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Mental Health Resources |
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Introduction Direct Service
Resources Mental Health Resources
Educational Resources Informational Resources Appendices
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"It is
easier to build strong children than to repair broken adults."
Children often have experienced a number of traumatic events in their lives which require formal kinds of treatment. Birth family difficulties and related losses, genetic predispositions to learning disabilities and mental illness, and pre-birth trauma such as fetal alcohol syndrome are just a few of the factors that can impact a child’s emotional development. Some of the more common conditions that result from these influences include depression, anxiety, and attachment difficulties. Finding appropriate mental health care can bring relief from acute symptoms for the child and make it possible for the family to maintain a stable home environment. The process of identifying root causes of a condition and implementing a plan for treatment can be a long term and complex process that requires persistence and self-education on the part of parents. The ultimate reward of successful intervention in childhood is a solid foundation on which to build a more secure and successful life as an adult. Mental Health Services in Maine Private non-profit agencies and independent licensed clinicians provide nearly all of the community mental health services in Maine. Some community mental health centers are multi-purpose providers with more than one location, and some are smaller single service organizations that are specific to one community. In locations where service providers are stretched, new patients that are not in a life-threatening crisis may have to wait several weeks or longer before the first appointment. It is important for a family to understand how the system works, the terminology that is used, forms of treatment, and how to get needed services in an affordable way. NAMI (National Alliance for the Mentally Ill) of Maine is one advocacy group that can help people navigate the mental health system. Local chapters of NAMI can be found in the resource lists on the following pages. Finding a Therapist for Your Adopted Child You might seek recommendations from other adoptive parents, statewide adoptive and foster parent organizations, or a trusted human services professional. Parents also may inquire at community mental health agencies, mental health associations, universities, or medical schools with psychology and psychiatry departments. Finding appropriate mental health care for a child requires assertiveness and advocacy from parents. Ask for a preliminary interview with a therapist, so that you can determine if he or she is a good match for your child’s needs and personality. Below are some questions you might ask during this initial meeting. Questions to Ask a Prospective Therapist
Types of Mental Health PractitionersPsychiatrist: A psychiatrist is a physician – a medical doctor – whose education includes a medical degree (M.D. or D.O.) and at least four additional years of study and training. Psychiatrists who pass the national examination administered by the American Board of Psychiatry and Neurology are board certified in psychiatry. Psychiatrists provide medical/psychiatric evaluation and treatment for emotional and behavioral problems and psychiatric disorders. As physicians, psychiatrists can prescribe and monitor medications. Licensed Clinical Psychologist: Someone who has completed a doctorate degree in Psychology, as well as advanced courses in human emotional development, psychological testing, and psychotherapy. Psychologists in Maine must go through a licensing process in order to practice. Licensed Clinical Social Worker (LCSW): Someone with a Master’s Degree in Social Work (MSW) who has completed a minimum of two years of supervised counseling practice after receiving an MSW and who has passed a state-recognized clinical level exam. Social Workers tend to view a person or family in the context of the social, cultural, and physical environments, and work with clients to identify strengths which can assist in the problem-solving process. Licensed Clinical Professional Counselor (LCPC): Someone with a Master’s degree, usually in Counseling, Education, or Psychology, who has practiced under the supervision of a licensed clinician, passed designated professional exams, and met other licensing requirements. LCPC’s offer counseling which targets improved communication skills and strengthened family relationships. Psychiatric Nurse Practitioner (NP): Someone with a medical nursing background who has received additional training in mental health counseling and treatment, including medication management. Licensed Substance Abuse Counselor (LSAC): A Master’s level mental health counselor who has completed additional training, college level courses, and practice experience related to chemical dependency treatment and who has passed written and oral state certification exams. Types of TherapyThere are as many approaches to therapy as there are practicing mental health clinicians. Most experienced therapists use a variety of techniques (also called “modalities”) for working with clients. They recognize that each person and family is unique and that “one size does not fit all.” It is important that your therapist clearly states what kinds of therapy he or she intends to use in working with your child and/or family, how each works, how many sessions will be involved, and what outcomes can be expected from the treatment process. You will also need to consider if your health insurance covers only certain types of treatment and/or certain providers, and how many visits are allowed. Psychotherapy Psychotherapy has become a generic term for on-going individual counseling. However, this term actually refers to the techniques of Sigmund Freud, in which the therapist asks the client to describe past events, interpersonal relationships, and dreams in order to uncover hidden drives and desires that exist within the client’s subconscious. You might think of the stereotype in which the client lies on the couch while the therapist scribbles notes at a desk, grunting “I see” and “ah-hah” in response to the client’s statements. Today’s psychotherapy is much more conversational and informal. Building trust, having investment from both client and therapist, and focusing on a client’s strengths are seen as the foundation for successful intervention. The client and therapist work together to identify major difficulties, contributing factors, and personal strengths. Strategies for improving coping skills and quality of life are also developed with the client’s input. During treatment, the therapist will offer challenges, interpretations, support, and feedback to the patient. Family Therapy This modality views the family as a system in which each member has an impact on every other member. The family is compared to a hanging mobile—when one part moves, every other part also moves in response. The therapist promotes the idea that everyone in the family has some responsibility for how the family functions, and avoids placing blame on a single family member. Adoptive families often confront issues of belonging, loyalty, entitlement, and attachment, and many therapists experienced with adoptive families find a family systems approach to be the most helpful in dealing with these issues. By working with all available family members in group sessions, the therapist gains direct experience with a family’s dynamics. Skills for improved communication and dealing with difficult situations can be practiced with coaching and feedback during each session. Play Therapy Therapists customarily use this form of therapy with very young children, who may not be able to describe events and express feelings with words. The therapist may engage the child in games using dolls and other symbolic toys. Through gentle questioning, the therapist will help the child to tell what is going on emotionally. In this way, the child may be able to act out feelings and reveal emotional trauma that had not be previously expressed. Group Therapy Therapists sometimes use this modality for a group of patients with similar issues, such as adolescents, adult survivors of sexual abuse, and people with addictions. Group therapy allows a small group of people (usually no more than 8) to share common struggles, practice communication skills, and challenge each other to develop better ways of coping. It is not unusual for participants to receive individual counseling in conjunction with group therapy. Group therapy is different from a support group, which is usually run by group members and is more focused on sharing information and providing general emotional support, and is not “therapeutic” per se. Behavior Modification When a child exhibits specific behaviors that are significantly disruptive or dangerous to him or others, reducing the frequency of the targeted behaviors becomes a first priority. Behavior modification refers to techniques that use immediate rewards and consequences to encourage the child to replace unacceptable behavior with desirable behavior. The therapist will identify specific changes desired and will establish a system of rewards and consequences. The reasons behind objectionable behavior are seen as irrelevant; the focus is on change. This therapy is especially useful with children who may not be inclined or able to examine and understand their inner feelings. The therapist may suggest that rewards be given to children even for little things such as talking with their adoptive parents or becoming involved in activities instead of withdrawing to their rooms. Most children respond enthusiastically to getting these rewards. “Consequence” usually refers to loss of a privilege or reward. Neurofeedback Neurofeedback is a newer treatment approach which is being used with children and adults who have Attention Deficit Hyperactivity Disorder (ADHD). It involves monitoring a patient’s brain wave patterns with an electronic device (EEG). The goal is to increase the amount of brainwaves associated with concentration and reduce the amount brainwaves associated with distraction and/or hyperactivity. EMDR EMDR (Eye Movement Desensitization and Reprocessing) is a fairly new technique used in individual therapy. It is primarily used with children and adults who have experienced traumatic events such as emotional, physical, and sexual abuse, warfare/violent events, and natural disasters and who experience post-traumatic stress disorder (PTSD – a condition with anxiety-type symptoms) as a result. During EMDR treatment, the therapist asks the client to think about a particular traumatic event. As the client remembers, the therapist provides a repetitive visual, auditory, or tactile (touch) stimulation, such as waving two fingers in front of the client’s eyes, or having the client wear a headset which emits a sound that alternates between the right and left earpieces. Although no one knows for sure, it is thought that alternate stimulation of the two sides of the brain somehow helps to “reprocess” memories of traumatic events in a way that reduces their emotional impact. Research studies indicate that EMDR can produce positive results in as few as 2-5 sessions. Before agreeing to EMDR treatment for your child or yourself, be sure the clinician is a licensed mental health practitioner who has received formal training in EMDR therapy. Attachment Therapy Many adopted children experience difficulties with trust and attachment. Separation from one’s birth parents/family, however abusive or inadequate the relationships may have been, can be powerful enough to create long-term barriers to attachment with other care giving adults. Multiple foster home placements prior to adoption can add to the impact of the original separation. There are many different approaches to working with attachment difficulties, some of which are quite controversial. If your child has been formally evaluated and significant attachment issues have been identified, ask your adoption caseworker, your child’s psychiatrist or mental health counselor if attachment therapy would be an appropriate treatment option for your child. As with all medical and mental health providers, make sure the person treating your child has the required professional licenses, training, experience, and recommendations from other professionals before you accept his or her services. Drug and Alcohol TreatmentAddiction and substance abuse, although closely linked with mental health concerns, require special treatment and support services. Intensive in-patient treatment, usually lasting 21 to 28 days, is available, as is outpatient treatment via individual counseling and group therapy. Some children and adults with substance abuse concerns have a “dual diagnosis” in which there are also chronic mental health issues needing attention. Many community mental health centers have their own substance abuse programs, which makes coordination of the two forms of treatment much easier. Other youth substance abuse resources are linked with Maine’s juvenile justice system. The costs associated with substance abuse treatment are covered to varying degrees by private medical insurance, Medicare, and MaineCare. Maine’s Office of Substance Abuse also has funds available for youth without insurance coverage for substance abuse treatement. Peer-led “twelve-step” programs such as AA, Alanon, ACOA (Adult Children of Alcoholics), and NA (Narcotics Anonymous) provide on-going support through meetings and phone contact for people with addictions and their loved ones. Attendance at twelve step meetings is often one component of an addicted person’s treatment plan. These services are provided at no cost to participants (donations may be accepted). For more information on assessment and treatment options, you can contact your local mental health center, or use the following resource numbers. Maine’s Office of Substance Abuse Services has a listing of providers on its website. For alcohol or drug-related emergencies, call one of the crisis hotlines below. Day
One Services: Youth substance abuse prevention and treatment, including residential and outpatient treatment and a parent support program. Department
of Behavioral and Developmental Services Al-Anon
(national help line) Alateen
(ages 12 to 20) Alcoholics
Anonymous (statewide) Alcoholics
Anonymous, Al-Anon, Adult Children of Alcoholics (statewide) NA
(Narcotics Anonymous) Statewide Hotline Crisis Intervention ServicesIf a family member is in danger of hurting him/herself or others, or otherwise cannot wait to see an outpatient therapist, there are toll-free mental health crisis lines available 24 hours a day. When necessary, a crisis intervention professional can come to your home or wherever the person in crisis is located, to do an emergency assessment for safety and referral to the appropriate level of services. There are also a number of crisis stabilization programs throughout the state which offer brief out-of-home placements for children who need to be in a secure setting but who do not meet the criteria for admission to a psychiatric hospital. These programs can be accessed through the existing statewide crisis intervention resources listed below. Crisis lines by region:
Outpatient Mental Health ServicesTherapist
Info-Line (Statewide) Services: A referral service for people seeking various types of mental health support. The info-line is staffed by therapists and trained volunteers, who ask callers about their location, specific needs, preferences, and payment options. The specifications are then used to pull the names and contact information of at least therapists from a statewide database. [Androscoggin] [Aroostook] [Cumberland] [Franklin] [Hancock] [Kennebec] [Knox] [Lincoln] [Oxford] [Penobscot] [Piscataquis] [Sagadahoc] [Somerset] [Waldo] [Washington] [York] Androscoggin CountyKidsPeace Tri-County
Mental Health Services Aroostook CountyAroostook
Mental Health Center
Community Health and Counseling Services
Cumberland CountyThe
Anchor Program Services: Mental health assessment and intensive clinical services for children age birth to 18 years who have MaineCare coverage. Community
Based Counseling Services: Counseling for individuals, couples, families, children, adolescents, and the elderly. Community
Counseling Center Services: Counseling and psychotherapy for children, adolescents and adults, family and couples’ counseling, treatment for survivors of sexual abuse, case management for children (age 0-21) with special needs, geriatric mental health and support programs. Dialogue
Center Services: Individual and family counseling for people without medical insurance or those who cannot afford standard fees or co-payment. Family Institute of
Maine Services: Individual, group, couples, and family counseling services. Substance abuse treatment, psycho educational services for children with learning disabilities, eating disorder treatment, stress management. Child
and Adolescent Consultation-Liaison Psychiatry Service Services: This program works with children and adolescents who have both medical and psychiatric problems; for example, those with psychological problems that present as physical symptoms. Franklin CountyEvergreen
Behavioral Services Services: 24 hour emergency services, outpatient counseling for individuals, families, and couples, chronic pain treatment, evaluation, substance abuse treatment, medication management. New
Directions Services: Outpatient substance abuse and mental health counseling for individuals and families. Protea
Behavioral Health Services Services: Outpatient therapy, children’s in-home support services, medication management, substance abuse treatment, and psychological testing. Tri-County
Mental Health Services Services: Outpatient mental health and substance abuse programs, crisis services. Hancock CountyCommunity
Health and Counseling Services Downeast
Community Mental Health Center Family
Counseling Services Protea
Behavioral Health Services Services: Outpatient therapy, children’s in-home support services, medication management, substance abuse treatment, and psychological testing. Kennebec CountyCrisis
and Counseling Services Services: Mental health, substance abuse, and dual diagnosis outpatient services for adults, children/adolescents, families, and couples. Community
Health and Counseling Services Services: Community-based residential and outpatient programs for children with emotional and behavioral challenges and their families. International
Adoption Services Center, Inc. (IASC) Services: To assist adoptive parents and children to maintain a stable permanency plan and reduce possible disruption. Kennebec Valley Mental Health Services
Services: Individual, marital, and family counseling services, child abuse services, medication clinic, substance abuse treatment, eating disorders clinic. Maine Children’s
Home for Little Wanderers Services: This Center specializes in the provision of outpatient counseling services for those affected by adoption. Services are available to all members of the adoption triad, (birthparents, adoptees, and adoptive families). Through the Family Care Program, adoptive families can also access temporary respite care for children (infants through age 18). New Directions/ Health Reach Network
Services: Outpatient substance abuse and mental health services to individuals, groups, and families. Protea Behavioral Health Services
Services: Outpatient therapy, children’s in-home support services, medication management, substance abuse treatment, and psychological testing. Knox CountyMid-Coast
Mental Health Center Services: Individual, group, and family therapy, medication management, in-school counseling, children’s community support services, children’s in-home support, case management for children, early start services, substance abuse services. Lincoln CountySweetser
(located in Sagadahoc County, but serves Lincoln county residents) Services: Individual and family counseling for children, adolescents, adults, and elderly. Oxford CountyTri-County Mental Health Services
Services: Outpatient mental health counseling for individuals, families, and couples. Substance abuse evaluation and treatment, crisis services. Penobscot County
Developmental Pediatrics Eastern Maine Medical Center 489 State Street Bangor, ME 04401 (207)973-7572
Eastern Maine Counseling and Testing 680 Evergreen Woods Bangor, ME 04401 (207)942-9305
Protea
Behavioral Health Services Services: Outpatient therapy, children’s in-home support services, medication management, substance abuse treatment, and psychological testing.
Somerset CountyCommunity
Health and Counseling Services Kennebec
Valley Mental Health Center New
Directions/Health Reach Network Waldo CountyMid-Coast
Mental Health Center Washington CountyCommunity Health and Counseling Services
Protea Behavioral Health Services
Services: Outpatient therapy, children’s in-home support services, medication management, substance abuse treatment, and psychological testing. Washington
County Psychotherapy Associates York CountyCommunity Based Counseling Counseling Services, Inc.
Grief and Loss Support for ChildrenCenter
for Grieving Children Services:
Pathfinders Services: Support groups for grieving children. Out of Home TreatmentWhen a child does not have life-threatening safety issues that require hospitalization, but is behaving in ways that are unmanageable at home or is in acute emotional distress, he or she may benefit from the structured environment of a residential treatment center. These programs focus on the development of positive coping skills and self-responsibility, often utilizing behavior modification therapies in which the child must exhibit appropriate behaviors in order to receive privileges and desired rewards. The goal is to enable the child to return home with these new skills in place. Parents are required to stay involved with the assessment, treatment planning, and discharge processes. Family connections can help to motivate a child to use positive coping skills and behaviors so that he or she can return home. Some residential programs provide chemical dependency treatment, while others work with pregnant and/or parenting teens. Most provide mental health assessment and counseling. Residential treatment facilities are located in individual community homes or in a campus type setting. Generally, 8 to 12 children live with "house parents" who provide supervision for daily living activities. Mental health clinicians and other treatment providers are a part of each care plan. The children attend school either at the facility or in a community school and have scheduled visits with their parents. The following page describes the services and case management procedures provided by Children’s Behavioral Health Services, (formerly: Department of Behavioral and Developmental Services) in relation to these kinds of services. Accessing
Out-of-Home Treatment
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Alternative
Services |
Rumford
Group Homes |
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Goodwill
Homes for Boys and Girls |
St.
Andre’s Home, Inc. |
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Ingraham
- MaineStay |
The
Spurwink School |
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Atrium
House West |
Sweetser
Children’s Services |
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KidsPeace
National Centers |
Weymouth
House, Inc. |
Inpatient Psychiatric Treatment
When a child or adolescent’s behavior indicates that he or she is either imminently suicidal or a danger to others, emergency psychiatric intervention should be pursued. If the crisis is prolonged, hospitalization may be the only way to protect the child and family. When a child is admitted to this level of care, he or she will be evaluated, and treatment goals will be set. Parental involvement is critical for creating appropriate treatment plans during and after inpatient care, and most child and adolescent units of psychiatric hospitals require parent participation in family meetings or therapy. Parents should ask to see their child's treatment plan and ask questions about how it will be accomplished and what type of support is available after the child is discharged.
Inpatient Psychiatric Facilities
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Acadia
Hospital |
St.
Mary’s Regional Medical Center |
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Augusta
Mental Health Institute |
Seton
Unit |
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Maine
Medical Center |
Spring
Harbor Hospital |
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Northern
Maine Medical Center |
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National Alliance for the Mentally Ill (NAMI), Maine Chapter
NAMI Maine is a family-centered, nonprofit organization dedicated to improving the quality of life for everyone affected by mental illness. Services are provided both directly and through a statewide structure of local affiliates and support groups. For the most current information about support groups, please contact Deb Daniels at 1-800-464-5767 or 207-622-5767.
Click here for a NAMI chapter near you.
National Resources for Children’s Mental Health
American
Academy of Child and Adolescent Psychiatry
Washington, DC
800-333-7636
www.aacap.org
American
Psychiatric Association
Washington, DC
(202)966-7300
www.aacap.org
Anxiety
Disorders Association of America
Rockville, MD
(301)231-9350
www.adaa.org
Child
Trauma Academy
www.childtrauma.org
Federation
of Families for Children’s Mental Health
Alexandria, VA
(703)684-7710
www.ffcmh.org
Maine
Association for Infant Mental Health
592 Sawyer Road
Greene, ME 04236
(207)375-8184