3. Treatment Process Youth is referred to services either by a mental health organization (Washington, Clackamas, Multnomah, FamilyCare) or Emergency Department Common risk factors include: Aggression / assaultive Self-harm / depression Lack of age appropriate boundaries Difficulty with peers / siblings Impulsivity History of residential living
4. Treatment Process Continued… Qualified Mental Health Professional assesses youth / family Current risks Developmental stages Family history/trauma Family dynamics Diagnosis Treatment plan Developed with youth, family, significant others Goal oriented, with concrete steps to obtain goal
16. Face-to face activities related to resource assistance i.e. locating places for youth to volunteer, assisting youth obtain food handlers’ card for employment, food boxes for the family, YES Non face-to-face activities i.e. picking up supplies for home repair, picking up prescription, dropping off clothes to respite home NO Case Management
17. Face-to-face session to youth/family monitoring behavior, mentoring, introducing/encouraging age appropriate recreational activities YES Respite Care Used also by non-QMHA’s
18. Face-to-face sessions focusing on skills training, mentoring, promotion of successful community living, monitoring behavior, educational support YES NO Sessions conducted at the CCS office Wraparound Multnomah County Only
19. Response to unplanned intervention when youth is threatening harm to self/others or their mental health/emotional functioning is limited. YES NO Use by non-QMHA’s Crisis Intervention FamilyCare & Multnomah County Only
20. Identify how the activity relates to the treatment plan. List the skill(s) you worked on. How did you work on the skill versus where did you work on the skill? Was the youth able to perform the skill? How do you know this? Youth’s Response to session. Steps in WritingProgress Notes
21. Identify Before your shift, get in touch with the clinician and specifically ask, Check the box that corresponds to the treatment issue you worked on the most throughout the session How does the activity relate to the treatment plan? 1 “What is the therapeutic intent of the session?”
23. How What did you do to work on the skill NOT where did you go to work on the skill. Conversation related to…. Role-played, Prompted, coached Provided clarification Challenged narrow thinking about an issue Formal problem solving around the event Empathetic/supportive environment on your part Normalization of feelings/situations Reminded youth of breathing and visualization exercises Engaged in outdoor activity / physical activity/ peer related activity How did you work on the skill(s)? 3 Use your Cheat Sheet!
24. Demonstrate 4 How did the youth demonstrate/fail to demonstrate the skill(s)? Youth was able to ________________ by identify skill/demonstrate skill ________________________________. Your observations? Youth’s action/words? Any prompting?
25. Demonstrate 4 Example Youth was able to remain calminstead ofgetting angrybycounting to 10, taking deepbreaths and then talking about the trigger of his anger.
26. Youth’s Response Include: Your observations about the client’s physical or emotional state related to session. Always use terms such as “seemed,” “appeared,” and “gave the impression.” How did youth appear to feel about the session? 5 Exclude anecdotal information: Youth was happy to see me Youth waved goodbye to me It was a good session. Youth said, “I like hanging out with you!”
27. Youth’s Response “Youth appeared withdrawn for most of session and agreed to talk with therapist about her feelings of sadness” Examples
28. Youth’s Response “Youth appeared withdrawn for most of session and agreed to talk with therapist about her feelings of sadness” Examples “After working through his frustration, the youth gave the impression that he could use his anger management skills in other situations.” “Youth appeared defensive at first, but warmed up after finding common interests.”
31. Step 1 Youth: __________________ Staff: ____________________ Service Date: ______________________ 1 Zach Galifianakis John Doe 10/7/2010 10:00 am 120 OT ALWAYS in Minutes Codes: *Found on the bottom of the D.S.S. HM = Home RH = Relative Home OF = Office FH = Foster Home SCH = School OT = Community DO = DHS ER = Emergency Room GH = Group Home HS = Homeless Shelter IP = Inpatient Psychiatric Facility JV = Juvenile Court JD = Juvenile Detentional Facility RT = Psychiatric Residential Facility
32. Step 2 2 Or “This Writer and ZachGalifianakis” Only check ONE box Those Present: _______________________________________ John Doe & Z.G. Develop effective problem solving skills Identifying & Verbalizing Feelings Positive coping & self-control skills Model/Teach appropriate social interactions skills Crisis Only: Provide supervision for safety Support academic/vocational improvement Asses environment for risk and/or modify to promote a safe environment Aid youth/family in accessing/maintaining community resources [food, housing, utilities] Family support to increase/educate parenting techniques, boundaries, Structure in home
33. Step 3 3 How did you work on the skill(s)? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ How did the youth demonstrate/fail to demonstrate the skill(s)? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 10/08/2010 ________________________________ ___________________________ Signature with educational credentials Date
