Doing Better Therapy

A Blog For Mental Health Professional's

Child Inpatient Program at Four Winds

 

The child inpatient treatment program at Four Winds Hospital provides a comprehensive range of mental health services for children and pre-teens. Four Winds is set up to offer a nurturing and therapeutic, home-like environment during the patient’s stay and integrates various treatment models such as Applied Behavioral Analysis (ABA) and Zones of Regulation. Children attend group therapy as well as art therapy while also attending school at the Learning Center.

ABA is the branch of behavioral science that deals with the application of scientific principles to improve socially significant behavior. It includes the methods by which behaviors are observed and measured, and new behaviors are taught. Since ABA has a significant research history, especially for children with disabilities, it is the primary approach taken at many schools and sychiatric treatment centers. It’s similar to Positive Behavior Interventions and Support (PBIS), which is a systems approach to evaluate the purpose of a child’s behaviors, reinforce appropriate behavior and effectively manage disruptive behavior, and is also implemented on the units. PBIS is an offshoot of ABA and one of the goals of using both techniques is to create an environment that provides positive reinforcement for improved socially appropriate behavior and decreases challenging behavior. Our staff has been trained to understand what purpose each behavior serves for an individual patient and what maintains or reinforces specific behaviors.

The treatment teams at Four Winds, which include psychiatrists, therapists, psychiatric nurse practitioners, nurses, mental health workers and teachers, all utilize positive reinforcement. They are trained specifically to identify disruptive behavior early so that they can redirect the child to use the coping skills that they are learning in therapy every day. Four Winds’ approach is based on the belief that there are reasons behind difficult behavior, that children should be treated with compassion and respect, and that behavior can be predicted and managed when the principles of behavior are understood. Expectations for every activity are distinctly defined. Having clear expectations sets each child up for success. Posters displaying the expectations are clearly visible on the walls and the staff praise children for appropriate behavior instead of only focusing on undesired behavior and punishing it. 

The development of social skills is the foundation for all activities. Each child participates in academic instruction and social skills groups. Education is a very important part of the Four Wind’s program. Our goal is to have school time at the Learning Center resemble a day of school in the community and to have the child practice appropriate behaviors. Throughout the day the children earn dollars for engaging in expected behaviors. Then, they choose various rewards such as time playing video games, a later bedtime and other reinforcing activities, depending on the number of dollars earned. Appropriate behaviors increase as the children are consistently reinforced. 

Four Winds makes a point to focus on family collaboration and participation in treatment, which includes parenting skills education and discharge planning and coordinating with outside community providers. In this way the child and support system can continue the work begun on our campus, using the skills they learned at Four Winds in their real-life situations.

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