Residential Diversion Program

Purpose:

To provide a versatile treatment program designed to create change within an individual’s home environment, thereby diverting a likely long-term placement in a residential facility and reducing the ongoing treatment needs upon return to home and community. Strategies for intervention and facilitating progress will be created based on both individual and family needs and will be incorporated into a level system that will serve as the family’s guide to change. 

Simulating a residential program within a client’s home and community is not only fiscally responsible, but will significantly decrease the rate of recidivism resulting from the removal and treatment of an individual prior to returning him/her to an unchanged home environment.  Additionally, the availability of this program allows for the opportunity to re-evaluate costly out-of-home placements and return an individual to his/her home and community while maintaining intensive therapeutic services at a lower cost. 

Additional benefits of a community home-based program include the following:

• The ability to provide a smoother transition to reduced services.
• A greater ability for learned skills to generalize to the home environment.
• Better access to the family interactions/dynamics.
• Enhanced integration of family work into the client’s treatment plan.

Treatment Goals:

• Conduct a comprehensive assessment identifying a client’s and his/her family’s strengths, needs and motivation.
• To develop a crisis intervention plan including a series of interventions designed to effectively intervene with explosive and noncompliant children and adolescents.
• Development of a collaborative plan for establishing structure through which an individual and their family be stabilized in order to begin identifying and practicing the skills necessary to eliminate acting-out and noncompliant behaviors.
• Initial focus on reducing potential trigger situations in order to develop a stable environment in which a collaborative effort on skill building can be developed.
• To link the practicing and subsequent mastery of skill building with individualized rewards including an appropriate and deliberate step-down in the intensity of services and transition into less restrictive levels of treatment.
• To provide parent training intended to positively impact the home environment and create the dynamics necessary for sustaining client changes.
• To provide 24 hours crisis stabilization.
• Link to appropriate community-based resources such as Alcoholics Anonymous and pro-social activities. 

Course of Treatment:

• Initial 30 days to include up to 40 hours per week of clinical staffing to provide behavior management, individual and family counseling as well as crisis intervention.
• Continued reviews to determine service plan per 4-week period.
• Planning for step-down in treatment services to begin in the second month and to be determined through weekly team meetings reviewing program participation.
• Community resources to be utilized as reduction in home-based hours is initiated.

Versatile program plan will include the following:

• Comprehensive evaluation of individual and family functioning
• Executive functioning
• Social skills
• Language deficits – both expressive and receptive
• Capacity for anticipation/planning
• Affect regulation
• Cognitive distortions
• Difficult temperament
• Development of individualized treatment goals and therapeutic interventions
• Development of home contract
• Utilization of level system
• Family therapy
• Individual counseling
• Behavior management
• Mentoring
• Life skills
• Academic enrichment activities
• 24 hour crisis intervention
• Case management
• Weekly team meetings with parents and other involved professionals

Additional components may include:

• Electronic monitoring
• Medication monitoring
• Drug and alcohol screening
• Substance Abuse Education
• Outpatient Substance Abuse or Dual Diagnosis Treatment
• Anger Management
• Therapeutic Recreation

Admission Criteria:

• Residential placement is imminent; the recommendation has been made and a program search is pending or underway.
• Parent(s) are committed to participation.
• A client is transitioning home from a residential setting OR is being discharged prior to completion of a residential program.
• Less intensive forms of clinical care have failed to produce a successful outcome.

What would make a family ineligible for the Residential Diversion Program?

• Psychiatric acuity or significant risk to self and/or others interferes with ability to establish safety (this would include active psychosis and 24 hour “eyes on” supervision).
• Sex offender fails to comply with recommended specialty treatment.
• Domestic violence or alleged sexual abuse reported within the home resulting in an inability to establish safety of client or family member.