CAT Presentation May 2013 C13 Council

Community Action Team
Response for Our Times
Circuit 13 Provider Meeting
Melissa Larkin-Skinner, LMHC, Vice President Inpatient & Residential Services
Melanie Teves Bell, LMFT, Vice President Outpatient Services
Manatee Glens
Case Studies in
Hazard and Heart Ache
• 7-year-old hyper active boy with Tourette’s up for
adoption as single mom with medical issues can’t
manage symptoms at home
• 14-year-old rape victim with mood disorder cuts
her arms at night and runs away to a gang
• 16 year-old boy explodes into aggression with
mom triggered by mood disorder and trauma
• 17-year-old boy hears voices that tell him he is
worthless and others are out to kill him
CAT Team Mission
Offer parents and caregivers of youth with serious
behavioral health issues a safe option for raising
their son or daughter at home, in their community
and school.
Provide lower cost alternative to state-funded
foster homes, residential treatment and juvenile
CAT Team Model
A Hospital Without Walls
 Modeled after Florida Assertive Community
Treatment Team (FACT) for adults
 Multidisciplinary team
 “Wraps around” the family to address their
unique challenges
 Whole family approach deals with all persons in
the home including siblings, parents and other
 Social service supports with integrated medical,
behavioral, trauma and substance abuse
 24 hour on call
 75% of services provided in home, school or
 Frequency of contact – weekly to daily based on
CAT Team Services
Medication management
Therapy – individual, family, group, multifamily group
Case management (behavioral health and medical)
Crisis Intervention
CAT Team Services
Educational advocacy/coordination
Legal advocacy/coordination
CAT Team Services
The Key to Success
• Mentoring
 role model
 social skills development
 vocational skills development
 problem solving skills development
 building strong sense of self
 self-esteem
CAT Team
Treatment Team Meetings
• Daily treatment team meetings ideal for ongoing
communication when providing intensive wrap around
• Minimum of twice weekly treatment team meetings and
MUST involve treating psychiatrist and ALL team members
• Review of all clients with status of progress, any concerns and
ongoing issues
CAT Team
Physical Space Design
• Large team office space area with open
design; no separate offices except for
individual sessions or Team Leader,
• Large team meeting space for staffing and
daily or weekly treatment team meetings
CAT Team
‘A Day in the Life’
• Individual, Family therapy with client and/or family daily to
• Mentor providing respite with mentoring, tutoring, outings for
social skills development and modeling appropriate behavior
• Crisis support and 24/7 on-call to help better manage daily
crises and/or family struggles as they arise, and not waiting
until they escalate and require inpatient hospitalization
and/or law enforcement intervention – prevent Baker Acts
and School Suspensions/Expulsions
CAT Team Record
3-Year Evaluation Manatee CAT Team
160 at risk of residential; diverted 87.5%
95 at risk of foster care; diverted 93.7%
62 at risk of juvenile justice; diverted 74.2%
Readmission to CAT over 3 years 4%
CAT Team Stories
• Trina Her mood swings were severe even for a sixteen year old
girl. Trina just couldn’t stand herself. She began cutting her
arms in secret and openly defying her mother by sexually
acting out. The CAT Team psychiatrist was able to stabilize her
moods but the damage had been done with Trina’s family
relationships and her school work. Counselors helped Trina
think about consequences before choosing actions and work
on positive communication. She is meeting her goal of a 3.0
GPA in school. Trina’s mother says, “I am glad to have my
daughter back.”
CAT Team Stories
• Sandy The grandparents of this ten- year-old girl knew they were in
way over their heads. They finally sought out residential treatment
because Sandy was explosive and aggressive without warning. Her
poor social skills meant she was always bullied at school. So Sandy
refused to go to school and her grades fell. CAT Team went in the
home to help the grandparents build structure and consistency.
Counselors addressed Sandy’s self-esteem and offered ways she
could be assertive without being aggressive. Sandy found out about
how to cope with the stress of school so she could make friends and
get her grades up. Grandmother told the CAT counselor, “We know
we can raise our granddaughter at home with us now.”
CAT Team Parents
“You would really do this for me?”
“It makes us feel like we are not alone.”
“You have put my mind at ease.”
“I am so glad to have you guys on my side.”
“Thank you, thank you, thank you.”
CAT Team Staff
Clinical Director
MA Therapists
BA Case Manager
1.0 FTE
.25 FTE
.5 FTE
2.0 FTE
1.0 FTE
3.0 FTE
1.0 FTE

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