These are the Regs
The state department that oversees residential and educational programs in Massachusetts
What is the Department of Early Education and Care? (EEC)
__________ are essentially goals broken into smaller measurable, quantifiable pieces. In order to be effective, they should be SMART - Specific, Measurable, Achievable, Relevant, and Time-bound.
What is a treatment plan objective?
This component of a treatment plan details the types of therapies, modalities, and education that will be employed to help clients reach their goals.
Think of ______ as, “What are WE going to do to help achieve your objectives and goals?”
What are interventions?
Intake, 7 days, 30 days, 90 days, 180 days, etc.
When are treatment plans completed?
This is the model of trauma-informed care that Key uses to inform all parts of our services and programs.
What is Risking Connection?
The document that Key and DCF developed that describes, in detail, our program structures, staffing, obligations, treatment types and models.
What is the contract?
These are TWO of the many reasons that all residential clients have the following goal on their treatment plans:
"To engage in appropriate recreational activities on a regular basis"
DAILY DOUBLE for 400 if you can name FOUR reasons.
1. Many/ most youth were NOT engaging in appropriate/ adaptive recreational activities in the community prior to placement.
2. Developing minds are built to learn through play -social skills, frustration tolerance, delayed gratification, and physical/ practical skills like hand-eye coordination and body awareness.
3. Fun activities promote Connection and Hope and so are important parts of trauma recovery.
4. Recreational activities can promote physical health and give opportunities to build confidence and competence in their areas of interest.
5. Recs and fun activities give youth opportunities to have "normal kid" experiences.
1) Ensure that all necessary routine and acute medical/ dental/ other healthcare appointments are scheduled as needed
2) Provide opportunities for healthy physical activity
3) Provide information and coaching about any prescribed medications, relevant diagnoses, and other health-related symptom management to promote informed healthcare decision-making
What are some of the most common RCW treatment interventions to promote clients' HEALTH goal?
The roles at Key that are actively involved in client treatment plan implementation
What are all Key staff that interact with clients?
RCWs, supervisors, overnights, shift workers, occupational therapist, clinicians, interns, directors, etc.
Staff who are effective in working with youth who have experienced trauma will respond to acting-out behavior by doing these things. (Name three)
-Focusing on helping the youth calm down
-Exploring the problem using active listening rather than focusing on the strict following of rules or issuing consequences
-Empathizing with/ validating the youth's feelings and needs, which does not require validating their decisions
-Asking for/ accepting help from teammates when getting upset or stuck in managing the behavior
This is not a complete list - see RC handout "Indicators of Trauma-Informed Staff Behavior"
These six or seven categories comprise the required EEC treatment domains
What are Health, Behavior, Social Services, Education, Family, Life Skills AND Vocational (youth over age 14)?
NAME will independently complete all activities of daily living (ADLs) each day (7/7 days per week), including hygiene routines and maintaining a clean living environment.
What is the OBJECTIVE for life skills development on youth treatment plans?
The treatment goals that staff are promoting when they let youth help cook lunch or dinner for the program.
Life Skills: To strengthen self-care and daily living skills
Vocational: To develop skills to live independently in the community
Social Services: To engage in appropriate recreational activities on a regular basis
Effective treatment plan objectives are SMART - Specific, Measurable, Achievable, Relevant, and Time-bound. The projected target date of treatment objectives is ___ ____. After this period of time passes, the clinician evaluates progress on all goals and develops a new, updated treatment plan.
What is 90 days?
When interacting with someone who has experienced trauma (whether it be a client, family member, or colleague), we want to strive to develop relationships that demonstrate/ promote these four qualities, sometimes abbreviated using the acronym RICH.
DAILY DOUBLE for 600 if you can explain WHY each of these elements is so important for the youth we serve.
What are Respect, Information, Connection, and Hope?
DAILY DOUBLE:
Respect - the foundation of any positive relationship and most kids haven't had adults consistently model respectful communication in a reciprocal - only demanding it from them.
Information - Providing accurate information reduces confusion in a complex system, promotes trust, allows for informed decision-making, and avoids power struggles.
Connection - these youth are displaced from family, have had many disrupted relationships, and have often had abandonment trauma. It's important for them to experience care from others in order to care for themselves.
Hope - these youth are often in one of the hardest parts of their lives when we start working with them. Why make difficult changes if there is no hope for a better future?
What is the Medicaid Rehabilitative Services Option (aka Rehab Option)?
"NAME will display proportionate responses to daily stressors and utilize learned skills to maintain safe and adaptive behavior in 4 out of 5 instances of distress."
What is the OBJECTIVE for the emotional/ behavioral goal on youth treatment plans?
These are the most important sources of information for clinicians when they conduct assessments and engage in treatment planning and progress evaluation. (Name any THREE)
DAILY DOUBLE for 800 if you can name all SIX
1. Staff verbal and written report of functioning, patterns, and behavior
2. Client's self-report/ description
3. Clinical observation and assessment in session
4. DCF verbal and written reports like the referral, family assessment, and service plan
5. Family/ caregiver report
6. Collateral contact (verbal or written reports) like school counselors, mentors, past therapists, IEP/ 504 plans, past psychological testing reports, etc.
Key's clients typically have skill gaps in most if not all of the following areas, which is why our treatment modality is DBT. (Fill in the blanks in order)
________ _________: communication/ social skills,
___________: paying attention to and responding only to what's happening in the present,
______ _________: managing upsetting situations without making it worse/ engaging in unsafe or illegal behavior, and
_________ __________ : correctly identifying, predicting, and managing their feelings so that they have more proportionate responses to the normal ups and downs of life.
What are Interpersonal Effectiveness, Mindfulness, Distress Tolerance, and Emotional Regulation?
A youth has a history of running away from programs and school. There is suspicion of CSEC involvement because they always return with new belongings that they didn't have before. This time, when they ran away from school, they came back to the program relatively quickly, only a few hours later. A trauma-informed response to the youth's return should include these components.
Hint: This is asking about your response to the youth NOT policies/ procedures for MOA clients.
DAILY DOUBLE for 800 if you can also give TWO potential responses that would NOT be trauma-informed.
1) Welcoming the youth back - "I'm so glad you came back today! We were worried about you!"
2) Meeting their basic needs - "What do you need? Are you hungry? Do you want to take a shower?"
3) Reinforcing their return, NOT focusing on punishing the run - "It's great that you came back so quickly this time. What went into that decision for you?"
4) Prevention plan for next time - "What could someone have done to help you make the choice not to run away at all today? What can we do to help you next time?"
DAILY DOUBLE: Asking a ton of questions, immediately implementing restrictions/ consequences, blaming/shaming/lecturing them, commenting on the inconvenience that the incident caused others (incident reports, medical clearance process, etc)
Examples of clinical documentation that are contractually required and important to EEC reviewers but NOT Rehab Options reviewers
(Name TWO!)
Youth Readiness Assessment Tool (YRAT)
Interim Treatment Plan (paper form at intake)
Safety plans
Child and Adolescent Needs and Strengths (CANS)
Biweekly Treatment Plan Reviews - ER only
These are TWO of the most common goals on residential treatment plans
DAILY DOUBLE for 1000 if you can correctly name FOUR of the eight most common goals.
-To strengthen self-care and daily living skills
-To engage in appropriate recreational activities on a regular basis
-To achieve his/her educational goals
-To maintain optimal physical/ medical/ dental health
-To strengthen family communication skills and relationships
-To better manage the emotions that lead to problems
-To develop skills to live independently in the community
-To develop a supportive relationship with a caring adult
The treatment goals that staff are promoting when they manage THEIR OWN emotions and speak with youth in calm, respectful ways - even when youth are escalated or verbally antagonistic.
DAILY DOUBLE for 1000 points - WHY is staff managing their OWN emotions an example of RCW intervention towards these goals?
Family: To strengthen family communication skills and relationships OR To develop a supportive relationship with a caring adult
Behavior: To better manage the emotions that lead to problems
Vocational: To develop skills to live independently in the community
DAILY DOUBLE - Because it involves staff MODELING use of adaptive communication and regulation skills that are necessary to have successful relationships in family, social/ romantic, and vocational relationships AND provides a corrective emotional experience.
EEC requires that treatment goals include a description of baseline functioning. These two components of the goal description fulfill that requirement and provide important information to everyone on the treatment team to ensure that interventions are effective for that specific client.
What are the client's STRENGTHS and BARRIERS?
Describe the overlap/ connection between RC (trauma-informed care) principles and CPI's teachings around de-escalation techniques and nonviolent physical interventions.
CPI promotes rational detachment, calm problem-solving and de-escalation, requires the least-restrictive intervention, only allows for physical intervention when there is immediate danger to self/others, and involves monitoring the physical and emotional safety of the client during and after the crisis. After the crisis, CPI teaches us to debrief with clients and repair the relationship.