Clinical & Rehabilitation

A significant time for youth and their families is the completion of treatment and the transition back into their home community. As part of our reunification/transitional program, Clinicare maintains contact with youth and their families for approximately 3 months after they complete their treatment. The goal of this contact is to encourage and assist them in their success as well as decrease recidivism. During this contact, we will monitor school attendance, medication compliance, ongoing treatment/therapeutic compliance, employment opportunities, and anything else that might assist the youth in remaining at home.

Through this contact we also obtain outcome information statistics to help us measure success and identify areas we need to improve.

The Family Therapy component at the Academy is designed to determine and address the resident's emotional impact on and from his/her family. Specific goals are developed by the resident's therapist and family therapist, in cooperation with the referring agency, and become a part of the resident's individual treatment plan.

Trained members of the clinical staff provide a variety of interventions so as to accommodate as many families as possible. Additionally, therapists provide family therapy services at the Academy, and when possible and appropriate, in the home community.

Family therapy and services are an integral part of the resident's overall treatment program as well as sucess. The therapist helps the family to understand the dynamics that led to admission to the academy as well as methods to change those dynamics. If the family is involved and it is possible, a pre-admission visit can be arranged. If the child is under the guardianship of the Department of Social Services or Department of Corrections, they may also chose to make a pre-admission visit.

Family therapy is utilized in creating emotional openness within the family, aiding parents in providing authority and supervision in the family, making decisions regarding home visitation, assisting the referring agency in determining aftercare planning, and helping the family develop some insight into their own family system.

Options for provision of family therapy include:

• Transportation of residents to home community for on-site family therapy location
• Family therapy with a provider based in their home community that they can remain with after discharge
• Video conferencing
• Teleconference family therapy
• Assistance in transportation costs of the family to the Academy location

Cognitive Behavorial Therapy (CBT); Interpersonal; Client Centered; Gestalt; Reality Therapy; Experiential Psychotherapy; Motivational Interviewing;  Dialectical Behavioral Therapy (DBT); Eye Movement De-sensitization and Reprocessing (EMDR) . Which approach is selected for a particular resident depends upon the needs of the resident. Individual therapy is provided for each resident at least one hour per week by the primary therapist.

Group therapy occurs daily on each living unit. Some groups may provoke more insight and discussion among residents regarding their treatment issues as well. The Clincal  staff conduct the clinical groups (DBT, Choice and Changes, AODA, Trauma Recovery, Health). The Acadmeny staff facilitate daily processing groups as well.  Group therapy topics include: social skills and opportunities to improve peer relationships, relationship problems and proper ways to give feedback and resolve conflict, anger control, education of sexually transmitted diseases, HIV, and birth control, self-awareness and assertiveness, taking responsibility for oneself, values clarification, AODA at-risk behaviors (tobacco use, alcohol or other drug abuse), cultural awareness and heritage issues, divorce and family relationships, and independent living skills. Specialty Group Therapies are offered based on any additional needs of the current population, and conducted by a therapist.

Related Diagnoses:

All youth are engaged in an intensive assessment and evaluation process at admiission that yields the best plan for their individual needs. Additionally, input from the child and the guardian is highly valued and is actively pursued.

Each youth's mental health and physical well-being is a priority in our treatment programs. Our psychiatrists, nursing departments and clinical teams constantly strive to establish and maintain a therapeutic balance for everyone in our care.

Through Clinicare's assessment and evaluation process, our staff consider the child's or adolescent's historical data as part of the overall treatment plan. Upon admission, the child/adolescent begins a short-term course of assessments that include the following:

Assessment:

• Psychiatric Assessment
• Nursing Assessment
• Social Assessment
• Psychoeducational Assessment
• Group Living Assessment
• Family Assessment
• A.O.D.A. Assessment
• Effects of Trauma Assessment

A list of possible testing:

• Minnesota Multi-Phasic Personality Inventory-Adolescent (MMPI-A)
• Youth Triage Screening
• Criminal Justice Screening-Adolescent
• Jesness Inventory
• Million Adolescent Clinical Inventory (MACI)
• Test of Variable Attention (TOVA)
• Shipley Institute of Living
• Substance Abuse Subtle Screening Inventory (SASSI)

This clinical assessment and evaluation is the optimal process in the development of a successful treatment plan. Using historic data together with current information and comprehensive assessment, the Clinicare facility, agency, and family can follow an appropriate therapeutic direction.

The primary focus for residents admitted for intensive treatment programming is to concentrate on individually identified areas of need.

The Individual Treatment Plan focuses on at least the following eight areas:

• Behavioral
• Emotional/psychological
• Personal and social development
• Family
• Health
• Educational/vocational
• Independent living skills/adaptive functioning
• Recreation

As appropriate, focus is added to the treatment plan to include alcohol and other drug abuse (AODA), and/or harmful sexual behaviors. The extent of focus for all of the treatment plan areas is determined by the placing agency's identification of outcomes desired. The individual needs of the resident will determine the extent of services.

Length of Stay:
The length of stay is determined individually for each resident. The placing agency directs this decision, with permanency planning occurring from the day of admission. Determining factors include:

• Resident investment in treatment
• Agency identified desired outcomes
• Resident ability to be successful in a less structured setting
• Availability of a viable discharge resource
• Resident age

Treatment Approaches:

• Individual therapy
• Group therapy
• Case management
• Residential program
• Family Therapy

Medical care can be provided on site for students with medical needs on a consistent basis. Medical care is administered based on recommendations from the academy nurse and is monitored consistently to ensure the anticipated outcomes are occurring.  The Academy's Nurse assists in guiding the resident's medical health and education in conjunction with their mental health needs.

Clinicare uses it's Neuro-Psychologist throughout it's programs to strengthen the assessment and evaluation process. Every youth at a Clinicare program has the ability to complete a Neuro-Psych Assessment if one is warranted. Additionally all children are screened for a need of the assessment.

• About 90% of our clients have significant learning struggles. Unidentified and unsupported learning can create “class clowns”, school avoidance, angry behaviors and chemical dependency concerns.
• About 10-15% of our clients have had significant brain injuries. Anoxia at birth, concussions, seizures, loss of consciousness, falls, assaults, sports injuries, etc. all impact the functioning of the brain. Damage in one area eliminates feelings of empathy; another area creates significant impulsivity and anger. Seizures constantly change the brain chemistry. 

Many different specific tests and assessments are used during a typical Neuro-Psychological Assessment. The main areas of concentration are:

• Cognitive Assessment
• Academic Assessment
• Learning Processes
• Executive Functioning
• Attitudes

In “A Handbook of Neuropsychological Assessment”, Edgar Miller outlined three broad goals of neuropsychological assessment. Firstly, diagnosis, to determine the nature of the underlying problem. Secondly, to understand the nature of any brain injury or resulting cognitive problem and its impact on the individual, as a means of devising a rehabilitation program or offering advice as to an individual's ability to carry out a certain tasks. And lastly, assessments may be undertaken to measure change in functioning over time, such as to determine the consequences of a surgical procedure or the impact of a rehabilitation program or over time.

The Academy specializes in treatment interventions with children/adolescents. The additional service of outpatient therapy can provide valuable tools to both children/adolescents and their families via group therapy, individual therapy, family therapy, and assessment and evaluation.

Outpatient therapy provides two significant services. Individual plans are developed to best suit each client. Children/adolescents can be assisted in a transition from more intensive services to be successful with less structure. Services can be provided as a part of preventative programming to maintain a child/adolescent in the community. In some cases, outpatient evaluations are inappropriate for clients.

Treatment areas that can be addressed in outpatient therapy include:

• Assessment and evaluation
• Family therapy
• Cognitive distortions
• Alcohol and other drug abuse
• Behavior problems
• Histories of abuse/neglect
• Harmful sexual behaviors
• Identity issues
• Anger control
• Social skills
• Psychiatric assessment/evaluation
• Psychiatric medication monitoring
• Mood disorders

Children and adolescents can receive community-based weekly individual therapy as a core component of their individualized treatment plan. The individual or group therapy is provided by a Master's level clinician and addresses issues related to the goals of the treatment plan. Eau Claire Academy and Milwaukee Academy are licensed by WI DHFS as a Mental Health Outpatient Clinic (DHS 35).

Our certified therapy dog assists in calming students who may be anxious, slightly agitated or upset, aids in motivating students, helps build confidence and self esteem within the student and teaches pet care skills. Her overall foundation is to teach respect and compassion.

Pets have been utilized for therapeutic purposes for over 100 years. Pets of all shapes and sizes are proven tools for working with trauma victims, those suffering from depression and many other mental health needs.

Equine therapy is also utilized through partnerships with local equestrian centers.

The Academy provides treatment for children/adolescents who present more complex psychiatric diagnoses or deficits in development. Through a greater staff-to-resident ratio and a less stimulating environment, psychiatric monitoring, on-campus nursing services, individual therapy, behavioral management, and crisis intervention we assist the resident to better manage and cope with their symptoms. Psychopharmacological therapy is also provided as a combined effort of the psychiatrist, pharmacy, nurses, clinical staff, education staff, and residential treatment workers. Psychiatric evaluations include the Nurse and the Program Therapist to give the most well rounded picture of treatment progress for the psychiatrist.

Clinicians work with your child to identify his/her needs on a psychological level.

The purpose of respite care is to provide relief for the adolescent, and their primary caregivers, from current stressors that may threaten to permanently interrupt that placement. The therapeutic intervention is focused upon developing a plan to assist in identifying and alleviating the stressors that necessitated the respite placement.

Length of Stay:
A placement for respite care can last up to nine (9) days for each occasion. If more time becomes necessary, any of the other types of admission can be considered.

When your child is admitted for short-term treatment, they will be prepared for a quick return to the community and continue with treatment intervention on an outpatient basis. The short-term program can be completed within 30-90 days.

The Individual Treatment Plan focuses on:

• Transition preparation - behavioral
• Education transition
• Community services - receptivity and transition

While your child is at the Academy, the primary focus is for them to achieve behavioral stability allowing them to successfully return to the community and benefit from outpatient treatment services. If short-term treatment is not the best fit for your child, the Intensive Treatment program may be a better option to help them reach their treatment goals.

The Strong Adolescent Female Empowerment (SAFE) Program provides single bedroom capacity, individual bathrooms, greater staff-to-resident ratio, and alarmed doors to eliminate intrusive behaviors. The therapeutic approaches combine an individualized 12-step model, cognitive intervention, and strength-based assessment and planning. A Protective Plan is developed individually to reduce the risk that these clients can have upon others.

Who will benefit from the SAFE Program?
The SAFE Program is designed to provide treatment for females who in general can be disruptive to programming. This disruption can take place in the form of:

• Aggressive and controlling behaviors
• Emotionally intrusive behaviors
• Sexually aggressive behaviors
• Predatory behaviors
• Strong negative influence behaviors

The Academy provides structural recreation through extensive, well-equipped on-ground facilities. This gives your child a safe environment to relieve stress and anxiety through physical activity. Off grounds activities are regularly planned as well, so that each resident can practice the skills they are learning in the structured environment.

Alcohol & Other Drug Abuse (AODA) treatment programming is provided as the need is identified. All residents who receive treatment at the Academy for alcohol and other drug abuse are dually diagnosed, meaning that the concerns related to AODA typically coincide with other physical, mental, emotional, or behavioral issues. As such, the AODA concerns are a secondary reason for placement.

AODA programs utilize a 12-step model in the daily group therapy. Individual relapse prevention plans are developed with the resident as they approach discharge. The expectation is for the residents to obtain sobriety, develop a greater awareness of the impact that drugs and/or alcohol have upon their lives, and create a plan to prevent future relapses.

All residents are screened for AODA treatment needs. Decisions to transfer the resident to the AODA program are made jointly with the placing agency and the parent/guardian.

Individual therapy and treatment planning address issues of sexual, emotional, and physical abuse histories for residents placed at the Academy. Building blocks toward continued successful recovery from histories of abuse are provided so that residents can learn and practice new response patterns.

Any adolescent who has a history of abuse will benefit from therapeutic intervention. Determining the level of intervention that is appropriate and correctly perceiving the response to the intervention is crucial. Adolescents present themselves at varying levels of readiness to understand and cope with histories of abuse.

For some residents, developing insight into the correlation between their own acting out behavior and their history of abuse, is the first building block toward continued therapy work in the future. Improving self-esteem, increasing understanding, and developing a comfort in discussing issues of abuse are other steps in the recovery process.

The goal of the survivors programming is to interrupt unhealthy "abuse-reaction" and avoiding behaviors so that improved coping skills and healing can begin.

The teen pregnancy component is operated within the residential treatment program. In addition to providing for behavioral and emotional treatment needs of the adolescent, this intervention also provides for the extra needs that are presented by a pregnancy. Additional services that are provided include:

• Prenatal medical services
• Prenatal health education
• Birth control education
• Labor and delivery education
• Infant development education
• RealCare© Baby education and practice
• Independent living skills training
• Parenting skills

Who will benefit from this Program?
Adolescent females who are already pregnant and require the level of intervention provided by residential treatment programming are candidates for the teen pregnancy programming. Girls who are maintaining healthy pregnancies (absence of medical complexities) can remain in the program through their seventh month of pregnancy. Also, girls who have been presenting risky sexual behaviors may benefit from this as well. Behavioral transition and adjustment to the group home, foster home, or relative home level of care is a significant part of the treatment plan.

Expected outcomes of the this program:
Residents who complete this program will benefit in the following areas:

• Improved behavioral and emotional control which benefits the health of the mother and unborn child
• Improved response to a less structured environment, which decreases chance of foster care requirements for the infant
• Improved readiness and understanding of infant care needs
• Independent Living Skills which include child caring expectations
• Continued progress in educational requirements toward graduation
• Increased confidence in meeting infant care needs through practice with RealCare© Baby infant simulators.

Every program will coordinate the transportation to and from the Academy for all needs.  We pride ourselves in minimizing the geographic impact of our programs.  Our programs routinely transport youth back home for any appointment that is important to their overall treatment success.  

The Academy's Harmful Sexual Behaviors Unit (also named West Unit) is designed for the intensive residential treatment of adolescent males who are exhibiting sexually harmful behaviors. This program provides single room occupancy for greater security to the residents.

Primary Objective:

The objective of this unit is to reduce the likelihood that the adolescents involved will commit further sexual offenses, thus reducing the number of sexual assault victims in the community.

The West Unit is open-ended. Referrals are accepted continuously, based upon how well candidates for placement meet the program criteria. Clients leave the program in a planned manner once having accomplished clearly established treatment goals.

1. Group members are required to address and reduce denial, accept responsibility and accountability for their sexual offenses, and help one another admit their offenses.

   Strategies utilized:

   • Daily group therapy
   • Psycho-educational groups related to human sexuality, beliefs about sex roles and sexual abuse
   • Focus upon the impact of sexual abuse upon the victim, in order to develop victim empathy
   • Develop an understanding of the motives and “cycle of abuse” that led to sexual offenses
   • Daily cognitive restructuring related to criminal thinking patterns and corrective thinking
   • Focus on relapse prevention and safety plans upon discharge

2. West Unit members are required to learn and demonstrate appropriate social and interpersonal skills.

   Strategies utilized:

   • Sex education
   • Anger management and assertiveness training
   • Social skills training (interpersonal relationships, respect for others)
   • Problem-solving training

3. Families of clients are strongly encouraged to participate in the treatment program whenever possible. The goals of family involvement are to assist families in accepting that the offenses occurred, confronting the offender appropriately, and to help cope with the effects upon all family members.

Specific and separate programming is provided to meet the needs of younger and pre-adolescent youth, (ages 10, 11, 12, and some 13 year olds, dependent upon levels of maturity). Children who require care at the level of residential treatment often have a long history of previous services.

The Academy provides structure, crisis intervention, and treatment in an environment compatible with the developmental level of the child. Separate living units (male and female) and a separate classroom is provided for residents in this category. The structure for this population includes:

• Play time
• Frequent behavioral rewards
• Attainable goals
• Shorter instructional periods
• Brief and compassionate intervention options

Who will benefit from the Young Child/Adolescent Program?
Males and females, ages 10 through 13, who require intensive treatment needs to address both behavioral and emotional concerns, may be appropriate for this Academy program. Both immature and inappropriately sophisticated youth can benefit from the treatment focus to address issues in a healthy and age-appropriate manner.

Related Diagnoses:

• Attention Deficit Disorder (ADD)
• Attention Deficit Hyperactivity Disorder (ADHD)
• Fetal Alcohol Syndrome Disorder (FASD)
• Reactive Attachment Disorder