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Connect Plus Therapy

Form Informed Consent for Behavioral Services Lakewood

  • Services

    Connect Plus Therapy provides Applied Behavior Analysis (ABA) services that use a natural approach, focusing on the overall quality of life for each individual and their family. Our mission is to use evidence-based and developmentally sensitive practices to help clients reach their greatest potential, such as Pivotal Response Training, Natural Environment Teaching, and Early Start Denver Model, to name a few. Through connecting with caregivers and other professionals in your child’s life, we develop a person-centered plan to work on all areas of need. Connect Plus Therapy continuously improves the quality of services and business relations to accommodate clients and staff in the best way possible. Our annual improvement report can be reviewed upon request. ABA therapy is regulated by laws, ethics, your rights as a client, and by standard business practices. Before intervention can begin, your agreement to the business practices described herein is required.

    Treatment Termination/Discharge

    If at any time during the course of your treatment it is determined services cannot continue, a discharge or transition report will be provided. Ideally, services end when treatment plan goals have been achieved. Additional conditions of termination/discharge can include: .

    • You have the right to stop treatment at any time.
    • Connect Plus Therapy will provide a 30 day discharge period
    • You failed to attend scheduled services for 45 consecutive days without any notification. Prior to discharge, the Connect Plus will make at least three attempts to contact you to discuss past attendance, ways to facilitate attendance in the future and the potential discharge for lack of attendance.
    • You failed to comply with schedule consistency, signed policies and procedures and the environmental checklist
    • Professional ethics mandate that treatment continues only if it is clinically beneficial. If a client’s individual treatment plan and goals have been met (e.g., the individual has achieved adequate behavioral stabilization congruent with age-appropriate development) and less-intensive treatment modes are appropriate, services are no longer clinically beneficial and ethical conduct requires a termination of treatment.
    • Treatment is making symptoms persistently worse.
    • The individual is not making progress toward treatment goals, as demonstrated by the absence of meaningful and measurable improvement or stabilization of challenging behavior and there is no reasonable expectation of progress within an authorization period (180 days).
    • Other situations that warrant termination may include: drug abuse, disclosing illegal intentions or actions, inappropriate behavior during services, or failure to meet parent participation, including expectations of services.
    Possible Risks Associated with Treatment
    • Disruptions in your daily life that can occur because of therapeutic changes.
    • No promises can be made regarding a client’s progress. Some individuals progress and learn skills quickly, while others take longer to acquire skills and may experience difficulty retaining skills once learned.
    • Feelings of upset due to tolerating your child’s reaction to behavioral intervention.
    • Initial increases in the duration, frequency, and/or intensity of problem behaviors.
    • Although treatment begins with the hope of behavioral improvement and positive outcomes, there is no guarantee that this will occur.
    Possible Benefits Associated with Treatment

    Multiple studies across recent decades have contributed to the current understanding of the benefits of Applied Behavior Analysis: .

    • Improvements in communication, social relationships, play, self-care, school, and employment.
    • Increased participation in family and community activities.
    • Improvements in “school readiness”.
    • Significant improvements (socially valid improvements) in learning, reasoning, and adaptability to change.
    • Studies have demonstrated that there is no age or diagnosis for which ABA services no longer have potential benefit, however it is well established that ABA treatment is most impactful for young children (ages 1-4 years), and when delivered intensively (25-40 hours a week). Individuals who receive intensive ABA treatment make larger improvements across more skill areas than do individuals who participate in other (non ABA) interventions.
    By signing you:
    • Acknowledge that therapy can involve potential physical, emotional, and mental risks, including but not limited to the potential for property damage, personal injury, and emotional duress.
    • Understand and agree to the use of SafetyCare de-escalation and physical management techniques. Additionally, you hereby authorize Connect Plus Therapy to utilize these techniques should your child engage in behaviors that cannot be safely managed in any other less intrusive manner.
    • Acknowledge that proper implementation of Applied Behavior Analysis requires ongoing training and support from a Board-Certified Behavior Analyst, adherence to the treatment plan, and diligence in data collection.
    • Acknowledge that you have read all of the information contained in this Informed Consent and that you have been fully informed about the nature of the treatment, risks involved and desired benefits.
    • Confirm that you are legally competent and have the authority to provide consent for treatment.
    • Voluntarily agree to receive treatment using Applied Behavior Analysis methods and that you may discontinue services, in writing, at any time.
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