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Children’s Home and Community Based Treatment (HCT)

HCT is a home-based behavioral health treatment for youth and families in need of treatment more intensive than outpatient therapy. Services are delivered by a team including a master’s level Clinician and bachelor’s level Behavioral Health Professional (BHP), providing individual and family therapy and support, parenting education, behavior management, after-hours phone support, and collaboration with case managers, psychiatrists and other treatment team members to ensure the most effective treatment. Teams provide an average of 5 to 20 hours per week of treatment for a duration of 6-9 months.

Pathways utilizes a multi-systemic approach with the family to establish a comprehensive support network including Pathways staff, extended family, friends, neighbors, case managers, school personnel, and other professionals.  Both individual and family services are available as well as sibling work. These services are delivered in client homes, schools and at various community sites utilizing a family systems approach to maximize parental strengths in order to support effective family management. With Child and Family Behavioral Health Treatment services, the Clinician and BHP work to honor the authority of the parent(s) in the home setting and use clear directives when necessary.

Pathways' model of focusing on the family system rather than solely on the individual child’s needs and behaviors helps to break generational patterns, which benefit the entire family system.

Children’s Virtual Residential Program (VRP)Consistent with the call for community-based, least-restrictive alternatives, Pathways of Maine's Virtual Residential Program© was created to meet the needs of an underserved subset of children and adolescents with mental illnesses: those with emotional disturbances so severe that they are at imminent risk of out-of-home placement. VRP is a family-centered and strength-based intervention that combines the structure of residential programs with the benefits of in-home efficacy. Utilizing a mix of theoretical perspectives and therapies, VRP targets multiple-determinates of problems faced by the youth and their families. VRP provides families, schools, and communities with a diversion alternative to unnecessary out-of-home placements and/or to expedite successful step-down of youth following residential or psychiatric placements.

All services are delivered in the client's home and community, allowing families the opportunity to address challenges in the environment in which they are most likely to occur. Interventions include behavior management, individual and family counseling, coordination with case management, crisis intervention, medication monitoring, parenting skills training and education. When appropriate, VRP staff will work with alternative education programs, to include on-site assistance, after school transition services and education/vocational planning. The average intensity of VRP services initially is thirty-five hours per week, with focus on defusing imminent risk factors and implementing crisis stabilization plans. Service delivery is designed to be flexible and available on a 24 hour, seven days a week basis. Intervention intensity is initially high, depending on the needs of the youth and family. Service intensity is stepped down as soon as clinically possible (typically within the first 2-3 weeks) to an average of 25 hours per week. The intensity of the service is further stepped down as the youth and family achieve their individualized goals and greater stability. Step-down services are available to transition families toward less restrictive services at the earliest possible opportunity.

As with most residential programs, the Virtual Residential Program utilizes a treatment team approach in the planning of all services. The VRP Treatment Team, including the client, referring agency representative and parent/guardian, establish the Virtual Residential Schedule, which individualizes daily routines and integrates treatment and behavior management components. The Team also introduces the Five-Phase System, which outlines the youth's goals, responsibilities and privileges while in each of the program phases: Orientation, Acceptance, Working, Consistency and Graduation.