Tuesday, October 1, 2013

C-S-C-huh?


Happy fall y’all!  It’s been a rainy one here in Montana but I hope somewhere the leaves are turning golden in the brisk fall sunshine.

I wanted to take time today to share more about the program I work for.  In Montana, there is a program labeled Comprehensive School and Community Treatment.  This program is administered by various agencies throughout the state which contract with the Office of Public Instruction (OPI).   Comprehensive School and Community Treatment, or CSCT for short, is designed to be an outpatient clinic built into a school system.  CSCT in each school is comprised of a two-person team, a licensed therapist (Kelly) and a mental health worker (me!).  The teams work with children identified as Seriously Emotionally Disturbed (SED) who qualify for state/federally funded health insurance.

So, what does SED look like in a school setting?  Currently, the kiddos in our program struggle with maintaining attention, impulsivity, aggression (toward self, peers, or authority), depression or inability to engage in class activities, and inability to recognize boundaries or other social cues.


The diagnoses for the kids in our program are often comprised of:

  • Oppositional Defiant Disorder,
  • Post Traumatic Stress Disorder,
  • Dysthymic Disorder,
  • Major Depression, and
  • Generalized Anxiety Disorder. 

These diagnoses can be precipitated by any or all of the following:
  • a childhood history of abuse and/or neglect,
  • witnessing violence between caregivers,
  • witnessing drug use/abuse,
  • a sense of shame by caregivers,
  • lack of empathy by caregivers,
  • inconsistent structure and stability throughout childhood,
  • unmet infancy needs,
  • harsh and inconsistent discipline,
  • lack of boundaries between caregivers or siblings,
  • lack of relationship with caregiver, and
  • a consistent and pervasive fear of physical and emotional needs being unmet

So, how do kids get referred to CSCT? Students are often referred to our program by teachers, parents, or the principal with a majority of referrals initiating with teachers.  This school year, our new principal, Mrs. Miller (#mrsmillerrocks), shared a referral form she utilized at her previous school.  The form consists of questions about struggling students- how are they struggling?  what classroom interventions have been utilized? how does the teacher define "success"?  what would a change in behavior look like? etc.  Teachers fill out the form, turn it into the principal and a carefully constructed team of teachers, administration, and counselors meet to discuss options to assist the student.  Not every student identified qualifies or is the right fit for our program, however, our numbers of participation are quickly rising this year.

So, what do you do exactly?  When kiddos are referred and accepted into our program (meaning they are struggling academically, in the home, and with peers AND are currently enrolled in Medicaid), they receive individual, family, and group counseling.  Smalls groups are conducted daily (usually with Kelly and I together) and individual and/or family therapy is conducted weekly (usually only by Kelly).  I truly enjoy creating lessons for small groups and can't wait to share more small group ideas and activities with all of you!

Whew, that was a mindful, I mean a mouthful, of information.  I specifically wanted to share this information to help create a better understanding of the population our program serves...so in future posts when I share how certain activities do not go according to plan, you might have an idea why ;-)

I hope you all have a cozy, warm week!


Kristina

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