One day, I threaten to change out our front door with a revolving door. With two kids in foster care from two different counties, the number of social workers, agency workers and therapists is quite a bit to manage. But the visitor count only multiplies when we’re in periods of intensive in home services.
When you’ve been doing this as long as we have the news that someone needs IIH means two things. First, that the family is in a rough patch. Second, their world is about to change.
Intensive in home services — sounds scary right? It really isn’t. Intensive, yes. In home, yes. Services… just means that you’re about to get a lot of assistance at one time.
Here’s a little bit on why and how it works from a family that’s got just a smidgen (read: a lot) of experience.
IIH is a type of trauma support recommended when there is an identified need for super saturated support. It could be for a period of intense behaviors that have been caused by a major life change. It could be to provide support following a mental health hospitalization or it could be to help a child adapt to normal home life for the first time.
When you need more support than a visit to an outpatient office once a week, IIH is the next logical step. It’s fully-paid through Medicaid (at least in North Carolina) and combines various types of therapy, behavior management, counseling and the teaching of vital life skills. As the name suggests, it takes place in your home.
Teams are made up of 2-3 professional therapists that work together but who often visit your home separately throughout the week. Most of the time IIH takes 5-10 hours per week over a course of three to four days. Often it is more but it can be less, depending on your situation. A course of IIH usually lasts three to six months before your are discharged.
Years ago, we had IIH when our oldest children came to live with us. The IIH team helped them integrate into the normal routines of a stable house. As we went through our daily lives (meals, play, bedtime routines, church, shopping, etc) the IIH team was with us, coaching us through various disruptions and discipline issues while working with the children to help them achieve normalcy.
For older children, it can be more direct. Team members can work with the children in the home to address specific behavior issues — even to the point of provoking a response to help the family respond and cope in a healthy way. Therapists come alongside the parents and siblings to help them adjust or handle complex issues in a healthy way.
When we get a new round of IIH, we’re usually at a point of relief because it means we have really strong support to deal trauma issues during an intense period of time. It also means that the therapists are going to see your laundry on the floor, your dishes in the sink, your unkempt bathroom and every bare emotion that you have. Nothing hides.
When you’re faced with a recommendation of IIH services for your family, embrace it. It’s going to be intense and invasive, but it’s also going to be some of the very best help that you can have while caring for kids who have experienced imaginable trauma.
Have you experienced IIH? Let me know your thoughts in the comments below!