Mental Health Support on College Campuses: What Parents Need to Know

Most larger universities like Indiana University (close to where my office is located) have health programs called CAPS which stands for Counseling and Psychological Service. They are often staffed with licensed therapists/counselors and psychiatrists with a range of experience and expertise. Their primary goal is to act as a stabilizing resource for most mental/behavioral health or substance use issues. Many university CAPS typically offer individual, group and couples counseling along with occassional free workshops. Here’s the list from IU CAPS on what they typical help with:

  • Academic Concerns
  • Relationship Concerns
  • Stress Management
  • Power and Privilege
  • Time Management Help
  • Sleeping Issues
  • Adjusting to College Life
  • Anxiety
  • Depression
  • Substance Use
  • Body Image, Eating, and Exercise Concerns
  • Sexual Assault or Abuse

They have the same confidentiality requirements as counselors like me off campus but are limited in many ways. CAPS limits the number of unpaid sessions (IU CAPS allows for two) and mandates that a student must be working with one of their counselors if they want to meet with a psychiatrist for medication management/evaluation. Here’s a breakdown of IU CAPS fees:

COUNSELING  With IU Health Fee  W/O IU Health Fee
First two sessions (per semester) No charge $55 per session
Additional full sessions $30 per session $55 per session
Additional half sessions $20 per half session $35 per half session
Additional group counseling $15 per 60 min. session

$17 per 90 min. session

$29 per 60 min. session

$35 per 90 min. session

PSYCHIATRY
First visit $55 $105
Follow-up visit $30 per visit $55 per visit

IU CAPS does not accept insurance but does provide a super detailed invoice to be submitted to a student’s insurance company for reimbursement.
Over the last few years, I’ve noticed many CAPS programs around the country have had a huge increase in demand for their services while also having budget cuts or mediocre increases that leave them without the full team of professionals they need for each semester. At IU CAPS, every one counselor is responsible for 2,110 students (yikes!). This is not a new problem at IU and not isolated to IU.

So what can a parent or student do? If CAPS doesn’t seem like a good option, look for a therapist/counselor convenient to campus who specializes in college students. Therapists should be flexible to accommodate busy course loads and social events. In my practice, I have extended evening and weekend hours since many students a slammed with class 9-4pm most days. It’s also important that the therapist be willing to talk with parents and provide updates and suggestions. Parents can sometimes feel like their kids are a million miles away. A good therapist can often act as a bridge and lower the anxiety associated with having kids at school.

Finally, talk with CAPS (or encourage your son or daughter to) the first week of school. It’s easier to cancel an appointment than to stand in line after all the students are back on campus. The intake process should be thorough and your kid shoul feel like the therapist/counselor will really understand their issues and help.

Insider’s Guide: Getting Insurance to Pay for Residential Treatment

imagesThis is our second installment on how to get insurance to pay for residential treatment and therapeutic programs. Below is some great information to help you beat the insurance companies at their own game. Insurance companies count on your ignorance, laziness and distractibility to avoid paying for services they are legally obligated to cover. 

With the Affordable Healthcare Act and the Mental Health Parity Act in full swing it’s time to learn how to get the most out of the insurance you pay for. We’ve included some tricks, strategies and how-to’s to help you out. Though we’re focusing on Residential Treatment for our discussion here, this info is applicable to therapeutic programs like wilderness programs, therapeutic boarding schools and intensive outpatient programs.

Ok, let’s get started with some basics… 

What If I Need Additional Help?

First, read through everything below. These strategies are time consuming and require steady attention but they are not impossible. If you still don’t feel confident in holding your insurer accountable, contact us for a free consult and we’ll help you figure out how to move forward. 

What is the Insurance Company’s Criteria for Residential Treatment?

…Or more importantly, how does an insurer define residential treatment? Each insurer has their own definition but most have virtually identical criteria. For our purposes, residential treatment is defined as specialized mental, behavioral health or substance abuse treatment that occurs in a residential (overnight) treatment center where the provider is responsible for clinical service, safety, shelter, and food.

Licensure differs by state, but these facilities are typically designated either as residential, subacute, or intermediate care facilities and may occur in care systems that provide multiple levels of care. Residential treatment is 24 hours per day and often requires a minimum of one physician (or psychiatrist) visit per week in a facility based setting. 

What Specific Criteria Do They Look For?

Now, let’s drill down a bit more and look at some of the more common criteria requirements insurance companies are looking for when determining whether to pay for residential treatment to a struggling teen or young adult. 

  • Was there a sincere attempt to first use evidence-based outpatient therapy in the home community by a licensed professional before residential treatment was requested and outpatient therapy did not work? Basically, they want evidence that you tried outpatient therapy with weekly sessions (or more often) and because it was not effective, a more intensive level of care like residential treatment was justified.
  • Prior to admission, did you contact your health plan for list of in-network residential treatment options? More on this later – what to do if you can not find a good option.
  • Is there uncontrollable risk-taking to self or others or other dangerous behavior?
  • Has there been a documentable and rapid decrease in level of functioning in one or more life domains. Another way to describe it is a decline in functioning resulting in the ability to perform self-care. 
  • Is there a likelihood of no improvement in current environment (ie. home or college)
  • Is there a reasonable expectation that patient will improve in residential setting and be able to return to outpatient therapy for aftercare? 

How to Request this Higher Level of Care?

Now that you understand the criteria, let’s talk about how to actually request residential treatment. 

  • Write a letter strongly recommending admission to residential treatment 
  • Provide copies of assessments and testing performed by a licensed professional that indicate 1) a formal diagnosis and 2) specific recommendations that list residential treatment.
  • Explain how outpatient therapy has not been successful
  • Explain why current circumstances make it unlikely that patient will show improvement (ie. Improvement is not likely in home setting due to social stressors such as negative peers that sell drugs but remain in the environment)
  • Document unsafe, declining behaviors – show symptoms and behaviors that represent a decline from usual state and include either self-injurious or risk-taking behavior that cannot be managed outside of 24 hr care. Can your kid maintain abstinence outside of 24 hr care? 
  • Explain that the residential treatment program uses evidence-based clinical interventions.
  • Request the residential treatment program directly contact your insurer for pre-authorization. Pre-authorization is the insurance company’s way of giving formal permission to use a higher (and more expensive) level of care. Make sure to obtain the tracking number and verification of the call from the residential treatment program. If approved, obtain written authorization confirming admission approval.

After you send off your request, your insurer should should respond in 5 days. Don’t wait that long – call them every day to find out the status of your request. Yes, seriously – call every day. 

Accepted! Now Some Additional Insurance Mandates

The insurance company accepted your request (more below on what happens when they do not accept it) and a wave of relief comes over you planning for some quiet time once your kid is safely transitioned. But before you get too comfy, there are a few things you want to make sure the residential treatment program will do to ensure insurance covers as much as possible. It’s easier to ask these questions during the admissions process rather than at discharge. Here’s a list of what to look for or ask for:

  • A basic physical during admission (urine screening for drug facility)
  • Onsite nursing and 24hr access to med care
  • Multidisciplinary assessment (also called a Biopsychosocial Intake) performed within 72 hr of admission, including information obtained from patient’s previous providers (ie. therapist, primary care physician)
  • Individual therapy with a licensed therapist (ie. LPC, LCSW, LMFT) at least one time per week
  • Weekly meetings with doctor for medication management
  • Weekly family therapy
  • Discharge plan created one week after admission which acts as a set of exit criteria
  • Licensed in the state in which they are located. Some facilities are owned by huge companies in another state. Make sure they are credentialed and licensed.

Denied. Now on to The Appeal Process

Denials are just a way of life in the therapeutic treatment world but it’s certainly not the end. Here are some information on what to do when you experience a denial.

  • First Thing – Do not let the denial get you mad and do not attempt to use logic, common sense or science to understand why. Insurance is a business and their business model is take in money and pay for as little service as possible – period. 
  • If residential treatment is verbally denied, request written denial. They must deny in writing and often will send the residential treatment program as well as the insured person a copy. 
  • Do not just ignore the denial and send your kid off unless you are willing to pay out of pocket and work your tail off at discharge to get the insurer to pay for it.
  • How to appeal depends upon the reason for denial. The insurance company will likely list specific criteria either your kid or the residential treatment program did not meet.
  • If the insurer states that residential treatment is not a covered benefit but they offer  other mental/behavioral health benefits, they are required by law to pay. In Harlick v Blue Cross of California – On August 26, 2011 the court confirmed that California’s Mental Health Parity Act requires health plans to provide coverage of “all medically necessary treatment” for “severe mental illnesses” under “the same financial terms as those applied to physical illnesses,” and are obligated to pay for residential treatment for people with eating disorders even if the policy excludes residential treatment.

And It’s Still Denied – What Next?

If you submit an appeal with additional information and site the law but still are denied or hear nothing, you can request an independent review from your state’s regulatory body that oversees insurance compliance. It’s amazing how quickly insurance companies can ‘find missing paperwork’ or reverse a denial when regulators and attorney’s get involved. 

  • Send a certified-mail cover letter describing the dispute
  • Provide all relevant evaluations, assessments and testing you already sent to the insurer
  • Submit a doctor’s letter stating care is medically necessary
  • You can also hire an attorney that specializes in insurance issues like this. They are often worth their specialist price tag.

Plan B – If You Can Afford It

If residential is denied and you don’t want to push the insurer for whatever reason, you can pay out of pocket for room and board and try to get the clinical services covered. This approach is often what is equivalent to out-of-network coverage. The insurer is more likely to cover outpatient therapy, group therapy and medication management (virtually the same as if client was living at home and going to therapy).

You can also request that the residential treatment primary therapist get a single case agreement which forces the insurer to pay at in-network rate and you only owe the copay, as usual. 

What if Our Family Member is at Therapeutic Boarding School?

With the growth of therapeutic boarding schools, we’ve received a ton of questions about how insurance pays for the clinical aspects of these hybrid programs. Here are some tricks we’ve picked up over the years:

  • Think like the insurance company – they want to hear your son or daughter is being referred to as a patient and not a student.
  • Make sure to request a physical assessment is done at admissions. This promotes the perspective that he/she is a patient and not a student. Remember – we want the insurer to understand this is a therapeutic program, not as much an academic program.
  • We also want to ensure the program is keeping daily records such as treatment plan updates, nursing and medical notes and service notes – health plans will want copies. We want to be documenting progress as well as setbacks. 

When we conduct placement services, we always request the therapeutic program develop a treatment plan with some specific exit criteria. The first day of treatment is the first day of discharge planning. Some plans will want exit criteria so err on the side of having the program provide it early on. It’s also a good clinical practice to give the providers a clear target. 

In Which State Should Insurance Regulators Be Notified if Insurance Refuses to Cooperate?

The state in which treatment is being provided is where insurance regulators should be contacted if your insurance company refuses to play nicely. The state in which you live may be where your insurance is attached, but legal oversight for provision of service and insurance regulation is in the treatment state. 

Can Insurance Pay for Services Retroactively?

Theoretically, yes. Practically, it’s pretty difficult and will require regular attention and contact with the insurer. They will likely ‘lose’ applications, claim forms and anything else you send. If you get insurance to agree to pay for residential treatment or other therapeutic services after treatment has started, you can request for retroactive coverage. It’s best to write a letter (and send it certified mail and keep a copy for your records) stating why you didn’t understand or it was not stated clearly in a policy that treatment was covered. 

Will Insurance Cover Partial Hospitalization Programs (PHP)?

Partial Hospitalization Programs or PHPs is typically a level of care designed for individuals who need structured mental health, behavioral health or substance abuse programming but do not need 24-hour supervision (ie. inpatient or hosplitalization). Many hospitals and residential treatment programs offer partial hospitalization or day treatment services. Good PHPs are designed to provide support, education, medical monitoring and accountability during the hours of the day often identified as most troublesome for patients. Patients participate in therapeutic groups, structured activities and discharge planning similar to those offered in the inpatient and residential programs. Many patients who have been in an inpatient or residential program can “step down” to this level of care because it continues to provide a high amount of structure and support. 

Insurance generally covers PHP at a per diem rate (daily rate) but will not cover overnight which the hospital or treatment program may charge extra for. Make sure to clearly understand how the treatment center charges for PHP before signing up. Also make sure insurance covers it and what portion it covers. 

So we covered several of the topics and tricks that can help you navigate the insurance company maze when it comes to paying for residential treatment. If you need additional help, contact us today – help@fonthillbehavioralhealth.com 

5 Signs of Suicide Risk in College Students

FACT: 15% of graduate and 18% of undergrads have seriously considered attempting suicide

FACT: 15% of graduate and 18% of undergrads have seriously considered attempting suicide

There is nothing more exciting than dropping of your college freshman in late August as the cool nights of Autumn return. But not all students carry with them the same energy and positive outlook for the Fall. Some are carrying some heavy baggage from High School or even younger while others don’t start to develop any major issues until they first get to college (and their first taste of freedom from parents). What parents don’t know is that you likely know your college friends (or at least a side of them) better than their own parents do, and you may be able to tell that something is wrong way before anyone else. This quick list is as much for parents as it is for you students out there. 

The following signs might indicate a student is considering suicide:

  1. A good student who’s behavior suddenly changes – they start ignoring assignments and missing classes which are likely signs of depression or drug and alcohol abuse, which can affect their health and happiness and put them at risk of suicide. And yes, good students and good kids use drugs. Seriously. 
  2. Anyone who doesn’t have friends or who suddenly rejects their friends may be at risk. A friend who suddenly rejects you, claiming, “You just don’t get it,” may be having emotional problems.
  3. College students may be physically or emotionally abused by a member of their family or their girlfriend or boyfriend – or suffering from abuse that occurred long ago but triggered by the new college environment. Abusive relationships can make a college student feel like crap about themselves. Signs that a person may be in an abusive relationship include unexplained bruises or other injuries that he or she refuses to discuss. 
  4. This is a common one – Significant changes in a someone’s weight, eating or sleeping patterns, and/or social interaction style may indicate that something is wrong. Eating disorders are super common at college. Lot’s of perceived competition, anxiety and stress that translates into really unhealthy views of one’s self. 
  5. Coming Out? College students may suffer from depression or have thoughts of suicide if they have a difficult time adjusting to their sexual orientation or gender identity. Gay, lesbian, bisexual, and transgendered students have higher suicide attempt rates than their heterosexual peers.

We understand regret and their could certainly be a real consequence of getting help for someone who seems to be really hurting. They might get pissed at you for not minding your own business. But think of it this way – is the regret of possibly losing a friend better or worse than the potential of knowing you could have saved your friend’s life but did nothing? Tough choice but that’s part of the burden of mental illness. 

Virginia Senator Deeds Stabbed by Son (…And How it Could Have Been Avoided)

Virginia Senator Creigh Deeds was Stabbed by his 24 year old son Austin (Gus) Deeds  who then killed himself with a shotgun at their rural home just West of Charlottesville, Va.. Austin Deeds had just been ‘psychologically’ evaluated just hours before at Bath Community Hospital under an Emergency Custody Order (ECO). The ECO is only good for 4 hours with a possible 2 hour extension if ordered by the magistrate.  Hospital staff stated, working within the maximum 4 hour window, they were unable to find a treatment facility to address Austin Deeds’ psychiatric needs despite several hospitals reporting they did in fact have availability.

Here is some analysis/questions from someone (me) that’s been in this profession for years. I also provide some ideas of solutions if you know of someone struggling with a similar situation:

1. Diagnoses: If the hospital was looking for a treatment facility this means that something the evaluator found indicated Austin was either a threat to himself or others or needed a a level of medical intervention not available at the current hospital. I’m also thinking about the type of evaluation that was conducted and why it was even done at BCH, what the evaluator’s credentials are, and how it was reviewed with Austin and his family. 

2. Discharge: If there were no options (which there clearly were), I wonder if and how the hospital communicated their findings from the evaluation as well as their concerns about safety to the parents and authorities. I’m also wondering what kind of discharge meeting took place. When a client is stepping down from a hospital or residential setting, we always facilitate a comprehensive treatment team meeting to talk about discharge so everyone leaves understanding what the next steps are – action steps. When we work with families struggling with similar issues, we don’t wait for the hospital to give updates. But as mental health professionals, we are able to navigate the bureaucracy much easier and get clear answers much faster. 

3. Responsibility: Providers, whether big hospitals or little, ole’ therapists, have an ethical and legal responsibility to communicate to authorities if a patient is in eminent danger. So who is responsible here? If you ask the hospital, they’ll probably point fingers until the next news cycle. If you ask an attorney, they’ll go through the policy and procedures for the hospital regarding intake, evaluations, referrals, discharge, etc. and anyone of making decisions in that chain could be liable.

4. Intervention (Placement Options): The hospital staff at BCH clearly did not consider referring outside of the traditional placement list (psych beds at hospitals). It’s unlikely that it was due to financial constraints and certainly not due to a lack of treatment centers as some have speculated (Yes, there are certainly a lack of medicaid-funded psych units in VA). There are facilities all over the country that are extremely well-equipped to accept, stabilize and work with patients just like Austin. Most hospitals, though, follow a tired, out-dated protocol of calling three near-by psych hospitals to find out if they have a bed avail. If they here no at all three, patient is discharged with a list of therapists to contact to set up an appointment. Sound ridiculous? You’re right. 

5. Solutions: In my humble opinion, Austin would be alive today if earlier intervention had been provided by a treatment team including a psychologist, psychiatrist, therapist, and case manager. The psychologist provides the initial psychological evaluation to identify the issues, what is causing them, and create a specific list of interventions for the rest of the team. The psychiatrist (though in limited supply in Bath Co, VA) performs an initial psychiatric (medical/medication) evaluation and identify what, if any, medication is necessary to compliment any individual counseling being performed. The therapist provides weekly counseling either in-office or in the family’s home to address areas identified within the psychological evaluation. The case manager is the project manager for everyone and is on-call 24/7. This person also facilitates regular treatment team meetings to ensure updates are provided to the family and all professionals. For instance, if the therapist starts seeing signs of bizarre thinking patterns which are historically correlated with dangerous behavior, the case manager can alert the rest of the team and monitor the client more closely while also increasing the frequency of support. If a higher level of care (ie. psychiatric hospitalization) is recommended by any member of the team, the case manager not only identifies a placement but completes all intake paperwork. The case manager also provides psychoeducation to the family to help them understand the client’s diagnoses and what they can do to most effectively support him. 

If you or someone you know is in a similar mess, do not assume your local hospital has the expertise to handle the situation. Contact a mental health professional to find services that can manage the entire project from assessment to placement to discharge and aftercare. 

Time to Start Thinking about Cyberbullying Again

Cyberbullying: The Fist of Technology

By Mary Hannah Ellis

Most of you probably remember your school bully at each level of your education – the tall fifth grader who liked to knock over kindergartners on the playground, or the burly, egotistical jock who made everyone else feel inferior with his brash jokes. However, a student could mostly avoid these school bullies by staying out of their way. Today, technology has enabled a new, ubiquitous form of bullying called “cyberbullying.” Cyberbullying involves a minor’s harassment, tormenting, humiliation, embarrassment, threatening, or otherwise targeting of another minor via technology.

Cyberbullying occurs through a variety of media, including social networking sites, text messages, online chat services, and email messages, to name a few. Facebook and twitter are some of the most active sites for cyberbullying

Do you suspect that your child or teen is a cyberbully or a victim of cyberbullying? Here are some warning signs to consider:

Your child or teen may be engaging in cyberbullying if he/she:

• Constantly uses the computer, even at all hours of the night

• Is secretive about his/her activities on the computer

• Appears nervous when using the computer or cell phone

• Quickly stops using the computer or switches screens when someone approaches

• Becomes excessively angry when cell phone or computer privileges are revoked

• Uses multiple accounts on different websites

Your child or teen may be a victim of cyberbullying if he/she:

• Unexpectedly stops using the computer or cell phone

• Avoids talking about what he/she is doing on the computer or cell phone

• Appears nervous upon receiving a text message, chat message, or email message

• Appears angry, depressed, upset, or frustrated after using the computer or cell phone

• Withdraws from interacting with usual friends

• Seems uneasy about going to school or going out in public

Children and teens who are victims of cyberbullying are more likely to use alcohol and drugs, have lower self-esteem, skip school, experience physical bullying, have poor academic performance, and have more physical health problems. Interestingly enough, cyberbullies themselves are also more likely to be bullied in real life and to have low self-esteem. There is also a significant risk of suicidal ideation associated with cyberbullying. With very little warning, a victimized kid could snap and hurt themselves or others. Without a doubt, cyberbullies and victims of cyberbullying could benefit from counseling or psychological intervention.

Contact us to find out how we can help.

Fonthill Response to Vice Article: AMERICAN TEENS ARE BEING TRAPPED IN ABUSIVE ‘DRUG REHAB CENTRES’

To those outside our field of therapeutic schools and programs, it makes sense that Matt Shea‘s article from May 2013 in Vice titled American Teens are Being Trapped in ‘Abusive Drug Rehab Centres’ is alarming.

To those of us in the field it’s a joke. You can read the whole article here: http://goo.gl/zW43F and judge for yourself. It’s a joke not because it’s inaccurate and not because there are no failures within the industry. It’s a joke because, just like so many other ‘journalists’ he paints a picture with such broad strokes that Mr. Shea fails to really understand the pressures, the people and, as cliche as it may sound, the passion with which so many in this field work. Mr. Shea fails to sort out the fiction from fact.

But how else can a budding journalist get retweeted and get his name out there without this version of quicky-journalism? Had Mr. Shea visited programs like many of us in the mental health and educational consulting world do, he would quickly meet and have experiences  which deepen his 2 dimensional paradigm. He would have been driven out into the remote and hot Utah desert to meet with small groups of teens guided by thoughtful and well-trained staff working on individual enrichment projects. He would leave thankful he never had to endure a Spring or Summer like they do yet, somehow, understands that this programming is providing a level of nurturing and structure significantly lacking in their home lives.

Let’s address the reference and correlation Mr. Shea makes between the therapeutic industry and Josh Shipp of MTV fame. Let’s revisit part of Mr. Shea’s article now…

Shipp is your classic Jerry Springer brand of therapist – no real qualifications, a huge ego and a penchant for money and entertaining TV over science and genuine psychology. “I’m a teen behaviour specialist,” he says in the intro. “My approach is gritty, gutsy and in your face.”

If he had actually spent time with Josh Shipp AND real mental/behavioral health and substance abuse professionals – he would very quickly understand that Mr. Shipp (…Mr. is used loosely here) does not represent the values of folks in this industry, an industry that is run by licensed clinicians and professionals. Mr. Shipp is nothing more than a court jester providing entertainment. He’s a monkey with two cymbals making noise and no signal for his ‘edgy’ reality-TV pushers at MTV (MTV is still around?). Occasionally, I’m sure there are teens and even parents (and maybe the rare delusion clinician) that hear the Shipp-Clown-message and it connects with them – changing their lives forever. But an overwhelming majority spend no more energy than a giggle or slight frown. Mr. Shipp does not have a degree, license or any sort of evidence-based training. He graduated from “Life Experience College” which sounds ‘super cool’ to the teens and teen parents he markets his wares to but there is no depth. He’s a can of soda full of empty calories. The therapeutic industry and Mr. Shipp are as polar-opposite as a Kardashian and Bill Moyers. And yes, we recognize as cold as it may sound, it’s an industry.  Just like cancer treatment, just like teaching, and just like daycare. If it were not an industry and did not have the same oversight as other industries, there would be little oversight. Trust me, you want therapy to be part of an industry. Industrialization provides codes of conduct, ethical guidelines, evidence-based treatment standards, inter-disciplinary work and research. NATSAP is an example of this type of self-imposed quality control.

FYI – Therapeutic wilderness programs are not boot camps. Therapeutic boarding schools are not military schools. There may have been some greedy, old-school meat-heads that sold parents on boot camps decades ago, but in the therapeutic world, those non-clinical programs as a laughable as Josh Shipp which may be why he talks about them in his MTV show. Boot camps and military schools are dying out and, thankfully, being replaced by sophisticated, evidence-based programs with transparency and clinical integrity. Not every program is awesome but, neither is every physician or dentist.

Mr. Shea, I make a challenge to you. Join me on a tour to visit 5 therapeutic programs. Together, you and I will kick the tires, dig through the closets and truly get to the bottom of whether this universe of programs is as detrimental as you propose. We’ll spend 2 days out in the back-country, in storage rooms with gear, and circled up in treatment centers. After that, I challenge you to write the same article blasting this world that has helped so many families. Not likely to happen.

Definition: Education Consultants, Case Managers, and Therapists oh My!

Those of us in mental, behavioral health and substance abuse fields generally know the difference between all the different professionals that support individuals and families. Unfortunately, we don’t always do a great job of helping clients understand the differences (and similarities). So, without further explanation, we present a humble attempt at defining professionals you may come across.

Educational Consultant: Also known as E.C.s, educational consultants started out decades ago helping families get their kids into college, private school and boarding schools. As family needs changed, so did E.C.’s focus. Nowadays, E.C’s serve families looking for academic advice and placement recommendations. In times of crisis, parents are often overwhelmed by a barrage of emotions, options and information. The confusion and desperation associated with having a struggling teenager or child can be extremely difficult. Parents may not be aware of the choices available, or may not be able to decide on their own which alternative best meets their situation and the needs of their child. Among the questions consultants often hear: How do we know when treatment is necessary? What would be best for our child? Is an intervention needed? Should we find a residential program? Would a wilderness therapy program be a good choice, or would an emotional growth boarding school be better? There is no one certification or academic program for educational consultants. Their quality and experience span a huge continuum.

Case Manager: Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes. Basically they specialize in the organization and treatment planning for families that need finding a treatment program or need help transitioning their child back home. Educational Consulting is often a part of good case management. Case management serves as a means for achieving client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The case manager helps identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source. Case management services are best offered in a climate that allows direct communication between the case manager, the client, and appropriate service personnel, in order to optimize the outcome for all concerned. Not unlike E.C.’s, Case Managers do not require certification or specific academic credentials but are often clinicians with at least a Master’s degree in a disciplin like counseling, psychology, social work or marriage and family therapy.

Therapist: A therapist is a general term for counselors, psychologists, psychiatrists, psychotherapists and psychoanalysts. They are trained professionals that treat mental and behavioral health and substance abuse problems through talk, discussion and interaction. A therapist helps clients you learn about conditions and moods, feelings, thoughts and behaviors. Therapy helps the client learn how to take control of one’s life and respond to challenging situations with healthy coping skills. There are many specific types of therapy, each with its own approach. The type of therapy that’s right for a client depends on their individual situation. Therapy is also known as talk therapy, counseling, psychosocial therapy or, simply, therapy.

Check back next time when we talk about Counselors, Psychologists, Psychiatrists, Social Workers and Clinicians. Got a clinical term you’re confused about? Contact us and we’ll post info on it. More than likely, you’re not alone in your confusion.