The monthly individual treatment plan is viewed as the primary tool with which to ensure comprehensive, individualized, and consistent treatment for each resident.  All treatment plans are based upon assessments of residents’ mental health condition and prognosis.   treatment plans are driven for the resident’s DSM-IV mental health diagnosis.  The mental health diagnosis is, of course, arrived at through clinical observation, psychiatric evaluation, psychological testing, past history, etc.  The parents, referral sources, and residents are all involved in the treatment planning process whenever possible.  Parents and referral sources are notified when the resident’s treatment plan is due to be  reviewed , once per month.  At that time, all parties are notified to discuss progress, goals and strategies to resolve the residents’ difficulties. It is often important for the clinician to write out in “Layman’s terms, the treatment plan and expectations for residents.  Oftentimes, the professional language that is used in treatment plans are to difficult to interpret by the resident.

Each family will participate in family counseling sessions facilitated by a licensed (LCSW/LPC) clinical therapist.  It is imperative and mandatory that a family member or significant other participate in the transition back into the home.  The family session will focus on developing positive communication skills, identifying and processing family issues or concerns that have a negative impact on the family structure, restructuring family power and authority, developing clear rules and consequences, values clarifications, building family resiliency and self esteem, established discipline and structure, and developing respect for authority.

Counselors are required to fully document all services being provided to clients, client’s responses to interventions, as well as staff’s impressions and concerns regarding the client’s level of functioning.  A progress note will be documented on each client daily and will specifically reference the objective of the treatment plan being documented, the interventions used, the client’s response to the intervention, and the continued plan regarding that objective.  All progress notes will be dated timed, and a signature is required.  Counselors are required to complete daily progress notes, update progress notes, update treatment plan, and other documentation as required.  A monthly progress report will be submitted to the referring agency and placed in the client’s confidential records.  A critical incident report will be filed in the case of an emergency or critical incident.  A copy of the critical incident report will also be placed in the client’s case record and forwarded to the referring source.

These groups are established to focus on education and appropriate confrontation of the effects of substance abuse as it pertains to mental illness and poor behavioral control. The following are used to achieve this goal:
These groups provide residents with information on how substance abuse impacts their life, family , spirituality, peer group, and value system.  These groups identify cognitive and affective defenses, which support and protect addictions, assisting residents in recognizing their disease process and identifying signs of relapse.  These groups also take advantage of negative thinking patterns often seen in residents.  They are appropriately confrontational with how their thinking leads to emotional suppression through the use of substance.

Youths are prepared for independent living through both formal and informal applications of a Life Skills curriculum. Youths learn to manage their physical, emotional, and social well-being. Youths are taught how to find and keep jobs; money management; nutrition and meal preparation; household management; conflict resolution; social skills; and utilization of community resources.

Each resident will participate in this treatment component and will learn the following:

Youths will have the opportunity to discuss relevant issues in an open forum with other peers from the community bi-weekly. Topics may include frank talks about teen pregnancy; drugs and alcohol; AIDS and STDs; violence prevention; self esteem, etc.

Self-image sessions will help students to identify their self-defeating patterns and to replace them with logic and reason. Sessions are designed to help foster a greater sense of self-pride and resourcefulness.

The behavior management program establishes general and specific standards of conduct designed to help the youth accept responsibility for their actions and make a logical connection between their behavior and consequences derived.  Standards of conduct are designed to promote the teaching of new methods of interactivity with parents, peers, authority figures, as well as the community at large.  Behavior management rules are fairly applied to all residents participating in the program and will be reviewed with each child prior to their admission.  In addition, each resident receives a copy of the behavior management plan which outlines the program rules and regulations and includes an explanation of the consequences and sanctions for specific rule violations.  Residents are expected to be accountable for their actions, exhibit appropriate behavior, and participate in all phases of program development.  Specific restrictions may be imposed on a resident in order to ensure safety and maximize the learning process.  Any restrictions imposed will be identified and enforced with the maximum involvement with the youth, parents, and the referral source.  The behavior management program does not restrict the resident’s rights, and any restriction imposed will not include intrusive aversive therapy, chemical or mechanical restraints, corporal punishment, or from injuring others.  These tactics will not be employed as punishment in any form.  Behavior management procedures include the following:

As previously discussed, the behavior management plan will be shared with the resident, family, and referral source upon admission to the program. The human rights policy will also be available for review which provides a detailed description of the residents’ rights and the procedures for filing a complaint with the local Regional Advocate.

Stepping Stone Family Services Inc., Legacy will provide a structured program designed to adhere to the following:

A daily schedule will be posted at the facility. Each resident will be aware of the schedule of activities on a daily basis. A daily activity log will also be maintained to inform staff of significant appointments or problems experienced by the resident. Health and dental complaints and injuries shall be recorded and shall include the resident’s name, complaint, affected area, and time of complaint. The identity of the individual making each entry in the daily log shall be recorded. Routines will be planned to insure that each resident receives the amount of sleep and rest appropriate for her age and physical condition. Staff will promote good hygiene, monitor supervise hygiene practices on a daily basis and will provide instruction and redirection when needed.  Counselors will also monitor the residents' behavior in compliance to the behavior management plan.

Legacy's House utilizes a four step phase system to assist residents identify short and long term goals and to measure their success or progression towards accomplishing these goals and objectives. Progression from one phase to another is determined when all goals for each phase have been achieved. Legacy's House uses a point system in which a resident has to achieve the prescribed amount of points to be considered for placement in the next phase. The resident is also required to submit a letter requesting her promotion to the next phase and clearly indicate reasons why.

Consequences will be given for extreme misconduct which includes a loss of points and/or privileges. The resident, however, will have the opportunity to appeal her restrictions or loss of points to the treatment team.  An explanation of the phase system indicates the following:

PHASE I-ORIENTATION: During this phase, the resident is oriented to the program and is introduced to staff and other residents.  The resident is also acclimated to the daily routine, is enrolled in school or vocational program, and begins the assessment program.  In addition, the residents participate in personal hygiene, house functions, individual and group counseling sessions, and experiential activities.  At the orientation stage, the resident also agrees to adhere to the rules of conduct and there is the initial development of the preliminary service plan to assess the youth’s immediate needs for services.  The resident has to maintain 80% out of 100% of her points on a daily basis.  The orientation phase is designed not to exceed 30 days.

PHASE II-ASSESSMENT: During this phase, the residents participates and completes the assessment process, identifies long and short term treatment plans, goals and objectives, has settled in school or vocational training, and begins participating in experiential activities outside the facility.  Family counseling sessions will commence during this phase. The assessment phase will conclude in approximately 3 weeks and is ongoing in conjunction with the orientation process.

PHASE III-TREATMENT: The resident begins to progress through the treatment plans, goals and objectives. The service plan is discussed and measured on a weekly basis. The resident is expected to discuss pertinent issues during the individual, family and group sessions. Regular attendance in school and vocational training is priority and each resident must comply with the compulsory school attendance policy. Residents will also be encouraged to be a peer facilitator within the therapeutic community and will be a positive role model for other residents. The family therapy session will begin focusing on providing weekend passes for the residents’ transition back into the community. This phase is approximately 2 to 5 months.

PHASE IV-DISCHARGE: During phase IV, the resident is gradually transitioning back into the home or their placement with a significant other. They have successfully met their treatment goals and objectives and are continuing to formulate their discharge plans. The resident is also volunteering in the community, attending school on a regular basis, is doing well academically and has found employment on a full or part-time basis. Individual and family sessions address transitional issues and aftercare planning. This phase is approximately 1 to 3 months and works cooperatively with the treatment phase.

NOTE: The average length of stay at Legacy House is six (6) months. The phase system is designed to work interactively with one another as the resident progresses through the treatment regimen.