Overview of PA’s FBMHS Program
Pennsylvania’s Family Based Mental Health Services Program (FBMHS) is a 32-week (eight-month), intensive, in-home team-delivered service serving children and youth ages three to 21 deemed at-risk for out-of-home placement. There are one and often two or more of these programs in each of Pennsylvania’s 67 counties. Families enrolled in FBMHS typically receive between three to 10 hours of service per week, which includes an individual session with the identified child, a conjoint session with the caregivers, and a family therapy session. In addition to child, parent, and family therapy, service components include parent education, family support services, school-based consultation, case management and service coordination, crisis intervention and stabilization, and 24 hour on-call emergency service.
Eco-systemic Structural Family Therapy (ESFT) is the clinical model that informs FBMHS treatment. In ESFT, families are viewed as more than just an element of a crisis -they are assumed to be capable of being the solution to children’s problems with additional support and guidance. Therapists work through caregivers to create change. For more information about ESFT, see the Logic Model here. All therapists and supervisors in FBMHS, regardless of training center, are required by state regulation to participate in a three-year (85 hours annually) training program focused on cultivating systemic thinking, assuring adherence, and developing competence
Family focused interventions are designed to strengthen caregivers’ executive skills, strengthen the caregivers’ emotional connection to the identified child, and improve the family’s ability to de-escalate conflict and problem solve when tensions are high. Child-focused goals of treatment include: 1) reducing the child’s symptoms and safety concerns, 2) reducing the risk of psychiatric hospitalization or out-of-home placement, and 3) improving the child’s capacity to handle the normal demands of home, school, and the peer community.
CFBT’s Approach to FBMHS Training
The training offered through the Center for Family Based Training builds the clinical skills critical for helping therapists to intervene effectively in the family, addressing parenting practices, intra-familial relationships, and family-community relationships. Currently CFBT hosts four regional training sites in Pennsylvania where therapists from contracted programs meet for ongoing training, either on-site or virtually. We provide a dual curriculum at these sites – one directed at supervisors (30 hours per year) and one directed at front-line therapists (85 hours per year). Supervision training is comprised of small group supervision-of-supervision, individual consultation, and access to online webinars that provide conceptual foundations. There are two training tracks for front-line therapists: 1) Foundations, which is focused on newer, first year FBMHS therapists and (2) Core, which is focused on therapists with more experience. About three-quarters of therapists’ training involves case presentations, where videotaped treatment sessions are reviewed and discussed by faculty in collaboration with their FBMHS colleagues. We believe that this work is best learned through supported practice and feedback involving real clinical situations. Therapists’ training also includes a conceptual component delivered through live streaming workshops and on-demand online courses.
CFBT also offers booster trainings for FBMHS therapists who have completed core training and established competency in applying ESFT. This curated combination of new didactics and on-line courses, which are open to all FB trainees, are recommended for graduates to help them meet Pennsylvania’s 30-hour annual booster training requirement.