Plan of Care
Crisis consultation services can be beneficial throughout the course of any challenge. As a consultant, my services can be provided during or immediately post-crisis. Consultations can also be provided as a mid-course treatment assessment.
Consultations start with a comprehensive examination of the client’s current status and treatment, if any. Analyzing this information, recommendations are made for initiation, discontinuation, or adjustment of a plan of care.
To assess the current status of the client, the following information may be gathered, upon client consent:
- Client history via interview with the client
- Client history via interviews with family, friends, teachers, school counselors, administrators, and other stakeholders
- Review of educational performance (i.e. report card, transcript, etc.)
- Review of existing/administration of neuropsychological and educational testing
- Client completion of recreational and leisure activity logs
- Client completion of nutritional logs
- Client completion of sleep logs
- Observation of living arrangements via home visit(s)
The analysis of this information will lead to the recommendation of a specific plan of care that may include:
- Short and long-term measureable goals and objectives
- Behavioral health and medical treatment plans that could include psychotherapy and pharmacotherapy
- Educational plans (i.e. transitional goals, academic/vocational training, employment including training and apprenticeships, volunteer assignments, etc.)
- Recreation, leisure, and nutritional guidelines including physical activity and community engagement
- Parenting plan (including rewards and consequences guidelines)
- Family interventions
- Therapist/counselor recommendations including psychiatrists to aid in medication management
- Educational consultant recommendations to aid in selection of secondary, higher education, vocational and life experience programs
Description of Crisis Consultation Services:
Neuropsychological and Educational Testing
Students and their families invest time and money on testing only to realize that the results can be confusing and sometimes misleading. By assisting in the interpretation of these tests, families are better prepared to advocate with school districts and others for appropriate accommodation of their child or adolescent.
Recreation and Leisure Activity Logs
How a child or adolescent uses their non-school time can affect their behaviors. There is both the possibility of too much and too little structured time. Assessment of whether a particular activity helps to develop social skills, provides opportunity for skill growth, or whether it generates an excessive sense of failure is important. Success often breeds passion and self-confidence which are beneficial traits. When balance of extracurricular activity is off, children and adolescents often retreat to isolation and/or increased use of electronic devices and other forms of technology. The use of technology and devices can result in stagnation and even addiction.
There is increasing evidence that caloric intake, processed food consumption, and balance of protein, carbohydrate and fat in one’s diet can affect both behavioral and physical health. This is especially important with anorexic and obese patients.
There is increasing evidence that insufficient sleep can lead to behavioral and physical health problems including educational and social challenges.
Developing Short and Long-Term Measurable Objectives
Short-term goals will likely address behaviors that precipitated reaching for the consultation. Longer term goals will involve helping the patient to develop life skills so that they will be better equipped to manage future challenges, without the assistance of professional behavioral health support. This may entail scaffolding interventions which allow a patient to experience multiple successes over a period of time.
Following the baseline assessment, a psychotherapy treatment plan will be developed that includes the presenting problem(s), diagnosis (or diagnoses), treatment goals, the type of psychotherapy, and the frequency and expected duration of sessions.
Medications have been demonstrated to serve an important and effective role in treating behavioral health issues. As a consultant, I will collaborate with the client’s physicians to develop a MAP (Medication Action Plan). The treatment plan will entail routinely and regularly sharing assessment of the patient’s progress with their physicians, as well as further collaboration to assist in best managing potential transitions in care.
Educational Plan/Failure to Launch Assistance
With years of professional experience working as a director at a residential school providing treatment for adolescents and young adults, my expertise offers a unique perspective with regards to the development of educational plans. I have an extensive background in developing IEPs (Individualized Education Plan) that specify the special services and accommodations that must legally be provided to students suffering behavioral or learning challenges. The treatment plan will set forth recommendations for special services and accommodations that should be provided to maximize likelihood of treatment success.
Not every young adult has a clear vision of their future upon graduation from high school. To overcome a young adult’s failure-to-launch, it is essential to help them identify specific higher education and vocational opportunities, including training and apprenticeship, and life experiences including volunteer assignments that may be of particular interest.
When a young adult struggles to leave home and to live independently it can be both frustrating and heartbreaking for families. Failure to launch is a common way to describe someone seemingly unable to transition to adulthood. To the outsider, the individual’s behavior may appear apathetic, but for the young adult struggling, there is a more complex set of factors leading them to be “stuck”. Working with young adults and their families in this scenario often includes a cooperative enforcement of structure and a commitment to tangible goals.
The treatment plan will also offer recommendations for transition planning. A critical component of overcoming failure-to-launch syndrome is the setting of clear expectations for young adults still living at home. The plan will also recommend an approach to gradually remove the in-home accommodations that only reinforce the anxieties preventing the outcome of change.
Recreation, Leisure and Nutritional Plan
Apathetic behavior can often be linked to an inactive lifestyle with poor eating habits. The treatment plan will offer recommendations for extra- and co-curricular recreation and leisure activities, physical activity, and a healthy diet that places restrictions on junk food and elimination of any drug or alcohol usage. It will also offer recommendations for limitations on use of electronic devices and other technology.
Children and adolescents require parenting consistency to thrive. The treatment plan will offer recommendations regarding parenting rules and expectations including values to be applied, appropriate and inappropriate activities permitted, communication approaches to be used between parent and child/adolescent, and recommendation of rewards and consequences to be implemented.
Rewards and Consequences
Without compliance, treatment plans are not effective. The treatment plan will offer recommendations regarding rewards and consequences to encourage client compliance.
Some patients do not realize that they are suffering from a behavioral health issue. To overcome this denial, families sometimes utilize the tool of an intervention. The most important goal of any intervention is to direct the patient in crisis to accept accountability and desire to participate in the process of change. This is often not easy for even the most loving and well-intentioned families to undergo.
An intervention could involve the psychotherapist joining the family at home. This approach is particularly appropriate to assist adolescents and young adults that present at-risk behavior towards either themselves or members of their family. While the immediate objective of this service is to minimize any imminent harm, the long-term goal is to equip families and loved ones with the emotional tools necessary to process and understand these challenging situations.
If deemed appropriate, the treatment plan will offer recommendations on the specific approach to the intervention.
Through the process of assessing the current status of the client and developing the treatment plan, the client and family will become familiar with me and my approach to psychotherapy. Likewise, I will assess the extent to which my services may be beneficial. If I or the patient feels that the relationship will not be productive, recommendations for alternative therapists will be provided. If pharmacotherapy is to be used, recommendations for child and adolescent psychiatrists will be made. Further, if there are physical health issues that need to be concurrently addressed with the behavioral health problems, recommendations for collaborating pediatricians or physician assistants will be offered.
Educational Consultant Recommendation
The assessment may lead to a recommendation that the client is better suited to an educational program different than their current placement. Options could include day or residential; public or private; enrichment, accommodative and treatment; secondary, higher-education or vocational programs; as well as academic year and summer –only offerings. If an alternative education approach is suggested as part of the treatment plan, recommendations will be made of qualified educational consultants.
Intermediary to School Districts and Treatment Centers
By offering the client a single point of contact with the educational, health care, social services and health insurance systems, case management can replace a haphazard process with a streamlined structure. Some of the key elements of advocacy and/or case management in which I may play a role include: attendance of a PPT (Planning and Placement Team) meetings, review of IEPs and coordination of the process for securing special services for children/adolescents and their families.
If your district is unable to provide your child with an accessible education and the supports required to be successful, I may serve as your advocate to aid in securing out-of district services.
If you believe any of the consultations listed above could be beneficial to you (or your child), I encourage you to call my practice at 203-499-7890. Following a brief conversation, free of charge and without any further obligation, we can decide together if a collaboration could be mutually beneficial.