Communities of Practice in Child and Youth Mental Health

Today’s Presentation What are communities of practice? (CoPs) What makes them work? What makes them last? How do we know they work? How do they affect you? Have taken place informally for a long time: Parents at a playgroup Knitting circles

The Context Child and youth mental health is under-resourced Complex issues require a diverse set of skills and perspectives Child and youth mental health is everyone’s responsibility Importance of practice-based evidence + evidence-based practice Limited resources in child and youth mental health Recognition of broad scope and complex nature of many of the problems faced by children, youth, and families Attempts to increase community capacity in responding to problems facing children, youth, and families Importance of “practice-based evidence” as a complement to evidence-based practice

Partnerships – Stages of Development Stage ONE – The Attraction Stage TWO – The First Date Stage THREE – The Courtship Stage FOUR – Will We or Won’t We? Stage FIVE – The Ceremony (Complete with Pre-Nuptial) Stage SIX – The Honeymoon Stage SEVEN – Day-to-Day Living Stage EIGHT – The Seven-Year Itch Stage NINE – The Mature Relationship Stage TEN – Opportunities for Growth ** risk for separation and divorce is ever-present put preventable

Characteristics of Partnerships Cooperation: “Informal relationships that exist without any commonly defined mission, structure, or planning effort” (Wilder Research Center) Collaboration: “A mutually beneficial and well-defined relationship entered into by 2 or more organizations to achieve common goals” (Wilder Research Center) Cooperation—the relationship involves: Information sharing as needed Low risk, since authority is retained by each organization Separate resources and rewards Collaboration--the relationship includes: A commitment to mutual relationships and goals A jointly developed structure and shared responsibility Mutual authority and accountability for success Sharing of resources and rewards PARTNERSHIPS TYPICALLY CENTRE ON A SHARED TASK/GOALS—ONCE THOSE HAVE BEEN ACHIEVED, THE PARTNERSHIP MAY NOT BE ONGOING—LINK TO CoP…

CoPs: A Definition “Communities of practice are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly” (Etienne Wenger) The term community of practice was coined to refer to the community that acts as a living curriculum for the apprentice. Once the concept was articulated, we started to see these communities everywhere, even when no formal apprenticeship system existed. And of course, learning in a community of practice is not limited to novices. The practice of a community is dynamic and involves learning on the part of everyone.

What is a CoP? Deliberate Emphasizes ongoing, collective learning Focuses on interaction, growth and evolution of members (both individually and as a group) No formal beginning or end A site for creating practice-based evidence (a complement to EvBP) Activity: A CoP or not?

CoP: Basic Ideas Learning is social and comes from participating in daily life Knowledge and activity are strongly connected Growth is nurtured and promoted

Growth and evolution of members Sharing information and experiences CoPs emphasize: Problem solving Growth and evolution of members Sharing information and experiences Reusing and recycling resources Evaluating information and developments Identifying gaps in knowledge Emphasis is on KNOWLEDGE, rather than TASKS Goals + Relationships

Individual Reflection List the different groups you are/have been a part of. Would you consider these to be a CoP? Why or why not?

Examples of CoPs Triple P (Positive Parenting Program) National Community of Practice on Collaborative School Behavioural Health CAFAS http://www.cafasinontario.ca/cop.asp Triple P Description to be inserted. National Community of Practice on Collaborative School Behavioral Health Focus of this CoP is to collaboratively work across diverse stakeholders to create a shared agenda across education, mental health and families. This community operates through 10 practice groups. 12 states, 23 national organizations and 6 technical assistance centers working together in this community. (web community hosted by the IDEAPartnership, an American organization that works to advance policy and practice in the area of education and child/youth mental health).

Elements of a CoP Subject (Domain) People (Community) A shared area of interest that provides a common focus Shared competence in this area People (Community) A group of people who interact in an ongoing way Emphasis on relationships as the route to collective learning Action (Practice) Practitioners who develop a set of shared resources (experiences, stories, tools for solving problems) Emphasis on sustained interaction over time Example: a group of social workers in a large agency who meet for lunch once a week—even it if isn’t a formal “meeting”, conversations about different experiences at work create an opportunity to share resources, stories, and problem-solving techniques. These three things need to be present in order for a CoP to exist, and it is through these things that a CoP evolves and is strengthened.

How does a CoP develop? Form Storm Norm Transform ELABORATE FROM GAIJDA Transform

In partners… Select one of the groups identified in the last exercise. Using the elements discussed, can this group be considered a CoP? What stage of development is your group currently in?

Barriers and facilitators What barriers might prevent a CoP from being developed and/or sustained? What facilitators might help a CoP to develop and be sustained?

How do we create and sustain a CoP? Identify the area of interest Invite different perspectives Invite different levels of participation Articulate a common vision. Ensure both familiarity and excitement Work towards evaluation Look for ways to sustain and enhance the CoP identity EXAMPLE HERE.

How do we know they work? Impact Measures Process Measures What have we changed? How? Process Measures What has worked well? Where can we improve? Impact measures: These are outcomes (specific to each group, based on the shared vision and goals). These can focus on: Real people (e.g., behaviour changes that take place among individuals, groups, families, and in communities) Policy development Systems development (e.g., integration of services or systems—justice/addictions/mental health) Resource development Process measures: These focus on the “how to” aspect of collaboration and can focus on (what are processes involved in producing the outcomes we see) Understanding the community (strengths, weaknesses, points for change) Community development Leadership (not just power, but drawing on appropriate roles to effect change) Communication Research and development (measuring outcomes and processes, strategies for communicating outcomes)

What makes CoPs last? Purpose Environment Process and Structure Communication Environment: History of collaboration within the community Collaborative group and associated agencies have credibility and legitimacy Favorable political/social climate in which the mission of the group is supported Membership: Mutual respect, understanding and trust Cross-sectoral representation Personal qualities (e.g., ability to compromise) Process and structure: Ownership over process and outcomes Flexibility and adaptability Clear roles and guidelines Communication: Open, frequent communication Both formal and informal ways of communicating Purpose: Unique purpose Clear goals that are attainable Shared vision Resources: Sufficient, sustainable funding Strong, skilled leadership Membership Resources

Thinking about the future… In the Eastern region, what CoPs should be created to support you in the work you do in child and youth mental health? What should your first step be in developing this CoP? Think through the lens of a CoP to identify a “wish list” for priorities that would address your needs as a practitioner (what priorities would be brought to life through a community of practice)? Dotmocracy exercise

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