The structure at Visions Residential is a safe, supportive, intensive program filled with daily activities that help the resident come to terms with their problems and begin to make positive choices that will lead them to a healthy and productive life.
*Males & Females;
*13 to 18 years old;
*Involvement Required from a Family Member or Legal Guardian;
*Average Length of stay is 45 to 90 Days.
Variations in length of stay determined by severity of symptom profile, psychosocial stressors, and global assessment of functioning upon intake and admission and during course of treatment.
The residential programs are housed in an environment that most easily conveys dignity and respect for the individual. These settings have a home-like, family feeling that expresses a sense of warmth and security for the client.
*Separate Sleeping Quarters for Male and Female Clients;
*Clients Sleep Two to a Room;
*Well Supervised by Staff Day and Night;
*Crisis Intervention is Available on a 24-hour Basis.
Visions residential facilities embody a quiet and supportive environment. Tucked away in the hills of Malibu, we offer 25 acres of land nestled in the utmost privacy and comfort. Latigo, our Mediterranean Style home, creates a feel of healing and growth. Mulholland, our original facility, offers a comfortable home-like setting. Each facility offers residents a safe and rural surrounding that is inaccessible to the public. The facilities are gated and hidden thus discouraging runaways. Our staff is supportive and our ambiance sets the tone for a healthy, rigorous atmosphere.
Our treatment team consists of highly skilled professionals who use effective techniques and current modalities. Each adolescent is assigned a licensed therapist and a counselor who work directly with them throughout their treatment. Residents will work with several other professionals over the course of their treatment to get the maximum results. Additionally, several consultants who specialize in working with teens will be utilized as needed in the following areas:
✓ Licensed Therapists
✓ Medical Doctors
✓ Registered Dietitian
✓ Equine Therapist
✓ Supervising Nurse
✓ Art Therapists
Program Objectives & Goals
Visions aims to teach every adolescent to seek out and actively become involved in community-based resources including healthy peer groups.
✓ Encourage and motivate the adolescent to achieve and sustain a healthy lifestyle;
✓ Help the adolescent to develop new, more effective problem-solving strategies;
✓ Assist the adolescent with recognizing and acknowledging the existence of destructive behaviors and mental health issues in their lives, and the impact they have on their family, friends and future;
✓ Help the adolescent recognize and change problematic attitudes and behaviors which stimulate relapse;
✓ Involve family and significant others in the rehabilitation process and reduce dysfunction within the family;
✓ Assess and meet the psychological and psychiatric needs of the adolescent;
✓ Assess and meet the medical needs of the resident, by referral;
✓ Establish a referral network system for services not rendered in our program; and
✓ Assist the adolescent with identifying situations if drugs and alcohol were used to cope with life’s problems, and in understanding that using drugs and alcohol to cope with or solve problems does not work.
Substance Abuse & Co-Occurring Disorders
- ✓ Encourage and motivate the adolescent to achieve and sustain abstinence.
- ✓ Assist the adolescent in identifying situations where drugs and alcohol were used to cope with life’s problems, and in understanding that using drugs and alcohol to cope with or solve problems does not work.
- ✓ Help the adolescent to develop new, more effective problem-solving strategies.
- ✓ Introduce the adolescent to the 12-step philosophy and strongly encourage participation in Narcotics Anonymous (NA), Alcoholics Anonymous (AA), and/or Cocaine Anonymous (CA).
- ✓ Assist the adolescent with recognizing and acknowledging the existence of destructive behaviors and mental health issues in their lives, and the impact they have on their family, friends and future.
- ✓ Help the adolescent recognize and change problematic attitudes and behaviors which stimulate a relapse.
- ✓ Involve family and significant others in the rehabilitation process and reduce dysfunction within the family.
- ✓ Assess and meet the psychological and psychiatric needs of the adolescent.
- ✓ Assess and meet the medical needs of the resident, by referral.
- ✓ Establish a referral network system for services not rendered in our program.
- ✓ Assist the adolescent to resolve any legal issues, which may involve criminal activity.
The adolescent residents themselves determine additional treatment goals. Examples of self-selected treatment goals include pursuing educational and vocational interests, examining psychological conflicts, and exploring new or previous recreational pursuits or interests.
Program admission involves several comprehensive assessments of each resident’s condition and their specific issues or needs, including medical, psychiatric, and psychosocial status. Whenever possible, collateral information is collected from additional resources including family, schools and previous treatment providers.
A licensed Medical Doctor, with experience in the area of mental health and substance abuse treatment, has assumed responsibility for ensuring the initial medical evaluation is properly performed on each resident and medical services are provided as needed. Additional medical needs of each teen are evaluated when needed. A history and physical is conducted by the Doctor or by the adolescent’s personal physician. All residents must be medically cleared. If further medical services are indicated, the teen will be referred back to his or her primary care physician or will be treated by the doctor.
Substance Abuse Assessment
The chemical dependency screening interview examines psychoactive substance use, establishes a baseline and identifies areas of need. The assessment measures seven chemical dependency-related domains: drug use, alcohol use, medical problems, psychiatric issues, legal issues, family/social issues, and educational issues. The assessment will also help determine if there are any psychological issues that would prohibit the resident from attaining complete recovery, and if there are any risks for danger to self or others and whether there is any propensity towards mood, personality or cognitive disorders. This assessment also evaluates the resident’s treatment and recovery belief systems and determines any indication of treatment resistance.
The psychosocial assessment reviews an adolescent’s medical history, family history, leisure and social functioning, developmental history, educational functioning, legal history, drug and alcohol history and any significant events that could impact a teen’s treatment process. If indicated, additional assessments may be conducted as a result of the findings from the initial assessments.
These can include:
* Psychiatric Evaluation
* Psychological Testing
* Educational Assessment
* Neurological Testing
* Trauma Assessment
* Eating Disorder Assessment
* Sexual Compulsivity Assessment
After the initial interview with a resident, the client will see the Psychiatric Director for an evaluation. If a resident has been discharged from an inpatient psychiatric unit, the attending physician will be contacted for treatment planning suggestions. A licensed psychiatrist who has experience in the areas of mental health and substance abuse treatment for adolescents has been designated as the Psychiatric Director. The Psychiatric Director will assume responsibility for ensuring that the initial psychiatric evaluation is properly performed and psychiatric services are provided as needed. Adolescents who are diagnosed with a Mental Health or Co-Occurring Diagnosis (mental health and substance abuse disorders) will be admitted to the program with approval from the Psychiatric Director.
If a resident is on psychiatric medication for a diagnosis, the Psychiatric Director will assess the resident every week for medication management.
Utilizing information collected during the assessment process, a Treatment Plan is created. The plan identifies issues and desired goals. Barring therapeutic contradiction, adolescents review their treatment plan with their counselor to ensure that the goals and expectations are fully understood. Action steps and goals are generated. The resident meets with their program counselor to review the Treatment Plan and to ensure the resident understands all expectations and goals.
All counseling services are performed by trained personnel under the supervision of the Program Director. Individual and group counseling techniques as well as specialized groups, e.g., psycho-education group, goal setting, and drug and alcohol education groups are utilized. Treatment services include but are not limited to:
* Process Group Therapy
* Goal Groups
* Substance Abuse Groups
* Individual Sessions
* Psycho-Education Groups
* Family Therapy
* Stress Management Groups
* Art Therapy
* Anger Management Groups
On occasion, the client may experience symptoms that will require 24-hour one-on-one care. Our staff is PART Certified and educated on client supervision. Our Psychiatrist will work closely with staff to ensure proper medication (if necessary) and will stay apprised of the moods and feelings of each client. During this period of observation, the client is never left alone and is no further than arm’s distance from staff. Clients who suffer from pervasive eating disordered behaviors or self-harm issues might qualify for this type of care.
In addition to the therapeutic program, Visions also provides several other services to enhance the treatment goals of each resident. Some of these services will be provided by outside consultants and include:
All residents will attend three hours of individualized schooling on weekdays. Upon admission, the program teacher will contact the teen’s previous school and receive a current curriculum for the resident. Each resident will have a personalized education plan that is created to maintain the student’s current study curriculum.
Conditioning is a physical fitness program “tailor-made” to the individual’s interests, needs, and limitations. This is centered on five main goals: cardiovascular endurance, muscle endurance, strength, flexibility and relaxation through the release of nervous tension. It is anticipated that each teen will leave the program not only with improved physical fitness and team-recreation skills, but with an understanding of the importance of each. Conditioning is provided 5 times a week for 1 hour and is facilitated by trained program staff under the supervision of the Activities Consultant who maintains a degree in a related health field.
Nutritional Services are provided under the supervision of a registered dietitian. Nutritional services provide health conscious and calorically appropriate meals and snacks. Meals are appetizing and served family style at scheduled meal times in the facility dining room. When indicated, staff monitors eating patterns. Clients, who for clinical reasons, are not allowed to eat in the dining room are served individual meal trays in their room. A nutritional assessment is provided for all clients and when appropriate a dietary consultation by a registered dietician is completed. Special diets are available as ordered by the physician. The dietary service works closely with program staff in planning food for special events, evening snacks, and in observing dietary habits of clients.
Like Wilderness experiences, equine therapy is an experiential therapeutic process that has shown significant advantages for working with youth. Through interactions with horses, teens learn to identify and recognize feelings and thoughts that may be difficult to access through traditional therapeutic modalities. Residents will then take what they have learned and process these feelings with their counselor and in group if appropriate.
Psychological Services are provided by contracted psychologists who conduct psychological testing on clients upon receipt of a psychological testing referral form. This includes a comprehensive assessment of personality characteristics, intellectual functioning, social adaptability, and screening for organic dysfunction. This assessment includes use of the full range of standardized tests, inventories and questionnaires. Projective techniques are also available to the psychologists as appropriate for the clinical symptoms presented. Information from the psychological assessment is used to assist in the interdisciplinary treatment planning and dis-positional decisions.
Discharge and Aftercare
The Discharge Plan is a continuing care plan that is developed by the Counselor with input from both the resident and the treatment team prior to the resident leaving the program. It addresses, as appropriate:
* Continuing Care Needs
may include: therapeutic schools, individual and family therapy, medication management and/or outpatient programs.
* Physical and Psychiatric Needs
* 12-Step Meeting Schedule
* Family Relationships
* Academic Needs
* Social Needs
* Accessibility to Community Resources
* Indication of Anticipated Problems Following Discharge and Suggested Means for Dealing with Them.
The continuing care plan, when indicated, provides recommendations and arrangements for support services, with an identification of providers. The Treatment Team begins developing the teen’s Final Discharge Plan and Continuing Care Plan at admission and any problems that have been deferred are addressed in the Final Discharge Plan.
Mental Health and Substance Abuse issues affect the entire family and studies have shown that the best outcomes for treatment depend on the family’s understanding of and participation in the therapeutic process. The family component of treatment is a critical aspect of what we do.
We find that nearly 100 percent of our families feel the same way about their child’s issues prior to and during treatment.
With the support of the Visions team our families move towards:
Our program includes a minimum of 5 weekly hours of family-focused therapy.
This group is held every Saturday. It is facilitated by the Family Therapist. The multi-family group addresses issues that are common to all families such as communication, handling conflicts, and maintaining boundaries. Family members and residents share in a supportive atmosphere. This group also provides families with feedback and support from other family members who are experiencing similar difficulties.
Individual Family Sessions
Individual sessions with residents and their family members will be conducted by a Family Therapist primarily for the purpose of assessing family therapy needs to complete treatment goals and addressing conflicts that the family may feel too uncomfortable with to bring up in group sessions. When it is assessed that an individual family member needs additional therapeutic services outside the scope of Visions treatment, they will be referred to appropriate professionals.
In education groups, residents and families are provided with information on the family systems and an overview of the progression and stages of family illnesses including adjustment/ reactions made. These presentations also address roles, rules and interaction patterns common in dysfunctional families. They discuss common issues parents bring into treatment when addressing their own family of origin and determining what to pass on to their children. The goal is to teach the resident and family members an understanding of typical roles, such as interaction patterns and family rules that people act out in addictive/alcoholic and other dysfunctional families.
Visions is unique in that it does not attempt to sequester the client from outside stimuli. Family Passes can be earned. Outings every Sunday and Monday include movies, museums, the beach, go-cart racing, community service, ropes courses and rock climbing. Integration of “normal” activities can help the client go out, have an experience, and come back to a safe place to process the activity.
If it is determined that family involvement would not be clinically appropriate, the Family Therapist may conduct individual sessions with the resident.
Examples of this would be as follows:
* Working on separation/individuation issues.
* Addressing enmeshment and appropriate boundary setting.
* Working towards acceptance of relationships.
* Processing family sessions that have taken place.
Following completion of the active treatment program phase, residents can benefit from continued participation in the Visions Alumni Program, The Fourth Dimension. They use what they have learned in the active phase of treatment program and bolster that learning by attending aftercare groups and continued participation in self-help groups.
* Aftercare Groups Offered on an On-going Basis to All Residents.
* Residents Attend Up to Two Aftercare Groups Weekly .
For as long as they need or wish to participate.
* Residents Become Members of the Visions Alumni
* Individual Sessions are Available to Alumni on a Fee for Service Basis
Crisis Intervention or Relapse Prevention
* Support Call Received from Visions Alumni Coordinator.
It is the goal to foster the adolescent’s utilization of community and personal resources in their new healthy way of living.
Annual Alumni Events:
*Winter Ski/Snowboard Trip
*Alumni Family Weekend
*Alumni vs. Staff Softball Game
*Knott’s Scary Farm Night