Mount Sinai West and Mount Sinai St. Luke’s Outpatient Clinical Services
The Child and Family Institute
The Child and Family Institute (CFI) at Mount Sinai St. Luke’s has a mission to be the leading voice in the field of child and adolescent mental health through state-of-the-art treatment, scientific research and outstanding educational and training programs for multidisciplinary mental health professionals. CFI offers comprehensive community education and clinical care programs targeted at prevention and treatment of mental illness. In addition, the clinical research program includes studies in the treatment of adolescent substance abuse, complex trauma, and health services, among other areas.
- Child and Adolescent Psychiatry Outpatient Department
- Parent-Infant Center
- Pediatric Neuropsychiatry Clinic
- Neuropsychological and Learning Disorders Service
- Crisis Clinic
Children’s Community Mental Health Services
Children’s Community Mental Health Services provide families with high quality, community-based, intensive mental health services for children and adolescents with serious emotional disturbance. These services are an alternative to residential treatment or hospitalization.
Children’s Single Point of Access
The Children’s Single Point of Access (CSPOA) program is designed to streamline the application process for intensive mental health services for children and adolescents throughout New York City. CSPOA links families with services that are provided by Mount Sinai St. Luke’s Hospital and other community-based mental health programs throughout New York City. Community-based mental health programs include the Home and Community-Based Services Waiver, Children’s Case Management Services, Family-Based Therapeutic Intervention, and Community Residence.
- Home and Community-Based Services Waiver
- Blended Case Management
- Family Based Therapeutic Intervention
- Community Residence
School-Based Health Clinics (SBHCs)
SBHCs provide mental health services in three high schools in western Manhattan (Louis D. Brandeis High School, A. Phillip Randolph High School, Martin Luther King, Jr. High School). Operated by CFI in collaboration with the New York City Department of Education, the New York State Department of Health, and the Departments of Pediatrics and Urban Family Practice of Mount Sinai St. Luke’s, SBHCs function as satellite clinics of the Child and Adolescent Psychiatry Outpatient Department. A full continuum of services is provided, including urgent evaluations, individual, group, and family therapies, focused diagnostic assessment, crisis intervention, psychopharmacologic management, prevention activities, consultation to educational staff, and in-service trainings.
Comprehensive Adolescent Rehabilitation & Education Service (CARES)
The Comprehensive Adolescent Rehabilitation and Education Service (CARES) is a unique adolescent day program composed of two tracks: the Adolescent Alternative Day Program (AADP) and the Comprehensive Addiction Program for Adolescents (CAPA). Both programs offer a fully integrated academic experience, which is taught by New York City Department of Education teachers.
A Safe, Therapeutic Program for Adolescents
CARES provides an intensive, five-day-a-week therapeutic milieu from 9 am to 3:15 pm with afterschool tutoring throughout the academic year. During the summer months (July and August), CARES typically provides summer school classes, continued clinical services, and increased prosaically recreational activities from 9 am to 2:30 pm.
CARES provides a safe, therapeutic school environment for New York City public high school students whose previous school performance has been limited by emotional and behavior difficulties, including alcohol or drug problems. CARES provides both educational and therapeutic components, including substance abuse treatment for students who use drugs or alcohol. We help teenagers to become motivated, examine and change their destructive behaviors, learn to cope effectively with life stresses, and become abstinent from mood-altering substances.
Who Can Attend CARES
The CARES educational component is provided directly by the New York City Department of Education. Referred teens must have successfully completed 8th grade, and be eligible to work towards their high school diploma or High School Equivalency. All CARES treatment components are designed to address the specific problems that have interfered with each individual student's academic and social success in the past. CARES teachers and clinical staff work hard to provide the education, life skills training, and individually-focused therapies that these students need in order to reach their goals.
CARES: A Respectful Community
CARES is a safe and friendly community, and all rules and policies are intended to maintain the mutual respect that will help our students succeed. As members of the CARES community, all students and families must be familiar with the rules and expectations, and must agree to abide by them in order to participate. These rules and expectations are described in the CARES Handbook.
CARES Tracks: AADP and CAPA
Although they share the same educational and treatment resources, each of the two tracks offered by CARES has a distinct focus.
The Adolescent Alternative Day Program (AADP) is designed to help students whose school performance has been affected most by problems with social skills, anxiety, and/or mood changes. The word "Alternative" in the AADP title refers to the more focused, individualized, safe, and respectful school environment that students are seeking when they apply here from regular high school settings. AADP, which utilizes a milieu treatment model integrating therapeutic and educational components, provides a unique opportunity to treat adolescents (ages 14-18) with severe emotional problems and school truancy.
The Comprehensive Addiction Program for Adolescents (CAPA) serves adolescents (ages 14-19) who are struggling with substance abuse, either as active users interested in stopping, or as persons in recovery. This program is designed for teens who require a significant level of structure to turn their lives around, but who can continue to live in the community. An integrated substance abuse/mental health model is used to allow for identification and treatment of all relevant issues. The program uses a harm-reduction model to help students reduce and ultimately abstain from substance use. CAPA is run in collaboration with The Addiction Institute of Mount Sinai, and provides an alternative for New York City teenagers who have just started abusing substances or who have already been in significant substance-related trouble. These co-occurring problems may include: depression and other mood-related disorders, mild to moderate behavior problems (angry outbursts, disrespect, breaking family rules, lying, truancy, early run-ins with the police), school problems, and/or legal problems.
CARES Education Component
CARES provides a full-time, diploma-granting high school education curriculum through the New York City Department of Education. In addition, certain students will be able to opt for a High School Equivalency (HSE) Diploma based upon their needs and preferences. Following New York State Education Department mandates, the diploma program enables students to earn and accumulate credits, as well as prepare for Regents exams. The diploma and HSE educational programs are run through ReStart Academy, District 79, New York City Department of Education.
CARES Treatment Model
CARES treatment is based on principles of Dialectical Behavior Therapy (DBT) and the Transtheoretical Model of Stages of Change. CARES provides multidisciplinary therapeutic services to students whose emotional and/or behavioral difficulties have interfered with their success at school. Clinical staff works together as a team to create an individualized treatment plan for each student. The different parts of every student’s treatment plan are described below.
Admission to CARES begins with a 30-day orientation period, in which each new student is expected to arrive for school on time 5 days per week, attend group and individual therapy meetings, and participate in family sessions as needed during this month. If these conditions are not met during this 30-day orientation period, CARES may extend orientation, but reserves the right to dismiss the new student from CARES and return clinical responsibility for him/her back to the previous clinicians.
Individual and Family Therapy
Each CARES student will be assigned an individual therapist and a psychiatrist, who will keep track of his/her progress on a weekly basis, and meet regularly with the student and his/her family. Therapists will help students focus on their treatment in order to target personal, emotional, behavioral, academic, family, and substance abuse goals. Additionally, pregnancy prevention, safer sex practices, and smoking cessation will be included in the treatment, as needed. Once a student has set their psychiatric treatment goals, the assigned therapist will monitor progress weekly.
The clinicians at CARES strongly believe that each student’s family has an enormous impact on the progress that each of our students makes. We believe the family has valuable insight into their teen’s personality, strengths, and interests. Thus, we believe that it is very important to include the family in the student’s overall treatment process. In addition to family meetings held at CARES, the CARES staff is available to meet with students and their families in the comfort of their home and community.
Like school classes, group therapy sessions form an essential part of the daily learning curriculum at CARES. Every student is assigned to a particular group schedule. We offer several kinds of groups, such as skills groups (including various creative art therapies), motivation, recovery, relapse prevention,, , diversity , healthy living, risk prevention, trauma-informed, CBT, and DBT groups (see below), and others. A major component of the CARES group program is modeled according to the principles of Dialectical Behavior Therapy (DBT), a highly effective treatment method for teenagers who wish to change from dangerous or self-defeating behavior patterns to more successful responses to stresses. Five sets of skills will be taught in rotating periods throughout the year, in coordination with the treatment goals monitored in each student's individual therapy. These five skill sets are:
- Mindfulness Skills(to increase awareness of feelings and thoughts experienced through the day)
- Distress Tolerance Skills(to teach how stress and bad news can be handled)
- Emotion Regulation Skills(to teach how to recognize and manage difficult thoughts and feelings)
- Interpersonal Effectiveness Skills(to teach how to make and keep positive relationships)
- Walking the Middle Path(to teach that there is always more than one way to see a situation and solve a problem)
All CARES students are evaluated by a psychiatrist or psychiatric nurse practitioner for their medication needs. They must meet with their assigned medicating provider on a regular basis. Each new CARES student must provide a written record of a recent physical exam, which will need to be updated at least once per year. Any changes to medication must be discussed with their psychiatrist beforehand. For students under the age of 18 years old, starting new medications requires the written consent of a parent or legal guardian.
Students can receive in-depth psychological/psychodiagnostic assessment conducted by CARES staff. Each battery is designed based on referral concern and tailored to individual needs.
Students attend daily academic classes taught by Department of Education teachers. Clinical staff works closely with the teachers each day to ensure that students are attending their classes, working well with teachers and peers, and participating to the best of their ability. On occasion, field trips are part of the academic coursework.
Each day, at least two clinicians monitor the community space. These milieu clinicians are available throughout the day for brief counseling, to answer any questions students have about the program, and to help students follow the program rules and to practice a variety of coping and regulation skills. The milieu schedule is posted throughout the floor, so students can easily determine who they are to go to each day for assistance. Milieu clinicians may require that CARES students complete a modified version of a behavioral analysis prior to returning to their class. Students are expected to follow directions given by the milieu team. By not following directions, students are communicating that they may need a clinically appropriate consequence.
Each student is expected to bring all of his or her individual strengths to the community in order to support fellow students. We expect each community member to take this role of peer support seriously. Community meetings are held weekly. The community meeting provides each student the opportunity to learn how to negotiate community issues effectively. Both students and staff share the responsibility for working out any differences of opinion in a safe and respectful manner. Participation in the community meeting will keep you informed about CARES events, allow you to contribute to decisions and increase your ability to assert yourself in a group situation.
Points and Tokens (Daily and Long-term Incentives)
Points will be accumulated based on punctuality, participation and positive behavior for each of seven periods for a possible total of 18 points per day. Students will be able to earn a token for the day if they’ve earned 15/18 points for the day. Points will be adjusted on shorter days.
Tokens can be cashed in for gift certificates in the beginning of each new month or can be built up for the school year, with mandatory cash in time at the end of June. Students will be updated regarding their accumulated tokens each week in Community Meeting.
At CARES, students also participate in a level system with the expectation to move up based on their attendance, behavior and participation in CARES. Levels are reviewed every month by staff.
The CARES student council is comprised of all Level IV and Level V students. Members of the student council represent the student body during meetings with the staff student council advisor. The student council members act as role models during classes, groups and Community Meetings and assist staff in making the community a safe and pleasant space. When a community issue is raised by the student council and will require direct meetings with the CARES staff, a member of the student council will serve as the liaison between the student council and the staff.
During non-educational days, clinical program will still be provided. Therefore, students are expected to attend (including most school holidays and summer months). If families need to request an exception, they will need to speak with the student’s assigned therapist and medicating provider.
Complementary CARES Services
Students often have additional needs that CARES cannot provide for, which may require involvement of other services. Such services may include AA or NA meetings, case management, waiver program, and community organizations including religious groups or after school programs. Participation in such services will be determined by each student and his/her family, with the help of the individual therapist. It may be decided that complementary services are required for a student to continue in CARES. Case management services are often deemed necessary for students attending CARES. If a student does not have case management services, it is likely that the student’s individual therapist will refer the student and his/her family for services through C-SPOA (Child Single Point of Access).
Comprehensive Adolescent Rehabilitation and Education Service (CARES)
Mount Sinai St. Luke’s
411 West 114th Street, 2nd floor
New York, NY 10025
To make a referral, please call our Intake Coordinator at 212.523.3083.
Download CARES application here.
Community Services for Children and Families
These community services for both children and their families comprise the following range of programs:
- New Beginnings Program
- Family Treatment Rehabilitation
- Dream Catchers Program