Therapeutic Consultation

What is Therapeutic Consultation?

The Developmental Disability (DD) waivers are offered to both children and adults with various levels of intellectual and/or developmental disabilities. There are a multitude of services and supports offered under each waiver, depending on individualized needs and program criteria met. Therapeutic consultation service through the DD Waiver means professional consultation provided by members of psychology, social work, rehabilitation engineering, behavior analysis/consultation, speech-language pathology therapy, occupational therapy, psychiatry, psychiatric clinical nursing, therapeutic recreation, or physical therapy disciplines that are designed to assist individuals, parents, guardians, family members, and any other providers of support services with implementing the individual support plan. Individuals that currently receive the Virginia Community Living (CL) or the Family and Individual Support (FIS) Waiver can receive therapeutic consultation services.

Therapeutic Consultation is what is called an indirect service. Indirect services include ongoing progress reviews; cooperative planning; consultation; demonstration teaching; modification and adaptation of the environment, curriculum, materials, or equipment; and direct contact with the pupil to monitor and observe. Indirect services may be provided by a related services professional to another regular education, special education teacher, related services professional, paraprofessional, support staff, parents, and public and nonpublic agencies to the extent that the services are written in the client’s ISP.

It is paramount to note that therapeutic consultation does not allow for 1:1 work with the patient. This service is for staff, caregivers, family, etc. to be taught strategies to support the individual. While I am a Supervisee in Clinical Social Work as well as a behavior analyst and will draw from both areas of expertise in therapeutic consultation, this service is not, and cannot, be psychotherapy.

Types of Therapeutic Consultation Offered

Behavioral

Currently, Matthew offers behavioral therapeutic consultation. Behavioral therapeutic consultation is focused on individual and caregiver psychoeducation regarding neurodivergence affirming behavior analytic conceptualizations of problem behavior and includes the creation of, and education on, a customized behavior intervention plan (BIP). Matthew can also evaluate for assistive technology (AT) and environmental modifications. If Matthew feels that AT or an environmental modification is needed to assist the patient with reaching their goals, a letter of medical necessity (LMN) will be written and submitted to the state.

Psychological

Matthew plans to offer psychological therapeutic consultation in early 2026. Psychological consultation is centered around psychoeducation on an individual’s diagnosis for family and caregivers through a psychological rather than behavioral lens. In addition to psychoeducation, caregivers will be provided with best practices to maximize the individual’s ability to thrive while managing their diagnosis as well as strategies that families can implement to minimize unintentional triggers.

What is Required of Caregivers and Staff to Participate in Therapeutic Consultation?

The following components are required by the state of Virginia:

Staff or caregivers meet with their behavioral consultant a minimum of once per month.
Staff and caregivers must take data on a weekly basis.
If staff or caregivers are unwilling or unable to carry out the BIP, the behavioral consultant is required to terminate immediately.
When the plan begins to be successful, fade out (removal) of services is to occur. Your behavioral consultant will typically do this via dropping meetings to every other week and then once a month. However, if problem behaviors begin to increase again, you can go back to weekly appointments.

What Requirements Does Lunsford Behavioral Consulting & Yoga have in Place?

In addition to the state requirements for services outlined above, I expect the following:

Outside of meetings with your behavioral consultant, all communication is to take place via email or the Simple Practice patient app. It is expected that you respond to any emails that your consultant sends as they will communicate things such as cancellations to you through this medium in addition to the use of announcements through the patient portal.
If you miss three appointments with your consultant without cancelling, services will be terminated.
If your consultant finds that you are not taking data for a month, services will be terminated. The state mandates at least six months of data before they will consider reauthorizing TC services.
Your consultant is to be informed of all changes to prescription and OTC medication changes including dosage and frequency of use. Your consultant also needs to be aware of all vitamins, supplements, and herbal formularies being used as any substance can influence behavioral topography.