ST. CLOUD — CentraCare will soon open a new unit dedicated to helping young children with their mental health issues.
In February, Clara’s House is expanding its services to kids ages 3 to 5. Barbara Skodje-Mack, director of Child & Adolescent Outpatient Behavioral Health for CentraCare, said it is the first early childhood partial hospitalization program in the Midwest.
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That means children will receive therapy and other services full-time, five days a week, to help them cope with various mental health problems and traumas. But they will still be with their families on nights and weekends.
Research shows 90% of core brain development happens in the first five years of life, so addressing problems early with evidence-based and trauma-informed interventions can have a great impact later in life, Skodje-Mack said.
Clara’s house has added nearly 5,800 square feet to its building to accommodate the program. It will be open to the public for a tour on Monday, Jan. 27.
There are other programs of its kind on the east and west coasts, but nothing closer, Skodje-Mack said. Other programs in the St. Cloud area are day-treatment programs, which aren’t as intensive as the new program at Clara’s House.
The new unit is opening soon after the children’s mental health unit celebrated its 20th anniversary in October 2024. Over the past two decades, it has served more than 6,000 youth in partial hospitalization units treating ages 5-18. They serve about 330 patients each year.
What kinds of problems do kids have?
Children and teenagers can experience a wide array of mental health issues, Skodje-Mack said.
“Usually, folks that make it to Clara’s House are struggling quite a bit, so they're needing a higher level of care than outpatient once a week or once every two weeks,” said Skodje-Mack, who is also a licensed therapist and counselor.
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For younger ages, they see kids struggling with anxiety disorders, reactive attachment disorders, sensory disorders, neurodevelopment disorders and behavior disorders.
For older kids, they see all those issues as well as depression, post-traumatic stress disorder, obsessive-compulsive disorder and substance use disorders.
What does that look like in kids?
“Children are not mini-adults. They don't have the same ability to articulate what's going on, what their thoughts and feelings are. So a lot of times, (their) mental health symptoms show up in behaviors,” Skodje-Mack said.
This might mean kids have a hard time managing their emotions. It can be so extreme that it interferes with sleeping, eating and their ability to use the toilet. It can result in tantrums, nightmares, not following directions, being excessively clingy or sad — all to a greater extent than other children, Skodje-Mack said.
These kids may have difficulty socializing with other children and may have been kicked out of multiple day care centers or classrooms because of these behaviors, Skodje-Mack said.
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Screening for trauma and neurodivergence
Kids who come to Clara’s House are also evaluated for other concerns, like autism, ADHD, dyslexia and speech and developmental delays.
“Just think how frustrating it would be when you understand what everybody's saying, but you can't communicate in a way that they understand you,” Skodje-Mack said.
A child’s life experiences can also be a source of problems. Those Adverse Childhood Experiences, or ACEs, can include experiencing violence, abuse or neglect or witnessing violence in the home. It can also include growing up in a household with addiction issues, mental health problems, divorce or incarcerated parents.
But their experiences don’t have to be that extreme.
“Even if (kids) don't know about paying bills and groceries and jobs and housing, they feel the stress,” Skodje-Mack said. “It's not necessarily bad parenting.”
How does it work?
Most patients are referred to Clara’s House by their current outpatient therapists. But they also get referrals from county social services, family doctors and schools, Skodje-Mack said.
Clara’s House accepts all types of insurance and will work with families to figure out how to pay for services. That might include working with insurance companies, setting up payment plans or seeing if they qualify for financial assistance through CentraCare.
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Older kids tend to stay three to six weeks, Skodje-Mack said. Patients ages 3-5 in the new unit will likely stay longer, six to 10 weeks, Skodje-Mack said.
The kids at Clara’s House have many tools to help stabilize and improve their mental health, Skodje-Mack said. That includes traditional talk therapy and one-on-one visits with individual therapists.
But most of the therapies are group-based, Skodje-Mack said. That includes recreation therapy, which focuses on team building and the ability to deal with being in distress or uncomfortable. They have art and music therapy, as well as yoga and mindfulness tools. There’s also family therapy and play therapy.
School-age kids also get some school instruction during their time, a few hours a day, Skodje-Mack said.
After kids complete the program, Clara’s House works with parents and schools to plan for continued outpatient services as needed.
What is play therapy?
As a play therapist, that’s where Skodje-Mack’s passion is, she said.
“People sometimes are like, ‘How are you going to do therapy with a four-year-old?’” Skodje-Mack said. “You're going to play. … Kids heal through their play, just like kids learn through play and song and movement.”
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Kids will act out their stories in play or with toys. Skodje-Mack talked about one of her clients who kept reenacting two cars crashing. She asked him who could be the helper in that situation.
“When we looked through the toys, and we tried to find the helpers, and we put them out, and then pretty soon his story changed,” Skodje-Mack said. “Things were shifting in his play, and there were resources and helpers, and the cars didn't have to crash anymore.”
Open house
- What: Clara’s House open house
- When: 4-6 p.m. on Monday, Jan. 27
- Where: Clara’s House, 1564 Stearns County Road 134, St. Cloud
- Details: Tour the new addition and learn more about Clara's House programs. Event is free and open to the public.
- More info: For more about Clara’s House and how to get help, visit centracare.com/locations/profile/st-cloud-hospital-claras-house.
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