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Therapeutic Behavioral Services


Therapeutic Behavioral Services is a short-term, intensive intervention that is included as one component of a comprehensive mental health service plan. TBS provides one-to-one support for children experiencing a life crisis or when a life crisis is imminent, who need additional support to transition from a higher to a lower level of care or to prevent movement to a higher level of care.

tbs_clean-up
The Therapeutic Behavioral Services team worked around the clock to remove debris,
paint and refurnish one grandmother's home to save her five grandchildren from being separated and placed in the foster care system.


How does a client know they need TBS?
If you receive mental health services and still feel very sad, nervous or angry, a trained mental health professional may be helpful to you. This person can help you deal with problems that cause you to get mad, upset or sad. This person can also come to your home, group home or go with you on activities and out in the community.

Who is eligible for TBS?
  • To qualify for TBS, clients must meet the following:
  • Have full-scope Medi-Cal,
  • Be under the age of 21,
  • Meet medical-necessity criteria,
  • Have target behaviors or symptoms that are not responding to other mental health services alone, are jeopardizing current placement and can be expected to respond to short-term, intensive intervention, and

Be an included member with one of the following criteria:
  • Being considered for RCL 12 or above placement,an RCL 12 or above placement;
  • One psychiatric hospitalization in the preceding 24 months or
  • Transitioning from an RCL 12 or higher to a lower level of care.

How does a client get TBS?
To access TBS for a client, refer the caregiver or clinician to the Five Acres TBS access referral line at (626) 204-1360 extension 3140. The treating clinician defines TBS as a necessary intervention and submits the referral to Five Acres’ TBS department.

How does TBS work?
Referral: Upon receipt of a referral, the treatment team, the parent or caregiver, client, clinician, social worker, attorney, and TBS specialist collaborate to develop goals, hours and days of service, and discuss relevant treatment information. TBS hours and length of service are based on the level of need to achieve the necessary amount of progress.

Focus:
TBS addresses specific targeted behaviors that are jeopardizing a client’s placement or assists clients in the transition to a lower lever of care. It also identifies triggers to clients’ behaviors and effective interventions, and passes on successful techniques to caregivers for continuity of care.

Treatment Goals/Behavior Modification:
TBS implements direct behavioral interventions for the client wherever she or he is having the most difficulty. These interventions are designed to smooth the fit between a child’s behavior and the child’s environment. The TBS specialist utilizes behavioral analysis, cognitive behavioral techniques, skill building interventions and rewards and consequences to strengthen the client’s functioning. Using these techniques the specialist develops a behavioral plan which targets a specific behavior with the goal of reducing or eliminating the identified behavior and replacing it with a more adaptive behavior.

Length of services:
TBS is authorized by the Department of Mental Health in intervals of 120 hours or 60 days, whichever comes first. Services are reviewed monthly and re-authorized as needed.

Why Five Acres TBS?
The Five Acres TBS team is composed of 16 TBS specialists and four administrative staff. As a whole, the team possesses over 142 years of working with emotionally disturbed youth.

The Five Acres TBS team has established an outstanding reputation for quality, going the extra mile to meet clients’ needs and being highly committed to helping them reside in the lowest possible level of care. The Department of Children and Family Services reports that Five Acres’ TBS program is the best in the county and is especially responsive to community needs.

The Five Acres TBS Team is as diverse as the population served in the greater Los Angeles County area.

Preserving a Family

 

A Five Acres community-based therapist referred John to our Therapeutic Behavioral Services (TBS). John is an 11-year-old and was at risk for being removed from his biological family because of his aggressive behaviors that included threats to harm or injure others. John was using verbal threats when not getting his way, yelling, kicking furniture and deliberately annoying others. The family, especially his mother, often met his inappropriate demands just to keep the peace.

 
The TBS specialist meets with John and his family in the morning as he gets ready to go to school because he lacks motivation and his parents are inconsistent. John’s TBS specialist showed the parents that too many prompts from them were triggers for John. His parents are learning to use positive reinforcement and past successes as successful interventions.

John is now consistently attending school an average of 4-5 times a week. TBS plans to maintain a five- day-a-week schedule until John and his parents can successfully implement the interventions in the morning hours that TBS identified.