In collaboration with several children’s mental health providers and the London Child and Youth Network System Re-engineering project, CPRI is co-leading the London and Middlesex Integrated Client Screening and Intake Committee. This committee is a multi-agency team of service providers committed to the development and implementation of an integrated point of service entry for all children and youth with mental health needs and their families. The goal of the project is to improve outcomes by ensuring every

child, youth and family receives the most appropriate services for their unique needs, at the right time, from the right service provider. The first step in this process has been the implementation of a common intake template among the children’s mental health providers in the London area. It is expected that models for a more integrated system for intake will be presented early in 2012.

SPOTLIGHT ON SERVICE

The Applied Research and Education division conducts analysis on multiple kinds of data, including internally collected data and external data managed by the Canadian Institutes of Health Information. Our focus is always threefold: promotion of evidence-based practice, improvement of services (including efficiency) and demonstration of outcomes.

This year, CPRI staff have been involved in projects with 184 other government divisions and organizations, including 72 international partners and 59 university departments across Canada. Our findings and practice implications have been shared through 30 presentations to audiences at provincial, national and international conferences, and 12 academic articles. As well, funding of almost $750,000 was awarded for 7 projects.

interRAI

A primary focus of the Applied Research and Education division is the development of a suite of child/youth assessment instruments. This international effort is being led by Applied Research and Education Program Manager Dr. Stewart, a member of the interRAI Network of Excellence in Mental Health (iNEMH) and an Associate Fellow of interRAI, a group of health researchers comprised of 50 members from 36 countries. The interRAI Child and Youth Mental Health (ChYMH) instrument is currently being piloted across multiple sites in Ontario and the interRAI Education instrument and interRAI Child and Youth Intellectual Disability are in development. These tools are designed to form an integrated health information system to improve continuity of care and integrate care supports for children and youth with mental health needs.

Supporting Positive Residential Treatment Outcomes

Findings from our analysis of intensive services treatment data demonstrate that, along with symptom reduction, long-term outcomes should focus on measuring other substantial outcomes such as remaining in an academic setting, extra-curricular involvement, maintaining employment, staying out of the criminal justice system, and improving quality of life. Additionally, supporting maintenance of positive treatment outcomes for children/youth involved with CAS through identification of placement characteristics that foster treatment sustainability is a priority.

Reducing the Risk of Out-of-Home Placement

Our analysis of intensive services data demonstrates that close collaboration between community agencies, CAS and schools can improve assessment (e.g., evidence-based care planning through use of an integrated, cross-sector tool) and outcomes (e.g., placement stability) to identify and support those at highest risk of out-of-home placement.

Medication Monitoring

A medication monitoring tool was developed at CPRI and its evaluation demonstrated that its use facilitates understanding and communication of medication side effects. This tool is now standard practice on all intensive service units. Vanier Children’s Services has expressed interest in adopting the checklists for use in their residential facility and planning is underway to conduct a replication study to assess the use and utility of the checklists within their organization. Eventual plans will be to modify the checklists for outpatient care and possibly in hospital settings.

Enhanced individualized treatment & transition planning – Individualized crisis management plans developed

Medication Reconciliation implemented

Innovation Council established

Homeshare implements questionnaire for parents, children & youth aimed at ensuring that the children & youth have a voice in their treatment

Literacy outreach program for intensive services successfully piloted

Chief of Treatment appointed at CPRI

Nurse Practitioner role introduced to the CPRI professional team

Youth Engagement Steering Committee established

Attachment Consultation Education Services collaborates nationally, providing supervision to clinicians in Manitoba in conducting the Circle of Security Parent Course Model ©

Brake Shop consults with Tourette Syndrome Foundation of Canada to provide feedback and ideas as they develop a transitional career and employment program for youth 14 - 25

Brake Shop consults with the Cape Breton District Health Authority and an alternative education classroom at a local school board to support skill building, resource sharing, and to provide expertise during implementation of Brake Shop model programming.

OTHER NOTABLE ACHIEVEMENTS

Emotional Disorders Treatment Service

Managing anxiety and mood disorders can be difficult. Managing them when you are a young person with an intellectual disability can be extraordinary. The Emotional Disorders Treatment Service at CPRI was developed because approximately 40% of children with intellectual disabilities also have mental health disorders. Using individualized adaptations of evidence based cognitive behaviour strategies with children and youth with intellectual disabilities, this highly specialized service is producing great results. We are a unique treatment service for this complex population of children and youth in Ontario.

For the Emotional Disorders Treatment Service an individualized plan is developed based on the child or youth’s symptoms as well as overall family need. The multidisciplinary and family centered approach explores the special considerations parents may have when parenting a child with an intellectual disability as well as an anxiety or mood disorder. Together we work to understand the needs of the child and try to help families understand how to meet those complex needs.

Individualized parent training is an important way to help parents recognize and respond to symptoms of anxiety and mood problems in their children. We offer individualized sessions for educators and support agencies to help build understanding within a child or youth’s community. We also offer broader community learning opportunities such as workshops for schools and community agencies.

A Family’s Experience

John is a young man whose severe insect phobia prevented him from going outside. From May to October, he would only leave the house to go directly into the car wearing long pants and a long sleeved shirt with a hood. Even in his home, he would avoid going into rooms where an insect had been killed. He and his family participated in adapted cognitive behaviour therapy to address his severe anxiety. Here are some comments from his family:

“We are doing great and I want to thank you once again for all you have done for our family. You taught us what we needed to do as parents and a family in order to help John help himself…. John enjoyed a family picnic at my sisters cottage and did great, you would have been as proud as we were.”

COLLABORATING WITH OUR PARTNERS TO CREATE A MORE EFFECTIVE, EFFICIENT AND ACCESSIBLE SYSTEM OF CARE: COMMON INTAKE

RESEARCH AT CPRI : BUILDING BETTER OUTCOMES AND INFORMING PRACTISE

600 Sanatorium Road London, Ontario N6H 3W7 | 519.858.2774

CPRI is a leader in providing highly specialized opportunities for future

clinicians in many fields including child and youth worker, developmental

services worker, nursing, occupational therapy, psychology, social work, speech

language pathology, administration and librarianship. Over 300 psychiatry, paediatric and clinical student placements occurred in 2010-2011.

CPRI is also committed to building the capacity of the community. We have re-launched our annual education calendar to provide internal and external expert level training to our staff and community partners. Presentations are strategically aligned with demonstrated client needs and are community driven and situated, and encourage engagement and partnership to develop best practice models of care. To view the course calendar for the year ahead and to register, visit www.vocpri.ca

ONGOING COMMITMENT TO SERVICE DELIVERY IMPROVEMENTS Facility Client Information System (FCIS)

CPRI has successfully implemented a new “Facility Client Information System” (FCIS) in collaboration with Thistletown Regional Centre (TRC). The new database, successfully implemented across the facility in November 2010, provides a web based client information management system to promote enhanced information security and timely access to up to date client information. The post implementation phase is now focused on development of improved statistical reporting capabilities and establishing more common client service protocols and information management in both facilities.

Individualized Planning: Reduction of Intrusive Measures

CPRI has committed to setting the reduction of intrusive measures as a top priority. At CPRI we understand that changing our culture and reducing intrusive measures is a continual process, and we are working hard to educate and collaborate on the best possible ways to promote children, youth and families in having a voice in their treatment.

Some results we have seen to date:

• Increased the effective use of prevention strategies by developing and training staff on new tools for crisis prevention and management systems that reduce the need to rely on high-risk interventions

• Developed a treatment statement, supporting a strength based and coercion free philosophy that has translated to successful practical applications (for example therapeutic diversion/calming spaces)

• Supported other agencies in Ontario by sharing our lessons learned, data collection tools, prevention tools and report formats

• Celebrated a reduction of 39% in intrusive measures when comparing quarters 1 & 2 in 2010-2011

• Created partnerships with international centers that have had success in reducing intrusive measures

• Engaged families in research studies to understand predictive factors for the use of intrusive measures, as well as children, youth and families’ perception of intrusive measures

Intensive Services Review

We continue to implement the recommendations from the Intensive Services Review, with an emphasis this year on our Plan of Care process. Changes, which will be implemented in the fall of 2011, include an emphasis on overarching goals developed by the child/adolescent, family and community, and SMART (specific, measurable, attainable, realistic, timely) goals developed by individual clinicians, leading to increased accountability for outcomes.

As a result of the Intensive Services Review, CPRI transitioned to a designated case coordinator for communities to facilitate access to treatment. Feedback from families and community partners has highlighted streamlined communication and stronger and improved relationships with both their coordinator and the treatment team. Families with multiple children involved with services remark that having one consistent case coordinator has been invaluable when planning for the care of their children and they noted a greater confidence in their coordinator’s ability to advocate for their families needs.

MEET OUR CHIEF OF TREATMENTDr. Ajit Ninan, HonsBSc, MD, FRCPC

Over a year has passed since I began my role as Chief of Treatment. I have continued in my role as the psychiatrist on unit 5 as well as Assistant Professor at the Schulich School of Medicine and Dentistry at Western. Here at CPRI I am proud to work with a team of healthcare professionals and uniquely qualified direct care staff to provide highly specialized care to children and youth with severe, multi-complex needs.

Message from the Director of Children’s Facilities, Anne Stark

We are happy to report on our past year and the progress we have made as we continue to improve our services. Although we are immensely proud of the many achievements spotlighted in this year’s annual report, we recognize that our journey has just begun.

There will always be room for improvement in the challenging and exciting times ahead. The landscape of children’s mental health is changing and we are changing with it. The service system is being called upon to demonstrate accountability for their outcomes. Our scorecard allows us to measure our outcomes, our quality and our overall performance. We have committed to renewing this tool in the year ahead, to further align our measurements with our commitment to program evaluation and clinical outcomes. We also want to ensure that we capture our performance against our service commitments.

This year CPRI has also voluntarily begun a new quality improvement journey through the National Quality Institute’s Progressive Excellence Program. Our long term goal of attaining certification for Organizational Excellence reiterates our commitment to continual quality improvement and achievement of efficient and effective service outcomes for children and youth.

We are also very proud of our ongoing commitment to enhancing the service system’s capacity through the training and educating of the next generation of clinical and medical professionals. CPRI is the chosen place of study for over 300 specialized clinical and medical placements annually.

The service system is on the brink of great change, and we’re committed to seeking better ways to deliver care that meet the needs of children and youth and their families. In the pages ahead you will see examples of our shared commitment. We have a long way to go, but we remain committed to the principles of shared responsibility and will continue our work to ensure that our services are child and family centered, community driven, accessible, coordinated and collaborative, and evidence-based and accountable.

COMMITMENT TO EDUCATION AND CAPACITY BUILDING

FINANCIAL INFORMATIONThe Numbers

We strive for excellence through all that we

do through learning and innovation,

openness, cooperation, systems planning and

accountability

76% CLINICAL SREVICES

1% TELEPYSCHIATRY

6% HOMESHARE

13% OPERATIONS (INCLUDES UTILITIES)

2% APPLIED RESEARCH & EDUCATION

2 % ADMINISTRATION

CPRI – EXPENDITURES BY DIVISION: 2010 - 2011

CPRI Funding & Expenditures - April 1, 2010 to March 31, 2011

Total Expenditures % of Total Spending

Clinical Services 18,904,325 76%

Homeshare 1,427,776 6%

Telepsychiatry 344,651 1%

Operations (includes Utilities) 3,230,000 13%

Administration 506,530 2%

Applied Research & Education 611,754 2%

Total spending 25,025,036 100%

211 COMMUNITY

PRESENTATIONS GIVEN

2447 COMMUNITY

CLIENTS SERVED

217 INTENSIVE SERVICES

CLIENTS SERVED (INPATIENT)

14,446 COMMUNITY PARTICIPANTS

REACHED THROUGH PRESENTATION WORKSHOPS, VIDEOCONFERENCING AND

ASSEMBLIES

Over the past year I have been privileged to lead or be involved in the direction of projects set to shape the future of service delivery in our field. The Reducing Intrusive Measures (RIM) Initiative represents a shift in workplace culture which is further captured in our Clinical Services Framework project (a collaboration with community partners to redevelop our treatment philosophy and share standards of best practice with our colleagues). Our Medication Monitoring project builds on previous work invested in creating medication monitoring checklists used internally, and adapting them for use in the broader community also serving our tertiary population. Additionally, as co-lead of the Professional Practice Council in our organization, I work to ensure all disciplines have the opportunity to meet regularly to share ideas on family centred, seamless service delivery, and work to ensure our collective feedback informs the ongoing service improvements resulting.

With much pride and confidence I delight in the leadership that CPRI is demonstrating to develop the future of treatment and direction of child and youth mental and developmental healthcare.

CELEBRATING PAST SUCCESSES, LOOKING AHEAD TO FUTURE GAINS

CPRI is a leader in providing highly specialized opportunities for future

clinicians in many fields including child and youth worker, developmental

services worker, nursing, occupational therapy, psychology, social work, speech

language pathology, administration and librarianship. Over 300 psychiatry, paediatric and clinical student placements occurred in 2010-2011.

CPRI is also committed to building the capacity of the community. We have re-launched our annual education calendar to provide internal and external expert level training to our staff and community partners. Presentations are strategically aligned with demonstrated client needs and are community driven and situated, and encourage engagement and partnership to develop best practice models of care. To view the course calendar for the year ahead and to register, visit www.vocpri.ca

ONGOING COMMITMENT TO SERVICE DELIVERY IMPROVEMENTS Facility Client Information System (FCIS)

CPRI has successfully implemented a new “Facility Client Information System” (FCIS) in collaboration with Thistletown Regional Centre (TRC). The new database, successfully implemented across the facility in November 2010, provides a web based client information management system to promote enhanced information security and timely access to up to date client information. The post implementation phase is now focused on development of improved statistical reporting capabilities and establishing more common client service protocols and information management in both facilities.

Individualized Planning: Reduction of Intrusive Measures

CPRI has committed to setting the reduction of intrusive measures as a top priority. At CPRI we understand that changing our culture and reducing intrusive measures is a continual process, and we are working hard to educate and collaborate on the best possible ways to promote children, youth and families in having a voice in their treatment.

Some results we have seen to date:

• Increased the effective use of prevention strategies by developing and training staff on new tools for crisis prevention and management systems that reduce the need to rely on high-risk interventions

• Developed a treatment statement, supporting a strength based and coercion free philosophy that has translated to successful practical applications (for example therapeutic diversion/calming spaces)

• Supported other agencies in Ontario by sharing our lessons learned, data collection tools, prevention tools and report formats

• Celebrated a reduction of 39% in intrusive measures when comparing quarters 1 & 2 in 2010-2011

• Created partnerships with international centers that have had success in reducing intrusive measures

• Engaged families in research studies to understand predictive factors for the use of intrusive measures, as well as children, youth and families’ perception of intrusive measures

Intensive Services Review

We continue to implement the recommendations from the Intensive Services Review, with an emphasis this year on our Plan of Care process. Changes, which will be implemented in the fall of 2011, include an emphasis on overarching goals developed by the child/adolescent, family and community, and SMART (specific, measurable, attainable, realistic, timely) goals developed by individual clinicians, leading to increased accountability for outcomes.

As a result of the Intensive Services Review, CPRI transitioned to a designated case coordinator for communities to facilitate access to treatment. Feedback from families and community partners has highlighted streamlined communication and stronger and improved relationships with both their coordinator and the treatment team. Families with multiple children involved with services remark that having one consistent case coordinator has been invaluable when planning for the care of their children and they noted a greater confidence in their coordinator’s ability to advocate for their families needs.

MEET OUR CHIEF OF TREATMENTDr. Ajit Ninan, HonsBSc, MD, FRCPC

Over a year has passed since I began my role as Chief of Treatment. I have continued in my role as the psychiatrist on unit 5 as well as Assistant Professor at the Schulich School of Medicine and Dentistry at Western. Here at CPRI I am proud to work with a team of healthcare professionals and uniquely qualified direct care staff to provide highly specialized care to children and youth with severe, multi-complex needs.

Message from the Director of Children’s Facilities, Anne Stark

We are happy to report on our past year and the progress we have made as we continue to improve our services. Although we are immensely proud of the many achievements spotlighted in this year’s annual report, we recognize that our journey has just begun.

There will always be room for improvement in the challenging and exciting times ahead. The landscape of children’s mental health is changing and we are changing with it. The service system is being called upon to demonstrate accountability for their outcomes. Our scorecard allows us to measure our outcomes, our quality and our overall performance. We have committed to renewing this tool in the year ahead, to further align our measurements with our commitment to program evaluation and clinical outcomes. We also want to ensure that we capture our performance against our service commitments.

This year CPRI has also voluntarily begun a new quality improvement journey through the National Quality Institute’s Progressive Excellence Program. Our long term goal of attaining certification for Organizational Excellence reiterates our commitment to continual quality improvement and achievement of efficient and effective service outcomes for children and youth.

We are also very proud of our ongoing commitment to enhancing the service system’s capacity through the training and educating of the next generation of clinical and medical professionals. CPRI is the chosen place of study for over 300 specialized clinical and medical placements annually.

The service system is on the brink of great change, and we’re committed to seeking better ways to deliver care that meet the needs of children and youth and their families. In the pages ahead you will see examples of our shared commitment. We have a long way to go, but we remain committed to the principles of shared responsibility and will continue our work to ensure that our services are child and family centered, community driven, accessible, coordinated and collaborative, and evidence-based and accountable.

COMMITMENT TO EDUCATION AND CAPACITY BUILDING

FINANCIAL INFORMATIONThe Numbers

We strive for excellence through all that we

do through learning and innovation,

openness, cooperation, systems planning and

accountability

76% CLINICAL SREVICES

1% TELEPYSCHIATRY

6% HOMESHARE

13% OPERATIONS (INCLUDES UTILITIES)

2% APPLIED RESEARCH & EDUCATION

2 % ADMINISTRATION

CPRI – EXPENDITURES BY DIVISION: 2010 - 2011

CPRI Funding & Expenditures - April 1, 2010 to March 31, 2011

Total Expenditures % of Total Spending

Clinical Services 18,904,325 76%

Homeshare 1,427,776 6%

Telepsychiatry 344,651 1%

Operations (includes Utilities) 3,230,000 13%

Administration 506,530 2%

Applied Research & Education 611,754 2%

Total spending 25,025,036 100%

211 COMMUNITY

PRESENTATIONS GIVEN

2447 COMMUNITY

CLIENTS SERVED

217 INTENSIVE SERVICES

CLIENTS SERVED (INPATIENT)

14,446 COMMUNITY PARTICIPANTS

REACHED THROUGH PRESENTATION WORKSHOPS, VIDEOCONFERENCING AND

ASSEMBLIES

Over the past year I have been privileged to lead or be involved in the direction of projects set to shape the future of service delivery in our field. The Reducing Intrusive Measures (RIM) Initiative represents a shift in workplace culture which is further captured in our Clinical Services Framework project (a collaboration with community partners to redevelop our treatment philosophy and share standards of best practice with our colleagues). Our Medication Monitoring project builds on previous work invested in creating medication monitoring checklists used internally, and adapting them for use in the broader community also serving our tertiary population. Additionally, as co-lead of the Professional Practice Council in our organization, I work to ensure all disciplines have the opportunity to meet regularly to share ideas on family centred, seamless service delivery, and work to ensure our collective feedback informs the ongoing service improvements resulting.

With much pride and confidence I delight in the leadership that CPRI is demonstrating to develop the future of treatment and direction of child and youth mental and developmental healthcare.

CELEBRATING PAST SUCCESSES, LOOKING AHEAD TO FUTURE GAINS

CPRI is a leader in providing highly specialized opportunities for future

clinicians in many fields including child and youth worker, developmental

services worker, nursing, occupational therapy, psychology, social work, speech

language pathology, administration and librarianship. Over 300 psychiatry, paediatric and clinical student placements occurred in 2010-2011.

CPRI is also committed to building the capacity of the community. We have re-launched our annual education calendar to provide internal and external expert level training to our staff and community partners. Presentations are strategically aligned with demonstrated client needs and are community driven and situated, and encourage engagement and partnership to develop best practice models of care. To view the course calendar for the year ahead and to register, visit www.vocpri.ca

ONGOING COMMITMENT TO SERVICE DELIVERY IMPROVEMENTS Facility Client Information System (FCIS)

CPRI has successfully implemented a new “Facility Client Information System” (FCIS) in collaboration with Thistletown Regional Centre (TRC). The new database, successfully implemented across the facility in November 2010, provides a web based client information management system to promote enhanced information security and timely access to up to date client information. The post implementation phase is now focused on development of improved statistical reporting capabilities and establishing more common client service protocols and information management in both facilities.

Individualized Planning: Reduction of Intrusive Measures

CPRI has committed to setting the reduction of intrusive measures as a top priority. At CPRI we understand that changing our culture and reducing intrusive measures is a continual process, and we are working hard to educate and collaborate on the best possible ways to promote children, youth and families in having a voice in their treatment.

Some results we have seen to date:

• Increased the effective use of prevention strategies by developing and training staff on new tools for crisis prevention and management systems that reduce the need to rely on high-risk interventions

• Developed a treatment statement, supporting a strength based and coercion free philosophy that has translated to successful practical applications (for example therapeutic diversion/calming spaces)

• Supported other agencies in Ontario by sharing our lessons learned, data collection tools, prevention tools and report formats

• Celebrated a reduction of 39% in intrusive measures when comparing quarters 1 & 2 in 2010-2011

• Created partnerships with international centers that have had success in reducing intrusive measures

• Engaged families in research studies to understand predictive factors for the use of intrusive measures, as well as children, youth and families’ perception of intrusive measures

Intensive Services Review

We continue to implement the recommendations from the Intensive Services Review, with an emphasis this year on our Plan of Care process. Changes, which will be implemented in the fall of 2011, include an emphasis on overarching goals developed by the child/adolescent, family and community, and SMART (specific, measurable, attainable, realistic, timely) goals developed by individual clinicians, leading to increased accountability for outcomes.

As a result of the Intensive Services Review, CPRI transitioned to a designated case coordinator for communities to facilitate access to treatment. Feedback from families and community partners has highlighted streamlined communication and stronger and improved relationships with both their coordinator and the treatment team. Families with multiple children involved with services remark that having one consistent case coordinator has been invaluable when planning for the care of their children and they noted a greater confidence in their coordinator’s ability to advocate for their families needs.

MEET OUR CHIEF OF TREATMENTDr. Ajit Ninan, HonsBSc, MD, FRCPC

Over a year has passed since I began my role as Chief of Treatment. I have continued in my role as the psychiatrist on unit 5 as well as Assistant Professor at the Schulich School of Medicine and Dentistry at Western. Here at CPRI I am proud to work with a team of healthcare professionals and uniquely qualified direct care staff to provide highly specialized care to children and youth with severe, multi-complex needs.

Message from the Director of Children’s Facilities, Anne Stark

We are happy to report on our past year and the progress we have made as we continue to improve our services. Although we are immensely proud of the many achievements spotlighted in this year’s annual report, we recognize that our journey has just begun.

There will always be room for improvement in the challenging and exciting times ahead. The landscape of children’s mental health is changing and we are changing with it. The service system is being called upon to demonstrate accountability for their outcomes. Our scorecard allows us to measure our outcomes, our quality and our overall performance. We have committed to renewing this tool in the year ahead, to further align our measurements with our commitment to program evaluation and clinical outcomes. We also want to ensure that we capture our performance against our service commitments.

This year CPRI has also voluntarily begun a new quality improvement journey through the National Quality Institute’s Progressive Excellence Program. Our long term goal of attaining certification for Organizational Excellence reiterates our commitment to continual quality improvement and achievement of efficient and effective service outcomes for children and youth.

We are also very proud of our ongoing commitment to enhancing the service system’s capacity through the training and educating of the next generation of clinical and medical professionals. CPRI is the chosen place of study for over 300 specialized clinical and medical placements annually.

The service system is on the brink of great change, and we’re committed to seeking better ways to deliver care that meet the needs of children and youth and their families. In the pages ahead you will see examples of our shared commitment. We have a long way to go, but we remain committed to the principles of shared responsibility and will continue our work to ensure that our services are child and family centered, community driven, accessible, coordinated and collaborative, and evidence-based and accountable.

COMMITMENT TO EDUCATION AND CAPACITY BUILDING

FINANCIAL INFORMATIONThe Numbers

We strive for excellence through all that we

do through learning and innovation,

openness, cooperation, systems planning and

accountability

76% CLINICAL SREVICES

1% TELEPYSCHIATRY

6% HOMESHARE

13% OPERATIONS (INCLUDES UTILITIES)

2% APPLIED RESEARCH & EDUCATION

2 % ADMINISTRATION

CPRI – EXPENDITURES BY DIVISION: 2010 - 2011

CPRI Funding & Expenditures - April 1, 2010 to March 31, 2011

Total Expenditures % of Total Spending

Clinical Services 18,904,325 76%

Homeshare 1,427,776 6%

Telepsychiatry 344,651 1%

Operations (includes Utilities) 3,230,000 13%

Administration 506,530 2%

Applied Research & Education 611,754 2%

Total spending 25,025,036 100%

211 COMMUNITY

PRESENTATIONS GIVEN

2447 COMMUNITY

CLIENTS SERVED

217 INTENSIVE SERVICES

CLIENTS SERVED (INPATIENT)

14,446 COMMUNITY PARTICIPANTS

REACHED THROUGH PRESENTATION WORKSHOPS, VIDEOCONFERENCING AND

ASSEMBLIES

Over the past year I have been privileged to lead or be involved in the direction of projects set to shape the future of service delivery in our field. The Reducing Intrusive Measures (RIM) Initiative represents a shift in workplace culture which is further captured in our Clinical Services Framework project (a collaboration with community partners to redevelop our treatment philosophy and share standards of best practice with our colleagues). Our Medication Monitoring project builds on previous work invested in creating medication monitoring checklists used internally, and adapting them for use in the broader community also serving our tertiary population. Additionally, as co-lead of the Professional Practice Council in our organization, I work to ensure all disciplines have the opportunity to meet regularly to share ideas on family centred, seamless service delivery, and work to ensure our collective feedback informs the ongoing service improvements resulting.

With much pride and confidence I delight in the leadership that CPRI is demonstrating to develop the future of treatment and direction of child and youth mental and developmental healthcare.

CELEBRATING PAST SUCCESSES, LOOKING AHEAD TO FUTURE GAINS

CPRI is a leader in providing highly specialized opportunities for future

clinicians in many fields including child and youth worker, developmental

services worker, nursing, occupational therapy, psychology, social work, speech

language pathology, administration and librarianship. Over 300 psychiatry, paediatric and clinical student placements occurred in 2010-2011.

CPRI is also committed to building the capacity of the community. We have re-launched our annual education calendar to provide internal and external expert level training to our staff and community partners. Presentations are strategically aligned with demonstrated client needs and are community driven and situated, and encourage engagement and partnership to develop best practice models of care. To view the course calendar for the year ahead and to register, visit www.vocpri.ca

ONGOING COMMITMENT TO SERVICE DELIVERY IMPROVEMENTS Facility Client Information System (FCIS)

CPRI has successfully implemented a new “Facility Client Information System” (FCIS) in collaboration with Thistletown Regional Centre (TRC). The new database, successfully implemented across the facility in November 2010, provides a web based client information management system to promote enhanced information security and timely access to up to date client information. The post implementation phase is now focused on development of improved statistical reporting capabilities and establishing more common client service protocols and information management in both facilities.

Individualized Planning: Reduction of Intrusive Measures

CPRI has committed to setting the reduction of intrusive measures as a top priority. At CPRI we understand that changing our culture and reducing intrusive measures is a continual process, and we are working hard to educate and collaborate on the best possible ways to promote children, youth and families in having a voice in their treatment.

Some results we have seen to date:

• Increased the effective use of prevention strategies by developing and training staff on new tools for crisis prevention and management systems that reduce the need to rely on high-risk interventions

• Developed a treatment statement, supporting a strength based and coercion free philosophy that has translated to successful practical applications (for example therapeutic diversion/calming spaces)

• Supported other agencies in Ontario by sharing our lessons learned, data collection tools, prevention tools and report formats

• Celebrated a reduction of 39% in intrusive measures when comparing quarters 1 & 2 in 2010-2011

• Created partnerships with international centers that have had success in reducing intrusive measures

• Engaged families in research studies to understand predictive factors for the use of intrusive measures, as well as children, youth and families’ perception of intrusive measures

Intensive Services Review

We continue to implement the recommendations from the Intensive Services Review, with an emphasis this year on our Plan of Care process. Changes, which will be implemented in the fall of 2011, include an emphasis on overarching goals developed by the child/adolescent, family and community, and SMART (specific, measurable, attainable, realistic, timely) goals developed by individual clinicians, leading to increased accountability for outcomes.

As a result of the Intensive Services Review, CPRI transitioned to a designated case coordinator for communities to facilitate access to treatment. Feedback from families and community partners has highlighted streamlined communication and stronger and improved relationships with both their coordinator and the treatment team. Families with multiple children involved with services remark that having one consistent case coordinator has been invaluable when planning for the care of their children and they noted a greater confidence in their coordinator’s ability to advocate for their families needs.

MEET OUR CHIEF OF TREATMENTDr. Ajit Ninan, HonsBSc, MD, FRCPC

Over a year has passed since I began my role as Chief of Treatment. I have continued in my role as the psychiatrist on unit 5 as well as Assistant Professor at the Schulich School of Medicine and Dentistry at Western. Here at CPRI I am proud to work with a team of healthcare professionals and uniquely qualified direct care staff to provide highly specialized care to children and youth with severe, multi-complex needs.

Message from the Director of Children’s Facilities, Anne Stark

We are happy to report on our past year and the progress we have made as we continue to improve our services. Although we are immensely proud of the many achievements spotlighted in this year’s annual report, we recognize that our journey has just begun.

There will always be room for improvement in the challenging and exciting times ahead. The landscape of children’s mental health is changing and we are changing with it. The service system is being called upon to demonstrate accountability for their outcomes. Our scorecard allows us to measure our outcomes, our quality and our overall performance. We have committed to renewing this tool in the year ahead, to further align our measurements with our commitment to program evaluation and clinical outcomes. We also want to ensure that we capture our performance against our service commitments.

This year CPRI has also voluntarily begun a new quality improvement journey through the National Quality Institute’s Progressive Excellence Program. Our long term goal of attaining certification for Organizational Excellence reiterates our commitment to continual quality improvement and achievement of efficient and effective service outcomes for children and youth.

We are also very proud of our ongoing commitment to enhancing the service system’s capacity through the training and educating of the next generation of clinical and medical professionals. CPRI is the chosen place of study for over 300 specialized clinical and medical placements annually.

The service system is on the brink of great change, and we’re committed to seeking better ways to deliver care that meet the needs of children and youth and their families. In the pages ahead you will see examples of our shared commitment. We have a long way to go, but we remain committed to the principles of shared responsibility and will continue our work to ensure that our services are child and family centered, community driven, accessible, coordinated and collaborative, and evidence-based and accountable.

COMMITMENT TO EDUCATION AND CAPACITY BUILDING

FINANCIAL INFORMATIONThe Numbers

We strive for excellence through all that we

do through learning and innovation,

openness, cooperation, systems planning and

accountability

76% CLINICAL SREVICES

1% TELEPYSCHIATRY

6% HOMESHARE

13% OPERATIONS (INCLUDES UTILITIES)

2% APPLIED RESEARCH & EDUCATION

2 % ADMINISTRATION

CPRI – EXPENDITURES BY DIVISION: 2010 - 2011

CPRI Funding & Expenditures - April 1, 2010 to March 31, 2011

Total Expenditures % of Total Spending

Clinical Services 18,904,325 76%

Homeshare 1,427,776 6%

Telepsychiatry 344,651 1%

Operations (includes Utilities) 3,230,000 13%

Administration 506,530 2%

Applied Research & Education 611,754 2%

Total spending 25,025,036 100%

211 COMMUNITY

PRESENTATIONS GIVEN

2447 COMMUNITY

CLIENTS SERVED

217 INTENSIVE SERVICES

CLIENTS SERVED (INPATIENT)

14,446 COMMUNITY PARTICIPANTS

REACHED THROUGH PRESENTATION WORKSHOPS, VIDEOCONFERENCING AND

ASSEMBLIES

Over the past year I have been privileged to lead or be involved in the direction of projects set to shape the future of service delivery in our field. The Reducing Intrusive Measures (RIM) Initiative represents a shift in workplace culture which is further captured in our Clinical Services Framework project (a collaboration with community partners to redevelop our treatment philosophy and share standards of best practice with our colleagues). Our Medication Monitoring project builds on previous work invested in creating medication monitoring checklists used internally, and adapting them for use in the broader community also serving our tertiary population. Additionally, as co-lead of the Professional Practice Council in our organization, I work to ensure all disciplines have the opportunity to meet regularly to share ideas on family centred, seamless service delivery, and work to ensure our collective feedback informs the ongoing service improvements resulting.

With much pride and confidence I delight in the leadership that CPRI is demonstrating to develop the future of treatment and direction of child and youth mental and developmental healthcare.

CELEBRATING PAST SUCCESSES, LOOKING AHEAD TO FUTURE GAINS

In collaboration with several children’s mental health providers and the London Child and Youth Network System Re-engineering project, CPRI is co-leading the London and Middlesex Integrated Client Screening and Intake Committee. This committee is a multi-agency team of service providers committed to the development and implementation of an integrated point of service entry for all children and youth with mental health needs and their families. The goal of the project is to improve outcomes by ensuring every

child, youth and family receives the most appropriate services for their unique needs, at the right time, from the right service provider. The first step in this process has been the implementation of a common intake template among the children’s mental health providers in the London area. It is expected that models for a more integrated system for intake will be presented early in 2012.

SPOTLIGHT ON SERVICE

The Applied Research and Education division conducts analysis on multiple kinds of data, including internally collected data and external data managed by the Canadian Institutes of Health Information. Our focus is always threefold: promotion of evidence-based practice, improvement of services (including efficiency) and demonstration of outcomes.

This year, CPRI staff have been involved in projects with 184 other government divisions and organizations, including 72 international partners and 59 university departments across Canada. Our findings and practice implications have been shared through 30 presentations to audiences at provincial, national and international conferences, and 12 academic articles. As well, funding of almost $750,000 was awarded for 7 projects.

interRAI

A primary focus of the Applied Research and Education division is the development of a suite of child/youth assessment instruments. This international effort is being led by Applied Research and Education Program Manager Dr. Stewart, a member of the interRAI Network of Excellence in Mental Health (iNEMH) and an Associate Fellow of interRAI, a group of health researchers comprised of 50 members from 36 countries. The interRAI Child and Youth Mental Health (ChYMH) instrument is currently being piloted across multiple sites in Ontario and the interRAI Education instrument and interRAI Child and Youth Intellectual Disability are in development. These tools are designed to form an integrated health information system to improve continuity of care and integrate care supports for children and youth with mental health needs.

Supporting Positive Residential Treatment Outcomes

Findings from our analysis of intensive services treatment data demonstrate that, along with symptom reduction, long-term outcomes should focus on measuring other substantial outcomes such as remaining in an academic setting, extra-curricular involvement, maintaining employment, staying out of the criminal justice system, and improving quality of life. Additionally, supporting maintenance of positive treatment outcomes for children/youth involved with CAS through identification of placement characteristics that foster treatment sustainability is a priority.

Reducing the Risk of Out-of-Home Placement

Our analysis of intensive services data demonstrates that close collaboration between community agencies, CAS and schools can improve assessment (e.g., evidence-based care planning through use of an integrated, cross-sector tool) and outcomes (e.g., placement stability) to identify and support those at highest risk of out-of-home placement.

Medication Monitoring

A medication monitoring tool was developed at CPRI and its evaluation demonstrated that its use facilitates understanding and communication of medication side effects. This tool is now standard practice on all intensive service units. Vanier Children’s Services has expressed interest in adopting the checklists for use in their residential facility and planning is underway to conduct a replication study to assess the use and utility of the checklists within their organization. Eventual plans will be to modify the checklists for outpatient care and possibly in hospital settings.

Enhanced individualized treatment & transition planning – Individualized crisis management plans developed

Medication Reconciliation implemented

Innovation Council established

Homeshare implements questionnaire for parents, children & youth aimed at ensuring that the children & youth have a voice in their treatment

Literacy outreach program for intensive services successfully piloted

Chief of Treatment appointed at CPRI

Nurse Practitioner role introduced to the CPRI professional team

Youth Engagement Steering Committee established

Attachment Consultation Education Services collaborates nationally, providing supervision to clinicians in Manitoba in conducting the Circle of Security Parent Course Model ©

Brake Shop consults with Tourette Syndrome Foundation of Canada to provide feedback and ideas as they develop a transitional career and employment program for youth 14 - 25

Brake Shop consults with the Cape Breton District Health Authority and an alternative education classroom at a local school board to support skill building, resource sharing, and to provide expertise during implementation of Brake Shop model programming.

OTHER NOTABLE ACHIEVEMENTS

Emotional Disorders Treatment Service

Managing anxiety and mood disorders can be difficult. Managing them when you are a young person with an intellectual disability can be extraordinary. The Emotional Disorders Treatment Service at CPRI was developed because approximately 40% of children with intellectual disabilities also have mental health disorders. Using individualized adaptations of evidence based cognitive behaviour strategies with children and youth with intellectual disabilities, this highly specialized service is producing great results. We are a unique treatment service for this complex population of children and youth in Ontario.

For the Emotional Disorders Treatment Service an individualized plan is developed based on the child or youth’s symptoms as well as overall family need. The multidisciplinary and family centered approach explores the special considerations parents may have when parenting a child with an intellectual disability as well as an anxiety or mood disorder. Together we work to understand the needs of the child and try to help families understand how to meet those complex needs.

Individualized parent training is an important way to help parents recognize and respond to symptoms of anxiety and mood problems in their children. We offer individualized sessions for educators and support agencies to help build understanding within a child or youth’s community. We also offer broader community learning opportunities such as workshops for schools and community agencies.

A Family’s Experience

John is a young man whose severe insect phobia prevented him from going outside. From May to October, he would only leave the house to go directly into the car wearing long pants and a long sleeved shirt with a hood. Even in his home, he would avoid going into rooms where an insect had been killed. He and his family participated in adapted cognitive behaviour therapy to address his severe anxiety. Here are some comments from his family:

“We are doing great and I want to thank you once again for all you have done for our family. You taught us what we needed to do as parents and a family in order to help John help himself…. John enjoyed a family picnic at my sisters cottage and did great, you would have been as proud as we were.”

COLLABORATING WITH OUR PARTNERS TO CREATE A MORE EFFECTIVE, EFFICIENT AND ACCESSIBLE SYSTEM OF CARE: COMMON INTAKE

RESEARCH AT CPRI : BUILDING BETTER OUTCOMES AND INFORMING PRACTISE

600 Sanatorium Road London, Ontario N6H 3W7 | 519.858.2774

In collaboration with several children’s mental health providers and the London Child and Youth Network System Re-engineering project, CPRI is co-leading the London and Middlesex Integrated Client Screening and Intake Committee. This committee is a multi-agency team of service providers committed to the development and implementation of an integrated point of service entry for all children and youth with mental health needs and their families. The goal of the project is to improve outcomes by ensuring every

child, youth and family receives the most appropriate services for their unique needs, at the right time, from the right service provider. The first step in this process has been the implementation of a common intake template among the children’s mental health providers in the London area. It is expected that models for a more integrated system for intake will be presented early in 2012.

SPOTLIGHT ON SERVICE

The Applied Research and Education division conducts analysis on multiple kinds of data, including internally collected data and external data managed by the Canadian Institutes of Health Information. Our focus is always threefold: promotion of evidence-based practice, improvement of services (including efficiency) and demonstration of outcomes.

This year, CPRI staff have been involved in projects with 184 other government divisions and organizations, including 72 international partners and 59 university departments across Canada. Our findings and practice implications have been shared through 30 presentations to audiences at provincial, national and international conferences, and 12 academic articles. As well, funding of almost $750,000 was awarded for 7 projects.

interRAI

A primary focus of the Applied Research and Education division is the development of a suite of child/youth assessment instruments. This international effort is being led by Applied Research and Education Program Manager Dr. Stewart, a member of the interRAI Network of Excellence in Mental Health (iNEMH) and an Associate Fellow of interRAI, a group of health researchers comprised of 50 members from 36 countries. The interRAI Child and Youth Mental Health (ChYMH) instrument is currently being piloted across multiple sites in Ontario and the interRAI Education instrument and interRAI Child and Youth Intellectual Disability are in development. These tools are designed to form an integrated health information system to improve continuity of care and integrate care supports for children and youth with mental health needs.

Supporting Positive Residential Treatment Outcomes

Findings from our analysis of intensive services treatment data demonstrate that, along with symptom reduction, long-term outcomes should focus on measuring other substantial outcomes such as remaining in an academic setting, extra-curricular involvement, maintaining employment, staying out of the criminal justice system, and improving quality of life. Additionally, supporting maintenance of positive treatment outcomes for children/youth involved with CAS through identification of placement characteristics that foster treatment sustainability is a priority.

Reducing the Risk of Out-of-Home Placement

Our analysis of intensive services data demonstrates that close collaboration between community agencies, CAS and schools can improve assessment (e.g., evidence-based care planning through use of an integrated, cross-sector tool) and outcomes (e.g., placement stability) to identify and support those at highest risk of out-of-home placement.

Medication Monitoring

A medication monitoring tool was developed at CPRI and its evaluation demonstrated that its use facilitates understanding and communication of medication side effects. This tool is now standard practice on all intensive service units. Vanier Children’s Services has expressed interest in adopting the checklists for use in their residential facility and planning is underway to conduct a replication study to assess the use and utility of the checklists within their organization. Eventual plans will be to modify the checklists for outpatient care and possibly in hospital settings.

Enhanced individualized treatment & transition planning – Individualized crisis management plans developed

Medication Reconciliation implemented

Innovation Council established

Homeshare implements questionnaire for parents, children & youth aimed at ensuring that the children & youth have a voice in their treatment

Literacy outreach program for intensive services successfully piloted

Chief of Treatment appointed at CPRI

Nurse Practitioner role introduced to the CPRI professional team

Youth Engagement Steering Committee established

Attachment Consultation Education Services collaborates nationally, providing supervision to clinicians in Manitoba in conducting the Circle of Security Parent Course Model ©

Brake Shop consults with Tourette Syndrome Foundation of Canada to provide feedback and ideas as they develop a transitional career and employment program for youth 14 - 25

Brake Shop consults with the Cape Breton District Health Authority and an alternative education classroom at a local school board to support skill building, resource sharing, and to provide expertise during implementation of Brake Shop model programming.

OTHER NOTABLE ACHIEVEMENTS

Emotional Disorders Treatment Service

Managing anxiety and mood disorders can be difficult. Managing them when you are a young person with an intellectual disability can be extraordinary. The Emotional Disorders Treatment Service at CPRI was developed because approximately 40% of children with intellectual disabilities also have mental health disorders. Using individualized adaptations of evidence based cognitive behaviour strategies with children and youth with intellectual disabilities, this highly specialized service is producing great results. We are a unique treatment service for this complex population of children and youth in Ontario.

For the Emotional Disorders Treatment Service an individualized plan is developed based on the child or youth’s symptoms as well as overall family need. The multidisciplinary and family centered approach explores the special considerations parents may have when parenting a child with an intellectual disability as well as an anxiety or mood disorder. Together we work to understand the needs of the child and try to help families understand how to meet those complex needs.

Individualized parent training is an important way to help parents recognize and respond to symptoms of anxiety and mood problems in their children. We offer individualized sessions for educators and support agencies to help build understanding within a child or youth’s community. We also offer broader community learning opportunities such as workshops for schools and community agencies.

A Family’s Experience

John is a young man whose severe insect phobia prevented him from going outside. From May to October, he would only leave the house to go directly into the car wearing long pants and a long sleeved shirt with a hood. Even in his home, he would avoid going into rooms where an insect had been killed. He and his family participated in adapted cognitive behaviour therapy to address his severe anxiety. Here are some comments from his family:

“We are doing great and I want to thank you once again for all you have done for our family. You taught us what we needed to do as parents and a family in order to help John help himself…. John enjoyed a family picnic at my sisters cottage and did great, you would have been as proud as we were.”

COLLABORATING WITH OUR PARTNERS TO CREATE A MORE EFFECTIVE, EFFICIENT AND ACCESSIBLE SYSTEM OF CARE: COMMON INTAKE

RESEARCH AT CPRI : BUILDING BETTER OUTCOMES AND INFORMING PRACTISE

600 Sanatorium Road London, Ontario N6H 3W7 | 519.858.2774

In collaboration with several children’s mental health providers and the London Child and Youth Network System Re-engineering project, CPRI is co-leading the London and Middlesex Integrated Client Screening and Intake Committee. This committee is a multi-agency team of service providers committed to the development and implementation of an integrated point of service entry for all children and youth with mental health needs and their families. The goal of the project is to improve outcomes by ensuring every

child, youth and family receives the most appropriate services for their unique needs, at the right time, from the right service provider. The first step in this process has been the implementation of a common intake template among the children’s mental health providers in the London area. It is expected that models for a more integrated system for intake will be presented early in 2012.

SPOTLIGHT ON SERVICE

The Applied Research and Education division conducts analysis on multiple kinds of data, including internally collected data and external data managed by the Canadian Institutes of Health Information. Our focus is always threefold: promotion of evidence-based practice, improvement of services (including efficiency) and demonstration of outcomes.

This year, CPRI staff have been involved in projects with 184 other government divisions and organizations, including 72 international partners and 59 university departments across Canada. Our findings and practice implications have been shared through 30 presentations to audiences at provincial, national and international conferences, and 12 academic articles. As well, funding of almost $750,000 was awarded for 7 projects.

interRAI

A primary focus of the Applied Research and Education division is the development of a suite of child/youth assessment instruments. This international effort is being led by Applied Research and Education Program Manager Dr. Stewart, a member of the interRAI Network of Excellence in Mental Health (iNEMH) and an Associate Fellow of interRAI, a group of health researchers comprised of 50 members from 36 countries. The interRAI Child and Youth Mental Health (ChYMH) instrument is currently being piloted across multiple sites in Ontario and the interRAI Education instrument and interRAI Child and Youth Intellectual Disability are in development. These tools are designed to form an integrated health information system to improve continuity of care and integrate care supports for children and youth with mental health needs.

Supporting Positive Residential Treatment Outcomes

Findings from our analysis of intensive services treatment data demonstrate that, along with symptom reduction, long-term outcomes should focus on measuring other substantial outcomes such as remaining in an academic setting, extra-curricular involvement, maintaining employment, staying out of the criminal justice system, and improving quality of life. Additionally, supporting maintenance of positive treatment outcomes for children/youth involved with CAS through identification of placement characteristics that foster treatment sustainability is a priority.

Reducing the Risk of Out-of-Home Placement

Our analysis of intensive services data demonstrates that close collaboration between community agencies, CAS and schools can improve assessment (e.g., evidence-based care planning through use of an integrated, cross-sector tool) and outcomes (e.g., placement stability) to identify and support those at highest risk of out-of-home placement.

Medication Monitoring

A medication monitoring tool was developed at CPRI and its evaluation demonstrated that its use facilitates understanding and communication of medication side effects. This tool is now standard practice on all intensive service units. Vanier Children’s Services has expressed interest in adopting the checklists for use in their residential facility and planning is underway to conduct a replication study to assess the use and utility of the checklists within their organization. Eventual plans will be to modify the checklists for outpatient care and possibly in hospital settings.

Enhanced individualized treatment & transition planning – Individualized crisis management plans developed

Medication Reconciliation implemented

Innovation Council established

Homeshare implements questionnaire for parents, children & youth aimed at ensuring that the children & youth have a voice in their treatment

Literacy outreach program for intensive services successfully piloted

Chief of Treatment appointed at CPRI

Nurse Practitioner role introduced to the CPRI professional team

Youth Engagement Steering Committee established

Attachment Consultation Education Services collaborates nationally, providing supervision to clinicians in Manitoba in conducting the Circle of Security Parent Course Model ©

Brake Shop consults with Tourette Syndrome Foundation of Canada to provide feedback and ideas as they develop a transitional career and employment program for youth 14 - 25

Brake Shop consults with the Cape Breton District Health Authority and an alternative education classroom at a local school board to support skill building, resource sharing, and to provide expertise during implementation of Brake Shop model programming.

OTHER NOTABLE ACHIEVEMENTS

Emotional Disorders Treatment Service

Managing anxiety and mood disorders can be difficult. Managing them when you are a young person with an intellectual disability can be extraordinary. The Emotional Disorders Treatment Service at CPRI was developed because approximately 40% of children with intellectual disabilities also have mental health disorders. Using individualized adaptations of evidence based cognitive behaviour strategies with children and youth with intellectual disabilities, this highly specialized service is producing great results. We are a unique treatment service for this complex population of children and youth in Ontario.

For the Emotional Disorders Treatment Service an individualized plan is developed based on the child or youth’s symptoms as well as overall family need. The multidisciplinary and family centered approach explores the special considerations parents may have when parenting a child with an intellectual disability as well as an anxiety or mood disorder. Together we work to understand the needs of the child and try to help families understand how to meet those complex needs.

Individualized parent training is an important way to help parents recognize and respond to symptoms of anxiety and mood problems in their children. We offer individualized sessions for educators and support agencies to help build understanding within a child or youth’s community. We also offer broader community learning opportunities such as workshops for schools and community agencies.

A Family’s Experience

John is a young man whose severe insect phobia prevented him from going outside. From May to October, he would only leave the house to go directly into the car wearing long pants and a long sleeved shirt with a hood. Even in his home, he would avoid going into rooms where an insect had been killed. He and his family participated in adapted cognitive behaviour therapy to address his severe anxiety. Here are some comments from his family:

“We are doing great and I want to thank you once again for all you have done for our family. You taught us what we needed to do as parents and a family in order to help John help himself…. John enjoyed a family picnic at my sisters cottage and did great, you would have been as proud as we were.”

COLLABORATING WITH OUR PARTNERS TO CREATE A MORE EFFECTIVE, EFFICIENT AND ACCESSIBLE SYSTEM OF CARE: COMMON INTAKE

RESEARCH AT CPRI : BUILDING BETTER OUTCOMES AND INFORMING PRACTISE

600 Sanatorium Road London, Ontario N6H 3W7 | 519.858.2774