DAY FIVE
Day five consisted of sitting in with Stephanie again for a patient who had been coming for therapy sessions for a few weeks now and was involved in the CDI ( child directive interaction) training of PCIT ( parental care interactive therapy). Every patient who comes for CDI is part of the PCIT program to fully complete the therapy training to help the behavioral issues. This training is primarily for children ages two to seven years old, once they get older the training is not as effective. These training sessions last around twelve to twenty weeks long. The goal of CDI is to train the parents to have the proper reactions and disciplinary moves to fix their child's misbehavior. The lesson goes on through two rooms connected by a one way glass window. One parent goes in with the child for "special play time" and this parent had a ear piece that the therapist talks to them through in the other room watching via the glass window. For each parent they had to give five directive commands in five minutes to master the CDI training. The questions were simple tasks such as asking the child to place a toy in their hand or to clean up one set of toys and play with another. The parents were to avoid using the words would, could, should because it gives the illusion that the task is optional. When the child complied the parent was to give encouraging praise for their behavior. If the child failed to comply they would implement time out, in this session the child complied with all commands and therefore was not placed in time out. All through the session the therapist is giving the parent encouragement on what they are doing helping them stick to the rules of the lesson and teaching the parent in their own behavior adaption therapy. The therapist encouraged reflection on the child's actions, and giving labeled praise such as saying "you did such a nice job putting the doll to bed". The parents are to give only one command at a time, if they give the child more than one it may confuse a young child and set them up to fail.
What was learned in these sessions with the therapist was meant to carried on and used at home. The only way the training would work is with time and repetition. The parents could not expect results if they only worked on the CDI skills while with the therapist. The homework that was assigned after this session was implementing a time out spot in public when needed. This was an important aspect when training children with aggressive behavioral issues. It shows that the same house rules apply to the child even when they are not at home. The way the therapist encouraged the parents to apply time out, was to have a portable spot that mom and dad can keep in their purse or wallet. The spot could be a pop out disk or a dollar bill, what ever the parent wanted. The child would have to go sit on the time out spot for one minute of compliance and thirty seconds of complete silence. If the child failed to comply the parent must leave everything in the store and take the child to the back up time out spot, which would be their vehicle. Once the time out was completed the parent was to take the child back into the store and complete the regular time out as well. Though it may be difficult to do in public, by creating a time out spot, the spot enforces in the child's mind that time out never disappears and they must behave where ever they go.
DAY SIX
Day six was a quick day because both Colleen and Dr. Schlesinger were out of the office, so this day allowed for some reflection on the program and the act of getting care in much needed facilities. When I begun my Magellan I had no idea the extent of information I would have the privilege to learn about. Not just deinstitutionalization, but different job positions in the psychiatry and psychology fields as well. I've learned so much about therapy it self, all the extra help that is needed to run a pediatric office for behavioral health, and all the physical grunt work to get a new program such as TiPS up and running and to keep it growing. At this time, I am going back and catching up on my daily entrees, my eyes have really been opened to what goes on behind the works at a doctor's office. People see only one side of these offices and sometimes these trips are viewed as a hassle, to long, or the trip didn't turn out the way as it was expected to and the patients fail to notice the back work. Through this project I have see a different side of the doctor's office, one that I had never seen before. I have seen the time the doctors put into reviewing all the information, consulting with other behavioral health professionals and I become more understating and grateful that the doctors aren't making one's visit quick, that the doctors are taking their time to give you the best care, even if their scheduled is full. A visit to the doctors is more complicated than patients often realize, yet keeping the wiring of how the office is run, behind doors, is part of the put together nature of a doctors visit that everyone knows. So the next time your doctor is taking a while to come back to your room, take a deep breathe and be grateful that they are doing a thorough job and making sure you are perfectly fine before they say you are.
The TiPs program is just more evidence of the hard work that these health professionals are doing to be better at their jobs. I talked with Melissa McCaslin, who works the front line at the children's pediatric offices and handles getting papers signed and the correct patients to the correct behavioral health professional in the office. Melissa has worked in the medical field for four years and has had pretty extensive experience working with health professionals in a different facilities that were not as nice and welcoming as this Children's office is. Behavioral health offices should be warm and welcoming because behavioral health issues are not an easy thing to work on, especially when they patients are very young and confused. Melissa advocates for the TiPs program because it reaches children with issues the doctors near the child's home may not have been equipped to deal with. If there is better care out there, than the adults in a child's life should be doing everything in their power to get that child that care.
Day five consisted of sitting in with Stephanie again for a patient who had been coming for therapy sessions for a few weeks now and was involved in the CDI ( child directive interaction) training of PCIT ( parental care interactive therapy). Every patient who comes for CDI is part of the PCIT program to fully complete the therapy training to help the behavioral issues. This training is primarily for children ages two to seven years old, once they get older the training is not as effective. These training sessions last around twelve to twenty weeks long. The goal of CDI is to train the parents to have the proper reactions and disciplinary moves to fix their child's misbehavior. The lesson goes on through two rooms connected by a one way glass window. One parent goes in with the child for "special play time" and this parent had a ear piece that the therapist talks to them through in the other room watching via the glass window. For each parent they had to give five directive commands in five minutes to master the CDI training. The questions were simple tasks such as asking the child to place a toy in their hand or to clean up one set of toys and play with another. The parents were to avoid using the words would, could, should because it gives the illusion that the task is optional. When the child complied the parent was to give encouraging praise for their behavior. If the child failed to comply they would implement time out, in this session the child complied with all commands and therefore was not placed in time out. All through the session the therapist is giving the parent encouragement on what they are doing helping them stick to the rules of the lesson and teaching the parent in their own behavior adaption therapy. The therapist encouraged reflection on the child's actions, and giving labeled praise such as saying "you did such a nice job putting the doll to bed". The parents are to give only one command at a time, if they give the child more than one it may confuse a young child and set them up to fail.
What was learned in these sessions with the therapist was meant to carried on and used at home. The only way the training would work is with time and repetition. The parents could not expect results if they only worked on the CDI skills while with the therapist. The homework that was assigned after this session was implementing a time out spot in public when needed. This was an important aspect when training children with aggressive behavioral issues. It shows that the same house rules apply to the child even when they are not at home. The way the therapist encouraged the parents to apply time out, was to have a portable spot that mom and dad can keep in their purse or wallet. The spot could be a pop out disk or a dollar bill, what ever the parent wanted. The child would have to go sit on the time out spot for one minute of compliance and thirty seconds of complete silence. If the child failed to comply the parent must leave everything in the store and take the child to the back up time out spot, which would be their vehicle. Once the time out was completed the parent was to take the child back into the store and complete the regular time out as well. Though it may be difficult to do in public, by creating a time out spot, the spot enforces in the child's mind that time out never disappears and they must behave where ever they go.
DAY SIX
Day six was a quick day because both Colleen and Dr. Schlesinger were out of the office, so this day allowed for some reflection on the program and the act of getting care in much needed facilities. When I begun my Magellan I had no idea the extent of information I would have the privilege to learn about. Not just deinstitutionalization, but different job positions in the psychiatry and psychology fields as well. I've learned so much about therapy it self, all the extra help that is needed to run a pediatric office for behavioral health, and all the physical grunt work to get a new program such as TiPS up and running and to keep it growing. At this time, I am going back and catching up on my daily entrees, my eyes have really been opened to what goes on behind the works at a doctor's office. People see only one side of these offices and sometimes these trips are viewed as a hassle, to long, or the trip didn't turn out the way as it was expected to and the patients fail to notice the back work. Through this project I have see a different side of the doctor's office, one that I had never seen before. I have seen the time the doctors put into reviewing all the information, consulting with other behavioral health professionals and I become more understating and grateful that the doctors aren't making one's visit quick, that the doctors are taking their time to give you the best care, even if their scheduled is full. A visit to the doctors is more complicated than patients often realize, yet keeping the wiring of how the office is run, behind doors, is part of the put together nature of a doctors visit that everyone knows. So the next time your doctor is taking a while to come back to your room, take a deep breathe and be grateful that they are doing a thorough job and making sure you are perfectly fine before they say you are.
The TiPs program is just more evidence of the hard work that these health professionals are doing to be better at their jobs. I talked with Melissa McCaslin, who works the front line at the children's pediatric offices and handles getting papers signed and the correct patients to the correct behavioral health professional in the office. Melissa has worked in the medical field for four years and has had pretty extensive experience working with health professionals in a different facilities that were not as nice and welcoming as this Children's office is. Behavioral health offices should be warm and welcoming because behavioral health issues are not an easy thing to work on, especially when they patients are very young and confused. Melissa advocates for the TiPs program because it reaches children with issues the doctors near the child's home may not have been equipped to deal with. If there is better care out there, than the adults in a child's life should be doing everything in their power to get that child that care.
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