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Introduction. Presenters ProfilesWhat is Specialist Intervention Service?Why Port Macquarie?What services we can offer...How to access Medicare services?How accessing our services can helpMental health and disabilityStress and its impact on the carersAutism Spectrum DisordersHow to contact
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1. DSA Specialist Intervention Servicescommencing psychological services at Port Macquarie 3 November 2008
Mercure Centro
2. Introduction Presenters Profiles
What is Specialist Intervention Service?
Why Port Macquarie?
What services we can offer...
How to access Medicare services?
How accessing our services can help
Mental health and disability
Stress and its impact on the carers
Autism Spectrum Disorders
How to contact us?
Questions
3. Presenters Profiles Specialist Intervention Services Team members presenting today....
Laura LeVan - Consultant Psychologist
Lorraine Teeuwen – Green (Assistant Manager/ Psychologist)
Ewa Geba – Consultancy Manager /Principal Psychologist
4. DSA Specialist Intervention Services Disability Services Australia is a not-for-profit organisation (NGO) providing services to people with a disability for over 50 years.
The Specialist Intervention Services (SIS) provide psychological and speech pathology services for children, adolescents and adults across several areas of the Sydney Metropolitan as well as regional areas of NSW.
Specialist Intervention Service specialises in intervention and consultancy services for people with a disability who are displaying challenging behaviours, their families, and people working in the disability field (special interest in ASD and DD).
5. Who are we? SIS Consultants are experienced and highly skilled in the delivery of individualised intervention services aimed at assisting people to learn functional skills and strategies in order to deal positively with life experiences and situations.
We consist of:
8 Registered Psychologists (3 Seniors)
3 Intern Psychologists
1 Speech Pathologist
1 Administration Support / Intake Officer
6. SIS Services available in NSW DADHC Funded Behaviour Intervention and Support
(Sydney South East & Inner West)
Consultancy services to DSA Supported Accommodation and Day Services
Fee for service Consultancy (all areas)
Medicare services (Redfern, Seven Hills, Bankstown, Campbelltown, Taren Point, Moss Vale and now
Port Macquarie!)
Early Intervention for children with ASD (0-6) coming soon
7. Why Port Macquarie? Partnership with ACES Inc.
Identified need for psychological services for adults with a disability and challenging behaviours
Need for more services for people with ASD
Need for more services and programs to support families and staff
Promoting mental health awareness
Developing partnerships and networks
8. Services available in Port Macquarie Assessments & Reports (cognitive, functional, disability, ASD, mental health, Guardianship, DADHC eligibility)
Psycho-education (sexual knowledge, disability specific, Autism, mental health), motivational interviewing
Behaviour Intervention and Support
Intervention for Anxiety and Depression (SFBT, CBT)
Relaxation Programs
Skills Development Training Problem Solving Skills; Anger Management; Social Skills Training; Communication Training; Stress Management; Parenting Skills Training
Autism and Disability Consultancy (Early Intervention*)
Training and Support to staff
Supervision for Intern Psychologists
9. How to access Medicare Services
GP / Pediatrician / Psychiatrist referral is necessary
SIS Medicare Services are available to any person eligible under:
“Enhanced Primary Care ”
“Better Access to Mental Health Care”
“Helping Children with Autism”
GP – In order to access our Medicare Services a.......
Initiatives – Your Doctor can provide you with further details on eligibility under these initiatives.GP – In order to access our Medicare Services a.......
Initiatives – Your Doctor can provide you with further details on eligibility under these initiatives.
10. Enhanced Primary Care - Eligibility Persons with chronic conditions and complex care needs
The GP has to provide a referral letter and ECP
5 sessions (30 min) per year for allied health professionals
Only individual service not a group
The referral lasts for 12 months
Allied health services include psychologists, speech pathologists, OT, physio, dieticians, podiatrists, audiologists, Aboriginal health, chiropractors, diabetes educators, osteopaths)
11. Better Access to Mental Health... Introduced in November 2006
Persons with an assessed mental disorder (e.g depression, anxiety)
Services:
Psychological therapy ( individual and group)
Solution focussed psychological strategies
12 ind. sessions per year (18) + 12 group (6-10)
Session length – 30 -50 min
Requirements:
Referral letter GP/Paediatrician /Psyciiatrist+ Mental Health Care Plan
12. Helping Children with Autism scheme Introduced in July 2008
Access to assessment and intervention services provided by Paediatricians/Psychologists/Speech Pathologists/OT
Eligible children under the age of 12 – 15
Services
Assessment (5 sessions) &
Intervention (20 sessions) per child per lifespan, to be shared
Requirements:
Referral from Paediatrician + ASD Management Plan
13. How accessing our services can help? Enhance generic services available to individuals with a disability, especially those who have mental health issues
Reduce waiting lists of other government and non-government organisations
Assist with family support during times of crisis
Assist in the improvement of the health and well being of persons with a disability
Assist with the development of resilience and coping skills for long term benefit. Point one: Medicare services can assist people with a disability to maintain their access to other services for example a person who is experiencing anxiety when involved in activities with groups could access assistance to manage their anxiety and therefore assisting in their access to work or Day Services.
Point two: We are currently seeing a number of clients who are waiting for assistance with behaviour intervention and support from other NGOs and Government agencies. In this way people can have access to some assistance while they wait.
Point three: Families can often be unable to receive assistance for associated concerns when their family member is receiving support from disability services. Medicare offers a pathway towards assisting families when they require it.
Point four: As you will see further in our presentation PWD are often experiencing higher levels of mental health concerns than the rest of the population. Psychological services through medicare can assist in the management of these issues particularly for those who would not ordinarily have access to private providers due to financial restraints or whose access could be limited by their disability or challenging behaviours.
Point five: In order to reduce symptoms of mental illness / disorders and to assist with life transitions Psychological services can offer a range of options for people with a disability, their families and carers.Point one: Medicare services can assist people with a disability to maintain their access to other services for example a person who is experiencing anxiety when involved in activities with groups could access assistance to manage their anxiety and therefore assisting in their access to work or Day Services.
Point two: We are currently seeing a number of clients who are waiting for assistance with behaviour intervention and support from other NGOs and Government agencies. In this way people can have access to some assistance while they wait.
Point three: Families can often be unable to receive assistance for associated concerns when their family member is receiving support from disability services. Medicare offers a pathway towards assisting families when they require it.
Point four: As you will see further in our presentation PWD are often experiencing higher levels of mental health concerns than the rest of the population. Psychological services through medicare can assist in the management of these issues particularly for those who would not ordinarily have access to private providers due to financial restraints or whose access could be limited by their disability or challenging behaviours.
Point five: In order to reduce symptoms of mental illness / disorders and to assist with life transitions Psychological services can offer a range of options for people with a disability, their families and carers.
14. Advantages of Medicare Items Clients often bring themselves to therapy
Short term progress is often visable
Provides individualised services to family members
Assists with waiting time for other services
Encourages parents participation in therapy
Assists in improving quality of life outcomes for individuals with disabilities within existing services
15. Disadvantages of Medicare items Short term intervention and support (6, 12 or 18 sessions per year subject to review by GP/Dr)
Families with referrals to multiple services can sometimes feel overwhelmed
Unable to claim ‘family therapy’ under Medicare
Separate referrals for each family member required
Lack of understanding within the sector about the role of Psychologists and services Psychologists can provide
Gabriela will now present to you some statistics on the provision of DSA Medicare services and some case studies to provide you with a greater understanding of what can be achieved through DSA’s Medicare Services.Gabriela will now present to you some statistics on the provision of DSA Medicare services and some case studies to provide you with a greater understanding of what can be achieved through DSA’s Medicare Services.
16. Historically, individuals with developmental disability were assumed to be free from mental health concerns. More recently, however research has suggested that people with intellectual disabilities may be at an increased risk for psychological problems (Deb, Thomas, & Bright, 2001; Stromme & Diseth, 2000).
Individuals with mild or moderate intellectual disabilities are more likely to experience anxiety, depression and psychosis than those with severe or profound intellectual disabilities (Holden & Gitlesen, 2004). Disability and Mental health
17. Australian Psychological Society (APS)
18. APS
19. Medicare Survey
20. Primary Disability 2008
21. Secondary Disability 2008
22. Case “Anna” Anna is 13 years old
Anna was born with developmental delay and speech impairment
Anna was diagnosed by her GP with depression and sleeping problems
Anna was referred for aggressive behaviour at school
Treatment Plan consisted of:
Makaton sign training
Social skills development
Referral to respite and dancing classes
Treatment has resulted in a complete extinction of Anna’s aggressive behaviour
23. Case “Paul” Paul is 32 years old
Paul has learning disabilities
Paul was diagnosed by his GP with depression
Paul was referred for depression and aggressive outbursts
Treatment Plan consisted of:
CBT thought monitoring
Using a diary to keep on track
Thermometer *
SFBT exceptions
Treatment has resulted in a considerable decrease of Paul’s outburst behaviour and a significant reduction of symptoms of depression
24. Thermometer
25. Case “Suzie” Suzie is 9 years old
Suzie was born with developmental global delay
Suzie was referred for aggressive behaviour at home
6 session Treatment Plan consisted of drawing therapy to explore feelings and Motivation Assessment Scale (Attention)
Referral for Suzie’s parents to receive counselling
Parents currently attending individual and couple counselling sessions
Treatment plan resulted in a reduction of Suzie’s aggressive behaviour at home
26. Stress and its impact on carers The additional challenge of supporting an individual with an ASD and an intellectual disability
The impact on primary caregivers
The impact on siblings
The impact on other family members
The impact on the family unit as a whole
27. What can be done to assist carers and family members? Stress management strategies can be provided directly to family members during individual medicare funded sessions
Behaviour intervention can be provided to family members to assist in the support of the individual with the disability
Education about the disability can be provided to family members
28. Training and education “Positive Behaviour Support”
“Duty of care/Guardianship/Restrictive Practices”
“Dual Diagnosis – mental health and disability”
“Working with families”
“Building staff cross-cultural competency”
“Using Augmentative and Alternative Communication and Support “
“Using social stories to support clients with ASD”
“Person Centred Active Support”
“Supporting Individuals with Autism Spectrum Disorders”
“Supporting Individuals with Specific Developmental Disabilities “
“ Sensory Issues in Clients with Developmental Disability”
“ Engagement in Meaningful Activities”
“Grief, Loss & Disability”
“Stress and Burn-out Prevention”
29. What is Autism? Autism is a lifelong developmental disability
Autism is a dysfunction of some parts of the central nervous system that affects the way an individual processes information (how the individual understands our world and what is happening around)
Onset prior to age 36 months
There is no cure for autism
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30. Triad of Impairments
Impairment of Communication
30 Communication: lack of facial expression/gestures; may be verbal/non verbal or some speech; repeats/echoes words or phrases; does not appear to understand word meanings; understands and uses words literally Communication: lack of facial expression/gestures; may be verbal/non verbal or some speech; repeats/echoes words or phrases; does not appear to understand word meanings; understands and uses words literally
31. Pattern of behaviours consistent with Autism Impaired communication:
Flat or limited facial expressions
Poor use of gesture
Little or no speech or very verbal
Echolalia
Difficulties understanding word meanings
Understanding and taking words literally 31
32. Pattern of behaviours consistent with Autism Impairment of Social Relating
Unresponsive to people
Difficulties using social smile
Unusual use of eye contact
Appears to be happy when left alone
Seeks social interactions in unusual way
Uses adult’s hand as a tool
Difficulties in turn taking
Different sensory responses 32
33. Pattern of behaviours consistent with Autism Repetitive , stereotyped and restricted interests:
Responds to objects/toys in an unusual/repetitive way ie lining up cars
Shows intense interest in one area (such as Thomas the Tank Engine or Star Wars) - Can help to relieve anxiety
Likes to watch or listen to same story/video/DVD repeatedly
Might appear to pay little or no attention to the needs and feeling of others (if someone is in pain or distressed)
May actually be very aware of others emotional state but unable to know how to label or respond to emotions appropriately
Unable to generalize uses from one purpose to another
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34. What can be done to assist Individuals with an Autistic Spectrum Disorder??
35. Supporting Person with Autism Visuals
Environmental Support
Staff ratio
Trigger control
Routine
Sensory Integration
Physical health
Social skills Training
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36. Contact us DSA Specialist Intervention Services
Ph: (02) 4620 9660
Fax: (02) 4620 9550
Email: sisadmin@dsa.org.au
Website: www.interventionservices.com.au