This issue of silos in foster family agencies comes into play in the area of confidentiality. Recently I worked with a foster family agency on law and ethics issues. The agency had a contract with a local county to provide mental health services for their foster youth. This meant each foster youth had a social worker and a therapist assigned to them at the agency. The therapists conducting mental health services were bound by client confidentiality unless issues of suicide, homicide, or child abuse arose. But the social workers did not understand or appreciate the therapist’s ethical duties.
When a youth at the foster family agency disclosed to their therapist they brought drugs to their school, the therapist was bound by confidentiality to not discuss this behavior with the youth’s social worker. The social worker was upset the therapist did not share this information. In their mind, had they known, they would inform the county social worker to evaluate potential placement change. The social worker also believed they should inform the school so they could intervene and confiscate the drugs from the youth.
I explained to the social workers and therapists confidentiality has different meanings for each discipline. Social workers and therapists cannot reciprocate the youth’s privacy. We discussed how the foster youth’s disclosure did not meet any requirements for breaking confidentiality. If the therapist discussed it with the social worker, they would violate the law, because no threat of suicide, homicide, or youth abuse was evident. However, had the youth brought a knife to school and threatened to harm another youth or teacher, this would be grounds for notifying the school. But drug possession didn’t meet the bar of breaching confidentiality.
Afterward, the social workers in the meeting appreciated the dilemma therapists have in hearing about risky behaviors but not being able to act on them. It creates more collaboration and cooperation between the two departments and a reduction of the silo effect between them. When foster family agencies have these two sectors (social work and therapy) in their organization, a better understanding of their counterparts’ responsibilities leads to integrated care.
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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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