Attachment - Child-in-Family Services

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Note: If you are interested in a neuro-behavioral assessment only, please click here to go to the Neuro-Behavioral Health page. A neuro-behavioral evaluation is for the purpose of creating a neuro-behavioral activity program to help correct neurological deficiencies. A behavioral health evaluation is for the purpose of creating a behavioral, psychological, neuro-behavioral and perhaps even an academic habilitative program for any child.

Child-in-Family Services provides out-patient services only. It is not an in-patient facility, nor is lodging provided at Child-in-Family Services for multi-day stays. The Conroe, Texas Chamber of Commerce is a good resource for lodging in this area.

There are three types of out-patient evaluation and treatment services:

Type I:

Partial Evaluation

2-hr. initial session. 2-day notice of cancellation of initial session required. Consists of partial evaluation: not definitive. Return session to finish evaluation: 2 hours; treatment sessions optional.

Type II:

Complete Evaluation and Treatment Plan

4-5 hr. initial session. 4-day notice of cancellation or postponement of initial session required. Consists of complete evaluation, prognosis, diagnosis and treatment plan. Treatment sessions optional.

The complete evaluation and treatment plan appointment happens in one day and is divided thus:

a. Morning- Evaluation: 2-3 hrs. Parents, child and evaluator are present.
b. Lunch- On your own. Typically about 1.5 to 2 hrs. Allows evaluator to create treatment plan (no charge, if official report not required)
c. Afternoon- Presentation of Results: 2 hrs. Evaluator presents plan to parents and child.

Type III:

Evaluation, Treatment Plan, Training and Therapy

Intensive evaluation, treatment and training spanning 2, 3, 4 or 5 consecutive days. Number of anticipated hours in session determines cancellation/postponement requirements (estimate 1 day per minimum anticipated hour). Consists of evaluation, prognosis, diagnosis, treatment plan and as much treatment and training as possible within the time frame.

Which type of service would be best for us? Type I, Type II or Type III?

Type I:

This evaluation service may be attractive to those who live within a 45-minute, one-way distance of Child-in-Family Services and who are not in crisis. Families who need shorter sessions due to cancellation/postponement requirements or who have extenuating circumstances, which prevent them from making long appointments, may need the evaluation and treatment plan period to be more than 1 session. Treatment sessions are optional and tend to last 1 to 2 hours. Treatment sessions could be weekly, bi-monthly or monthly, depending on need.

Type II:

This type of service may be attractive to those who desire to proceed through the evaluation process as quickly as possible and who live within a 5-hour-round-trip drive of Child-in-Family Services. Evaluation, treatment plan, prognosis and diagnosis take place on one trip. Some initial training will take place in the evaluation session. Treatment takes place on other trips. Treatment sessions could be weekly, bi-monthly or monthly, depending on need and distance. Treatment sessions are optional and could last 1-2 hours if families are local. They could last 3-5 hours a session if families are not local.

Type III:

This type of service may be attractive to those who live longer than a 5-hour-round-trip drive from Child-in-Family Services. Evaluation and initial training take place on the same day and therapy along with more intense training takes place on other days. Families seek local lodging. Sessions can be 3-6 hours a day.

What is the difference between therapy and training?

Training pertains to the caregivers: how they can best help their child. Therapy pertains to the experience the child has in treatment.

Our child has Medicaid and we are driving quite a distance to see you. Do you know of any organization to help us pay for gas and maybe lodging?

Please contact Texas Medicaid Health and Human Services Commission at (877) 633-8747 before your appointment. They may be able to help you with the cost for the medical transportation of your child and for perhaps even lodging.

How can a Type III multi-day stay do us any good? Don't we need to be seeing you weekly?

Not necessarily. This is the benefit to a child-in-family approach to treatment, rather than an individual model. A multi-day stay is designed to help teach you the tools, quickly and intensively, to turn your home into a 24 hr. treatment center. Have you seen the TV show, Super Nanny? An intensive, multi-day treatment protocol, which relies heavily on parent training, is followed. Of course, Child-in-Family Services does more than experiential, individualized parent training for eliminating undesirable behaviors, but the concept is the same: Empower and support the parents to do what needs to be done to help the child become a successful, future adult; Provide follow-up as necessary to ensure success.

What happens in an evaluation?

The caregiver(s) brings the child for an evaluation which typically takes place in the morning at 9 or 10 a.m. and can go as long as 4-5 hours, depending on how long we have the child’s cooperation and attention. Breaks are taken as needed. Toys, and a therapy dog (a miniature dachshund named Julie) are available for the child to interact with. Parents are encouraged to bring high protein snacks for the child and are asked to provide a nutritious high protein breakfast for the child the morning of the evaluation. It is also a good idea for the child to bring his or her favorite toy, doll, or stuffed animal. It is most important that the child be as psychotropic and class II stimulant free the morning of the evaluation. This is to enable the examiner to do a more thorough and accurate evaluation, particularly if a neuro-behavioral screening is involved. Please check with the child’s doctor if necessary to see which medications can be deleted or delayed the night before the evaluation and the morning of the evaluation. Please inform Child-in-Family Services if your child has special needs such as: allergies to or fear of dogs, needing special items such as newspapers or magazines (in the case of perseverative, anxious paper shredding).

The evaluation includes observation, interview, and gathering of history. Some evaluatory instruments may be appropriate. A neuro-behavioral screening may be appropriate as well. The examiner is trying to determine the root causes of the problems, identify the child’s strengths and create a plan for home, office and school treatment that will be effective and expedient. There may be referrals to other professionals for adjunct therapies or examinations. For example, it may be beneficial for the child to have a sensory integration evaluation, neuro-psychological examination, a SPECT Scan or neuro-transmitter testing at a later date.

What about after the evaluation? What does follow up treatment look like for people who don't live as far away as West Texas but may have to make a 3-4 hr. round trip to get to you?

Certainly the closer a family lives, the more frequently a family can return. But please don't think in terms of a traditional session of 45 minutes, one day a week. This type of session would be inadequate for someone who lived just down the street.

One of the reasons why this child-in-family approach is so successful is because treatment is more intensive (time-wise) at the beginning of the treatment. The intensity decreases with the more tools the caregivers gain and the healthier the child becomes. If a family lives even 1.5 hours away from the Conroe office, then they could probably only come every 2 weeks or maybe only once a month. Certainly the farther one has to drive, the longer one would want the appointment to be.

For how long will we need to come to therapy?

That depends on how long it takes you, the home caregivers, to learn and internalize the new way of thinking that will be required to help your child heal. It's not an issue of learning new techniques. It's an issue of learning to see the world and relationships through the eyes of the specific hurting child you have, so you can be one step ahead of him or her. It's an issue of being able to follow through, consistently, with the therapeutic home program that will be created for you to help heal your child. It's a matter of how fast you can become the therapeutic parents your child needs." So, in other words, we can have a short...or a long relationship.

Can anyone besides family attend the evaluation and treatment sessions?

Any caregiver, case manager or home town therapist is welcome to attend the evaluation and treatment services at no cost. CEU training credit, at a cost of $10 per hour is available as well to professional attendees. CEU training hours are available to the foster parents in charge of the child at no cost.

Does my husband need to come?

Your husband should certainly come if he is a primary or secondary home caregiver. The more caregivers on board, the better. Simply put: It's the bigger bang for your buck. Coming to treatment at Child-in-Family Services requires committment and investment on the part of the home caregivers who are paying the bill for a child's future. The more investors who can be present, the more you up your odds of creating a successful future adult. If there is no way that the husband can come, then a video can be made of the session.

Can we bring our other children?

Yes, as long as you have arranged for childcare other than Child-in-Family Services since there is no child care here.

What if our child is violent, unpredictable and aggressive?

Child-in-Family Services cannot serve violent, unpredictable, and aggressive clients whom the home caregivers are unable to physically contain.

I know you use a child-in-family approach. Can my husband be the only one who accompanies our child to the services?

The primary maternal caregiver must be present at every session, whether it is the evaluation or the therapy session.