Child
and Adolescent Addictive Diseases Intensive Outpatient
Currently, outpatient
services are available Monday through Friday, from 8:15 AM until 5:00
PM. In order to accommodate those parents who are working, evening
appointments are also offered after 5:00 PM (schedules vary according
to need). In the event that a family experiences a crisis after normal
working hours, or during the weekend when the centers are not open,
the crisis service is utilized as a resource for these families. The
assigned on-call staff work closely with the DeKalb CSB Crisis Center
in order to reduce the risk of hospitalization or other out-of-home
placement. Clearly, hospitalization is the appropriate intervention
if the child presents a danger to him/herself or others, or is gravely
disabled.
The providers
of outpatient clinical services are master's level clinicians who
include social workers, professional counselors, and marriage and
family therapists. Many of the clinicians are licensed in their
respective professions; others are license-eligible. Those staff
who are not license-eligible perform the bulk of the case management
services, and are usually bachelor's level staff. Psychiatrists
are either board-certified or board-eligible, in child or adolescent
psychiatry.
Outpatient programs
located at three DeKalb CSB outpatient sites offer the following
specific services:
Family
therapy
Family therapy is offered as the preferred method of clinical intervention,
unless otherwise indicated. Whatever the constellation, every available
family member who has regular contact with the child or adolescent
is typically invited to participate in treatment, even if the participation
is brief, sporadic, or minimal. The inclusion of all significant
others provides a richer contextual understanding of the child's
current difficulties.
Individual/Play
Therapy
Specialized play therapy is usually indicated for young children
who often express themselves through the medium of play much more
fluently than through direct dialogue. Clinicians who are specially
trained in the art of play therapy often utilize the tools which
are most familiar to children, including art materials like paint,
crayons, or modeling clay; dolls and doll houses; puppets or stuffed
animals; storytelling; and therapeutic board games. The clinicians'
ability to speak to the child using metaphorical language during
play often affords the child a sense of comfort and protection from
directly confronting painful and disturbing issues. This is especially
important during the rapport-building phase of therapy. For older
children and adolescents, individual time is often equally necessary
for the purposes of rapport building, though play may not be involved.
These consumers typically need time to develop a sense of trust,
both in the therapeutic process and in the clinician, and may also
desire some separation from parents or guardians in order to more
fully disclose concerns they may have.
Group
Therapy
Children and adolescents who may have difficulty with the intimacy
which characterizes individual sessions may function better in groups.
The group format also allows for these consumers to hear from, be
confronted by, and join with their peers. The groups may be didactic
and structured around a particular theme, or may be open-ended and
more process-oriented.
Medication
Services
Board-certified (or board-eligible) child and adolescent psychiatrists
evaluate all children who have been referred for service, and, whenever
medication is indicated as part of the treatment regimen, the psychiatrists
prescribe and monitor the medications for effectiveness. Children
and adolescents who receive medications prescribed by the psychiatrist
are scheduled to see the psychiatrist at least once per month, and
more often as indicated.
Case
Management Services
Clinical intervention in any of the aforementioned forms also requires
that case management, or case coordination, be provided as well.
These services may consist of, but are not limited to, the coordination
of ancillary services as needed; the development of specific crisis
plans which do not rely on hospitalization as a primary method of
intervention; consultation with school or medical personnel; participation
in the earliest stages of discharge planning if a consumer is admitted
to the hospital; or consultation with the juvenile justice system.
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