Expanded Tool For Providers – PREVIEW –

Focus of Service

PARENT FOCUSED - Identified intervention need for parent to promote family stability (e.g., parenting skills, help with referrals or accessing resources); need for targeted care coordination and/or in-home intervention to address multiple or complex concerns/risk factors impacting child wellbeing (e.g., parent's trauma history, parent substance misuse, intimate partner violence).

CHILD FOCUSED - Treatment options to address child/adolescent behavioral health needs (mental health, substance use and co-occurring)

Service Type

Coordination of Care - Identifying needs and securing access to resources

Need for Parenting Education or Parent-Focused Treatment/Intervention

Are there concerns about parental substance use?

Yes

Unsure

Current / Anticipated DCF Status

None - Family would benefit from connection to resources to promote child/family wellbeing

Family Assessment Response (FAR) - Differential response alternative to investigation for lower risk reports of suspected abuse/neglect

Investigation - planning to close but with identified ongoing family needs

Ongoing Services

Primary Intervention Need for Parent

Pregnant/New Parent

Other Parenting Education/Support

Substance Use

Intimate Partner Violence (IPV)

Mental Health

Is there concern about substance use?

Yes

Is there DCF involvement due to child safety concerns?

Yes

Level of child safety concern? (Refers to protective service risk levels from Structured Decision Making (SDM) tool)

Safe - No conditions identified that may place children in danger of serious harm

Conditionally Safe - One or more safety factors are present, protective safety interventions are in place, a safety plan is required

Unsafe - Child(ren) at high risk of placement out of the home due to significant safety concerns

Peer/Specialized Supports for Parents:

Parenting Education

Support for parents of children with autism

Peer Support / Advocacy for parents of children with special needs (to connect parents to social/emotional supports or help with special education advocacy)

Level of child safety concern? (Refers to protective service risk levels from Structured Decision Making (SDM) tool)

Safe - No conditions identified that may place child(ren) in danger of serious harm

Conditionally Safe - One or more safety factors are present, protective safety interventions are in place, a safety plan is required

Unsafe - Significant safety concerns

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Are there children in the home, or is there a plan for reunification in the next few months?

Yes

Age of Index Child in the home

0-5 Years Old

6-17 Years Old

Age of child:

Birth to 5

5-18

18-22

What best describes your main behavioral health concern/need for the child?

Crisis - The child is in IMMEDIATE danger; talking about hurting themselves or someone else

Care Coordination to help parent access/match/connect to services for complex behavioral health need of the child

Emotional/Behavioral - Symptoms such as: increased sadness, frequent tearfulness, excessive worry, irritability, not enjoying things they used to, grief/loss, reaction to trauma, acting out behaviors, not following rules, destroying things, angry outbursts, hitting or threatening, running away, high family conflict)

Substance Use (Including misuse of prescription medication)

Both emotional/behavioral concern(s) AND substance use (including misuse of prescription medication)

Unusual thoughts (question about disordered thinking/psychosis) - For example: Confused thinking, odd/false beliefs that seem real to them, seeing/hearing/smelling things that are not there, high level of suspicion or mistrust

Eating Problems

Autism

Is there current DCF involvement?

Yes

No (or is closing in next 30 days)

Severity of Concern

MILD - Child does not have prior treatment history and/or their symptoms have limited impact on daily life.

MODERATE - Child has symptoms that negatively impact daily functioning in at least one area (school, home, relationships).

SEVERE - Child's emotional/behavioral difficulties are highly disruptive at home, in school and/or in the community. Concerns may include extreme emotional dysregulation; explosive behaviors; very high family conflict; frequent aggressive or destructive behaviors; extreme defiance; breaking the law; at risk of out-of-home placement/hospitalization or is being discharged from a hospital or out-of-home placement and will need a high level of therapeutic support.

Is the child currently receiving treatment?

Yes

Do you have any of the following specific areas of concern:

Increasing SUICIDAL Thoughts (but NOT IMMEDIATE threat) - NOTE: If immediate threat call or text 9-8-8 for CRISIS assistance.

Disordered thinking/Psychosis - Such as: Hallucinations, delusions, high level of suspicion or mistrust.

Problem Sexual Behavior - Such as: taking advantage of others sexually; forcing sexual contact; sexualized threats; repeated engagement in risky sexual behavior/activities on social media or text; receiving money or goods for sex; arrested or at risk of arrest for sexual behavior; voyeurism (exposing self or spying on others).

Legal Issues - Child is court involved and/or on probation.

Child has been diagnosed with Autism

Child has been diagnosed with an Intellectual Disability

None of the above apply

Is there any Opioid use?

Yes

Severity of Concern

MILD - Substance use is present and a concern; however, there is not an immediate risk for adverse outcome

MODERATE - Substance use is having a negative effect on at least one aspect of daily living (academic, social, behavioral)

SEVERE - Substance use is negatively impacting multiple areas of life; there is a high risk for adverse outcomes such as injury, juvenile justice involvement, school dropout, or risk of an overdose event. There may be evidence of an inability to control or stop using.

Is there any Opioid use?

Yes

Severity of concern

MODERATE - Drug and/or alochol use and other problem behaviors have been increasing; there is quite a bit of tension at home.

SEVERE - Frequent or increasing drug/alcohol use and emotional/behavioral difficulties are highly disruptive at home, in school and/or in the community. Concerns may include extreme emotional dysregulation; explosive behaviors; very high family conflict; frequent aggressive or destructive behaviors; extreme defiance; breaking the law; at risk of out-of-home placement or youth is returning home from placement.

Is this a new concern?

Yes

No - Child has been diagnosed and/or is/has been in treatment for disordered thinking/psychosis

Does the child currently have a diagnosis of Autism?

Yes

Which best describes current concerns:

Child's behavior is safe, but they need therapy to help with their adjustment at home or school

Child is able to be kept safe with increased support, but is showing increasingly challenging behavior that is seriously impacting school or home life such as self-injury, aggression, property destruction, school refusal