Children’s Behavioral Health Services: Mapleton Programs
The Devereux Mapleton Programs serves approximately 90 adolescents between the ages of 12-18. About 80% of the client population is female. Clinical diagnoses vary widely, but generally are encompassed in one of the following categories: Post Traumatic Stress Disorder, Mood Disorders, Disruptive Behavior Disorders, and Pervasive Development Disorders.
Treatment Program Overview
The guiding treatment philosophy is based on a cognitive behavioral/ behavioral approach. A combination of Cognitive-Behavioral therapy (CBT) and Dialectic Behavioral Therapy (DBT) is used to identify dysfunctional beliefs about the self, others, and the world. Unhealthy belief patterns are challenged and replaced with more functional ideas and thinking that assists individuals with everyday problem solving. Clients learn skills in relaxation, challenging upsetting thoughts, and social problem solving. These problem solving skills along with behavioral principles such as rewards and natural consequences are woven into milieu interventions. In addition to the overarching framework, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) interventions are employed. TF-CBT is an evidence-based treatment approach designed to help clients and their families overcome trauma-related difficulties. It is designed to reduce negative emotional and behavioral responses following child sexual abuse and other traumatic events.
In addition to direct service delivery, the Mapleton programs have adopted a three-tiered prevention framework to more effectively prevent and address problem behavior. Training and technical assistance activities are focused on developing program-wide interventions for both the residence and school programs.
Assessment. Interns are required to demonstrate competency in assessment during the training year. Assessments are tailored to meet the referral questions and encompass many forms such as the assessment of cognitive functioning, academic skills, functional skills, diagnostic evaluations, functional behavioral assessments, intake evaluations and personality functioning.
Intervention. Interns carry a caseload of approximately 6 clients. Interns meet with clients individually for at least 1hour per week and with the client’s family for 1 hour per week. Additionally, the intern also provides group therapy for 1 hour per week. Interns are expected to be available for crisis intervention as needed for their clients.
Consultation. Consultation occurs at multiple levels ranging from program-wide to the individual client. Through this indirect service delivery approach, interns have the opportunity to work with a variety of disciplines (e.g., school, residence) to ultimately improve outcomes for the clients served.
Systems Management. Interns are responsible for the case management activities associated with clients. Case management typically involves collaborating with multiple systems, including delinquency and dependency courts, managed care organizations, resource coordinators and educational settings. Case management includes planning for visitation and securing aftercare services.
Research/Program Evaluation. Interns complete a research project or program evaluation during their training year. The projects may be part of an existing research project or the intern may develop his or her own research initiative. Past interns have presented their projects at regional conferences.
Diversity/Cultural Competence. Interns work with a culturally diverse population. Therefore, the ability to provide culturally sensitive interventions is essential to the treatment of the population.
Supervision. Interns receive training in supervision and have the opportunity to provide supervision to direct care professionals as they implement behavioral interventions in the milieu. In some cases, interns have the opportunity to supervise a practicum student.
Professional Skills and Development. Professional skills and development begin during the first week of the internship and are continuously evaluated throughout the year. After an initial self-assessment is completed, specific goals and objectives will be established. These targeted areas will be reviewed and discussed during individual supervision.
The intern is provided with four hours of individual and group supervision each week throughout the training year. The intern will be assigned to work with a primary supervisor and a supplemental supervisor. The primary supervisor will supervise the intern on individual and group therapy assessment, the research project and general internship issues. The secondary supervisor will supervise the intern on family therapy and case management. Group supervision, including all Devereux interns, is also offered on a bi-weekly basis.
Desired Intern Qualifications and Competencies
The ideal intern candidate will have experience in providing evidenced based and manualized interventions to children and adolescents, the ability to conceptualize a case from a CBT framework, and experience in administering a variety of assessments to children and adolescents. The ideal candidate will be trained in behavioral principles and have the ability to apply behavioral interventions. Intern candidates should have strong consultation skills and be able to work collaboratively with a multidisciplinary team. Additionally, intern candidates will be able to conduct independent research (e.g., conceptualization, methodology, and analysis).
Outcomes of Training
During the training year the intern will develop a proficient clinical acumen. As a member of the treatment team, the intern will be exposed to multiple theoretical approaches for individual, group and family therapies with diverse clientele. Throughout the training year, the intern will become skillful in managing crisis situations and will develop and implement long term treatment objectives. Additionally, the intern will become adept at working as a part of a multidisciplinary team and in navigating complex systems and collaborating with outside agencies.
Upon successful completion of the training year, interns move on to work in acute and sub-acute settings. Some Interns secure faculty and research-based positions.