The Third in a Series of Seven Stories

M.F. was admitted to Hillsides on 4/11/05 and discharged on 7/18/07. M had severe and sometimes violent tantrums at home and in school which led to this youngster’s placement at Hillsides. Intensive use of Therapeutic Behavioral Services helped him develop a number of substitute behaviors as an alternative to having tantrums, which led to experiencing more success in school and on home visits. He also became an avid swimmer, participating in aquatics activities at the Rose Bowl.

The Hillsides therapist worked intensively with his grandparents and his mother although she felt that the DCFS Social Worker’s plan to send him to live with the grandparents was not feasible. The mother was an active substance abuser and clearly unable to provide a home for M. The court concurred that sending M to his grandparents was not advisable, but an aunt living in another county showed up and petitioned the court to let her take him.

The court agreed in spite of his very vocal opposition. As M was very unstable at the time, we recommended that a little more time was necessary to help prepare him. The court discharged him immediately into the aunt’s care. She was opposed to any outside services to help her with him. Within a month, he was back into the system and, as far as we know, is doing well in a foster home.

REFLECTION
1. Outside County and Court should have allowed Hillsides to spend time with County’s social worker in planning M’s movement out of Hillsides.
2. Listen to M’s objections about living with his aunt (after all he has control on how cooperative he is going to be in the placement).
3. See if there are things that would make this aunt more acceptable to M.
4. If there are no alternatives to the aunt’s acceptability of M, explore alternative permanent placements.

CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, DCFS, the child and the family is necessary for a successful transition. (A plan is not going to work if the child or the receiving party is saying they are not ready.)
3. We should consider mandatory supportive services in the home.
4. Once a plan has been agreed upon, there should be some benchmarks set to determine the move-in date.
5. As a general rule, the residential treatment agency should provide Wraparound services to the receiving family where ever possible, since they are the ones who know the child and the family. (This would entail an exception to the Service Provider Areas (SPA) specific structure of the Wraparound program, since most residential treatment centers do not have Wraparound programs in all the SPAs.)