PYS/KPR/PVNC Day Treatment Program 

Program Screener 

 

The following information is intended to provide guidance and assistance to individuals in informing their decision to refer children/youth and their families to the PYS Day Treatment program. 

Basic Criteria to initiate a referral: 

❑ Youth is a resident within the Peterborough Region and registered in either the Kawartha Pine Ridge District School Board (KPR) or Peterborough Victoria Northumberland and Clarington Catholic District School Board (PVNC) 

❑ Youth in grade(s) 9 – 12 

Youth should NOT be referred if (any of the following 3 conditions exist): 

❑ Current indications/diagnosis of active and/or untreated psychosis 

❑ Youth has been diagnosed with or suspected of a diagnosis of moderate to severe Autism Spectrum Disorder 

❑ Youth has been diagnosed with or suspected of a diagnosis of an Intellectual disability within the 2nd percentile 

❑ Youth has been diagnosed with or suspected of a diagnosis of moderate to severe Fetal Alcohol Spectrum Disorder 

Youth’s concerns/presentation: 

❑ Youth experiences severe, complex, and/or chronic/persistent mental health problems that significantly impair their functioning in home, school and in the community 

❑ Youth presents with social, emotional and/or behavioural needs exceeding their capacity to be successful in an educational program despite concurrent implementation of school-based interventions due to their primary need for mental health treatment 

  1. Youth has experienced/is experiencing significant difficulties in any or all of the following:  Moderate to Severe Anxiety/Depression 
  2. Suicidal ideation or history of attempted suicide
  3. High degree of Family/Caregiver Conflict 

❑ Youth demonstrates the basic skills needed to benefit from the therapeutic interventions used in a group environment, and in accordance with the mental health services model (Mindfulness, Motivational Interviewing and Talk Therapy) 

❑ Youth demonstrates the basic skills and ability to manage their behaviours/education program expectations through the implementation of program interventions (i.e., verbal prompts, social cuing, modeling, positive reinforcement, visual schedules) in the absence of physical intervention (holdings/restraint) 

❑ Youth demonstrates the willingness and ability through self-regulation to integrate and learn safely with other youth 

(For example, no evidence of extreme violent behaviours towards others or a history of aggression resulting in medical harm to others for which they have not demonstrated some form of remorse and remediation, including mental health treatment) 

For Board of Education initiated referrals only: 

❑ Specialized strategies and interventions have been utilized/attempted within the education program as outlined in the youth’s Individual Education Plan (IEP) 

Youth (and Family, if possible) commitment: 

❑ Youth (and Family, if possible) are willing and able to engage and work cooperatively and collaboratively with Peterborough Youth Services and KPR/PVNC 

❑ Youth (and Family, if possible) voluntarily commit to participate in all aspects of the Day Treatment program, as outlined in the program’s brochure 

If most or all of the above boxes are checked, please refer this youth to the PYS Adolescent Day Treatment Program at the following: 

Rose Powers 

[email protected] or 705-761-2055