DSS Liaisons Making a Difference: Davidson County

Cardinal Innovations Healthcare — July 8, 2021 — 4 min read
Two months ago, John* petitioned the Department of Social Services (DSS) court. He was making a tough decision for his family: to give up custody of his grandson, Lucas.

Davidson County’s DSS connected Lucas’ family to one of our DSS liaisons. She stepped in to find out why John felt that giving up Lucas was his only option.

*All names have been changed to protect privacy.

Lucas’ Story

Lucas lived with his older sister, grandmother, and step-grandfather John. The family coped as best as they could, but Lucas faced a lot of challenges. He was stealing. He wasn’t sleeping at night. He had other troubling behaviors impacting his relationships. Simply put, he needed 24-hour supervision.

The Loss of a Caregiver

For a long time, Lucas’ grandmother took care of him. However, she recently passed away.

John wanted Lucas to continue living with him, but he traveled a lot for work. So, Lucas’ Aunt Lisa moved in to help.

Aunt Lisa operated a little differently from Lucas’ grandmother. She often traveled out-of-state. She would sometimes drop Lucas off to stay with other family members for weeks. Her life didn’t follow a routine.

When Lucas was at home, the family would sleep in shifts. They did this to make sure someone could always keep an eye on him. Lucas’ behavior only got worse, and John and Aunt Lisa were hitting their breaking point.

A Support Strategy Focused on Prevention

Once our DSS liaison met with the family, she better understood how to help. Like all of our DSS liaisons, she wanted to see if Lucas could avoid entering DSS custody.

First, she scheduled Lucas for a Comprehensive Clinical Assessment (CCA). During a CCA, a mental health clinician sits down with someone to ask certain questions. They ask the patient about their life to find out about their:
  • Medical or mental health history
  • Substance use history
  • Education or employment
  • Social history
Our DSS liaison had to reschedule the CCA several times to fit the family’s needs. But finally, Lucas was assessed in June. He was diagnosed with several behavioral health disorders, including: The clinician who did Lucas’ CCA also believed he was a victim of trauma.

The CCA Recommended Treatment

Lucas’ family received the CCA results. They recommended that he stay in a “Level III” group home for a little while. This type of group home is not foster care. It’s a behavioral health service. Lucas would return home when he and his family were ready.

“[Aunt Lisa] didn’t know there were levels of care like this. She had no idea about all the services out there for him,” the DSS liaison said.

Level III group homes provide Residential Treatment Level III. Compared to other levels, this type of group home has fewer children and more staff. An adult is always supervising, even at night.

Family therapy also plays a huge role in Residential Treatment Level III. This therapy will help Lucas and his family learn effective coping skills. The family will visit before Lucas returns home, so everyone can practice what they’ve learned.

“Level III is a lot more structured than at home,” said the involved DSS liaison. With this program, she said, “Many families see how structure helps kids. Especially kids who’ve had trauma.”
Information & Resources

Learn more about our Child Program.

What’s Next for Lucas

Now our DSS liaison and providers are finding Lucas the right group home.

“We already talked to the family about a step-down plan,” said the DSS liaison. Clinicians create this plan to help patients “step down” from higher level treatment. “We’re considering Family Centered Treatment® (FCT®) for when he comes home,” she continued.

FCT® provides family therapy for children and teens with a behavioral health diagnosis. Ideally, Lucas and his family will start FCT® a month before he leaves the group home. Starting early will help Lucas get the support he needs during the transition.

One Less Child in Foster Care

“Because we got involved—because we’re working to get these supports in place—DSS is not taking him into custody,” the DSS liaison said.

She shared that many frustrated caregivers call DSS to take custody of challenging kids. “But we say: ‘Wait a minute, let’s see what we can do to help.’”
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