THE PLAYBOOK
Psychiatric Residential Treatment Facility
Residential Treatment Center: PRTF-RTC
Empowering Our Team with Clear Goals and Collaborative Success
AMessageFromOurCEO
Alexander Youth
Network Chief Executive Officer
On behalf of the Senior Management Team, I am delighted to welcome you to the Alexander Youth Network! We are honored you have chosen to join us on this transformative journey.
Our mission is clear and powerful: to provide quality treatment to children with serious emotional and behavioral challenges, enabling them and their families to achieve their potential and contribute positively to society. Every day, you have the incredible opportunity to change lives and create lasting impact.
What sets us apart is not just our expertise but the compassion and dedication we bring to our work. As you become part of our vibrant community, remember to lean on your colleagues, ask questions, and share your insights. Every interaction and challenge you overcome brings us closer to fulfilling our mission.
Together, we can make a profound difference in the lives of countless children and their families. Here’s to a future filled with hope, resilience, and positive transformation.
Best regards,
N. Craig Bass, ACSW Chief Executive Officer Alexander Youth Network
Introduction:ThePlaybook
Purpose of the Playbook
Welcome to The Playbook! This eBook is a central resource for all employees, providing a clear overview of our program expectations and guidelines. Our goal is to ensure everyone in your department has consistent, accurate information, helping us maintain high standards and achieve our goals.
Why the Playbook?
Enhance Clarity: Ensure everyone understands their roles and aligns with department goals.
Improve Communication: Clearly communicate expectations, reducing misunderstandings.
Support Training: Serve as a resource for onboarding and ongoing training.
Facilitate Accountability: Establish clear benchmarks and performance indicators.
How the Playbook Can Help You
Program Overviews: Detailed descriptions of each program and key performance indicators.
Expectations: Clear outlines of your role and tasks.
Resources: Access to templates, forms, and contact information.
Procedures: Step-by-step guides to our processes.
Improvement: Best practices and tips for better performance.
Using The Playbook, you’ll have the tools to perform your job effectively and contribute to our department’s success. This eBook will be an invaluable resource in your professional journey.
VP of Residential Services
Executive Director - PRTF-RTC
Qualified / Associate Professionals
Program Manager Clinicians / Therapists Nurse Manager Coordinator
Behavior Health Counselor
Registered Nurse’s
Discover the vital players shaping PRTF-RTC success. Click to explore team roles and responsibilities. Click Here! Roles
ProgramExpectations
Program Overview
Population: Adolescents aged 12-17 experiencing serious emotional, psychological, and behavioral challenges.
Model: Trauma-Informed Approach, incorporating Aggression Replacement Training (ART) and Intensive Psychiatric Residential Treatment (iPRTF).
Goals: Stabilize residents, help them develop coping skills, and transition to less restrictive environments.
Accreditation: Joint Commission on Accreditation of Healthcare Organizations
Service Focus: Youth requiring structured residential care beyond typical outpatient settings but not in need of acute hospitalization.
Treatment&Therapeutic Interventions:
Approach:Individualized,trauma-informed,andculturallysensitivecare.
Availability:24/7therapeuticandpsychiatriccare.
PrimaryModels:
IndividualTherapy:Focusesonpersonalchallenges,traumaresolution,and copingskills.
GroupTherapy:Enhancessocialskills,problem-solving,andemotional regulation.
FamilyTherapy:Regularsessionstosupportfamilyreintegration.
24-HourPsychiatricNursingCare:Providescontinuousmonitoringandcare forbothphysicalandmentalhealthneeds.
SupplementaryModels:
RecreationalTherapy:Activitiesthatpromoteemotionalandphysical development.
MilieuTherapy:Asupportiveenvironmentthatallowsyouthtopractice socialandlifeskills.
AggressionReplacementTraining(ART):Astructured,evidence-based approachforreducingaggressionandimprovingsocialskills.
Treatment&Therapeutic Interventions:
AggressionReplacementTraining(ART)
ModelOverview:ARTisamulti-modalprogramaimedatreducing aggressionandpromotingprosocialbehavioramongadolescents.
ThreeKeyComponents:
SocialSkillsTraining:Teachesyouthconstructivebehaviorsthrough role-playingandmodeling.
AngerControlTraining:Guidesadolescentsinmanaginganger, identifyingtriggers,andapplyingself-regulationtechniques.
MoralReasoningTraining:Encouragesyouthtoconsiderother perspectivesinconflicts,fosteringempathyandresponsibledecisionmaking.
Structure:Conductedover10weeks,withthreeweeklygroupsessions focusingoneachcomponent
ExpectedOutcomes:Reducedaggressivebehaviors,improvedconflict resolutionskills,andstrongerpeerrelationships.
NeurosequentialModelofTherapeutics(NMT)
TheNeurosequentialModelofTherapeutics(NMT)isadevelopmentally sensitiveandneuro-biologicallyinformedapproachtoworkingwithchildren whohaveexperiencedtrauma.DevelopedbyDr.BrucePerryandthe ChildTraumaAcademy,NMTisbasedonextensiveresearchintotheimpactof earlychildhoodtraumaonthedevelopingbrain.
CoreConcepts
NMTfocusesonassistingchildreninformingnewpathwaysforhealthy braindevelopment.
Itprovidesaframeworkforassessingthechild,identifyingissuesand strengths,andapplyingeducational,enrichment,andtherapeutic interventions.
Themodelincludesanassessmenttoolthatproducesagraphical illustrationofthechild'scurrentbrainfunctioning,allowingforthe considerationofdevelopmentalriskandresiliencyfactors.
IntensivePsychiatricResidential Treatment(iPRTF)
WhatisiPRTF?
TheiPRTFprogramatAlexanderYouthNetworkcombinesresidentialcare fortroubledyouthwithintensivefamilysupportWhileachildreceives treatmentatourfacility,ourteamalsoworkswiththeirfamilyathome.This dualapproachaimstoshortenresidentialstays,betterpreparefamilies,and reducereadmissions.Byprovidingtherapybothon-siteandathome,we helpkidsreturnhomesoonerandstaytherelonger,improvingoutcomesfor bothchildrenandfamilies.
Focus:Providesenhancedfamilyengagement,decreasedlengthof stay,andimprovedoutcomesforadolescent’spost-discharge.
ServiceDelivery:Adedicatedteam,includingamaster’s-levelclinician andaFamilyPeerPartner,offersservicesbothintheresidentialsetting andinthechild’shometopreparethefamilyforsuccessfulreintegration.
TherapeuticFocus:Includesin-hometherapysessionsandon-site interventions,addressingchallengesinreal-time.
KeyComponents:
FamilyInvolvement:Beginsatadmission,withweeklyin-homefamily therapy,homepasses,andovernightvisitstopreparefamiliesfor reunification
SmallCaseloads:Serves4-6activeclients,allowingforfocused, individualizedcare,andsupports12-15post-dischargeclients.
ShorterLengthofStay:Providesintensivecareinashortertimeframe, aimingforfasterreunificationandreducedreadmissionrates.
ComprehensiveDischargePlanning:Beginsatadmission,ensuring continuityofcare,includingmentalhealthservices,schoolplacement, andcommunitysupports.
Post-DischargeFollow-Up:Continuesforuptooneyear,offeringhome visits,phoneconsultations,andcrisisinterventiontoensurestability duringtransition
ProgramExpectations
ProgramPhases:
InitialAssessment&Stabilization:Comprehensiveevaluationand treatmentplanningatadmission.
IntensiveIntervention:Daily,targetedtherapyandskills-building activities.
Transition&DischargePlanning:Focusedonpreparingyouthand familiesforcommunityreintegration.
Person-CenteredPlan(PCP):
Purpose:Directsindividualizedgoals,includingaCrisisPlanand TransitionPlan.
ChildandFamilyTeam:Includesfamilymembers,therapists,school personnel,andcommunitymembers.
ReviewProcess:Monthlyreviewstotrackprogressandadjustgoalsas needed.
Services(BasedonMedicalNecessity):
Individual,Group,andFamilyTherapy:Weeklysessionstailoredto eachyouth’sneeds.
CrisisManagement:Immediate,in-personortelephonicsupportas required.
IntensiveCaseManagement:Coordinatesservicesandsupportsfor successfulcommunityreintegration.
Psychoeducation:Educatesfamilymemberstoenhance understandingandsupportofthetreatmentprocess.
ClinicalOutcomes:
ACORNMeasurement:MonthlyevaluationsduringChildandFamily Teammeetings,integratedintothePCP
CGASAssessments:Conductedatadmissionanddischargeby licensedtherapiststomeasurefunctionalprogress.
DischargeMetrics:Trackspost-dischargestability,emergencyroom visits,andadherencetofollow-upservices.
ServiceTypeandSetting:
24/7structuredcareprovidingcontinuoustherapeuticandmedical support
Averagelengthofstay:90-120days,adjustedbasedonindividual progress
Year-roundavailability,minimumofthreehoursperday
Primarilyatlicensedsiteswithcommunityoutingsasneeded
ProgramStaff
Executive Director: Overall program management, ensuring adherence to service standards
Program Supervisor: Oversees daily operations, manages staffing
Licensed Psychologist or Licensed Psychologist Associate: Clinical oversight and specialized assessments
PRTF Therapists: Clinical interventions, therapy services, treatment planning
Qualified/Associate Professionals (QP/AP): Support program operations, handle intake, maintain medical charts
PRTF Coordinator: Provide comprehensive case management for PRTF clients, ensuring regular family contact, coordinating treatment plans, and monitoring client progress
Lead Behavioral Health Counselors: Coordinate direct care activities, supervise Behavioral Health Counselors, and ensure adherence to safety and intervention protocols
Behavioral Health Counselors: Implement interventions, provide direct support, manage therapeutic milieu
Nurse Manager: Lead the nursing team to provide quality healthcare for clients while ensuring regulatory compliance
Registered Nurse: Medical care and physical well-being monitoring
Special Education and General Education Teachers: Provide tailored educational services
Food Service Manager: Develops, directs, and evaluates the Food Services program; supervises food service employees; ensures compliance with nutritional, budgetary, and safety guidelines
Food Services Cook: Prepares and cooks nutritional, balanced meals for residents and employees
ProgramExpectations
TrainingandSupervision:
Comprehensiveonboardingincludingtrauma-informedcare,crisis intervention,NMT
Ongoingprofessionaldevelopmentandannualcertifications
Clinicalsupervisionunderboard-certifiedchildandadolescent psychiatrist
Regularperformanceevaluationsanddocumentationrequirements
SpecifictrainingincludesHandlewithCare,CPRforPRTF,TCIStress ModelofCrisis,MedManagement,developmentalassessments,and individualizedtreatmentplanning
Documentation:
ProgressNotes:Within24hoursofeachtherapeuticintervention
WeeklySummaries:Recordsprogressduringteammeetings
CrisisDocumentation:Detailedrecordsofincidentsandresolution strategies
MonthlyPCPReviews:DocumentedincollaborationwiththeChildand FamilyTeam
Accuratedocumentationofyouthprogress,treatmentplans,and interventionsensuringcompliancewithregulatorystandards
ProgramExpectations
IncidentReporting:
Anincidentorunusualoccurrenceisanyhappeningnotconsistentwith routineoperationorcarethatmayleadtoadverseeffectsonachildincare StaffmustcompleteanIncidentReportwheneversuchaneventoccurs,or theybecomeawareofone.
Examplesofreportableincidentsincludebutarenotlimitedto:
Injuryrequiringmedicalattention
Hospitalizationoroff-siteemergencyassessment
Suicidalthreatsorgestures
Possessionofaweaponorillegalsubstance
Allegationofmaltreatment
Runaway
Seriouspropertydestruction
Medicationerrors
Serioussexualactingout
Death
Rapeorsexualassault
Schoolsuspensionorremoval
Physicalaggressiontowardothers
ReportingProcess:
1.
NotifysupervisororQualifiedProfessional(QP)oncallwithin4hoursof theincident.
3.
2Completetheincidentreportassoonaspossible. . SupervisororQPwilltakeappropriateactionandcompleterelated documentation.
4.
Incidentsareclassifiedasminor(levelI),moderate(levelII),orserious (LevelIII).
5.
CriticalIncidents(LevelIIorIII)requireadditionalreportingintheNC IncidentResponseImprovementSystem(IRIS).
Additionalnotificationsmayberequiredforspecificincidents,suchas medicationerrorsorassaultallegations.
RestrictiveInterventionsGuide
ImportantNote
Beforeproceeding,pleasereviewtheBHPoliciesfoundinourAYNConnect PoliciesandProcedures.Thesepoliciesprovidecomprehensiveguidelinesthat complementthisguide.
Overview
Restrictiveinterventionsareemergencymeasuresusedonlywhenthere's imminentriskofharm.Ourgoalistominimizetheirusethroughproactive preventiontechniques.
KeyPointsforStaff
Authorization:Onlytrained,authorizedstaffmayinitiaterestrictive interventions.
Training:Youmustcompletetraininginde-escalation,physicalholding, clientmonitoring,CPR,andfirstaid.
Procedures:
Alicensedindependentpractitioner(LIP)mustordertheintervention. Documenteachinstancethoroughly. Followage-basedtimelimitsforrestraintorders. Continuouslymonitortheclientduringandaftertheintervention.
Discontinuation:
Stoptheinterventionassoonastheindividualiscalm. Informthechildofbehaviorcriteriaforendingtheintervention.
Post-Intervention:
Conductadebriefingwithin24hourswiththechild,staff,andwhen appropriate,thelegalcustodian.
PlannedInterventions:
MaybeincludedinthePerson-CenteredPlanifapprovedbytheClient RightsandEthicsCommittee. MustbereviewedmonthlybytheChildandFamilyTeam.
Remember:Ourprimaryfocusisonpreventionandde-escalation.Restrictive interventionsarealastresort.AlwaysrefertothefullBHPoliciesinAYNConnect forcompleteandup-to-dateinformation.
ProgressNotesExpectation
ShiftResponsibility
LeadBHCsareresponsibleforensuringalldocumentationiscompleted duringtheirshifts.
IfnoLeadBHCispresent,thisresponsibilityfallstotheProgram Manager.
End-of-ShiftConfirmation
LeadBHCsmustconfirmallprogressnotesarecompletedbefore endingtheirshift.
Thisconfirmationisrequiredeveryshift,everyday.
ProgramManagerOversight
ProgramManagersmusttagprogressnoteswithin24hours. Incompletenotesrequireimmediatedisciplinaryaction,includinga writtenwarning.
WrittenwarningsmustbesubmittedtotheExecutiveDirectorwithin24 hoursoftheinfraction.
QualityandCompliance
Allstaffareaccountableforfulfillingdocumentationduties. Documentationmustbecomplete,accurate,andtimelytoensure funding,qualitycare,andlegalcompliance.
ContinuousImprovement
ProgramManagersmustaddressdocumentationinconsistencies promptly.
Staffshouldstriveforongoingimprovementindocumentationpractices.
Remember
Accuratedocumentationimpactsfunding,qualityofcare,andlegal compliance.
CommunicationbetweenProgramManagers,LeadBHCs,andstaffiscrucial formaintaininghighdocumentationstandards
Consistentlymeetingtheseexpectationsisessentialforjobperformance andcontinuedemployment.
LeadBHCsareresponsibleforensuringallstaffcompletetheirdocumentation bytheendoftheirshiftswithProgramManagersprovidingoversightand addressinganyinconsistenciespromptly.
ProgramExpectations
Referrals:
Accepted Sources: Referrals are accepted from schools, social service agencies, healthcare providers, mental health providers, juvenile justice, and families.
Processed By: Managed through the Alexander Youth Network Access Department, ensuring all documentation is complete and evaluating the appropriateness of the referral.
Criteria for Appropriateness: Youth must meet the medical necessity for the highest level of residential care, including those with significant emotional or behavioral challenges.
Exclusion Criteria: Referrals are not appropriate for youth whose primary diagnosis is substance abuse without accompanying behavioral health needs.
Alternative Recommendations: If the PRTF program is not suitable for a child, the Access Department will recommend alternate services to meet the child’s needs.
Final Note:
Our staff are more than caregivers; they are mentors, guides, and advocates for each adolescent’s future. By engaging deeply with youth and their families, they foster resilience, build hope, and ensure that every transition is a step toward a brighter tomorrow. Your dedication makes a difference every day. Together, we are shaping a path toward recovery and success for every young person we serve.
IntroducingAlexander'sOneStopShop:
CentralizedResourceFolder:Accessourcollaborativedocumentlibrary, whereinterdepartmentalfilesharingbecomeseffortless.
PoliciesandProcedures:Neverwonderwheretofindcriticalinformation again.Accessallagencypoliciesandproceduresinonecentralized,easy-tonavigatelocation.
DedicatedTeamSites:Eachdepartmentenjoysatailoreddigitalspacefor filestorageandteamwork,enhancingproductivityandorganization.
AYNStream:UnlockthefullpotentialofAYNConnectwithlivestreamsand videotutorials,ensuringyou'realwaysup-to-speedwithourlatestfeatures.
VivaEngage:YourCommunicationPowerhouseStayconnectedwith colleaguesthroughthisdynamicplatformforannouncements,discussions, andtimelyupdates.
AYNConnectisn'tjustatool;it'syourgatewaytoamoreefficient,collaborative, andinformedworkexperience.Embracethefutureofworkplaceconnectivity withAYNConnect–whereinformationmeetsinnovation.
PoliciesandProcedures: AgencyWide
Agency Policies
Agency Policies Click Here
Agency Procedures
AYN Connect
At Alexander Youth Network, we provide top-quality care through comprehensive policies ensuring safety and consistency. Visit our Policies & Procedures page on AYN Connect for more information.
Access Our Policies Instantly!
Get to know our agency policies in no time. Simply click the folder to your left and find all the important guidelines at your fingertips.
Employee Handbook
Behavior Healthcare Policies IT Policy
Need to find our Agency Procedures?
Click the folder to your left and access all our Agency Procedures instantly!
CCA and Reassessment Procedure
Agency Procedures Click Here
Emergency and Inpatient Notifications
IHAP Procedure
Handle with Care Physical Intervention
Emergency and Inpatient Notifications
AYN Connect
Program Procedures
Program Procedures is designed to assist our staff in efficiently accessing and implementing essential protocols within your PRTF-RTC program. By following these procedures, we collectively contribute to delivering the best possible care and services to the youth under our care.
Here are some of the most frequently used procedures:
Procedures - RTC Progress notes submission
RTC 3rd Shift Supervision Procedure
RTC 3rd Shift Support Procedure
DiscoverPRTF-RTCProgram ProceduresStreamlined!
Simplyclickthefoldertoyourrighttoaccessthe streamlinedPRTF-RTCProcedures!
PRTF-RTC Procedures Click Here
Procedures Streamlined Click Here
AYNConnect: ResourceFolder
Resource Folder
Welcome to AYN Connect's Resource Folder, designed to support all staff with comprehensive departmental information, standardized templates, checklists, forms, best practices, and training materials. This centralized hub ensures you have the tools and resources needed for success. Our goal is to equip you for excellence and enhance our mission.
AYN Connect
AYN Connect - Resource Folder Click Here
Welcome to the PRTF-RTC Resource Folder! Here, you'll find essential tools, guidelines, templates, checklists, workflows, forms, and training materials tailored for the PRTF-RTC program. Access and contribute valuable resources to empower your team and support our mission effectively.
PRTF-RTC Resources Click Here
Explore the Top PRTF-RTC Resources Available Inside!
Administrative Staff
iPRTF Folder
Self-Care-Assessment
Feelings Chart
Relationship Conflict Resolution
Self Aware (TCI) Training for parents
Automatic Thoughts
EnvironmentofCare (EOC)
The EOC is a comprehensive approach to safety and well-being within our organization.
Key Points Include:
Safety Philosophy
Highest safety standards in all operations
Safety is everyone's responsibility
Prevention of injury and illness is a primary goal
EOC Committee
Assists in implementing campus safety plans, policies, and procedures
Develops, implements, and evaluates the safety program
Aims to create and maintain a safetyconscious environment
Principles:
All injuries and accidents are preventable
Safety is the first consideration in all workplace actions
Written safety plans are essential
Off-job safety awareness is encouraged
Employee Expectations
Follow all safety program aspects
Contribute to a safe, organized, and efficient workplace
Know and follow written safety plans
Suggest improvements to the safety program
Enviroment of Care Resources
Explore the top resources!
Safety Checklist
Medication Resources
Safety Plan
Logs Checklist
Discharge Resources
Field Trip Permission Form
MAR EOC Plan
Program Sinage Power Outage Flowchart
EchoVantage
At Alexander Youth Network, we use EchoVantage to streamline our operations and ensure we provide the best care possible. EchoVantage is an advanced electronic health record (EHR) system designed specifically for behavioral health organizations, and it's a key tool in our daily work.
WhatisEchoVantage?
Click Here
EchoVantage’s Knowledge Base
EchoVantageisacomprehensiveEHRsystemthatintegratesvariousaspectsof clientmanagement,documentation,billing,andreporting.Ithelpsusmaintain accurateandup-to-dateclientrecords,manageappointments,andensure compliancewithindustrystandardsandregulations.
KeyUses
ClientManagement:Maintaindetailedclientprofilesandtreatmentplans. Scheduling:Manageandcoordinateappointments.
Documentation:RecordSessions,ProgressNotes,andIncidentReport.
Billing:Automatebillingandclaimssubmission.
Reporting:Generatereportsforperformancetrackingandcompliance.
AYN Stream - EchoVantage
Visit our playlist on AYN Stream, you'll find a collection of recordings that offer: Guidance and Support: Step-by-step video guides on logging in, troubleshooting, and using new updates.
New Feature Explanations: Detailed breakdowns of the latest EchoVantage features. Assessment and Note Guides: Comprehensive tutorials on conducting assessments and managing notes effectively.
EchoVantage Videos Tutorials
NeedSupport? AskAlexAI
Create a Ticket
Access Teams: O Microsoft Teams. 1.
Open AlexAI: Fin con and click 2.
Restart Session: Click restart" or type it. 3. Open Ticket: Click "Open a New Ticket". 4. Select Support Team: Click the right team. 5. Enter Request: Provide lots of details. 6. Submit Ticket & Attach files if needed. 7.
Restart & Quit Commands
Starting a Conversation: Type "restart" to clear previous chats and start fresh
Ending a Conversation: Type "quit" to properly end the conversation.
Switching Topics: Type "quit" to end the current topic, then "restart" to begin a new one This keeps the chatbot on track Click Here: AlexAI Tips & Tricks
Paycom is a comprehensive and user-friendly HRIS solution where we complete HR processes (submitting timesheets / time off requests, viewing benefits, etc.)
Learn more: AYN Connect: Paycom
Need Help? Visit Paycom’s Help Center
Paycom offers a comprehensive Knowledge Base with 125 articles and guides on features and troubleshooting. Additionally, there are 123 step-by-step instructional videos and FAQs addressing common questions on various topics.
Examples of tutorials in Paycom’s Help Center:
Benefits: Show Me How: to Enroll in Benefits
Paycom Basics: Payroll: Show Me How: to Approve My Check (Mobile)
Payroll: Show Me How: to Set Up My Direct Deposit
Time Management: Show Me How: to Approve My Timecard
Time Management: Show Me How: to Submit a Punch Change Request
Time-Off Requests: Show Me How: to Request Time Off (Video)
Scheduling: Show Me How: to Review My Schedule
Scheduling: Show Me How: to Offer and Pick Up Shifts
Click Here: Show Me How to Download the iOS App
Click Here: Show Me How to Download the Android App
NextSteps
Thank you for taking the time to read through our PRTF-RTC Program Playbook. We hope this resource has provided you with clear expectations, useful guidelines, and valuable insights to help you thrive in your role. If you have any questions please contact your manager, search the PRTF-RTC SharePoint site, or ask AlexAI for assistance.
Recap of Key Points
Program Expectations: Understand the standards and responsibilities for PRTFRTC staff.
Streamlined Procedures: Follow the outlined processes for efficient and effective operations.
Resources and Tools: Access the tools and information you need to succeed.
Your Role in Our Mission
Each member of our team plays a vital role in achieving our mission to provide exceptional care and support to those we serve. Your dedication, professionalism, and compassion make a significant impact.
Stay Connected
For ongoing support and updates, stay connected through:
Microsoft Teams: Join discussions, ask questions, and share insights
SharePoint: Access the latest documents, updates, and resources
Stream Videos: Watch quick demos and tutorials for visual guidance
Looking Forward
We are excited to have you as part of our team and look forward to your contributions. Together, we can achieve excellence and make a difference in the lives of those we serve.
Thankyou,
AlexanderYouthNetwork
THE PLAYBOOK Empowering Our Team with Clear Goals and Collaborative Success