Kids Belong in Families

1
Kids Belong in Families

• Therapeutic Foster Care and Other Community
  Services for Youth with Mental Health Needs

2
Kids Belong in Families - Presenters

• Charles Davis, State Director, NC MENTOR
• Marci White, Asst State Director for TFC, NC
  MENTOR
• Fred Waddle, Sr. Vice President, Easter Seals UCP
  NC

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Its All About Relationships
A kid can walk around trouble if he has somewhere
to walk to and someone to walk with.. Tito, a
former gang member
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The State of our State

• New policies transition to community-based care
• Goal Place all children in the most
  family-like setting possible
• Budget tightening continues
• Closing 25 of level 3 residential facilities
• Approximately 500 children will be discharged
• Many cannot return home and still need support
• More children will continue to come into the
  system needing placements and/or intensive
  services
• Where will they go??????

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Alternatives to Group Homes

• Therapeutic Foster Care
• Intensive In-Home
• MST
• Mobile Crisis Teams

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Why Therapeutic Foster Care?

• Presidents Commission on Mental Health
• TFC is an evidence-based practice combining
  family based care with specialized treatment
  interventions lead to positive outcomes.
• National Mental Health Association identified TFC
  as a promising practice for children in the
  juvenile justice system.
• Better outcomes at a lower cost.
• Least restrictive form of out-of-home care.
• Because kids belong in families!

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Comparative Research

• Researchers have found that kids in TFC are
  arrested less than half as much as kids in group
  homes.
• Children in Family-Based settings remain in
  out-of-home care for shorter lengths of time than
  do children in group care.

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Why do Kids Belong in Families?

• To learn behaviors that other children learn,
  which can help them better relate to other
  children in school and the community
• To depend upon the 24 hour, unconditional support
  that only families provide
• To learn to develop the relationships that all of
  us build our lives around.
• When return to the natural family is impossible,
  TFC can become the permanent placement for a
  child through adoption.

9
The Matching Process

• One of the most important aspects of TFC is the
  matching and placing of an individual in the
  foster home.
• Referrals come from CS agencies, parents, LMEs,
  DSSs, group homes, etc.
• Childs clinical needs and strengths are
  matched with TFC parent.
• Pre-placement calls and/or visits as appropriate.
• Visits with individuals family, treatment team
  members, and/or funding source case manager, as
  appropriate.

10
REMEMBER!

• All client referrals look and sound bad.
  Referral sources highlight negative behaviors to
  assist in risk management and to get funding
  approval for our service
• Highlight client strengths
• Investigate a clients special talents, interests
  and personality traits

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Treatment Components of TFC

• A safe environment is a therapeutic environment
• Therapeutic interventions, including Skill
  Building, is the work of TFC
• Individualized care, focused on desired outcomes
  (adulthood/permanency)
• Positive, nurturing relationships are the basis
  for growth and change. These relationships are
  best fostered through active participation in the
  daily activities of neighborhood and family life.

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House Rules and Routines (Part of Therapeutic
Structure)

• Be Clear and Specific/Age Appropriate
• Keep the List Short
• Review and Post Rules

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Why House Rules?

• Children learn what to and not to do without
  having to be told each time.
• Treatment parents then have clear and explicit
  parameters for acceptable and unacceptable
  behaviors.
• Provides a framework that will help the child
  transition into the foster home which is less
  anxiety producing.

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Preventing Disruption-Being Proactive

• Intentional Matching Placement
• Thinking Ahead Assessments
• PCP
• Skill Building
• Specific Strategic Monitoring
• Planning Crisis Management Intervention
• Proactive Communication Assessment
• Empowerment

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Support from Licensing Agency

• Guidance to complete the licensure process.
• All pre-service training classes.
• Opportunities for continued skill enhancement,
  education and training.
• Professionally trained Coordinator assigned to
  the home.
• Weekly phone calls and bi-weekly visits.
• Individualized Crisis Plan
• On call support 24/7.

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Inspirational quote or summary of success story
Through all this, my husband and I have learned
that teenagers just need someone to love them
unconditionally and be willing to give them a
chance. We also learned that teenagers do not
keep you at arms lengththey will open their
hearts to you if you open your heart to them.
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Successful Transitions

• Adding Out Patient Therapy
• Intensive In Home
• Multi Systemic Therapy - MST
• Mobile Crisis
• Trauma Focused CBT
• Day Treatment
• Crisis Respite

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Transitions

• Natural homes or Relative home
• Therapeutic Foster Homes
• Adoptive Homes
• Teens - College or work, roommates

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Success story

• TFC to College, work, support

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Challenges

• Sudden loss of Community Supports
• Funding reductions
• Qualified staff and families w training
• Capacity build out

21
Success Story

• Home at last