vpp-vip focus 4.2011
TRANSCRIPT
R ADAMS COWLEY SHOCK TRAUMA CENTER
VIOLENCE PREVENTION PROGRAM (VPP)UNIVERSITY OF MARYLAND MEDICAL CENTER
Who We Are and What We DoA Focus on the Violence Intervention Program
(VIP)April 2011
Melissa Cole, LCSW-C
VIOLENCE PREVENTION PROGRAM (VPP)
Carnell Cooper, MD, FACS Founder & Team Leader 1998-present
VPP Component Services Violence Intervention Program (VIP)
Promoting Healthy Alternative for Teens (PHAT)
My Future My Career (MFMC)
VIP-City Wide (VIP-CW)
Component 1Violence Intervention Program
(VIP)
Victims in the Hospital
Talk to victims of violent injury at the bedside in STC
Assess immediate needs
Develop individualized service plans / “plans of action”
Deliver intensive clinical case- management services in the community post-discharge
Priorities / Outcomes
Interrupt the cycle of violenceTeach non-violent coping strategiesConnect clients to community providersReduce risk taking behavior & re-injuryReduce criminal behaviorPrevent violence and criminal activity
Component 2Promoting Health Alternatives
for Teens (PHAT)
Youth in the Community
Talk to youth about the “power of choice” & decisions
Have youth & professionals talk about career paths in
Introduce youth to former victims/perpetrators of violence to talk about positive life lessons
Deliver messages through spoken word artistry
Priorities / Outcomes
Interrupt the cycle of violencePlant “seeds” for pro-social behavior, problem solving & future orientation Increase discussions about “taboo topics” & important life decisions Decrease risk factors for violence
Component 3My Future My Career
(MF-MC)
Group of at Risk Youth
Expose a group of at risk youth to specific career paths over 8 weeks of sessions at UMB through VPP
Youth talk with professionals, express themselves through spoken word exercises & are connected with resources in the community
Re-engage youth with school
Priorities / Outcomes
Interrupt the cycle of violence Plant “seeds” for pro-social behavior, problem solving & future orientation Increase discussions about “taboo topics” & important life decisions Decrease risk factors for violence
Coordinated Hospital Effort
Extend VIP service model to area Emergency Departments
Collaborate with healthcare providers to maximize quality care for victims of violent injury
Reached MOUs with eight Emergency Departments in 2009 – no funding available
Efforts to expand city-wide continue
Priorities / Outcomes
Extend the VIP service model to reach eligible victims of violence across the city Reduce violent crime & re-injury Contribute to best practice standards Implement a cost-effective, evidence- based & pro-active approach to interpersonal violence
Component 4Violence Intervention Program-
City Wide (VIP-CW)
COMPONENT SERVICES of the UMMC Violence Prevention Program (VPP) (rev 05/10)
KEY DEMOGRAPHICS Urban Victims of Violence
African American MaleAges 15-27High School drop outUnemployed-no stable incomePositive toxicology screen for drugs / alcoholHistory of involvement with criminal justice Repeat victims of intentional violent injuryNo health insuranceNo stable housing – no rental historyNo credit or banking history
IMPACT ISSUES Risk Factors
Poverty Limited education Under-employment Untreated mental
health problems Untreated medical
conditions History of victimization Recent victimization Inadequate social
supports No insurance
Protective Factors Healthy social supports Preventive medicine &
timely health care Timely mental health
assessment & services Sufficient financial
resources Adequate education Gainful employment No history of victimization
– help for traumatic experiences
Insurance coverage
Rev. 4.2011 Melissa Cole, LCSW-C
Snapshot of the VIPThe foundation for the core set of services under the VPP umbrella
Serving victims of intentional violent injury ages 14 and older
Reaching residents of Baltimore city & contiguous counties
Evidence-based outcomes: 1) reduction in repeat hospitalization due to violence
gunshot stabphysical assault
2) reduction in criminal behavior arrestsconvictionsactivities
3) increase in pro-social activity employment parenting
housinglife skillsmentoring
VIP SERVICES Recruitment at the hospital bedside IRB consent Comprehensive questionnaire /
assessment Service planning Role modeling / mentoring Referrals to the best community
resources Advocacy Crisis intervention Life skill development Counseling / peer support group
Phase 1 Crisis Intervention &
Enrollment
Assessment Relationships
Public and Private Safety
Involvement of social networks
Identification of & connection to services
Goal identification
Willingness to change
Other?
Phase 2 Goal Development
Rapport BuildingGoal solidification
Commitment to change
Develop & reinforce future orientation
Learn non-violent means of self-expression & communication
Learn & practice healthy coping & social skills
Stay community connected
Other…
Phase 3 Goal Solidification
Values Clarification Growth in personal responsibility
Improvements in setting & reaching personal goals
Success with referrals & service plans
Decrease in violence & other risk factors
Increase in pro-social attributes & other protective factors
Other…
Personal GrowthSignificant & substantial personal accomplishments
Sustained relationships with community providers
Positive social networks
Protective factors outweigh risk factors
Other…
Phase 4Reinforcement
VIP Phases of Intervention: Objectives & Outcomes
Rev 4.2011 Melissa Cole, LCSW-C
Phase 1 Crisis Intervention &
Enrollment
Assessment Eligible for the program? Active parole/probation? Repeat victim of violence? Immediate safety issues? Mental health needs? Medical concerns? Educational history? Employment status? Illicit substances / alcohol? Housing situation? Gang affiliation? Children? Other?
Phase 2 Goal Development
Rapport Building Meeting with VIP staff Following special conditions Identifying risk taking behavior Attributing meaning to events Practicing new skill sets Increasing positive supports Completing identified tasks Engaging in nonviolence Meeting new service providers Getting documents in order Recognizing stressors Other…
Phase 3 Goal Solidification
Values Clarification Setting priorities for goals Identifying emotional triggers Reducing risk taking behavior Increasing protective factors Managing external stressors Incorporating new skill sets Planning for the future Maintaining positive supports Keeping new service providers Completing service plans Building nonviolent skills Other…
Personal Growth Utilizing adaptive skills Maintaining positive supports Self-referring for services Making own service plans Completing personal tasks Role modeling for others Volunteering in the community Minimizing risk taking behavior Maximizing protective factors Attributing meaning to events Applying nonviolent tenets Reconnecting with VIP staff Other…
Phase 4Reinforcement
VIP Phases of Intervention: FOCAL POINTS
Rev 4.2011 Melissa Cole, LCSW-C
Key Elements of the VIP Intervention Rapport between worker & client Strategic community referrals Teachable moments / defining moments “No topic is taboo” / Values clarification Trigger identification for risk taking behaviors Positive social support & resource development Skill set practice in safe environments Getting documents in order Ongoing assessment & service plan review Conscious use of self Respect, Respect, Respect
Rev. 4.2011 Melissa Cole, LCSW-C
ASSESSMENT Safety (assessments for personal & public lethality need to be ongoing)
Revenge, retaliation, gang affiliation (past & present)
Self-injury, impaired impulse control (past & present)
Impaired functioning (addiction, mental status) (past & present)
Perpetrator behavior (past & present)
Benefits (they need identification to apply for benefits & a stable mailing address)
Social services, disability, food stamps, mobility Victim of crime compensation Health insurance
Criminal Justice Warrants (ie: may need to contact probation officer of hospitalization to avoid FTA & warrant)
Special conditions (ie: ex-parte, urination, reporting requirements)
Active cases (ie: pending charges, pending sentence, multiple jurisdictions)Rev. 4.2011 Melissa Cole LCSW-C
ASSESSMENT Substance Abuse / Addiction
In patient consultation Possible detox / community referrals
Mental Health / Spiritual Needs In patient consultation
In hospital crisis intervention Community referrals
Physical / Medical Needs Community referrals & advocacy for ongoing issues
Housing Community referrals for shelters, recovery homes, etc.. Assessments of living conditions
Rev. 4.2011 Melissa Cole, LCSW-C
SERVICE PLANNING
KEY VARIABLES:*Motivation
*Capacity*Support *Opportunity
* Tasks *Time Frames
*Obstacles
*Protective Factors
* *Primary & Secondary Gain
*Risk Factors
Rev. 4.2011 Melissa Cole, LCSW-C
THE VPP TEAM Carnell Cooper, MD, FACS, team leader: [email protected] Miller, LCSW-C, clinical supervisor: [email protected] Moore, case manager: [email protected] McCray, case manager: [email protected] Ross, PHAT coordinator:[email protected] Lawal, PHAT coordinator: [email protected] Cole, LCSW-C, clinical trainer: [email protected] Carter, parole agent: [email protected] Carlson, business development mgr: [email protected]
110 South Paca Street, 3rd Floor, Baltimore, MD 21201Office: 410-328-7436fax: 410-328-0864
http://www.umm.edu/shocktrauma/vip_mission.html