Some Words from Cesar E. Gonzalez, TBS Director
In observance of Mental Health Awareness in the month of May, Therapeutic Behavioral Services (TBS) would like to contribute by sharing a few success stories with the overall goal of decreasing the stigma of asking for support in the form of mental health services.
For those who do not know what TBS is, we are an adjunctive service program that unites with a leading therapist in providing one on one behavioral support to children and adolescents in the home and the school setting. In theory, TBS Specialists/Coaches can meet with their clients five (5) days per week for about two (2) to three (3) hours each time, if the presenting behaviors are intense enough, frequent and impair the client’s overall functioning. Because of the intense service, overall TBS Specialists/Coaches establish a well-balanced rapport with clients and caregivers that is the basis for achieving the snowball effect and building on client’s progress.
During the past fourteen (14) months of the COVID-19 global pandemic, TBS Specialists/Coaches were able to adjust their delivery of services. Instead of the traditional face to face at school and at home support, TBS began providing telehealth services. Subsequently, in conjunction with telehealth services, field based services began on August 31, 2020 that are in compliance with the Centers for Disease Control and Prevention (CDC) guidelines.
I want to recognize my TBS staff for overall adjusting to the climate of the times by learning something new (telehealth) in short period of time, remaining committed to your clients/caregivers, for supporting each other and for keeping safety in mind when restarting field support services. I was once a Community and School Based Therapist that met with clients one (1) day per week, but engaging clients as TBS does for two (2) to three (3) hours per session, multiple days per week is unique.
Please enjoy a few of the success stories that TBS Specialists/Coaches perform in a regular basis:
A Success Story from Veronica Sanchez, Rancho TBSS
A few months into the pandemic, I was assigned to work with a 10 year old female in foster care in the City of Hesperia. The child initially presented with a difficulty in the home by demonstrating negative behaviors of hitting her siblings, hitting other foster children in the home and refusing to follow caregiver directions. I began service by engaging the client and Foster parent via telehealth sessions, as it was still early into the pandemic.
In order to maintain client’s interest in telehealth sessions, I used various activities and interventions, such as praising, role playing, but mostly tailored games and craft activities considering the client’s age (10 y/o). I also worked a lot with the client’s foster mother who was noted being uncomfortable with praising the client.
I focused on attaining tangible weekly progress to get the caregiver’s interest in TBS and further adopted response cost interventions and rewards for caregiver to use with the client. I allowed the caregiver to be a part of the course of treatment versus just telling her what she needed to do which lead to both caregiver and client making efforts to implement learned interventions.
As a result, the caregiver was appreciative of services as she learned different methods to respond to the client’s behaviors by praising, offering redirection and active ignoring of non-risk behaviors. The client was able to successfully decrease her negative behaviors in the home, engaged her younger siblings without hitting and complied with caregiver directives.
A Success Story from Maria Rivas, Lancaster TBSS
For the past 3 years, I’ve been a TBS Specialist for Masada Homes at the Lancaster office. During this hard time after the Covid-19 global pandemic, we as TBS Specialists have encountered many challenges to provide services to our clients. I have to say that I feel very fortunate to be one of the 1st programs from Masada to be out in the field as a Specialist.
Being out in the field, I have been able to have a positive impact in some of the most challenging cases. For instance, I was assigned a case involving an 8 year old male in residing in foster care in the city of Lancaster with the goals of decreasing refusal in following directions as well as decreasing hitting behaviors.
Initially, I began engaging with client which proved to be effective. However, it quickly became apparent that the caregiver needed more assistance in solidifying a continuation of learned interventions for a successful termination. This caregiver in particular happened to be an older caregiver with a strong background in military-style discipline. One of the challenges was to convince the caregiver to utilize interventions, such as the reward system or setting appropriate limits, assist the client in meeting his goal, but overall simply praising the client.
With a bit of time, persistence, acknowledging cultural background and building rapport, I was able to motivate the caregiver to work through the resistance. Currently, after working with the client and caregiver for almost six (6) months, caregiver is now open to full utilization of TBS interventions. Caregiver consistently uses praise, active ignoring, and encouragement of coping skills which have helped the client tremendously in meeting his goals.
In conclusion, even with all the challenges we face, currently with covid-19, I am honored that as a TBS Specialist, I have been able to facilitate growth with not only the client and caregiver, but also with the community we serve every day one client at a time.
A Success Story from Ekene Chukwuma, Rancho TBSS
One of my most memorable success stories was with a male client that was referred to TBS due to fighting at school and refusal to follow directions.
The client had given up; his school had an IEP couple of days prior and it was decided that client should be best supported in non-public school due to behavioral problems. The client had a history of physical aggression, being rebellious with authority, and refusal to follow directions.
When I came on board, the client verbalized his displeasure in receiving services. It was a challenge to work with the client initially, due to the continuous resistance. However I was determined to support him.
Despite the ups and downs of this case, this young man was able to continue attending the school and went on to win multiple awards. When it came down to graduation, he graduated with honors. The client’s family till this day, updates me with his continuous achievements.
This case has has been a constant reminder through my career, that when I get a difficult case, it fortifies my determination to work harder because I can make a difference in a client’s life. I love my job because of cases like this one.
In words of Chuang Tzu, just when the caterpillar thought the world was over, it became a butterfly.