SUMMARY

Under the direction of the Clinical Director and daily monitoring by the Exposure Coach III, is responsible for the care and safety of assigned children. As a member of the interdisciplinary treatment team, assumes primary Exposure Coach I role. Is responsible for input into the formulation of an exposure with response prevention (ERP)-based therapeutic milieu care plan as well as the implementation, observation, and documentation of this program under the direction of the Clinical Director and Exposure Coach III. This ECI position is on the DBT-X team, which is designed for teens with severe OCD and/or other functionally impairing anxiety disorders that co-occur with emotional and interpersonal dysregulation, suicidal ideation and/or non-suicidal self-injury (NSSI) behaviors. In the DBT-X program coaches work with up to 8 patients aged 12-18 years, and their families, who are in need of stabilization, assessment and intensive treatment at the partial hospital program (PHP) level of care. 

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

• Instill Trust and Value Differences
• Patient and Community Focus and Collaborate

RESPONSIBILITIES

A. Participates in maintaining a safe and therapeutic environment.

• Actively engages with assigned children throughout shift.
• Participates in the development and operationalization of the ERP-based milieu care plan for assigned patients according to established department and unit-based procedure/policy.
• Supervises assigned children in exposure-based milieu activities.
• Assists patients in completing anxiety-impacted ADLs using an exposure therapy framework to help patient move toward, rather than avoid, anxiety triggers.
• Identifies, reports, and resolves potential problems on the unit.
• Demonstrates appropriate critical incident follow-up skills by timely verbal reporting to program RN and documentation in medical record. Completes other documentation [i.e.: incident reports, seclusion, and restraint forms (MR38)] as applicable. Participates in debriefings.
• Carries out daily assignment as assigned by Clinical Director and Exposure Coach III and reports back prior to end of program day.
• Intervenes in disruptive milieu or destructive to self/other patient situations providing timely therapeutic intervention(s) to children in distress.
• Maintains appropriate boundaries.

B. Adheres to Hospital, Departmental, and Program policies and procedures.

• Attends peer review and staff meetings as assigned.
• Maintains current certification in crisis management.
• Maintains current CPR certification.
• Maintains current OSHA, ERS, Safety Certifications
• Attends unit/hospital staff development as assigned.

C. Actively participates in the patient care planning process under the direction of the Clinical Director and Exposure Coach III

• Participates in the initial admission interview process as assigned.
• Works to support initial therapeutic alliance with patient and family on admission. Assists with the separation process and performs other duties necessary to provide a smooth transition to the program milieu.
• Completes initial program assessment with patient including eliciting specific details about patient’s anxiety symptoms. Collaborates with patient’s psychologist and psychiatrist to develop initial anxiety symptom hierarchy that will guide ERP throughout the admission and are the core part of implementing ERP with patients.
• Review’s milieu care plan and anxiety symptom hierarchy daily and suggests revisions based on observations.
• Communicates individual patient milieu care plans and anxiety symptom hierarchy updates in an ongoing manner to other unit staff including liaison with other interdisciplinary treatment providers.
• Actively participates in diagnostic conferences, treatment team, rounds, and hand-off shift report, as assigned.
• Is aware of department QI indicators and responsibilities related to these.
• Accurately documents significant patient/family observations/milieu care in medical records in a timely fashion.
• Offers information and knowledge acquired through experience to other staff via formal/ informal staff development forums.
• Adapts care “style” to meet needs of various children and adolescents.

D. Supports and contributes to the development of patient-specific exposure and behavioral management plans.

• Assists and teaches patients in activities of daily living and personal hygiene based upon patient’s abilities.
• Co-leads community meeting/milieu meeting/social skill group.
• Co-leads twice daily exposure groups.
• Demonstrates ability to set consistent and supportive therapeutic limits within guidelines of hospital, unit, and department standards.
• Collaborates with other members of the treatment team in designing and revising exposure-based behavioral programs specific to the needs of the patient.
• Organizes unit activities.
• Coordinates, supervises, and actively participates in children’s activities such as physical &social development activities. Arranges for transportation of materials if required.
• Participates in daily community visits with patients and parents. Provides psychoeducation about exposure therapy to patients and parents.
• Models’ appropriate exposure coaching behavior for parents on community visits.
• Supports parents in delivery of exposure coaching on community visits.
• Consistently models to patient/families appropriate and therapeutic interpersonal staff/patient interactions.
• Co-leads therapy groups with a clinician.
• Supports and actively participates in recreation therapy programs.
• Handles crisis situations in a safe, effective manner, utilizing the least restrictive, safe patient care alternative.
• Takes the initiative to seek forma and informal supervision, incorporating suggestions for improvement/changes in job performance.
• Performs other related duties as required, assigned, or directed by Clinical Director and Exposure Coach III.
• Coaches participate in a weekly DBT consultation team with clinicians (Psychologists, Psychiatrist) and fellow exposure coaches on the team. 
  

MINIMUM QUALIFICATIONS

BASIC KNOWLEDGE

• Baccalaureate Degree in a Human Service field. Other education and experience considered and may be substituted for educational requirements at the discretion of the Hiring Manager.
• Demonstrated knowledge and skills necessary to provide care to patients throughout the life span with consideration of aging processes, human development stages and cultural patterns in each step of the care process.

Bradley Hospital Safety Care Certification:

Employees in this position work in a psychiatric setting under stressful conditions associated with care of psychiatrically impaired, aggressive, and sometimes, self-injurious individuals. Employees are expected to utilize de-escalation techniques taught by Bradley Hospital to minimize need for physical intervention. They must have the ability to remain calm during a crisis as evidenced by the ability to make quick rational decisions and prioritize immediate patient care needs to maintain a therapeutic environment and ensure safety.

Employees in this position must also be able to participate in the physical management of patients which can include, but is not limited to, awareness and demonstration of safe body positioning always, awareness and coordination to block and deflect possible aggression, and the ability to physically hold struggling patients, using approved methods only, to maintain safety for extended periods of time. Specifically, such employees must be able to: lift up to fifty pounds; reach with their hands and arms; grasp and hold with their hands; bend/squat/kneel without limitation and physically escort patients who may become combative for short distances. Position requires occasional running for short distances, and frequent standing, walking, and sitting.

Pediatric Anxiety Research Center Training in Exposure Treatment.

Employees in this position must complete 1 month of on-the-job training in the exposure treatment approach. This training involves short didactic readings, observing experienced staff and being observed by experienced staff in conducting effective exposure exercises that are adherent to the principles of the exposure model.

At the conclusion of this training, employees in this position must show evidence of being able to identify patients’ core fears and the functional relationships among their symptoms.

Employees must be able to adapt exposure plans in real time while working independently with patients and their families on home visits. These adaptations must be consistent with the case conceptualization and must be adherent to the principles of the exposure model.

EXPERIENCE

• Six months to one year of direct childcare work with emotionally impaired youth.
• Current Bradley Hospital Safety Care Certification.
• Current CPR certification.
• Current ERS, OSHA and Safety Certification.

SUPERVISORY RESPONSIBILITY

None

Pay Range:

$19.03-$31.39

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

Bradley Hospital - 1011 Veterans Memorial Pkwy East Providence, Rhode Island 02915

Work Type:

M-F 8am-5pm

Work Shift:

Day

Daily Hours: 

8 hours

Driving Required:

Yes