Family-Driven Care Values in the Child/Family System and Using Values in a Cultural Context

2 Learning Objectives Define the core values of Family Driven Care. Demonstrate application of these core values in practice. Define resiliency and articulate its application to working with children and youth. Articulate cultural differences in values.

Foundational Information Children who receive services in the mental health system generally fit the following criteria: They are considered seriously emotionally disturbed - a term used to describe children with significant difficulties. The impairments can be emotional, mental and/or behavioral. The diagnosis meets the standard of DSM and Includes significant disruption in a functional domain.

Domains of Functional Impairments Family Educational Community Activities

Exercise – Identifying Functional Impairments

Complicated Etiology Generally no one thing causes SED. Factors that tend to predispose children include: Biology Genetics Environment including family, peers, siblings, school Natural developmental changes

Developmental Process It’s important to understand that serious disorders emerge in the context of an ongoing developmental process and shifting relationships within the family and community.

Developmental Factors Must be carefully evaluated and addressed in order to: Maximize healthy development Remediate functional impairments Enhance adult outcomes

Service Delivery Children’s services can become quite complicated as they are provided among different types of service providers. School Mental health Juvenile justice Child welfare General health

Changing Models Over the last several years the children’s system of care has moved from a “medical model” to a “social model”. This is primarily due to parent/caregiver advocacy.

Changing Model of Care Traditional Model Practitioner-based Problem-based Professional dominance Cure or cessation of symptoms Facility-based Family Driven Model Family-directed Child-centered Strengths-based Skill acquisition Quality of life Community-based

Changing Model of Care Dependence Regimented Reactive Professional supports Empowerment Least Restrictive Preventative and/or wellness-based Natural supports Education Program of the British Film Institute

Family-Driven Care The MHSA states that family-driven care will exist when: The beliefs, opinions and preferences of every child, youth and their family/caregiver are a deciding determinate in service planning at the individual level.

Family-Driven Care Children/youth and families are a significant determinant in program development at the agency level and They are integral to legislation and appropriation at the policy level.

Family-Driven Care Changes in the way children are served: increased focus on families provision of services in natural settings greater cultural sensitivity a community-based system of care

Important Principles Families are the “expert” on their children. There is shared decision-making between the provider and family/care-giver. Services are culturally appropriate/relevant. Family support is important.

Important Principles A holistic (integration of medical and social model) approach is used. The focus is strengths-based. Care is individualized. The family is defined broadly. Peer Support is available for families.

Cultural Relevance Child-centered services should be culturally relevant and take into consideration: The family culture and norms Cultural identity of the family Ethnic identity of the family Whether the child is struggling to incorporate family culture within the dominant culture.

Family Supports Direct assistance with navigation, education and information Practical support – help with SSI, food stamps, respite care Support groups for information and emotional support Hiring “parent partners”

Exercise – Empowering Families

Considerations of the Child Recent research has focused on the adaptability/resiliency of children. The child’s ability to self-right in the presence of crisis or disruption to his/her environment. The implication is that skills can be taught or modeled to improve a child’s ability to adapt and improve resiliency skills.

Resiliency Thought to be an inborn trait. People have it to greater or lesser degrees. Resiliency skills can be taught. Stressors can threaten resiliency. Protective factors can strengthen resiliency.

Resiliency It is thought that utilizing the principles of family-driven care in treatment will improve resiliency in children.

The Seven C’s of Resiliency Developed by Kenneth Ginsburg, M.D. Competence Confidence Connection Character Contribution Coping Control

Resiliency In summary, the research shows that the development of resilience in children is most affected by an adult in their life who believes in them and loves them unconditionally. Kids will live up or down to our expectations.

Exercise – Building Resiliency