Creating Competence from Chaos

Children with emotional and behavioral disorders are often adrift in our society, lacking adequate mental health care or caught between several child-serving systems, such as child welfare, juvenile justice, and the schools. In Pennsylvania, a commitment has been made, on a statewide basis, to serve these children and strengthen their vulnerable families through a home-based approach grounded in ecosystemic thinking and practice. This book tells the story of Pennsylvania's evolving treatment program, providing a model for other professionals who believe that a family's needs are best met through individually tailored, family-centered, community-based, culturally competent, and outcome-oriented services. This is a complete, comprehensive guide, covering everything from planning and development of home-based services through supervision and training of home-based practitioners and evaluation of treatment outcomes. Particular attention is given to the clinical challenges faced by home-based therapists working with families where children are depressed and perhaps suicidal, oppositional and defiant, out-of-control and aggressive, or hyperactive/impulsive.