Rehabilitation Services and Activities at Elizabeth House
Rehabilitation services at Elizabeth House occur in a multitude of settings ranging from the highly structured residential program, to a daily education program, a transitional living experience, and support services in the community. It is through this continuum of services that Elizabeth House is best able to respond to its clients’ needs. An integrated treatment approach is used to identify and understand clients’ multi-dimensional needs, such as taking into consideration their cultural backgrounds, value systems, etc., and the impact of societal and family systems on their needs.
Elizabeth House is classified by the Ministry of Health and Social Services as a rehabilitation centre (RC). This signifies that our services are considered to be second line or specialized and therefore not “preventive” in nature. Preventive services are the responsibility of other community organizations and institutions, in particular, the local CSSSs.
Core services in the rehabilitation programs at Elizabeth House emphasize the development of parenting and independent living skills. Our Educators use structured and purposeful activities as well as teachable moments in activities of daily living to help clients acquire and develop the skills they need. Specifically designed teaching modules and programs, therapeutic groups, and individual counseling are among the approaches used with clients in all programs. Program development, to better serve our clients to meet the challenges they face, has been and will continue to be a priority for Elizabeth House.
The concept of “psychosocial rehabilitation”, which most closely approximates the type of rehabilitation offered at Elizabeth House, has been defined as “the process of facilitating an individual’s restoration to an optimal level of independent functioning in the community (…) psychosocial rehabilitation invariably encourages persons to participate actively with others in the attainment of mental health and social competence goals (…) The process emphasizes the wholeness and wellness of the individual and seeks a comprehensive approach to the provision of vocational, residential, social/recreational, educational and personal adjustment services”. (Cnaan et al, “Psychosocial Rehabilitation Journal, Vol 11, No. 4”, April 1988, pg. 61).
While rehabilitation implies a return to a more optimal state of functioning, this does not necessarily always apply at Elizabeth House. Many of our clients are first-time parents and are therefore not coming from a previous functioning base (as a parent). They require support and intervention to attain an adequate level of parenting. Thus, rehabilitation at Elizabeth House may be considered as a form of psychosocial rehabilitation perhaps without the emphasis on “restoration” but more an emphasis on the development, attainment and maintenance of the necessary skills and attributes required to be a “good enough” parent.
Pre-Natal and Mother-Baby Programs
These highly structured programs offer residential care coupled with targeted intervention services to pregnant women and mothers of young children. Elizabeth House has space for up to 18 residents (comprised of mothers and their children). Clients requiring residential services are not able to live in the community for a variety of reasons. They need to develop the necessary skills and support systems that will enable them to parent and function successfully in the community. Residential placement at Elizabeth House provides them with the resources, the focus, and the time they need to develop these skills.
The Residential Pre-Natal Program at Elizabeth House helps mothers have healthy pregnancies and deliveries, and offers support to enable them to continue their education and to make plans for themselves and their baby after the birth.
The Mother-Baby Program teaches parents to develop healthy routines and patterns of care, both physical and emotional, for their child. The emphasis in this program for both mother and baby is on developing a secure attachment and bond. Emphasis is also placed on the parents feeling safe and secure, having a new and different experience as a parent, learning new skills, integrating these skills, and preparing to live independently in the community. For the babies, the emphasis is on feeling safe and secure, having their needs met in a healthy and predictable manner.
All clients receive support and intervention in learning how to manage the documents that need to be completed when one becomes a parent. They also have the opportunity to develop or improve their independent living skills such as managing finances, cooking, making appointments, articulating their needs, and asking for help. A major focus is also placed on increasing the amount and availability of social and family support systems for these young parents.
Supervision, intervention, and support are offered 24/7 by trained educators. The program is open (not a locked unit); clients are encouraged to maintain connections to their communities; the amount of support and intervention offered is based on the client’s individual needs.
Semi-Supervised and Transitional Apartment ProgramsSupported independent Living:
Elizabeth House runs two supported independent living programs in housing situated in close proximity to the main residence. They are followed either by a member of the Residential team or by a Family Assistance worker.
When followed by the Residential team, clients receive daily intervention and support.
When followed through Family Assistance, the program is designed to replicate as closely as possible a real living situation in the community and therefore does not involve close intervention and support.
These programs support the transition from residential care to independent living or in particular cases, the transition from living with family to independent living.
Family Assistance Program
In the Family Assistance Program, clinical staff provides intervention and support services to young families in the community who are experiencing difficulties. These difficulties are differentiated from those treated by first line services such as Centres de santé et de services sociaux (CSSS) or community organizations by the number of problems requiring intervention, the seriousness of the problems (based on an assessment of the potential repercussions or risk of non-intervention to the young child or to the unborn baby) and the lack of appropriate social or familial resources available to adequately support the young parent and child.
Our work is mainly done in the client’s home; we accompany clients to other resources in the community when needed. We serve clients throughout the Montreal area and surrounding regions.
Family Assistance services are offered based on the needs of the clients. As much as possible, the educators follow the parent’s lead, taking into account parental goals. This approach facilitates the parent being an active participant and fosters a sense of partnership between parents and the educator. Interventions are based on an integrated approach and address the hierarchy of the family’s needs, taking into account the emotional well-being of the parents and child. Program objectives also include developing and improving independent living and parenting skills.
The emphasis in this program is on clients applying and maintaining their skills and abilities as a parent. The focus can be on both direct parenting skills as well as independent living skills and lifestyle issues. Elizabeth House educators support the physical, emotional, and cognitive development of young children and help parents to identify and connect with community resources, decrease their isolation and develop the skills to know when, where and how to ask for the appropriate help needed, and to acknowledge that this is a strength, not a weakness.
Education Program (Day Centre and Nursery Program)
Elizabeth House offers an Education Program for teenagers who are pregnant or have a child in their care. The program is available to clients in the residential programs as well as to teenagers living in the community.
This program is run through a partnership with the English Montreal School Board and offers academic courses from Secondary I-V as well as individual counseling and specialized groups. Clients who meet the requirements for entrance into a youth sector school and who meet eligibility requirements for access to English education may attend this specialized high school.
The emphasis in this program is on the girls and young women continuing their education as they prepare for motherhood or develop their parenting skills. Clients benefit from individual intervention and the significant relationship they develop with the Elizabeth House educators, as well as from peer support. Specialized groups are offered by trained educators on the topics of prenatal care, enhancing parenting skills, relationships and sexuality, anger management, independent living skills, dealing with government organizations, learning about the dynamics of violence and control in relationships and strengthening the clients’ ability to identify and address personal issues that have an impact on their lives and ultimately, their children.
Our Education/Day Centre Program continues to address complex clinical issues: conjugal violence, relationship issues, homelessness, difficulties in finding affordable housing, unexpected pregnancies. As well, the Day Centre Educator supports mothers around pragmatic problems such as difficulties in budgeting, issues with welfare, family allowance, and birth certificates. Clients who are living in the community but who require more intensive intervention may be referred to the Family Assistance program.
Elizabeth House further supports mothers attending school by offering access to an on-site Nursery program for babies 18 months of age and younger and clinical intervention and support through an on-site educator. The staff in the Nursery program not only cares for the babies while the mothers attend school and groups, they also monitor and track child development and assist the mothers with specific parenting issues and concerns.
Rehabilitation and Parental Support Activities
Child Stimulation Program
The Child Stimulation Program is offered to clients in the residential programs. It is animated by our Nursery Educator, who is a specialist in Early Childhood Education. The goal of the child stimulation program is to work with and through the parent to promote optimal child development. The program teaches mothers how to play and interact with their child, and how to stimulate their child according to their age. The Ages and Stages Questionnaire published by Paul H. Brookes is being implemented within the program to teach parents how to track their children’s development, and how to provide their children with additional stimulation if required. The primary objective for using the tool at Elizabeth House is to promote the parents’ interest in their child’s development, and to help them recognize the benefits of child stimulation.
Parents are also encouraged to participate in child stimulation programs offered through the CSSSs and community organizations to further maximize their child’s development and to learn how to access and effectively use community services.
Summer Day Camp
The Elizabeth House summer day camp offers Elizabeth House clients in any program a unique opportunity to spend quality time with their children, taking part in child-oriented activities and benefiting from some teenage or adolescent time while children are cared for in the nursery. It provides much needed respite for young parents and demonstrates to them how it is possible to balance their needs and their children’s needs through the planning of family-centered activities and through the friendships developed with other parents. For some parents it breaks the isolation they experience as single-parents with limited support.
The day camp activities run two full days a week for six weeks; one day is dedicated to parent/child activities, while the other is dedicated to activities solely for the parents. The activities are supervised by the staff, while clients play a role in determining which activities they will take part in throughout the summer. The activities are budget friendly and consistent with what clients could afford to do on their own. Among the goals of the day camp program are teaching clients about their city and its surroundings, and how to take advantage of the numerous free or low-cost public events and activities that are held during the summer period.