Types of Treatment
*Definitions adapted from the CT Behavioral Health Partnership-Child Psychiatric Level of Care Guidelines 12/2008.
Outpatient Treatment – (Individual, Group, Family, and Intensive) Outpatient therapy services are clinical services provided by a general hospital, private freestanding psychiatric hospital, psychiatric outpatient clinic, school-based health clinic, state-operated facility, or by a licensed mental health practitioner practicing independently or in a private practice group. The treatment is provided in an office-based setting and typically occurs once per week, but may be more frequent depending on the child’s needs. This service involves the evaluation, diagnosis, and treatment of individuals, families or groups as well as medication management. Services are typically scheduled in advance, but may occur urgently without a scheduled appointment. Outpatient services are designed to promote, restore, or maintain age appropriate social/emotional functioning and are intended to be focused and time limited with services discontinued as the child/adolescent and family are able to function more effectively.
Medication Management – Medication management is provided by a qualified, licensed, medical provider such as a pediatrician, child/adolescent psychiatrist, or a nurse practitioner. Medications are prescribed to address a range of mental health concerns with the goal being to reduce or eliminate symptoms and restore the child to the best functioning. Because medications can have side effects and children can respond differently, it is extremely important for a qualified medical professional to follow your child closely and routinely monitor the use of medication. Medication management is typically provided with other forms of therapeutic mental health treatment.
Home-Based Services – Psychiatric home care services are psychiatric, psychological or psychotherapy services given by a mental health clinician delivered away from a professional office, usually at a patient’s home. The treating provider must be a licensed clinician or a licensed eligible, master’s level clinician. This level of service may be needed when the patient and/or family: a) cannot attend clinic-based treatment, b) have life circumstances that make treatment attendance very difficult, presenting a barrier to effective treatment, or c) the treatment goals can be more effectively addressed in a home or community setting. Further, in spite of active treatment in another level of care, symptoms and functional problems cannot be fully understood or resolved without direct intervention in that environment. The service can be provided along with other treatment services such as Extended Day Treatment Intensive Outpatient or outpatient treatment if deemed appropriate in the treatment plan.
Care Coordination or Case Management – This is a system to help families coordinate care allowing more effective and efficient use of resources. Clients who are eligible for Case Management services must have a DSM-IV diagnosis. They generally are involved with multiple systems such as multiple mental health providers, physical health providers, school and/or work. Case Management entails referring, linking, coordinating, monitoring and evaluating the effectiveness of services from those multiple systems.
Case management services can either be face-to-face meetings or telephone contacts with external agencies, providers, families, DCF, school systems or other community resources in which the focus is the current treatment of the client. The client or family may or may not be present. The individual’s treatment plan or case management care plan must list the goals and actions that must be done to address the medical, social, educational and other services
Connecticut’s Mobile Crisis Intervention Services Services for children and adolescents that gives immediate, mobile assessment and intervention to individuals in an active state of crisis and can occur in a variety of settings including the member’s home, school, local emergency department, or community setting. Because this service is mobile and available to all Connecticut residents, it can be a helpful alternative to bringing your child to an Emergency Department in a time of crisis. To access mobile crisis services across Connecticut, call 2-1-1 or click here to visit their website.
Emergency Department Services – Treatment at an Emergency Department is required to prevent a possible loss of life or major loss of physical or psychological function. Children who are in crisis when there is concern that they may be of harm to themselves or others can be assessed at an Emergency Department to determine whether hospitalization or other intensive treatment is needed.
Day Treatment or Partial Hospitalization – Refers to treatment programs that offer intensive, coordinated and structured therapeutic and assessment services in a stable setting. All programs provide psychiatric evaluation, treatment planning and oversight and serve as a step down to, or diversion from, inpatient psychiatric care. Children receiving this service remain in their homes and/or communities, but spend a part of their day in a therapeutic setting.
Residential Treatment/Hospitalization – A Residential Treatment Center (RTC) is a 24- hour facility licensed by the State of Connecticut or appropriately licensed by the state in which it is located (and not licensed as a hospital), that offers integrated therapeutic services, educational services and activities of daily living within a clinical setting and based on an individually tailored treatment plan. This level of care is reserved for those children/adolescents whose psychiatric and behavioral concerns warrant the structure and supervision provided by this type of setting. This setting offers all necessary services including an on-site educational program, therapeutic services and intensive supervision when necessary. RTC frequently serves as a step down from psychiatric hospitalization or may serve as the treatment of choice when a child’s behavioral status places him or the community at risk should services be offered in a less restrictive setting.
Acute Psychiatric Hospitalization – Acute psychiatric hospitalization is inpatient treatment services in a licensed general, psychiatric hospital or a state operated psychiatric hospital offering a full range of diagnostic, educational, and therapeutic services with capability for emergency implementation of life-saving medical and psychiatric interventions. Services are provided in a physically secured setting. Patient admission into this level of care is the result of a serious or dangerous condition that requires rapid stabilization of psychiatric symptoms. This service is generally used when 24-hour medical and nursing supervision are required to provide intensive evaluation and treatment. Typically this treatment is shorter term, but may be long-term in extreme circumstances. Children discharged from inpatient hospitalization often enter a step down level of care.
Alcohol and Drug Detoxification – (limited availability for adolescents through the CT Department of Children and Families (DCF) and the CT Department of Mental Health and Addiction Services (DMHAS)) Detox services include 24-hour inpatient programs and various outpatient programs. Inpatient programs are located in hospitals and community-based settings. It is also possible to go to an inpatient hospital for an observation period of up to 23 hours while appropriate treatment decisions are made. Outpatient detox options include Ambulatory Detox and Methadone Detox.
Residential Substance Abuse Programs – (limited availability for adolescents through DCF/DMHAS). Various 24-hour residential substance abuse programs range from short-term to long-term programs. Intensive Residential Treatment offers short-term programs, frequently for individuals leaving inpatient detox. Long-term care offers a supportive environment in which to work on your goals towards recovery.
Therapeutic Support Services – At the core of the Therapeutic Support Service is an individualized mentoring relationship between professional, adult mentors and children and adolescents with serious emotional disturbances. The term “mentoring” is generally used to refer to a sustained, supportive relationship between one person and another. The “mentor” in this model is an adult with specific personal or relationship skills and a willingness to commit personal resources to a relationship that is intended primarily to benefit the other person, although most mentors would indicate that they gain from their giving. The “mentee” is a person, most commonly a young person, identified because of stressors or difficulties in their lives, with a need for support as they work to improve their life, coping or relationship skills. The intended outcomes for youth mentees generally fall into three categories: educational achievement; health and safety issues; and social and emotional development.