A Treatment Plan Overview

It’s true!  You can have all 576 Treatment Plans That Worked — with the data that documents it — for $65.

The Executive Director of the Institute for Behavior Change, licensed psychologist and certified school psychologist Steve Kossor, has been involved in the planning and delivery of Behavioral Health Rehabilitation Services (BHRS, still mistakenly referred to in Pennsylvania as “wraparound services”) since 1996.  Mr. Kossor and the staff of The Institute for Behavior Change have been extremely successful in helping parents obtain and keep EPSDT funding for treatment programs involving 20, 30 and more hours of intensive, individualized treatment for children between the ages of 1 and 21 years with Autism spectrum disorders, ADHD and other conditions.  This funding is available in all 50 states to children with disabilities who are enrolled in Medicaid; it is a Civil Right, in fact.   Click here for information about BHRS funded through EPSDT

In 33 states, children with disabilities can enroll in Medicaid regardless of family income and are entitled to EPSDT funding for the treatment of their disability.  This is “the greatest treatment funding secret ever concealed.”  Our Executive Director has produced several videos about EPSDT funding since 2007.  Click here to view Mr. Kossor’s comprehensive explanation of the Medicaid EPSDT benefit, how EPSDT funds Behavioral Health Rehabilitation Services, and how to Defend the Civil Rights of Children with Disabilities.

Mr. Kossor offers a two hour individualized program of training, consultation, demonstration and assistance to parents so that their advocates, service providers and attorneys can do their work more effectively at Fair Hearings and other meetings where denials of EPSDT funding can be challenged successfully.  The cost for these training sessions is $200 per family.  Many people have found Mr. Kossor’s training sessions to be more useful and informative than any other consultation they have ever had — they will learn how to get and keep the funding necessary for their child’s treatment services to be delivered in their home and the child’s school or community at no cost to parents whatsoever, through the EPSDT mandate of the Medicaid Act.

Training groups are limited in size to four families at a time in the Southeastern PA region. On-line sessions via Skype or other media sharing methods are available at the same hourly rate also.  Please send e-mail inquiries about this to employment@ibc-pa.org.

US Congress honors IBC Founder

PA House of Representatives honors IBC Founder

PA Senate honors IBC Founder

CMS Director’s letter complimenting IBC Founder

The Issachar Project was inaugurated in Phoenix, Arizona on February 21, 2009 when Steven Kossor addressed a group of about 70 people in a meeting sponsored by the Phoenix chapter of the Autism Society of America who had gathered to learn more about the opportunities that exist within the Medicaid system to fund behavioral treatment for children with Autism and other disorders using the EPSDT funding mandate.  This presentation was highly praised and explains the treatment model created by Mr. Kossor and how it could be applied in Arizona and other states.  Mr. Kossor is available to present this information, customized for any state in the USA.  Watch this video to learn more

Researchers at the University of North Carolina at Chapel Hill have completed an initial analysis of over 300 “Treatment Plans that Worked” between 2002 and 2007, finding strong support for a link between the implementation of these Plans and improvements in child behavior.  Without a Control Group, it is not possible to claim that these Plans caused the improvements in child behavior that were documented, but the data is remarkable nonetheless and clearly calls for further research on the effectiveness of the IBC model for Behavioral Health Rehabilitation Services (BHRS) that we have developed.  Press Release authorized by UNC researchers 

Latest Research:  Researchers at Thomas Jefferson University in Philadelphia, PA released the results of their analyses of 887 Treatment Plans implemented by staff of the institute for Behavior Change between 2007 and 2010.  They found that over 75% of the Plans were associated with positive changes in child behavior and noted that all plans studied were completed in one year or less.  Children with Autism spectrum disorders accounted for more than 500 of the treatment records studied; more than 200 had ADHD as the primary disabling condition.  Without a Control Group, it is not possible to claim that these Plans caused the improvements in child behavior that were documented, but the corroboration of previous findings, and the extremely large data base strongly indicates that BHRS is a promising treatment practice for children with ASD, ADHD and other serious behavioral challenges.  Our research has been presented at meetings of the Training Institutes in Nashville, TN and Washington, DC and at every annual meeting of AutismOne since 2007.  View research findings here

Click here to visit the Institute for Behavior Change (IBC) website for more information.

An appalling lack of standards exists as to what a child’s behavioral treatment plan should look like. As a result, parents are frequently at a loss to determine if the Plan proposed for their child is either adequate or appropriate. As an alternative to wishful thinking, misplaced trust in an unknown and untested service provider, and to raise the standards for treatment plans for children who are displaying challenging behavior, this internet resource has been created. Let’s define our terms, first of all.

A Treatment Plan should provide all of the information necessary for a conscientious person to deliver the correct treatment procedures, at the correct times, and with sufficient consistency to produce the changes in behavior that are described in the Plan — reducing or eliminating undesirable behavior and increasing or improving desired behavior, while providing a means to monitor progress on an ongoing basis that informs the process of treatment.

With that in mind, the following “treatment plans that worked” are offered as examples to guide professionals in the creation of age-appropriate behavioral treatment interventions for children, and as examples of successful treatment planning documents that parents may provide to professionals as a means of setting basic standards for treatment design and monitoring. These plans were all successful in that they all produced reduction or stabilization in the target (undesirable) behavior of children. Although these plans were successful in these cases, it is clear that all children are different, and that the exact same plan may or may not be effective for any other child, and that professional guidance should always be sought before and during the implementation of any treatment plan or program.

Subtle differences can change the outcome of any treatment plan. Because these plans are presented in the interest of helping to establish “standards” for the development of behavioral intervention plans for children, all of the treatment plans here are offered “as is” for informational and comparison purposes only, without any warranty whatsoever as to suitability for any particular purpose or child, or any claim of usefulness or value in the treatment of any disability. Results will vary in any treatment program; the fact that any one of these treatment plans “worked” in one case does not indicate that it will “work” in any other case.

In this field, for every expert, there is an equal and opposite expert. Nevertheless, there are some basic standards on which everyone should agree. At a minimum for example, all behavioral treatment plans should provide the following information. The order of presentation isn’t as important as the level of understanding that it creates in the mind of the person who is to implement the plan, such as a mental health worker or a parent. A very simple plan, accompanied by a very high level of professional supervision, training and support, can achieve tremendous results. A highly complicated, lengthy, jargon-ridden treatment plan written by someone with impressive credentials obviously doesn’t guarantee success. The middle ground (where the treatment plan is complete in terms of its components, explicit in its directions to the person who will implement it, and which can be evaluated objectively as to its effectiveness) is ideal.

Any behavioral treatment plan should specify the exact behavior that is “targeted” for improvement. The plan must say exactly what is to be reduced or eliminated. By the same token, the plan must say exactly what is to be taught in replacement of the “targeted” behavior. It is rarely helpful to tell a child what not to do; you always have to specify what he/she should do as well.

A treatment plan should explain exactly what the treatment provider should be doing to accomplish the replacement of the “target” behavior. A treatment provider should be able to look at the treatment plan and know precisely which techniques are to be used, how often and in which circumstances. When terms like “contingency contracting” are used, a glossary of terms that is accessible to the treatment provider is essential. How else can the treatment provider know exactly what to do?

A treatment plan should always contain a simple and easy means of measuring progress from the perspective of the treatment recipient, not the treatment provider. Outcome progress measurement should include a “baseline” measure, which is a starting point in the measurement of treatment outcomes that precedes the start of the treatment period. How else will you know how far you’ve come (or how far you’ve gone astray) if you don’t know where you started?

Treatment plans must include a planned stop date, so that the treatment team can prepare to present information to funding authorities prior to that date in order for funding to be continued. Continued funding is necessary and therefore justifiable whenever the child is within the age served by the funding entity, the treatment plan is working, but the work has not yet been satisfactorily completed.

All of the “treatment plans that worked” in this collection meet these standards, to a greater or lesser extent. They are all actual real-life plans written by many different authors at the Institute for Behavior Change between 2002 and the present date, so some variation in quality and effectiveness will be apparent — but they were all successful, nonetheless. Some corrections in the use of punctuation, grammar and formatting were made to improve the consistency of the plans in order to facilitate rapid comparison between plans. It is a good idea to look at several plans and take “the best ideas from all” in the process of creating a plan for any given child.  You can view the current list of Treatment Plans that Worked in the database here

Suggestions for improvement or corrections to the plans are always appreciated.  

Visit www.ibc-pa.org for more information.

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