Family Recovery Program A Multi-Systemic Recovery Approach to Families Transcultural Mental Health In A Changing World: Building A Global Response 2007

2 Your Presenter for Today Margaret Trujillo Piurek & Associates How do you create a multi-systemic recovery program to serve complex families? How do you overcome barriers to collaboration with organizations operating under different missions and visions?

3 Program Motto By supporting substance abuse recovery, we serve the family and protect the child.

4 Overview The Partnership provided for a holistic approach to family recovery. Accountability for shared outcomes held by both the child welfare and service providers. Success measured by permanency for the child and recovery support for the family.

5 Overview (Continued) The Family Recovery Partnership was a multi-cultural pilot collaborative between the following stakeholders: Department of Economic Security, Department of Health Services, Regional Behavioral Health Authority, Juvenile Court, Attorney Generals Office and Community Providers.

6 Overview (Continued) Rapid and comprehensive substance abuse intervention and recovery services for children and families. Focused on shared responsibility, shared decision making and shared financial obligations.

7 Eligibility Eligible families were referred by Child Protective Services to the Regional Behavioral Health Family Recovery Planner. Family involvement was contingent upon signing an informed consent and Release of Information forms for participating agencies.

8 Eligibility (Continued) Revocation of the informed consent constituted self-selection from the program. Program designed for families that were involved with Child Protective Services in a current dependency case and had substance abuse as an overriding issue to the welfare and stability of the family unit.

9 Array of Services The goal was to provide seamless services to the entire family. Family-centered services include: –Rehabilitation –Intervention, prevention and support –Wraparound approach to services –Addressing immediate family needs –Services to the extended family unit

10 Engaging Families Extensive outreach to engage clients in the program by neutral person not related to court case. Explains benefits of the program. Many attempts to engage client. More support, more staffings, and more intensive help.

11 Services / Delivery Service Time Frame Services were appropriately intensive and incorporated time frames based on family progress and need.

12 Services / Delivery (Continued) Estimated Service Timeframe Day :Intensive Assessment & Stabilization Services Develop Family Intervention Plan –Assess extent and severity of substance abuse disorder –Rapid stabilization placement of individuals in appropriate level of care occurs. –Present proposed case plan to Judge within 5 days of referral.

13 Services / Delivery (Continued) Day :Family Recovery & Stabilization Complete –Complete intensive family assessment. –Design family recovery support plan including plans of ALL other agencies. Month 2 - 9:Recovery Phase Services –Active treatment of family members occurs. –Introduce and monitor recovery support interventions.

14 Services / Delivery (Continued) Month 6 - 9: Aftercare & Relapse Management –Stepped-down services offered –Active on-going assessment and monitoring by Child Protective Services Case Manager and Family Recovery Planner –Relapse management offered

15 Services / Delivery (Continued) Month :Extension special consideration granted (i.e. Relapse Management) Conditions: –Parental compliance w/ treatment plan –Child Protective Services recommendation for family reunification at one year.

16 Non - Traditional Services Services to incarcerated parents. Services offered to any and all extended family (family definition very open). Services not limited to specific funding streams. Flexible funding. Services focused to meeting families where they were in their recovery process. Ability to fund Non-Traditional Services and remove barriers for families.

17 Shared Treatment Plans A Family Recovery Treatment Plan was developed to include all organizations touching the family: - Behavioral Health - Child Protective Services - Probation or Parole - Developmental Disabilities

18 Family Recovery Planners Role Engage Families and stakeholder agencies. Plan and facilitate staffings. Attend court hearings and meetings. Communicate treatment updates. Assist in the coordination of treatment. Driver of process.

19 Cultural Competency Cultural assessment developed to meet needs of Hispanic families. Linguistic needs addressed at initial contact. Contracts with agencies specializing in specific cultures were obtained. Community and natural supports were built in the neighborhoods that the families lived.

20 Lets All Get Along Sources of Conflict –Work Philosophy Child-focused protection system Adult-focused Substance Abuse Treatment System –Work Obligations –Relapse is part of Recovery –Recovery has no timelines

21 Lets All Get Along (Continued) Sources of Conflict –Court timelines –Court mandates –Child Protective Services timelines –Safety for child

22 Lets All Get Along (Continued) Resolving Conflict –Focus on issue –Clarify key points –Be detailed –Validate diverse perspectives

23 Lets All Get Along (Continued) How to Build Trusting Relationships –Cross-training of different agency personnel crucial in understanding others roles in process –Co-location –Develop a partnership for the family

24 Technical Difficulties Data sharing among agencies Reporting Client confidentiality Co-location at the courts and DES-CPS offices

25 Evaluation The Partnership participated in a study to assess outcome and process measures. The comparison was among Family Recovery Partnership participants and families not involved, but meeting the same criteria.

26 Outcome Measures Reductions in alcohol/drug use from intake to discharge Parenting skills Understanding/coping with family addition dynamics among involved family members Child permanency Parent support for child (financial, etc.)

27 Outcome Measures (Continued) Client Satisfaction (family, parent, CPS, Family Recovery Planner, addiction treatment agencies) New allegations resulting in an investigation Subsequent birth of a drug-exposed infant

28 Evaluation Outcomes Successes Perceived benefit of the Partnership by Child Protective Services staff Parent satisfaction Effective governance Increased attention to substance abuse in the child welfare population

29 Evaluation Outcomes (Continued) Successes Continued Intensive outreach efforts Improved child functioning Improved parent functioning Increase in reunification with biological parent

30 Evaluation Outcomes (Continued) Successes Continued Greater receipt of substance abuse treatment and other services Reunification with biological parents Timely achievement of permanency for children Model of preferred practice principles

31 Evaluation Outcomes (Continued) Challenges Ongoing role definition Ongoing training and cross-training (turnover) Building collaboration on the front line Evaluation on impact of pre-petition status (a population not included in the Partnership)

32 Evaluation Outcomes (Continued) Challenges Continued Improve continuity of treatment provider staff for families Formulized process of accountability Increased resource development Discussion of reasonable expectations

33 Accomplishments Team approach to providing services and monitoring One family treatment plan Strengths based True partnership between CPS, behavioral health and the families

34 Accomplishments (Continued) Better communication between all agencies Involvement of probation, parent aides, providers, therapists, substance abuse agencies, mental health providers, courts and child protective services Positive outcomes for families

35 Sustainability How do you sustain a philosophical shift for treating the families? Need a champion Strong leadership Clearly defined and rapid resolution process Constant cross systems communication

36 Wrap Up ¤Family centered ¤Innovative ¤Collaboration ¤Paradigm shift ¤Designed to close all gaps

37 Wrap up Any Questions?