I would have to agree with both K and CrazyinVA. I have dealt with in home therapist in 3 states. We also now have one that was a PO as well at one point in time. What I can say is that the continuity of care is not good from agency to agency and turn over is extremely high. The turn over is always high for several reason I've learned in speaking to not only the workers themselves but the higher ups in administration including at the highest state levels when I was really active in advocacy work years ago. The emotional toll, the stress, the pay (BIG factor), amount of paperwork (big surprise there as there is so many restrictions/constraints and they get sick of it), and finally the younger ones that come in often realize that this isn't the type work they thought it would be.
The ex PO turned worker (who coincidentally has been from lowest on the totem poll all the way up to starting and opening up a residential facility that is still running today) who by choice has chosen to be a general in home worker now as he "likes" this type of work now that he is older and experienced all the other levels and it fits his needs in life and he feels he can do the most effective work with the kids he works with. The kids he has chosen to take on are adolescence. He prefers boys but does have girls and his experience is that if they can be reached before they hit that 15/16 mark there is hope for them but they MUST be worked with intensively. He does not EVER give up hope on his kids and goes above and beyond to reach them however he can no matter what it takes. He is also of the thought that we all are and that is there is no need to put a child in juvenile for mental health needs. You need to treat the issues effectively, not warehouse a child. Once placed in juvenile you tend to loose them. Even placing them in a residential facility or group home is risky but sometimes it is a necessary evil for the good of the child and or family but at least it is a mental health placement and not juvenile. He also knows that not all placements are created equal, meaning some are not as effective.
He, as well as my other workers here get that they are almost just "supports" for me as I am more knowledgeable at this point of what needs to be done. What they can offer is guidance towards other supports or resources that may be able to assist if possible and that extra person or people helps build the "village" around the child so that they know they have a kind of "fencing" in of themselves to keep them inline/in check towards their goals we have set and are working on to help them obtain as much of a normal life as possible. I don't know if any of this makes sense. I just know that this is NOT the norm I've found in the past in anywhere else we've been. Hence why I can agree with both K and C in VA. He knows what K says to be true at times and it "can be" very frustrating.