Core Element Overview
The Team collaborates and coordinates with all relevant Family Team members (especially parents, family, and youth’s and family’s natural supports) and collaterals (such as providers, school personnel, professional and natural supports, group care, hospital staff, etc.) to support continuity of treatment and supportive approaches with the youth/family while the youth is in an out-of-home treatment intervention (such as group care or hospital, etc.).
When clinically indicated and authorized, the Home-based team may be paired with group care as a short-term, flexible treatment intervention that is integrated with the Home-based team treatment plan and incorporates clinical and therapeutic interventions necessary to strengthen youth’s and family’s skills that promote flourishing together at home.
The Team coordinates the use of consistent effective strategies and approaches with youth and family across all of these entities and settings. The Team shares successful approaches with the other levels of care (as agreed upon with youth/family) and also utilizes other’s approaches that youth and family has had success with. The Team supports continuity of treatment by continuing to provide seamless initiation or continuation of the same intensity of family treatment, ongoing family engagement, youth and parent skill building, peer mentoring, care coordination, and linkage to the community when a youth is participating in an out-of-home treatment intervention. They continue to promote and build connections between youth/family and natural network of supports as well as professional long-term, community-based supports while the youth is in an out-of-home setting. They help to coordinate, as clinically appropriate, the youth spending as much time as home as possible to provide practice for a smooth transition back to home.
