Summary:
Under the direction of the Clinical Director and daily monitoring by the Exposure Coach III is responsible for the care and safety of assigned children.  As a member of the interdisciplinary treatment team assumes primary Exposure Coach I role.  Is responsible for input into the formulation of an exposure with response prevention (ERP)-based therapeutic milieu care plan as well as the implementation observation and documentation of this program under the direction of the Clinical Director and Exposure Coach III. Provides services to children/adolescents.

Responsibilities:
A. Participates in maintaining a safe and therapeutic environment.
Actively engages with assigned children throughout shift.  Participates in the development and operationalization of the ERP-based milieu care plan for assigned patients according to established department and unit-based procedure/policy.
Supervises assigned children in exposure-based milieu activities. 
Assists patients in completing anxiety-impacted ADLs using an exposure therapy framework to help patient move toward rather than avoid anxiety triggers.
Identifies reports and resolves potential/actual problems on the unit. Demonstrates appropriate critical incident follow-up skills by timely verbal reporting to program RN and documentation in medical record.  Completes other documentation [i.e.: incident reports seclusion and restraint forms (MR38)] as applicable. Participates in debriefings. 
Carries out daily assignment as assigned by Clinical Director and Exposure Coach III and reports back prior to end of program day. 
Intervenes in disruptive milieu or destructive to self/other patient situations providing timely therapeutic intervention(s) to children in distress.
Maintains appropriate boundaries. 
B. Adheres to Hospital Departmental and Program policies and procedures.
Attends peer review and staff meetings as assigned.
Maintains current certification in crisis management.

Maintains current CPR certification.
Maintains current OSHA ERS Safety Certifications
Attends unit/hospital staff development as assigned.
C. Actively participates in the patient care planning process under the direction of the Clinical Director and Exposure Coach III
Participates in the initial admission interview process as assigned.
Works to support initial therapeutic alliance with patient and family on admission.  Assists with the separation process and performs other duties necessary to provide a smooth transition to the program milieu.
Completes initial program assessment with patient including eliciting specific details about patient�s anxiety symptoms.  Collaborates with patient�s psychologist and psychiatrist to develop initial anxiety symptom hierarchy that will guide ERP throughout the admission and are the core part of implementing ERP with patients. 
Review�s milieu care plan and anxiety symptom hierarchy daily and suggests revisions based on observations. 
Communicates individual patient milieu care plans and anxiety symptom hierarchy updates in an ongoing manner to other unit staff including liaison with other interdisciplinary treatment providers.
Actively participates in diagnostic conferences treatment team rounds and hand-off shift report as assigned.
Is aware of department QI indicators and responsibilities related to these.
Accurately documents significant patient/family observations/milieu care in medical records in a timely fashion.
Offers information and knowledge acquired through experience to other staff via formal/ informal staff development forums.
Adapts care �style� to meet needs of various children/adolescents.
D. Supports and contributes to the development of patient-specific exposure and behavioral management plans.
Assists and teaches patients in activities of daily living and personal hygiene based upon patient�s abilities.
Co-leads community meeting/milieu meeting/social skill group.
Co-leads twice daily exposure groups.
Demonstrates ability to set consistent and supportive therapeutic limits within guidelines of hospital unit and department standards.
Collaborates with other members of the treatment team in designing and revising exposure-based behavioral programs specific to the needs of the patient.
Organizes unit activities.
Coordinates supervises and actively participates in children�s activities such as physical & social development activities.  Arranges for transportation of materials if required.
Participates in daily community visits with patients and parents. Provides psychoeducation about exposure therapy to patients and parents. 
Models� appropriate exposure coaching behavior for parents on community visits.
Supports parents in delivery of exposure coaching on community visits. 
Consistently models to patient/families appropriate and therapeutic interpersonal staff/patient interactions.
Co-leads therapy groups with a clinician. 
Supports and actively participates in recreation therapy programs.
Handles crisis situations in a safe effective manner utilizing the least restrictive safe patient care alternative.
Takes the initiative to seek formal/informal supervision incorporating suggestions for improvement/changes in job performance.
Performs other related duties as required assigned or directed by Clinical Director and Exposure Coach III.

Other information:
BASIC KNOWLEDGE:
Baccalaureate Degree in a Human Service field.  Other education and experience considered and may be substituted for educational requirements at the discretion of the Hiring Manager.
Demonstrated knowledge and skills necessary to provide care to patients throughout the life span with consideration of aging processes human development stages and cultural patterns in each step of the care process.
Bradley Hospital Safety Care Certification:
Employees in this position work in a psychiatric setting under stressful conditions associated with care of psychiatrically impaired aggressive and sometimes self-injurious individuals. Employees are expected to utilize de-escalation techniques taught by Bradley Hospital to minimize need for physical intervention.  They must have the ability to remain calm during a crisis as evidenced by the ability to make quick rational decisions and prioritize immediate patient care needs to maintain a therapeutic environment and ensure safety. 
Employees in this position must also be able to participate in the physical management of patients which can include but is not limited to awareness and demonstration of safe body positioning always awareness and coordination to block and deflect possible aggression and the ability to physically hold struggling patients using approved methods only to maintain safety for extended periods of time. Specifically such employees must be able to: lift up to fifty pounds; reach with their hands and arms; grasp and hold with their hands; bend/squat/kneel without limitation and physically escort patients who may become combative for short distances. Position requires occasional running for short distances and frequent standing walking and sitting. 
Pediatric Anxiety Research Center Training in Exposure Treatment.
Employees in this position must complete 1 month of on-the-job training in the exposure treatment approach. This training involves short didactic readings observing experienced staff and being observed by experienced staff in conducting effective exposure exercises that are adherent to the principles of the exposure model.
At the conclusion of this training employees in this position must show evidence of being able to identify patients� core fears and the functional relationships among their symptoms.
Employees must be able to adapt exposure plans in real time while working independently with patients and their families on home visits. These adaptations must be consistent with the case conceptualization and must be adherent to the principles of the exposure model.
EXPERIENCE:
Six months to one year of direct childcare work with emotionally impaired youth.
Current Bradley Hospital Safety Care Certification.
Current CPR certification.
Current ERS OSHA and Safety Certification.
SUPERVISORY RESPONSIBILITY:
None

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status.   Brown University Health is a VEVRAA Federal Contractor.

Location: Bradley Hospital USA:RI:East Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union

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