10.4 Key Casework Practices with Adolescents

10.4.1 Assessment and Planning | 10.4.2 Transition Planning and Services | 10.4.3 Use of Lifebooks with Adolescents | 10.4.4 Behavioral Health | 10.4.5 Physical/Medical | 10.4.6 Education | 10.4.7 Housing | 10.4.8 Employment | 10.4.9 Youth in Residential and Department of Corrections

Adolescents must be provided with essential services to help them develop the skills for a successful and competent adulthood. The caseworker, birth parent, foster parent and service providers are most effective in providing the required services and programs when there is a team. It is critical, as with all cases, for the worker to engage the Child and Family Team to assist with planning, resource development and decision-making. The adolescent should be an active participant on the team. All critical decisions regarding the youth's future must be made with the Child and Family Team and in consultation with the supervisor.

The worker's relationship with the youth is pivotal to the successful and meaningful strategic planning for the youth's future. The caseworker may assume multiple roles in relation to the adolescent. These roles may include coach, mentor, mediator, advocate and role model. Which role the worker assumes and at which time are dependent on the needs of the youth at any given point in time.

Practice has proven that the following continuum of preparation services and supports are the most beneficial to adolescent in substitute care:

10.4.1 Assessment and Planning

All youth in care, 14 years of age and over, regardless of the placement type or permanency goal, must be provided services designed to prepare him/her for adulthood. At a minimum, each youth must have a life skills assessment in order to establish a baseline. The assessment must be administered at the following strategic intervals:

The adolescent's caseworker is responsible for administering the life skills assessment with both the youth and caregiver participating in the assessment process. The life skill assessment does not replace other specialty assessments (such as psychological assessments, SACY, etc), used to identify other conditions or issues that may require services.

The administration of the assessment at the intervals specified above provides a vehicle for ongoing re-assessment of life skills development. For ongoing use of the assessment, (prior to each case review) the caseworker must:

10.4.2 Transition Planning and Services

Transition planning and services are intended to prepare a youth for self-sufficiency when discharged from the guardianship of DCFS. The youth's caseworker shall incorporate transition-related objectives and tasks into the youth's portion of the CFS 497, Client Service Plan within 30 days following the youth's 14th birthday. For new placements, a transition-related tasks must be developed within 30 days of placement.

Before transition tasks are finalized, a family meeting must be scheduled. Participants should include the caseworker, his/her supervisor, the youth, the caregiver and the youth's birth parent(s) and/or relative(s) when feasible and if the youth chooses to invite them. Other interested persons such as teachers, counselors/therapists may be invited at the youth's discretion and consent. At this meeting, the youth's occupational and/or post-high school educational interests shall be discussed, including options for college education or vocational programs. The youth's need to develop skills and/or knowledge to enable him/her to live independently shall be reviewed.

The caseworker will base the transition tasks on a thorough assessment. Tasks must be developed based on the input from the family meeting and in collaboration with the youth. The transition-related service plan must contain the interventions and services that are to be provided, specific time frames for completion and who will be responsible for specific tasks leading to the successful completion of a service or intervention.

The transition-related service plan should also specify:

Concurrent planning continues to be a critical aspect of successful service planning for adolescents. Workers should be cognizant of alternative means to accomplish the independence goal in the event that the youth is unwilling or unable to accomplish the established objects and tasks. The caseworker will monitor the youth's progress in accomplishing transition tasks specified in the youth's 497 Service Plan Part II and will frequently discuss that progress with the youth.

"Services work best when a set of particular services are targeted to meet specific goals. The provision of any services, or even a number of services, that are not targeted to specific outcomes was not shown to be effective in providing the desired results" (Westat, Inc.,1987). Therefore, a transitional living plan that focuses on the independent living preparation services to meet a youth's particular needs is a critical step in ensuring a youths' successful transition to independence.

Education is a primary requirement of a successful plan for independence. The caseworker must ensure that all youth are given the opportunity and assistance to complete their high school education. The education plan shall be included in the transition-related service plan. Use of the Graduate Equivalency Degree (GED) may be considered only when completion of high school is not feasible or practical. Completion of high school is an important milestone in the transition to independence. The decision to drop out of school should be discouraged. The plan should identify the efforts made by the caseworker and caregiver to assist a youth to remain in high school. The reasons for the youth dropping out must be documented in the record in addition to a plan to provide for the youth's educational needs. Each region has an Educational Advisor located in the regional offices that can provide technical assistance and consultation to caseworkers on educational issues and specific educational systems.

10.4.3 Use of Lifebooks with Adolescents

Each youth is entitled to documents necessary for self-sufficiency as an adult and to enhanced self-identity through understanding his/her own past. A Lifebook is an account of the life of a child conveyed in words and pictures that can enhance that understanding. Lifebooks afford children an opportunity to explore their past and to question, understand and accept their own life histories. The caseworker should develop the Lifebook as soon as a child comes into care. The caseworker must ensure that the Lifebook is updated throughout the child's foster care stay.

Use of Lifebooks may also enhance the youth's strengths and help improve his sense of control over his life. The caseworker must assist the youth in obtaining or compiling a Lifebook and other documents necessary for the youth to function as an independent adult. Lifebooks can be made from spiral notebooks, 3-ring binders, scrapbooks or an accordion folder. The Lifebook is an ongoing project for the youth, caseworker and substitute care provider throughout the youth's life in substitute care.

Following is a list of documents to be included in the youth's Lifebook:

The Lifebook should be updated throughout the child's foster care stay and should be discussed with the youth during worker visits.

10.4.4 Behavioral Health

Adolescents or children who have serious mental health issues are commonly referred to as SED. They may have been admitted to a psychiatric hospital at least once and have a psychiatric diagnosis. Their serious emotional disturbance can be incipient to a mental illness that will evolve as they approach adulthood. They are placed in all placement types from foster care to residential programs. These youth may need to be transitioned to the adult mental health system depending on the severity of the mental illness and the youth's ability to care for him/herself. For those youth who demonstrate the ability to live independently, they need to be given the opportunity to learn life skills and practice those skills in a supportive setting. The Division of Education and Transition Services should be contacted for assistance with adolescents who are transitioning to adult services.

Many adolescents will need to be involved in individual and/or group counseling to deal with their feelings and apprehensions and to help prepare them for living in a self-sufficient manner. Adolescence is typically a time of turbulent feelings, conflictual relationships and distorted self-image. For youth in the substitute care system, these developmental crises become exacerbated due to their already low self-esteem and poor self-images. For these young people, the transition to independence can be an abrupt and fearful experience. Adolescents in substitute care often have a weakened and diffused sense of identity, and may therefore have less resiliency with which to face independence. It is imperative that adolescents address unresolved developmental, identity and familial issues. Caseworkers must continually assess the youth's mental health and make appropriate referrals to mental health providers.

Depression is common and treatable. Many teens hide their feelings and others don't know that they are suffering from depression. Some act out their distress through anger, aggression, running away or delinquency. Some teens numb themselves with drugs and alcohol. Both of these drugs mask depressive symptoms. It is critical that youth with symptoms of depression or suicidal ideation see a professional for proper treatment and care. If imminent danger is present, an immediate referral to SASS has to be made by the caseworker and signed by the supervisor.

Indicators of Potential Suicide Risk

Suicide is a scary subject; however, if a youth on your caseload is hinting about suicide, discuss it with him. Talking about suicide can help a suicidal person think of other options. Assume that the youth is serious and take immediate action to get a SASS assessment and therapeutic assistance. It is important to find a trained professional who understands teen depression. In addition to the above indicators of suicide, see the Appendix A for indicators of depression and other mental illness.

A caseworker should do the following if the above symptoms persist for more than a week with a youth on their caseload:

(Adopted from When Nothing Matters Anymore: A Survival Guide
for Depressed Teens, Bev Cobain, R.N.)

Substance abuse is a serious problem affecting many teens and needs to be addressed immediately after it is identified. It is more likely to impact on the foster care population because a large majority of their families also have substance abuse as an identified issue. See the Appendix A for indicators of substance abuse.

Developmentally delayed youth may be more dependent upon the agency and the community. Services should be directed toward supporting the youth and his/her placement and preparing him/her for eventual discharge from foster care to another appropriate adult program or living situation. Caseworkers must collaborate with other public agencies to provide services for these adolescents (Griffin, 1987).

The Department of Children and Family Services, the Department of Human Services (DHS) and the Guardianship and Advocacy Commission (GAC) have an Interagency Agreement that mandates joint planning among the three agencies to ensure that agencies effectively work together to provide for the smooth transition of DCFS children with developmental disabilities to adult living. Joint planning should begin when the youth is 17-1/2 years old and is commenced when a worker makes a referral to the independent service coordination agency (commonly known in the field as the "PASS" or "PASSAR" agency). The Division of Education and Transition Services should be contacted for assistance in this process.

Note that the Daniel Memorial Life Skills Assessment should not be administered to the developmentally disabled population.

The Department and the Illinois Coalition Against Sexual Assault (ICASA) developed standards to guide intervention with sexually aggressive youth. The standards, which were adopted in July of 1996, outline procedures for DCFS and private agency service providers responding to sexually problematic and aggressive youth. The intent of the standards is to ensure that all persons are protected from sexually problematic or aggressive behavior of youth in the care of DCFS and to ensure that a youth in care who is engaging in aggressive sexual behavior receives appropriate intervention. In addition, the standards ensure that youth/children who engage in sexual behavior that is developmentally expected will not be identified as sexually problematic or aggressive.

Sexually aggressive behavior involves actual coercive touching of another child to include penetration, fondling, etc. These behaviors are not initiated for affection, but rather for the purpose of power or control or for sexual pleasures. Children who are the instigator or initiator of these behaviors may deny their involvement or implicate the other child(ren) as the initiators.

(The preceding material was adopted from Chapter 1 of the Sexually Aggressive Children and Youth Procedures and Standards, adopted July 1996).

10.4.5 Physical/Medical

Adolescents will need regular health screenings to assure continued normal physical development. All wards receive the public aid medical card that covers physical and dental health services. In addition, other special health needs may be covered such as eye care, orthodontic work, gynecological exams, etc. Pregnant youth may receive prenatal care, delivery and post-delivery services. The youth will need to apply for a medical card from Public Aid for her baby.

All teens in care need to receive information regarding STD and safe sexual practices. HIV testing should only be done when there is a strong likelihood that the youth may have been exposed to the HIV virus (for example, where the youth has been on run and engaging in risky behavior.) Information regarding one's HIV status is confidential and can be disclosed only in specific, restricted situations. Refer to the AIDS Confidentiality Act for more information.

Adolescent pregnancy is an untimely occurrence for all youth. Adolescents are not prepared to assume a parenting role. Because most youth in care have experienced poor parenting that led to abuse or neglect, it is critical that they receive in-depth assistance in learning how to parent in addition to learning independent living skills. Care should be taken to avoid assuming that these youth are "adults" simply because they are now mothers or fathers.

When the caseworker learns that an adolescent in care is pregnant and/or parenting, s/he must ensure services are tailored to meet the adolescent's parenting role. Caseworkers should not assume that only females should be provided with auxiliary services because of their added responsibilities. Adolescent fathers should also be included for appropriate parenting services.

DCFS has developed and provides services for the pregnant and/or parenting population (refer to Procedures 302, Appendix J). These services are geared to helping parenting adolescents become more effective parents. Even though the infants are not wards of the state, the worker should make every effort to engage the mother and/or father to participate in programs for their child. Workers should never use threats of removal of the child to get adolescent parents to cooperate with services. The child should not be removed from the ward parent unless there is imminent risk of harm to the child and/or children. Services should be delivered in a manner consistent with the adolescent's type of placement.

10.4.6 Education

Middle and high school years can be a difficult period for youth. However, these years are critical in terms of the vocational and career decisions that have to be made at this time. Educational decisions made in high school can affect the course of one's career, choice of college and eventual success in the job market. Many DCFS wards choose not to go to college. For these youth, sensible decisions regarding job skills need to be encouraged. All too often our youth choose to drop out of high school altogether. It is particularly important that these at-risk youth be identified early so that intervention strategies to keep them in school can be developed. Frequent contact with teachers and guidance counselors, encouragement of caregivers to be involved in the youth's educational program and support for the youth around school work (tutors, special educational programs, gifted programs, etc.) will go far in providing a sound educational foundation for our youth as they prepare for college or full-time work.

The DCFS Scholarship program provides supplemental services, maintenance payments and tuition waivers to a limited number of adolescents for whom the Department is currently legally responsible. Children previously under the guardianship of the Department prior to adoption or subsidized guardianship are also eligible to apply for a scholarship. Senior high school awardees may participate in the program for four consecutive years without having to reapply each year. Students can now appoy in any year following their high school graduation.

Requirements include:

The scholarship provides tuition and academic fee waivers to all nine Illinois state-supported colleges and universities for up to four consecutive years, a medical card and a monthly stipend that is valued at the regular foster care reimbursement rate.

The DCFS Scholarship Committee makes the scholarship selections on a competitive basis each spring. Youth may attend a private school or one out-of- state and still receive the stipend and medical card. However, schools other than those supported by the State of Illinois are not obligated by law to waive the tuition and academic fees.

All scholarship recipients must have applied in January of their high school senior year for Federal Financial Aid (FFA). The DCFS Scholarship DOES NOT cover dormitory or any room and board expenses.

10.4.7 Housing

In many instances the adolescent is sophisticated enough to advocate for themselves when their health, safety and well-being are in jeopardy. Risks to adolescents in care may go unrecognized by caseworkers. Caseworkers must take into consideration those risk factors related to safety when considering a placement for the adolescent, particularly if the placement is a relative care situation. The caseworker must conduct an assessment of safety prior to placing any youth in a substitute living arrangement. This task becomes a little more complex when the youth will be living in an apartment or boarding situation. The caseworker, however, needs to be involved with the youth in identifying and selecting this type of living arrangement to assess the risk factors of the neighborhood and community for appropriateness. The critical questions the caseworker should be addressing are:

10.4.8 Employment

Finding jobs is a major challenge that faces all young adults. For those about to leave foster care, sound preparation to make employment decisions is even more critical. Preparing youth to work, therefore, must be a primary treatment concern for foster care programs serving older adolescents. (North, Mallabart and Desrochers, 1988).

The components of employability are best described as:

DCFS has mandated that all youth 14 years and over must have work or volunteer experience incorporated into their service plans. One of the best ways to independence is through work. Many youth are capable of and will find their own jobs or volunteer placements. Developmentally disabled youth can be referred to the State of Illinois Department of Human Services, which provides job training and job coaching services for this population. While there are some youth who may resist development of pre-employment skills or maintaining a job, it is incumbent upon the Child and Family Team (especially caregivers) to expect and support development of this self-sufficiency skill. Resistant youth may require more support until they develop good work habits. There are many resources and job programs available to assist the caseworker and caregiver.

Employment and training opportunities for Department youth are provided through collaboration with the Illinois Department of Employment Security and Department of Commerce and Community Affairs. Youth enrolled in the programs receive meaningful work experience, job skills training and in some cases, an opportunity to earn extra school credit. The Department employs a youth employment coordinator who facilitates interagency communication and ensures that workers and youth are made aware of job opportunities.

In addition, the Department has contractual relationships with private providers to secure job placement services for eligible youth. The Division of Education and Transition Services has more information on how to access job placement services. In addition, job skills assessment and preparation, job placement, job fairs and training for staff regarding how to best utilize these supports are available. The focus is developing job opportunities that pay more than minimum wage, have career possibilities and have benefits, which are all critical for youth emancipating out of care.

Youth age 14-21 may be referred to the Job Training Partnership Act (JTPA) summer employment program throughout the state. The goal of the Summer JTPA is enrichment, school drop out prevention and job experience.

In Cook County only, youth who are 14-20 years of age may participate in the Mayor's Employment Training (MET) program. The purpose of MET is similar in scope to the JTPA programs. Other options for employment are Job Corps and the Lincoln Challenge Program. Contact the Division of Education and Transition Services for more information.

In the world of work for the first time, foster youth must relate to an adult who is totally foreign to them. Caseworkers have a dual role in helping the youth develop employment skills. Caseworkers should ensure that caregivers are providing the support necessary for a specific youth. If the caregiver is unable or unwilling, the caseworker must identify services to assist the youth directly.

The foster parents or caregivers play a vital role in their foster youth's search for employment by assisting the youth with:

After the youth has obtained a job, the foster parent or caregiver plays a very important role in helping the youth become successful in the job. The caregiver should know:

Other ways in which the foster parent/caregiver can assist the foster youth include making sure he/she has an alarm clock or other reliable mechanisms for waking in order to be on time for work; supplying appropriate clothing, personal hygiene items and necessary spending money for transportation and lunch; scheduling treatment for health problems and eyeglasses so that absences from work are limited; and adjusting home chores to the youth's work and school schedules.

The foster parent should work with the youth on money management and encourage the youth to make deposits into the youth's savings account. The youth's caseworker also plays a very important role in assisting the youth identify and acquire employment. The worker can make referrals to youth employment services and help the youth prepare for the interview.

10.4.9 Youth in Residential and Department of Corrections

Youth placed out-of-state, to the extent that it is feasible, must also receive independent living preparation services. The Department has amended all substitute care contracts to include preparation for independent living services.

DCFS youth who are in the custody of the Department of Corrections (DOC) will receive appropriate independent living preparation prior to their parole or discharge date if it is indicated in their discharge plan, or they must be placed in a post-discharge setting that will provide independent living preparation services.

10.4.1 Assessment and Planning | 10.4.2 Transition Planning and Services | 10.4.3 Use of Lifebooks with Adolescents | 10.4.4 Behavioral Health | 10.4.5 Physical/Medical | 10.4.6 Education | 10.4.7 Housing | 10.4.8 Employment | 10.4.9 Youth in Residential and Department of Corrections