1 SUMMER 2006 Setting the bar higher: Rehab program promotes recovery T One of the managers of Gateway s rehabilitation services program says that in today s way of thinking, simply providing medications hese can be fulfilling times for professionals working with a population with serious mental illness, because the discussion of clients potential no longer begins and ends with symptom control. Now that more clients have the capacity to live stable lives in the community, programs have been able to turn their attention to an even higher aim: enhancing the quality of that life. Valley Schools offer youths an empowering learning environment Avisit to the structured educational settings of Gateway s alternative schools for children and adolescents with special needs leads to some obvious conclusions about a community behavioral health organization s role. It succeeds when it identifies needs in the community and fills the void, and when it does so with a caring staff that can adjust to ever-changing circumstances. The Valley Community School and Valley Day Program offer all the services of a traditional public school and meet all the regulatory requirements for educational and health facilities, but on top of that they are asked to address the needs of students who for behav- Schools continued on page 4 to treat symptoms and doing nothing else amounts to professional negligence. This is the essential question agencies should be helping their clients answer, Paul Teixeira says: Do I have a life? Rehab continued on page 2 inside 3 Message from Rich Making summer brighter for youths 5 Children s homes offer structure amid challenges 6 Shelter constitutes only the beginning of New Hope s mission 7 Gateway is partner of Rhode Island Institute for Mental Health Excellence 7 Gateway s adolescent residential facilities awarded $3,500 grant 7 New Hope for Families receives $5,000 grant A Publication of Gateway Healthcare, Inc.
2 2 Rehab continued from page 1 Gateway s psychiatric rehabilitation program meets clients where they are in terms of their life goals and their readiness to pursue them. We help people achieve recovery by helping them succeed in valued roles in a chosen environment, Teixeira says, whether that is as a worker, a spouse, or whatever it is that gives them meaning in their life. Gateway maintains no strict eligibility criteria for the program. If you just want to talk about making a change, we ll accept you, Teixeira says. All the program asks of clients is that they show for their scheduled appointments. Recently the program adopted the Boston University Center for Psychiatric Rehabilitation s approach to assessing client readiness for change and any barriers that must be overcome. This approach measures a client s commitment to change, awareness of personal likes and dislikes, and awareness of alternative options in the community, among We help people achieve recovery by helping them succeed in valued roles in a chosen environment, whether that is as a worker, a spouse, or whatever it is that gives them meaning in their life. Paul Teixeira, Psychiatric Rehabilitation Program Manager other factors critical to embarking on a course toward recovery. The typical rehabilitation client at Gateway has been referred by a clinician from a primary service program at the agency. The client usually needs to develop skills for work, learning, or social environments, Teixeira says. Participants age range tends to be late 30s to early 50s, he says. In the area of group activities, the program offers both weekly activities and one-time events. Library groups, exercise groups, personal development sessions and other weekly activities dot a packed monthly calendar, while other activities over the course of a month include restaurant, shopping and special-event excursions. The program staff is constantly looking for meaningful activities for clients, in settings that offer them the same opportunities for interaction that all individuals in the community have. Gateway has sponsored overnight trips with 10 clients and two staff members to places such as Nova Scotia and the Poconos. In addition, Gateway conducts a monthly dinner dance event for rehabilitation clients. The program s work-related services also are tailored to each individual s background and status. Clients with a good amount of previous work experience will receive help with resumé preparation and job-related coaching, Teixeira says. For those with a limited work history, the program will develop a job plan and will actively market the client to potential job contacts. For clients who have made progress along this track, the boost that the program s services gave them has proven invaluable. Laurene, 37, had been battling depression and was living with her parents before starting in the rehab program. She now lives in supported housing and visits the Rhode Island Donation Exchange Program, an agency providing donated furniture to needy families, five days a week for volunteer work. I m getting out instead of being in the house all day, she says. My confidence is getting up there now. Laurene hopes the volunteering will eventually translate to a paid position. Her caseworker says Laurene served as her own advocate to land the volunteer slot. David, 49, says participating in the psychiatric rehabilitation program helped him see that he was not alone in his struggles. He came to the United States from Africa 18 years ago
3 3 Message from Rich by Richard Leclerc, President, Gateway Healthcare Even if your only summer break will be one getaway weekend, chances are you still see the summer as that sun-splashed reward for surviving the year s rigors. It s hard to forget those endless stretches of summertime bliss that for most of us marked our youth. You might think that the children we serve have that same carefree attitude about the summer months. But for many of the troubled or neglected children assisted by Gateway s programs, summertime can be the most difficult period for maintaining progress. At least during the academic year, the school day s routine offers familiarity and comfort to the young person with a troubled past or an unstable home life. Summer days without that routine can be fraught with potential danger for many of our youths. In the child-serving programs we administer, maintaining stability during the summer months takes on critical importance. Students in our Valley Community School and Valley Day programs attend structured summer sessions, with older students spending some time learning about future work options and younger children doing some academic work and plenty of field trips. Youths residing in our group homes attend school in the summer if they are in alternative-school programs during the academic year. Many of those whose public schools are out of session go to summer camp. The idea is to offer these youths structured activities to maintain a healthy mind and spirit, and to make the summer experience a reinforcement of progress made during the year. But of course, everyone deserves and needs some fun over the summer, and the children we serve will commonly attend everything from a beach or deep-sea fishing excursion to a Pawtucket Red Sox game in the coming weeks. Our programs set aside some of their funding for these kinds of activities, but much of what we are able to provide for our children is made possible through the generosity of our community leaders. Even the smallest of gestures, such as donating an event ticket or devoting some of one s time, can mean so much to a child who hasn t had many positive summer memories. Let s all think about the ways in which we can make this a season of hope for the children who need us. and has received his citizenship; he is now working full-time at a manufacturing plant. He is also taking classes to become a truck driver. You wouldn t see my illness now unless I told you, David says. The times when he was in the throes of his illness seem far behind him now. Being at home makes you think too much, he adds. A written overview of the rehabilitation services program for clients emphasizes their many options for receiving support or enhancing skills. Answering the question, What kind of rehab activities will help me achieve recovery?, the overview states, It depends on what your goals are; what you want to achieve in life! Teixeira, who has managed the rehabilitation program for seven years, sees these services as carrying an unprecedented level of importance. As payers and policy-makers emphasize the provision of evidencebased treatments leading to better outcomes, rehabilitation services will continue to become more prominent as the key element in a recoverybased system, he says. One of his goals for the program is to expand the kinds of vocational options available to clients, who sometimes get pigeonholed into certain expectations about the kind of work that is appropriate for them. We need more partnerships in the community and with businesses, he says.
4 4 Our approach is very hands-on very one-on-one. The students have [Individualized Education Plans]; we follow those to the letter. Lou Azie, Valley Community School program manager Schools continued from page 1 ioral reasons have faltered in a traditional school setting. School programs in Pawtucket, Cranston and Middletown receive referrals from local school systems that are struggling with a student. The goal is usually to place the youngster on the right track and have the student return to public school, although some students end up staying with and graduating from the Gateway program. All of the staff are trained in crisis intervention, says Lou Azie, program manager at the Valley Community School site in Pawtucket. Our approach here is very hands-on very one-on-one. The students have [Individualized Education Plans]; we follow those to the letter. The Valley Community School is for middle and high school students, while younger students attend the Valley Day Program. The operations in Pawtucket are housed at the same site but in distinct quarters. On a recent morning visit to the Pawtucket site, a relatively quiet atmosphere prevailed, outside of a couple of occupied timeout rooms at the Valley Community School that are operated under accepted procedures for seclusion. But program administrators warned a visitor that it is never easy to predict what kinds of situations staff will encounter over the course of a day. You have to be creative to work here, says Jill Lusignan, program manager at Valley Day in Pawtucket. You take what you re given on a regular basis. The staff is very invested in the student s well-being. The success of the programs for both the older and younger children depends on communication, consistency and clear expectations. Many of the students have come from a school environment where they felt ignored and often unsafe. Both Valley Community School and Valley Day use a point system that affords students certain privileges, such as recreational time or purchases at the school store, when they meet academic and behavioral goals. The younger kids love the point sheet; they eat it up, Lusignan says. That s not to say that these students see success immediately upon transfer from a traditional school. Many come in with a bad history of attending and are not thrilled to be here, Azie says of the older students. But while much of the program mirrors the offerings in a traditional school, the class sizes of no more than 10 and the youths access to social workers and other support staff make this a much more caring environment than what they have seen before. Some might say they hate the school or their teacher, but they ll be responsive here, Azie says. A diagnosis of conduct disorder with ADHD is commonly seen among the older students referred to the Valley programs. The programs generally maintain a boys-to-girls ratio of about 4-to-1. Valley Community School operates a highly successful vocational component supported by grant funding. Over a typical two-week period in the vocational program, students will spend five days in class and five days at a work site such as an auto repair shop or food service outlet. Their self-esteem is enhanced, Azie says. The continuity of the lessons learned during the school year is maintained during the summer months. Lusignan says Valley Day operates a 230-day program, with a summer program combining academics and field trips starting immediately after the end of the main academic year. Staff members manage their share of challenges and crises in these settings, but the long-term results they achieve stand out. Lusignan says 11 of the 54 students in the Pawtucket Valley Day program during this past school year will transition to a public school or a less restrictive classroom in September. Gateway s superintendent of schools believes these kinds of numbers are a testament to a professional staff that s in this work for the right reasons. You can t hide that from these kids, James DePasquale says. They are the best I ve seen at judging character. They ve learned to survive, and to assess who each person is as people come in and out of their lives.
5 5 Children s homes offer structure amid challenges O ne is situated on a quiet, sprawling campus in West Greenwich, the other wedged into a busy neighborhood in Pawtucket. But Gateway s Arcadia Children s Home and Blackstone Children s Home both are designed to offer security and a positive experience for children ages 5 to 12 who are more familiar with instability in their lives. All of the children residing in the homes are referred by the Department of Children, Youth and Families, but their family profiles differ. For some of the children, a biological parent retains custody and family reunification remains the goal. Others are in adoptive or foster care, but the new parents may have sought help for problems in the home. Using a clinical team that includes mental health counselors, milieu therapists and consulting psychiatrists and psychologists, the homes take a skills-based approach to assist the children, most of whom have a diagnosis of ADHD and many of whom have experienced trauma. But given the age group that staff members are working with, a healthy amount of fun is blended into the homes structured activities. I tell the staff when they come in to be prepared to have fun. Come dressed to play, says Periane Thomas, program manager at the Arcadia Children s Home. Busy kids are happy kids. Periane Thomas and Tracey Pryor, House Manager at the Blackstone Children s Home, say that behavioral modification approaches with a punitive focus don t tend to work well with the children in their care. The approach at the homes involves natural consequences to actions that help children build competencies. For example, Pryor says, if a child inappropriately throws away an item, the emphasis is not on punishment for the action but on how to adjust to the loss of the item. Given that staff members are trying to give the children a sense of security and stability, they are attuned to times of the year that threaten to break the routine and lead to setbacks. Holiday times, which often have been unpleasant in the children s lives, are one of those. Summertime can be another, which is why the children whose schools do not have summer sessions are sent to a therapeutic summer camp or other daily program. A lot of the children will say that summers weren t good for them, Pryor says. We try to keep that time as consistent as possible. While some of the daily payment Homes continued on page 7
6 6 Shelter constitutes only the beginning of New Hope s mission H omeless families need the immediate security of warm and safe shelter, but ensuring their long-term stability requires much more than an available bed. This is why the director of the New Hope for Families shelter in Pawtucket describes her operation not as a place to sleep, but as a place where people improve their lives. Sister Marta Inés Toro, who has directed the shelter since 2002, describes the program s services as occurring along three stages: immediate shelter, transitional housing, and long-term supportive services that can follow families to the community. That third feature has come into view as funding sources have begun requiring providers of services to the homeless to incorporate the supports necessary to offer individuals and families permanence in the community. If we had four buildings instead of Andrew Duehring (right), president of the Pawtucket Lions Memorial Foundation, presents a check to Sister Marta Inés Toro, OP, program director of New Hope for Families, and Richard Leclerc, President of Gateway Healthcare. one, they d all be full, Sister Marta said as she led a tour of the modest Pawtucket home that houses up to eight families. But I m convinced that the key is to offer supportive services that help people avoid homelessness. New Hope for Families became affiliated with Gateway last summer. While the two organizations share the same board of directors, New Hope for Families operates as a separate entity while benefiting from access to Gateway s diversity of services and contacts in the community. Sister Marta s arrival four years ago came at a time when administrative and financial difficulties had forced the closing of the shelter for about four months. Today, New Hope for Families is a welcoming, efficiently run operation where residents and their children receive guidance from a staff of 11, access to case management and community resources, and support from families in similar circumstances. Up to six families on the home s main floors have their own bedroom and share other living space, while up to two families in the house s basement reside in transitional apartments that serve as a bridge to permanent housing. Most families at the shelter are from the Pawtucket and Central Falls area. The circumstances by which families arrive at New Hope reflect the tenuous situations in which disadvantaged families often find themselves. Sister Marta says it is very common for low-income families to face a sudden financial crisis after the sale of a property in which they have been living. Also, a prolonged illness of a working parent renders many families unable to maintain rent payments, forcing them out of their housing. The shelter s affiliation with Gateway has established important linkages to behavioral health services and other supports, which many families need as they struggle to restore stability to their lives. While families at New Hope contribute toward the services they receive based on ability to pay, they benefit from the gift of time as they piece their lives back together. Families average stays tend to be about two to three months. This is about making sure the problem doesn t get bigger, Sister Marta says. Any family with a child under 18 is eligible to receive shelter at New Hope for Families, but program staff conduct thorough assessments to make sure that the home s composition is conducive to the families progress. Because of the home s close quarters and need for security, background checks are conducted for all prospective residents. In addition, staff has to be cognizant of problems that could arise when, for instance, a parent with a substance use history seeks shelter at a time when adolescents are living
7 7 in the house, Sister Marta says. No one funding source can be relied on to support the efforts at New Hope for Families. Sister Marta and Gateway staff are constantly identifying grant opportunities and fundraising strategies. Local businesses and other institutions have contributed everything from playground equipment to dining room furniture. This outpouring of support harks back to the efforts of several churches in the mid-1980s that came together to establish the shelter, which has since become a mainstay for the Pawtucket and Central Falls communities. Homes continued from page 5 rate that the homes receive from DCYF can support recreational activities for the children, the homes also receive much help from the community. Donated or reduced-price tickets for sporting and cultural events offer the children enjoyable activities and new settings in which to interact with others. The Arcadia home has capacity for 14 children and Blackstone for 8, and both programs report high demand for services at present. A typical length of stay ranges from 9 to 18 months, and offers balance to a child who may have come from an unstable home or a hospital setting. In keeping with Gateway s continuum-of-care approach to serving the child, many of the children continue to have involvement with Gateway services after leaving the home, such as through the Children s Intensive Services (CIS) program. Thomas says the consistency of the homes clinical approach gives staff a common language that they can share with the children s family members, so that the lessons the children learn at the homes can be reinforced in the next place they will call home. This just in Gateway Healthcare is a proud partner of The Rhode Island Institute for Mental Health Excellence bringing cutting edge science to real world, community-based settings while building a new national model for integrating research and treatment. For more information, visit Carter Family Charitable Trust awarded a $3,500 grant to two of Gateway's adolescent residential facilities (Blackstone Adolescent Counseling Center and Lincoln House) to run a summer art workshop program for the residents. New Hope for Families was recently awarded a $5,000 grant from Bristol County Savings Bank for necessary repairs to the shelter. SAVE THE DATE! Gateway s Third Annual Golf Tournament will be held at the Kirkbrae Country Club in Lincoln, RI on Monday, September 11th. If you are interested in receiving more information on this important fundraiser, please contact Joanne King at ext COMING SOON Gateway's new and improved website.
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