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A&C School Based Team Philosophy

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The philosophy of School Based is simple: problem kids are not bad kids, they’re kids who simply need more support. This is the very sentiment Skills Development Specialist Chad Ridge tries to embody daily as he winds through the halls of Grassy Creek Elementary throwing out high fives to children passing in lines and advice to ‘make better choices’ to those working at ‘time out desks’ in the hallway.

As a Skills Development Specialist, Chad has a unique but oft necessary position in the school. He helps kids on his caseload work through issues such as ADHD, Oppositional Defiant Disorder, a tendency to flee, a tendency to hit. Therapists on the team do the hard, emotional work with the kids one-on-one to help them address what they feel and why they feel it. Skills Development Specialists (SDS) work with the kids on their actions and how to make better behavioral choices, both in one-on-one sessions and in the classroom. “You kind of have to play a little dance with your caseload,” said Chad, referencing the relatively unstructured day-to-day operations of a Skills Development Specialist. There are a certain number of meetings they must have with their clients per week depending on their level of need, but the landscape always seems to be changing. The caseload rotates slowly, but teachers have different preferences, schedules for extra activities blend and shift, a client may have an outburst in the morning, or an emergency might pop up in the afternoon. Chad manages by staying flexible and spending his day weaving in and out of classrooms, talking with teachers and dropping in on clients to assess the needs of the day. “You have to feel out who needs what at what time and adjust accordingly.”

Kids usually end up on the School Based caseload through a teacher recommendation. Teachers approach parents about working with Adult and Child to help their child tackle behavioral issues. Often the option is discussed when working out Individualized Education Plans. When a child is added to the caseload, a team will take around 30 days to really get to know them. They asses the child’s struggles and develop an individually tailored plan with goals to work on. This happens through classroom observation, discussions with parents and teachers, and familiarizing the child with the School Based team. After 30 days, the SDS will confer about their findings with a psychologist who will provide their own feedback, and then the intensive work begins.

SDSs will often work through storybook-type models that encourage children to examine their own behavior. Titles like “Jake the Frog Settles Down” and “Hunter and His Amazing Remote Control” are designed to illustrate what it looks like to use self behavior modification skills through the example of cheerful cartoon characters. An SDS will also spend time with their clients in the classroom, physically sitting beside them and helping to navigate different types of stimulation, distraction, emotions, etc. One other important piece of the School Based puzzle is parent interaction. When parents sign up their child, they also sign up themselves. Chad says that he usually meets with parents twice a month both to discuss their child’s progress and to involve them in the curriculum. “My work with parents and their children looks a lot like play,” said Chad. He says he often plays games to model and facilitate new types of parent-child interaction individualized to the child’s struggles. “If parents are on board and they’re actively involved in the child’s therapy or skills, then it goes a lot smoother and you move a lot faster toward a graduation or resolution.”

The ultimate goal of School Based is graduation from the program. Once a child is consistently meeting their goals with less and less support from the team, that’s when it’s time to transition them out of the program. Chad has worked in School Based for over a decade and has seen so many kids work through their behavioral problems and function well in school. “School Based works,” he said simply. “We’re there for the kids when they need us.” Supplying that line of defense helps children who might otherwise escalate their behavior so much that it leads to expulsion, a consequence where nobody’s happy and nobody’s learning. But with School Based interaction, Chad has seen that happen much less frequently, a factor that drives his passion for working with kids. “I wouldn’t work anywhere else,” he said, “I love it to pieces.”

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Agency News

A&C 75th Anniversary and Irvington Clinic Grand Opening

Integrated health care is a concept that recognizes how a person’s physical health and behavioral health affect their overall wellness and quality of life. Adult & Child Health celebrated integrated health at a combined celebration of history and growth at its Irvington clinic in Indianapolis April 30.  The event served as both a 75th anniversary celebration for the Adult & Child Health organization, and as a grand opening for the clinic on Washington Avenue, which opened in early 2025.  Adult & Child operates three clinics in Indianapolis and one clinic in Franklin. At the Irvington clinic, primary care providers, psychiatric care providers and licensed therapists see patients in the same building.  “Our goal is to help people live happy and healthier lives and have them be able to succeed in whatever it means for them,” Dr. Christine Negendank, President and Chief Medical Officer at Adult & Child Health said. “Many of our patients have been stigmatized — even in the health care setting — so we are very careful to make sure everyone is welcome here, no matter their circumstance and no matter their level of illness.”  Clients of all ages come to the Irvington clinic for psychiatric and primary care. “Integrated care clients,” as they are called, can come to the Irvington clinic to have multiple needs addressed in one place. It’s a combination of providing the best practices and ease of care for each client.  “It’s so wonderful to see a patient who tells me, ‘I’m out of my blood pressure meds,’ or ‘I have a severe headache,’ and I can say, ‘Well, you know, we have primary care across the hall; why don’t we go get you connected?’” Negendank explained.  A client can get primary care, psychiatric care, therapy and connections to housing programs in a single trip to the Irvington clinic.  “They leave with so much more hope,” Negendank said. “We really try to make it easy for our patients when we can. We offer someone a safe place to come, to feel welcome, to leave feeling better and to leave feeling better about themselves.”  A&C offers addictions treatment at the Irvington clinic. Addictions treatment involves one-on-one therapy, medication assisted treatment (MAT), activities of daily living support, psychoeducation, peer recovery services and case management. The average wait time for a new patient to schedule their first appointment is less than three weeks.  Be Well Bell art installation  The Be Well Community movement is designed to ring in a new narrative about brain health through a variety of programs, including the public display of ceremonial bells that symbolize hope and healing. The bell in Indianapolis was unveiled to the public during Adult & Child’s 75th Anniversary event April 30. Be Well Initiatives works with community partners to bring visibility to the mental wellness movement. The Be Well Bell program offers blank bells to be painted with a meaningful design by an artist(s) or as a community arts project.    Brightli Director of Be Well Initiatives Bailey Pyle, LPC, explained that the art installation includes a QR code that smartphone users can scan to access information on the Be Well program and on mental health services available at Adult & Child in the Indianapolis metro area.  “These aren’t just bells that we’re creating and plopping down into a community, but they are truly reflective of the community in which they exist,” Pyle said. “We know from lots of research that that’s when the bells are the most impactful and meaningful.” The Be Well Bell at the Irvington clinic is the 21st for the program and the first Be Well Bell in Indiana.  Adult & Child Health’s history  Photo Gallery

Sarah Miller, PMHNP-BC

Sarah Miller works with the addictions team, general psychiatry for adolescents and adults, and the competency restoration team. She is board-certified as a Psychiatric Mental Health Nurse Practitioner. Her specialties are working in addictions and with people who experience serious mental illness.

Miller graduated from Indiana University with a psychology degree and went back to school for nursing. She received her nursing degree from Indiana Wesleyan University and worked in a nursing home and also spent time working in a group home with adolescents. She received her master’s degree from Vanderbilt University.

She enjoys hanging out with her family and her two dogs, and going to sporting events.

Joanna Chambers, MD

Dr. Joanna Chambers is a psychiatrist who began seeing Adult & Child Health patients in November 2021. She graduated from Medical College of Georgia with her Doctorate of Medicine in 1996 and completed her residency in psychiatry at Yale University School of Medicine. In addition to bringing a wealth of experience, she currently serves as an associate professor at Indiana University School of Medicine where she teaches Clinical Psychiatry. She is certified in Addiction Medicine and has a special interest in treating pregnant and postpartum women. She is President of the American Academy of Psychoanalysis and Dynamic Psychiatry Organization as well as a sitting member of many medical association boards. Recently, she has won the Residents’ Award for Teaching Excellence in 2020 from Indiana University and has received “Best Doctors Award” in 2010, 2011, and 2014. Dr. Chambers is incredibly active in the medical, academic, and research realms of medicine. She is currently accepting new patients on Wednesdays.