Family Recovery ProgramA Multi-Systemic Recovery Approach to Families

Transcultural Mental Health In A Changing World: Building A Global Response 2007

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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?

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Program Motto

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

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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.

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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 General’s Office and Community Providers.

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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.

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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.

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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.

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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

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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.

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Services / Delivery

Service Time Frame

Services were appropriately intensive and incorporated time frames based on family progress and need.

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Services / Delivery (Continued)

Estimated Service Timeframe

Day 1 - 14: 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.

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Services / Delivery (Continued)

Day 1 - 30: 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.

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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

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Services / Delivery (Continued)

Month 9 - 12: Extension

special consideration granted

(i.e. Relapse Management)

Conditions:– Parental compliance w/ treatment plan– Child Protective Services

recommendation for family reunification at one year.

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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.

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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

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Family Recovery Planner’s 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.

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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.

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Let’s 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

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Let’s All Get Along (Continued)

• Sources of Conflict

– Court timelines

– Court mandates

– Child Protective Services timelines

– Safety for child

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Let’s All Get Along (Continued)

• Resolving Conflict

– Focus on issue

– Clarify key points

– Be detailed

– Validate diverse perspectives

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Let’s All Get Along (Continued)

• How to Build TrustingRelationships

– Cross-training of different agency personnel crucial in understanding others roles in process

– Co-location

– Develop a partnership for the family

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Technical Difficulties

• Data sharing among agencies

• Reporting

• Client confidentiality•

• Co-location at the courts

and DES-CPS offices

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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.

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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.)

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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

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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

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Evaluation Outcomes (Continued)

Successes Continued

• Intensive outreach efforts

• Improved child functioning

• Improved parent functioning

• Improved parent functioning

• Increase in reunification with biological parent

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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

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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)

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Evaluation Outcomes (Continued)

Challenges Continued

• Improve continuity of treatment provider staff for families

• Formulized process of accountability

• Increased resource development

• Discussion of reasonable expectations

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Accomplishments

• Team approach to providing services and monitoring

• One family treatment plan

• Strengths based

• True partnership between CPS, behavioral health and the families

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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

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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

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Wrap Up

¤Family centered

¤Innovative

¤Collaboration

¤Paradigm shift

¤Designed to close all gaps

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Wrap up

Any Questions?