Addressing the Mental Health Needs of THP Participants

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Addressing the Mental Health Needs of THP
Participants

• Tracy Davis, ASW
• Shawna Lauer, MFT
• Rebecca Hathorn, ASW

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About our programs

• Supported Housing Program (THP), Bay Area
  Youth Centers
• Scattered site model providing individualized
  support to youth
• Social workers assist in creating goals around
  relationships and self-awareness, education,
  employment, mental health and housing and
  community development
• Foster Youth Development Program,
  WestCoast Childrens Clinic
• Flexible, community-based, wraparound mental
  health services a relational approach

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Healthy Development vs. Disrupted Attachment

• NURTURING CONSISTENCY confidence, joy,
  problem solving skills, playfulness curiosity
• TRAUMA LACK of NURTURING CONSISTENCY
  interruption of the development of initiative,
  autonomy, self-esteem, social awareness, ability
  to learn, physical health, emotion regulation
  interpersonal relatedness

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• Relationship problems
• Emotion regulation difficulties
• Substance abuse
• Irritability
• Sleep difficulties
• Hopelessness helplessness
• Spacing out
• Oppositional behavior aggression
• Academic problems
• High risk behaviors
• Problems with daily living activities
• Paranoia, bizarre behaviors, delusions,
  hallucinations

• Signs and Symptoms of Mental Health Problems in
  Adolescents Young Adults

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• Identity development
• Separation from family of origin
• Exploring educational and vocational
  opportunities goals
• Desiring and achieving responsible social behavior

• Developmental Tasks of Adolescents Young Adults

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Accessing Mental Health Services

• Former foster youth are entitled to FULL SCOPE
  Medi-Cal until their 21st birthday
• After the age of 21
• Build a relationship with a Medi-Cal specialist,
  or Transition Age Youth Liaison, who can support
  the young person to navigate the system

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To Make a Referral

• Call Medi-Cal to get a list of providers in your
  area
• Contact those providers and ask questions
• What services do you provide?
• What is the referral process? Waitlist?
• What are grounds for discontinuing services?
• What model/approach do you use?
• Use your own judgment. Would you feel comfortable
  with this person? How do you imagine the youth
  might respond to this provider and his/her
  approach?

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Encouraging Mental Health Services

• Building the youths interest and willingness to
  participate in therapy is a process

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Educate Yourself

• Seek out trainings for yourself and your staff
• Familiarity Comfortability
• Trainings should be culturally relevant and
  specific to this age group. Recommended topics
  include
• Trauma Attachment
• Depression in adolescents
• Anxiety, PTSD, Complex PTSD
• Neuropsychology and brain development
• Substance Abuse Harm reduction Motivational
  interviewing
• Crisis de-escalation

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I dont need therapy, Im not crazy!!

• Resistance ambivalence about therapy is normal
  and understandable
• Cultural implications
• Growing up in a system
• Past experiences with mental health services

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Speak to the Ambivalence

• A part of you might really want help with this
• Another part of you might be worried about
• What other people might think
• What your family might say or think
• That people think youre crazy
• That you might have to talk about things you
  dont want to

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Normalize

• Symptoms behaviors are a normal, adaptable, and
  functional response to an abnormal situation
• This really worked for you before. But, now I
  wonder if it might get in your way sometimes?
• Everyone needs help now and then
• It seems like the more support and different
  perspectives you can get, the better.

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Wouldnt it be nice to talk to someone who

• Is unbiased and neutral
• Can offer an outside perspective
• Keeps things confidential
• Doesnt have the authority to

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Curiosity, A Powerful Tool

• Help the youth to become curious about his/her
  behaviors and symptoms
• Wondering aloud
• Naming the symptoms/patterns
• Externalize
• De-stigmatize good? Bad? Or just is?

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Use your relationship

• I know a guy/gal
• I know that its really hard for you to trust
  people, it took a long time for you to trust me.
  I imagine its hard to think about opening up to
  someone new.
• I really think this might be good for you
• Do you know how much those people charge? Id
  love the chance to go for free!

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Speak to the hopeful part

• We dont have to start with the biggest problem
  here
• What is resolvable?
• What matters to you?
• What are you willing to let others help you with?

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Empower the youth to take action on his/her own
behalf

• Therapy is voluntary
• You can interview the therapist and decide for
  yourself.
• You can go at your own pace, quit if you need
  to
• What kind of person would be a good fit for
  you?
• Lets think about what questions you might want
  to ask.
• What have your past experiences in therapy been
  like?
• What would you want to be different?
• Maybe I can help you find someone who would be a
  better fit.

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Fight, Flight, or Freeze

• Therapy can stir up anxiety and anxiety can
  trigger the desire to
• Fight
• I hate my therapist
• Flee
• Im never going back there
• Freeze
• I dont know when my next appointment is
• Oh, I forgot

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Opening a dialogue

• You might want to quit sometimes, or get mad at
  the person youre working with. Lets talk about
  it if you start to feel that way.
• It seems like maybe youre feeling overwhelmed
  (scared). Thats understandable.
• Wow. Therapy is hard, huh.
• Encourage the youth to bring these problems back
  to the provider and let him/her know what the
  he/she needs or wants
• Remind the youth that this is a safe place to try
  new ways of resolving interpersonal problems
• A corrective emotional experience

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Effective collaborations How do we get there?

• Define roles from the beginning and be ready to
  redefine as needed
• Build upon each others strengths, resources, and
  expertise

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Effective collaborations How do we get there?

• Communicate, communicate, communicate!
• Be responsive to phone calls and follow through
  on tasks
• Schedule regular face to face meetings
• Define how confidentiality will be handled and
  share this with every member of the team, most
  importantly, with the client
• Open communication amongst team members
• Respecting the clients privacy
• How to describe this to the youth

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Effective collaborations How do we get there?

• Problems and differences of opinion will arise
  work it out
• Be prepared for splitting
• Check yourself. Are you feeling territorial? Is
  your ego getting in the way?
• Work with the youth to help him/her work through
  difficulties that arise in his/her relationship
  with other team members

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It takes a village

• For us too!
• Have fun. Share successes and funny stories
• CELEBRATE when things go well
• Support each other when they dont
• Be honest when youre feeling hopeless or
  frustrated
• Attend trainings and events together and get to
  know your team outside of the office

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An Example
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• These symptoms were many years in the making and
  will take many years to heal
• Experiencing long-term relationships that are
  consistent, predictable, and safea valuable and
  necessary intervention to improve the emotional
  functioning of Transition Aged Youth

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