Case Management

 Context for the Training  Training Related to Implementation of Safety Decision Making Methodology  Fidelity of the Ongoing Family Functioning Assessment ◦ Philosophy of practice ◦ Intervention purpose and framework ◦ Conceptual and criteria basis for practice and decision making ◦ Process, practice and outcomes 2

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As a result of this training, participants will be able to:  Identify the ongoing family functioning intervention stages;  Define child needs;  Recall the purpose of assessing child needs;  Identify and demonstrate assessment skills utilized in assessing child’s needs;  Demonstrate assessment skills through case application. 4

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 Inform training and development  Provide feedback to trainer  Measure change 6

Foundational Knowledge: Review of Methodology

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Child Protection Investigator Safety Danger Threats Caregiver Protective Capacities Present and Impending Danger Safety Plans Case Management Safety Danger Threats Caregiver Protective Capacities Present and Impending Danger Safety Plans Safety Management Case Plan/Treatment--Change 9

Safety Management and Enhancing Caregivers Protective Capacities Preparation Developing Strategy for Engagement IntroductionEngagement Exploration Determine What Must Change Through Information Collection Caregiver Protective Capacity Assessment Child Needs Danger Statement Family Goal Motivation for Change Case Planning Develop Strategies for Change Case Plan Outcomes Complete FFA-Ongoing Case Plan 10

FFA- Ongoing Engage Raise Awareness Focus Treatment Caregiver Protective Capacities and Child Needs 11

 Are danger threats being managed with a sufficient safety plan?  How can existing protective capacities -- STRENGTHS – be built upon to make changes?  What is the relationship between danger threats and the diminished caregiver protective capacities? What must change?  What is the parent’s perspective or awareness of his/her caregiver protective capacities?  What are the child’s needs and how are the parents meeting or not meeting those needs? 12

 What are the parents ready and willing to work on in the case plan to change their behavior?  What are the areas of disagreement with the parent(s) as to what needs to change?  What change strategy will be used to address the diminished protective capacities? 13

 Safety is paramount and the basis for intervention!  Case planning process and interventions can be more clearly defined around the use of safety concepts and behavior change.  Case planning process can be structured in a way to encourage and direct parents’ involvement and establish consistent intervention decisions and objectives. 14

 Engagement  Teaming  Assessment/Understanding  Planning ◦ Safety Plan ◦ Case Plan  Tracking and Adapting ◦ Safety Plan Sufficiency Evaluation & Update ◦ Case Plan Progress Evaluation & Update 15

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Intervention Standards

PreparationIntroductionExploration Case Planning Module 918

 Preparation is the act of getting ready, being prepared. In ongoing case management and services this entails key actions and tasks: ◦ Review of the Family Functioning Assessment-Investigation ◦ Review and analysis of the Impending Danger Safety Plan ◦ Review of case information and content ◦ Contact with collaterals ◦ Response to any immediate safety management needs ◦ Consultation with the Supervisor to reconcile information and prepare for family contact 19

Introduction is the act of introducing you as the change agent and agency representative, the agency’s role, what case management is and is not, and providing clarification as to the role of the ongoing case manager. Objectives of Introduction for Case Manager ◦ Begin to establish rapport with family; get to know them. ◦ Establish a working relationship with the family. ◦ Provide clarification and process with family for ongoing case management. 20

Exploration is the act of exploring with the family how they are functioning in relationship to the protective capacities, understanding how danger threats or negative family conditions have manifested, exploring motivation for change, resistance or ambivalence, identifying family strengths, creating danger statements, and finding mutuality for continued work. Achieve agreement with parent(s) as to:  What must change for children to be safe.  How to achieve change.  Parent’s role in achieving change.  Role of others in helping parent(s) achieve change.  How progress will be measured. 21

Case planning with the family is the act of establishing outcomes and motivation for change. 22

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Child Development: Assessing Child Needs

HeredityEnvironment 26

 Statistical concept  Typical or expected for the majority of members of a group  Identified traits and processes displayed by most children within timeframes 27

PhysicalEmotionalCognitiveSocial

 Body structures  Sensory development  Motor development  Sensation and movement 29

 Intellectual/Mental  Thinking  Memory  Reasoning  Language  Concept Development  Problem Solving Ability  Abstract Thinking 30

 Personal traits and characteristics  Self-Esteem  Reciprocal Emotional Relations  Mood and Affect- Appropriate for Age and Situation 31

 Interactions with others  Development of relationships  Social roles and norms  Group involvement 32

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Birth to 3 Pre-School (3-5) School Age (6-12) Adolescenc e (13-21) 34

 Small Group Activity  Working in small groups: ◦ Complete Worksheet: Identifying Indicators of Ages and Stages ◦ Large Group Report Out

 Newborn-6 Months:  6-12 Months:  Months:  Months:  2-3 Years: 36

 Language Development  Time and Order of Events  Social Development  Emotional Development  Self-Control  Self-Esteem  Conscience 37

 Cognitive Development  Physical Development  Memory  Social Development  Emotional Development 38

 Transition  Physical Development  Cognitive Development  Social Development  Moral Development  Emotional Development 39

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Factors Affecting Child Development

42 Child Environmental Factors Biological Factors Interpersonal Relationships

 Housing  Income  Employments  Education 43

 Gender  General Health  Mental Health  Health Practices  Hereditary Factors 44

 Family and Friends  Social Interaction  Sibling Interaction 45

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Abuse and Neglect Interpersonal Factors Environmental Factors Biological Factors 47

48  Growth retardation  Poor muscle tone and motor control  Language and speech delays  Immobility  Listless demeanor  Lack of separation anxiety  Unresponsiveness  Lack of play skills

49  Small in stature  High incidences of “sickness”  Poor muscle tone, motor coordination  Delayed speech  Poor articulation/pronunciation  Short attention span  Insecurity  Detachment  Social immaturity

50  Suspicious of adult figures  Overly solicitous  Agreeable  Manipulative  Unrealistic view of parents  Assuming adult responsibilities  Inability to focus: educational  Lack of coping skills

51  Varying Degree Based Upon: ◦ Age of maltreatment ◦ Frequency of maltreatment ◦ Severity of maltreatment ◦ Relationship with maltreating parents/caregivers

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 Take Away from today: ◦ What did you find helpful? ◦ Questions that still need to be answered? ◦ More time spent on…? 53

Case Management Day 2: Assessing and Scaling Child Needs

 Overnight Thoughts? ◦ Questions from yesterday? ◦ Feedback from yesterday? ◦ Reflections from yesterday? 55

 Child Needs and Scaling  Assessing Core Skills and Practice  Small Group Exercise: ◦ Case Application 56

Child Needs: Defining the Needs

58 Child Environmental Factors Biological Factors Interpersonal Relationships Abuse and Neglect

 Small Group Activity  Using Worksheet, and based upon what we have learned about child development, identify: ◦ Examples of each child need. ◦ Specific examples as experienced in the field or through case review.

 Management of emotions  Self-regulation  Response to stress  Coping skills and techniques  Physical symptoms of trauma 60

 Empathy  Right from wrong  Impact of behavior on self and others  Actions towards others  Societal expectations/norms 61

 Cognitive abilities: ◦ Language development  Physical skills: ◦ Riding a bike ◦ Dressing 62

 Academic advancement: ◦ Reading ◦ Math ◦ Language ◦ Advancement to next grade level 63

64  Interactions with others  Demonstrated social skills  Peer pressure: life choices

 Parent/child relationship  Sibling relationships  Dynamic family relationships  Support and guidance from family  Sense of family identity 65

 Provision of basic and appropriate health care  Physical symptoms of health concerns  Dental and visual needs  Medical and dental established providers/provision for care 66

 Race  Class  Ethnicity  Religion  LGBTQ  Identified cultural identity  Sense of cultural identity  Desire for cultural identity 67

 Self  Others  Treatment  Awareness of effects  Recovery 68

 Life skill development: ◦ Housing ◦ Employment ◦ Financial ◦ Educational ◦ Support ◦ Planning 69

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Child Needs: The Assessment and Scaling

72 Information Collection Family: Parents and Children Observations Review of Information Family and Friends

 CPI-Family Functioning Assessment ◦ Based on six domains of information ◦ Limited information known at the time in relation to what can be known ◦ Focused on the assessment of safety  CM-Ongoing Family Functioning Assessment and Evaluation ◦ Based on four domains of information ◦ Extensive information to be known ◦ Determination of degree of need from a limited to extensive perspective ◦ Knowledge of the child and the parents 73

Engagement Critical Thinking Observation 74

◦ Probing ◦ Going beyond what is said ◦ Seeking clarification ◦ Reflecting content ◦ Reflecting feeling and meaning ◦ Active Listening ◦ Self-awareness 75

◦ Observation is getting information about objects, events, moves, attitudes and phenomena using one or more senses. 76

77  Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication. A statement by Michael Scriven & Richard Paul presented at the 8th Annual International Conference on Critical Thinking and Education Reform, Summer 1987

 Large Group Activity  Observation: ◦ Group of three six-year-old children who do not know they are being filmed.  What do we see happening between the three?  Consider the Ages and Stages we have discussed.

80 Child Needs Well-BeingPermanencySafety

81  A: Demonstration of exceptional ability in this area OR that the need is being addressed by the parent.  B: Demonstration of average ability in this area OR that the parent is attempting, or has made attempts to meet the need.

82  C: Demonstration of need for increased support or attention in this area; could be for both child and parent response.  D: Demonstration of need for intensive support in this area; could be for both child and parent response.

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 Small Groups of 4  Croft Family: ◦ Review FFA. ◦ Identify the child needs. ◦ Scale the needs based upon your analysis of the information.

Case Application Practice

Using the OFFA that you brought to training:  Review Child Functioning and Parenting General Information.  Consider information known about the Family:  Review and revise, if necessary, and/or complete the Child Functioning and Child Needs Scaling.  Identify the missing information, and develop strategies for obtaining the information (interview with collateral, observation, etc.).

 Used to: o Inform training and development; o Provide feedback to trainer; o Measure change. 89

 Used for: o Professional growth and development; o Updating/refining training material content and exercises; o Measuring change 90

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