St. Joseph Orphanage is committed to ensuring that children and youth receive excellent mental health care and support. The use of evidence-based practices (EBP) is a key component to the quality of services we provide and the high level of success/satisfaction our youth and families achieve.
Utilizing and researching evidence-based practices and data-based decision making, ensures we are able to continuously improve our quality of care.
It is not uncommon for youth receiving our services to have histories of victimization of their own, including sexual, physical, emotional abuse, or traumatic loss. Those who have experienced some form of trauma and perceive their environment as unfair and inescapable often exhibit a complex array of behavioral problems including conduct and/or oppositional disorders, nonviolent criminal behavior, sexual behavior problems, anger management difficulties, depression, suicidal ideation, property damage, running away, school problems, hyperactivity, and substance abuse issues. As a result, it is necessary to recognize and address the impact that trauma has on each youth, particularly those diagnosed with post-traumatic stress disorder. We are committed to providing an environment and treatment which are Trauma sensitive and informed.
Creating Cultures of Trauma-Informed Care (CCTIC):
We are committed to creating continuous organizational improvement around CCTIC’s five core values of trauma sensitive treatment – safety, trustworthiness, choice, collaboration, and empowerment. We utilize the Creating Cultures of Trauma Informed Care model designed by Community Connections, Inc. The model has challenged the agency to incorporate knowledge about trauma- prevalence, impact, and recovery- into all aspects of service delivery and practice. Our Trauma Informed Care Committee was formed in 2011, encompassing representatives from multiple departments and positions. The Trauma Informed Care Committee has made many structural changes around the core values in an effort to make the agency more trauma-informed. All staff and clinicians receive specialized training on trauma informed interactions to be utilized with all youth and families.
Collaborative Problem Solving Approach (CPS).
CPS is an approach to understanding and helping children with behavioral challenges originated by Dr. Ross Greene. The CPS model views behavioral challenges as a form of learning disability or developmental delay, in other words, behaviorally challenging kids are lacking crucial cognitive skills, especially in the domains of flexibility, frustration tolerance, and problem solving and seeks to create fundamental changes in interactions between kids with behavioral challenges and their adult caregivers by having caregivers engage kids in solving problems collaboratively.
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Developed and tested to help children and their caregivers in overcoming the negative effects of traumatic life events, TF-CBT includes 12-16 treatment sessions that teach children skills in stress management, cognitive processing, communication, problem solving, and safety. An essential component is the participation of the child’s primary caregiver in order to enhance parenting skills and support around the child’s treatment. This therapy is intended for children ages 3-18 and has proven effective with individuals recovering from sexual abuse, traumatic bereavement, and domestic and/or community violence.
- Directive and Non-Directive Play (a therapy approach): The clinicians utilize certain aspects of Trauma-Focused Integrated Play Therapy (TFIPT) which is a program that involves a combination of directive and nondirective approaches in an effort to advance structured, goal-oriented therapy for abused children. The formal model attends to the developmental needs of young children, incorporates the scientific and practice literature, as well as evidence-based practices currently available, and promotes resolution of traumatic events by direct or indirect processing of traumatic incidents. This model includes a focused interest in facilitating, encouraging, and allowing nondirective play therapy which often leads to children’s discovery and utilization of post-traumatic play, a unique form of play which is considered a spontaneous occurrence with young children who experience trauma. ‘Posttraumatic play’ is defined as a child’s natural way to introduce gradual exposure and trauma processing. Often this involves the use of groups of toy animals, dinosaurs, and similar ‘live’ objects to represent or symbolize the actual familial dynamics that might exist. When some aspects are used by our clinicians the main goals derived from this approach include: an understanding child’s experience of trauma and trauma impact; the identification of trauma-related symptoms, if any; helping the child explore and express thoughts and feelings associated with children’s abuse, increase coping strategies and self-regulation to restore functioning, and enhancing the child’s self-esteem and sense of competence.
Transition to Independence Process (TIP)
The Transition to Independence Process (TIP) model (http://tipstars.org/) is an evidenced based practice based on published studies that demonstrate improvements in real-life outcomes for youth and young adults with emotional/behavioral difficulties (Dr. Hewitt B. Clark, Ph.D., Department of Child and Family Studies, Louis de la Parte Florida Mental Health Institute, University of South Florida). The TIP system is operationalized through seven guidelines and their associated core practices that drive the activities with young people and provide the framework for the program and community system to support these functions.
TIP’s Core Practices:
- strengths discovery and needs assessment
- futures planning
- in-vivo teaching
- social problem solving
- prevention and planning for high risk behaviors
- mediation with young people and other key players.
St. Joseph Orphanage Director of Transition Services, Esther Urick, LPCC-S holds a National Network on Youth Transition for Behavioral Health (NNYT) Certification as a TIP Model Site-Based Trainer and embraces the TIP guidelines and associated practices of the TIP model. As a key resource for our agency, Esther and her team have overseen the continued implementation of the TIP model, resulting in St. Joseph Orphanage becoming a certified TIP Model Site through NNYT in association with the STARs academy. http://tipstars.org/NNYTSiteCertification.aspx#
Positive Behavioral Interventions and Supports (PBIS)
Positive Behavioral Supports (PBS) is an empirically validated, function-based approach to eliminate challenging behaviors and replace them with prosocial skills. Intended as a school-based system of positive behavioral recognition, SJO has expanded its philosophy into our residential and community based programs. PBS involves data-based decision making using functional behavioral assessment and ongoing monitoring of intervention impact. PBS can target an individual or entire group, as it does not focus exclusively on the individual, but also includes changing environmental variables such as the physical setting, task demands, curriculum, instructional pace and individualized reinforcement. Thus it is successful with a wide range of students and behaviors in various contexts. http://education.ohio.gov/Topics/Other-Resources/School-Safety/Building-Better-Learning-Environments/PBIS-Resources
The Pathways curriculum has been a cornerstone in the treatment of youth with sexual behaviors for over 20 years. Pathways reflects on current research and clinical experience with adolescents by focusing on strength-based methods to help clients develop healthy and productive lifestyles consistent with the Good Lives Model of rehabilitation. Pathways continues to use a restorative justice theme emphasizing concern for restitution, development of victim empathy and personal responsibility. http://www.safersociety.org/safer-society-press/new-titles-from-safer-society-press/pathways-fourth-edition/
The Residential Child and Youth Care Professional Curriculum (RCYCP) is a standardized training program to strengthen the role and skill of child care professionals who provide residential care services. RCYCP was developed by the National Resource Center for Youth Services at the University of Oklahoma. All direct care staff, supervisors, therapists, group leaders, teachers, and other staff who work with youth go through this empresive seven day training, focusing on 4 key areas :
- Developing a culture of care,
- Understanding child development,
- Building relationships, and
- Teaching discipline.
The Stop &Think Social Skills Program: This program focuses on teaching youth interpersonal, problem-solving, and conflict resolution skills. The program has four levels to ensure that all skills are taught in a developmentally-sensitive and appropriate way. Stop and Think has been designated by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Administration (SAMHSA) and U.S. Department of Justice’s Office of Juvenile Justice and Delinquency Prevention (OJJDP) as an evidence- based and national model program. In early summer 2013, staff received initial training on the program by the program’s creator, Howard Knoff, Ph. D. http://www.projectachieve.info/stop-think/stop-and-think.html
The evidence-based behavioral/social learning teaching process used by the Stop & Think Social Skills Program involves the following five components:
- Teaching the steps of the desired social skill.
- Modeling the steps and the social skills language (or script).
- Role-playing the steps and the script with youth.
- Providing Performance Feedback to youth relative to how accurately they are verbalizing the skill script and how successfully they are behaviorally demonstrating the new skill.
- Applying the skill and its steps as much as possible during the day to reinforce the teaching over time, in different settings, with different people, and in different situations.