Becky Eissinger, admissions coordinator for the Fargo Campus; and Noah Fischer, residential coordinator for the Fargo Residential Center, were presenters at the April N.D. Psychological Association.
The conference focus was on “Aggressive Youth” and the Ranch’s presentation served a two-fold purpose: giving an overview of the continuum of care for behavioral health in North Dakota; and the continuum of care offered by DBGR and how DBGR fits into the North Dakota continuum of care. Included in the presentation were Ranch statistics on the reduction of high risk incidents and the techniques and tools used in therapy and milieu management.
The continuum of care is a complete range of programs and services. Not every community has every type of service or program on the continuum (and not every child accesses every service), however the continuum of care at DBGR, Fargo, follows:
The continuum of care at DBGR, Fargo, for aggressive youth:
- home
- family foster care
- PATH (Professional Association of Treatment Homes)
- RCCF (Residential Child Care Facility)
- RTC (Residential Treatment Facility)
- Inpatient Psychiatric Hospitalization
How successful are we?
Here are some interesting statistics provided by Becky and Noah at the presentation:
- From 2003 to 2005, the Fargo Residential Center has reduced aggressive, high-risk incidents by 65 percent.
The great reduction in incidents was achieved by focusing on human resource, program and culture changes (also called milieu management).
- Human resource changes: reformed team, increased number of staff on shift, added full time positions and shift supervisors, increased staff training and engaged a certified Fargo Residential Center coordinator to instruct Crisis Prevention and Intervention (CPI). They also added a second full time therapist and a wellness coordinator.
- Program changes: Dialectic Behavioral Therapy (DBT) became the primary approach of therapy groups. This focuses on interpersonal effectiveness, distress tolerance, emotion regulation, mindfulness and mastery exercises. They also incorporated was a new level system adapted from the residential treatment program at our Minot Campus, with DBT concepts incorporated. This provided a tool for staff and our residents. It helped staff apply training and logic to the “grey” areas they experienced while caring for the youth and it could be individualized, as needed. Finally, daily tracking sheets were enhanced that identify each child’s strengths and resiliencies during each shift.
- Culture change: staff posted monthly data from the tracking sheet in common staff and client areas. They held weekly review by the multidisciplinary team that focused on researching trends, patterns and concerns for the youth. The facility team conducted a monthly high risk review. Other culture changes included striving for a positive environment that promotes safety, recognizing and supporting the efforts of direct care staff, and involving direct care and client in the treatment planning.
Changes such as these are happening at all DBGR campuses, so when parents and caregivers have a child in residence at the Ranch, they can be assured that we are attentive to our mission of “helping at-risk children and their families succeed in the name of Christ.”
