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Diane, Dunn County

The team is very supportive. Trainings are helpful to learn how to handle different situations with the kids.

Therapy Programs

Image of Parent and ChildrenOur specialty programs are as follows:

  • STOP (Sexual-Abuse Treatment/Offender Program – youth that have problematic sexual behaviors)
  • TF-CBT (Trauma Focused-Cognitive Behavior Therapy)
  • Family Reunification Therapy (transitioning kids from out of home care back to birth homes or to adoptive homes)
  • DBT (Dialectical Behavior Therapy)
  • OT (Occupational Therapy)

For more information on any of our programs, please contact Mary Simon at 608-827-7100 or via email.

STOP

(Sexual-Abuse Treatment/Offender Program – youth that have problematic sexual behaviors)

The STOP (Sexual abuse Treatment & Offender Program) program through Community Care Programs, Inc. was developed in 1998. The STOP program provides consumers with evidence-based targeted treatment that promotes positive outcomes and focuses on risk factor reduction so that sexual recidivism is prevented. As with all of our specialized programs at CCP, the STOP program treatment providers use a trauma-informed, holistic approach to treatment. The STOP program combines cognitive behavioral therapy, motivational interviewing, TF-CBT, DBT and various other evidence-based models to meet the individual needs of consumers. This program is not a “one size fits all” program. This weekly program includes individual, group, and family therapy with a strong emphasis on psycho-education for consumers, their family, and other treatment team members.

It is highly recommended that youth being referred for the STOP program receive a thorough Psychosexual Assessment prior to treatment so that treatment providers have a baseline understanding of the youth’s strengths and needs with regard to risk and treatment planning. CCP offers Psychosexual Assessments as a stand-alone service. The STOP program treatment providers are highly experienced clinicians who stay current with regard to research and practice with youth that have problematic sexual behaviors.

What’s involved with STOP? Please see our Program Components.

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The following components are included in STOP programming:

  • Disclosure Statement
  • Victim Empathy
  • Apology/Clarification Letters
  • Boundaries
  • Psychoeducation regarding legal issues
  • Healthy Sexuality
  • Trauma History
  • Grooming/Maintenance Behaviors
  • Relapse Prevention Planning
  • Cycle of Abuse
  • Healthy Living Plan

STOP Individual Therapy

Consumers participate in weekly, hour-long sessions with a licensed psychotherapist addressing the above components of the program. Programming can be tailored to the individual’s age, gender, and/or cognitive ability. The individual components of the STOP program often take 9 months to 1 year to complete. Length of treatment varies significantly based on the youth’s age, developmental level, cognitive functioning, trauma history and motivation to complete treatment.

STOP Group Therapy

Consumers participate in weekly, 60-90 minute group sessions with other clients in the STOP program. The group focuses on:

  • PRAC Skills (Psychoeducation, Relaxation skills, Affect Regulation, Cognitive coping)
  • Correcting Thinking Errors
  • Healthy Sexuality
  • Safe Media and Technology Use
  • Independent Living Skills
  • Moral Development
  • Healthy Decision Making
  • Pornography Cessation

STOP Sibling Reparative Therapy

This component of the STOP program is geared towards families in which sibling sexual abuse has occurred. The youth’s individual therapist coordinates co-therapy sessions with the victim’s individual therapist with the goal of promoting and practicing healthy and safe sibling relationships. The primary purpose of the sibling reparative therapy component is to assist the victim in his/her “healing process”. This treatment component also provides the family with guidance regarding safety and supervision planning. The sibling reparative therapy piece is often utilized during the family reunification process after a youth with problematic behavior has been placed outside of the home where the victim(s) resides.

STOP Family Psychoeducation

Active parent participation is strongly encouraged in the STOP program. The youth’s individual therapist incorporates family psychoeducation at a frequency determined by the youth’s individual treatment plan. This component focuses on educating parents on issues such as supervision and safety planning, healthy technology/media use, recognizing their child’s grooming behaviors, and understanding their child’s cycle of abuse.

TF-CBT (Trauma Focused-Cognitive Behavior Therapy)

Image of Parent and ChildrenTrauma Focused Cognitive Behavior Therapy (TF-CBT) is an evidence based treatment modality that facilitates healing from traumatic experiences. This treatment program offers modules that teach coping skills and provide desensitization for intrusive and disruptive emotions. TF-CBT respects the individuality of the consumer and their unique personal stories and needs. This therapy can be used with all ages and populations. The length of treatment is typically 6-9 months from start to completion.

TF-CBT treats the youth and the caregiving system supporting the youth. This might include biological parents, foster parents and county partners. The treatment starts with psychoeducation on how the emotional brain reacts to toxic stress. We encourage extensive discussion and interaction around how the problem-solving brain (prefrontal cortex) helps to manage toxic stress and re-regulate the emotional brain. Reactions of flight, fight and freeze are normalized as natural reactions of the emotional brain under perceived threat.

Caregivers and youth are taught coping skills to manage the emotional distress from traumatic memories, intrusive thoughts and neuro-emotional hypervigilance. These coping strategies may include breath-based meditation, noticing and naming bodily signs of distress, and helping widen their feelings vocabulary. Therapists teach and coach cognitive strategies including, Errors in Thinking and the causal relationship between sensations, feelings, thoughts, and actions.

The eight components of TF-CBT treatment, which can be referenced via the acronym “PRACTICE”.

Psycho-education and Parenting Skill Building

  • Administration of the trauma assessment tools to assess a history of traumatic experiences and signs/symptoms of Posttraumatic Stress Disorder (PTSD).
  • Educating youth and caregivers about the impacts of trauma on the brain.
  • Naming and dispelling myths about trauma and providing a road map for treatment.

Relaxation Skill Building

  • Teaching/coaching/practicing breath-based strategies to calm the brain and body.
  • Helping to create a “green plan” of calming or soothing activities.
  • Teaching gratitude and kindness practices to down-regulate the brain’s threat centers.

Affect Regulation

  • Helping youth/caregivers widen their feelings vocabulary in order to more specifically describe their ‘inside feelings’ to others.
  • Training youth to connect emotional feelings with body sensations so they can recognize distress.
  • Learning to use the “Stress Thermometer” to communicate ‘inside feelings’.

Cognitive Coping

  • Encourage youth to recognize and share their internal dialogue and thoughts about their traumas.
  • Learn to identify and target inaccurate and unhelpful thoughts and training positive self-talk.
  • Introduce the idea that bodily sensations, emotional feelings and thoughts are connected and impact our well-being.

Trauma Narrative

  • Allow youth to tell the story of their traumas and record it in a journal or narrative.
  • Help youth and caregivers make meaning of the traumatic experiences in order to empower healing.

In-Vivo Desensitization

  • Desensitizes youth to emotional aspects of traumatic memories by pairing them with relaxation responses.
  • Encourages youth to master fear reactions and substitute healthy responses.

Conjoint Child-Parent Sessions

  • Therapist prepares caregiver to hear and respond to the Trauma Narrative reading
  • Youth practices reading the Trauma Narrative as if the caregiver is present
  • Youth reads Trauma Narrative to caregiver who witnesses and reassures youth

Enhancing Future Safety

  • Helps the youth name and practice ways to stay emotionally and physically safe
  • Builds assertiveness and help-seeking skills
  • Supports youth and caregivers in creating a safety plan for the protection of the youth

Trauma Focused Cognitive Behavior Therapy< (TF-CBT) has been shown to be an effective treatment for Posttraumatic Stress Disorder (PTSD) and Childhood Traumatic Grief (CTG) in youth and adults. When the traumas are chronic and began in early development, it is often the only treatment that helps youth heal.  Complex developmental trauma affects a youth’s brain by interfering with working memory, reasoning and planning skills. The coping strategies that TF-CBT teaches help to improve executive functions and memory abilities.

TF-CBT can also be used to address Childhood Traumatic Grief (CTG). In CTG, the clinician provides developmentally and culturally appropriate education to the grieving youth and his/her caregivers about death. The therapist inquires about their beliefs regarding death and afterlife. Therapy includes naming ‘inside feelings’, observing how ‘inside feelings show on the outside, reviewing positive and negative experiences with the deceased and completing a “goodbye”. There are exercises devoted to preserving positive memories of the deceased and acceptance of the idea that people may differ in their feelings towards the deceased.

Family Reunification Therapy (transitioning kids from out of home care back to birth homes or to adoptive homes)
In keeping with our belief that every youth deserves permanence, we provide our county partners with a comprehensive and impartial assessment of a family’s strengths and needs. Through collaborative interviews and focused testing, our experienced clinicians identify the interventions and services necessary for a successful family reunification. When court testimony is required, we are available to explain our recommendations to judges, juries and attorneys.

DBT (Dialectical Behavior Therapy)

  • Dialectical Behavioral Therapy (DBT) is a specific type of cognitive behavioral psychotherapy developed in the late 1980’s by Psychologist Marsha M. Linehan to treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health disorders.
  • DBT emphasizes the psychosocial approach that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those focused in romantic, family and friend relationships. DBT theory suggests that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels.
  • People who are diagnosed with borderline personality disorder sometimes experience extreme swings in their emotions, see the world in black-and-white shades, and seem to always be jumping from one crisis to another.
  • Because few people understand such reactions – most of all their own family and a childhood that emphasized invalidation – they don’t have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in this task.
  • Please read our DBT Program Components for a more in-depth breakdown of what we offer.

Dialectical Behavior Therapy (DBT) Program Overview

Generally, DBT has two main components:

  • Individual weekly therapy sessions
  • Weekly group therapy sessions

Individual weekly therapy sessions emphasize problem-solving behavior for the past week’s issues and troubles that arose in the person’s life. Self-injurious and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process. Quality of life issues and working toward improving life in general may also be discussed. Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses (from previous trauma in the person’s life) and helping enhance his or her own self-respect and self-image.

Weekly group therapy sessions generally last 60 minutes and are led by a trained DBT therapist. They focus on learning skills from one of five different modules:

  • Core mindfulness skills
  • Distress tolerance/reality acceptance skills
  • Walking the middle path
  • Emotion regulation
  • Interpersonal effectiveness

Core mindfulness helps to be in control of your mind rather than letting your mind be in control of you. This section focuses on:

  • Emotional Mind v. Reasonable Mind v. Wise Mind
  • “What” Skills – Keep the focus on the here and now
  • “How” Skills – Focus on coping skills that work

Distress tolerance teaches pain is a part of life and can’t always be avoided; if you can’t cope with painful feelings, it may lead to impulsive behaviors and acting impulsively can lead to hurting yourself or someone else. Participants will learn:

  • Crisis Survival Skills – Utilize distractions, self-sooth, improve the moment, and look at the pros and cons when in distress
  • TIPPS – Use the body’s autonomic nervous system to calm intense emotional moments
  • Accept Reality – Accept the things that cannot be changed and see things for what they are rather than what you want them to be.

Walking the middle path assists in thinking and acting dialectically. In other words, walking the middle path teaches that there is more than one way to see a situation, and more than one way to solve a problem. All people have unique qualities and different points of view and two things that are opposites can be true, while honoring the truth of both sides of a conflict. Participants will learn:

  • Thinking Mistakes – Correct errors in thinking that often times lead to miscommunications or misunderstandings
  • Validations – Validate self, validate others, and learn to recognize invalidating relationships
  • Behavior Changes – Positive reinforcement, ways to increase or decrease behavior, and extinguish personal problem behaviors

Emotional regulation assists in taking control of emotions rather than allowing emotions to take control of you. Participants will learn:

  • Emotional Vocabulary – More accurately describe emotions for more effective communication
  • ABC PLEASE – Increase positive emotions and decrease negative emotions by building mastery, planning for potentially emotional situations, and focusing on self-care
  • Accumulate positive experiences – Build a “force field” between the individual and their intense emotions
  • The “Wave” Skill – Utilize mindfulness techniques to assist in “feeling” the emotions rather than pushing them away or succumbing completely
  • Opposite Action – “Do the opposite” in an effort to curb behaviors that are motivated by emotional states

Interpersonal effectiveness assists in keeping and maintaining healthy relationships, asserting one self, and maintaining self-respect.

  • Barriers to Achievement – Review barriers to achieving such as lack of skill or indecisiveness
  • GIVE Skills – Relational skills of being gentle, acting interested and validating others
  • THINK Skills – Make peace, reduce conflict, and reduce anger by having empathy and using kindness

OT (Occupational Therapy)

Cheryl Hunt is a master’s level occupational therapist who travels to the home to provide direct OT services and to teach treatment interventions to the parents.

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