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Immigrating to a new country can be a tough challenge for anyone. For Sara, age seven, it was an especially rough transition. Sara came to Fred Finch shortly after her family immigrated to San Mateo County from Guatemala, when she was referred to the San Mateo Therapeutic Behavioral Services (TBS) program after she was placed on a voluntary hold at psychiatric emergency services.

When she started with the TBS program, Sara’s behavior was extreme. She was engaging in self-harm, scratching her face until she bled and banging her head against hard surfaces. She was also acting out a lot of aggression towards classmates- kicking and hitting her peers, verbally insulting them, and throwing tantrums at school. Particularly frightening for her family were the threats- Sara had recently started to threaten her younger sister, putting their relationship in jeopardy and leaving the entire family concerned that her behaviors would escalate.

San Mateo Therapeutic Behavioral Services (TBS) is just one branch of Fred Finch’s TBS offerings, which are also offered in Alameda County and Santa Clara County. Through San Mateo TBS, children and youth ages 3-18 get paired with a Fred Finch staff member who works closely with the participant, their existing program therapist, and their family and caregivers. The participant’s team- consisting of themselves and this support- develop behavioral interventions, and Fred Finch staff coach the participant for a specified short-term period, usually 6-9 months.

During these services, Sara was engaged and receptive. One of the most useful interventions the team came up with was coaching Sara into styles of play that targeted positive social skills and empathy building; she also learned frustration tolerance skills and got better at regulating her responses to challenges and self-soothing when she needed to.

Soon, Sara was verbalizing her feelings more and developing a new emotional vocabulary, voicing when her needs were unmet. She began attending school regularly and didn’t have such a hard time following directions. She’s made a few friends, and her self-harm and threats have reduced dramatically. In late 2019, Sara met all of the goals that she and the TBS staff had set out, and graduated the program successfully; the tools she gained through TBS help her everyday to live a happier, more expressive, and more comfortable life.



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