THE FAMILY ADOLESCENT PROGRAM ADMISSION CRITERIA RESIDENTIAL TREATMENT FOR ADOLESCENTS

1. The patient is age appropriate, 14 to 18 years of age. The patient has an I.Q. appropriate to milieu.
2. Admission for a diagnosis of a mental disorder will be defined by the DSM-IV-TR, (i.e., substance abuse, conduct disorder, identity disorder, post traumatic stress disorder, thought disorder, affective disorder, and adjustment disorder).
3. Enrollment interest in academic program of special or regular education.
4. Less intensive treatment options have failed or are not available.
5. Family dysfunction is perpetuating the problem, (i.e., family violence and or abuse, substance abuse, lack of structured living environment, lack of appropriate boundaries and limit setting).
6. Displays potential to benefit from the long term treatment program and transfer to a lesser level of care within a reasonable length of time.
7. Medically stable.

These are general guidelines for exclusion of admissions to the Adolescent Residential Treatment Program at The Family.

1. Actively suicidal and/or homicidal within the past three (3) weeks.
2. Medical or physical needs that require a level of care that exceeds the resources of The Family.
3. Severely mentally retarded with chronic, episodic lack of control manifested by impulsive, unpredictable aggressive behavior.
4. Non-ambulatory individuals.
5. A sustained history of physical violence or aggressively inappropriate behaviors.

1. Contact Clinical Assessment Center- 1-800-417-6237 or 1-800-366-8466
2. Forward copies of the following information- Face sheet, social history, admission history, physical exam and history, psychological and neurological testing, progress notes (past two weeks), immunization records, physician's orders (past two weeks), list of current medication, including PRN.

The above material will be reviewed for appropriateness for admission. A clinical interview may be required. Transmission of data and scheduling of pre-admission interviews will be arranged by The Family's Admission and Clinical Departments.

Upon determination of appropriateness for admission, transportation and admit date will be arranged.

All adolescents will be evaluated by a Medical Doctor within twenty-four (24) hours of admission. The physician's report includes a mental status examination, a Nursing Assessment, including chemical use profile, which is completed immediately. A Psychiatric Evaluation is completed within twenty-four (24) hours of admission. A battery of psychosocial assessment is administered within the first seventy-two (72) hours of admission. The assessment data is organized to form the basis of the initial Treatment plan.

The confidentiality of alcohol and drug abuse patient records maintained by this program is protected by Federal law and regulations. Generally, the program may not acknowledge a patient's attendance, nor may the program disclose any information identifying a patient as alcohol or drug abusers unless:

1. The patient consents in writing.
2. The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit or program evaluation.
3. Threat or harm to self or others.
4. Court orders.

Be informed that:

• Violation of the Federal law and regulations is a crime and that suspected violations may be reported to appropriate authorities in accordance with these regulations.
• Information related to a patient's commission to a crime on the premises of the program or against personnel of the program is not protected.
• Reports of suspected child abuse or neglect made under State law to appropriate State or local authorities are not protected.

1. A copy of this grievance procedure will be provided to each patient upon his/her initial intake for any services rendered at The Family Recovery Center.
2. Forms with respect to the filing of grievances ("Grievance Form") shall be distributed and made available to patients at all times.
3. In an event that a patient grievance arises, the aggrieved party shall complete a Grievance Form. The patient will then have the opportunity to discuss his/her grievance with The Family Recovery Center Clinical Director within three (3) working days of the circumstances which gave rise to the grievance. If the patient fails to adhere to this requirement, and does not file a Grievance Form, his/her right to appeal shall be forfeited.
4. In the event that the aggrieved patient does not obtain a satisfactory resolution to the grievance by means of the process outlines above, he/she may choose to seek resolution of same by contacting the Director of Department of Alcohol, Drugs and Mental Health at the Florida Department of Health and Rehabilitative Services at (561)540-1308.

1. You have the right to be treated with dignity and respect; as an individual who has personal needs, feelings, preferences, and requirements.
2. You have the right to privacy in your treatment, in your care, and in the fulfillment of your personal needs.
3. You have the right to be fully informed of all services available to you in The Family and of any changes to those services.
4. You have the right to be fully informed of your rights as a patient and all of the rules and regulations governing your conduct as a patient in this facility.
5. You have the right to manage your personal financial affairs. If you desire assistance, The Family staff will arrange appropriate assistance for you.
6. You have the right to know about your physical condition unless your physician, for medical reasons, chooses not to inform you, and so indicates in your medical records. You have the right to participate in the development of your treatment plan.
7. You have the right to receive information necessary to give informed consent prior to the start of any procedure and/or treatment.
8. You have the right to refuse treatment to the extent permitted by law and to be informed of the consequences of this right.
9. You have the right to continuity of care. You will not be discharged or transferred except for medical reasons, for your personal welfare, or the welfare of others. Should your transfer or discharge become necessary, you will be given reasonable advance notice, unless an emergency situation exists.
10. You have the right to voice opinions, recommendations and grievances in relation to policies and services offered by the facility, without fear of restraint, interference, coercion, discrimination, or reprisal.
11. You have the right to be free from physical, chemical and mental abuse. Physical and chemical restraints may only be applied when ordered by your physician, in writing, and for a specific limited period of time, except when necessary to protect you from injury to yourself or others.
12. You have the right to confidential treatment of your personal and medical records. Information from these sources will not be released without your prior consent, except in your transfer to another health care facility, or as required by law, or under third party payment contracts.
13. You have the right to refuse to perform any service for the facility or for other patients, unless they are part of your therapeutic plan of treatment, which you have approved.
14. You have the right to retain and use your personal clothing and belongings, as space permits, unless to do so would infringe upon the rights and safety of others, or be contrary to your written plan of treatment.
15. You have the right to participate in the activities of social, religious and community groups of your choice unless your physician, for medical reasons, considers such activities contrary to your welfare and so indicates in your medical record.
16. You have the right of choice of persons with whom you associate and communicate, publicly and privately, unless your physician feels some or all such associations are detrimental to your welfare and so indicates in your medical records.
17. You have the right of privacy during visits by your spouse, family, clergy and others.
18. You have the right to receive visitors at times other than the established visiting hours, particularly at times of critical illness, or for other pressing personal matters.
19. You have the right to reasonable access to a telephone to conduct private telephone communications. You have the right to both make and receive telephone calls.
20. You have the right to send and receive mail.
21. You have the right to be informed in advance of any visitors of The Family's and the right to privacy if you do not wish to see visitors or participate in activities while visitors are present on the Family's premises.

Problem reduction and skills development are best facilitated through the use of a structured therapeutic environment. Within an atmosphere of nurturing and support, this environment consistently elicits, encourages, and reinforces appropriate and adaptive behaviors. The therapeutic community allows the patient to explore and express feelings, develop and enhance self-esteem, gain insight into behaviors and develop appropriate coping skills and behaviors in a safe, secure, empathic, warm and firm atmosphere.

The program is designed to meet the cultural, social, and emotional needs of our patients. We maintain a staff composition that is diverse and able to provide positive role modeling.

Treatment is an integration of didactic, therapeutic and experiential approaches conducted in the context of a healthy milieu where these principles can be practiced and reinforced. Social skills, coping skills, interpersonal relationships, daily living skills, and leisure skills are taught and practiced within the milieu. Working through unresolved developmental issues and self-defeating behaviors take place within group therapy, and family counseling. Alternative decision making is emphasized through role-playing and verbal-cognitive oriented therapies. The staff works jointly with parents, guardians, and placement agency representatives to develop a better understanding of the adolescent's behavior and the family dynamics. Treatment includes a thorough psychiatric assessment and diagnosis and judicious utilization of psychotropic medications when indicated. Our goal is to curtail and eliminate the destructive behaviors that resulted in the need for treatment, while developing the capacity to elicit positive behavior and the ability to form meaningful and rewarding relationships with peers and adults.

PROGRAM SERVICES, TREATMENT TEAM AND TREATMENT PLANNING PROCESS

• The multidisciplinary treatment team is led by licensed therapists and is composed of master level mental health counselors and social workers, addiction therapist, nursing staff, recreational therapist, and educational staff. All treatment is overseen by a board certified adolescent psychiatrist.

  The treatment team meets minimally once per week and is responsible for developing, implementing and monitoring the course of treatment for each patient. The team develops comprehensive treatment plan that is individualized and meets all the needs of the patient. The plan also includes discharge criteria as well as aftercare plans. Parents, guardians and referral agencies are critical components of the treatment and aftercare process and their participation is highly encouraged. The patient is also an integral part of the planning process and may at times be included in the team meeting.

CASE MANAGEMENT SERVICES

• Case management services are provided by highly trained case managers.

INDIVIDUAL THERAPY

• Patients have a minimum of one individualized session per week. The focus and style of these sessions are individualized to meet the needs of the patients.

GROUP SESSIONS

• The purpose of all group therapies is to utilize the group process to alleviate interpersonal and social dysfunction, to develop communication and relationship skills, to develop shared identity and allegiance of peers and to foster appropriate attitudes and behaviors. These groups are held twice daily; 6 days a week.

FAMILY THERAPY

• Included in the Family's philosophy is the importance of parental and family involvement. A dysfunctional family system may be a significant factor in the patient's dysfunction. The family, when available, is involved in treatment to address issues pertaining to the patient and family. The goal is to restore and maintain functional, healthy family systems and to provide for continued emotional growth and well being of the identified patient and other family members. In some cases, the goal of family workshops is to facilitate and assist the family in the decision to place the patient outside of the home. Where extended families do not exist, efforts are made to work in a similar fashion with surrogate family units or substitute support systems.

CHEMICAL DEPENDENCY THERAPY

• These educational groups are held daily. The Twelve Step Recovery Program Philosophy for Alcohol Anonymous (AA) and Narcotics Anonymous (NA) guides all chemical dependency interventions. These interventions focus on such topics as drug education, denial reduction, acceptance of responsibility and the disease concept of addiction. Daily attendance at Twelve Step Recovery Meeting of AA and NA is required. The meeting addresses such issues as the disease concept, family dysfunction, trust, self-esteem, and "letting go".

MALE/FEMALE EDUCATIONAL GROUPS

• These groups educate adolescents in the area of sexuality. These respective groups focus on the physiological and psychological aspects of sexuality. Role-play and experiential situations are utilized to educate adolescents in areas of decision making, safe sex, sexually transmitted diseases and relationships. These groups are held at least one time per week. These groups are facilitated by medical staff.

PROCESS GROUPS

• These groups are traditional, insight oriented, social adjustment case management group sessions. Each group meets twice a day and 6 days a week.

SOCIAL SKILLS GROUP

• The social skills group meets a minimum of twice per week. A certified recreational therapist facilitates this group. Groups are focused on enabling the patient acquiring appropriate coping skills by breaking these skills into basic steps and practicing them in role play situations.

EDUCATIONAL SERVICES

• Parents are encouraged to contact guidance counselors to coordinate the appropriate individualized school program. The goal of this educational program is to help patients perform to the best of their ability in a supportive environment and to prepare them for return to the appropriate educational setting. Upon fulfilling academic responsibility, patient will receive full credit for all academic work and records will be transferred to their respective schools.

DISCHARGE PLANNING

• Discharge planning implies change and new direction. From the start of every patient's hospitalization, we must be thinking of what can reasonably be expected from the treatment stay. Inpatient stay is the beginning and plans must be made for the patient's longer-term care. If they complete treatment, they will return to their referring therapists. When needed, the staff at The Family, will provide ideas, names and information for new treatment situations. It is the responsibility of the patient and the family to realize this change in direction through such concrete steps as setting up outpatient appointments, requesting school meetings, and the like. Such arrangements are often complicated and time consuming. The therapy team will assist the family in development of plans that may continue after discharge.

  The first choice is to return home. For some adolescents, returning home is not an option. The treatment team and the family must review this possibility in the early stages of treatment in order to make appropriate discharge plans. This may be a painful realization involving doubt, mixed feelings and frustration. Often, residential and boarding school placement involves months of complex negotiations. In some situations, the patient must go home and work with family therapist, school officials, and staff in the Department of Social Services towards the goal of long-term placement. Because of the frustrating and confusing nature of this process, the treatment team and unit staff will be available to share ideas, hopes, disappointments, and frustrations of the process. It is important to remember that in spite of the difficulties associated with finding the adolescent a new home; it is most difficult on the patient. We have found that the end result is a good one and permits the adolescent to heal and begin anew. Again, our primary goal is to facilitate discharge to home.

PATIENT GOVERNMENT PROTOCOL

• Adolescents are encouraged to be functional members of the patient population. One mechanism for this is structured patient government. Active participation in this system serves to facilitate open expression of thoughts and feelings related to the patient's current living experience. Government officials must be level III or IV. Officers consist of a president and secretary. Officers' performances are reviewed weekly.

RECREATIONAL ACTIVITIES

• Recreational activities afford the adolescent the opportunity to enhance a sense of physical well being, to utilize constructive use of leisure time, to increase self-esteem, and to increase socialization and interpersonal skills.

PYSCHO-EDUCATIONAL LECTURES / DIDACTIC SESSIONS

• General lecture series that focus on a variety of topics, inclusive of, but not limited to: Family systems, shame, guided imagery, and boundaries. Interaction is encouraged and emphasis is placed on the relationship between the subject matter and the chemical addictions.

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