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Policies for Consent to 
Pediatric Recreational Therapy Services 
at Inclusion Therapies LLC Center

PRACTICE POLICIES
THIS ACKNOWLEDGMENT INCLUDES POLICIES FOR PEDIATRIC SERVICES AT OUR CENTER.
PLEASE REVIEW IT CAREFULLY.

EFFECTIVE 4/17/2024

1. Where are the therapy sessions?
We hold most Psychosocial (PSR) Rehabilitation therapy sessions online or at our Lake Travis Center for Therapeutic Recreation Technology (CTRT), located at 16201 Dodd St., Ste. 200, Volente, TX 78641. In select cases upon approval, sessions are held in school, at home or at other community locations.

(a) Clients must be toilet trained to be able to independently use the bathroom or have an aide/parent/legal guardian with them to help assist with bathroom needs. Our staff will not accompany or assist clients with toileting (and/or related clothing/ hygiene needs). 

(b)For clients with a recent history of elopement and/or physical aggression, at least one adult parent or guardian will transport and accompany them (for the duration of the session) on community outings outside of their residence .

(c) Who is seen during the session?
Only the client will be treated by our staff during the session. No other minor children may be present (if present without staff preapproval, no other child will be provided any supervision and guardian and/or social services will be called to retrieve the minor child). For any approved home-based sessions, at least one adult parent or guardian must be onsite for the duration of the session. There is no childcare available at our center or available during our sessions and only the client may be left in our care for the duration of the session (no other unsupervised minors will be allowed to remain onsite). If we have space available, family members are welcome to remain in our waiting area. Any visitor(s) must be respectful of other businesses and individuals at our shared office location (or will be asked to leave the premises).

2. What activities are available at the therapy sessions located at the center at 16201 Dodd St., Suite 200, Leander, TX, 78641?

At the community activity center, our office has a variety of indoor activities:
· games,
· music,
· virtual reality,
· biofeedback,
· arts,
· crafts, and more...

Right outside the activity center and around the corner, .2 miles away at Volente Beach Resort & Waterpark, outdoor
activities (weather and lake levels permitting) include:
· water slides,
· volleyball,
· game lounge,
· and more...

3. What is the staff ratio for clients?
For our pediatric clients, we provide a one-on-one session supervised by the Clinical Director Recreational Therapist (supported by a bachelor's degree level Therapist Assistant/ Technician carrying out activities) and/or (if permitted by the client payer agency) small group sessions (1:4 ratio).

4. How long are the Recreational Therapy sessions?
Our standard pediatric sessions are 45 minutes in duration. The maximum hours per week of services is individually determined based on client diagnosis and treatment plan (and, if applicable, payer agency parameters).

5. What do I need to bring to the activity center?
Nothing.

6. Are food and drinks provided at the activity center?
No, only water is provided to clients. This is to ensure that no allergen (or guardian unapproved food or drink), is consumed by clients. Any food or drinks that a client desires onsite must be pre-approved by the guardian and sent with the client to the session. We have a refrigerator to store client items during the session. Food or drink is not to be shared with any other clients.

7. Do you provide medication at the activity center?
No, we do not dispense any medication at the activity center.

8. Will therapists or other staff pay for client to buy things and/ or participate in activities?
Inclusion Therapies has invested in providing a community activity center with a variety of indoor and nearby outdoor public activities. This is to ensure that all clients are able to participate in activities without any economic investments. If a client desires an activity that is fee-based outside of our provided activities, that would be negotiated on a case-by-case basis with their guardian providing payment in advance of the activity
. Our staff do not buy any items or give money to clients under any circumstances (including buying online and/or in-game purchases).

9. May guardians wait at the center if they want to?
Yes! If a guardian is available to stay for the session, we would encourage them to participate in activities with the client and treatment therapist. Most clients are dropped off and picked-up by their guardian at the end of the session.

10. May clients do any activity they want to do?
Our client, and their guardian(s) will authorize approved activities. Within those approved activities, with the understanding that there may be availability issues (weather, public health, equipment availability, waiting for other people to finish using/ doing the activity, etc.); during each session the therapist and client will select from their preapproved options.

11. What if clients only want to do one activity?
An important aspect of Psychosocial Rehabilitation (PSR) for mental and behavioral health is to learn new things by engaging in new experiences. For example, if a client really loves to play card games, being open to trying a new card game for the first time is important for building new skills and self-efficacy. We structure each session so that clients will have the opportunity to engage in a new experience during each session.

12. What if a client doesn't want to do anything at all?
If there is a time where a client doesn’t want to do any activity, we ask the guardian to contact us ahead of time and let us know that the session needs to be rescheduled. On the rare occasion that a client is at the activity center (or any other session location) and becomes unwilling or unable to participate in any activity, we will request their guardian to immediately come and pick them up. If there is a medical emergency with client, and/ or client is physically abusive or otherwise a danger to themselves and/or others; 911 will be called for assistance with ensuring client safety (and preventing property damage and/ or harm to others). Inclusion Therapies LLC staff will not restrain or physically engage with clients and will rely on 911 services to attend to client in a safe manner.

Client's legally authorized representative (parent, guardian, etc.) acknowledges and accepts by their signature herein that any and all property damage caused by client to Inclusion Therapies LLC property (or that of any other owner), will be their sole responsibility to pay for repair, replacement and all other related costs to place the property owner in the position they were prior to the property damage.

13. Will the Recreational Therapist force clients to do an activity?
No.
Recreation is the Client's Creation.
Inclusion Therapies provides outpatient healthcare treatment for the benefit of each client. At Inclusion Therapies, we respect the choices that each client makes, and our mandate is to work with clients to achieve their treatment plan outcomes. We are a partner striving together towards our client’s productive outcomes; thus, we are not able to provide healthcare services to a client that refuses or rejects them. If a client refuses services during a session, we will request their guardian to come and pick them up. If a client is refusing services before coming to the center, we require that the guardian contact us and let us know that the session needs to be rescheduled.
If a client refuses services/ “no shows” for confirmed sessions two (2) times within 30 days or two (2) times in a row; we will remove the client from the schedule and request a meeting to reassess their commitment to participate in services. Upon reaffirmation of the desire to actively participate in services, we will place the client back on the schedule.
We provide patient/ client-centered care and adhere to the multidisciplinary treatment team concept, “No decision about me without me.” We work to support our clients and we acknowledge their choices to participate or not in treatment. We provide activities, highly qualified therapists and support staff, evidence-based treatment interventions and a passion to partner with our clients to achieve healthy outcomes. When a client decides they want our services to support them in achieving their goals, we are ready! Here are some tips for supporting teens into participating in therapy and younger children.

BY SIGNING, THE SIGNATORY IS AGREEING THAT THEY HAVE READ, UNDERSTOOD AND AGREE TO THE ENTIRETY OF THE TERMS STATED HEREIN.