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PROVIDING CLINICAL SERVICES TO HOMELESS CHILDREN IN CHICAGO by 2CxzIx

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									PROVIDING CLINICAL
SERVICES TO HOMELESS
CHILDREN IN CHICAGO,
ILLINOIS


Susan Reyna-Guerrero, LCSW
President/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
 Basedon 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 OLDS
LITTLE 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 functioning
      Traumatic 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 funders
   Service Providers Commissions
   Homeless Families Constituency Group
   Chicago Alliance to End Homelessness
   New Initiatives in Chicago

								
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