Community Clinic Jennifer Evancy LCSW SAC Professional Services Group Trauma Focused Cognitive Behavioral Therapy in Schools SBBH The Basics Consistent day of week Consistent and comfortable office space ID: 1044210
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1. Jes Springer, LCSWNorthLakes Community ClinicJennifer Evancy, LCSW, SACProfessional Services GroupTrauma Focused Cognitive Behavioral Therapy in Schools
2. SBBH: The BasicsConsistent day of weekConsistent and comfortable office spaceOperate by bell schedule (except elementary)Roughly 42 minute sessionsExcused absence from classROI differs per student/family wishesAt very least, for scheduling purposes, though consultation is desirable
3. Referral ProcessReferrals can come from:Client/FamilySocial WorkersSchool Admin Team (Kent, Brian, Troy, Joel)DoctorsCriminal Justice SystemCommunityIf staff are concerned about a student and believe SBBH services would be helpful, go to admin team at the school to discuss the case.School needs to have discussed the service with parent/guardian prior to referralUpon receive of the referral:Providing agency contacts family to confirm interest and insuranceSchedules intake based on course schedule and availabilityNotifies school of intakeNo ROI is in place yet, only limited information is shared
4. Intake ProcessParent/Legal Guardian is requiredLocation depends on Parent/guardian availability and preferencePaperwork is signed, including ROIROI may be only for appointments or could be all informationPreferred if the client is present as wellMay go full 60 minutes, try to keep to bellEstablish consistent appointment time
5. Therapy ProcessFrequency is based on client needOperates the same as in officeMay include art, music, play, relaxation trainingTF-CBT and most types of concernsCannot be interrupted unless true emergencyDo not knock on door or call the roomConsistency is keyFamily sessions may occur at school or at the clinic
6. ConfidentialityTerminology: meeting or appointment: NOT THERAPY!Being called down/absent from class:Please don’t hassle them Be discrete: don’t announce to the class or over loud speaker that they have to go see Jes.No check in before leaving class, come straight to therapy roomEven if an ROI is in place, still on a need to know basis Discussed with each client at intake, including knowledge of peers in therapyMay ask certain staff members for updates, but won’t go to each teacherIf staff have a concern that therapist should know about, pass it along to school team, which helps keep them in the loop as well.
7. Why TF-CBT?“An evidence-based trauma treatment proven to decreasesymptoms of PTSD, anxiety, depression, and other childbehavior problems…also proven to decrease sham,improve parenting skills and strengthen thechild-caregiver relationship.” – The National Child TraumaticStress Network
8. What is TF-CBTEvidence-basedFor ages 3 to 18 years oldTime limited (roughly 12-30 sessions)Components based (PRACTICE)Adaptable and flexibleTreats single and complex traumaAttachment based; requires a strong therapeutic relationshipFamily-focused
9. What is TF-CBTP = Psychoeducation & Parenting SkillsR = RelaxationA = Affect RegulationC = Cognitive CopingT = Trauma narrative developed and practicedI = In-vivo exposure to trauma remindersC = Conjoint sessions (share the narrative)E = Enhancing future safety & social skills
10. ComponentsP = Psychoeducation & Parenting SkillsR = RelaxationA = Affect RegulationC = Cognitive CopingT = Trauma narrative developed and practicedI = In-vivo exposure to trauma remindersC = Conjoint sessions (share the narrative)E = Enhancing future safety & social skills**Remember they are flexible, though not fluid
11. Ending TF-CBTGraduation partyMaintenance sessions as neededChange diagnosis and treatment planAdminister UCLA PTSD index
12. Adapting TF-CBT in School Based Behavioral Health ServicesConsider the appropriate time of day for SB appointmentsMay need to shift to end of day as you near the narrativeMay need to shift to the office/clinicFamily sessions-clinic vs. school, time of dayCommunication with school staff (ROI dependent)Beginning to write the narrativeCheck in/heads up if rough sessionManaging Crisis of the WeekTend to be more of them in school as they are fresh out of the situationCompartmentalize, Relax, Cognitively shift at end of sessionRequires paying more attention to the clock/bell
13. Communicate with school staff the skills used to help youth when they are struggling or PTSD symptoms are triggered.Even better, help the youth to teach school staff “what works” (skills) for themMay need to shift to end of day as you near the narrativeMay need to shift to the office/clinic
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