Family Information Regarding Your Child’s Residential Stay
Family members and friends are encouraged to call; however, clients have a right to refuse any calls. Clients will only be able to call and receive calls from their contact list. If you would like a name added to the contact list, please contact your assigned therapist. To support your child’s progress in treatment and therapy, we request no phone interruptions during groups, school, or therapy sessions. Due to the volume of phone calls we receive, please limit calls to fifteen minutes. Staff will also keep track of the time, and might “cue” your child that it’s almost time to end a call, to allow other clients access to the phone as well. The best times to call are generally after 3:00 pm and before 8:30 pm.
Clients may receive mail from people on their contact list. Writing materials and stamps are provided for clients, so they can also send letters during their residential stay. Clients are encouraged to correspond with their families and others who are involved in their treatment.
Clients will only be allowed to correspond (by phone or mail) with people who are identified by the family and/or caseworker as appropriate for their treatment and safety. Mail can be withheld if it comes from a source identified by the treatment team (which includes families and legal guardians) as detrimental to their treatment, or if it is of a suspicious or harmful nature.
Each client has their own room that locks from the outside. This provides a safe environment that feels secure. A client is always able to exit their room, but staff must unlock the door for them to get in. Clients are not allowed in each other’s rooms.
Occasionally a client may bring their own money along on an outing to spend, but in general clients do not need large amounts of spending money. We ask that any spending money you feel your child should have be kept at less than $10 total. We also ask that if you are giving money that you give it to a staff on the unit – in other words, money should pass from directly the hands of parents to the hands of staff. Client funds are kept in a locked drawer on the unit for security.
Your child will have a personal snack box for any snacks brought from home. Snack items should be given to staff to be placed in your child’s snack box. We encourage you to bring healthy snacks, but the occasional treat is just fine. Please avoid bringing bulk items or perishable items as we may not be able to store them. We are unable to cook snacks other than items that can be heated in a microwave. If you choose not to bring personal snacks, we will provide snacks for your child.
Emergency and Safety Drills
As part of our ongoing effort to ensure the safety of our clients, your child may be expected to participate in fire and safety drills.
Clothing and Hygiene
All clients coming into our program need loose-fitting active wear. It is helpful if all items are clearly marked with initials in permanent marker. If this is not done prior to admission, staff will do it when they check the clothes in. We discourage any clothing that depicts or glorifies violence, drugs or alcohol, or has sexual undertones. Clothing deemed to be inappropriate will not be allowed in the treatment environment, and will be returned.
Each child in residential care will have an Individual Plan of Care (IPC) which outlines their personal goals for treatment. Treatment plans are designed to meet the individual needs of each one of our clients. Goals are determined by the client’s treatment team as part of the admission process. This team includes the client themselves, you as their parent or guardian, the Child and Family Therapist, the Psychiatrist, Skills Trainers from the unit who know the child well, and any community members who would be helpful to support the client’s treatment. Each child’s plan is reviewed monthly by the treatment team to determine progress towards goals and to discuss plans for the client after they leave residential care.
As the parent or guardian, it is essential that you participate in these IPC Review meetings. It can be difficult to coordinate everyone’s schedules, and we will do our best to ensure that they are held at a time that is most convenient to you. Wherever possible, your child is strongly encouraged to attend this meeting as well. Our goal is to place them in a position to help make treatment decisions and express their needs as part of the treatment team. You are also welcome to invite anyone that you feel would be helpful in planning your child’s treatment, including family members, advocates, or other supports. We will ask you to complete a written Release of Information for these people, as we will be discussing confidential client information during the meeting.
All clients are assigned and scheduled to meet with their Child and Family Therapist at least once weekly for individual therapy. They may also check in with their therapist at other times when in need of additional support.
Families are an important part of the treatment team and family therapy is a key part of a client’s treatment. Our goal is to learn more about your family and incorporate your family values into the treatment here, while supporting the client and family to develop more successful interactions. Our Child and Family Therapist will work with you to establish a schedule for therapy sessions which is both convenient for your family and adequate to meet therapy goals. We can also help you to find resources from other family members who have experience with this field and can provide support to you and your child.
Medication therapy and stabilization is an important piece of all clients’ overall treatment. In addition to the psychiatrist’s evaluation upon admission, each client meets with the psychiatrist on a regular basis. Sometimes it is determined that a trial of medication might be helpful for stabilizing a client or for helping them manage their behavior. If that is the case, medication will be prescribed and monitored by agency psychiatrists and nursing personnel. You will be involved in decisions regarding medications for your child, and you will have an opportunity to ask any questions you have to make sure you understand the medications and any potential side effects. Medications are administered by nurses or staff members specially trained in proper medication administration.
Prior to beginning any new medication, consent is required by the legal guardian. This is generally obtained through the family, legal guardian, or DHS caseworker (when DHS is the legal guardian).
One of the most significant features of residential treatment and care is the therapeutic “milieu.” The term milieu describes the therapeutic environment that includes all the clients, staff, and activities in the program. The milieu setting offers an opportunity for your child or teen to practice safe and appropriate interactions with peers and adults while becoming more responsible. Treatment staff are available 24 hours per day to help clients with anything that may come up during the day.
Our Horticultural Therapy Program offers year round nature based activities in our extensive Parry Center Healing Gardens. Each child adopts a raised bed in the garden to nurture and care for as part of their individualized treatment plan. These raised beds become a great source of pride as the children learn skills that can transfer to all other aspects of their lives. Our gardens offer the opportunities to not only learn the craft of gardening, but to also learn teamwork, safe healthy attachments and creative positive self expression.
The equine therapy program at Children’s Farm Home provides a wonderful opportunity for children to spend time in our barns, caring for the horses. Learning about these remarkable animals, caring for them, cleaning and working in the barns, and learning to ride the horses are unique experiences that our clients remember for years.
Health, Eye Care, and Dental Services
Our nursing staff provide care; taking care of any tummy-aches, rashes, cuts, or scrapes. To keep all clients safe and healthy, we give some immunizations and TB testing upon admission. A pediatrician comes to our campus 2-3 times per month to provide physical exams, follow-ups, and consultation as needed. If a client needs further care or treatment, they are taken to the OHSU Family Practice Clinic. Our Health Services Office Manager makes routine vision and dental appointments for clients in residential care. Clients are transported to those appointments by our Health Services department, in coordination with staff in the unit. Legacy Laboratory Services comes to our campus routinely every Tuesday to do all of our blood draws. These happen for any child/teen who has a blood draw ordered by their physician, or as needed on other days.
Restraint and Seclusion
In situations where children are behaving in ways that create danger either for themselves or for others, staff may use manual restraint or seclusion to keep everyone safe. Staff are trained to supervise clients closely to identify problems before they begin, and we do our best to intervene proactively to avoid unsafe behaviors. However, at times these incidents are impossible to avoid, and staff use restraint or seclusion as a last resort when needed.
Restraint- being physically held to prevent movement- can be a humiliating and scary experience. Sometimes seclusion- having to stay in an empty room alone- can be, too. If a client is in seclusion, a Trillium staff is monitoring at all times to ensure their safety, but this can sometimes also be perceived as cold or unfriendly. However, seclusion is sometimes experienced as a quiet refuge, and children may request it. If a client exhibits behavior that is dangerous to self or others that leads to either a physical restraint or seclusion, the client’s parent or guardian will be notified promptly.
After these types of incidents, staff work to discuss the incident with the child and with staff who were present, in order to learn from the situation and make attempts to avoid similar situations in the future. We work hard to help children use positive coping skills to remain safe, and offer them alternatives so they are able to express their feelings without dangerous behaviors.
Trillium views visits with family or other supports to be an integral part of your child’s treatment. Visits should be scheduled in coordination with family therapy, to discuss what works best for your child. Typically, visits are first scheduled on-campus to provide an opportunity to interact in a supportive environment. If these visits are going well, we encourage clients to go off-campus for short visits, working up to overnight or weekend visits at home. This allows you and your child to practice the skills they are learning in treatment, and prepare for the time when your child comes home.
Visits should to be discussed and scheduled with your child’s therapist, and should be scheduled at least 24 hours in advance. If the therapist is out of the office on the day you call to schedule your visit, you may schedule it with the Unit Manager. However, we strongly recommend that you schedule your visit at least three days in advance so that the therapist can be involved in the planning. Since the therapist and Unit Manager do not work on the weekend you will need to schedule all weekend and Monday visits by Friday. This will allow you and the therapist to work together to determine the best schedule and treatment for your child.
Clients generally excitedly anticipate visits, and may need extra support to work through their feelings if a visit is cancelled. If you must cancel a visit, please speak with the cottage’s Skills Trainer Supervisor (STS) when you call. Likewise, please call if you are going to be late for a visit. If your visit is scheduled to be in the family room and you are late for a visit, you may not be able to make up the time because another visit may be scheduled in the family room.
During on-campus visits you may walk around our campus, spend time in our family rooms, or go to breakfast, lunch or dinner in our Commons area. You may also bring in food to eat and share with your child. If there are any safety concerns about your child’s behavior during the day, you may be asked to meet with your child on the unit. We will do our best to make your visit as calm and private as possible. If there is any way that we can help to make your visit with your child better, please do not hesitate to ask.
Guidelines for on-campus visits:
- Before coming to the unit, please get a visitor pass from the main office, except on weekends, then you should get one from the unit.
- Please always check in with unit staff before and after visits. We see you as a partner in treatment, and appreciate the information you have to offer about your child’s visit.
- Families are allowed to be in the treatment milieu when it is OK for the other clients present. Please check with staff first.
- This is a non-smoking campus. Please only smoke in the assigned smoking area.
- Please supervise your child, and any other children you bring to the visit, at all times.
- If your child would like to visit with a family pet, please remain in the assigned pet area on campus. Not all clients feel comfortable around animals, and we do our best to meet everyone’s needs.
- To ensure the safety of our clients, please leave lighters, cigarettes, matches, medication, guns, knives, or other potentially dangerous items in your car. Items dropped, misplaced, or left behind on campus may be picked up by a child.
Off-campus visits usually occur after clients have been in residential treatment for a while, and are assessed by their treatment team to be ready for the change in routine. These visits are an important part of treatment, and allow the child and family to integrate their treatment progress into their normal home environment. It is our experience that off-campus visits will be most successful if the routine followed on the unit is also followed as closely as possible at home. Your child’s therapist may also develop an individualized treatment plan for your child’s visits to help integrate visits with treatment goals.
Clients may be required to meet some safety expectations prior to going on off-campus treatment visits. This is to assure their safety, and provide for the most positive experience possible when they share time with their family. If a client displays risky behavior that warrants cancellation of a confirmed visit, our staff will do their best to notify you as soon as possible. It may also be helpful to call the unit before leaving to pick up your child, to confirm that the visit is still occurring as scheduled.
Guidelines for Off-campus visits:
- Please supervise your child at all times.
- Please maintain the same clothing expectations as we have for the treatment milieu, avoiding tight clothing, sexually provocative clothing, or references to drugs or alcohol.
- Please refrain from viewing television programs or videos that have violent or sexual content.
- For overnight visits, it is helpful to maintain a consistent bedtime as on the unit. Bedtimes are typically between 8:30 p.m. and 9:00pm, with lights out at 9:30 p.m.
- Please limit video game time to 1 hour per day, with another family member. Please avoid video games depicting violence or sexual content.
Please remember that you are responsible for administering all medications at the appropriate times when your child is on off-campus treatment visits. When you arrive to pick up your child for the visit, a staff person will review your child’s medication schedule with you. It is very important that you ensure medication is given correctly and according to schedule, and that medications are kept in a secure place. Many medications can have serious side effects if given off-schedule or inconsistently. If a medication is missed, let us know and give it back to us so that we can dispose of it.
You are also responsible for your child’s behavior while off-campus. If you feel that an expectations contract would be helpful for you in supervising your child, please ask the therapist for assistance. If you have questions about behavior expectations, please feel free to ask any of the staff. You may end the visit ahead of the scheduled time if your child cannot comply with expected behavior. If possible, please call the unit staff to let them know you will be returning earlier than originally scheduled. Please always check in with staff before and after each campus visit.
Please keep in mind the items that clients can and cannot have in the treatment milieu, and avoid sending them back with items they are not allowed to have. Please give items and money directly to staff, rather than your child. Staff will need to check in new items.