For years, residential facilities used the level and point system as a means of positive discipline. The concept was that each youth who arrived at the facility would start at the bottom level, say Level A. They were able to receive points for their positive behavior. When they spent a certain amount of time in the facility or they accumulated sufficient points, the youth was then promoted to Level B. Then depending on the agency, there were upper levels consistent with the time in the facility and increased points for good behavior. If a youth engaged in inappropriate behavior, they could have points subtracted. If the infraction was severe such as possession of contraband or altercations, they could be moved down a level.
The theory behind the level system was that getting points for the youth would incentivize them to improve their behaviors and reduce problems within the community. However, in the past twenty years, literature came out disagreeing with the level and point system. You can Google papers about the prior research conducted, which stated that it led to increased restraints, more staff injuries, and turnover. The research also indicated that it was not trauma-informed, which had some validity. For example, if a youth was penalized for running away due to a re-traumatization, they are punished due to their trauma.
In 2019, I wrote in a blog about other challenges, including that the level and point system was not “real world” based; adults do not have level systems at work (not the same as promotions) or points awarded to them. Plus, the youth entering always comes in at the bottom only because they’re new, giving them a clear disadvantage to benefit as others do. Finally, I wrote about how levels can stigmatize youths, that they are seen as an “A”, “B”, or another level rather than the person.
However, in a web conference in 2020 by the Association of Children’s Residential and Community Services (ACRC), several organizations presented how they work with commercially sexually exploited children and youth (CSECY). Most of them used a level and point system with their clients to help them move from living “the life” into a new self-perspective. This population has one of the highest incidences of trauma, yet a level and point system proved beneficial to them. This contradicts past research.
Fast forward to 2022. Many organizations are now rethinking their view of level and point systems. Those who abandoned them now see that their youth are having more difficulties instead of less. Increased AWOLs, physical and verbal altercations, substance use, and delinquent activities are reported by agencies. Executive Directors of these residential facilities I’ve spoken to express their frustration. “How can I keep the youths out of trouble when there are no consequences to their actions?” is a common question.
The answer is to keep the level system but use it more positively. Rather than move a client down a level due to negative behavior, they can stay where they’re at. They can’t move up until they engage in requested behavior, but they’re not penalized. Also, include earning points for treatment participation such as therapy, groups, family visits, and other services. Add these to the other ways the client can earn points such as chores, homework, and other healthy tasks. Setting up a level and point system combined with a therapeutic system increases their success rate.
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PRAXES is a nationwide behavioral health software, consulting, and training company. No one in the behavioral health industry has a better reputation, and if you give us the chance, we’ll show you why! At PRAXES, our services improve the efficiency and structure of behavioral health agencies serving children and families nationwide. PRAXES brings over 45 years of administrative and clinical expertise. With more than 100 client companies nationwide, we offer the expertise to advance the quality of behavioral health services. We accomplish these goals through our new clinical decision software, our training of best practices, and helping companies meet regulatory standards. At PRAXES, we believe in being creative and fostering new ways to serve children and their families. Our vision is to empower the families our agencies serve with skills that not only improve their functioning, but help them to thrive in their everyday lives. When you give us the chance, you’ll be connected directly to our friendly staff, so you can expect immediate attention to your inquiry. So, don’t wait, call now!
Dan Thorne has unique perspectives on the field of mental health. As a clinician, he has had over 40 years of experience working with clients in the Southern California area. After obtaining his Bachelor’s degree from the University of California at Irvine, he worked with children in the Orange County Juvenile Hall. Here he honed his earliest techniques on at-risk children. After that, he obtained his Master’s degree in Counseling from California State University, Fullerton.
In the 1990’s, Dan turned his attention to the clinical and administrative side of behavioral health organizations. For three years, he was the Assistant Administrator of Starting Point, a chemical dependency facility in Costa Mesa, CA. In 2001, he took an opportunity to be the Director of Harbor View Community Services Center in Long Beach. When he arrived, the Center had only 80 clients and 13 staff. When he left, there were over 400 clients and 75 staff. Dan created several programs through their contract with the Los Angeles County Departments of Mental Health and Child and Family Services. Under his guidance, Harbor View became one of the leading providers of children’s services in Los Angeles County.
While improving the results of the client’s parents at the Center, Dan reflected on his experiences as a parent. His children themselves had special needs such as mental and intellectual challenges, and Dan knew the toll it takes on the parent. In order to help the child, the parent has to be healthy. From this concept, he created his parenting program. After years of refining it, teaching it to his staff at the Center, and then taking the results and comments from these efforts, he became the developer of the current PRAXES program. It is a culmination of Dan’s personal trials and tribulations as a parent along with empirical results and research of over 40 parenting programs.
Our vision at PRAXES is to advance the strength of parents and caregivers of children with special needs (mental health, intellectual, or physical) through education, support, and empowerment. Thus, they can live healthy and functional lives while caring for the child.
Apogee is a clinical decision software designed to help behavioral health practitioners with their treatment and patient engagement. It provides evidence-based and research-based components. Not only do they consist of elements from such practices as Cognitive Behavior Therapy, Seeking Safety, Dialectical Behavior Therapy, Motivational Interviewing, Functional Behavior Analysis, but also the Intensive Models for Parents, Youth, and Children.
PRAXES has over 30 years of accreditation experience. We know what it takes to get your organization accredited. Whether it’s Joint Commission, CARF, or COA, our team can provide an evaluation of your current status and review the standards which need improvements. We will assist you with the policies, documentation, and training required to be accredited.
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