Healthy Families Virginia FSW Stop-Gap Training Markella Maschas, Coordinator of Training and Parent Education for HFV

HFA Five Guideposts Strength based Family centered partnerships Relationship based interactions Culturally sensitive practice Integrated parallel process Describe each one: Strength based- build upon families strengths, do not ignore concerns but addresses them honestly using the families strengths Family centered partnerships- the family defines who the family is, home visitor must ask. Varies for each family. Provide services/information/education to everyone caring for baby. Relationship based interaction- the relationship between the home visitor and family is the primary vehicle for change. Strengthening the relationship allows opportunity for growth and change in family. Culturally sensitive practice- must ask family about traditions, culture, values. Start from the beginning of home visiting. Use family values cards to start conversation. Integrated parallel process- the relationship you have with parents reflects on their relationships with their own children. Honest, nurturing, kind, compassionate.

Cultivate and strengthen nurturing parent-child relationships HFA Program Goals Cultivate and strengthen nurturing parent-child relationships Promote healthy childhood growth and development Enhance family functioning by reducing risk and building protective factors Brainstorm what home visitors do to promote these goals.

Infant Mental Health Approach Dyadic Work Fun and Joy Feeling special to your baby and vice versa Focus on experience rather than right or wrong Focus on how the present impacts the future Dyadic work- one on one Promote fun and joy during visits- parents from trauma often don’t have experiences of fun and joy Talk to parents repeatedly about how their daily interactions and relationships with their children affect their future. What they do currently affects their future.

HFA Eligibility: Designed for Overburdened Families Positive Screen & Positive Assessment (parent survey) Look at risk /stress factors associated with maltreatment Look for strengths to build upon Referrals for all families Positive screen = 1,9,12 are true or any two questions are true or 7 or more unknowns Positive assessment= a score of 25 or higher for either participants Some risk factors: hx of child abuse and neglect; current or past substance abuse or mental health, punishment for discipline of children, violent behavior between parents or others; poor coping or support systems, many stresses: financial, housing,

Overview of the 12 Critical Elements (CE) Service Initiation (CE 1-3) Linking, assessing and reaching out to families Service Content (CE 4-8) What happens during a home visit Staff Characteristics (9-12) Hiring, training & supervising staff Healthy Families is built on 12 research-based critical elements that can be broken down into 3 categories. I’m introducing these now because they are the foundation for your program. They are also the standards against which your program will be evaluated during accreditation. HOMEWORK: review standards 5,6,7,8,11

What is a Home Visit? A face-to-face interaction focused on program goals Occurs in the home when possible Lasts approximately an hour and the child is present

What Do I Do On A Home Visit? Address parent survey topics Parent-child activity Assess and promote parent-child interactions Identify strengths and needs of family Facilitate family goal plan Promote child development Provide health and safety information Developmental screens & follow-up

Protective Factors to Strengthen in Families Knowledge of Parenting and Child Development Parental Resilience (Family Functioning) Social Connections/Support Concrete Support for Parents Social and Emotional Competence of Children/Nurturing and Attachment Review each one and discuss the home visitor’s role in strengthening each. What are they currently doing? Discuss how to determine which one parent’s need more of, use of assessment and other HFV evaluation tools. Build goals to increase those that need strengthening.

Promotion of Healthy Childhood Growth and Development Developmental screens Health Care Provider Encourage well baby checks Track immunizations Referral and linkages Curriculum Milestones Health, safety, nutrition

Enhancement of Family Functioning Trust-building and relationship development Support family well-being and improved self-sufficiency Family goals & problem solving skills Stress management, coping & self-care

Enhancement of Family Functioning Home management & life skills Linkage to appropriate community resources Reduction of self-defeating behaviors Reduction of social isolation

The First Several Home Visits Build the relationship Listen and show interest Express empathy and support for the parents/family

The First Several Home Visits Focus on the health, safety, and care of the baby Start learning about the family’s value and culture Begin to establish boundaries of your relationship with the family Invite the father to be present during the home visit

HFA 6 Reflective Strategies Accentuate the Positive Strategic Accentuate the Positive Explore and Wonder Feel, Felt, Found Normalizing Problem Talk Review each- pass out handout.

C= cues H= holding E= empathy E= expression R= reciprocity S=smiles CHEERS C= cues H= holding E= empathy E= expression R= reciprocity S=smiles Review each, pass out handout. Stress 3 F’s= frequency, facts, flavor for each letter

Documentation Contact Log Home Visiting Record Referrals Immunizations Goal Plans ASQ’s Evaluation Tools

Documentation Home Visit Record Status of home, child Parent-child activity Curriculum used Parent-Child interactions/CHEERS* Child development information Health and Safety information Parent survey topics Referrals Goal Planning Status Discuss documentation components that are found on the home visiting log.

Training Requirements Orientation Core Within 3 months of hire Within 6 months of hire Within 12 months of hire Continuing/On-going Orientation topics- boundaries, confidentiality, community resources, multisite information 3,6,12 month trainings- online at the TLC Core training CPS- annual plus what the staff training needs are

Weekly Scheduled Supervision Administrative Clinical Reflective 1.5 to 2 hours a week with your supervisor. To cover topics that are administrative (reports, data, documentation), clinical (resources for families, problem solving), reflective ( how does this work affect you?, how does it affect the child/parent, what do you need to grow professionally in this field). Get Support!

Questions