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Positive Steps for Families in Crisis and Those Heading That Way

Maintaining a record of efforts made on behalf of the child (the paper trail)

More of this Feature •Introduction •Definitions •Correct Diagnosis •Professional Involvement •Maintaining Records •Contingency Plans •Resources

Related Resources •Past Crisis: Disruption •Discipline/Behaviors in Stepfamilies •Early Intervention •Respite Care •Support Groups •Therapeutic Foster Care

Illustrated with the example of a real life family (names changed to protect privacy).

Diego is now 15 years old. He is on level or above in all academic areas and maintaining As and Bs with only an occasional C. Thanks to Joan's careful planning and early intervention services, Diego has overcome all of his early problems with the exception of some behavioral problems. Even those improved quite a bit between the ages of 10 and 13. However, in recent months, Diego has shown signs of an increasingly violent temper.

Diego is no longer cooperating with his therapist and sits through most of the sessions staring straight ahead, waiting for the hour to end. He completes his homework and his household chores, but is rarely cooperative in any other area. Recently, when Joan refused to extend his curfew, he began kicking the coffee table and did not stop until it was destroyed. He showed remorse for this action, but Joan is worried. She meets with her son's weekly therapist and with the Junior High school counselor to go over the treatment plans and IEP.

Maintaining a paper trail, or a record of efforts that have been made on behalf of the child to deal with the diagnosis, is crucial to avoiding a crisis, or dealing with one successfully. If you have a file that details what has been done, and a crisis looms, the professionals who have the ability to help your child will be much better prepared to do so. They will know what has been tried, and for how long, what worked, did not work, or worked only temporarily, and more. This file is invaluable in developing a new course of treatment for the teen-ager or young adult in the throes of a crisis.

Furthermore, in the event that the child requires hospitalization or residential treatment, the insurance "gatekeeper" is likely to require evidence that all other methods for helping the child have been tried prior to taking the expensive step of out-of-home care.

In a few cases, a child will be "terminated" from a residential program due to extreme behaviors that put others in danger. When this happens, other residential programs will probably be unwilling to accept the child. In some states, a parent may be forced to ask a court to order the department of social services to temporarily accept physical custody of the child for purposes of finding in-patient treatment.

State departments have contracts with some residential treatment centers and therapeutic foster homes that will accept a youth no matter how dangerous his or her behavior has been in the past. The parents are expected to pay child support and to accept the child back into the home once he or she is stable and safe to live with. When a court hears such a request, it will expect the parent to provide evidence that a private placement is no longer a possibility and that all other possible solutions have been tried. The paper trail is the proof of this.

Next Page: Contingency Plans

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