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ATTACHMENT CENTER of SOUTH
CAROLINA
@ Children Unlimited of Family Service
Center of SC
1800 Main Street
Columbia, SC 29201
803-733-5474
Fax: 803-929-6699 e-mail:
jill@fsc-sc.com
Program
Philosophy:
Children Unlimited is a private
non-profit agency that was founded in 1977. Our mission has always
been to find adoptive homes and clinical resources for children with special
needs. These children have a variety of emotional, educational,
medical and, sometimes, physical disorders. Twenty-five years later,
our mission has expanded to include assisting all families, birth and
adoptive, to find permanence and stability.
In May of 1998 the Attachment Center of
South Carolina (ACSC) officially opened. This was a long time dream
for the agency since we have been serving clients and training therapists
since 1989. We provide treatment for children with attachment
problems/disorders, including Reactive Attachment Disorder, Post Traumatic
Stress Disorder, and other related disorders. We treat many children
who, along with their attachment problems, have co-morbid conditions such as
Post Traumatic Stress Disorder, Anxiety Disorders, ADHD and other
conditions.
We will consider working with any child
from birth to twenty-one years of age. The majority of the ACSC’s
clients are children ages four to sixteen who have been adopted or who are
in the foster care system. We treat children with histories of abuse
and neglect, multiple placements, histories of institutional care, and
internationally adopted children. We have also treated children who
live with their birth families. All services are on an outpatient
basis.
Level of Practice
At the ACSC we consider ourselves to have
a broad range of training and experience, most of which is in attachment,
adoption, therapist training, foster care and post adoption services and
both clinical and family support services. We see clients with mild to
moderate symptoms and we use a variety of techniques and modalities for
treatment. On occasion we may see a child and their family with severe
symptoms. This may happen as a result of follow-up from an inpatient
or intensive treatment outside our agency. If we are unable to help a
family due to the severity of the child’s needs we will assist them in
finding a more suitable resource.
Program/Practice Overview
Any treatment we provide always involves
both the child and the parents. The parents are always involved in
every aspect of treatment. They are either in the therapy room or watching
through a two-way mirror.
Our therapy has many components:
·
The first is educational, designed to help a
family understand their current situation in regards to attachment and
bonding problems.
·
The teaching of parenting skills comprises the
second part. This can be done before, during and after the child’s therapy.
These skills are designed to help the parents learn new coping skills and to
provide necessary corrective parenting experiences for the child. These
parenting skills are also a conduit in heightening the child's motivation
for treatment by allowing them begin to understand the cause and effect of
their behavior.
·
The third component involves intensive emotional
work with the child. This may be done in the form of an intensive or
weekly therapy sessions lasting from one to five hours.
·
The final part involves follow-up therapy with the
family. This is done at least quarterly but is often monthly for the
first year.
Our complete list of services are varied and
tailored to the needs of the family. These include:
-
Assessment
-
Consultation
-
Individual Therapy
-
Family
Therapy
-
Respite
-
One
Week Intensive Therapy
-
Two
Week Intensive Therapy
-
Quarterly “Booster” Sessions
-
Parent
Preparation Sessions
-
Love &
Logic Classes
-
Therapist Training
Description of Services
If attachment and bonding problems are
suspected during the initial call an information/application packet that
includes an application, a fee schedule, informed consent, limits of
confidentiality, mandatory reporting laws, client rights/appeals information
and other releases are sent to the family or professional.
Admission occurs when a family arrives for
their first appointment.
The objectives of our clinical services
are:
·
Provide an
accurate assessment of a disorder/problem
·
Treat the disorder
thereby causing:
v
Increased insight
v
Reduction of
inappropriate behaviors
v
Client’s/family’s
acceptance of responsibility for behaviors
v
Client/family’s
acceptance of responsibility for one’s own well being.
·
Connect clients to
appropriate support services
Assessment:
The therapist meets with the family to
discuss their histories and the assessment materials that were sent to them.
The therapist then informs the family of the types of therapy we can provide
and the fees involved. We discuss with them at length the
possibilities of this therapy and the appropriateness of therapy for their
child. We also work with the family to develop financial and support
resources. The assessment usually involves one session and follow-up
phone calls. The assessment will require from three to five hours of
direct client contact. It will take place only in our Columbia office.
There are four stages to our assessment.
We will first meet with the parents where we will discuss the psychosocial
history as described on the application, signed informed consent document,
initial treatment plan, client rights information and other releases. We
will then meet with the child (with the parents present/viewing). Typical
instruments used during both these sessions include the Randolph Attachment
Disorder Questionnaire, psychosocial history questionnaire,
House-Tree-Person projective test, Kinetic Family Drawing projective test,
Parent Profile for Attachment and the Cline Helding Adopted and Foster Child
Questionnaire among other tests and interview protocols. In the
session with the child we are predominantly assessing their degree of
accessibility and capacity for emotional engagement. We are also
interested in the child’s eye contact, ability to contract to work on their
life, and their ability to be held or touched by his/her parents.
After meeting with the child we then meet with the parents one more time to
discuss treatment planning. The preliminary results of the assessment
are shared and an agreement is reached on the best course of action.
The parents are informed a report detailing psychosocial information, test
results and recommendations will be written within 30 days and sent to the
family and/or referral agent.
Our service to the family does not end with
the assessment. We often spend a great deal of time finding and
accessing resources, providing crisis intervention and talking to referral
sources. We want to know that a family has received the help they
need.
Treatment:
If future treatment is appropriate and/or
requested the family will begin either parent preparation sessions for an
intensive or family/individual therapy. A new treatment plan will be
developed in conjunction with the family that informs the family of their
rights, responsibilities, and course of treatment. Treatment of
children with attachment and bonding problems involves sessions that occur
at regular intervals. Sessions are usually one to five hours in
length. The parents are included in all sessions either in the room or
viewing through a one-way mirror.
If one or two week intensives are necessary,
they will include three to six sessions at three to five hours a day.
One primary therapist, one supervising therapist, a family specialist and
the hometown therapist (if available) are involved in treatment. The
family specialist provides Love and Logic training to assist the parent with
effective parenting methods.
A new treatment plan will be written if the
service changes or any other significant therapeutic event occurs. A
family must have a new plan at least every six months, or more often as
required by the outside referral/payee source.
After the intensive is complete, even if a
family discontinues treatment, a report similar to the assessment report
will be prepared and sent to the family and/or the referral agent. A
section will be added to include treatment.
A plan will also be made for follow-up
treatment. This includes quarterly, if not monthly
sessions.
Methods Used:
Our therapy is conducted in a manner
consistent with established ATTACH/state licensing ethical guidelines and
therapeutic practices. This includes a variety of strategies to help a
child learn about and deal with their emotions.
In addition to using standard verbal
techniques, we use techniques designed to engage the child in a nurturing
way that will allow them to heal. The therapy has a major effect on the
child’s emotions that he/she feels they are unable to allow. We
believe that by using these techniques we create a safe environment for a
child to express their emotions. Oftentimes this is about a child
giving up control to an adult caregiver, which can be both frightening and
difficult. The most common of these emotions are fear, shame, sadness
and anger. These emotions often are the reasons for a child’s
unwillingness to attach.
Contracting and therapeutic holding of the
child by the parents and/or therapist is employed by our center. Both of
these techniques are done with everyone’s consent and after significant
preparation. Contracting is usually in the form of verbal directives
to get the child to a place where they appear ready to work on their life.
This is often done in a playful but sometimes firm manner as we want to let
the child know that we take the child’s recovery seriously. We do not
yell, shout or otherwise try to coerce or frighten a child into contracting.
Any holding is primarily done by the parent.
This is used in an effort to allow a child to have nurturing from their
caregiver. The parent is the primary agent in this holding. This
is done to assist the child and parent with attunement and establishing a
reciprocal relationship. This technique is used in an across the lap
nurturing cradling, as one would feed or hold an infant. The
Attachment Center of SC does not use compression holds, rebirthing, or any
type of blanket wraps. All holding is done at the request and consent
of the parent and child. We do not use any type of therapy that
elicits painful responses from a child or causes them any physical
discomfort. We do not restrain. However, we reserve the right to
contact the authorities or take other necessary emergency precautions should
a child become out of control or become a severe risk to themselves or
others.
Fees
The standard fee for therapy for one
therapist is $80.00 per hour.
The assessment appointment will last between
3-5 hours. Total cost for the assessment including the application fee
will not go over $500.00, even if the initial appointment is longer than 5
hours.
Up to six family therapy sessions often
precede an intensive or future therapy with the child. The ACSC can
provide this therapy at $80.00 per hour, and provide these sessions in one
to three hour increments. Each family is expected to complete family
sessions prior to their intensive. The amount of time necessary will
depend on the family situation but does not usually exceed six sessions.
Should a child
require intensive interventions, the ACSC can provide one and two week
options that consist of up to 3 days a week and three-five hours a day.
The base fee is $960.00 for one week and $1,920.00 for two weeks. Each
family is expected to complete family sessions prior to their intensive.
A family may also need therapeutic respite during the intensive. If
necessary, the fee is $100.00 per day.
Follow-up treatment for a family is
essential to the ongoing success of intensive treatment. It is
strongly recommended that a family find a hometown therapist. The ACSC
can provide these follow-up services at a fee of $80.00 per hour.
These sessions are usually three hours in length at three, six, nine and
twelve-month increments or more as indicated.
The Attachment Center of South Carolina
does not accept Medicaid. We accept medical subsidy, credit card,
cash, check or payment through a state agency. CU is on the approved
provider list for the SC Department of Social Services and a limited number
of insurance companies. We will assist with the filing of insurance.
However, payment is due at the time of service. As stated above we
will attempt to find alternatives to funding and resources for the client
who cannot afford treatment. However, it is unethical for us to begin
treatment without a verified funding source.
Safety/Risk Management Plan
If the parents and therapist have
discerned a child is out of control or violent; and believe the child is a
danger to themselves and others, arrangements will be made for crisis
stabilization in a secure facility. We will not treat nor will we send
a family home with a child in this state of mind. This is for the
safety of all involved. Although this type of therapy is regarded by
our Center as nurturing and not restraint, there is controversy about
attachment therapy. Therefore it is important for us to note the
following for parents and professionals. None of the techniques we
employ shall do the following:
1.
Cause physical discomfort to the child.
Note: children often feign discomfort. It is the joint
responsibility of the therapist and parent to accurately attend to the
child’s discomfort level and attend to a child immediately when true
discomfort is present.
2.
Inhibit the family from watching, participating
in, or halting a session. Parents have the ultimate rights concerning
the care of their child. Parents are involved in all sessions.
The parents are either in the room with the child or watching through a
two-way mirror. Close attention is paid to the child’s emotional
state.
3.
A client always has freedom of choice. We
will not restrict a client’s right to choose. Any therapy is done to
assess compliance with directives and evaluate nonverbal cues. A
client and/or their parent must agree to any treatment thereby giving them
total self-determination.
Our agency has an ongoing risk management
program. This involves an ongoing process of identifying risks or
potential problems that can result in loss, injury or liability. The
primary goal is prevention of negative events and analysis of negative
events in order to improve policies, procedures and practices or initiate
training. It encompasses financial, personnel, facility, service and program
policies and practices. Staff, volunteers, contractors and consultants
all have a responsibility to report potential problems and document
incidents as specified in Incident Reporting Procedures.
The Board of Directors, Executive
Director, Risk Manager, Business Manager, Supervisors, staff, volunteers,
consultants and Quality Assurance Committees have defined responsibilities
for evaluating incidents, assessing themes and trends in incidents and
recommending corrective action. Additional responsibilities include
following up on policy and procedure changes to insure implementation,
arranging for training to prevent problems, and determining if corrective
action has been taken and is sufficient.
Board members, staff, volunteers,
consultants and contractors have a professional and ethical responsibility
to report actual and potential risks as outlined in the Risk Management
Procedure. Pro-active vigilance is a vital principle in prevention
efforts. Self-reporting of incidents, as well as observed incidents,
are also an important principle in order to take corrective action as
quickly as possible.
The primary intent of Risk Management is to
address systemic issues that place the agency, its staff and clients at
risk. From time to time, incidents may reflect individual performance
issues rather than systemic issues. These will be addressed through
normal supervisory channels. However, failure to report incidents can
be cause for disciplinary action or dismissal. An “Incident” is
defined as any unusual, atypical, unexpected, unanticipated occurrence,
which has or may have negative consequences for individuals, groups or the
agency as a whole.
Clients are seen as soon as possible and
with a frequency that has been agreed upon between the therapist and family.
Initial appointments are rarely ten days from the date of the initial call.
When indicated, patients will be referred to
a psychiatrist for medication evaluation or to other professionals as
indicted, i.e. neuropsychological evaluations.
Access to medical records will be limited to
those persons directly involved in the client’s treatment. The release
of information from a client’s record requires a signed release of
information form. No information about a client will be provided by
telephone without a written release of information and verification that the
person calling is permitted to receive this information. Records are
kept in locked cabinets.
Our office space meets all applicable state
codes and the federal guidelines for handicap accessibility.
Our office hours are Monday through Friday
8am to 5pm. However, we often make appointments with clients during
the evening hours and on weekends. Families may call the office
during off hours where they can leave a message or page us via beeper on the
emergency line. The families may also beep our therapists once they
have made initial contact. Families are encouraged to call their local
emergency services if the situation resembles a 911 call.
Each program at our agency has goals and
specific outcome expectations. Our agency reviews outcomes and goals
on a regular basis. Family satisfaction is also important to our
agency. Each family will be given an opportunity to voice their
opinions verbally, on a written satisfaction questionnaire or with a call to
the agency/supervisor. All of this is done in conjunction with
our detailed Quality Improvement/Assurance Plan. Our agency does not
currently conduct research and would consider research only as set forth in
standards approved by the American Psychological Association and the Council
on Accreditation. We do use scores on the RAD-Q, Cline Helding and/or
any other assessment tools as a baseline at assessment, at benchmarks,
throughout the treatment process and during any follow-up. Our hope is to
ascertain change, movement and problem areas.
Qualifications of Staff
In regards to therapist training, The
Attachment Center of South Carolina has been working with emotionally
disturbed children since 1977. We have been providing post adoption
and clinical services since 1989. We believe in order for a
therapist to have a well-rounded knowledge of the theories, practices and
program development they must be trained by a variety of professionals and
agencies. It is under this philosophy that we have developed our
training program. Therapists are trained over the course of one year.
They are required to attend one, sometimes two, weekend training sessions
each month. Our therapists have also been specifically trained in
family/individual therapy. Among other skills, this training consists
of numerous basic readings on attachment theory/therapy including but not
limited to:
|
Ainsworth
|
Hughes |
Magid |
Orlans |
Karen |
Satir |
|
Bowlby |
James |
McKelvey |
Delaney |
Keck |
Thomas |
|
Brazelton |
Jernberg/Booth |
McNamara |
Fahlberg |
Kupecky |
Verny |
|
Cline |
Jewett |
Randolph |
Rhodes |
Levy |
Welch |
Our therapists have at least a master’s
degree in social work, psychology, or other clinically based program.
Each therapist is licensed by a state licensing organization. We have also
presented at various workshops on topics such as attachment, attachment
disorder and parenting strategies, adoption, foster care, have lead support
groups, and classes on post-adoptive parenting; and have consulted with
other organization to assist them with program development.
Our therapists have not only attained
knowledge from a variety of professionals in the field but also have
garnered other skills as a result of experience and training that include
but are not limited to: in-depth knowledge of abuse/neglect, foster care,
group care, adoption, and post adoption services. Each staff member
also observed and was present for/participated in several sessions by a
fully trained therapist. The training they received has included: The
Attachment Center at Evergreen, The Theraplay Institute, EMDR Institute, Dr.
Joanne May, Dr. Greg Keck, Kathleen Moss, Nancy Thomas, Dr. Daniel Hughes,
Mark Henningson and Dr. Bill Goble.
Our staff also receives consultation as
needed from a variety of seasoned professionals in the field of attachment.
This consultation can be informal in nature or more structured and based on
a fee schedule with one professional. We have used and will continue
to use both methods as needed. Finally each therapist is expected to
regularly attend training institutes, workshops, and programs. A
minimum of 20 hours a year of training is expected.
Our current therapists are:
Jill M. Corrigan, MSW, LISW-CP – University of
South Carolina 1995
Donetta Palmyra Powell, MSW, LISW-CP –
University of South Carolina 1993
10/4/05
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