Clinical Fellowship in Home-Based Child and Family Treatment

Mission

The primary mission of the Family Support Services Section of the Child Study Center is to promote positive child and family functioning through developmentally informed, theory based programs and practices delivered in real world settings. Services provided by faculty and staff are accessible, culturally competent, and responsive to the strengths and needs of each child and family.

Purpose

Family Support Services (FSS) programs provide population specific, home-based interventions for families with children whose behavioral problems are responsive to or exacerbated by persistent, severe environmental stress. The overarching goal of FSS programs is the maintenance of each child’s primary relationship with parents or other adults in the interest of permanency, safety and nurturance.

Services

Programs of special interest for clinical fellows are the following: Intensive In-Home Child and Adolescent Psychiatric Service, (IICAPS) for children and adolescents with severe emotional disturbances who are at high risk for psychiatric hospitalization as well as those involved in both the mental health and juvenile justice systems and at risk for placement in either hospital or detention facilities, Intensive In-Home Child and Adolescent Re-integrative Services (IICARS) for children in transition from residential treatment to the community, and Family Based Recovery (FBR)a unique integrated reinforcement-based substance abuse and parent/child relationship-based treatment. All services are provided by two person teams of licensed or license-eligible social workers, psychologists and the like and bachelor’s level mental health counselors.

Core Curriculum

Supervisors

1. Work with Individual Supervisor: Each fellow will work individually with a senior member of the section faculty who will provide individual supervision throughout the fellowship year and provide guidance on issues of special interest and/or concern
2. Team Supervisors: Clinical supervision will be provided to each team by faculty within the elective home-based treatment program, i.e. IICAPS, IICAPS/CSSD, IICARS, or FBR. Fellows will learn to partner with the family to identify the problems that need to be addressed so that the child can remain safely in the community; develop a treatment plan, complete with goals and action steps that can be achieved by the child and family and rated by them regularly, and implement a plan for discharge and post-discharge that supports the family’s utilization of on-going community-based services.
3. Rounds: Each case is presented every three weeks at weekly rounds facilitated by a program coordinator and a child psychiatrist. Rounds provides an important opportunity for group discussion and support.
4. Supervision for licensure: Each fellow will be supervised for licensure by a member of the social work faculty. It is likely that FSS will also offer several group meetings as part of preparation for licensure. (This may be the individual supervisor).

Training

The following will be a required part of the fellowship.

1. IICAPS Training: All fellows, regardless of their elected program will attend a three-day, fifteen-hour IICAPS training program. The theories, concepts, principles and tools used in the IICAPS model are common to all FSS programs offered to the fellowship.
2. Home-Based Treatment: The Fellow will be introduced to the basic concepts and principles of providing treatment in the home. Topics will include core issues of engagement, role definition, boundary and limit setting, creating safe treatment spaces, collaboration with public and private community resources, and personal safety This is a twelve-hour training given over two weeks.
3. Family Support Service Staff Meetings: The entire Family Support staff meets weekly at 9 a.m. on Tuesdays. Largely didactic, this year’s topics have included modules on trauma, depression, substance abuse and other issues relevant to the work of the section.
4. Other training: Fellows who select FBR, will have additional training in the treatment and understanding of addictions; those selecting IICAPS/CSSD will become familiar with the activities of probation and the court system in Connecticut.

Core Clinical Experience

1. Treatment: Fellows will be responsible for 20 hours of clinical work per week. Work will include clinical assessment, treatment planning, individual psychotherapy with child or parent, family treatment, marital counseling, child guidance, support and case coordination and management. Fellows will carry a caseload that will allow time for training and research activities, as determined by the particular program chosen. The Fellow will be available by beeper Monday through Friday. Beeper rotation on weekends and holidays is idiosyncratic to each program.
2. Work as Team: Fellows will gain experience working with partners who help to support and validate the experience of providing family focused, mental health treatment in the home. Fellows will learn to co-facilitate family sessions and use their partners in ways which move the treatment forward.