At IMHC we believe that treatment is provided through the relationship with a clinician and bio-psycho-social interventions agreed upon by the client and the clinician in order to enhance the client’s quality of life. This philosophy is based on a firm belief in the worth and dignity of each person and their right to self-determination. Therefore clients have a primary responsibility for their treatment and thus have the need for any information we may have or any educated opinions we may formulate. If the clinician perceives that such may be harmful to the client, information may be temporarily limited.
Services in the Clinical Program are based on evidence based practices such as, Cognitive, Behavioral, and Solution Focused Modalities. The services provide direct interaction with clients in order to support a recovery type of approach. The Clinical Program places the focus on reducing symptoms in order to restore and improve the client’s quality of life. Services are intended to support the integration of the clients within and into the community. The program’s overall goal is to assist clients in reducing their symptoms and to improve their overall functioning. Services are designed to meet the needs of the diverse population and culture that IMHC serves.
The Program views clinical assessment of the client’s dysfunction to be the most crucial phase of client contact. It is in this assessment phase that the person’s strengths and needs are matched with the appropriate level of care in order to ensure that the person receives the optimal level of treatment intensity within the least restrictive environment.
Once the individual is assessed as appropriate into the Program, an individualized treatment plan (ITP) must always guide the treatment intervention.
If the nature of the mental illness or distress is such that the client is unable to exercise this responsibility, receive accurate information, or formulate informed decisions, the clinician will assume this responsibility in lieu of the client. If the clinician or agency is unable to meet the client’s needs for service, referrals will be made outside of the agency. The Program is based on treatment plans which are behaviorally written and measurable. The program’s expected outcome is for treated individuals to increase their level of functioning from the admitting assessment to discharge (as measured by the DSM-IV GAF and CGAS Scales). The Program also deems the acquisition of life skills to improve adaptation as a central component in treatment planning. In gaining such skills, the client prognosis for long-term recovery is further enhanced.
Clients suffering emotional issues have family members and/or other people who are significantly involved with them. When the individual with an emotional diagnosis enters treatment, his/her prognosis is improved to the degree that his/her support system is involved in their treatment, gains insight into their own dysfunctional behaviors, and modifies these behaviors to support the recovery of the identified client. The Clinical Program maintains an educational/informational approach to address the needs of the client and family.
Service planning begins with an evaluation conducted with the client of their social history, strengths, needs, abilities, and supports as they relate to their areas of distress. Based on this evaluation a treatment plan is generated by the client in conjunction with the clinician (and others that may be selected by the client) in order to delineate a strategy to resolve the area of distress. This strategy also aims to raise their level of bio-psycho-social functioning, enhance their self-esteem and increase their coping skills. The focus of treatment planning is to enhance the client’s ability to maintain, and to improve his/her global level of functioning. The language of the treatment plan is worded such that it is understood by the client. It also includes the intensity, mode, location, and anticipated length of treatment. The treatment plan also incorporates the initial components of discharge planning. The counselor working with the client is responsible for ongoing assessment, treatment planning, reviews, modifications, treatment implementation, referral, linkage, discharge, and follow-up contacts. During a crisis, the service planning may be abbreviated.
Services of the outpatient department are offered to all residents of Iroquois County and other counties in Illinois and Indiana, who request help for: emotional disturbance, mental illness, self esteem issues, social functioning, or coping skills. The clients served must meet the DSM-IV criteria for a mental disorder. In the event a person does not meet criteria a referral is made.
Services in the Clinical Program are provided by Clinicians who have met the legal requirements for each program. The Clinical Program staff have demonstrated competency as it relates to the needs of the population served and as dictated by each job description.
Admission Criteria and Referral Process
Clients requesting services will be screened during their first appointment (i.e. intake). Clients within the diagnostic criteria of the DSM IV, who are judged to be capable of benefiting from services, will be admitted to the outpatient clinical program. Clients who are released from a Psychiatric Hospital will be scheduled with a counselor within a week of their release from the hospital. Clients who are in an acute emergency state and/or pregnant women are given priority. The Clinical Director, Assistant Clinical Director, or Crisis Director assists in making admission decisions for clients in a crisis situation. Clients with primary problems including substance abuse, will be referred to the Substance Abuse Program for screening. This client may be opened to both departments. Client’s with a diagnosis or level of functioning that appear to fall within the Psycho Social Rehabilitation Services (PSRS) Program guidelines will be referred to that department for screening. If they are found to be appropriate to that department, the therapist, PSRS Director, and/or Clinical Director will determine whether to open them to both departments or to transfer to PSRS. If IMHC is unable to fill the client’s needs, or if the client does not fall within the target population, the Counselor will formally inform the client as to why services at IMHC cannot be given. The Counselor will then locate and offer referral options. Recommendations for alternative services are provided to the client. A written consent is developed and a formal referral is completed. This process is documented in the progress note. IMHC tries to ensure the appropriate resources to meet the clients’ needs; therefore, a waiting list does not exist. Every referral is given the first available appointment with a Counselor to start the counseling process. A list of referral sources is available and will be provided to the client.
Clients who have met the percentage of their goals as stated on their treatment plan and judged to be able to continue to improve or maintain without services will be terminated. After discharge, the program’s staff send out a satisfaction survey to obtain feedback regarding the clients overall satisfaction to IMHC and the services provided.
Procedure to Insure Internal Communication
Management Team Meetings (including outpatient clinical staff, executive director, all program directors, and administrative staff) will be held from 1:00PM-2:30 PM each Wednesday. This time will be used to enhance communication within IMHC staff.
Psychiatrist staffing is held for clinical staff on days when the psychiatrist(s) will be providing services to clinics for the entire day. Clinical staff attendance at the meetings is mandatory. The psychiatrists’ staffing provides a platform for consultation between clinical staff and psychiatrists to review clients seen on that particular day and/or those with future appointments. Clinical staff provides feedback on the client’s progress or lack of progress.
A clinical staffing (including clinical staff and crisis staff) will be held from 1:00-2:00PM each Thursday for full time staff and the last Tuesday and Thursday of the month at 6:00PM for part time staff. IMHC utilizes the services of a contracted consultant on a monthly basis to assist with full time clinical staff meetings. This time will be used to enhance communication within IMHC staff by reviewing current crisis clients, and sharing relevant information concerning other agency clients.
In addition to increasing communication, this time will be used to review cases, provide peer supervision, present trainings, explore relevant safety, and administrative concerns. This time is not meant to substitute for the minimum of one hour of clinical supervision provided for each individual crisis and clinical staff.
Procedure to Enhance Response to Interagency Client Needs and Insure Interagency Communication
Outpatient staff always has the option to attend school staffings and other meetings as requested by client, guardian, or school.
As dictated by the needs of the client, outpatient therapists/case managers may interface with other services (e.g. Equip for Equality, IPA, LCHA, Court Services, Township Supervisors, etc.) in person or by phone.
Clinical Staffing is an opportunity to share information from various trainings that we attend throughout the year.
IMHC contracts with individual consultants in the areas of child, adolescent and adult outpatient therapy, to assist and participate on a monthly basis, in outpatient staffing.