Therapeutic Consultation
Therapeutic Consultation (TC) is a Medicaid waiver service for people with intellectual and developmental disabilities that focuses on assessment, planning, and caregiver training—not ongoing direct therapy. It is available to individuals with the Community Living (CL) or Family & Individual Supports (FIS) waivers and is delivered in home and community settings as part of the Individual Support Plan (ISP).
Program Philosophy
"Virginia Therapeutic Network’s value-based, multidisciplinary therapeutic consultation program is designed to provide comprehensive, personalized support for individuals with intellectual and developmental disabilities. This program integrates expertise from behavior analysts, occupational therapists, speech-language pathologists, physical therapists, and recreational therapists to collaboratively assess client needs, develop tailored intervention plans, and train caregivers and support staff. The approach focuses on ethical practices and evidence-based strategies to optimize outcomes, address complex challenges, and empower individuals to achieve the life they want in all environments."
Chris Allen
Chief Clinical Officer
WHAT IS THERAPEUTIC CONSULTATION
Therapeutic consultation is a professional, team-based service where clinical specialists—such as behavior analysts, occupational therapists, speech-language pathologists, physical therapists, recreational therapists, and other licensed professionals—evaluate needs, develop individualized support plans, and provide ongoing guidance to the person and their support network.
Instead of providing ongoing direct therapy, TC focuses on:
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Assessing strengths, needs, and current supports
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Developing and refining written plans and strategies
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Training caregivers, staff, and teams to use those strategies in daily life
The goal is to promote skill development, safety, and quality of life in natural home, day, and community settings. Family members and caregivers are essential partners—they help shape the plan, practice new approaches, and share feedback so supports stay person-centered, effective, and sustainable.
OUR MULTI-DICIPLINARY MODEL
Across all disciplines, our consultants design a therapeutic consultation support plan and teach others how to implement it as part of the person’s ISP.
Behavior Analysis
ABA
SERVICE FOCUS: Assess behavioral needs, develop and recommend individualized intervention plans, train caregivers and staff in behavioral strategies, observe implementation, and refine plans to increase helpful behaviors and reduce behaviors that interfere with safety or quality of life.
CAREGIVER ROLE: Consistently implement strategies, collect simple data as taught, monitor progress, and collaborate with the consultant to adjust supports as needed.
Occupational Therapy
OT
SERVICE FOCUS: Evaluate daily living skills, sensory processing, and routines; recommend adaptations, sensory supports, and assistive technology; and train caregivers to use strategies that increase independence and participation.
CAREGIVER ROLE: Practice recommended exercises or modifications, use sensory and adaptive supports as instructed, and share feedback on what works or needs adjustment.
Physical Therapy
PT
SERVICE FOCUS: Assess mobility, positioning, and physical function; recommend exercises, physical supports, and environmental adaptations; and train caregivers to safely assist with movement and promote physical health.
CAREGIVER ROLE: Follow exercise and mobility plans, practice safe assistive techniques, and communicate any changes in mobility, safety, or comfort.
Speech Therapy
ST / SLP
SERVICE FOCUS: Evaluate communication skills, recommend strategies or devices to support speech, language, and augmentative or alternative communication (AAC), and coach caregivers on language-building and social communication supports.
CAREGIVER ROLE: Use recommended communication strategies, reinforce language and AAC use throughout daily routines, and encourage consistent use of any devices or systems.
Recreational Therapy
RT
SERVICE FOCUS: Assess leisure, play, and social participation; design meaningful activities that support engagement, skill-building, and quality of life; and help caregivers build inclusive, enjoyable routines.
CAREGIVER ROLE: Participate in suggested activities, encourage social and recreational involvement, and provide feedback on preferences, successes, and barriers.
How Therapeutic Consultation Fits With Your Other Services
Therapeutic consultation works alongside other supports such as in-home services, day programs, residential services, counseling, ABA, and IFCT classes.
TC focuses on assessment, written planning, and training the people who support the individual day to day. Other services provide ongoing, direct support or therapy. Together, they create a coordinated, person-centered system that turns the plan on paper into consistent action across settings.
THERAPEUTIC CONSULTATION INTAKE PROCESS
Referral
Getting started with Virginia Therapeutic Network is simple and exciting! Begin by filling out our Referral Form, conveniently located at the top right corner of every page. This quick form helps us understand your needs and how we can best support you. Once submitted, our dedicated intake coordinator will promptly reach out to guide you through the next steps.
Authorization
After submitting your intake forms, we’ll work alongside your Support Coordinator to gather all documentation needed for service authorization. Our team prepares a comprehensive support plan and submits the authorization request to the Department of Behavioral Health and Developmental Services (DBHDS) for review. DBHDS carefully evaluates your submitted information to ensure all clinical qualifications, regulations, and documentation requirements are met before approving services; you and your coordinator will be promptly informed once authorization is granted so you can begin your customized treatment journey.
Intake Forms
After your referral is accepted, we’ll initiate the authorization process with your Support Coordinator by your side every step of the way! While waiting for approval, you’ll complete two essential forms: the Release of Information and the Service Intake Packet. These forms ensure we have everything needed to tailor our services to your unique goals.
Begin Services
​Once authorization is approved, your journey officially begins! Your clinician or clinical team (if receiving multiple services) will contact you to schedule an intake meeting. During the first few weeks, you’ll collaborate closely with your clinician to complete a thorough assessment and develop a personalized treatment plan designed to help you thrive.
FREQUENTLY ASKED QUESTIONS
What is therapeutic consultation?
Therapeutic consultation is a waiver service in which licensed or qualified specialists (such as behavior analysts, OTs, PTs, SLPs, and other professionals) assess a person’s needs, develop a therapeutic consultation support plan, and train caregivers and staff to use strategies that improve daily functioning, safety, and skill development.
Who qualifies for therapeutic consultation services?
Individuals enrolled in the Virginia Community Living (CL) or Family & Individual Supports (FIS) waivers who have a documented need for consultation—meaning their ISP cannot be implemented effectively without this support—may qualify, as determined and authorized through the ISP and service authorization process.
What does a therapeutic consultant do?
Consultants interview the individual and team, observe in natural settings, review current supports and devices, design a written plan with recommended interventions, and train caregivers, staff, and other supporters to use these strategies. For behavior consultation, they may also provide limited direct intervention to demonstrate techniques and gather baseline/treatment data.
Does therapeutic consultation include direct therapy?
For most disciplines, TC does not include ongoing direct therapy; it is primarily assessment, planning, and training. Behavioral consultation is the exception and may include direct behavioral interventions and demonstrations with the individual in the presence of caregivers or staff when clinically appropriate.
Where are therapeutic consultation services delivered?
TC is delivered in the settings that matter most to the individual—such as the home, day program, job site, or other community locations—and may also include HIPAA-compliant telehealth when appropriate. The focus is always on embedding supports into real-life routines, not clinic-only settings.
What is the caregiver’s role?
Caregivers are central to success. They learn recommended strategies, integrate them into everyday routines, document or share information about what’s happening, and collaborate with the consultant to review data and adjust the plan over time.
Can someone receive both ABA therapy and therapeutic consultation at the same time?
​Sometimes. If ABA therapy is already addressing behavioral needs under another funding stream, TC typically cannot be used for the same behavioral goals because that would duplicate services. In certain complex situations, both may be approved with clearly distinct roles and targets; this is reviewed case by case with your Support Coordinator and the authorizing agency.
How are service plans reviewed for technical adequacy and safety?
Behavior support plans that include restrictive procedures (such as restraints or time-outs) are subject to additional oversight and review to protect the individual’s rights and safety. Plans follow human rights regulations and are monitored through required data, quarterly reviews, and annual updates.
Is therapeutic consultation considered a crisis service?
No. Therapeutic consultation is not an emergency or crisis response service. It is designed to proactively assess needs, develop long-term support plans, and train caregivers to use evidence-based strategies. In any immediate behavioral or mental health crisis, families should contact emergency services, 988, or local crisis teams—TC providers cannot respond to active emergencies or provide on-the-scene stabilization.