In 2007, Massachusetts implemented the Children's Behavioral Health Initiative (CBHI) in response to a class action lawsuit on behalf of Medicaid-eligible children with serious emotional disturbances to provide improved screening, evaluation, and access to behavioral health services for youth up to age 21 with MassHealth.
One of the services created was Intensive Care Coordination (ICC) to "help get all the adults in your child’s life to work together." In my previous work as an in-home family therapist, mobile crisis intervention supervisor, and point of contact for families entering the CBHI system, I can tell you this is one of the biggest challenges and most important factors in providing effective care that wraps around and buoys a child and the family. While some families I worked with had a dedicated Intensive Care Coordinator, others relied on the family therapist or outpatient therapist to provide the coordination. Too often, it fell on a parent who was already approaching or well past the stage of burnout trying to decipher acronyms and navigate an incredibly complex system all while dealing with anxiety about finding help for their child. Throw in a doctor, a teacher, a special education services coordinator, an occupational therapist, or a mentor and it's not hard to imagine the benefit of making sure everyone's talking to each other.
In my private practice, I see children and families, as well as individual adults, and I always consider who else is working with whoever is sitting with me in my office. Together, we review the pros and cons of signing releases allowing me to communicate with those other providers. Here are some common themes that arise:
One of my strengths is looking at the bigger picture and navigating larger systems. When we think together about who is currently involved in your life and how you'd benefit from working with other providers, we have the best chance of efficiently meeting your goals, but it's critical that appropriate communication happens to ensure everyone on your team is working together.
Do you have any success stories or cautionary tales of collaboration among providers? Therapists, what makes you hesitant or excited to take on the role of coordinating care? Please feel free to share your thoughts in the comments.