Step By Step of Maryland

1. Step By StepofMaryland Psychiatric Rehabilitation Program for Minors and Adults & Therapeutic Behavioral Services

2. The Agency’s Mission To provide rehabilitative services to individuals in a conducive atmosphere/arrangement and an opportunity to collaborate with affiliated government agencies working with individuals with varying degrees of emotional disturbances and behavioral disorders, such that these populations are served, assisted, and rehabilitated fully functional, productive and integrated back into the community.

3. Step By Step of MD’s Goals • Recognizing the behavioral issues with our clients • Identifying the facts based around the treatment required for a successful rehabilitation plan • Building goals that are specific to the client • Assisting with the client establishing a new outlook on life challenges • Employing experienced Direct Care Counselors and Therapeutic Behavioral Aides • The agency will carry out all functions ethically and professionally

4. Eligibility Requirements for the PRP Program • Consumers must be covered under the Maryland Medical Assistance Program • Consumers must be referred by a MD, PhD, LCSW-C, LCPC, or LGSW • LGSW providers must have a licensed clinician sign off on the referral • Consumers must be in on-going therapy • All demographic information (name of consumer, address, tele #, DOB, MA#, SS#, gender, race, age, grade (minors), and guardian’s information must be completed on the referral • The living situation for adults must be checked off • The need for services must be outlined on the referral up to and including the consumers background information, reason for referral, risk behaviors, psychiatric/psychological history, medical history including somatic and psychiatric drugs, name of psychiatrist and therapist, diagnostic information (Axis I-V), and any additional psychiatric/psychological notes, including educational records that could assist with the case • The therapist must sign and date the referral with a current date and fax to Step By Step of MD

5. PRP Program Outline • The PRP program is structured to assist individuals with wrap around services to further enable them to meet rehabilitation needs regarding mental and behavioral health disabilities. • Minor ages are 6-17; Adult ages 18 & up • Services are completed in the home, or in the community • An assessment and an Individual Rehabilitation Plan will be developed in accordance with the consumer’s needs. • Long and short term goals will be established, which are individualized, specific to the consumer, measurable, and they will include achievable timeframes. • Minors will receive four encounters per month (one of the encounters being at the office in a group setting) and adults will receive six encounters per month (one encounter being at the office in a group setting). • Group topics are all related to the consumer’s needs and are all age appropriate.

6. PRP Minor Group Session A Direct Care Counselor and client are interacting regarding utilizing conflict resolution skills.

7. Minor Rehabilitation Skills • Personal Hygiene • Grooming • Nutrition • Dietary Planning • Food Preparation • Self Administration of Medicines • Assessing the Living Environment • Community Awareness • Mobility Skills • Money Management • Accessing Available Entitlements • Community Activities • Employment Preparedness • Conflict Resolution Skills • Anger Management Techniques • Interactive Skills with Peers and Authority Figures • Maintaining Personal Living Space • Maintaining Age Appropriate Boundaries • Personal Safety in a Social Environment • Time Management • Coordinated Transportation • Assisting with Tutoring • Prevention of Illness • Social Skills

8. Adult Rehabilitation Skills • Education on Mental Health Disorders • Promotion of Individual Wellness and Self Management and Recovery • Assistance with Supported Housing • Personal Hygiene • Dietary Planning • Food Preparation • Self Administration of Medicines • Assessing the Living Environment • Community Awareness • Mobility Skills • Money Management • Accessing Available Entitlements • Community Activities • Maintaining Personal Living Space • Personal Safety in a Social Environment • Time Management Skills • Coordinated Transportation • Employment Preparedness • Prevention of Illness • Social Skills • Crisis Intervention Assistance • Educational/Vocational Skills • Conflict Resolution Skills • Substance Abuse Problems • Legal Issues

9. Therapeutic Behavioral Services (TBS) • TBS services are geared for consumers that exhibit very aggressive behaviors that result in a consumers being at risk of being removed from the home environment. The age ranges for this program are 6-21. What is an aggressive behavior?? • A persistent pattern of behavior that causes or threatens harm to other people. • Violates the basic rights of others; • Violates major age-appropriate societal norms or rules; or • Causes impairment in social or academic functioning. Elements of Aggressive Behavior • Verbal – taunts, threats • Physical – tantrums, throwing, fights • Instrumental – goal directed • Reactive – unplanned retaliation • Proactive – bullying, provocation • Overt – externalized • Covert – lying, stealing, cheating, drug use • Indirect or Relational – social manipulation

10. TBS Eligibility • The agency must receive a fully completed TBS referral (four pages) • The therapist must attach a psychosocial or updated psych notes with the referral • The agency must submit the referral along with the psych notes to the state for the approval to complete an assessment • Once the approval is granted to complete the assessment, the Rehabilitation Specialist completes the assessment/behavioral plan. • The plan is submitted to the state and based from the plan, the state will approve from 10-30 hours per week for treatment. • TBS services are closely monitored and all interventions are completed in-home with the parent/guardian involved during each session.

11. Program Highlights • Parenting Classes • Job readiness six week course • Anger Management Classes • Utilizes a consulting group on a quarterly basis to ensure that the agency is continuing to stay in compliance with COMAR regulations • Members of Community Behavioral Health (CBH) • Members of the National Council for Community Behavioral Health • Holds yearly Back-To-School events • Provides Thanksgiving baskets to families • Implemented a birthday club for clients • Quarterly outings for all clients (outside of group session)

12. Questions ??? We appreciate your time regarding these very rewarding programs…