What is Therapeutic Staff Support?

There are many different positions within the Behavioral Health field, Therapeutic Staff Support (or TSS) is one of them. TSS's provide one on one interventions to help child, teen or adult to assist in behavioral modification. They work either in the home, school (includes day care), or community, wherever the behavior is most prevalent. Some things they provide are crisis intervention, behavior reinforcement (reinforcements for good behavior), emotional support, and time structure. A TSS does not work alone, they work alongside a Behavioral Specialist Clinician (BSC) or a Mobile Therapist (MT).

Some of the TSS duties and responsibilities include modeling treatment interventions established by the MT or BSC as documented in the treatment plan, providing specific interventions in the home, school, or community settings as outlined in the treatment plan, develop progress notes describing each client contact and how that contact relates to treatment goals, and collaborating with other members of the treatment team and other professionals working in the home, or in other community settings, as well as participation in Inter-agency/team meetings when necessary.

There are various required experience to be a TSS. Any Bachelor's degree with at least one year of full time paid work experience in a CASSP system, any full time position in behavioral or mental health works. One must also have all clearances from state, child abuse as well as the Federal Bureau of Investigation. Different companies have different policies on training such as CPR/First Aid and Crisis Intervention. Family Behavioral Resource in Southwestern Pennsylvania requires 24 extra hours of training and provides various trainings throughout the months.

Being a TSS can be hard because you have to adapt yourself to each client. No client is the same, nor will they respond to the same interventions. As a TSS you need to be creative in your interventions. Sometimes proximity (where place yourself with client ie: eye level, next to, behind) may work for one client other times you need to do something else like games or reinforcement. You can turn learning things into a game such as for following directions you can begin with a game of Simon Says. A good idea is when you need to ask questions like "Wh" questions you can intermix them with a game. Before child's turn you can ask two questions and they can take their turn. The sky is the limit with how creative you can be with interventions and teaching clients what they need to know.

Some of the downfalls are that your day/week depends on the client. If the child is sick, on vacation, or something unexpected comes up and the family cancels, you do not get paid. Sometimes when you are just beginning as a TSS you may not get all the hours you need, some may get 20-25,but as clients come in hours can go up. There is a whole lot of paperwork to be done weekly, along with timesheets there are progress note, data collection, and encounter forms (billable and no billable) along with other paperwork your company may need. There is also a lot of travel time involved. It gets discouraging when a client cancels services or would like a different TSS because of personality/cultural differences.

Some companies have specifics fields they concentrate in such as Family Behavioral Resources in Southwestern Pennsylvania whom focus on Autism but also have clients with behavioral issues. It helps families find exactly the help they need for their child. It also helps TSS's find the field that they want to work in. Working as a TSS is stressful and rewarding at the same time. The longer you work with the child you get to see their progress. You get to see their improvement and growth because of the work that you do with the child.