Dear Prospective Camp Family,

It is with great pleasure that we announce the details for our “Pathway to Hope” fallfamily camp for 2018. Our family day camp will run from September 10ththrough November 12th, 2018. The entire family, including the target child, both parents (if applicable), and siblings living in the home, will attend the 10 week camp. We will be accepting 2-4 families with at least one child from a hard place. The cost of the camp is $650 (for a family up to 4 – 2 parents and 2 children). Please add an additional $50 for each additional child. Fees will be due after formal acceptance into the program.

Our camp is built off the great work of Dr.Karyn Purvis, Dr. David Cross, and the Institute of Child Development at Texas Christian University. We have been extremely blessed to be trained under this great group of people to offer this wonderful camp through Anchor Point. This model is an emerging intervention for a wide range of childhood behavioral problems. It has been applied successfully in a variety of contexts, and with many children for whom other interventions have failed (e.g., medications, cognitive-behavioral therapies).

The Trust Based Relational Intervention (TBRI) is based on a solid foundation of neurophysical theory and research, tempered by humanitarian principles. It is a family-based intervention that is designed for children who have come from a hard place. Research has found that a 'hard place' can be caused by abuse, neglect, trauma, a difficult pregnancy, a difficult birth or prematurity. For the past ten years, Drs. Purvis and Cross have been implementing and evaluating the TBRI model, and their strategies have proved extremely effective in creating healing environments for children who have come from hard places.

The TBRI model emphasizes the integration of the following intervention principles:

  • Empowering Principles (felt safety, safe touch, nutrition, hydration, sensory processing and self-regulation)
  • Connecting Principles (attachment, engagement strategies and playful interaction)
  • Correcting Principles (life value terms and IDEAL response)

The ultimate goal of our camp is to help families and children construct meaningful connections and deeper relationships. It will allow the children to not only survive but ultimately thrive in life.

After we receive your application, we will be able to verify that each family meets our initial criteria. In the month of July, we will contact families who have applied to schedule ahome visit to further determine eligibility for the camp. Families will receive final notification of acceptance no later than August 10, 2018. If your family meets the following criteria and is interested in participating in our camp, please complete the application and return by July 13,2018. The earlier you return the application the better.

The following is the criteria for family camp:

  • Your target child will be between the ages of 5-13 by September 1, 2018.
  • Your target child will have been living in your home for at least one year by September 1, 2018.
  • You and your family are willing to be videotaped and photographed.
  • Both parents are willing to complete a criminal background check.
  • Meet all the expectations below.

Expectations

Participate in Pre-CampHomeVisit: Families will participate in a home visit prior to camp as part of determining participation in the camp experience.

Attend ALL Day Camp Activities: Every Monday starting September10th-November12thfrom 6:00 pm to 8:30 pm atAnchor Point Seabrook Location.

Attend ALL Family Sessions: Each family will choose a day andan hour of time (Tuesday- Friday 10am-6pm) to complete their family counseling session each week starting September 11th-November 16, 2018.

Participate in a Post Camp Home Visit: Families will participate in a follow up home visit. This will be scheduled about one month after camp.

We look forward with great anticipation to the“Pathway to Hope” fallfamily camp 2018. It is our goal to offer connection and healing for our children from “hard places” and assist families to implement a solid intervention model at home. This camp can serve as a first step on the long arduous journey. We firmly believe that there is hope for every child.

If you have any questions, please do not hesitate to contact me or 832.819.2734.

Sincerely,

Rendie Brown

Director of Family Services

Anchor Point

Camp Criteria

  • Will your target child be between the ages of 5-13 on September 1, 2018? YESNO
  • Will your target child have been living within your home for one year? YESNO
  • Are you and your family willing to be photographed and videotaped? YESNO
  • Are both parents willing to complete a criminal background check? YESNO
  • Your family can participate in all camp, pre-camp, and post camp sessions? YESNO

Parent Information

First Name / Last Name / Date of Birth / Cell Phone / Email
Mother
Father

Employment

Degree / Occupation / Travel? Y or N / Work Schedule
Mother
Father

Contact Information

Street Address / City / State / Zip Code
Address

Child Information

First Name / Last Name / Date of Birth / Current Age (as of 9/1/18)
Target Child

Sibling Information

First Name / Last Name / Date of Birth / Current Age (as of 9/1/18)
Sibling 1
Sibling 2
Sibling 3
Sibling 4
Names / T-Shirt Sizes
Mom
Dad
Target Child
Sibling 1
Sibling 2
Sibling 3
Sibling 4

What does your family hope to gain from coming to camp?

What are you family’s major strengths?

What are your family’s major challenges?

As a parent(s), what are your major strengths? Complete for mom and dad

As a parent(s), what are your major challenges? Complete for mom and dad

Please list 3 goals you have for yourself during camp.

Child Information

First Name / Last Name / School / Grade

Is this child adopted? YESNO

If so, type of adoption?DomesticInternational (which country) -

Previous Care (if applicable)

Type of Care (i.e., foster care, orphanage, group home, only our home, etc.) / Age at
Entry / Duration of Stay / Age at
Exit
Care Environment 1
Care Environment 2
Care Environment 3

Has this child experienced:

YES / NO / If Yes, explain
A difficult pregnancy
A difficult birth
Early hospitalization
Neglect
Physical Abuse
Sexual Abuse
Loss of a Primary Caregiver
Other Trauma

Child Medical History:

YES / NO / If Yes, explain
Does the child have any medical or physical diagnoses?
Does the child have any known allergies or food restrictions?
Does this child have any limiting physical difficulties?
Has this child received any psychological diagnoses (e.g., ADD/ADHD, Autism, ODD, etc.)?
Has this child ever been hospitalized for a serious injury (e.g., broken bones, head trauma, bleeding)?
Has this child ever been hospitalized for a significant illness (e.g., pneumonia, asthma, etc)?
Has this child ever been hospitalized for behavioral or emotional problems?

Medical Diagnoses

Label / Date of Diagnosis / Current Medications
(if any) / Comments
Diagnosis 1
Diagnosis 2
Diagnosis 3

Allergies or Food Restrictions

Label / Date of Diagnosis / Current Medications
(if any) / Comments
Restriction 1
Restriction 2
Restriction 3

Physical Limitations

Label / Date of Diagnosis / Current Medications
(if any) / Comments
Difficulty 1
Difficulty 2
Difficulty 3

Psychological Diagnosis

Label / Date of Diagnosis / Current Medications
(if any) / Comments
Diagnosis 1
Diagnosis 2
Diagnosis 3

Serious Injuries

Cause / Date of Injury / Duration of Stay / Comments
Injury 1
Injury 2
Injury 3

Serious Illness

Illness / Date of Onset / Duration of Stay / Comments
Illness 1
Illness 2
Illness 3

Behavioral or Emotional Problems

Reason / Date of Entry / Duration of Stay / Comments
Hospitalization 1
Hospitalization 2
Hospitalization 3

Concerns:

YES / NO / If Yes, explain
Does the child have behavioral difficulties?
Does the child have emotional difficulties?
Does this child have educational difficulties?
Does this child have sensory difficulties?
Does this child have social difficulties?
Have you ever worried about the physical safety of your child or others around your child because of the emotional or behavioral difficulties your child may be experiencing?
Has your child ever harmed or attempted to harm another person, animal or himself?

What are these child’s major strengths?

What are these child’s major challenges?

Please list three goals you have for this child during camp

Are any other children residing in the home?YESNO

** if yes, please complete child profile for each child in family.

RETURN COMPLETED APPLICATION TO RENDIE BROWN

EMAIL:

MAIL: ANCHOR POINT, 103 DAVIS RD, SUITE B, LEAGUE CITY, TX 77573

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