Children's Transitional Residence
The Children's Transitional Residence (CTR) is a residential treatment program for eight seriously psychiatrically impaired children five to ten year of age. Primary goals are to provide a safe, nurturing residential treatment program for children who have been previously hospitalized, and to develop and facilitate meaningful disposition plans. Maximum length of stay is six months. The CTR is a 24-hour, seven-day a week program located in its own, specially designed facility on the RBHS campus.
All children admitted to the CTR no longer require the level of security and supervision provided by an inpatient unit. All continue to require intensive treatment. Children admitted to the CTR fall into one of the following categories: the dispositional plan calls for long-term residential care that is not immediately available to the child; the child continues to require intensive treatment and/or medication adjustment that requires a level of care greater than outpatient but does not require a full hospital setting; or the child's family requires additional intervention or support in order to function adequately once the child returns home. The custodial parent or in cases where the Department of Children and Familes/Division of Child Protection has custody, must agree to the placement. The family is expected to participate in treatment as clinically indicated. Children are not appropriate for admission if they are severely developmentally disabled or if they cannot be safely treated outside an inpatient unit.
Referrals come from the University Behavioral Health Care (UBHC) inpatient unit or from other child inpatient units. Recommendations for transfer from the inpatient unit are made in the treatment planning meetings of that unit. The clinician supervisor of the CTR or his/her designee attends these meetings. The clinician supervisor of the CTR will make an admission decision within one week. It is the responsibility of the inpatient unit to notify the involved family and agencies, obtain consent forms, and provide a physical examination. Whenever possible, a pre-admission visit is arranged for the child and family prior to the transfer to the CTR. Diana Violante, LMFT, is the contact person. This program receives referrals from children's In Patient Mental Health units and also accepts referrals from community agencies. Callers should be directed to 732-235-4300.
Children are referred directly from inpatient psychiatric units where they have received comprehensive psychiatric and psychosocial evaluations. In a pre-admission interview, the child and family are introduced to the CTR and are interviewed by the clinician supervisor and program mental health clinician. After admission they are interviewed by the program psychiatrist and are evaluated by the education department. The clinician supervisor, the program clinician, the program psychiatrist, and the psychiatric nurse review all data. At a comprehensive case conference, the data is reviewed for all staff and a treatment plan is developed. Prior to admission, while the child is an inpatient, problems are defined and initial treatment and dispositional goals are formulated. The tentative length of stay is projected upon admission.
The CTR provides the following services: therapeutic services including individual, family, group, and milieu therapy; special education services on both a group and individual bases; basic care and supervision; ongoing clinical evaluation; ongoing psychiatric evaluation and psychotropic medication as indicated; age-appropriate recreational activities and outings; case management and discharge planning, including consultation with the Division of Youth and Family Services, child-study teams, outpatient mental health offices and other community agencies, and basic medical and dental care through scheduling and transportation to community-based practitioners. Treatment goals and progress, discharge criteria, and treatment projections are reviewed and revised throughout the course of residential treatment.
While home visits of varying duration may be part of the child's treatment, he/she may be returned to the program at any time. When necessary, children may be re-admitted to the inpatient unit. In emergency situations the CTR staff notify security and/or Acute Psychiatric Services, depending upon the nature of the emergency. The clinician supervisor of the CTR is a senior clinician, who reports directly to the clinician administrator for Child and Adolescent Services, is responsible for the overall unit functions.
Discharge planning begins at the moment of referral to the CTR. The main objective is to either assist the child and/or family sufficiently so that the child may be discharged to the family with community services in place or provide treatment services for the child awaiting long-term residential treatment. The program's mental health clinician carries out discharge planning under the supervision of the clinician supervisor. Discharge planning is part of every treatment team meeting during which the child's case is reviewed. Each case is reviewed at least twice monthly.