Youth Treatment Description
Youth is a [select name="playernum" value="5|6|7|8|9|10|11|12|13|14|15|16|17"] year old [select name="gender" value="female|male|gender nonconforming"], attending [text] in [text] grade. Youth is currently living [text] and being cared for by [text]. Youth relies on support and care from [text] and [text] is the youths current legal guardian. Previous history of services to address mental health and behavioral concerns: [checkbox name="services" value="CBR|hospitalization|autism focused behavioral supports|school counseling|SBBH services|IEP placement|previous IIH placement|therapeutic foster home|iterim home placement|religious counseling|private talk therapy|pharmacological intervention|peer support|anger management|MST|functional family therapy|private group therapy|private family therapy|case management"]. Response to services has been [select name="response" value="mixed|limited |negligible|poor|unknown|moderate|good"]and resulted in [text]. Youth has a [select name="attitude" value="enthusiastic|hostile|unknown|fearful|cautious|curious|optimistic|hopefull"] attitude about receiving services, while [text] has a [select name="attitude" value="enthusiastic|hostile|unknown|fearful|cautious|curious|optimistic|hopefull"] about services and [select name="engage" value="may be fully engaged |may be partially engaged|may be minimally engaged|may be absent from treatment|may be unable to engage"] in treatment and family sessions. Youth interests include [checkbox name="interests" value="cooking|science|academic success|caring for children|film and TV shows|computer science|helping animals|performing arts|creative arts|surfing|skateboarding|cars|basketball|social connection|independent living|video games|gardening|financial wellbeing|writing|reading|excercise and health"] . Abilities noted so far are [checkbox name="able" value="responsible choice making|positive outlook|determined attitude|flexiblity|social competence|literacy|planning and time management|physical fitness|domestic capabilities|caring for pets"]. They enjoy activities such as [checkbox name="activities" value="swimming|surfing|cooking|bike riding|self-care|exploring nature|basketball|football|soccer|social online gaming|family gatherings|social gatherings|volunteering|playing music|creating art and doing projects"]They relate well with [text] and like to spend time with [text]. When they are with [text] they like to [text]. Known trauma-likely experiences that have impacted the youth in the past include [checkbox name="trauma" value="sexual abuse|physical violence|homelessness|death of a close loved one|parental instability|removal from home by DHS services|emotional abuse|proximal exposure to danger|proximal exposure to substance abuse|physical illness|food insecurity"] Youth reffered to services to [select name="ref" value="improve|address|prevent|manage|gain|build"] [text]. Concerns noted are [checkbox name="symptums" value="grief/loss|feelings of guilt/shame|hopelessness|low self worth|anhedonia|suicidal ideation|self-harm|aggression (verbal)|aggression (physical)|rage|anger|frustration|anxiety|panic attacks|racing thoughts|rumination|obsessive thoughts reported or noted|compulsive behaviors/thoughts|phobia|nightmares|avoidance|depressive symptoms increase|increased fatigue|difficulty with concentration/memory|increased difficulty completing Tasks|difficulty following directions|stealing|lying|refusal to cooperate with adults|peer conflict|social isolation|mood lability|manic behaviors and thoughts||increased sexual activity|new sexual activity noted/stated|withdrawl from social activities|hyperactive behaviors at school or home|treatment avoidance|excessive sleeping|difficulty sleeping|increased appetite|loss of appetite|binge eating|restrictive eating|purging|excessive dieting|excessive exercise|body dysmorphia|noticable weight loss or gain|personal hygeine decline"] Youth has recently [text].
There are 27 form elements.