Highpoint Manual

Hillcrest’s Treatment Model

This program’s treatment model and all of our treatment interventions are designed to provide trauma informed treatment to youth and their families. Through the lens of trauma informed care, we utilize the Skills for Life treatment model and Therapeutic Crisis Intervention (TCI). Skills for Life is a strength-based, comprehensive treatment model designed by Hillcrest Educational Centers. TCI is an evidence-based crisis prevention and intervention system through Cornell University. Together, these two models encompass day-to-day treatment interventions, structures, routines, skills coaching/rehearsal opportunities, verbal interventions, and crisis support.

Trauma Informed Care (TIC) 

When the environment is very overwhelming, as is often the case when a person experiences trauma, attachment disruption, loss, domestic violence or abuse, the result can be significant impact on the development of the person’s skills and resources. Exposure to those who have experienced these events has impact on others in the community. A trauma informed environment requires an understanding of trauma and considers its effects, at the personal, individual, and societal levels.

 VALUES AND EXPECTATIONS

Skills for Life has specific values and expectations for both students and staff. We use these values and expectations to make decisions about programming, to address behavior concerns, and to recognize successes. Here is a list and definitions of our values and expectations.

Safety

  • Use safe words and actions toward yourself and others
  • Promote peacefulness
  • Provide predictability, fairness, and accountability

Respect

  • Respect yourself and others in every way
  • Respect your environment

Show healthy boundaries

  • Build healthy relationships

Accountability

  • Accept responsibility for your decisions & actions
  • Build skills that will help you avoid harm to self or others
  • Make repairs when your decisions & actions are harmful to self or others

Empathy

  • Think about what others are experiencing
  • Think about what others need, & what might be getting in the way of their goals
  • Work to be the best helper, peer, coach, employee, supervisor, friend, & citizen you can be

Realistic Expectations

  • Set realistic expectations & goals for yourself and others
  • Support one other in achieving these goals
  • Modify the environment in order to meet these expectations & goals, when needed

Self-Care

Take care of yourself in every way

Support each other in this process

Collaboration/Teamwork

  • Work together to bring the greatest success
  • Allow everyone’s voice to be heard

Personal Enrichment

  • Explore your interests and try healthy new things
  • Develop your talents
  • Celebrate the things that make all of us unique

MEETINGS AND DOCUMENTS

Here as some important meetings and documents in Skills for Life that you should know about.

Comprehensive Treatment Plan (CTP): While you are at Hillcrest, you will have goals to work toward. These goals are what make up your Comprehensive Treatment Plan (CTP). Your first CTP will be held within 45 days of your admission. You will then have a CTP meeting every 3 months to review your goals, objectives, and progress in treatment. You, your family, your agency worker(s), and your Hillcrest staff will work together to set up goals, objectives, and skills to practice that are specific to your individual needs. Everyone on your treatment team will know your goals and will help you work on them throughout your stay at Hillcrest. When you have completed your goals, you will be ready for discharge.

Daily Logs: Every student at HEC has a daily log that staff use to manage your schedule, to guide staff on the things you are working on in your treatment, and to track your progress in building skills. At your CTP meeting, we work together to decide what things are written into your log. The logs use a rating scale of 1 through 5.

1 = skills assessment

2 = significant coaching

3 = moderate coaching

4 = minimal coaching

5 = independent skill use

Circle-Up: Your team/class will have a group discussion called circle-up at least 3 times a day (at the beginning of school, after school, and before bedtime). Circle up is an important part of your treatment. Staff will talk with you about how your day is going, review your skill practice, and talk about how much support you have needed during the day. Circle up is also used to problem-solve issues on the team, to learn about upcoming events for the team, and to recognize successes of the team.

Team Meetings: Once a week, the treatment team members meet to discuss students’ progress, review any requests students have made to the team, and to problem solve any team issues. This meeting is also where CTP meetings take place. Staff who attend team meeting are YDCs, clinicians, assistant supervisors or supervisors, a nurse, teacher or TA, and a campus administrator. The kinds of student requests reviewed at team meeting include requests to move up treatment levels, shopping requests, and privilege requests.

Student Community Meetings: Once a week, your team will have a student community meeting. They usually occur at the end of the school day. In addition to the YDC’s that work with your team, a clinician, and a campus supervisor/administrator will come to your meeting. The meeting is an opportunity to talk about team issues, review any requests that students have sent to the team meeting, and to recognize team successes.

TREATMENT LEVELS

 Skills for Life includes a set of treatment levels. Each student is assigned to the “Welcoming Level” when admitted to Hillcrest. Each level has a specific set of treatment tasks for you to work on. When you achieve these tasks, you can request to move up to the next level. Here is a description of each level. Your program may also have specific treatment expectations for your levels that are based on a specific treatment issue. If so, these expectations are also included in this handbook or will be given to you by staff when you are admitted.

Welcoming

  • Get to know peers and staff, identifying some individuals that you are comfortable with and can accept help or support from.
  • Learn about and participate in basic parts of program, including school and residential programming as well as learning basic routines, expectations, and rules.
  • Participate in assessment and safety/treatment planning, culminating in an ICMP and treatment plan.
  • Begin to learn about DBT and other skills that can support your treatment through participation in individual and group therapy, and various skill practice opportunities.
  • Participate in a trauma assessment and help to identify sore spots, strengths, skills, and quick relief behaviors as part of the Trauma Informed Treatment Protocol.
  • Begin working with your family to identify realistic goals for treatment and discharge, including family reunification, if applicable.
  • Students cannot request to move up from Welcoming until all of their 45 day diagnostic assessments have been completed.

Commitment

  • Maintain safe and healthy relationships with peers and staff, utilizing support and encouragement.
  • Participate in all parts of program to the best of your ability, including taking an active role in student community meetings and group therapies.
  • Identify academic and vocational goals for yourself and participate in steps toward reaching those goals.
  • Further develop/implement a safety plan and/or begin high risk relapse prevention plan.
  • Exhibit skill rehearsal and behaviors that meet the treatment objective identified in your CTP, including identifying specific skills that you have found effective. Commit to continuing to use these skills.
  • Continue to develop skills through participation in DBT group, high risk group therapy, individual therapy, and by participating in skill coaching by staff throughout the program.
  • Continue to engage in work in the Trauma Informed Treatment Protocol, and work that involves connecting quick relief behaviors to triggers and sore spots.
  • Continue family therapy process, committing to clear goals for family relationships and discharge.

 Responsibility

  • Maintain safe and healthy relationships with peers and staff while participating fully in program.
  • Develop insight into the contributing factors, sore spots, triggers, and motivations that led to prior high risk behaviors and build these into safety and/or relapse prevention plans.
  • Be accountable for past and current high risk behaviors; make amends and utilize relapse prevention plans.
  • Exhibit skill rehearsal and behaviors that meet the treatment objectives identified in your CTP, including identifying specific skills that you have found effective. Commit to continuing to use these skills.
  • Continue to build awareness of how thoughts and feelings. Use this awareness to guide you through thoughtful decision making during situations.
  • Continue to engage in the Trauma Informed Treatment Protocol, including engaging in the process of meaning-making.
  • Continue work on academic and vocational goals, meeting IEP goals set in these areas.
  • Continue family work and discharge planning as identified through the CTP process, including work toward reunification or identified next placement.

 Community

  • Maintain safe & healthy relationships with peers & staff while participating fully in program, taking on a leadership role in the process of student community meetings, & generally serving as a “good citizen” of your team & HEC community.
  • Exhibit use safety & relapse prevention plans at all times.
  • Exhibit skill rehearsal & behaviors that meet the treatment objectives in your CTP, including identifying specific skills that you have found effective. Identify ways you can support your community through the use or role-modeling of these skills.
  • Develop & practice a set of values and life goals within your home community as well as in the HEC community. Participate in academic & vocational tasks that support these goals as indicated by meeting IEP goals & any tasks assigned to meet these goals during community/home visits.
  • Participate in all discharge planning meetings & events as an active member of the treatment team.
  • Exhibit skill rehearsal & behaviors that meet the treatment objective identified in your CTP, including utilizing these skills consistently at HEC & in your home community.
  • Continue trauma treatment & the process of meaning-making.
  • Complete a community repair/restitution project, if applicable.
  • Continue in family therapy, if applicable.

Leadership

  • Demonstrate safety/accountability, character, skills, understanding, and connection through all of your behaviors
  • Internalize safety and relapse prevention plans
  • Continue active participation in all parts of your discharge planning and continue monitoring its implementation
  • Mentor others, showing your skills as a leader and positive role model
  • Complete a community enhancement project
  • Educate family and/or next placement on safety and relapse prevention plans, supports needed, your skills, understandings, values, goals, and important connections.

PRIVILEGES

Privileges: Each campus has a specific set of privileges for each treatment level. As you build skills and make progress in treatment, you will be showing your treatment team and your family that you are ready to manage situations with less and less support. When you need less support, you can access more privileges. The specific list of privileges for your program is included in this handbook.

 Privileges for Welcoming

–     Participate in on campus clubs (photography, magic,etc.)

–     Scheduled program activities on campus

–     Watching TV

–     Remote control cars

  • Board and card games
  • Outdoor sports (football, basketball, etc.)
  • Arts and crafts activities
  • Books, reading during free time
  • Eligible for student council committee member
  • $10 withdrawl from student checking account (students can petition for more money if they are looking for something specific)
  • Handheld electronic video games (must not have internet access or camera installed)
  • Ability to visit the GameRoom on campus
  • Eligible for on campus jobs as approved by treatment team ( no food service, maintenance or horticulture positions) Welcoming students are eligible for clerical, library and housekeeping positions
  • Eligible for 1 potted plant in their bedroom, type is at the discretion of team

**No off campus trips other than for medical reasons. **

Privileges for Commitment

  • All above mentioned privileges
  • Eligible for off all campus trips as approved by treatment team (Intercampus trips, church, drumming, trail access trips from campus/adventure sports, etc.) always subject to supervisor approval
  • NYPUM eligible
  • $20 withdrawl from student checking account (students can petition for more money if they are looking for something specific)
  • Intramural sports/Traveling sports team (basketball, softball, etc.)
  • Eligible for open elected positions within the student council
  • Eligible for all jobs within the commitment level jobs in the vocational program

Privileges for Responsibility

  • All above mentioned privileges
  • Half hour late bedtime- able to stay up until 9:30 Sunday through Thursday until 10pm on Friday and Saturday. If students are using late bed, they must be ready for bed at the normal bedtime so once the half hour comes by they will be ready to go into bed
  • $30 withdrawl from student checking account (students can petition for more money if they are looking for something specific)
  • All other off campus trips- trail access trips that involve departing campus to go on the trip (Kennedy Park, etc) At the discretion of supervisors
  • Can purchase a basic Kindle or Nook (e-reader that does not have internet access)
  • Eligible for applying for their Learner’s ID and photo ID’s, must be safe in order to travel for tests and approved through team meeting
  • NYPUM Support Services positions in the vocational program , eligible for attending the NYPUM rodeo and to go and watch other kids

Privileges for Community

  • All above mentioned privileges
  • Can petition for a passive pet (Beta fish in bedroom, no rocks or tank, must be in plastic bowl) NO OTHER PETS
  • $40 withdrawl from student checking account (kids can petition for more money if they are looking for something specific)
  • Art supplies in their bedrooms, Crocheting/Knitting with plastic looms and needles
  • Assistant coaching positions (basketball, flag football, softball, etc.)
  • Able to have a personal DVD player in their bedroom (no internet access)
  • $20 of their personal money able to be kept on their person
  • Can order out take out on Saturday for the amount of $10.00. Supervisors will pick the restaurant where students can order from and every student has to either order from that restaurant or pass until next week. There will not be orders from multiple restaurants!

Privileges for Leadership

  • Able to purchase TV for use in their single bedroom at team approval
  • Eligible for off campus job in the local community
  • Can petition for an individualized late bedtime
  • $50 withdrawl from student checking account (kids can petition for more money if they are looking for something specific)
  • Independent transitions with staff communication before and after student movement (this is not an automatic privilege, this is subject to review on an individual basis)
  • Eligible to participate in elections/voting in their local community
  • Use of public transportation to approved destinations such as public library, to manage bank account (this is not an automatic privilege, this is subject to supervision by HEC staff and by review on an individual basis)

** This list is a working document. Students can request additional privileges be reviewed through the campus Student Treatment and Intervention Committee**