Clinical Services Provided to Students in the TLC Residential Treatment Program

1. Clinical plans – Detail target skills to be practiced by students and parents. Students demonstrate abilities that meet standards of performance for increased choices and freedoms.

2. Treatment Procedures – identify target skills to be practiced, with proactive and reactive strategies listed. Proactive strategies (e.g., advanced rehearsal, review of opportune moments to demonstrate the skill, etc.) are designed to elicit practice and apply the skill. Reactive strategies redirect the student to rehearsal of skills that need practice and mastery.

3. Independent Living Skills are practiced daily using schedules of activities that provide opportunity to use independent living skills, e.g., menu planning, cooking, laundry, general upkeep of their house, activity planning, and community time.

4. Data collection is to verify demonstration of skill sets, and to modify strategies as needed and agreed upon.

5. Group process meetings – with a clinician, are scheduled both weekly and based on student needs. Daily consultation with residential staff is to review student peer-staff, social interactions. Menus of activities are jointly planned for the week.

6. Clinical on call support is provided morning and evening by telephone consults with clinical and/or administrative staff and telephone consults as needed or direct real time video consults.

7. Psychiatrist and clinicians meet 3X per month to review students’ clinical issues and relevant data and evidence of medication influences on behavior. Students meet with psychiatrist 1X monthly for review of medication effectiveness.

8. Nursing is provided by two registered nurses that are available during day and residential hours. They provide monitoring and oversight of student care plans, medication regimens, medication changes, education related to self-care, weight management, nutrition, and overall health and nursing assessments of student medical needs.

9. Medication management and oversight is provided by certified medication administration of residential staff, on-site to administer medications and coach students on medication identification, side effects, and adverse effects. Video observations across settings real time and over time samples validate procedures.

10. Social skills and social judgement are assessed daily during social activities across settings that provide opportunities for practice of social skills/judgement with and without staff rehearsal or corrective feedback.

11. Executive functioning skills are monitored. Highly structured residential settings and staff coaching elicits student practice of time-management, planning, organizing, identifying options and managing pre-potent behaviors.

12. Uses of real time video samples are to facilitate clinical consultation and plan intervention in real time for across classroom and residential setting application.

13. Available video footage for “backward chaining” reviews of successful application of skill sets and review and rehearsal of abundant alternative strategies following unsuccessful interactions.

14. A clinically oriented focus on the student’s incremental introduction to the community. The steps begin with the TLC residential community, and progresses to staff supported and independent community apartments in the surrounding communities of Northeast Connecticut.