Elizabeth House operates a Day Centre Program for up to 22 pregnant adolescents or adolescent mothers which comprises a Youth Sector educational program run by the English Montreal School Board and specialized readaptation services provided through Elizabeth House, including individual counselling and groups which are facilitated by the Elizabeth House educators. There is close collaboration between the school and clinical services provided by Elizabeth House.

The program is designed to assist and support pregnant adolescents and adolescent mothers to continue their education while making decisions concerning their pregnancy or adapting to their role as parent.

The specific objectives of the program are as follows:

• To facilitate clients who would otherwise be at risk of dropping out of school, to continue their secondary education;
• To support the clients through structured programming and intervention to attain their goals as young mothers and young women;
• To support the bonding process between mother and baby;
• To provide an opportunity for these young mothers to be with other young parents so that they might benefit from the mutual support and learning;
• To assist the clients to experience trusting relationships and success through which they can develop feelings of self-worth and competence;
• To help the clients re-integrate into the community.

The educational program offers core curriculum from Secondary 1 - 5. A modified curriculum is also offered to prepare some students for a vocational or skills related program. Clients have the opportunity to complete their high school education. Clients have their own individual educational plans and are facilitated to work at their own pace. Groups in Relationships and Sexuality, Life Skills, Parenting, Pre-Natal Support and Infant Nutrition and Stimulation are facilitated by the educators. Individual counselling and support is provided for every client according to their needs.

The program can accommodate up to 22 clients and is situated on both the ground floor and basement of Elizabeth House.

• The client must be eligible to attend an English Youth Sector school. Normally, this means that the client must have an English eligibility certificate and must be under the age of 18 years. If the client is 18, she must have the possibility of completing her High School Diploma in one year; if not, she would need to enroll in Adult Education.
• Clients who have previously enrolled in Adult Education are not eligible for admission.

• It must be counter-productive for the client to continue in her community school.
• The client requires the specialized services and intensive support of a 2^nd line program.

There are 2 full-time and 1 part-time teachers hired through the EMSB who teach the core subjects of English, French, Math, History, Geography, Home Economics, Word Processing, Physical Science, Economics and Moral Education.

One full-time educator from Elizabeth House provides individual counselling and facilitates some groups. Residential educators facilitate groups as well.

Clients may or may not have an outside social worker, although the majority of clients will have one.

• Carry out intake assessments and develop initial goals and objectives based on the client’s needs.
• Ensure overall functioning of the program.
• Provide individual counselling and support in relation to the client’s educational program and their job as a young parent.
• Develop intervention plans for each client in the program.
• Initiate communication with outside social workers and other treating professionals concerning pertinent information related to the client’s intervention plan.
• Facilitate groups in relation to client needs.
• Work as a team member in collaboration with the school, nursery and residential program.

• For clients without social workers, to refer them to the appropriate social worker when needed.

• Provide individual counselling to the client and the client’s family (as per the client’s intervention plan).
• Initiate communication with the Day Centre Educator concerning information pertinent to the client’s functioning in the program.

• Participate in the development of the client’s intervention plan with the Elizabeth House educator.

• Provide the teaching of Secondary I through V curriculum for core subjects.
• Develop individual education plans for each client in the program.
• Work as a team member in collaboration with the Day Centre Educator and Nursery team leader.

• The client herself must contact the DPRS directly to request admission.
• After ensuring initial eligibility, the DPRS will give the request to the Day Centre educator who will arrange for an intake assessment with the client and her family.
• Upon acceptance, the client will then see the head teacher for an educational assessment.
• An admission date will be established at the Day Centre team meeting which is normally held on Tuesday afternoons.

The Nursery Program is an integral program of Elizabeth House. It is located on the bottom floor and is composed of one large room divided into a play area, kitchenette and sleep area. The Nursery Program exists primarily as a support for Residential and Day Centre clients who are pursuing educational, work or treatment plan goals. Depending on numbers, it may also be a support to other external clients of Elizabeth House depending upon their needs. The baby mother and father are encouraged to participate in the program both pre and post natally, offering opportunities to learn about infants and infant care through hands on experience. The program can accommodate up to 12 infants under the age of 1 year.

The Nursery Program’s mission is four-fold, encompassing both the needs of the infants and of the young parent(s):

• For infants, the nursery strives to promote healthy growth and development. This is accomplished through play and constant care. The infants are stimulated in an age appropriate manner – i.e. newborns are encouraged to actively engage in the world by experiencing baby massages and by having both their auditory and visual faculties stimulated. Slightly older babies are given the opportunity to explore their environment in the safety of an oversized playpen, where both staff and babies can interact. Whenever possible, babies are taken outside for walks and have the opportunity to explore the outdoors. The care provided for the babies is consistent in that staff duplicates the schedules and feeding patterns the parents create. If the schedules are found to be inappropriate for the baby’s age and/or development in the Nursery educator’s professional opinion, the parent is assisted in modifying the schedule.

• For mothers, work is aimed at modeling play and infant stimulation. Mothers are given opportunities to interact with their babies in the presence of staff. Staff maximize these times by providing feedback on what is working and in what areas the parents may need more support. Mothers are taught basic baby care: how to change diapers, grooming (cutting nails, caring for diaper rash), how to develop feeding schedules, behaviour management in a formal and informal manner.

• Baby fathers are also given the opportunity to participate in the nursery program. Fathers are always encouraged to visit and to actively care for their infant while they visit. During this time, staff help the father acquire or enhance parenting skills.

• For residents of Elizabeth House, the Nursery is often an integral part of their intervention plan. Mothers who have been reunited with their babies after a period of separation or who need extra supervision can take part in the nursery program, with or without their baby. While being supervised by staff, they are given the opportunity to play, learn and care for their baby or other Nursery babies in a safe environment. The residential clinical team is given feedback on areas of strength and weaknesses to further enhance their intervention plan with the client.

A full time educator (team leader), two part-time nursery workers and baby helpers (volunteers) staff the nursery. The educator works directly with the babies and parents in the nursery, which supports the focus on the dual and sometimes opposing needs of infants and adolescents.

• Oversee overall functioning of the program.

• Work directly with the babies and parents in the Nursery Program.
• Work as part of the clinical team to ensure that the clients’ parental capacity is enhanced to its fullest and that the infants are adequately cared for.
• Communicates directly with the Day Centre educator and Residential educators to ensure continuity of services.
• Co-ordinate program scheduling, including the volunteer schedules.
• Facilitate groups on subjects such as literacy, infant nutrition and play.

• Process admissions.

• Provide direct care to the babies.
• Complete documentation regarding the babies’ day in the nursery.
• As a member of the clinical team, works with the parents.

• Babies must be under 1 year of age.
• Babies must have parents who are clients of the Residential or Day Centre programs; babies of other external clients may be considered depending on need and on numbers in the nursery.
• The Nursery Program educator processes admissions-there is an application form that all clients must complete.

This program offers individualized, external services to young families living in the community who require more intensive support and intervention than may be available through different first line community organizations. The clientele serviced include clients referred to Elizabeth House from outside organizations and institutions as well as residents of Elizabeth House who are making the transition to independent living. Occasionally, a client will be self-referred; in these instances, an evaluation takes place to assess whether the client is in need of 2^nd line services; if not, the client will be referred to the appropriate resource. This program has been recently developed to support the Ministry orientation to work with clients in as normalized an environment as possible. It is anticipated that the need for residential placement will be decreased with the provision of services through this program.

The emphasis of the program is to help young parents make a successful adjustment to independent living from residential care or to continue to live successfully in the community. Clients from the latter category would be seen as being at risk for residential placement without the support and intervention.

The following are objectives of the Family Assistance Program:

• To assist the client in establishing meaningful ties with community supports and resources both as an individual and as a young parent.
• To help the client develop a system of social support and decrease isolation.
• To strengthen the family unit such that the cycle of violence, abuse, neglect, welfare dependency, etc has been positively impacted to promote healthier interactions and relationships.
• To support the client in developing and maintaining independent living skills such as banking and budgeting, smart shopping, apartment searching, cooking, health and nutrition, effective job hunting, etc.
• To establish collaborative relationships and partnerships with different organizations and institutions, to ensure continuity of services, that services are not being duplicated.
• To work on establishing ententes with the various organizations for a meaningful accessibility of English services.
• To develop a protocol for the transfer of cases between the organizations.
• To sensitize the first line services to the specialized work that Elizabeth House does.

Some guiding principles of the program are:

• The learning experience is a valid process in the successful transition to independent living. The client needs to be able to make her own decisions and experience the consequences.
• The client’s family and relatives are viewed as potential sources of support and their participation and involvement is actively solicited and encouraged at all times.
• Do ‘with’, but do not do ‘for’ the client.
• Intervention and support is provided on an individualized basis based on a clear under- standing of the client’ s needs and goals. The client is an active participant in this process.

The program is currently staffed with 1 full-time educator and 3 part-time educators.

• Carry out a needs assessment for clients referred to the program.
• With the client, develop an intervention plan establishing goals, objectives and strategies.

• Provide psycho-social intervention based on the intervention plan-will involve home visits, accompanying clients to appointments and assisting them in negotiating services for themselves, facilitating the development of parenting skills etc.
• Facilitate groups based on the needs of the clients, i.e. infant stimulation, life skills etc.
• Log and prepare reports as required.

• Testify in court when required.
• Collaborate with community resources and institutions in providing services to clients.

• Collaborate with the educator in providing services to clients.
• Participate in the development of service plans.

• Client must be assessed as requiring 2^nd line intervention services.
• Client must be willing to receive services from Elizabeth House.
• Referrals are processed through the Director of Professional Services. Requests may either be written or verbal.
• For all requests for service, a needs assessment is done before services are offered to ensure the appropriateness of the client being serviced at Elizabeth House.

P.A.T.H. is a transition apartment set up to assist young mothers in the transition from residential placement at Elizabeth House into independent living. It is also occasionally used to assist young mothers in making the transition from family into independent living. The program is committed to providing young mothers with the opportunity to test out their skills in a reality-focused environment while receiving maximum support. It is recognized that the transition from an institutional program such as provided at Elizabeth House to an environment of total independence and autonomy can be overwhelming, especially for parents who have little or no family support.

The program is located at 2044 Marlowe Avenue and consists of a lower duplex with a living room, 3 bedrooms, a kitchen and dining area. The close proximity to Elizabeth House offers psychological support as well as access to staff on a daily basis. The program can accommodate 2 mothers and 2 babies or children. P.A.T.H. is an external program and clients are not considered to be admitted to residential services of Elizabeth House.

Mothers living in the apartment are enrolled in a full time time program of either work or school and are expected to pay rent on a monthly basis. The amount of rent will realistically reflect the norms in the community as well as the parent’s ability to pay. The parent signs a lease with Elizabeth House for the amount of time that has been determined for them to be in the program and agreeing to follow certain rules and expectations. Maximum stay in the apartment is six months; however, on an individual basis, extensions may be arranged. The client normally pays $400.00 a month in rent to Elizabeth House, which includes heating and electricity. At the end of the client’s stay, half of the rent monies are returned to her, in effect, giving her a head start towards purchasing items for her own apartment.

Clients are followed by the externals workers from Elizabeth House. They also have access to support from the residential staff 24 hours a day, 7 days a week in times of crisis.

As the apartment program offers no on-site staff supervision, the clients are required to meet the following criteria:

• The parent must be 17 years of age or older. For parents under 18, parental or court approval must obtained.
• The parent must be attending a full-time education or vocational program or be working full-time.
• The parent must have an income that will support her living expenses.
• The parent must be ready for discharge from residential services.
• The parent must be able to related positively with peers and adults.
• The parent must not be physically aggressive or destructive.
• The parent must be willing to be followed by a worker from Elizabeth House.
• The parent must be capable of maintaining a standard of conduct commensurate with the community within which she is living.

• All mothers being considered for the apartment program must meet with DPRS, social worker (if applicable) and educator prior to admission to discuss expectations and procedures and negotiate the conditions of the lease.
• The mother herself initiates the referral procedure by contacting the DPRS to set up a meeting.
• After acceptance into the program, the mother signs the lease and a date for admission is established.

• To support the client in the transition to independent living i.e. more specifically, by ensuring the client is learning how to, and is comfortable with, accessing community supports and resources, is developing a network of social support and is developing the ability to successfully manage their finances.
• To support the client in dealing with the consequences of their decisions.
• With the client, develop an intervention plan establishing goals, objectives and strategies.
• Collaboration with community resources and institutions in providing services to clients.