Therapeutic Behavioral Services

Therapeutic Behavioral Services (TBS) are available for eligible children who need short-term behavioral support in addition to any other mental health services they are receiving. TBS’s goal is to help children avoid being placed in a higher level of care such as a residential treatment facility or to help children make a successful move to a lower level of care such as returning home after residential treatment.

TBS is a short-term program that focuses on changing a child’s behavior, while emphasizing the child’s strengths. TBS works in collaboration with the child, the child’s caregivers and the primary mental health provider to address 1 to 3 behaviors that jeopardize the child’s ability to remain in his or her current home.

TBS services are provided in the child’s home and other environments where the child’s behaviors occur. Services are approved for 30-60 days at a time and are expected to produce the desired changes within a few months.

The TBS program develops and implements plans that smooth the fit between a child’s behavior and the child’s environment. When needed, the TBS staff’s first objective is to help respond to safety issues. After that, TBS unfolds in three phases:

  1. TBS staff begins by gaining an understanding of the child’s behavior. TBS then develops replacement behaviors for the child to use as alternatives to the undesirable behaviors. Strategies may include the development of a behavioral plan, such as a step-by-step process in which caregivers follow a guideline to manage specific behaviors as they occur, or an incentive plan where the child is rewarded for choosing productive replacement behaviors.
  2. Next, TBS staff works directly with the child and those who care for the child. During this time, TBS staff, the child and the child’s caregivers are learning together and taking responsibility for their parts of the child’s behavior plan. Interventions and strategies focus on improved self-management, self-awareness, and communication skills as well as positive reinforcement of desirable behaviors.
  3. During the final phase, TBS staff oversees a transition plan to ensure that the positive behavioral changes will continue. A child graduates from TBS once the frequency, duration, and intensity of the 1 to 3 targeted behaviors have been reduced and interventions and strategies have been transitioned to support persons. TBS may also need to stop services if the child does not appear to be benefiting from services or progress has reached a plateau.

How does a child receive services from this program?
TBS accepts referrals from many sources, such as probation officers, therapists, schools, day treatment programs, and psychiatrists, as long as the child is receiving other mental health services and meets the following eligibility requirements:

Eligible child or youth:

  • Must have full-scope Medi-Cal.
  • Must meet medical necessity criteria (or have a qualifying mental health diagnosis).
  • Must be a member of a certified class by meeting one of the following criteria:
    - Currently living in a group home facility, RCL (Rate Classification Level) 12 or above and/or locked treatment facility
    - Has undergone at least one emergency psychiatric hospitalization related to his/her current presenting disability within the past 24 months
    - Is being considered for placement in a group home facility, RCL 12 or above, and/or a locked treatment facility
    - Has previously received TBS services
    - Must be receiving other mental health services

Counties Served:

> Los Angeles
> Monterey
> Nevada
> Placer
> Sacramento
> Santa Clara
> San Joaquin

Los Angeles County

How do I get more information?
Contact Hollygrove at (800) 864-KIDS or call the TBS Clinical Program Manager at (323)769-7156.

> TBS Referral Form – Los Angeles (doc)

Monterey County

How do I get more information?
Contact the TBS Clinical Program Manager at (408) 876-4268.

> TBS Referral Form – Monterey County (doc)

Sacramento County

How do I get more information?
Contact the EMQ FamiliesFirst Sacramento office at (916) 388-6400.

> TBS Referral Form – Sacramento (doc)

Santa Clara County

How do I get more information?
Contact EMQ FamiliesFirst’s Client Services Center at (408) 379-3796.

> TBS Referral Form – Santa Clara County (doc)

Therapeutic Behavioral Services (TBS) is the result of a California lawsuit (Emily Q) creating an entitlement for children eligible for Medi-Cal and who have been hospitalized or placed in treatment group homes to targeted behavioral service that will assist them to be successful in the least restrictive environment.
Confidentiality of EMQ children and families has been preserved through the use of models. Some stories may be composites of multiple cases.