Targeted Case Management

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Targeted Case Management (TCM) is a mental health service that addresses needs that may be outside the scope of therapy or psychiatry.

Wraparound Targeted Case Management is a highly effective additional layer of support to mental health counseling.  Tykes & Teens is the leader of the evidence-based Wraparound movement of case management on the Treasure Coast.

This team-based approach focuses on a family’s strengths, needs and culture in order to address complex behavioral health and material needs such as attaining stable housing, finding childcare and ensuring other basic needs are met. In study after study, the Wraparound Model produces significant and long-lasting improvements in mental health symptoms and functioning.

Family voice, choice, strengths and natural support system are the foundation of Wraparound, meaning that a family’s culture and values are not only respected in the process, but they serve as its foundation.

Wraparound is a teaching model, which focuses on turning more and more of the process over to the family as we move through the case management process.  The goal of our Wraparound TCM services is to help children and families build new natural support systems that enable them to address their needs independently in the future.

Sofia & Katherine’s Story – a mother-daughter story of overcoming multi-generational impacts of trauma

For many of our clients and families, there is a history of trauma. When left untreated, this can have a lasting traumatic impact on future generations. Four-year old Katherine’s story starts before she was born with her mother, Sofia, who was abandoned along with her siblings by their neglectful biological mother at an orphanage. For four years Sofia suffered at the hands of the orphanage’s administration and even other children living there. She was sexually assaulted, malnourished and physically abused in the overcrowded facility. To make matters worse, she was separated from her siblings. She swore to herself that her children would grow up far away from such suffering. While Sofia was eventually reunited with her siblings and adopted by loving parents, the adoptive parents did not seek professional mental health support for the children because hey believed a caring and loving environment was all they needed. Sadly, their trauma could not be erased solely through love.

Years later and despite Sofia’s best efforts, she learned that her four-year-old daughter Katherine was experiencing similar trauma unbeknownst to her. Katherine’s father had been taking pornographic pictures and video of his daughter and posting them on the internet.

Upon starting individual outpatient therapy with Tykes & Teens, Katherine was diagnosed with Prolonged Post Traumatic Stress Disorder (PPTSD). This in turn triggered Sofia’s own PTSD and she was inconsolable. She blamed herself for not being able to protect her daughter and for placing Katherine in the same situation she herself had experienced in her youth. She had difficulty sleeping, eating, working and driving her car. She was also afraid to bathe Katherine out of fear that she would unintentionally cause her daughter to relive her trauma by washing her private areas.

The first step in healing both mother and child was creating stability by focusing on life’s essentials. Tykes & Teens provided Wraparound Targeted Case Management services which are designed to help children and families improve their level of functioning and serves as an additional layer of support to mental health counseling. We started with easy-to-complete action steps that gave Sofia a sense of accomplishment, focusing first on Sofia’s health and linking her to the mental and physical health services she needed. We also connected her to Medicaid and food assistance programs among other necessary services, including social security disability and applications for voluntary pre-K for Katherine. Sofia has made tremendous progress. She is driving again. She got a full-time job. She opened her first savings account. And she has successfully accomplished nearly all of her Wraparound plan!

All of this led Sofia to be able to take the next important step – helping her daughter begin the process of working through her trauma with a Tykes & Teens therapist. Our therapist helped Katherine understand that her trauma is not at all her fault and that she is entitled to a normal childhood doing what she loves – dressing up as her favorite Disney princess, Elsa, and playing with her mom. Katherine is making great progress. She has started pre-K and is acclimating well now to her new routine.

The abusing father was sentenced in U.S. Federal Court for two felony charges of manufacturing and distribution of child pornography, and sentenced to 70 years in federal prison with no chance of parole. He is also facing five additional felony charges locally.

*Name has been changed to protect client confidentiality.

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