This is the heading
State definition aside, Intensive In-Community has distinct levels of services and application. We will give you a brief description of all 3. But first, think of three ways a person responds to situations. They can think about it, feel about it, or do something about it. So as Cognitive Behavioral Therapists we look at the thoughts, feelings, and/or behaviors when describing these services.
Level of Services
Behavioral Assistant (IIC-BA)
The Behavioral Assistant is focusing on the behavioral component of what is going on with our families and their children. They have a bachelor’s in psychology, social work, or a related field. The BA’s job is to take the plan that the therapist makes and try to help our families create positive changes in their life, while reducing negative behavioral choices.
They do this by:
Providing instructions for anger management
Helping the parents to develop their parenting skills
Aiding in stress reduction
Developing problem-solving skills
Provide psychoeducation to aid in understanding a youth’s mental health needs
Professional Level (IIC-MA)
If we are looking at Intensive In-Community from the point of view of a Cognitive Behavioral Therapist, Professional Level IIC work is now beginning to focus on the thoughts and feelings more. At this level the practitioner must have at least a master’s degree in psychology, sociology, or a related field, they can do all the work of the BA level and can now start to look at things a little differently.
Professionals can also:
use techniques associated with behavioral therapies but also play therapy, art therapy, drama therapy, music therapy and more.
They can provide clinical consultation and evaluations
Clinical Level (IIC-Licensed)
When looking at the licensed level, it is sometimes hard to see the difference between themselves and the other two levels. That is because a licensed practitioner is not only able to do everything from the other two levels but has been in the field long enough to transition seamlessly between them. A licensed level clinician is usually a fully Licensed Professional Counselor or Licensed Clinical Social Worker but can also be a Psychologist or an Advanced Practice Nurse. Most licenses require two to three years of experience in the field after their master’s degree and having passed a rigorous licensing test. At this point in their work, a clinician should be able to not just see the connections between a youth’s thoughts, feelings, and behaviors but also be able to express those connections to their families as well.
At the Clinical level a therapist can also:
Aid the family and child in reducing symptoms associated with mental health issues
Provide clinical assessment as well as counseling, consultation, and evaluation at the licensed level.
Having spent years working in the Intensive In-Home (IIH) field, specifically with the Autism population, we saw the need for social skills groups. The problem is that IIH does not offer group therapy. So, we spent years making referrals to social skills or group therapy programs, but the waiting list was usually too long and the need too great.
As a therapist we can say we are working on social skills with our client one on one, but that has its limitations. Intensive In-Community is meant to help rehabilitate and stabilize the child, adolescent, and family and can also do so in a group setting.
Yes and No.
Years ago, Dr. James and Dr. Quinones worked with companies that did IIC Group therapy. We saw them do weekend or eight-week programs but then stop for one reason or another. For over a year now, we have taken Gaming Approaches Towards Education’s group therapy concepts and brought them to the IIC field. So, the idea of IIC Groups is not new, we are just passionate about getting it to the people who need it most.
We emphasize that our programs focus on social skills groups and development, but it is a little more than that. G.A.T.E. provides a place in the community that children, adolescents, and parents can teach, talk, play, and create together. We provide individual and group counseling, behavioral assistant support, social skills trainings, and family support groups.
When referred through PerformCare, our customers receive BA treatment during pick-up. They focus on communication skills, coping strategies and just talking about their week.
After pick up the clients get to meet with their therapist, do a check in and discuss what kind of activities they want to do together. Once everyone is together with the therapist, they can pick an activity that helps address their group’s target treatment goals. Between activities and discussions, the session usually ends with building Social Emotional Learning skills and a question about what they want to do together next week.
The IIC practitioners determine what intervention works best with the groups’ chosen activity, as well as what skills and benefits we introduce based on their choices.
After the activity, the therapist aids in discussion and debriefing. The Behavioral Assistant drives the youths’ home and provides group discussions that focus on social functioning, relationship
connections, behavioral change, and helps them reflect on their session, what behaviors they had and what behaviors they want to have more of between now and the next session.
The name of our company gives it away. We are using board games, tabletop roleplaying games, and narrative storytelling games. Now analog games are not going to work for everyone, in those cases we have groups that focus on creative and expressive arts, tactile/sensory play, jigsaw and other visual puzzles. But no video games.
We talk about video games with our groups, we look for board games and other activities that have a similar feel, but we are not using video games in session, and are keeping electronics to a bare minimum.
Can video games be therapeutic? Yes, and we do believe they are a tool for therapeutic change.
But we are using alternatives to video games that promote Social Emotional Learning in a unique way.
Primarily, Dr. James and Dr. Quinones both chose Cognitive Behavioral Therapy as a concentration for their doctorates. Additionally, they both received training in Rational Living Therapy and Rational Emotive Behavioral Therapy, respectively. As time progressed, we found that CBT did not have the words we were looking for in describing what we do. So, over the last year we looked to integrate Play Therapy and Autplay Therapy into our groups. Each therapeutic approach we use has core strengths that we incorporate with our game play.
We use CBT, Autplay and Play Therapy Techniques to create groups that focus on cognitive restructuring, developing personal strengths, and enhancing social emotional wellness.
The way we use CBT is both traditional and original at the same time. Conventionally speaking we are looking at the thoughts, feelings, and behaviors held by our group members and their families that are helping them or hurting them. And if they are hurting them how do we change them to be healthier. From a practitioner standpoint, we are taking different approach towards the use of games in session.
Board games, TTRPGs, and narrative storytelling games aren’t just for building rapport, we use them as a tool for behavioral rehearsal, role modeling, teaching cause and effect, consequences for one’s actions, reality and fact checking.
We do not change traditional board games and make them therapeutic; we look for the therapeutic qualities already present in those games and use each game as a teachable moment for our groups.
As time progressed, we begun comparing what we were doing to other forms of therapy. And we kept coming back to the same question, “Why play therapy?” Play therapy has a multitude of different approaches including Cognitive Behavioral Play Therapy. But what about play therapy made it useful to us. Dr. Charles Schaefer, co-founder of the Association for Play Therapy created a list of the Therapeutic Powers of Play. The list contained four different categories of the powers of play; Communication, Emotional Wellness, Enhancing Social Relationships, and Increasing Personal Strengths, which fit our goals for our groups. After seeing this similarity, the question became, “Why not play therapy?” So, we started looking into additional trainings and therapeutic models that were moving in similar directions.
Autplay is an evidence-based approach to working with children and adolescents with ADHD, autism disorder, dysregulation issues, or other neurodevelopmental disorders. Dr. Robert Jason Grant describes Autplay Therapy as a behavioral play-based treatment approach to working with youth who are living with Autism Spectrum Disorder and other developmental disabilities. His model contains a parent- training section, that teaches the parents to use directive play therapy interventions within the home.
Autplay looks to set treatment goals around six target areas, Emotional Regulation, Social Functioning, Relationship Connections, Anxiety Reduction, Sensory Processing Improvement, and Behavioral Change.
Having worked in the home with families and children with Autism we believe that the Autplay approach can be invaluable to educating parents and professionals on what Autism looks like, and what play looks like at different developmental levels for children with Autism.
And it is our belief that if you know how a child plays you know how they learn, and how better to teach them vital social skills necessary for everyday life.
Gaming Approaches Towards Education, LLC is looking to help as much as we can. We look to function as a community center that provides education to children, adolescent, adults, parents, and families who are suffering from symptoms associated with:
Attention Deficient Hyperactive Disorder
Blended Family Issues
Peer Sibling Conflicts
We do focus on Social Emotional Learning in all our groups, and we believe that direct and/or indirect play can help address many of the issues above. We look for games, interventions, activities, and stories that empower our youth to control the negative thoughts, feelings, and behaviors in their life and make steps towards a better tomorrow.
When you put it all together, how exactly do we help people? Our focus is on skill building and development. Based on the participants strengths and needs, those skills can address any number of the topics above for individuals, families and/or groups. For each service level we determine, the stated goals, the interventions necessary to reach those goals, the activities that coincide with those interventions and lastly, the skills and benefits they produce.
We have found the Autplay tools and assessments to be very flexible for what we do. So, we start by asking the family what primary and secondary goals you want us to address from the list below.
Sensory Processing Improvement
Active Listening, Warm Acceptance, Unconditional Positive Regard
Cognitive Behavioral Therapy
Usually, the group comes together to pick an activity, or the clinician will suggest one for them.
Auditory games, singing, musical instruments
Boarding Gaming – either cooperative, creative, collaborative, or competitive
Creative and Expressive Arts
Story Telling Games
Tactile and Sensory Play (Kinetic Sand, Playdoh, and Legos)
The following list of skills and benefits are what we look to foster with our customers:
Accelerated Psychological Development
Access to the Unconscious
Creative Problem Solving
Logic and Problem Solving
Protection of Others
Protection of Self
STEM and Creative Thinking
Visual Perception and Reasoning
Word and Language practice and mastery
Two phrases that you hear often, “your child needs more social skills,” or “your child needs to develop more coping skills,” with little else in terms of detail. We thought we should provide some examples of both.
Appropriate Body Language
Asking for Help
Understanding Personal Space
Expressing Emotions Appropriately
Joining a Group
Recognizing Emotions in Others
Saying Thank You
Starting and Ending Conversations
Do a crafting project
Play at the Park or Exercise
Play with a friend or Talk to someone you trust
Shred Paper, Pop Bubble Wrap, Punch a Safe Surface (like a pillow)
Starting a new hobby
Taking a Break
Use a stress ball
Write or Listen to Music
Write poetry, stories, or in a Journal
Since starting our services in Perth Amboy, New Jersey, we are getting questions regarding preschoolers and therapeutic services on site. We believe that IIC would work for situations where the child would benefit from services in their school setting. There are times where the teachers and preschool directors need help seeing how the child’s behavioral issues connect to their environment. That is why we combine the different techniques we use in the office and community to conduct a play-based behavioral observation and treatment approach.
If your child is four years or older, having play and behavioral problems in their preschool setting, and you would like for us to make observations and provide our play therapy interventions as IIC Individual or Group in the schools, feel free to contact PerformCare and request our services.
We are currently in talks with Case Management Organizations, Family Support Organizations, and PerformCare about providing an IIC group therapy service that would act as a parent support group. Too often we take for granted that we are alone in all of this, and that no one else can understand what we go through. Our goal is to create a place where parents can learn, laugh, cry, and play together as they share what has worked and what hasn’t worked when getting their child and adolescent the help they need. We want our communities to realize that they are not alone, that they can co-author the shared success that is the story of our lives.
If this is something that interests you please call PerformCare, your Case Manager, or your Family Support Organization representative to see if groups are available.
CSOC defines Intensive In-Community Services as “an analytical, focused goal oriented, and needs based clinical intervention that addresses emotional and behavioral challenges of youth with moderate to high needs. It may be provided in a youth’s home or in an amenable community location by a licensed behavioral health clinician and is intended to stabilize and support the youth and family in an effort to deter more intensive interventions and to support the youth and family in collaboration with the Child Family Team (CFT) or identified support system. This is a short-term, solution focused intervention that addresses presenting behaviors resulting in the youth and her/his family/care giver/guardian gaining insight and improving function at home and in the community. Youth and families are eligible to receive Intensive In-Community Services if they are receiving Care Management, MRSS services, and as part of the Transitional Planning process from OOH treatment back to the community, through the NJ Children’s System of Care.”
“The primary objective of the interventions is symptom reduction and individual skill development with the goal of restoring or maintaining the youth’s functioning.”
IIC work is restorative, focusing on helping the youth:
•Improving youth and family dynamics and functioning;
•Preventing / reducing the need for higher intensity behavioral health or substance use treatment;
•Preventing /reducing the need and / or risk for inpatient hospitalization or out of home treatment;
•Preserving a youth’s current residence;
•Transitioning youth from out –of –home treatment back into the community