PROVIDING CLINICAL SERVICES TO HOMELESS CHILDREN IN CHICAGO, ILLINOIS Susan Reyna-Guerrero, LCSW President/CEO
Dec 29, 2015
PROVIDING CLINICAL SERVICES TO HOMELESS CHILDREN IN CHICAGO, ILLINOIS
Susan Reyna-Guerrero, LCSWPresident/CEO
ABOUT BEACON THERAPEUTIC
Located in Chicago, Illinois Began in 1968 as a Therapeutic Day
School Today, a multi service site offering
special education services to students 3-21; community mental health clinic and supportive services to homeless children and families.
KEY OBJECTIVES OF PRESENTATION
Overview an approach to addressing the mental health needs of homeless children
Understanding attachment issues as they relate to a homeless child
Understanding system building to keep homeless families and homeless children’s issues in the forefront
ABOUT BEACON THERAPEUTIC
Based on a homeless systems gap, therapeutic day services were developed in 1996 to address the specific mental health needs of homeless 3-5 year olds.
AN APPROACH TO MEETING THE MENTAL HEALTH NEEDS OF HOMELESS 3-5 YEAR OLDSLITTLE INTENSIVE OUTPATIENT PROGRAM
The program addresses the emotional, behavioral and social needs of homeless children
Children are picked up by agency transportation five days a week at their residence (often shelters) and brought on site to Beacon
Services include individual as well as group intervention for five hours a day. There is also the opportunity for more in-depth evaluations to occur
LITTLE INTENSIVE OUTPATIENT PROGRAM – con’t
Parents must participate at a minimum of once a month to provide input into their child’s treatment planning
As a means of including the parent more in treatment, an outreach worker provides the bridge between the home community and the day treatment program for the child and family
AN APPROACH TO ADDRESSING THE NEEDS OF HOMELESS FAMILIES:SHELTER OUTREACH SERVICES
SOS provides Mobile Mental Health Services to 22 homeless shelters in Chicago (Citywide) with over 600 families served each year
First in Chicago to respond to the continually increasing numbers of homeless families
SERVICE DELIVERY MODEL
A multi-disciplinary approach that is inclusive of: Primary therapy and counseling Intensive case management Psychiatric and Psychological services Access to other outreach services Developmental pediatric & well-child evaluations
in partnership with University of Chicago Utilizing a wrap around approach
WHAT IS A “WRAPAROUND” APPROACH
Wraparound is a philosophical approach to delivering services
Services are unconditional, continuous and coordinated.
Delivers individualized services based on the inherent strengths of the child and family
WHAT IS A “WRAPAROUND APPROACH”
Services are community-based with the goal of ensuring that children and families succeed in their own natural home community
What ensures success in their own community is the family’s ability to identify and access natural supports in that community
CLINICAL DEMOGRAPHICS OF HOMELESS CHILDREN 3-6 Unique needs of homeless children ages 3-6
Observation of insecure/indiscriminate attachment to adult figures
Children acting out based on the stress placed on children in shelters
Children often exhibit a delay in both developmental as well as social functioning
Symptoms of children range from oppositional defiant to post traumatic stress symptoms to early signs of depressive symptoms. It is important to note the comorbidity of symptoms versus a singular diagnosis as in older presenting clients
CLINICAL DEMOGRAPHIC STUDY OF HOMELESS CHILDREN
Based on observations made by the demographics of homeless children, there are a variety of presenting problems that children exhibit (comorbid diagnoses)
Problems are systemic Need for a wraparound approach to
delivering services
ATTACHMENT ISSUES NOTED IN HOMELESS CHILDREN
Understanding the foundation for secure attachment:
Sensitive, responsive caregiving provided consistently over time by a specific caregiver
Primary caregiver is attuned & responsive to child’s cues, state, emotions, needs (Ainsworth)
UNDERSTANDING THE FOUNDATION FOR A SECURE ATTACHMENT CONT’D
Caregiver’s emotional investment in the child (Howes)
All these features are deeply impacted by the family’s homeless state and parent’s availability to ‘parent’ and facilitate a secure attachment
TREATMENT PHILOSOPHY
Strengths based, culturally sensitive & developmentally focused (for child and parent) are most effective
Belief in the resiliency of the child and family and capacity to improve functioning
Recognize the myriad of resources that can be mobilized for the benefit of the child and family
TREATMENT PHILOSOPHY – con’d
Addressing the child’s needs now will have long term impact (impact on future homelessness, early identification of needs….)
Homeless mothers’ availability severely impacted by:
Mental Health issues/cognitive functioningTraumatic histories (abuse, homelessness…Attachment issues (ghosts in the nursery)Reality of homeless state (inability to cook,
parent,….
TREATMENT APPROACHES & MODALITIES
Reflective practice & supervision Within a milieu setting: recognize and regularly
monitor areas of functioning: Problems & positive reinforcement to child strength areas
Parent-child psychotherapy Reflective developmental guidance Supporting direct play, caregiving,
communication, interaction modeling & coaching
Play Therapy – focused attention to child’s developmental needs (gross & fine motor, sp/l…)
TREATMENT MODALITIES - cont’d
Video scrapbooking, Mommy and Me program, Medical Home Model
Psychiatric/psychological assessments and treatment
Intensive case management to address the family’s needs for housing, financial support, education/employment, …
COALITION BUILDING TO ADDRESS THE NEED OF HOMELESS CHILDREN AND FAMILIES
Chicago’s Ten Year Plan to End Homelessness Planning Council (representative of Constituency Groups, Consumers, public/private fundersService Providers CommissionsHomeless Families Constituency GroupChicago Alliance to End HomelessnessNew Initiatives in Chicago