At HEC we believe that people want to succeed and will do so if they can. We also believe then, that if they are not doing well there is something interfering in their ability to be successful.

At HEC we believe that a lack of skills (distress tolerance, relationship, mindfulness, emotional regulation), a lack of resources (community support, cognitive capacity, brain injury, etc.), and/or an environment that overwhelms the person’s skills and resources are what interfere with a person’s success. In order to create success, the incongruence between the person (skills and resources) and the environment (supports and demands) must be repaired.

As humans we are all in a developmental process, with strengths and limitations based on our unique developmental capacities. When the person and others in the environment know what skills, resources and limitations a person has, everyone involved can work together to overcome these limitations, and the environment can simultaneously modify its demands, supports, and expectations to help make success possible.

Hillcrest Educational Centers (HEC) is founded on the values of providing unwavering compassion, mobilizing second chances for children, and believing that change is always possible. Today’s intervention model builds upon this foundation, incorporating principles of Collaborative Problem Solving, Trauma Informed Treatment, and Applied Behavior Analytic services. The HEC treatment model also recognizes the parallel process at work between staff, students, and family, and incorporates this process in the model. We ask all citizens of the Hillcrest community, both staff and students, as well as families at home, to take part in this model, beginning with abiding by the HEC Community Values.

HEC Community Values 

Safety– At HEC we endeavor to maintain safety by creating an atmosphere of predictability, fairness, accountability, and peacefulness.

Respect– At HEC respect means recognizing what is important to us and to others, acknowledging how our actions and decisions affect our lives, the lives of others, and the community, and considering these in our decision making process.

Empathy– At HEC, we prioritize understanding others, what they need, and what gets in the way of their goals, so we can be better helpers, peers, coaches, employees, supervisors, friends, and community members.

Realistic Expectations– At HEC, we modify our expectations within the environment whenever possible based on the individual’s needs in order to create an environment in which they can be successful.

Self-care–

At HEC, we recognize that everyone gets overwhelmed at times. Through proactive self-care, identifying specific vulnerabilities, and building skills and supports, we can minimize our distress and better help others and ourselves through difficult times.

Collaboration/Teamwork- At HEC, the student, their family, support system, and the entire HEC community are committed to working together to bring the greatest success.

Personal Enrichment– At HEC, new opportunities to learn and grow are everywhere. No one is good at everything, but through trying new things, growth and eventually mastery can occur.

In order to ensure that the above values are clear and maintained in the campus environment, each campus may have a related set of expectations for its campus community.

On admission to HEC, students are assessed by all departments represented by the treatment team. Departments include, but are not limited to: clinical, residential, educational, vocational, and medical. Based on individual need, the treatment team will choose either a Skills for Life (SFL) or Applied Behavior Analysis (ABA) approach to student treatment. Regardless of the methodology, HEC treatment maintains the same core principles.

A. Core Principles of HEC Treatment 

Collaborative Problem-Solving (CPS) 

At the core of the HEC treatment model is the belief that problematic behaviors are displayed as adaptations to situations where coping skills and resources are overwhelmed. In order to intervene effectively, we must help individuals understand and recognize the impact of their own behavior, identify the related skill/support deficits, and assist the individual to develop needed skills and resources to manage the situation more effectively in the future.

The primary intervention approaches guided by the CPS philosophy are skills assessment, skills development, and a collaborative problem solving process that leads to a mutually acceptable plan for working things out. HEC community members must practice the steps of collaborative problem solving in their interactions with others. This process involves three steps: 1) empathize, 2) define the problem, 3) invite the other person to problem-solve. Potential solutions  must be brought to interdisciplinary team meeting for discussion and approval prior to implementation.

In order for the collaborative treatment approach to work, the student, and as approved, the family or community members connected to the well-being of a student, as well as HEC staff, must understand behavior from a skills perspective, provide formal and informal opportunities to develop lagging skills, and have collaborative input into all aspects of the treatment and problem-solving process. Students should attend, or if unwilling/unable, have input into the CTP, special and emergency team meetings, as well as other venues when important decisions/problems are being considered.

Trauma Informed Care (TIC) 

When the environment is very overwhelming, as is often the case when a person experiences trauma, attachment disruption, loss, domestic violence or abuse, this can result insignificant impact on the development of the person’s skills and resources. Exposure to those who have experienced these events has impact on others in the community. A trauma informed environment requires an understanding of trauma and considers its effects, at the personal, individual, and societal levels.

As trauma and loss are, at their core, violations of interpersonal connection, the HEC community focuses on developing healthy relationships with others. Within these healthy relationships, motivation, healthy sense of self and connections to others and the community are developed. Other primary intervention approaches from the TIC philosophy include psycho-education about trauma/vicarious trauma and its effects, understanding the influence of individual trauma histories, making meaning from these difficult experiences, developing self-awareness, developing skills and resources to manage more effectively, and proactively planning for safety.

Applied Behavior Analysis 

When indicated, HEC uses Applied Behavior Analysis  as the method of treatment for individuals with developmental disabilities or behavioral difficulties associated with a number  other medical or psychiatric conditions.. Behavior analysis is the scientific study of behavior. Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation, and the procedures and technology derived from those principles, to the solution of problems of social significance, including the education and treatment of individuals with .varying difficulties including Autism.   Applied Behavior Analysis has been empirically validated as an effective treatment for reducing challenging behavior and teaching adaptive skills. Educational and clinical programming relies on the principles of reinforcement, extinction, shaping, secondary and generalized reinforcement, and chaining, to teach appropriate skills in a variety of areas including communication, discrimination, daily living skills, academics, vocational skills and leisure skills.

Students appropriate for ABA services are those who have not benefited from traditional clinical interventions. Some students under an ABA treatment model may not have the insight, social skills, communication skills, or the developmental capabilities to engage in either individual or group therapies. Those students receiving ABA programming will have a Behavior Support Plan written in lieu of a Comprehensive Treatment Plan (CTP) and will receive their clinical services from a Board Certified Behavior Analyst (BCBA). All students who are capable will participate in the development of their educational and behavioral programs.

Integrated Treatment Domains 

HEC students’ treatment progress and resulting treatment phase are determined by accomplishing certain landmarks of growth and development in the areas of building connections with others, developing competency (utilizing skills), and becoming a good citizen, as well as other domains as determined by the specific campus. These core treatment goals for each treatment domain and phase are detailed and consistent across campuses. Progress in these domains is measured by specific task completion, as well as other meaningful measures as determined by the campus.

 

Skills Assessment and Development 

Developing a comprehensive understanding of each individual, their strengths and challenges, and the specific influences to their difficulties is a primary and ongoing component of treatment. The Assessment of Lagging Skills and Unsolved Problems (Greene & Ablon), along with supporting assessment tools, are utilized to facilitate this process, and to guide the treatment/intervention planning for each student. Through this process a thorough understanding of strengths, resources and limitations is acquired and a plan to help develop skills and resources while not overwhelming one’s resources can be initiated.

The core skills that are focused upon throughout all HEC campuses include: independent living/functional skills, academic skills, and the skills identified in Dialectical Behavioral Therapy (DBT) (Linehan): Mindfulness, Emotional Management, Distress Tolerance and Interpersonal Effectiveness.

Safety/Self-care Planning 

Each member of the HEC community completes a plan to help them and others recognize when they may be more vulnerable to getting overwhelmed and what to do about it if it occurs. The plan utilizes previous learning from skills assessment, trauma assessment, and the situational analysis processes, to communicate triggers, high risk situations, cues, coping skills and resources.

Accountability and Recognizing Successes 

The HEC Skills for Life model minimizes the use of reward and punishment as a means to gain compliance. Instead, the collaborative and respectful relationships between members of the community are seen as the primary change agents. Recognizing individual strengths and developing them into areas of ongoing success and competency lead to lasting change.

Consequences may be used to help create an environment of accountability. They may be used only when directly connected to a violation of the HEC Community Values or campus rules based on those values. They may be instituted when necessary to create or maintain safety or in effort to bring about internalization of a value or the development of skills. Consequences must therefore be meaningfully connected to the violation, should include a Life Space Interview to facilitate understanding, and a strategy to foster connections with others. Whenever possible, consequences should include the input of the person receiving them and any person affected by the act/event and includes an act of reparation for the effects on others. Consequences are not to be time or punishment-based (example: 72 Hour or “LOP” loss of privilege, restriction). Behavioral problems not related to the HEC Community Values must be managed through the relationship or more formally through Collaborative Problem Solving based interventions detailed previously.

Strengths and successes, even during times of problematic behavior, should be recognized and emphasized whenever possible. Strengths will be listed on each student’s treatment plan as well as their tracking logs. The students and their HEC community of support will be encouraged to recognize and indicate their use on the tracking log on an ongoing basis.

Rewards for good work, productivity and success are a wonderful part of life. Everyone works harder when a desirable outcome will be the result. Rewards are used in these ways within the HEC community as well. However, natural and relationship based (recognition from or time with a caring person, more options for recreational time) rewards should be prioritized. Rewards are never to be used as a means to coerce or bribe.

B. Cruel and Unusual Punishment 

HEC prohibits the use of all cruel and unusual punishment and coercion including, but not limited to, the following: 

1. Any type of physical hitting.

2. Excessive physical exercise or assignment of unduly physically strenuous or harsh work.

3. Causing a student to take an uncomfortable position or repeat physical movements.

4. Group punishments.

5. Ridicule, humiliation, verbal abuse, threatening statements or statements made to elicit fear.

6. Denial of essential program services.

7. Withholding of any meal, snack or earned reinforcement.

8. Denial of sleep or opportunities for exercise.

9. Denial of shelter, clothing, bedding or bathroom facilities.

10. Excessive withholding of emotional response or stimulation.

11. Use of non-approved physical or chemical restraint; or the use of any mechanical restraint.

12. Exclusion from entry to the residence.

C. Treatment Plan Components

The components of a Treatment Plan minimally include: 

1. Positive teaching strategies and programs intended to teach skills.

2. Individualized treatment with reasonable changes or accommodations in the environment to accommodate individual needs.

3. Strategies and techniques intended to extinguish maladaptive behaviors such as self-injury, aggression, excessive self-stimulation or non-compliance, emphasizing replacement behaviors and skills.

4. Interventions to promote change and growth of cognitive and emotional patterns.

5. A plan, with specific strategies, to aid the student toward moving to a less restrictive setting.

Assessment Policy for Residential Campuses 

Hillcrest utilizes an extensive assessment process during the admission process, during the diagnostic period (first 45 days of treatment), and ongoing. Throughout all of our assessments, the student, the student’s family and/or guardian, referring agencies, and the HEC treatment team are utilized in order to gather data and determine treatment interventions/services. The following is a summary of these processes.

Admission process 

Intake Assessment 

Before a student is admitted to an HEC program, an Intake Assessment and a Preliminary Treatment Plan (PTP) are completed by a member of the clinical staff and then distributed to the campus staff. The information gathered and relayed to staff includes information provided in the admission packet, information gathered through the Admissions Interview (see ICF), and when possible, direct communication with the family and referring agencies.

To ensure that staff are adequately prepared to work with the student, the following information is included in the Intake Assessment:

• Student identification, legal guardian, relevant family information, and current intellectual functioning
• Student Strengths
• Reason for Referral
• Significant Behavior Problems:
  • Physical Aggression
  • Verbal Aggression
  • Sexual Behaviors
  • Firesetting Issues
  • Self-Harm Behaviors
  • Elopement/Runaway
• Substance Abuse
• Delinquent/Status Offenses
• Significant Medical Problems
• Current Medications
• Current Diagnosis

Preliminary Treatment Plan 

To ensure the safety of the student, the safety of others, and for developmentally and culturally appropriate treatment during the assessment process, the Preliminary Treatment Plan includes goals that focus on the following areas:

• participation in the assessment and orientation process
• participation in counseling/mental health services
• participation in individual and group therapies
• participation in medical/health assessments
• completing a family contact plan
• participation in recreational activities
• developing and practicing age appropriate social skills
• reducing the occurrence of high risk behaviors

Each goal has treatment objectives that are appropriate for the student and his/her specific needs. Specific to reducing high risk behaviors, the high risk behaviors identified in the Intake Assessment, basic parameters for the use of therapeutic physical intervention are included in the Preliminary Treatment Plan. These parameters include articulating that physical intervention may only be used after all other interventions have been attempted and are ineffective, when a student is presenting an imminent risk to self or others, or when by evading staff, a risk to self or others is imminent.

It should be noted that participation in this process is program specific and that not all students may possess the skills to participate as articulated above. Students having significant cognitive impairments may not be skilled enough to participate in verbal therapies. In such cases functionally appropriate alternative behaviors are taught proactively as a means of providing students with alternative behaviors that can be prompted and reinforced when used in crisis situations.  

Individualized Crisis Management Plan 

Additionally, a very detailed plan for ensuring the safety of the student and managing high risk behaviors is completed upon admission. This plan, entitled the Individualized Crisis Management Plan or ICMP, is rooted in utilizing a trauma informed approach to treatment. The ICMP is a component of Therapeutic Crisis Intervention (TCI). Hillcrest’s ICMP is a 2 page document that incorporates input from the student, the student’s family, guardian, funding agencies, and the HEC treatment team developed within the first 24 hours after admission. All parts of this process will utilize the input of the family, guardian, and funding agencies as well as student records as current interactions with the student.

The goal of the first page of the ICMP is to ensure the student’s input is immediately utilized in his/her treatment. It utilizes questions posed to the student to identify the student’s goals, strengths, and interests. It includes questions posed to the student that help identify the student’s triggers, sore spots, and situations that overwhelm their coping skills. Page 1 also identifies skills, resources, and interventions that the student finds helpful or not helpful.

The second page of the ICMP provides important information about the student’s current and historical high risk behaviors and high risk situations. Important safety information such as medical concerns, trauma triggers, current diagnoses, and current medications is included. This page then identifies individualized interventions to utilize when the child presents at different stages in the stress model of crisis. Page 2 also identifies very specific parameters for the use of physical intervention and what types of physical intervention are permitted.

Behavior Support Plans

Treatments based on upon the results of FBA’s  referred to as the Behavior support plan will employ strategies designed to increase functionally appropriate alternative responses, using the least restrictive procedures possible. All such procedures should be reinforcement based, using known preferences of the child.A behavior support plan is a very detailed intervention plan designed to render the most challenging behaviors exhibited by the child useless. Behaviors targeted for intervention are those that present the most risk to child and staff, or those responses that are significant enough that they hinder learning or further stigmatize the child.  This document is split into two main sections each providing specific instruction on how to teach, reinforce, and redirect student behavior.  

The Pro-active section of the BSP is designed to inform staff on what appropriate replacement behaviors should be prompted and reinforced when exhibited by the child.   Following this process will establish new patterns of behavior for the child, teaching them that exhibiting these behaviors will serve the same purpose as their previously inappropriate behavior, and also teach them that they will receive positive attention and reinforcement when these desirable behaviors are exhibited.

The Reactive portion of the behavior support plan is a supportive process designed to tell staff how to redirect the child when precursor behavior is observed that may lead to more challenging behavior.  If the child accepts redirection they are praised for their appropriate behavior and staff encourages the child to re-engage in their regularly scheduled activities.  If redirection is not successful and the child continues to escalate, the staff are instructed in how they should proceed if the need to interrupt the behavior, or if staff must intervene to keep the child and others in the environment safe.

Mental Status Exam and Risk Assessment 

Within 24 hours of admission, the student’s clinician completes a mental status exam and risk assessment, gathering important information about the student’s current mental status, including assessing for any current risks of harm to self or others as well as protective factors.

Diagnostic Period 

Diagnostic Tools 

Within the first 45 of days of treatment, students, their families, referring agencies, and treatment team members participate in a wide variety of interviews, assessments, and diagnostic tools that culminate in the Comprehensive Treatment Plan (CTP) or Behavior Support Plan, and the Diagnostic Psychosocial Assessment Report (DPSA). The following is a list of assessments/tools that are completed. A timeline of all documents, the departments responsible for ensuring their completion, and the dates by which they are due in the chart can be found under separate cover.The following is a list of assessments/tools that are completed:

• Trauma Assessment
• High Risk Behavior Assessments as deemed appropriate (Firesetting, Sexual Behavior)
• Substance Abuse Assessment
• Psychiatric Evaluation
• Other Diagnostic Scales as deemed appropriate (i.e. ADHD scale, Depression Inventory, Trauma Symptom Checklist, Family/Developmental Questionnaires)
• Academic Assessments
• Recreational Assessment (Leisure Scope Assessment)
• Life Skills Assessment (Ansell Casey, Youth Readiness Assessment)
• Spirituality Assessment
• Treatment Map (completed during Diagnostic Assessment Team Meeting)

Diagnostic Assessment Team Meeting 

By day 45 of a student’s placement, the Diagnostic Assessment Team Meeting is held in order for all departments to share their findings. The goals of this meeting include (1) examining all assessment information in preparation of the CTP and (2) for inclusion in the Diagnostic Psychosocial Assessment (DPSA). The following is a brief outline of the meeting agenda/process:

• Identifying the treatment team’s diagnostic and treatment planning questions
• Identifying data: distribute genogram, providing brief identifying data for student, family, and presenting problem, including strengths, resources, areas of needed support
• Historical data & formulation: distribute DPSA draft; review family, behavior, and placement history; provide summary of developmental & family questionnaires; summary of trauma assessment, summary of high risk assessments
• Current functioning w/ focus on connections between current behavior & trauma
  • Student self report of functioning, insight, treatment needs, and goals
  • Identify strengths & resources of the student and family. Include spiritual and cultural practices, traditions, and resources.
  • Intellectual functioning- academic reports & summary of psychological testing including assessments of intellectual functioning, projectives, any other testing, and recommendations of the psychologist
  • Medical functioning – nursing report
  • Social functioning – residential report
• Answering diagnostic & treatment planning questions
  • Discuss identified sore spots, triggers, and quick relief behaviors
  • Brainstorming treatment goals & interventions, utilizing all of the above
  • Recommendations for any further assessments

In the ABA program completing a preliminary Functional Behavior Assessment with parents or caregivers may occur as a means of identifying the previously known variables that may reinforce challenging behaviors. Functional assessment interview forms are brief in nature and help guide future assessment directions.   

Diagnostic Psychosocial Assessment Report (DPSA) 

As noted above, the DPSA is completed by the clinician within 45 days of intake and provides staff with important information to utilize in the treatment of the student. The following is a list of information provided in the DPSA:

• Presenting Problems
• Strengths/Resources
• Developmental and Medical History
• Educational History
• Placement and Treatment History
• Family Situation, Past and Present
• Trauma History
• High Risk Behaviors:
  • Substance abuse
  • Sexual aggression
  • Physical aggression
  • Firesetting
  • Self-Harm
  • Elopement/Runaway
• Criminal involvement (legal disposition)
• Religious Affiliation, Spirituality
• Psychological Evaluation Results
• Medications and Physical Intervention History
• Current DSM Diagnosis
• Clinical Impressions
• Clinical Formulation
• Recommendations for Intervention

Ongoing Assessment 

Assessment does not end at day 45 of a student’s placement. Assessment of treatment needs, interventions, risk levels, are progress in treatment are ongoing.

Individualized Crisis Management Plan (ICMP) 

The ICMP is distributed to staff and staff and is reviewed quarterly at the student’s CTP meeting. In addition, students and staff sometimes identify new goals, strengths, interventions, triggers, sore spots, or safety concerns during the quarter. In these cases, students and staff are expected to communicate these findings with the clinician or in team meeting so that the changes can be made to the ICMP immediately. The updated ICMP is then redistributed.

The Behavior Support Plan (BSP) is available to staff at all times through the electronic data collection system on the ASD Unit.  BSP’s are stored on IPADs carried by staff and are available to staff through Catalyst.   Staff are encouraged to review and consult the BSP’s frequently because they are extensive and offer a wide range of strategies to increase positive behavior and student success. Each BSP is a fluid document that changes frequently.  When changes are made to BSP’s they are announced at team meetings, community meetings, and shift stand up meetings.  Additionally clinicians will email all staff to announce changes and encourage review of the procedures prior to working with the child again.   BSP changes are made based upon changing acuity levels of student behavior, having new behavior targets added, and when behaviors have improved and targets are removed.   

High Risk Behavior Assessments 

Hillcrest Educational Centers is committed to the careful assessment and appropriate treatment of students with high risk behaviors.Students  with histories or clinical presentations of sexualized behavior or fire setting require specialized assessment.

Students who present with either sexualized behaviors or firesetting/fire related behaviors may require a  risk management assessment being completed by their clinician in conjunction with the clinical administrator and/or staff psychologist. If a student is admitted to Hillcrest Educational Centers with a current risk assessment specific to their high risk behavior (within the last 12 months) a new one will not be completed during the diagnostic period. It would be completed one year from the date of the existing evaluation. It is appropriate to summarize the current evaluation and treatment recommendations  in the student’s diagnostic psychosocial assessment.

The  risk management assessment gathers information in the following areas: social, emotional and developmental background, family history and current functioning, trauma history and current functioning, history and course of treatment of the problematic behavior, current attitudes and behaviors related to the high risk area. It also identifies current high risk indicators (both static and dynamic) and protective factors as well as a determination of risk management needs. The assessment will also outline a safety and prevention plan as well as treatment recommendations for the student. This assessment will be shared with the student’s treatment team and redone on an annual basis, if a new disclosure occurs or if there is a notable change in the student’s functioning related to this behavior.

When these special assessments of sexualized behaviors, sexually abusive behaviors, and fire setting behaviors suggest that these problems continue to represent active risks in the clinical profile of the child, the high risk behavior must be addressed both in the treatment milieu and in the CTP treatment objectives. These special assessments may be built into formal psychological evaluations when psychological testing is required for the identified student. Updated high risk assessments must be done on at least a yearly basis as part of the CTP process or whenever a child shifts dramatically in the risk management needs, e.g. when new information surfaces that suggests the child should be considered at higher or lower risk. High risk assessment outcomes should be included as part of the discharge summaries, either in the form of the screening tools provided by HEC or in the narrative section of the discharge summary.

Functional Behavior Assessments

Functional Behavior Assessment is a varying set of procedures used to determine the purpose/function of challenging behavior.  Predicting behavior occurrence, identifying the purpose/function/ motivation of challenging behavior, and identifying those variables that maintain such responses allow for the development of effective function based treatments.

Function based treatments are those treatments implemented using the hypothesized functions of behavior derived from assessment. These procedures will focus on the use of positive approaches to develop functionally appropriate alternatives to the challenging behavior evaluated.  The final goal of assessment and treatment will be to make meaningful (socially significant) measurable changes to student behavior that will improve the individual’s quality of life. Treatment based upon these assessments are included in Behavior Support Plans (BSP), and Daily Management plans (DMP).  

The assessment process follows a general course which includes screening and general disposition, definition and quantification of a target response, identifying target responses to teach, program development (BSP), progress monitoring, and follow-up as deemed necessary by data analysis.

Comprehensive Treatment Plan (CTP) 

Comprehensive Treatment plans are reviewed regularly by the treatment team.  Each program has specific timelines identified for these review meetings and updated documents.  Further information about the specific contents of the CTP can be found in Chapter 4 Hillcrest Educational Centers Policies and Procedures.

Program Timelines are as follows:

Hillcrest Academy:  45 days, annually

Highpoint:  45 days, quarterly

Brookside ITU: 30 days, 90 days, quarterly

ASD Behavior Support Plans: 45 days, quarterly

Intake Assessment and Treatment Planning Policy for Housatonic Academy

Housatonic Academy completes an assessment of youth at admission as part of it’s treatment planning process. Throughout all of our assessments, the student, the student’s family and/or guardian, referring agencies, and the HEC treatment team are utilized in order to gather data and determine treatment interventions/services. The following is a summary of these processes.

Comprehensive Intake Assessment: Beginning at the time of acceptance, information will be gathered in order to complete a Comprehensive Intake Assessment document on the day of admission. To ensure that staff are adequately prepared to work with the student, the following information is included in the Comprehensive Intake Assessment:

• Client identification, legal guardian, relevant family information, and current intellectual functioning
• Client Strengths, Resources, Preferences, and Recreational Interests
• Reason for Referral
• Educational History
• Placement History
• Behaviors of Risk: Suicide, Non-Suicidal Self Injury, Substance Abuse, Agression, Sexual Behaviors, Sexual Exploitation, Fire Setting Issues, Elopement, Poor Judgement/Impulsivity, Potential Risk for Victimization, Delinquent/Status Offenses
• Medical and Developmental History
• Family History
• Spiritual, Cultural, and Communication Needs
• Significant Medical Problems
• Current Medications
• Current Diagnosis
• Current Treatment Needs and Services

Mental Status Exam: The Mental Status Exam is completed by a clinician as part of an initial interview with the student on the day of admission. It gathers important information about the student’s current mental status, including assessing for any current risks of harm to self or others.

Trauma Screening: The trauma screening is completed by the clinician as part of an initial interview with the student on the day of admission. It is a questionnaire designed to identify past trauma experiences that staff may need to be aware of in their work with the youth.

Substance Abuse Screening: The substance abuse screening is completed by the clinician as part of an initial interview with the student on the day of admission. This is designed to assess any current risk for substance abuse and potential needs for treatment referrals.

Individualized Crisis Management Plan (ICMP): The ICMP is completed in 2 parts, and is finalized within 7 business days of admission. Whenever possible, direct communication with the family and referring agencies will be utilized in this process.

The ICMP is a detailed plan for ensuring the safety of the child and managing high risk behaviors. This plan is rooted in utilizing a trauma informed approach to treatment. The ICMP is a plan mandated by Therapeutic Crisis Intervention (TCI). Hillcrest’s ICMP is a 2 page document that allows for input from the student, the student’s family, guardian, funding agencies, and the HEC treatment team. The first page is completed with the student and clinician within 24 hours of admission. The second page is completed by the campus management team and/or the treatment team within 7 business days of the student’s admission utilizing the input of the family, guardian, and funding agencies as well.

The goal of the first page of the ICMP is to ensure the student’s input is immediately utilized in his/her treatment. It utilizes questions posed to the student to identify the student’s goals, strengths, and interests in their treatment. It includes questions posed to the student that help identify the student’s triggers, sore spots, and situations that overwhelm their coping skills. Page 1 also identifies skills, resources, and intervention that the student finds helpful or not helpful.

The second page of the ICMP provides important information about the student’s current and historical high risk behaviors and high risk situations. Important safety information such as medical concerns, trauma triggers, current diagnoses, and current medications is included. This page then identifies individualized interventions to utilize when the child presents at different stages in the stress model of crisis. Page 2 also identifies safety measures. The ICMP is updated whenever an addition or change is determined by the treatment team.

Spirituality Assessment: The Spirituality Assessment is completed within 15 days of admission with the family. It is designed to identify any spiritual supports the student may need or request at the Housatonic Academy.

Comprehensive Treatment Plan: Within 45 days of admission, the treatment team will complete a treatment plan during the IEP meeting to address the treatment needs and goals of a student. HA will make every effort, unless contra-indicated, to have the student and family participate in this meeting and the final treatment plan. The treatment plan utilizes goals identified in the IEP. Measurable objectives and school services/interventions are designed to address school interfering behaviors and to support the discharge goal of the student. This plan will be reviewed annually during the student’s annual IEP meeting.