Child study center helps at-risk children

Jean Adnopoz is the Director of In-Home Clinical Services at the Yale Child Study Center (YCSC), which studies children’s mental health problems. Adnopoz’s focus revolves around creating programs and policies that address the needs of children severely at risk for mental disorders while keeping them involved in normal community activities.

Q What does the YCSC offer for children?

A The study center offers a continuum of care that ranges from the inpatient unit (a 15 bed unit called the Children’s Psychiatric Inpatient Service) to in-home services that often serve as a transition from the hospital to the community and to the outpatient care. We do various kinds of specialized evaluations and assessments, psychological testing, neurosociological testing. We treat young children from birth to five years old at the Young Child clinic. We have a world-class autism clinic. We offer a full array of treatment services for children who present a mental health disorder of any kind. We have very strong research programs that correlate with the clinical programs that inform them. We also have a number of programs that are actually delivered in the community to schools. The work at the YCSC ranges from the most intensive models to community based preventive services, all designed to improve the mental health of children and families.

Q What project are you currently working on at the child study center?

A Among the projects that I am currently working on is the randomized trial of IICAPS, which stands for Intensive In-home Child and Adolescent Psychiatric Service. It is a program that we developed here at the child study center a number of years ago. It is a home-based treatment service for children who are either being discharged from psychiatric hospitals or who can be prevented from going into psychiatric hospitals. We do this by working with the child and their family within their own homes and communities. The program has been implemented across the state and is provided at more than 20 different locations in Connecticut. I am one of the initial developers of IICAP, along with Dr. Joseph Wooslton and Dr. Steven Burkowitz.

Q What is the goal of the project?

A To maintain kids with psychiatric disorders in the community in their schools and within their families (in normative community activities). We work with 4-5 year olds through adolescents. We were initially funded by the Connecticut Department of Children and Families (DCF). We have been a fee for service program paid for by Medicaid or the families. Our referrals come primarily from hospitals and other clinics, and also from the Court Supported Services Division of the superior court. It’s the arm of the court in Connecticut that deals with community programs for children and adults. We look at children that have both a mental health disorder — carry a diagnosis — and that are also involved with the juvenile justice system. In all instances we are committed to working with the various systems with the community in which these children interact.

Q What does your project FBR focus on?

A FBR is Family-Based Recovery. It is one of the very few programs in which substance abuse treatment is combined with parent child intervention and provided in the home. We developed it with the help of DCF in large part because those children who come into the child welfare system particularly for reasons for neglect or abuse were often coming from homes in which there is significant substance use or abuse. FBR is also aimed at maintaining children within their own homes and communities as much as possible. The drug treatment follows a model that was developed at Johns Hopkins. It uses the reinforcement approach with a parent-child relationship based approach. This program has been replicated at five additional sites in Connecticut. We are currently preparing for an eventual trial of FBR, [but] we are not ready for it yet.

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