Lorenz Clinic adds Intensive Treatment in Foster Care

Introducing Intensive Treatment in Foster Care

Lorenz Clinic is thrilled to announce its certification as the twelfth agency in Minnesota to provide Intensive Treatment in Foster Care (ITFC) through the Minnesota Department of Health. The addition of this service to the clinic’s existing home-and community-based service menu will translate into greatly improved access to mental healthcare for children in foster care.

There is a significant need to support children & families involved in and impacted by the foster care system, who all too often are experiencing myriad stressors including financial hardship/poverty, generational trauma exposure, and impact, mental health struggles, addiction, or unstable housing in addition to being dependent on systems that were not designed to serve and support them. Lorenz Clinic is excited to bring our existing energy to this new opportunity, further fulfilling our mission to expand access to those who need it most.

Clinically, this service will increase clinical integration with the clinic’s other services, like day-treatment, in-home, and testing, to provide continuity of care to the children we serve who have experienced trauma. ITFC employs models of relational treatment focused on increasing relational function in the child-guardian relationship. It is a flexible mental health service package designed by Minnesota’s Department of Human Services. It provides relational treatment and support for children/youth while they are in a family foster care setting, and ranges from birth to age 21.

Lorenz Clinic Structure and Leadership

With this addition, Lorenz Clinic’s Home-Based service will now operate as Community-Based Therapeutic Services. The Day Treatment service will transition to Community-Based Intensives. Lorenz’s ITFC effort is led by Jessica Lynch, MA, LMFT, who brings years of experience in ITFC program administration and supervision. Jessica was recently promoted to Director for Community-Based Intensives after ushering the program through the certification process. Lorenz Clinic is currently in the process of hiring clinicians to support this area and those roles can be found on our open positions page. Please contact Jessica (jlynch@lorenzclinic.com) directly with any questions about the program.

De-Masking Our Kids and Managing Their Anxiety

“You may take your mask off if you’d like.” 

This is a statement that I’ve been told several times over the past few weeks. It’s my ‘go to’ line while walking a client back to a therapy session in my office. Wow, what a strange feeling. It’s been two years of living with this “temporary normal”.

Is it really safe to take the mask off now? Will we have to put the mask back on again? What if I have food in my teeth? What if someone perceives me differently without my mask? All of those thoughts whirl through my mind as I enter the grocery store, walk my daughter into school, or sit with a client in a therapy session, with nothing covering the bottom half of my face. If I have those worries and fears as an adult, imagine what children and teens must be thinking and feeling.

Is your child struggling to take their mask off? Do they fight you to go to school or insist on keeping their mask close by, just in case? Maybe your child becomes more withdrawn when they eventually take their mask off. Do you notice they aren’t as social or their behavior changes  when asked to go mask-free in public? Maybe their grades have changed or they seem nervous about their surroundings.

These are all possible signs of anxiety and are likely due to underlying uncertainty about the change. The mask has become more than just a barrier for germs. For many kids, the mask functions as a security blanket of sorts.

If your child is struggling with anxiety about going mask free, here are a few things you can do to help them:

  1. Remember, just like when we transitioned towards masking, it will take time to adjust to the change. Try giving your child time and space to explore the change without excessive pressure.
  2. Meet them where they’re at. Seek to understand their fears by asking questions and try to avoid judgmental or dismissive language. The fear or worry may seem small or silly to you, but it is very real for your child.
  3. Make a plan with your child, to separate from the mask slowly. Could they wear the mask for part of the day? You could challenge them to go as long as they can without the mask with permission to put it back on if the anxiety becomes overwhelming. Maybe they leave the mask in their pocket, then in their locker, the car, and eventually it stays at home.
  4. Ask your child questions about what it feels like to take the mask off. What was their experience and did they notice anything that surprised them?
  5. Reduce avoidance of your own. Do not change plans or avoid situations that will raise the mask issue. Avoidance will perpetuate anxiety for both you and your child.
  6. If your child is severely anxious or experiencing panic, the sympathetic nervous system is likely activated (think fight flight or freeze response). At this time, reasoning and logical problem solving probably won’t serve you or your child very well. Instead, try using mindfulness techniques with your child, to engage all 5 senses in a soothing way.
    1. Comfort with touch, a hug, or a gentle back rub (with permission from your child)
    2. Visualize a safe space such as their bedroom or their favorite place
    3. Speak slower and more quietly or move to a less overwhelming spot
    4. Pace breathing; 4 seconds in, 7 seconds hold, 8 seconds out
    5. A cold ice pack or water on the back of their neck or wrists
    6. Suck on a sour candy or chew a piece of minty gum
  7. Lastly, If your child is struggling to function e.g., missing school, struggling with sleep, changes in appetite, severe anxiety, or panic on a weekly basis, it is time to reach out to a professional for support. Psychotherapy can be immensely helpful for both children and adults who are struggling with anxiety.

Lorenz Clinic offers a variety of services such as outpatient psychotherapy, psychiatric medication management, day treatment programs, and home-based family therapy services.

(952) 443-4600

 

About the Author:
Emily Groteboer-Distad, MS, LPCC, NCC, is a mental health professional, based out of our Rosemount Clinic. She joined Lorenz Clinic in 2021 and has been in the mental health field for 10 years, serving as a practicing clinician for 5 of those years. Emily, her husband, and her daughter call Minnesota home after living in various places while her husband served in the USAF.

Lorenz Announces Early Childhood Day Treatment

Lorenz Clinic has initiated a significant expansion plan at its Chaska location, where the clinic has been actively pursuing the development of added service lines including early childhood day-treatment and family-focused home-based services in addition to its existing outpatient psychotherapy and medication management offerings.  Overall, the initiative will provide notably expanded access to early childhood mental health services in Carver County and outlying areas where such services for very young children have been conspicuously lacking.  The program will open 3/1/20.

The new Day Treatment and its companion Home-Based program will feature high treatment fidelity and demonstrable clinical outcomes.  Young children often require access to various levels of care, and these changes will offer families a more seamless experience of what for many has become an inaccessible and
all-too-fragmented system.

The expanded clinic will features four service lines:

  • Outpatient Psychotherapy for all ages
  • Early Childhood Day-Treatment
  • Family-Focused Home-Based Services
  • Medication Management

In order to add day-treatment and home-based services, the clinic has been preparing for Children’s Therapeutic Support Services (CTSS) certification with the State of Minnesota.  The addition of CTSS certification will allow providers to serve families outside the four corners of the clinic and will enable them to provide a higher level of care that includes more than the typical one hour per week of therapy commonly found in outpatient settings.

About Day Treatment 

The day treatment program will be based on the treatment practice of Developmental Repair, an intensive treatment model that was developed by Dr. Anne Gearity to treat children who have experienced early complex trauma and are displaying aggressive and disruptive behaviors (Gearity, 2009).  The treatment model will be used to treat children ages 3-7 in a day treatment program, three hours a day, five days a week.  Through Developmental Repair, day treatment will target 4 main areas of functioning: relating, feeling, thinking, and acting.  With a combination of group therapy and group skills training, children will move through a daily routine that includes art projects, snack, large motor play, structured learning activities (books, puzzles, and games), and school work.  Each child will have individual goals created through collaboration among mental health professionals, clinical trainees, and/or mental health practitioners, and caregivers.

Each day treatment room will be comprised of up to 6 children and 2-3 trained staff.  The day treatment team will have day treatment specific consultation at least one time per week for 1.5 hours. Consultation will be provided by a mental health professional trained in Developmental Repair. 

Children participating in day treatment will attend either the morning session (9am-12pm) or the afternoon session (1pm-4pm).  A premier goal of Developmental Repair is to support continued inclusion in the community and prevent social isolation due to challenging behaviors (Gearity, 2009). Collaboration between day treatment staff, caregivers, and educators will work to support attendance in both preschool and day treatment for the younger children, and day treatment and kindergarten for the older children.  Ongoing collaboration between day treatment staff and educators will also support use of common language and goals.

Mental Health Professionals and Practitioners working in day treatment will work to build a partnership with families of clients in day treatment.  Clinicians will encourage weekly family therapy that will include sessions with caregiver and child, and/or caregiver without child.  Family therapy will happen in-center or in-home based on medical necessity.   The Developmental Repair model will be utilized in family therapy and work to partner with caregivers to improve the child’s functioning in the community. 

For More Information

For more information about the program, interested parties should contact Anne Fleming, the Assistant Clinical Director in charge of the program’s implementation and overall direction, at (952) 443-4600.

References

Gearity, A.G. (2009). Retrieved from http://www.washburn.org/pdf/WCCDevRepairGrayscale-singlepages-smallerfile.pdf, on 11/14/19.

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