Treatment at a Distance and Intensive Home-Based Treatment during a Pandemic

Innovative Conversations Session 11 – Recorded June 2020

The Center for Innovative Practices (CIP) presents guests Bobbi Beale, PsyD and Maurie Long, PhD, discuss ‘treatment at a distance’-type services, becoming more widely accepted in behavioral healthcare during the Covid-19 pandemic, and which may thrive even post pandemic. They also explore Intensive Home-Based Treatment (IHBT), an intervention designed to address extremely challenging behaviors of youth within a home setting, often seen as a preferable alternative to removing a youth from their home.

(Click on photo below right to view video of session)

The Covid-19 pandemic has impacted behavioral health care, especially for youth and families, in especially unique and challenging ways. It was not too long ago that the idea of ‘tele-health’, or virtual health care, was seen as a real exception to behavioral health practice. Today, out of necessity, the idea of ‘treatment at a distance’ is much more widely accepted and, in fact, will likely thrive even post pandemic. Along with this, in the area of behavioral health for youth and their families, there is a treatment called Intensive Home Based Treatment (IHBT), an intervention designed to address extremely challenging behaviors of youth within a home setting. It is often seen as an alternative to removing youths from their homes. Ohio has a long and successful history of IHBT and thousands of Ohio youth and their families have benefited from this treatment. The design of the service presents some very unique challenges to implementing it successfully in a pandemic environment.

View Video of Intensive Home-Based Treatment during a Pandemic Session

The Ohio Department of Mental Health and Addiction Services (OhioMHAS)  and the Center for Innovative Practices (CIP) continues curating relevant resources to help organizations, supervisors, practitioners and care givers ideas, resources, and support, especially during the Covid-19 pandemic. More detailed descriptions of some of these are at the bottom of this page. – Immediate access to some of the resources are below:

View Video of Shifting Gears | View the Video of The Impact of the Pandemic | Download PDF of Covid-19 and School Mental Health Resource Guide | Visit  | Visit

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IHBT is an intensive, time-limited mental health service for youth with serious emotional disabilities and their families, provided in the home, school, and community where the youth lives, with the goal of stabilizing mental health concerns, and safely maintaining the youth in the least restrictive, most normative environment possible.

This Innovative Conversation session examines various challenges to the ‘new normal’ of ‘treatment at a distance’ and discusses various strategies,exercises and virtual engagement activities that might indeed optimize opportunities for recovery during in-home ‘distanced treatment’. Areas of interest include: How to connect with families, and what are some family dynamics to anticipate with families, quarantined together with so much potential additional conflict? And how might organizations keep the behavioral workforce, already stretched thin, healthy, empowered, and productive?

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The session also speculates on the lasting effects, if not paradigm shifts at many levels, that the pandemic may have on behavioral healthcare after some of the current reality realignment; that this may likely be a longer-term environment and what to anticipate if that is indeed the new landscape.

Bobbi Beale, PsyD, Senior Research Associate, Center for Innovative Practices, has specialized in designing non-traditional therapy programs for youth populations that are at risk or have trauma histories. Her programs have utilized adventure therapy (AT) to increase skills and resiliency, and include individual, family and group applications. She also worked on validating AT with clinical research in Trauma-Informed Day Treatment and implementing a new AT program with both home-based and multi-family group components. Bobbi is also a trainer and consultant on issues related to youth including: Trauma & Resiliency, Bullying, Supportive Behavior Management, Outcomes, Cultural Diversity, Evidence-Based Practices and Teambuilding. Dr. Beale previously served as the Director of the Center for Applied Resilience at Child & Adolescent Behavioral Health in Canton, Ohio. She has been serving at-risk youth and families at C&A since 1991; first as a home-based therapist, then a program supervisor, program designer and division director.

(Dana) Maurie Lung, PhD, LMHC, LMFT is the co-founding partner Life Adventures For All. She has over 25 years of experience as a therapist, business owner, author, speaker, trainer, evaluator, and professor. She has co-authored two books for mental health professionals as well as a variety of articles about how to experience nature and adventure in order to heal our hearts and restore dignity. To more directly bring this experience to marginalized populations, she collaborated to launch Life Adventures for All. Maurie is also the founder and CEO of Life Adventures Counseling, a community organization that provides adventure-based mental health therapy. Additionally, she is an Associate Professor at Prescott College, overseeing the Adventure-based Psychotherapy and Ecotherapy concentrations. All of this while being a mama to four amazing littles (3 year old triplets and a five year old!) In all of her spare time, she has just started writing a blog ( to reflect on the social justice and parenting learning she is gaining from their toddler logic.

Life Adventures Counseling
As an alternative to traditional counseling, we our committed to offering adventure therapy services as a way to provide clients with relevant mental health counseling focused on resolving primary concerns, increasing skills, deepening meaningful understanding, and creating a space for authentic healing to occur. Adventure therapy is based in outdoor and experiential education. Both indoor and outdoor activities are available and are safely structured to encourage personal growth and development. Gass, Gillis, & Russell (2012) provide the most commonly agreed upon definition in the field, “The prescriptive use of adventure experiences provided by mental health professionals often in natural settings that kinesthetically engage clients on cognitive, affective, and behavioral levels.” Learn More about Life Adventures Counseling


Shifting Gears & Changing Minds | Adapting Mental Health & Behavioral Health Services for COVID-19
The Center for Innovative Practices (CIP) offers a timely webinar on how mental health and behavioral health specialists and clinicians can meet the evolving needs of young clients and their families during the Covid-19 crisis and the necessary distancing involved. The session explores strategies, tools, and lessons learned in ways to offer connection and continuity those in recovery. – Hosted by the CIP’s Senior Research Associate, Bobbi Beale, PsyD as part of the CIP’s continuing mission to help clinicians, their organizations, their clients, families and  communities adjust to new ways of connecting in recovery, especially with high fidelity intensive home-base treatment and Wraparound Systems of Care approaches to youth mental health and substance use recovery. View Session in Bigger Frame | View Video of Session

Shifting Gears & Changing Our Minds – Adjusting BH services during COVID-19 HO2 (PDF)  Here | Shifting Gears & Changing Our Minds – Adjusting BH services during COVID-19 HO2 (Word Document) Here | Individualized Resilience Plan – Sample (PDF) Here | Individualized Resilience Plan – Sample (Word Document)  Here

NEW RESOURCE for Children;s Mental Health, Covid-19 and School Mental Health | National Association of State Mental Health Program Directors
The coronavirus has many people feeling distressed. This is very normal in times of crisis. You can manage these feelings and try to keep yourself healthy by taking some simple steps as shown in the many resources below. OhioMHAS has assembled this toolkit of various wellness resources for all of Ohio’s care providers. Research shows the mental health of frontline care workers may be compromised during disasters and other traumatic events (such as COVID-19) when their focus is on assisting others. We hope everyone in high stress positions will take a moment to familiarize themselves with what’s available so that if they find themselves emotionally overwhelmed, help will be no further than a click away.  Download PDF of Resource Guide

New CIP Video Session Explores Trauma Effects from Covid-19
Bobbi Beale, PsyD, Senior Research Associate with The Center for Innovative Practices (CIP) at Case Western Reserve University’s Begun Center for Violence Prevention, presents an overview of the Covid-19 and understanding the global traumatic stress it has created. Entitled, “The Impact of the Pandemic: Understanding Global Traumatic Stress,” Dr. Beale examines the various forces impacting young people and families – especially young people in recovery. She also highlights the different assessments for gauging levels of trauma and informing treatment strategies as well as the ultimate goal of resiliency, Resiliency is an inner capacity that when nurtured, facilitated, and supported by others, empowers children, youth, and families to successfully meet life’s challenges with a sense of self-determination, mastery, hope, and well-being.
View the Video of The Impact of the Pandemic | Download PDF of Presentation

For Teens In Crisis Seeking Support, “Hey, I’m Here” Is a Place to Turn
Youth dealing with challenges to their mental wellness, especially during current times of crisis and concern, can find like-minded young people via, “Hey, I’m Here.” As the video says, “When you need support, every second matters and it’s important to know that you are not alone.”

View You’re Not Alone’ Video | Visit Hey, I’m Here’ Website
Contact via Instagram @HeyImHereOhio | Email

“Hey, I’m Here” is part of Ohio’s Mobile Response and Stabilization Services (MRSS), helping children, youth, and their families who are experiencing an emotional or behavioral stressor by interrupting immediate crisis and ensuring youth and their families are safe. MRSS provides the support and skills necessary to return youth and families to typical functioning. | Learn More about MRSS |

Conversations and Resources on Covid-19 | The Institute for Innovation & Implementation

University of Maryland School of Social Work
Over the past weeks we have held a number of conversations to support your work during COVID-19. Each conversation—crisis communications, in-home behavioral health, supporting families, residential care, infant and early childhood mental health, and mobile response and stabilization—has had a large turnout and active online participation. Access the recordings here. We continue to plan new conversations to address the challenges of today and to create forward-looking solutions for a brighter tomorrow. And we are working on new resources based on your questions.

Please visit Conversations & Resources on COVID-19 and sign up for our new dedicated email list.


Urban Zen Avoiding Burnout in High Stress Work Environments
Presented by Marcia Miller, E-RYT 500
Marcia Miller has been teaching yoga for over 40 years and has taught all levels and types of students from new beginners to yoga teachers and everyone in between. In 2001 Marcia was one of the founders/owners of Yoga on High. She is one of a few Master Teacher Trainers for the Urban Zen Integrative Therapy (UZIT) Trainings and in charge of Reiki training for UZIT. She is on a community advisory board for the Center for Integrative Health and Wellness at the Ohio State University and offers UZIT modalities in Wexner Medical Center at the Ohio State University.
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ADDITIONAL RESOURCES: is presented by The Center for Innovative Practices (CIP)
and the Child and Adolescent Behavioral Health Center of Excellence (CABH COE)
Part of the Begun Center for Violence Prevention
at Case Western Reserve University’s
Mandel School of Applied Social Services
Campus Location: 11235 Bellflower Road Room 375  |
Cleveland, OH 44106 Mailing Address: 10900 Euclid Avenue |
Cleveland, OH 44106-7164
Telephone: 216-368-6293 | email:
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