T.C. had been neglected from infancy. Lacking in self-esteem, she had no hygiene or self-care abilities, and reacted with angry resistance to all efforts aimed at parenting her. Through patience, kindness and structure, her cottage staff achieved remarkable results and T. developed not only age-appropriate social skills, but a sense of her self-worth.
Admitted 3/27/03 and discharged 5/17/05; readmitted 11/02/05 and discharged 7/21/06; readmitted 11/19/07 and discharged 6/27/08. Hillsides staff was not in favor of any of these discharges. T is very unstable. She was discharged the first two times to a previous foster mother who was very uncooperative and was not amenable to services either before or after discharge.
During the third stay at Hillsides, a P3 worker located relatives of her mother in Pennsylvania. T had never met these people. DCFS sent her for a visit on Spring Break in 2008, and by 6/08, had cleared the home as an acceptable placement. Our request to keep her bed open was denied. In less than 2 weeks, the relatives called child services in Pennsylvania and they removed her from the home. Shortly thereafter, she was returned to California and is currently living in a foster home in Los Angeles County. The Los Angeles County Department of Children and Family Services child social worker made it clear upon our inquiry that Hillsides was not an option for placement again. We have no reason to think she will be any more successful in this home than in the others.
REFLECTION
1. Back in 2003, LA DCFS should have conducted a TDM that would address her needs and the support services she would need in transitioning to a new placement. (A TDM meeting is an opportunity for all interested parties in the life of the foster care child to convene and address his discharge and treatment plan for a successful replacement.)
2. The County should never place a child with a foster home that will not be open to supportive services.
3. When considering a new placement out of state have some graduated visits which get longer each time to determine the suitability of the fit. Note, this might be expensive, but would cut down on the trauma of the child involved.
Supervisors comment:
This was a very unstable plan. I am worried about the outcome. This mother has a history of serious problems, and she had very little in the way of pre-placement services. She is also extremely resistant and suspicious, making it difficult for her to make use of the services that were offered.
CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, LA 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.)
Monday, March 16, 2009
The Final Story in a Series of Seven Stories
Tuesday, February 3, 2009
The Sixth in a Series of Seven Stories
J.R. was a victim of severe child abuse, who suffered from profound Post Traumatic Stress Disorder, resulting in dangerous acting out, typically as the evening approached. Yet by day, she successfully attended a local parochial school through funding support by private donors. School achievement helped rebuild her trust in herself and others, and led to a big reduction in abuse-reactive behavior.
J. was admitted on 3/14/05 and discharged on 6/25/08 at the recommendation of Hillsides and confirmed at a Team Decision Making meeting of the Los Angeles County Department of Children and Family Services. (A TDM meeting is an opportunity for all interested parties in the life of the foster care child to convene and address his discharge and treatment plan for a successful replacement.)
She went to the home of her father and stepmother, with whom she had never lived. Her mother is a mentally ill substance abuser. She received Wraparound services in the home by another agency. (Wraparound is a program where the process of creating safe places for a child includes wrapping support services around the child and the entire family to increase the possibility of successful outcomes).
She was in the home for less than a month before she reported that she was sexually abused by her father. The accusation was confirmed by her stepmother. J. was removed to a foster care home, and we have been unable to locate her to find out how she is doing. The father and stepmother, who came on the scene fairly late in J’s stay while at Hillsides, received family therapy prior to J.’s discharge from Hillsides. We also sent a rehabilitation specialist into the home for several months prior to the discharge. Obviously, no one saw this coming.
REFLECTION
Again, no one saw this coming. We would assume that the father had no record of child molestation.
Supervisor’s comments:
This is another case where it would have been very helpful if Hillsides Wraparound could have been involved. We know her and would have been able to offer crisis services when she reported the abuse.
CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, LA 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.)
J. was admitted on 3/14/05 and discharged on 6/25/08 at the recommendation of Hillsides and confirmed at a Team Decision Making meeting of the Los Angeles County Department of Children and Family Services. (A TDM meeting is an opportunity for all interested parties in the life of the foster care child to convene and address his discharge and treatment plan for a successful replacement.)
She went to the home of her father and stepmother, with whom she had never lived. Her mother is a mentally ill substance abuser. She received Wraparound services in the home by another agency. (Wraparound is a program where the process of creating safe places for a child includes wrapping support services around the child and the entire family to increase the possibility of successful outcomes).
She was in the home for less than a month before she reported that she was sexually abused by her father. The accusation was confirmed by her stepmother. J. was removed to a foster care home, and we have been unable to locate her to find out how she is doing. The father and stepmother, who came on the scene fairly late in J’s stay while at Hillsides, received family therapy prior to J.’s discharge from Hillsides. We also sent a rehabilitation specialist into the home for several months prior to the discharge. Obviously, no one saw this coming.
REFLECTION
Again, no one saw this coming. We would assume that the father had no record of child molestation.
Supervisor’s comments:
This is another case where it would have been very helpful if Hillsides Wraparound could have been involved. We know her and would have been able to offer crisis services when she reported the abuse.
CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, LA 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.)
Tuesday, January 27, 2009
The Fifth in a Series of Seven Stories
S. A. was first admitted to Hillsides on 2/07/06 and was discharged to his grandmother and legal guardian 8/27/08. S. came to Hillsides after multiple suicide attempts resulting in numerous psychiatric hospitalizations. While living here, program staff had to intervene repeatedly to prevent self-harm. Over time, these crisis contacts developed into healthy, secure relationships, and the self-injurious behavior gradually disappeared.
They received family therapy during his entire stay, Therapeutic Behavior Services from Hillsides upon discharge and Wraparound from another agency. (Therapeutic Behavior Services offer intensive one-on-one services to children whose needs go beyond a weekly therapy session. Trained therapeutic behavior specialists work with a child in school, in the community, and in the home, devising an attainable behavioral goal, and then meeting with the child to assist him or her in developing the skills to reach that goal. ) In spite of everything, he was readmitted 12/24/08. We have reinstituted family therapy with a new focus.
REFLECTION
This was a case in which Hillsides and the County agreed on the plan. The one thing that “may” have made a difference would have been if Hillsides provided the Wraparound services since we had the relationship with the client and the family. (Wraparound is a program where the process of creating safe places for a child includes wrapping support services around the child and the entire family to increase the possibility of successful outcomes).
CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, LA 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.)
They received family therapy during his entire stay, Therapeutic Behavior Services from Hillsides upon discharge and Wraparound from another agency. (Therapeutic Behavior Services offer intensive one-on-one services to children whose needs go beyond a weekly therapy session. Trained therapeutic behavior specialists work with a child in school, in the community, and in the home, devising an attainable behavioral goal, and then meeting with the child to assist him or her in developing the skills to reach that goal. ) In spite of everything, he was readmitted 12/24/08. We have reinstituted family therapy with a new focus.
REFLECTION
This was a case in which Hillsides and the County agreed on the plan. The one thing that “may” have made a difference would have been if Hillsides provided the Wraparound services since we had the relationship with the client and the family. (Wraparound is a program where the process of creating safe places for a child includes wrapping support services around the child and the entire family to increase the possibility of successful outcomes).
CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, LA 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.)
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