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What is a Home Visit?
The groundwork for a successful working relationship with FamilyLight usually begins with a Home Visit. Usually scheduled on a normal business day, it is a daylong meeting between the FamilyLight consultant(s) and the family. The Home Visit must be on a day free from distractions, obligations, and all other responsibilities. The purpose of this visit is to gain awareness of family interaction and to openly discuss the issues at hand
Why a Home Visit?
We instituted the Home Visit tradition for these reasons:
- Since our clients are scattered around the country, and to some degree around the world, the standard concept of the client going to a professional office is unrealistic. It is far more cost-effective for the consultant to travel to the family.
- Some families engaging our services have a young person whose behavior is seriously out of control. Since getting to know the young person is vital to making any qualified recommendations, it is more practical, especially in these cases, for the consultant to travel to the family’s home. Many oppositional young people would not go to a consultant's office, but we have yet to find a teen not at home for a home visit. (Only exception has been a young lady involved a traffic accident while our consultant was on his way to her home)
- Historically, before Tom Croke became an educational/ special needs consultant, he discovered that he could learn more about people in their homes than in a professional office setting. Prior to becoming a consultant, Tom was doing much work in people's homes that was more traditionally done in a professional office, and he was frankly more comfortable doing home-based work.
(Because we work with a home visit model, we do not maintain office space suitable for meetings with clients. Our office space is workspace only.)
We maintain the Home Visit tradition because we see these results:
- The Home Visit establishes a sound basis for a working relationship between our consultant and the family.
- We affirm the young person. Several times Tom has met with groups of young people already in programs, some of whom he had referred and some of whom had been referred by other consultants. The student we referred becomes the envy of the group. Young people in the group talk about the "educational consultants [they] don't even know" deciding how their lives are to be run (that is how they see it at least). Then my client will speak up and say, "I not only know my consultant. He came to my home just to see me and he took me to lunch. And he really listened."
- The home visit establishes a sound basis for a working relationship between our consultant(s) and the family. (We acknowledge that an in-office visit might accomplish as much if the young person goes to the office with in a positive frame of mind)
- We usually identify the common ground among family members in families that did not think there was common ground.
- We begin the process of intervention with young people who may be resistant to moving in a constructive direction.
- We help to determine that all reasonable alternatives are exhausted before placement. (Our view of "reasonable alternative" is based upon what is practical and is more likely to endorse residential placement than most public agencies, insurance companies and managed care caseworkers. We are working for what is good for the child and the family; not saving some bureaucracy's budget.)
- We observe personality nuances that can contribute to the success or failure of any proposed solution and the synergy with any particular proposed program. Even with a cooperative young person who would go to a professional office easily, we believe we get a better picture at home.
- We give the young person confidence that his/her life is not being run by a stranger and that the person guiding the parents knows and respects the young person.
Will our son or daughter actually sit through a meeting like this?
With rare exceptions, yes. As you read through all that is on this page, you will see why we usually keep young people involved, including those you would expect would not handle a lengthy meeting. It actually works well even in the majority of families where the parents tell us they do not think it will work well. This includes all ages and with various issues including usual examples of ADHD.
- We have never had a young person not present for a home visit. Two exceptions: When Tom first started this procedure in 1993, he got to see one young man disappearing over the back fence. Now we have improved our procedure so that particular scenario would not occur. We also had one young lady injured in an accident while Tom was on the way to her house. The young people clearly could absent themselves. For some reason they never do. We think curiosity is a factor.
- With very young children and/or developmentally delayed or developmentally disabled children, and/or children with self-regulation issues that are far beyond typical ADHD, we need sometimes need to modify the usual approach.
- Rarely, an oppositional young person will refuse to come into the room where the meeting is occurring. That does require a modification of our procedure. In all such cases in the past our consultant has made meaningful contact with the young person during that day. Most of the time when the parents anticipate this situation the young person does participate, after initial resistance.
- Once a young person is in the room where the meeting occurs, the way we handle the meeting invariably draws the young person in for at least the morning session and cooperation develops. This procedure is explained below. We always make the afternoon session optional for the young person. This might turn out to be just the parents and the consultant. Following the meeting with parents and the young person, we want some opportunity to hear from the young person out of hearing of parents. That is the only additional time we need the young person present, and we are very flexible on how to accomplish that. We nearly always get cooperation for the part of the meeting where the young person's participation is important. When we do not, the manner in which cooperation is resisted, tells us what we need to know. However, those situations where we do not get cooperation almost always lead to a recommendation for placement in a structured environment very quickly. The uncooperative ones are the rare ones who simply refuse to come into the room.
- We will very rarely refer a young person to an evaluation program (which might be a clinical wilderness program) prior to a visit if to do otherwise would be dangerous, in that case we do that visit at that program. Occasionally, the young person is already in a program of some kind when we first become involved. Again the visit can occur at that location if that program allows it.
- We do not work with clients who allow us to have no opportunity to meet with the young person at issue either in person or in a teleconference.
Who should participate in a Home Visit?
The parents, young person, and FamilyLight sm consultant are usually the main participants in the home visit and need to be available for the entire time without interruptions or scheduling conflicts. The term “parent”, as used in this context, is defined as any person in an active parenting role with the child or young person.
All parties to legal or physical custody of the young person must be notified of the consultation and, depending on the individual circumstances, should be present for the entire Home Visit. We have been advised by legal counsel that it is illegal for any person to engage in a process of educational planning without all parties to custody having the opportunity to participate fully. If there are incompatible people among the parties to custody, as might be an issue following a difficult divorce, we will discuss possibilities of alternative arrangements.
Sometimes a question arises about the inclusion of another person who has a particularly close relationship with the young person (such as a grandparent or a therapist). We have two criteria: (1) Such a person should be acceptable to the parents as a constructive person in the life of the young person and (2) this person must be someone the young person would view as supportive to him or her. We do not want to include additional people who might contribute to a sense of "ganging up."
It is not usually necessary that siblings be present. If they are home it may be nice to meet them. Their schedules should not be disrupted for this visit. (There could be rare exceptions where the presence of a sibling during a home visit would be important) Sometimes a sibling of the young person of concern, usually a younger sibling, may have been impacted by problems in the family. If it is constructive, our consultant will take time with the sibling.
Professional input is obtained through telephone conversations with clinicians prior to or following the Home Visit. Although it is not typical, occasionally a young person will request the presence of a therapist or trusted professional advocate to attend the Home Visit. If arranged in advance, it is usually constructive for the young person making the request to have that professional present for approximately an hour at the beginning of the visit.
When a young person is already in a placement outside the home and the “Home Visit” needs to be conducted at a specific program location, we like to have a representative of that facility present for about an hour at the beginning of the session.
Scheduling your home visit
When parents wish to engage the services of FamilyLight, a family coordinator will assist parents in completing the Service Agreement and scheduling the home visit. The home visit date is not confirmed until the completed and signed Service Agreement is in our possession at the Greensburg, PA, office.
Home Visits are scheduled Monday through Friday and are approximately five hours in length. They generally begin at 10:00 a.m. and conclude when the work is complete about 3:00 p.m. Because the session might run longer, we ask you not to to schedule anything immediately following the anticipated conclusion of this session.
Planning for the Home Visit
Perhaps the most important part of planning for a home visit is to be certain that the day is free of distractions and interruptions. All parties need to be present at the agreed upon time. Parents need to arrange to be absent from work and for the young person to be absent from school. Telephones, cell phones, and pagers should be turned off during the meeting, allowing an answering machine to pick up all messages. The consultant will have a cell phone to be accessible only to the FamilyLight office only for emergencies. Parents may also set up a means for someone to reach them in an emergency. As the visit progresses, there may be several short breaks during which a parent could touch base with the workplace to deal with critical matters.
We hate to say it but it is true. Teenagers in the range between resistant and unenthusiastic about the Home Visit do better if they are missing a day of school. That is not an absolute, but it can make a difference. Some parents for obvious reasons try to schedule so that the Home Visit will be on a day the young person does not attend school. However the Home Visit should be an excused absence and more often than not things work better on a school day.
If parents discover that the scheduled home visit date does not allow everyone involved to be available for the entire time, they should inquire about a change of date. We will not start the visit until all are present, as we feel strongly that this level of commitment and cooperation is necessary to ensure the success of the home visit. We will not schedule a home visit at a time that both parents cannot be present for the entire time and giving this event their full attention.
The FamilyLight consultant does not depart for a home visit until the Service Agreement has been received in our office in Greensburg, PA, and payment arrangements have been finalized.
The young person’s biography – usually written by the parent – and all available clinical and academic records regarding the young person – should be sent directly to the consultant prior to the home visit. The biography should be approximately two pages in length and should include a description of significant events in the young person’s life from infancy to the present. A detailed psychosocial history, included as part of the clinical records, may be substituted for the biography, provided parents believe the history is accurate as stated. More lengthy biographies are certainly welcome if parents feel additional information would give the consultant a better understanding of the young person.
To assist with your preparations, make sure you follow the checklist for a home visit.
Discussing the Home Visit with the young person
Under no circumstances should parents lie to the young person. Parents lying to a son or daughter even to achieve a good purpose can destroy trust in a manner that it may never be restored.
One of the following options may apply:
- If the young person is likely to be cooperative or enthusiastic about what we are doing, then it is generally wise to be as informative as possible regarding the home visit and consultation. In this case it is wise to involve your son or daughter in the planning process at least as soon as you are definite with your plans to work with us. In some cases, it might be helpful to discuss it with your son or daughter even while deciding. You will want to wait until you are committed to going forward if (1) your son or daughter is likely to feel intimidated by the possibility of going forward with the consultation, or (2) your son or daughter will feel that an opportunity has been taken away if you do not go ahead with the consultation. The scenarios where you do not discuss the matter with your son or daughter until you have decided have in common any situation in which your son or daughter is likely to become overinvested in a particular outcome and to be negatively impacted emotionally if you make a decision contrary to his or her preference.
- If the young person is likely to resist participation in any way, we think it is better to wait until about 48 hours prior to the visit. This gives her or him time to prepare mentally but does not give time to a major plot to derail the process.
Following are suggestions for a non-threatening way to approach a reluctant son or daughter:
- Communicate the idea that you believe there is a problem that you as a parent need help solving and that an outside consultant has been engaged to help the family resolve issues. Tell your son or daughter that the consultant has said that "he needs to meet you [your son or daughter] and understand how you see things" in order to consult with parents. Do NOT say the consultant is coming to "help you."
- If your son or daughter says she/he will not to attend, make it clear that you want him/her there and a “solution” will be based solely on parental input if not, which may not be fair to the young person. Attendance by the young person allows him/her to be involved in the decision-making process. If you can do it without making is sound like a threat, you might mention that residential placement is at least a possibility, and being present at the home visit avoids having a solution imposed without the young person’s input.
- Invite the young person to telephone the consultant prior to the meeting. Most will not actually make the call, but a few will. The ones who don’t will at least know that they were invited to do so and will be somewhat reassured by the invitation.
- Even the most challenging and out-of-control young person will generally participate in the home visit if the information has been presented in a fair and truthful manner.
Procedures during the Home Visit
Home Visits normally begin at 10 a.m. on the scheduled date. If necessary, alternate times may be discussed with your consultant; however, please read through this entire section before suggesting any variations.
The morning session is the one thing that has changed significantly for the better in the past few years. We had originally used that time to involve the young person in obtaining history. We generally have fairly complete history already at hand with the information submitted in advance. Instead we take just a moment at the beginning to make sure the young person knows why the consultant is here -- keeping this to less than a minute if at all possible. We then move immediately to asking the young person to talk about talents, accomplishments, and interests. After the young person has time to say all he or she might want to say about this, we invite parents to join this discussion. At this time all references to problems and other negativity are off limits. This is a very affirming experience for the young person who may be getting mostly negative feedback most of the time.
After we have exhausted that topic, we move on to a discussion of problems. Again the young person is invited to take the lead. Following the very affirming conversation we have just had, the young people are remarkably open about what is going on. We always invite the young person to speak first and to take control of this part of the meeting, then invite parents to elaborate with more details and items missed. Most of the time the young person will simply tell us what is happening, including those things that we might expect young people not to want to talk about. More often than not they will reveal information the parents did not previously know, although no pressure is put on them to do that. A few teens will ask their parents to speak to this issue instead of doing it themselves but are open to parents putting it all on the table.
Surprisingly, these discussions of problems rarely become the least bit confrontational. The most likely place for friction to occur would be after a young person has given an account of problems, leaving out something that is important to parents and the parents bring that up. We do need to have all issues that we will be addressing out in the open during this time, so negative reaction from the young person is not a good reason for parents not to say what they are thinking. But we do want it all out in the open and we want to gauge the young person's way of relating to each piece of information that comes out.
In all cases during these meetings we invite the young person to talk. We demand nothing. We locate the meeting in the most comfortable location for the young person. We let the young person choose how much to participate. They always choose to participate, once in the room. We let the young person control the agenda as much as possible within the outline we have identified here.
If we run into serious resistance, it will show immediately by the young person not coming into the meeting room. It is not unusual to have the young person not quite out of bed when the consultant arrives. We work with that and usually it resolves itself quickly. We have on rare occasions modified our schedule because of a young person willing to speak with our consultant but not in front of his parents. A few young people have refused to engage the process directly at all. However the interaction between the parents and the young person who resists generally tells us what we need to know in order to make an initial referral. Those situations almost always call for prompt residential placement.
Historically, we have invited the young person to go to lunch with the consultant, away from the parents. This served the important dual purpose of giving insight into how the young person functions differently away from parents and gives an opportunity for the young person to talk privately with the consultant, while doing something most young people enjoy (eating). However we are no longer meeting with the young people alone apart from parents (possible exception with young adults; see item 1 below). We still want to hear from the client young person usually under conditions where the parents cannot hear but at least one parent is able to observe us in line of sight. Telephone, Skype, and FaceTime offer other possibilities.
We currently have these options for lunch time:
1. When the young person is 18 or older we might follow the traditional lunch out but we will do it selectively. We have come to like the other options and even with young adults a one to one meeting is not risk free.
2. Parents may provide a light lunch for everyone, which also will be an opportunity for everyone to have a break from the task at hand. The casual conversation with the whole family together can provide important insight that we missed in the traditional “lunch out.” Before or after that our consultant would like to confer with the young person where parents can see what is happening but remain out of hearing.
3. If the young person is under 18, parents may transport the young person to a restaurant where our consultant and the young person can have lunch together as has been customary and parents are in the same restaurant but not close enough to overhear. We apologize for the inconvenience this creates for parents, especially when we prefer that the young person be allowed to choose the restaurant. When this option is used, we ask the parents to remain in the same restaurant. The cost of lunch for the consultant and the young person is still "our treat."
4. Parents may transport all of us to a restaurant to have lunch together with same advantages as number 2 above. As in number 2, the consultant will still like to have a conversation with the young person. If the young person is under 18, this should be where parents can see but not hear.
5. The "Skype" option for the entire home visit provides a further alternative, although we feel this us usually less helpful.
In all of the above, the young person has consistently responded well, except the Skype option does not work quite as well as the other methods. This time enables the young person to express his/her point of view and specific concerns in a more neutral setting. Even if a positive rapport is not developed at this time, young people in placement are likely to be less resentful and more invested if they feel they know “their consultant.”
After lunch, the consultant will begin to develop a plan with the entire family. This plan could involve placement in a school or treatment center. Or, a structured plan could be developed with a parent coach; this would allow the young person to continue living at home under a set of specific expectations known as a Home Contract.
If any of the above procedures cause concern, please discuss this with us prior to the visit.
After the home visit
At the conclusion of the home visit, the consultant provides a time to answer any questions or concerns about the proposed “solution”.
The consultant, the family coordinator and the parent coach will fully develop the plan outlined during the home visit. This can include contacting the treatment resources and/or schools and requesting literature, as well as facilitating the application process. If the suggested plan includes efforts to allow the young person to remain at home, the family coordinator/parent coach will work with the parents to lay the groundwork for implementing a Home Contract.
For the term of the Service Agreement, the resources of FamilyLight will be at your disposal. Although we don't make it a binding part of our contractual obligation, typically we normally continue to monitor your son's or daughter's progress in any facility to which we refer for as long as that placement continues, notwithstanding that the service agreement may have expired.
Last update May 16, 2018