A Clinician’s Guide to Placement Options for Children and Adolescents in DHS Custody

Whether in inpatient or outpatient settings, mental health clinicians treating children/adolescents in DHS custody may be asked for their opinion on the best placement for the child at some point during their treatment. This request may be more common in inpatient settings and can come at the request of a representative of DHS or a representative of the court.

There are different types of placement options for children and adolescents in DHS custody. Thus, it can be very helpful for clinicians to have a brief listing of some of these placement options to assist them in making the best possible recommendation for the child or adolescent, taking into consideration their mental, emotional, and physical well-being.

Below is a list of potential placement options for children in DHS custody. This list is not exhaustive, so for more information please visit Oklahoma Human Services. You are also encouraged to consult a local DHS representative if able.

Kinship

A kinship home includes the home of a relative or someone who has or has had a close relationship with the child and family. This is often seen as the ideal option for the child/adolescent if available. If a kinship home cannot be established, then the agency turns to typical placement options such as foster homes.

Traditional Foster Care

Traditional Foster Care provides daily substitute temporary care and supportive services in a home environment for children in DHS custody, ranging from birth to 18 years of age. Traditional foster homes receive support including respite, medical, daycare, training and other resources.

Specialized Foster Care (SFC)

This level of foster care serves children (ages 3 and up) and adults who have a primary diagnosis centered on an Intellectual Disability and qualify for Developmental Disabilities Services (DDS). SFC parents can provide care for 1-3 people at a time and are highly involved with the decision to have someone placed in their home. Caring for an individual with intellectual or developmental needs requires extra time and attention, therefore the SFC program requires one stay-at-home foster parent.

Therapeutic Foster Care (TFC)

Therapeutic Foster Care provides treatment for children (aged 4-18). Children in this level of care require more specialized therapeutic services to enhance their well-being. The child must meet medical necessity criteria as established by the Oklahoma Health Care Authority for TFC admission and be able to cognitively participate in and benefit from therapy. These children typically come from hard places with behaviors that are an attempt to meet a need. Private agencies work alongside DHS to support the TFC program to help children heal so they can transition to traditional-level foster care.

Intensive Treatment Family Care (ITFC)

The Intensive Treatment Family Care program provides treatment for children ages 6-18, particularly for those children who have had multiple placements in various settings but are now able to be placed in a family setting. These children have a history of trauma and may have behavioral, medical, developmental and/or intellectual challenges. 

Group Home

Group homes provide therapy, 24-hour supervision, and support to people with complex health needs in a home-like setting. This approach is sometimes used to treat teens experiencing mental health or behavioral issues. Group homes offer a small therapeutic setting where each teen becomes well known to the staff. Each teen's individual needs can be addressed. There are different levels of group homes based on the child’s behavioral history, needs, and services offered at each level.

Level E services include a combination of behavioral descriptors including, very high AWOL risk, dysfunctional behavior in public school settings, repeated indiscriminate acts of violence and aggression toward peers, property and/or authority figure.

Level D+ services include structured group therapy, a minimum of two hours per week for each child; individual therapy, a minimum of one hour per week for each child; family time; family therapy; substance use, abuse, or chemical dependency therapy within a group or individual counseling or therapy session for each child, as needed; psychological or psychiatric intervention for each child through direct contact with a psychologist or psychiatric consultant or the contractor's designated therapy counseling staff.

Level C services include structured group treatment, a minimum of one hour per week for each child; individual treatment for each child, as needed; family time; family treatment, when deemed appropriate by the contractor and the assigned child welfare (CW) specialist; active teaching and redevelopment of the child's basic living and social skills, both on-site and in the community. 

Level B services include a structured and supportive living environment that provides direction and guidance. Children appropriate for placement demonstrate the ability to positively interact with adult caregivers and have limited, unsuccessful placements; agree to the placement; agree to attend the placement provider's identified place of worship in family-style living programs or non-funded group homes; demonstrate the ability to attend public school; and exhibit minimal behavioral or emotional problems.

Shelter

A children’s shelter is a non-secure public or private residential program that provides temporary care and supervision for children. The shelter, however, employs an adequate number of staff as childcare workers to meet the needs of the residents.  All staff members on duty are always accessible. Habitable living areas are provided. 

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