS’s fit into this process?<br />Your role is to carry out the steps to the treatment plan<br />What does that l...
Teach / Model / Mentor / Coach
Social skills
Age appropriate behavior
Focus on strengths, successes, needs & creative solutions
Connect youth/family to community activities/resources
Focus on successes experienced during activity/session; relay to family & clinician</li></li></ul><li>Services CSS Provide...
<ul><li>Face-to-face sessions with the        </li></ul> Youth and/or Family Members<br /><ul><li>Developing self-care/lif...
Educational support</li></ul>YES<br /><ul><li>Babysitting siblings
Medical appointments
Transportation UNLESS you can clearly document you are working on a skill.</li></ul>NO<br />Activity Therapy<br />
Face-to face activities related to resource assistance<br />	i.e. locating places for youth to volunteer, assisting youth ...
Face-to-face session to youth/family monitoring behavior, mentoring, introducing/encouraging age appropriate recreational ...
Face-to-face sessions focusing on skills training, mentoring, promotion of successful community living, monitoring behavio...
Response to unplanned intervention when youth is threatening harm to self/others or their mental health/emotional function...
Identify how the activity relates to the treatment plan.<br />List the skill(s) you worked on.<br />How did you work on th...
Identify<br />Before your shift, get in touch with the clinician and specifically ask, <br />Check the box that correspond...
List<br />What skill(s) did you work on? Be specific!<br />2<br />
How<br />What did you do to work on the skill NOT where did you go to work on the skill.<br />Conversation related to….<br...
Demonstrate<br />4<br />How did the youth demonstrate/fail to demonstrate the skill(s)?<br />Youth was able to ___________...
Demonstrate<br />4<br />Example<br />Youth was able to remain calminstead ofgetting angrybycounting to 10, taking deepbrea...
Youth’s Response<br />Include:<br />Your observations about the client’s physical or emotional state related to session.<b...
Youth’s Response<br />“Youth appeared withdrawn for most of session and agreed to talk with therapist about her feelings o...
Youth’s Response<br />“Youth appeared withdrawn for most of session and agreed to talk with therapist about her feelings o...
Odds & Ends<br />Sign your name with your credentials<br />If you make a mistake<br />Draw a single line through the mista...
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  1. 1. Meghan Franklin, MSW<br />Catholic Community Services<br />Family Preservation Systems<br />Bridging the Gap<br />Between Field and Charting<br />
  2. 2. Overview<br />Treatment Process<br />CSS in the treatment process<br />Progress Notes<br />
  3. 3. Treatment Process<br />Youth is referred to services either by a mental health organization (Washington, Clackamas, Multnomah, FamilyCare) or Emergency Department<br />Common risk factors include:<br />Aggression / assaultive <br />Self-harm / depression<br />Lack of age appropriate boundaries<br />Difficulty with peers / siblings<br />Impulsivity<br />History of residential living<br />
  4. 4. Treatment Process Continued…<br />Qualified Mental Health Professional assesses youth / family<br />Current risks<br />Developmental stages<br />Family history/trauma<br />Family dynamics<br />Diagnosis<br />Treatment plan<br />Developed with youth, family, significant others<br />Goal oriented, with concrete steps to obtain goal<br />
  5. 5. Where do CSS’s fit into this process?<br />Your role is to carry out the steps to the treatment plan<br />What does that look like?<br /><ul><li>Establish trust and understanding with youth & family
  6. 6. Teach / Model / Mentor / Coach
  7. 7. Social skills
  8. 8. Age appropriate behavior
  9. 9. Focus on strengths, successes, needs & creative solutions
  10. 10. Connect youth/family to community activities/resources
  11. 11. Focus on successes experienced during activity/session; relay to family & clinician</li></li></ul><li>Services CSS Provides<br />Activity Therapy <br />Individual Skills Training<br />Case Management<br />Respite Care<br />Wraparound<br />Crisis Intervention<br />
  12. 12. <ul><li>Face-to-face sessions with the </li></ul> Youth and/or Family Members<br /><ul><li>Developing self-care/life skills
  13. 13. Educational support</li></ul>YES<br /><ul><li>Babysitting siblings
  14. 14. Medical appointments
  15. 15. Transportation UNLESS you can clearly document you are working on a skill.</li></ul>NO<br />Activity Therapy<br />
  16. 16. Face-to face activities related to resource assistance<br /> i.e. locating places for youth to volunteer, assisting youth obtain food handlers’ card for employment, food boxes for the family, <br />YES<br />Non face-to-face activities<br /> i.e. picking up supplies for home repair, picking up prescription, dropping off clothes to respite home<br />NO<br />Case Management<br />
  17. 17. Face-to-face session to youth/family monitoring behavior, mentoring, introducing/encouraging age appropriate recreational activities <br />YES<br />Respite Care<br />Used also by non-QMHA’s<br />
  18. 18. Face-to-face sessions focusing on skills training, mentoring, promotion of successful community living, monitoring behavior, educational support<br />YES<br />NO<br />Sessions conducted at the CCS office<br />Wraparound<br />Multnomah County Only<br />
  19. 19. Response to unplanned intervention when youth is threatening harm to self/others or their mental health/emotional functioning is limited.<br />YES<br />NO<br />Use by non-QMHA’s<br />Crisis Intervention<br />FamilyCare & Multnomah County Only<br />
  20. 20. Identify how the activity relates to the treatment plan.<br />List the skill(s) you worked on.<br />How did you work on the skill versus where did you work on the skill?<br />Was the youth able to perform the skill? How do you know this?<br />Youth’s Response to session.<br />Steps in WritingProgress Notes<br />
  21. 21. Identify<br />Before your shift, get in touch with the clinician and specifically ask, <br />Check the box that corresponds to the treatment issue you worked on the most throughout the session<br />How does the activity relate to the treatment plan?<br />1<br />“What is the therapeutic intent of the session?”<br />
  22. 22. List<br />What skill(s) did you work on? Be specific!<br />2<br />
  23. 23. How<br />What did you do to work on the skill NOT where did you go to work on the skill.<br />Conversation related to….<br />Role-played, Prompted, coached<br />Provided clarification<br />Challenged narrow thinking about an issue <br />Formal problem solving around the event<br />Empathetic/supportive environment on your part <br />Normalization of feelings/situations<br />Reminded youth of breathing and visualization exercises<br />Engaged in outdoor activity / physical activity/ peer related activity <br />How did you work on the skill(s)?<br />3<br />Use your Cheat Sheet!<br />
  24. 24. Demonstrate<br />4<br />How did the youth demonstrate/fail to demonstrate the skill(s)?<br />Youth was able to ________________ by <br />identify skill/demonstrate skill <br /> ________________________________.<br /> Your observations? Youth’s action/words? Any prompting?<br />
  25. 25. Demonstrate<br />4<br />Example<br />Youth was able to remain calminstead ofgetting angrybycounting to 10, taking deepbreaths and then talking about the trigger of his anger. <br />
  26. 26. Youth’s Response<br />Include:<br />Your observations about the client’s physical or emotional state related to session.<br />Always use terms such as “seemed,” “appeared,” and “gave the impression.”<br />How did youth appear to feel about the session? <br />5<br />Exclude anecdotal information:<br />Youth was happy to see me<br />Youth waved goodbye to me<br />It was a good session.<br />Youth said, “I like hanging out with you!”<br />
  27. 27. Youth’s Response<br />“Youth appeared withdrawn for most of session and agreed to talk with therapist about her feelings of sadness”<br />Examples<br />
  28. 28. Youth’s Response<br />“Youth appeared withdrawn for most of session and agreed to talk with therapist about her feelings of sadness”<br />Examples<br />“After working through his frustration, the youth gave the impression that he could use his anger management skills in other situations.”<br />“Youth appeared defensive at first, but warmed up after finding common interests.”<br />
  29. 29. Odds & Ends<br />Sign your name with your credentials<br />If you make a mistake<br />Draw a single line through the mistake<br />Initial it<br />Mistake must be visible, do not scratch/black it out<br />The little things…<br />February<br />January 25, 2010<br /><ul><li> If shifts are more than 2.5 hours in length put them in Desiree’s Box</li></ul>(This does not apply to BRS DSS’s)<br />
  30. 30. Practice D.S.S.’s<br />In Steps One, Two, and Three<br />
  31. 31. Step 1<br />Youth: __________________ Staff: ____________________<br />Service Date: ______________________<br />1<br />Zach Galifianakis<br />John Doe<br />10/7/2010<br />10:00 am<br />120<br />OT<br />ALWAYS in Minutes<br />Codes: *Found on the bottom of the D.S.S.<br />HM = Home RH = Relative Home OF = Office<br />FH = Foster Home SCH = School OT = Community<br />DO = DHS ER = Emergency Room GH = Group Home<br />HS = Homeless Shelter IP = Inpatient Psychiatric Facility<br />JV = Juvenile Court JD = Juvenile Detentional Facility<br />RT = Psychiatric Residential Facility<br />
  32. 32. Step 2<br />2<br />Or “This Writer and<br />ZachGalifianakis” <br />Only check ONE<br />box<br />Those Present: _______________________________________<br />John Doe & Z.G.<br />Develop effective problem solving skills<br />Identifying & Verbalizing Feelings<br />Positive coping & self-control skills<br />Model/Teach appropriate social interactions skills<br />Crisis Only: Provide supervision for safety<br />Support academic/vocational improvement<br />Asses environment for risk and/or modify to promote a safe environment<br />Aid youth/family in accessing/maintaining community resources<br />[food, housing, utilities]<br />Family support to increase/educate parenting techniques, boundaries,<br />Structure in home<br />
  33. 33. Step 3<br />3<br />How did you work on the skill(s)?<br />________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________<br />How did the youth demonstrate/fail to demonstrate the skill(s)?<br />________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________<br />10/08/2010<br />________________________________ ___________________________<br />Signature with educational credentials<br />Date<br />
  34. 34. Timesheet & Log<br />
  35. 35. CSS All Time Log<br />10/10/10 - 10/23/10<br />CSS Name:______________________ Pay Period:____________________ <br />John Doe<br />DIRECT<br />TRAVEL<br />INDIRECT<br />
  36. 36. Timesheet<br />John Doe<br /># ON PAYCHECK<br />10/10/10 - 10/23/10<br />Numbers will self-total in Excel spreadsheet DOUBLE CHECK<br />10/07/10<br />1.0<br />PDX<br />0.50<br />2.0<br />ZD<br />25<br />
  37. 37. “Thank You”<br />

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