Mental Health Client Handbook
At our Children's Mental Health Locations, our goal is to give people the tools, strategies and confidence they need to cope with their struggles. Our children’s mental health treatment programs work to prevent further social, emotional and behavioural difficulties for young people and their families at home, school and in the community. Building on each individual’s unique strengths and needs, we develop progress plans and strategies using therapeutic relationships and best practices that help people to achieve their goals. In addition, we use an individualized and strength-based approach in the work we do to support the young people and their families. We also consider and respect cultural, ethnic, spiritual and religious traditions and encourage people to engage in opportunities for personal growth and development.
With us working together, we see positive changes in the lives of the individuals and families who turn to us for help.
Click here to download a printable PDF version of this Mental Health Handbook
Click here for more Resources, Links and Emergency Phone Numbers.
In order to participate in Lutherwood programs, clients must sign a Service Agreement that confirms:
- They wish to receive service from Lutherwood
- Treatment is voluntary
- They understand the agreement clearly.
This agreement clearly outlines Lutherwood’s responsibilities and commitments to our clients, as well as client responsibilities while participating in our programs.
At any time, for any reason, service may be stopped by the client. If we are concerned that the agreement is not being maintained, we will contact you and ask for your continued commitment to the program. Should you not wish to provide it, we can assume that you are withdrawing your voluntary consent to participate in the program.
If there is any confusion or lack of clarity, do not hesitate to ask questions and share your concerns with us.
If you are under 16 years of age both you and your parent(s)/caregiver(s) will be required to give consent to enter service voluntarily. If consent is not given by both you and your parent, we will try to assist in problem-solving and finding a resolution. In some instances, there are steps that may be taken when parents see a clear need to obtain help for their child and the child is unwilling.
If you are over the age of 12 and want individual service without family involvement, this can be provided and your wishes respected.
When you enter one of our programs, we start a file. We only collect information necessary to provide service and to support you.
Lutherwood is committed to protecting the privacy of the personal information of its clients. You can learn more about your Client Records and our Privacy Policies on our Privacy and Confidentiality page.
Exceptions to Confidentiality
- The law indicates that confidentiality is limited when a person discloses any of the following:
- Abuse to themselves or to another person (physical, sexual, emotional);
- Intention to hurt themselves (suicidal);
- Intention to hurt another person (homicidal); or
- Where a Lutherwood staff member has reason to suspect that a young person has been or is currently being abused or at risk of abuse.
Under these conditions our staff members have a professional and legal “duty to report” the information they have received to the appropriate authorities including
- To Family and Children’s Services if the young person is under the age of 18) and there is reasonable suspicion they may be in need of protection ;
- To a police officer if the need is urgent;
- To a medical practitioner if the need is urgent;
- To authorized staff of the Ministry;
- To courts with proper warrants.
Your Rights (Safe Haven and Live-in/Day Treatment Clients)
While receiving services from Lutherwood, every family and youth has given rights. Your participation is protected by the Ontario Human Rights Code, the Canadian Charter of Rights and Freedoms and all these guarantee your:
- Right to legal counsel
- Right to be informed
- Right to be heard
- Right to voice concerns or complaints
- Right to know of the Office of Child & Family Service Advocacy
- Right to know your responsibilities in the program
- Right to know about rules and disciplinary practices
- Right to receive appropriate nutrition
- Right to appropriate clothing
- Right to participate in recreational activities
- Right to receive and participate in an appropriate education,
training or work program
- Right to receive medical and dental care
- Right to privacy of mail
- Right to religious practice
- Right to privacy
- Right to personal property
- Right to visits with family
- Rights of communication
- Right to a plan of care/reintegration plan
- Right to be free from corporal punishment
Your rights regarding participation in Lutherwood’s program or service will be reviewed with you, and/or your parent(s)/guardian(s) during the intake process. These rights include:
- Recognizing that the treatment service is voluntary and giving your consent to the service. Consent means that you clearly understand all aspects of the service.
- You have the right to participate in designing your Treatment Plan including setting goals, strategies and time limits.
- You have the right to be informed of any information, decisions and actions that will affect you.
- You have the right to participate in all decision making relevant to you.
- You have the right to review and, if necessary, correct Agency information your file/record.
The following is a list of responsibilities that will help you get the most out of your experience while participating in our programs and services:
- Let us know your needs in the most accurate and complete way possible so we can provide the most appropriate service options.
- Be respectful of other clients, volunteers, students, staff and property.
- Contact us when you’re unable to keep appointments or to notify us of any change of address or other information relevant to treatment.
- Inform us of health and safety concerns and any accommodation required.
- Provide feedback on services and programs.
- Understand and follow the terms of the Service Agreement.
As is the case with any mental health program or service, there are benefits and possible risks that you may experience while participating in one of our programs.
In the course of making changes, difficult topics may need to be addressed and there may be distressing emotions and reactions that come along with that. You may experience an increase in negative behaviours during this time including resistance, self-harm and uncooperative or disruptive behaviours. Every effort will be made to support you during difficult and challenging periods.
If you or your family refuse supports or withdraw from the program early, the conflicts and concerns that brought you to Lutherwood are likely to continue.
Inherent to the nature of our group treatment program is a level of risk related to peer relationships and interactions. While we understand that peer relationships are likely to form, we hope to support this occurring in a healthy, productive way and ask your support in engaging, where necessary, to ensure peer relationships do not negatively impact your own or other children/youth’s treatment. You may be asked to consult or support if peer dynamics become problematic and, in incidents where safety is a concern, we will engage those involved in a plan to ensure safety is maintained and treatment is not negatively impacted. This may require adjustments in scheduling or placement to avoid contact between the children/youth involved and, in the most severe circumstances could result in discharge from program.
Program interventions and participation in services will offer you a unique opportunity to observe and practice new skills, learn about social norms and improve on relationships at home, in the community and with your peers. While participating in this program or service you may discover new ways of relating to yourself and/or your family that may help resolve the challenges that brought you to Lutherwood.
Lutherwood’s Community Advisory Committee is a small, informal group that offers constructive feedback to Lutherwood on ways to enhance the quality of its mental health services. We value the unique perspectives of the parents of our youth or adult past participants of one of our programs or services. For more information or to get involved, contact our Director of Mental Health Services.
Live-in and Day Treatment Programs
While you are participating in a Live-in or Day Treatment Program, you can expect:
- Our treatment team will work with you to identify areas of strength and needs and to create a treatment plan. The treatment plan will include goals that you will work toward achieving and the approximate time needed to achieve these goals.
- Regular meetings will be set to review progress, change goals and discuss transition plans. It will be important for you (and your family/guardian) to attend and participate in all of your scheduled appointments.
The following are some examples of what we do to provide a complete treatment program and some of the services that might occur while you are involved in our program:
Needs Assessments are the way you and your family express your wishes about treatment at Lutherwood. Clinical staff complete the assessments soon after you request our help. The recommendations will be shared with you.
Educational Programming is provided by Waterloo Region District School Board (WRDSB) as well as by Waterloo Catholic District School Board (WCDSB) on-site, whose teachers are fully accredited for regular classroom assignments.
Group Programming: We take advantage of each conversation, relationship, or event in school or residence as an opportunity for learning. For example, when a problem arises between two clients in school, our staff will use that as an opportunity to teach about social skills and conflict resolution. Similar learning may take place on an outing, in the gym, or during a meal.
Skills Groups: We offer group therapy and skills training to assist you in developing your emotion management, social skills, and healthy sexuality, which are based on effective principles of change. In group activities, you will learn new skills, and practice them with the support of staff “in-the-moment” as well as between group meeting times. Other topics for groups are offered from time to time depending on needs and availability of group leaders. We also offer parent support and education groups dependent on desire and availability.
Individual Therapy and Counselling sessions may be part of the interactions between you and your primary worker(s) or they may be planned sessions between you and a clinician or psychologist. Therapy is organized around your individual treatment goals with an emphasis on known effective methods.
Family Therapy: This essential portion of treatment includes you along with members of your family. Family therapy follows up on recommendations regarding specific needs identified in the area of family interaction, roles of family members, emotion management in the family and parenting support. The schedule for these contacts will be negotiated with you and your family.
These optional therapeutic interventions may be available to you in combination with your overall treatment goals:
- Music therapy is a goal-directed process in which you can engage in musical experiences with the music therapist in order to address an area of physical, emotional, cognitive, social, or spiritual need. Sessions include musical interventions such as song writing, clinical improvisation, singing and instrument playing, music listening, and creating art to music.
- Recreation Programming uses leisure education programs, and recreation participation in community programs to help use leisure time to enhance your health, functional abilities, independence, and quality of life.
- Community Involvement is often included, using community resources on a group and individual basis (e.g., outings to recreation centres, movies) as part of our program. Where possible, we will also try to maintain any involvement in existing community activities (e.g., sports teams, clubs).
- Psychiatric Support includes psychiatric assessment and monitoring of a medical plan which are provided by a consulting Psychiatrist and the Nurse. Your parent(s) and/or guardian(s) will be consulted to provide consent for any assessments and medical intervention.
Specialized Accommodations: We recognize the individual and unique needs of those participating in our programs. We are able to accommodate spiritual/religious, ethno-cultural, medical and dietary needs as identified at any point of your service with Lutherwood. In certain cases, we will seek outside resources if we are unable to provide the type of accommodation required internally.
Security and Emergency Systems
To ensure the safety and security of clients, staff and other visitors at the Benjamin Road site, an emergency response plan is in place to respond to emergency situations including Evacuation, Severe Weather and Tornados, Bomb Threat, Hostage Situation, Major Disturbance, Utility Outage and Lockdown. These procedures are overseen by Lutherwood Leadership and the Joint Health and Safety Committee and are in compliance with fire code and licensing requirements. Clients and staff are oriented to these procedures and drills are practiced based on emergency preparedness training.
As is the practice in all Waterloo Region schools, a lockdown is used to secure the Benjamin Road facility and protect all occupants from life-threatening-violence that requires everyone to find a safe place to hide out-of-sight. Lockdown drills help to keep staff and clients safe, just as drills are done for other emergencies such as fire and tornados. The goal of a lockdown drill is for participants to practice moving rapidly to the closest room where a door can be closed and locked regardless of the circumstances. Lockdown drills will be no longer than five minutes in duration to minimize anxiety for participants. The needs of current children and youth will be identified ahead so that individual preparation and support can be planned for. Staff will be trained on the lockdown procedure during their initial orientation and annually as part of emergency preparedness training. Lockdown drills will be scheduled twice a year in the early Fall and Spring. If you have any questions or concerns, please contact the Program Manager.
Video Monitoring for Door Security
The Benjamin Road building and grounds is equipped with video monitoring devices for the purpose of identifying who is at the door prior to allowing them access to the building. Please note that the video is not recorded and that surveillance cameras are not located inside the building. Signs are posted notifying clients and guests that video cameras are in effect. At the time of admission, staff will inform the client, and/or parent/guardian that video cameras are in effect and explain the purpose for such monitoring practices at this time.
At Lutherwood, we believe that you are able to increase appropriate behaviour and learn from a situation with the support and guidance of staff and with programming opportunities.
Below are the interventions we use at Lutherwood to support clients who are having difficulty managing their behaviour:
1. Verbal Interventions
- Asking youth to stop what they are doing;
- Inquiring about the situation by setting a time to talk immediately or later;
- Problem solving a plan that will help the next time a similar situation arises;
- Providing cues that the behaviour is not appropriate;
- Providing calming strategies;
- Cueing and coaching to use emotion regulation and other skills learned in treatment groups;
- Requesting the youth leave the group/activity to do something independently;
- Support in using a “time out” and planning how to rejoin the group when the issue is successfully resolved either independently or with staff support;
- Facilitating group discussions related to managing difficult situations.
2. Alternative Interventions
- Suspending privileges, if necessary, until the youth is better able to manage and problem solve an issue;
- Working to set up a plan to pay for the damage(s) if required;
- Developing an individualized program together;
- Removing the youth to a place of safety (quiet room).
3. Quiet Room/Debrief Room
The ‘Quiet Room” or “Debrief’ is a room away from regular program where a youth can be supported to go to by staff for safety reasons and/or to give the youth an opportunity to regain self-control away from his/her peers.
4. Physical Intervention
Physical Proximity - Staff may support a youth by placing a hand on their shoulder, arm, or wrist to gently redirect them.
Physical Restraint - The use of physical restraints is limited to circumstances where any delay in restraining or moving a youth will likely result in one or more of the following:
- Imminent risk of physical harm to self or others. And in addition, for use within the Youth Justice Services related to: · An attempted escape from custody or detention; or
- Significant property damage.
Following an incident of physical restraint, staff will then debrief the incident with the youth to ensure the youth is aware of why they used a physical restraint and to set up a plan of how staff can support the youth to maintain control if a similar situation arises.
Follow-up: staff will write an Incident Report, the Supervisor will be notified, the report reviewed and significant adults and/or agencies are notified of the use of restraints.
The goal of the wellness program at Lutherwood is to promote your well-being. The various health services offered contribute to this goal through prevention, education, restoration, support and the promotion and maintenance of health and well-being specific to adolescence.
Some aspects of the wellness program include:
- Offering health care during your stay at Lutherwood including health teaching especially in the areas of sexuality and mental health.
- Ensuring that you are up to date with your immunizations.
- Ensuring all medical/dental regulations outlined by the Child, Youth and Family Services Act (CYFSA) and the Youth Justice Services Act (where applicable) are met and adhered to.
- Facilitating the correct administration and monitoring of all medications.
Parent(s) and/or guardian(s) need to know:
A Lutherwood Physical Examination form must be completed by a physician within 30 days prior to admission to a Live-In Program at Lutherwood. This is a directive from the Child, Youth and Family Services Act and families are not required to pay. Should your health care provider have any questions about this have them contact the Health Office at Lutherwood 519-884-1470, ext. 1171.
- Nursing care is available Monday to Friday and we consult with the youth’s doctor or a local clinic as needed to support with medical needs.
- Upon admission to Lutherwood you are asked to sign a medical consent for:
- emergency medical, surgical or dental procedures in the event you as a parent/guardian are unavailable;
- the nurse to administer immunizations where indicated;
- the administration of some over the counter medications available should your child require them (please contact the Health Office if your child requires additional medications that are not normally provided (e.g., nicotine patches).
- In the event that your child is taking prescribed psychotropic medications a specific consent is required. This consent is required with every medication change.
- You are asked to provide payment for all medication while your child is admitted. If this proves to be a challenge please contact the Health Office.
Any time that you have questions about your child’s medication or other health concerns feel free to contact the Health Office at 519-884-1470, ext. 1171.
Community Mental Health and EDDT Services
What to Expect from Community Mental Health
Our Community Mental Health Services offers a range of programming from brief to intensive Child & Youth Mental health services based on need and referral source.
Our goal is to offer individualized, flexible and goal-focused services. Our programs offer a variety of direct treatment interventions and case management supports based on needs and goals. Our programs are accessed through professional referrals only and not self-referrals.
Examples of services include:
Community Mental Health Intensive (CMHS)
- A core funded, intensive treatment program designed to work with youth & families whose needs are deemed; complex, high risk and often requiring multi-service utilization within the system and community. The goal plans and length of service vary depending on need.
Emergency Department Diversion (EDDT)
- EDDT program deploys a Community Mental Health worker and/or Clinician to assess needs and provide short term stabilization. Respite through Safe Haven Youth Service is also a component of the program, where needed. The service is designed to be up to 1 month in length.
Brief Community Mental Health (BCMH)
- A combined core funded & pilot-based model of brief services designed to work in alignment with family health teams. The service is designed to be approximately 4 meetings or 1 month in length.
Once we receive a referral for service, you can expect:
- A telephone call from one of our program staff to set up an initial meeting and answer any questions you may have. They will also ask detailed questions about your history, life situation and present distress to assess the types and extent of concerns you have.
- Support from a Community Mental health worker and where required, a Clinician.
- After we have identified the areas of need, together we will agree on a plan of action including specific goals and objectives, methods to accomplish these goals and the approximate length of time it will take to achieve the goals.
- Depending on the specific service that has been identified to meet your needs, a start date and end date will be discussed with you.
- An agreement, also known as a Service Agreement, will be reviewed and signed with you and is a service contract between you and Lutherwood
- Periodically, we will meet to review progress. Sometimes the review will lead us to change the goals and/or adjust the discharge date we have agreed on.
- At the end of your contract, we will evaluate the success of the work by referring back to the goals you set at the beginning.
To make the service work, it is important for you and your family to participate in all of your scheduled appointments.
We encourage you to be as active, open and honest as possible as it will help us understand how best to support you. Finally, the most important responsibility is to work toward the goals we have mutually agreed upon.
Our mental health services are expanding with culturally aware staff and we continually educate ourselves on the diverse needs of our community. We invite you to read more about Lutherwood, our Mission, Vision and Values, and about our commitment to Anti-Racism and Land-Acknowledgement throughout our website.
Our tagline is our commitment to you: Caring People. Strengthening Lives.