Intensive In-Home Behavioral Health Treatment
Intensive In-Home Behavioral Health Treatment (IIBHT) is Oregon Community Program’s highest level of outpatient care. It is tailored for children, adolescents, and young adults (up to 20 years old) who need more support and services than traditional outpatient programs provide. Many referred children have challenges in multiple settings and situations, including at school or work, with peers, or in their homes. The program targets each of these areas with the goal of helping them remain safe and stable in their homes and communities. IIBHT reduces the number of out-of-home placements for children including residential treatment and inpatient hospitalizations.
Once enrolled in IIBHT, children receive access to a team of professionals and are provided with 24/7 crisis response (over the phone, in-home, or at an emergency department). IIBHT services are tailored to meet the individual needs of the child and family and include psychiatric treatment, mental health therapy, care coordination, skills training, and peer support. IIBHT provides 4-6 hours of intensive, in-home services per week and typically lasts 3-6 months; though services can continue longer based on individual needs.
Youth and family with Oregon Health Plan insurance are eligible to enroll in IIBHT.
For information about enrolling in IIBHT services, please contact your insurance’s care coordinator or email us at iibht@oregoncp.org
What services do youth receive through your program?
Youth enrolled in IIBHT are offered a minimum of 4 hours of therapeutic services weekly, but may receive more, depending on the level of need. Services comprehensive and wrap-around, meaning our team will seek to include primary caregivers, school staff, and other helping professionals to ensure excellent care. Services may include Individual Therapy, Skills Training, Youth and Family Peer Support, Case Management and Care Coordination, Psychiatric Medication Management, and 24/7 access to telephonic crisis support and in-person response, when necessary.
Oregon Community Programs (OCP) believes strongly that primary caregivers are their child’s most important teacher and supporter. Because of this, family therapy is a core component of every one of our programs, including IIBHT. Caregivers participate in the development of their child’s treatment plan, provide information about themselves and their family, and are expected to work between therapy/counseling sessions.
Your child’s success in treatment is affected by your efforts, input, and candidness. It is important for us that we work together as a team throughout the treatment process.
How do program staff work with the youth?
An IIBHT Team Lead (TL) is assigned to work with the child’s primary caregiver. The TL will coordinate services and help caregivers construct and implement the child’s service plan. TLs are guided by strengths-based, behaviorally-focused interventions and are sensitive to the impact of trauma on children’s emotional and behavioral wellbeing. TLs support caregivers in learning and practicing strategies with the goal of improving family functioning and increasing caregivers’ confidence in managing difficult behaviors across settings. TLs are responsible for overseeing comprehensive care coordination and case management so that a child’s broader treatment team is operating collaboratively, and the family is connected to relevant services to address and support their complex needs.
Our program is structured with clear, separate roles for each staff member to make treatment clear and predictable for the youth and families involved. To do this, caregivers and all professionals (school staff, caseworkers, caregivers) start inquiries with Team Lead.
The individual therapist/counselor or skills trainer will help your child learn new skills and strategies to make progress on the goals they have set for themselves and those set by the adults in their lives. Peer Support Specialists (PSS) are also available to work with you and your child, and may be OCP employees or of local partners: Oregon Family Support network or Youth Era. PSS are a distinct and special part of any IIBHT team as they come to this work with a wealth of lived experience and a unique perspective to client-centered care.
How long is your program?
Typically, IIBHT serves range anywhere from 3-6 months, but may continue for as long as individual support is needed. OCP offers a spectrum of services; families who have evidenced improvement and increased stability, may step down to a lower level of care such as Intensive Outpatient Services and Support (IOSS). Families who step down are able to maintain a high level of support and psychiatric medication management, which results in fewer disruptions in providers and smooth transition between programs.
After enrolling in IIBHT, reviews of treatment goals and engagement in services occur regularly. If youth and family are demonstrating engagement in services, yet still meet eligibility for IIBHT level of care, the TL will submit a request to continue services to Oregon Health Plan (OHP) or the child’s Coordinated Care Organization (CCO). Once progress has been made, the TL will request a final authorization for 30 days of treatment and support the youth and family to transition down in care or to another provider.
What does IIBHT therapy look like?
IIBHT services are tailored to individual family needs. The constellation of services one child and family receive may look different than another family. However, all of our interventions are informed by therapeutic models with a robust evidence base. Therapists are encouraged to incorporate their specific specialties and integrate family’s voice and values into treatment, and balance this with delivering behavioral interventions that inform all of our work at OCP.
Core elements of therapy at OCP include: parent engagement, sensitivity to a child’s developmental needs and trauma exposure, and balancing encouragement and limit setting to shape more positive behaviors and improve emotional wellbeing. IIBHT teams work hard to help families and youth to identify small, achievable steps to success.
Learning new skills can be hard, especially for youth who may have a long history of behavioral problems. As children or adolescents start to learn and practice new skills, our staff provide a high level of encouragement and support along the way. We provide coaching and practice to caregivers and expect they too practice using encouragement with their child, across settings between sessions. Youth in our program receive robust verbal reinforcement for practicing new skills, and may also experience a formal encouragement system to shape positive change. Encouragement systems are individualized and developmentally modified and may include sticker charts, marble jars, routine charts, allowance and more. Encouragement systems are not static and are adjusted and fine-tuned throughout the program as youth make progress and new needs are identified.
What if my child needs a specialized service in addition to what you provide?
Because of the intensive level of service offered in IIBHT, we typically ask that youth not have additional mental/behavioral health obligations while receiving IIBHT services. We also encourage youth involvement in pro-social community activities; we have found that it is helpful when youth are not spending all of their time in treatment activities. A comprehensive mental health assessment is conducted when families enroll in IIBHT and updated consistently thereafter. If we assess there are unmet needs, TLs can assist families in becoming connected with additional service providers (e.g., WRAP, occupational therapy, academic testing, etc.) If there is a specific concern for a youth entering the program, please speak with the TL to discuss how the program can ensure the youth and family’s complex needs are being addressed.