Youth Mentoring Registration

Transcription

1 Youth Mentoring Registration TODAY S DATE CLIENT NAME: DOB: REFERRING ORGANIZATION ORGANIZATION: CONTACT PERSON: PHONE: How will these services be paid for? (check one) o WPS o CCS o County o LSS o Other If the assessment/services are funded through the Children s Waiver (WPS), we need the Authorizations on or before the day of assessment and before services are rendered. Assessment Authorization must be for the date of the assessment appointment only and in the amount of $150. Ongoing Services Authorization must have all pertinent information, including the start/end date of authorization, the appropriate service codes, definition of unit, unit rates and number of approved units. Billing Agency s Information: Name of Agency: address: contact person: BASIC FAMILY DEMOGRAPHICS LEGAL GUARDIAN: MOTHER S NAME: FATHER S NAME: MOTHER S ADDRESS: FATHER S ADDRESS: MOTHER S PHONE: FATHER S PHONE: SIBLINGS (names, ages, note if in same household): SIGNIFICANT FAMILY INFORMATION:

2 CLIENT S STRENGTHS & POSITIVE CHARACTERISTICS PRESENTING ISSUES (check all that apply) o AODA o Suicide Tendencies o Property Destruction o Enuresis/ Encopresis o Sexually Active o Delinquency o Sexually Abused o Gang Affiliation o Sexually Inappropriate o Medical Concerns o Depression o Physically Abused o Attachment Issues o Animal Cruelty/ Fear o Eating Disorder o Smoking o Physically Aggressive o Emotionally Abused o Cognitively Delayed o Elopement o Fire Setting o Verbally Aggressive o Other: EXPLAIN PRESENTING ISSUES Client History PRIOR PLACEMENTS o AWOL o Foster Home o Hospital o Corrections o JCI o Group Home o Detention o Shelter o Respite o Home o Relative s Home o Adoptive Home o Home o Unknown o Other NAME OF PLACEMENT: DATES STATUS (Progress/Reason for Leaving)

3 The child is being referred for assistance in the following areas (check all that apply): o Academic Issues o Behavioral Issues o Delinquency o Vocational Training o Self-Esteem o Study Habits o Social Skills o Peer Relationships o Family Issues o Special Needs o Attitude o Other, specify: On a scale of 1-10 (10 being highest) rate the students level of: Academic performance Communication skills Social skills Attitude about school/education Self-esteem Peer relations Family support MEDICAL/PSYCHIATRIC HISTORY MENTAL HEALTH DIAGNOSIS: PSYCHIATRIST, PSYCHOLOGIST, THERAPIST / CLINIC (include how often seen and last appt.): HISTORY OF EXPLOSIVE BEHAVIOR? YES / NO TRIGGERS? DE-ESCALATING METHODS: PHYSICAL ISSUES / ALLERGIES: PRIMARY CARE PHYSICIAN: WHERE: MEDICATIONS/ REASONS/ DOSAGES/ SIDE EFFECTS:

4 RISK ASSESSMENT HISTORY OF SUICIDE/ SELF HARM/ HOMICIDAL IDEATION: PSYCHIATRIST, PSYCHOLOGIST, THERAPIST / CLINIC (include how often seen and last appt.): CURRENT POTENTIAL DANDER TO SELF: o Yes o No SELF HARM / MUTILATION: o Yes o No SUICIDAL IDEATION: o Yes o No DANGER TO ANIMALS: o Yes o No DESCRIBE SAFETY PLAN: DESCRIBE RELATED SAFETY PLAN: GENERAL SAFETY PLAN Describe steps to take in case of behavioral or mental health crisis while at Trinity Equestrian Center. Include names and phone numbers of support people along with any other relevant information. COURT DISPOSITION o CHIPS o JIPS o Delinquent o CH. 51 o Voluntary o TPR COURT REPORTS: Date Requested: Date Received: PSYCH EVALS: Date Requested: Date Received: PREVIOUS TX: Date Requested: Date Received: SCHOOL RECORDS: Date Requested: Date Received:

5 SCHOOL o Regular ED o Special ED o LD o CD o Mainstream o Partial Mainstream o Self-Contained Classroom SCHOOL ATTENDING: GRADE LEVEL: CLASSROOM TYPE: o Self Contained o Partial Mainstream o Total Mainstream HISTORY OF: o Truancy o Suspension o Expulsion CONTACT PERSON: PHONE: OTHER SIGNIFICANT SCHOOL INFORMATION: DISPOSITION APPROPRIATE FOR ENROLLMENT IN HEALING WITH HORSES? o Yes o No IF YES, WHAT PROGRAM? o EAP o Therapeutic Riding o Youth Groups o Mentoring IF NO, PLEASE EXPLAIN: OTHER SERVICES RECOMMENDED: NOTES MENTAL HEALTH PROFESSIONAL SIGNATURE: DATE:

6 Parent/Guardian Agreement (please initial each of the following) I give my informed consent and permission for my child to participate in the TEC Mentoring Program and its related activities. I agree to have my child follow the basic mentoring program guidelines and that any violation on my child s part may result in suspension and/or termination of the mentoring relationship. These guidelines are: No use of drugs & alcohol, tobacco while with Mentor No possession of weapons No physical or verbal aggression against Mentor Be prepared and ready for mentoring appt. _Make a reasonable effort to engage in the Mentoring process I hereby acknowledge that my child will be transported by his/her mentor and/or TEC staff or representatives while participating in the POWER OF EXAMPLE Mentoring Program, and that such transportation is voluntary and at his/her own risk. I understand and agree that it is not guaranteed that my child will be with the same gender or mentor every time. Trinity will do their best to accommodate the preference if one exists. Preference is: Male Female Either CLIENT SIGNATURE: DATE: PARENT/GUARDIAN SIGNATURE: DATE: Youth Interest Survey Do you like school? o Yes o No Favorite subject? Do you like to read? o Yes o No Favorite book? Do you like music? o Yes o No Favorite type of music? Do you like to play games? o Video o Board Favorite game? Do you like movies? o Yes o No Favorite movie?

7 Do you like sports? o Yes o No Favorite sports? Do you have friends? o Yes o No Favorite things to do with friends? : If you could spend a day anyway you wanted, what would you do? If you could learn something new, what would it be? (example: learn to play guitar) If you could learn about a job/career, what would it be?

8 Trinity Equestrian Center - Program Goals CLIENT NAME: DATE: PROGRAM GOALS CLIENT SIGNATURE (if over 14 years old): DATE: PARENT/GUARDIAN SIGNATURE: DATE: TRINITY REPRESENTATIVE: DATE:

9 Trinity Equestrian Center - Custom Mentoring Plan CLIENT NAME: DATE: MENTORING GOALS REQUESTED HOURS OF CARE HOURS PER DAY: _ DAYS PER WEEK: _ PREFERRED DAY OF THE WEEK: Monday Tuesday Wednesday Thursday Friday PREFERRED TIME OF DAY: ACTIVITIES I PREFER THAT MY CHILD SPENDS MOST OF THEIR TIME AT: o AT THE RANCH Spending most of the time at the ranch will limit the activity costs and travel expense but will also limit the community exposure and training. Ranch activities include but are not limited to: fishing, work shop, nature walks, bicycling, walking dogs, ranch tasks, swimming, limited time with horses. o IN THE COMMUNITY Spending most of the time in the community will create more travel expense and activity costs but will also create more community exposure, social skills training opportunities, and experiences. Community activities include but are not limited to: movies, mini golf, batting cage, archery range, gardening, and park. Trinity Equestrian Center is considered home base, therefore mileage is calculated from this point. The associated mileage for the pick-up and drop-off is predictable. The amount of additional travel that takes place on a weekly basis is determined by your choice of activities for this client. o TEC s mentoring program is primarily a one-on-one, but there are times when we have group activities and special events. Do you give permission for this clinet to participate in such events? o Yes o No This Customized Mentoring Plan is accepted and approved by: PARENT/GUARDIAN SIGNATURE: DATE: FUNDING AGENCY: TRINITY S POWER OF EXAMPLE DIRECTOR SIGNATURE: YMR 01/2015

10 Trinity Equestrian Center - Authorization I HEARBY REQUEST AND AUTHORIZE: ADDRESS: TO DISCLOSE INFORMATION TO AND RECEIVE INFORMATION FROM: Trinity Equestrian Center S5300 State Road 37 Eau Claire, WI (p) (f) I AUTHORIZE THE EXCHANGE OF THE FOLLOWING INFORMATION FROM MY RECORDS: o Discharge Summary o Treatment Update o Psychological Eval o Treatment Plan o or Phone Correspondence o Other: PLEASE LIMIT CORRESPONDENCE TO: The purpose of disclosure is to assist in a complete evaluation for diagnostic and/or consultation and /or treatment planning or facilitation. I understand that records/information relating to my treatment may be released only upon my written consent, or as otherwise specified by law. I understand that persons receiving treatment provided by Trinity Equestrian Center s Healing With Horses have certain rights of access to the treatment records pertaining to those services. This consent is given voluntarily, and I may revoke this authorization at any time, except to the extent that information already released pursuant to this consent cannot be recalled. A photocopy of this authorization shall be considered as valid as the original. This authorization is effective for one year from the date below, unless otherwise specified. CLIENT/PARENT/GUARDIAN SIGNATURE: DATE: WITNESS SIGNATURE: DATE: Trinity Equestrian Center - Participation Release _In return for being allowed to use Trinity Equestrian Center s Equine Therapy Programs, including its facilities, horses, and equipment, where applicable for horseback riding and other horse related activities. I/my son/my daughter/my ward (Client s Name) agree to abide by all rules and regulations of Trinity Equestrian Center now in effect or later adopted. In addition, I hereby agree to assume all responsibility and risk for me and from my son s/my daughter s/my ward s participation in activities at Trinity Equestrian Center. I further agree to hold Trinity Equestrian Center, its Board of Directors, instructors, therapists, aides, volunteers, and employees free and harmless from all damages or liability for any injury to person or property arising as a result of the use of facilities, horses, or equipment owned by or leased to Trinity Equestrian Center, including any injury caused by their negligence. _I am aware of the significant risks of injury that horseback riding and horse-related activities may cause to myself/my son/my daughter/my ward, however I feel that the possible benefits are greater than and out weigh the risk assumed. By signing this agreement, I am assuming all risk and do hereby understand that horses are animals, not subject to any guarantee of reliability. Therefore, I agree to release, indemnify and hold harmless Trinity Equestrian Center, its Board of Directors, instructors, therapists, aides, volunteers, and employees from all liability they may incur. _In accordance with the Wisconsin Law relating to the limitation of civil liability regarding equine activities: NOTICE: A person who is engaged for compensation in the rental of equines or equine equipment or tack or in the instruction of a person in the riding or driving of an equine or in the being a passenger upon an equine is not liable for the injury or death of a person involved in the equine activities resulting from the inherent risks of equine activities, as defined in section (1)(e) of the Wisconsin Statutes. CLIENT/PARENT/GUARDIAN SIGNATURE: DATE:

11 Trinity Equestrian Center - Photo Release o I do o I do not consent to and authorize the use and reproduction by Trinity Equestrian Center of any and all photographs and any other audiovisual materials taken of me/my son/my daughter/my ward for promotional materials, educational activities, exhibitions or for any other use for the benefit of the program. EXCEPTIONS: CLIENT/PARENT/GUARDIAN SIGNATURE: DATE: Trinity Equestrian Center - Emergency Medical Treatment Authorization Consent Plan In the event emergency medical aid/treatment is required due to illness or injury during the process of receiving services, or while being on the property of the agency: o I authorize Trinity Equestrian Center to: 1. Secure and retain medical treatment and transportation if needed. 2. Released client records upon request to the authorized individual or agency involved in the medical emergency. This authorization includes x-ray, surgery, hospitalization, medication, and any treatment procedure deemed life saving by the physician. This provision will only be invoked if the person below is unable to be reached. IN THE EVENT I CAN NOT BE REACHED, PLEASE CONTACT: PHONE PHYSICIAN S NAME: PREFERRED MEDICAL FACILITY: HEALTH INSURANCE COMPANY: POLICY #: o I do not give my consent for emergency medical treatment/aid in the case of illness or injury during the process of receiving services or while being on the property of the agency. IN THE EVENT EMERGENCY TREATMENT/AID IS REQUIRED, I WISH THE FOLLOWING PROCEDURES TO TAKE PLACE: CLIENT/PARENT/GUARDIAN SIGNATURE: DATE:

12 Trinity Equestrian Center - Rights & Responsibilities Welcome to the Trinity Equestrian Center. Services provided to you through the program include treatment, education and support. These are accomplished through meetings between members of our core program/treatment team. Please be aware that as a client your right to confidentiality will be protected. No one outside of the this treatment team will have access to information pertaining to you without your informed consent. In some cases this rule of confidentiality is set aside, by law and/or regulation of the Department of Health and Family Services. Some of these are: 1. In cases where the court orders evaluation or treatment or orders us to surrender your case record. 2. Cases of child abuse and neglect may be reported to Protective Services. 3. A therapist is required to report if a client is dangerous to themselves or others and doesn t agree to appropriate treatment. The Civil Rights Act of 1964 prohibits discriminatory practices in the provision of services by program receiving federal funds regardless of dollar amounts. In accordance with the Civil Rights Act no one will be denied services based on race, color, creed, national origin, sexual preference, or history of mental health treatment. You will not be discriminated against in receiving services and the Civil Rights Act upholds that right. Treatment Rights - Every client has the right to: 1. Receive prompt and adequate treatment 2. Participate in their treatment planning 3. Be informed of their treatment and care 4. Refuse treatment and medications (unless court-ordered) 5. Be free from unnecessary or excessive medications Record Privacy and Access: 1. Staff must keep client information confidential 2. Records cannot be released without client consent (with some exceptions) 3. Clients may see their records 4. Clients can always see records of their medications and health treatments 5. During treatment, access may be limited if the risks outweigh benefits 6. Clients may challenge the accuracy, completeness, timeliness or relevance of entries in their records. Treatment responsibilities you have: 1. Attend all scheduled sessions. 2. If you cancel or decide not return, inform your therapist or social worker at least one day prior to session, or sooner. 3. Keep the billing clerk informed about your financial status and pay bills promptly. 4. Notify the social worker of any change of address, phone number, etc. 5. Be clear with your therapist about the purpose of the sessions and the goals you have agreed to work on together. It is your responsibility to decline specific procedures or therapeutic requests if not wanted. 6. If you are on medication, please inform your physician. Meetings are arranged by special appointment between program staff and family members. We expect appointments to be kept if at all possible. Costs for program services will be explained when you make out an application and are admitted for services. You are encouraged to keep current on your account if you are a private pay client. Each month bills are sent to all of our clients regarding their accounts. After discharge you may be asked to fill out a client feedback form which assists us in determining the effectiveness of our services as well as identifying gaps in services. Lastly, an Informed Consent form requiring your signature is also enclosed in the Intake packet. Before any services can be provided to you by the Program team members, you and/or your parent or guardian, if any, must sign this form. In doing so you are indicating that you have received sufficiently specific, complete and accurate information about program services, enough time to study, discuss and understand this information and you are giving your permission for these services to be provided. CLIENT/PARENT/GUARDIAN SIGNATURE: DATE:

13 Trinity Equestrian Center - Privacy Policy Regarding Health Information Trinity Equestrian Center is required to maintain the privacy of any personal health information it generates or receives on behalf of its clients. Furthermore, it is required to notify clients as to how this information may be used, disclosed and/or accessed. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Trinity Equestrian Center must maintain the privacy of your personal health information and give you this notice that describes our legal duties and privacy practices concerning your personal health information. In general, when we release your health information, we must release only the information we need to achieve the purpose of the use or disclosure. However, all of your personal health information that you designate will be available for release: if you sign an authorization form; if you request the information for yourself; to a provider regarding your treatment; or due to a legal requirement. We must follow the privacy practices described in this notice. Trinity Equestrian Center reserves the right to change the privacy practices described in this notice, in accordance with the law. Changes to our privacy practices would apply to all health information we maintain. In the event of a change, Trinity Equestrian Center will provide a copy of the revised notice to you upon your request. Without your written authorization, Trinity Equestrian Center can use your health information for the following purposes: Treatment. Trinity Equestrian Center may share your health information with other internal or external providers providing service to you and your family members. For example, a doctor may use the information in your record to determine which treatment option, such as a drug or therapy, best addresses your health needs. The treatment selected will be documented in your record, so that other professionals can make informed decisions about your care. Payment In order for Trinity Equestrian Center to receive payment for the services provided, your personal health information will be provided to third party payers such as private insurance carriers or governmental insurance programs such as Medicaid or Medicare. This will typically include information that identifies you, your diagnosis, and the treatment provided to you. Health Care Operations We may review your diagnosis, treatment, and outcome information in order to improve the quality or cost of care we deliver. These quality and cost improvement activities may include evaluating the performance of your doctors, nurses and other professionals, or examining the effectiveness of the treatment provided to you. In addition, we may want to use your health information for appointment reminders. For example, we may look at your record to determine the date and time of your next appointment with us and contact you with a reminder. We may also review your health information to determine if another treatment or a new service we offer may be of benefit to you. As required or permitted by law. Sometimes we must report some of your health information to legal authorities, such as law enforcement officials, court officials, or government agencies. For example, we may have to report abuse, neglect, domestic violence or certain physical injuries, or to respond to a court order. For public health activities. We may be required to report your health information to authorities to help prevent or control disease, injury, or disability. This may include using your record to report certain diseases, injuries, birth or death information, information of concern to the Food and Drug Administration, or information related to child abuse or neglect. We may also have to report to your employer certain work-related illnesses and injuries so that your workplace can be monitored for safety. For health oversight activities. We may disclose your health information to authorities so they can monitor, investigate, inspect, discipline or license those who work in the health care system or for government benefit programs.

14 For activities related to death. We may disclose your health information to coroners, medical examiners and funeral directors so they can carry out their duties related to your death, such as identifying the body, determining cause of death, or in the case of funeral directors, to carry out funeral preparation activities. For organ, eye or tissue donation. We may disclose your health information to people involved with obtaining, storing or transplanting organs, eyes or tissue of cadavers for donation purposes. For research. Under certain circumstances, and only after a special approval process, we may use and disclose your health information to help conduct research. To avoid a serious threat to health or safety. As required by law and standards of ethical conduct, we may release your health information to the proper authorities if we believe, in good faith, that such release is necessary to prevent or minimize a serious and approaching threat to your or the public s health or safety. For military, national security, or incarceration/law enforcement custody. If you are involved with the military, national security or intelligence activities or you are in the custody of law enforcement officials or an inmate in a correctional institution, we may release your health information to the proper authorities so they may carry out their duties under the law. For workers compensation. We may disclose your health information to the appropriate persons in order to comply with the laws related to workers compensation or other similar programs. To those involved with your care or payment of your care. If people such as family members, relatives, disaster relief personnel, or close personal friends are helping care for you or helping you pay for the services you are receiving, we may release limited health information about you to those people. You have the right to object to such disclosure, unless you are unable to function or there is an emergency. It is our duty to give you enough information so you can decide whether or not to object to the release of your health information to others involved with your care. NOTE: Except for the situations listed above, we must obtain your specific written authorization on Dunn County s AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION form for any other release of your health information. If you sign an authorization form, you may withdraw your authorization at any time, as long as your withdrawal is in writing. If you wish to withdraw your authorization, please submit your written withdrawal to your service provider or in their absence to the Deputy Privacy Officer. YOUR HEALTH INFORMATION RIGHTS You have several rights with regard to your health information. If you wish to exercise any of the following rights, please contact your current service provider or in their absence, the Privacy Officer. Specifically, you have the right to: Inspect and copy your health information. With a few exceptions, you have the right to inspect and obtain a copy of your health information. However, this right does not apply to psychotherapy notes or information gathered for judicial proceedings. In addition, we may charge you a reasonable fee if you want a copy of your health information. Request to correct your health information. If you believe your health information is incorrect, you must make a written request to correct the information, and give a reason as to why your health information should be changed. However, if we did not create the health information that you believe is incorrect, or if we disagree with you and believe your health information is correct, we may deny your request. Request restrictions on certain uses and disclosures. You have the right to ask for restrictions on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment or our payment or health care operation activities. You may want to limit the health information provided to family, disaster relief personnel, or friends involved in your care or payment of medical bills. However, we are not required to agree in all circumstances to your requested restriction.

15 As applicable, receive confidential communication of health information. You have the right to ask that we communicate your health information to you in different ways or places. For example, you may wish that information about your health status be sent to a private address. You may make a request in writing at any time to your current service provider. We will accommodate reasonable requests that specify an alternative address or other method of contact and provide information as to how payment, if applicable, will be handled. Receive a record of disclosures of your health information. In some limited instances, you have the right to ask for a list of the disclosures of your health information we have made during the previous six years, but the request cannot include dates before April 14,2003. This list must include the date of each disclosure, who received the disclosed health information, a brief description of the health information disclosed, and why the disclosure was made. We must comply with your request for a list within 60 days, unless you agree to a 30-day extension, and we may not charge you for the list, unless you request such a list more than once per year. In addition, we will not include in the list disclosures made to you, or for purposes of treatment, payment, health care operations, national security, law enforcement/corrections, and certain health oversight activities. Obtain a paper copy of this notice. Upon your request, you may at any time receive a paper copy of this notice. File a complaint. If you believe your privacy rights have been violated, you may file a complaint with us and with the federal Department of Health and Human Services. We will not retaliate against you for filing such a complaint. To file a complaint with either entity, please contact your current service provider or the Deputy Privacy Officer. If you have any questions or concerns regarding your privacy rights or the information in this notice, please contact the Trinity Equestrian Center Program Director at HIPAA CITES: (i), (a), (d), (b) PREEMPTIONS: Wisconsin Statutes and 42 C.F.R. Part 2

16 Trinity Equestrian Center - Acknowledgement of Receipt of Privacy Practices Regarding Health Information By signing this form, you acknowledge that Trinity Equestrian Center has given you a copy of its Policy and Notice of Privacy Practices Regarding Health Information, which explains how your health information will be handled in various situations. Clients receiving services on or after April 14, 2003 will be asked to sign this form. If your first date of service with Trinity Equestrian Center s Healing With Horses was due to an emergency, we must try to give you this notice and get your signature acknowledging receipt of this notice as soon as possible after the emergency. By my signature below, I acknowledge I have received a copy of the Trinity Equestrian Center Policy and Notice of Privacy Practices Regarding Health Information and have been given an opportunity to discuss my concerns and questions. CLIENT/PARENT/GUARDIAN SIGNATURE: DATE: Trinity Equestrian Center staff should complete if this acknowledgement form is not signed: Was the client given a copy of the Trinity Equestrian Center Policy and Notice of Privacy Practices Regarding Health Information? o Yes o No Please explain why the client did not sign this acknowledgement form. STAFF SIGNATURE: DATE: Trinity Equestrian Center - Informed Consent I, believe that I have been given sufficiently specific, complete and accurate information about assessment, treatment and education services I may need as a client of this Program. I also believe I have been given enough time to study, discuss and understand this information so that I can make an informed decision regarding needed services. The specific information about which I have been informed includes the following: 1. Benefits of proposed service(s) 2. The way services are to be administered 3. Expected or risks of side effects which are a reasonable possibility 4. Possible alternative modes of services 5. Possible and probable consequences of not receiving the proposed services as well as service noncompliance 6. Client rights and grievance procedures 7. Limits of confidentiality I understand that in signing this consent form I am giving Trinity Equestrian Center permission for services until one year from the date of signing. I understand I may withdraw my informed consent for services at any time, in writing. I also understand my consent to services ends at the time of termination of program services to me. Lastly, I understand I must be given a copy of this consent document upon my request. Therefore, I consent and give permission for services by the staff of the Trinity Equestrian Center. Financial information needs to be updated yearly or at the time of any change in your financial or insurance status. CLIENT/PARENT/GUARDIAN SIGNATURE: DATE:

17 Therapy Services Pricing FEES GOOD THROUGH 12/2015 THERAPY SERVICES DURATION FEES ASSESSMENT/ NEW CLIENT 1 hour $150 Youth Mentoring Services Call for rates THERAPEUTIC RIDING 50 minute session $60 THERAPEUTIC RIDING 50 minute session/5 weeks $60/person/session Daily living skills from horseback Therapeutic Driving 50 minute session $110 EAP - (EQUINE ASSISTED 50 minute session $130 PSYCHOTHERAPY) EAP - FAMILY 50 minute session $160 EAP - VETERAN 50 minute session -12 week series $130 EAL - GROUP (social skills, trauma, 50 minute session/10 weeks $80/person/session bullying, grief, soft skills basic training, my journey to a job) Psychotherapy Individual 50 minute session $125 Psychotherapy Family 50 minute session $160