Agency Visit 2
Agency Agency Visit Diana Guy BSHS/332 September 6,2010 Audra Duhon Agency Visit When beginning to get into the field of Human Services, one would like to be given the the opportunity to explore potential Field Placement sites, to arrange for a placement, to apply the concepts related to legal and ethical issues in human services, and to identify ethical dilemmas in human services and apply critical thinking skills to the resolution thereof. The following paper will touch base on visiting an agency, and go some details on what it takes to work with an agency in Human Services.
An interview took place on August 28, 2010. The interview was with Lori Baird who is a child psychotherapist at C. R. Darnall Army Medical Center in Ft. Hood, Texas. She works at Child and Adolescent Psychiatric Evaluation Services. She is a Licensed Clinical Social Worker, with a specialization in Infant and Early Childhood Mental Health. The Hours of Operation are Monday thru Friday, 7:30 a. m. – 5:30 p. m. After hours on weekends & holidays, psychiatric emergency services for children and adolescents are available through Carl R.
Darnall Army Medical Center’s Emergency Department, 288-8114/8113. Location of the agency is Carl R. Darnall Army Medical Center, Building 36000, 5th Floor (5 West Ward). Some phone numbers that can be reached to reach the agency are (254) 288-8731, 286-7079, 286-7820, and also facsimile (254) 286-7629. Darnall hospital also offers other services in the Behavioral Health Division. It provides outpatient and inpatient treatment and consultation related to the management and treatment of behavioral issues and mental health concerns.
The Behavioral Health Division consists of outpatient mental health services provided at the Resilience & Restoration Center (R&R Center), the Child & Adolescent Psychiatry Evaluation Service (CAPES), the Inpatient Psychiatry Service, the Department of Social Work (DSW), the Administrative Psychiatry Service, and the Department of Substance Abuse Services (DSAS). While visiting with Lori Baird, the agency has a variety of programs and services.
This agency of Child and Adolescent Psychiatry Evaluation Service (CAPES) can provide comprehensive evaluations and consultations for children and adolescents who exhibit a wide variety of behavioral and psychiatric challenges. The goal of the agency is to provide the most clinically effective and least restrictive level of care to our patients. The services are provided by a professional staff that includes Child Psychiatrists, Clinical Psychologists, Clinical Social Workers, and Social Work & Psychology Interns.
CAPES services are available for children and adolescents (infant to 18 years) of active-duty and retired service members who are enrolled in DEERS and are TRICARE eligible. This agency also takes patient referrals various clinics, schools, legal systems, and walk-ins are welcome. CAPES services for Triage parents only, perform a screening and classification to determine the priority of need for psychiatric care. Upon completion of required form, a triage counselor (usually an intern) performs a brief evaluation of the problem and provides any additional paperwork or forms.
The triage counselor provides an appointment with a clinician for a comprehensive assessment for definitive treatment recommendations. CAPES also offers group sessions and classes for patients. An example of one group is Attention-Deficit / Hyperactivity Disorder (ADHD) Group. This group meets on Tuesdays from 4:15 – 5:30 p. m. This group is for children who have ADHD. A CAPES therapist (me) provides age appropriate information about ADHD and how to cope with the disorder.
Games and activities focus on social skills, listening, planning ahead, self-esteem, and other areas that usually give ADHD children and adolescents problems. Another group is Attention-Deficit / Hyperactivity Disorder (ADHD) Psychoeducational Group for Parents, which is held also on Tuesdays from 4:15 – 5:30 p. m. For this group, depending on the desires of the group members, the group facilitator presents basic-to-advanced information about ADHD and treatments. This affords parents the opportunity to meet other parents of ADHD children and to discuss specific concerns.
The individuals who do not have children attending the ADHD children’s group are still invited to attend the ADHD Parent Group. Another example of a group session held by CAPES is the Adolescent Support Group on Wednesdays from 4:15 – 5:30 p. m. This group is a forum for adolescents to discuss pressing issues and to gain insight into themselves and others. This unique approach focuses, but is not limited to, the following issues of personal/interpersonal relationships, social/interpersonal skills, communication skills, and also problem solving.
There is also the Anger Management Group (Children), which is on Thursdays from 4:15 – 5:30 p. m. This group is for children who have difficulty dealing with their anger. The group facilitator provides games and activities that focus on anger control, problems solving, journaling, and self-esteem. An additional example is the Psychoeducational Group on Anger Management for Parents held on Thursdays from 4:15 – 5:30 p. m. This is an education and support group for parents. Participants discuss family dynamics, communication skills, and problems solving.
This is an opportunity for parents to meet with other parents and brainstorm about specific concerns. This agency strives to protect information obtained from patients and ensure that only authorized sources have access in accordance with the above guidelines and the provisions of the Privacy Act. There are multiple ethical dilemmas on a daily basis. The agency first limits the confidentiality of medical information. This means that access to information in a file is possible when required by law and/or regulation.
They are required to keep a written summary of each patient visit. This is kept at our clinic separate from medical records. Some examples of limits to confidentiality are if the patient is on active duty, the chain of command may have limited access to information contained in the case file (as governed by Army regulation). Lots of soldiers refuse to get care based on this, fearing there will be consequences from superiors. Lori also stated that, “Unfortunately there are many commanders that will cause problems for soldiers seeking treatment. Another example is if information in file may be subject to subpoena when ordered by a judge. However, being a federal worker for the agency protects Lori from having to go to court. If she is subpoenaed, then she can refuse and the hospital lawyer takes it from there. Lori stated that there has been times that she agreed to testify, but most of the time she does refuse. Lori also stated if she believes a patient intends to harm themselves or someone else, it is her ethical and professional duty to inform others as the circumstance requires.
She said that just last week she spent countless hours on the phone with doctors at Children’s Hospital in Dallas, Child Protective Services and Unit commanders in reference to saving a child’s life. In situations of suspected child or spouse abuse, it is required that she report this to the appropriate authorities. Another example of limits to confidentiality is if other professionals associated with the patient’s care may have access to information on record in the file without the patient’s or sponsors written consent.
In group therapy, the patient and every other member of the group will be told that anything discussed is private. This includes the names of group members of any problems they discussed in group. This is not to be talked about with anyone outside the group. Confidentiality will exist only to the extent that each patient trusts and respects every other member of the group. While conducting the interview with Lori Baird, she gave some perceptions of the unique challenges currently facing the human services profession.
Such as, The Military Health System (MHS) Notice of Privacy Practices is provided as a requirement under the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Although the MHS has always had privacy and patient confidentiality standards in place to limit unauthorized access or disclosure of personal health information, the new privacy rule provides TRICARE beneficiaries with additional safeguards for ensuring their health information is adequately protected and is used by the MHS and TRICARE to provide quality patient care.
She also added other examples of challenges in her profession, for instance, since she lives in a military community, she would often see parents and patients outside of the office. She has been served by a waitress that was a previous patient, her two boys have also gone to school with patients and would come home and say “so and so told me you are their therapist, so what’s wrong with them? ” She said it “puts me in a very tight spot, because for one I can’t even acknowledge they are or were a patient. She also had a previous patient’s father work on her air conditioner. She must behave like a professional at all times, for fear that she could run into a past or present patient. She has had lots of family and friends that wanted professional advice or therapy for them or their children, which is another ethical no no. She has noncustodial parents wanting information about their child, which she can’t release without the custodial parents authorization.
She also has had kids and parents want to give me gifts as a thank you, which is not just a professional no no, but also against agency policy. L. Baird (personal communication, August 28, 2010) “as you can see, there are lots and lots of ethical dilemmas or decisions we must make on a daily basis. In order to make decisions, I often consult with coworkers, but I also must complete 3 hours of ethics training per year to keep my license. ” The following paper was written based on an interview with Lori Baird.
The interview was conducted because when someone would like to be given the opportunity to explore potential Field Placement sites, to arrange for a placement, to apply the concepts related to legal and ethical issues in human services, and to identify ethical dilemmas in human services and apply critical thinking skills to the resolution thereof in the profession of Human Services. References This is a hanging indent. To keep the hanging indent format, simply delete this line of text using the backspace key, and replace the information with your reference entry.