Now at age 12, Kendra had been through quite a bit. When she was 9 years of age, she couldn't take all of the chaos and fighting and uncertainty. Kendra tried to reach out, but, at age 9, no one really listened to her or took her seriously. Kendra cut herself terribly in an attempt at suicide.
Kendra was taken to the hospital and, after the initial injuries healed, placed at a children's residential facility for ongoing mental health treatment. Here she stayed for 9 months. Her mother participated in some "family" sessions over the phone and occasionally in person.
When Kendra was released, she returned to Philadelphia to live with her mother. The next two years were a mix of outpatient therapy, in-home therapy, "alternative" therapies, all to little avail. Now at age 12, Kendra was as unhappy as ever. She thought about going to live with her dad, but she knew that his drinking had only gotten worse since the divorce.
Kendra had few friends in Philadelphia, although there happened to be a girl who she met at the residential placement whose family lived nearby. She occasionally got together with this person, one of her only friends. They sometimes didn't seem to have much to say, and other times they couldn't stop talking the whole time they were together.
1) What residential facilities are typically available for children, and who pays for a child to attend? What kind of mental health treatment was Kendra likely to have received?
2) What kinds of follow-up treatment are typical when a child has been in a residential facility?
3) Assuming that Kendra was treated for depression and possibly other kinds of mood difficulties, describe the outcomes associated with residential treatment for children given the diagnosis of depression. How much improvement typically occurs? On what factors does this depend? What is the rate of return to residential facilities? On what factors does that depend?
4) What are the typical developmental milestones for a 12 year old girl? In what ways is Kendra atypical as far as you can tell?
1. After looking on the Virginia Department of Social Services website, I was unable to find any child residential facilities in the Washington D.C. area. However, I found a facility in Charlottesville, Virginia called Elk Hill. Elk Hill has been offering Community-Based Residential Services for boys and girls between the ages 11-18 for over 40 years (Elk Hill, 2012). All of their residential facilities are Level A Medicaid programs. They have programs in Goochland County, Richmond, Charlottesville, and Fluvanna County. Their programs provide individualized service plans, an array of clinical services, and life skills. At Elk Hill, kids find the courage to succeed and the confidence to return to their families and communities whenever possible (Elk Hill, 2012). Another residential facility available to children is the Certified Educational, Recreational, Therapeutic Schools and Programs (CERTS). CERTS has been widely recognized as a leading provider of specialized residential treatment centers for adolescents in the United States. They provide a specialized program that works specifically with one type of individual, meeting their clinical needs while also working with them in ways that they understand best (CERTS, 2012). CERTS residential treatment is a level of care that combines 24/7 support staff, individual therapy, group therapy, and education. Residential facilities can be very expensive, and depending on your mental health benefit families can use insurance to cover their child’s stay. Also some school districts will authorize payments of at least the educational portion of the stay if your child has an Individualized Education Plan (IEP) with them (CERTS, 2012). However, home equity loans generally are the best way to borrow for many families, as interest rates tend to be lower and the interest is tax deductible (CERTS, 2012). Being that Kendra attempted suicide, she would have received therapy programs that successfully treated individuals with depression and suicidal thoughts. The mental health services that she would likely have received would have focused more on providing a fun and challenging academic education that worked toward enhancing Kendra’s self-esteem, encouraging her to rediscover the joy of learning while she clinically stabilizes. The main challenge faced was to get Kendra emotionally stable and overcome her depression so that she could begin to look at life in a lighter perspective!
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ReplyDelete2. The transition from a residential facility to back home can be a scary and overwhelming time for your child. Thoughts of relapsing into past behaviors are running through their minds, but as a parent it is important that you make this transition the least bit stressful for your child. There are many follow-up treatments that are available to your child when he or she gets out of residential care. Two-day In-Home visits can occur prior to, or following your child’s discharge. “An In-Home visit is customized to your families needs and may include: job and or volunteer search, formalizing structure within the home, meeting with or assisting in finding a home therapist, or meetings with school teachers or counselors” (New Haven Residential Treatment Center, 2012, para. 5). Parent and student transition support groups are available as well after discharge. In addition to an In-Home visit, families can take advantage of coaching sessions with their therapist after leaving their residential facility (New Haven Residential Treatment Center, 2012).
ReplyDelete3. Treatment can help teens to realize how they are feeling and to learn effective ways to cope with their emotions. Outcomes for residential treatment can depend on many things, including the environment one lives in and is surrounded by. The article completed by the Magellan Health Services Children’s Services Task Force (2008) claims that any gain made during a stay in residential treatment may not transfer well back to the youth’s natural environment, creating a cycle where children are often repeatedly readmitted. Outcomes can also depend on the relationship the individual has made with their therapist. Those in residential facilities are most likely to make some sort of gain while in the residential facility; however the gains do not typically last once the individual is discharged. This same article cited a study completed stating that adolescents discharged from residential treatment found at a seven year follow up had either been readmitted or incarcerated. Also, there was a returning rate to placement of 32 percent after one year, 53 percent after two, and 59 percent by the end of the third year once discharged (Magellan Health Services Children’s Service Task Force, 2008). The amount of improvement an individual makes from a residential treatment facility can depend on three things: the amount of family involvement in the treatment process, placement stability once discharged from the facility, and the availability of aftercare supports for youth and their families (2008).
ReplyDelete4. By the time children reach 12 years of age, their sense of independence and responsibility is growing. According to the Centers for Disease Control and Prevention (2012), it is important for individuals of this age to develop healthy relationships because peer pressure can become very strong during this time. This peer pressure includes drugs and alcohol and other poor decisions. Girls this age are also going through puberty were their body is physically changing. Some thinking and learning aspects that change during this age include more academic challenges, understanding the view point of others more clearly, and obtaining an increased attention span (Centers for Disease Control and Prevention, 2012). Other challenges they can face is depression, eating disorders, and family problems (2012). Some emotional changes a 12 year old girl may experience include more concern about body image, express less affection toward parents, feel more stress from school work, and feel more sadness and depression that can lead to other problems. Kendra seems to be experiencing more pressure from her friends (or lack thereof) and from her family. She does not seem to be receiving much attention from either one of her parents. Hopefully she can keep that one friend that she seems to be close with. This one friend seems to be one of the best relationships Kendra has. We are sure that she is probably experiencing more academic troubles to go along with the other personal troubles she is going through. We do not think her attention span has increased, at least not in the academic area. She may be more interested in other things but we have no information of that. She does seem to be experiencing more depression as she is getting older.
ReplyDeleteReferences:
ReplyDeleteCenters for Disease Control and Prevention. (2012). Young teens (12-14 years of age). Retrieved on June 12, 2012 from http://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/adolescence.html
CERTS. 2012. CERTS residential treatment centers. Retrieved June 13, 2012, from http://www.certsgroup.com/residential-treatment-center/more-information
Elk Hill. 2012. Group homes. Retrieved June 13, 2012, from http://www.elkhill.com/group-homes.html
Magellan Health Services Children’s Service Task Force. (2008). Perspectives on residential and community-based treatment for youth and families. Retrieved June 13, 2012, from Magellan Health Services Website: http://www.magellanhealth.com/media/2718/CommunityResidentailTreatment_White_Paper.Pdf
New Haven Residential Treatment Center. 2012. Treatment. Retrieved June 14, 2012, from http://www.newhavenrtc.com/treatment-transitionservices.php