Transcript 1.7 FoundationsofPractice

Foundations of Practice
CA’s Practice Model
Washington DSHS Children’s Administration (CA)
Created by the Practice Model Team in conjunction with Dr. Dana
Christensen
Developmental Competency
SW101-05 Ability to identify core principles and goals
of the agency practice model such as building
partnerships, focusing on pragmatic everyday life
events, and targeting measurable prevention skills
By the End of This Session
You will be able to:
• Describe the reasons for having a practice model
• State the four milestones that make the SBC practice
model
• Explain the three basic tenets of the SBC practice model
• List the three foundational theories of SBC
• Navigate the research that shows the effectiveness of the
practice model
• Explain how the practice model addresses
disproportionality
What is a Practice Model ?
• Theoretical and values based
• Operationalizes specific casework skills/practices
• Provides a conceptual map to optimize the safety,
permanency, and well-being of children who
enter the child welfare system
What is our practice model?
Solution-Based Casework
Solution-Based Casework (SBC) is an evidenceinformed practice model for Casework Management in
Child Welfare and Juvenile Justice. The model provides
a conceptual map for a family-centered practice from
assessment through case closure. The SBC practice
model is best thought of as the architecture that holds
our practice to a consistent focus on our outcomes.
Three Main Tenets of SBC
We Prioritize
the Family
Partnership
1
2
We Focus on
Pragmatic
Solutions to
Everyday Life
Problems
We Help Families
Document and
Celebrate
Success
3
Integrated Framework from:
Family Life
Cycle Theory

(Carter and McGoldrick, 1999)

Cognitive
Behavior
Therapy
Solution
Focused
Interviewing
Family Life Cycle Theory
Relapse Prevention (Cognitive
Behavioral Theory)
(Marlatt & Gordon, 1985, Pithers, 1990,
Beck, 1993)

Solution-Focused Therapy
(Berg, 1994, DeShazer, 1988)
All three models have their own well-documented evidence base.
Research on SBC in Child Welfare?
(Antle et al, 2005, 2007, 2009, 2012)
SUMMARY of OUTCOMES
• 30% reduction in removal of children
• Over a 100% increase in goal attainment
• 27% more workers contacted referral sources directly
• 64% increase in identified client strengths
• Families with chronic CPS involvement more likely to be successful
• Clients with Co-morbidity also achieved more goals.
• 35% reduction in recidivism referrals over 6 months
• Full implementation of SBC met all 23 CFSR review items and the 7
outcomes of safety, permanency, and well-being (4500 cases)
More information on other studies at www.solutionbasedcasework.com
What is the SBC Evidence Base ?
(Antle et al, 2005, 2007)
Achievement of Goals
• Families achieved significantly more case goals/outcomes when SBC was used
• Chronic CPS families were even more likely to experience success with SBC
• Families with all types of maltreatment and co-morbid factors achieved more goals with the
use of SBC
(Antle et al, 2005, 2007)
Worker Effort
(Antle et al, 2005, 2007)
Worker Attitude
(Antle et al, 2005, 2007)
Overview of Study
Research:
• What is the relationship between implementation of SBC and
performance on federal review items and outcomes
• What are the most critical points in the child welfare casework process to
use SBC in order to promote positive outcomes?
Sample:
4,559 cases over four-year time period (2004-2008)
Procedure
•
•
•
•
CQI Review Process
Merged data across four years
Extracted SBC items from review tool
Federal review items and outcomes mapped onto CQI tool by CFSR/PIP team in KY
(Antle et al, Child Abuse and Neglect, 2012)
Summary of Study 5
Solution-Based Casework is associated with significantly better scores
on all 23 CFSR review items and the 7 outcomes of safety, permanency,
and well-being
95.00%
90.00%
85.00%
Low SBC
100.00%
100.00%
90.00%
90.00%
80.00%
80.00%
70.00%
70.00%
60.00%
60.00%
50.00%
Low SBC
50.00%
Low SBC High SBC Federal Standard
High SBC
High SBC
80.00%
40.00%
40.00%
30.00%
30.00%
20.00%
20.00%
10.00%
10.00%
Federal Standard
Federal Standard
75.00%
70.00%
0.00%
0.00%
Safety 1
Safety 2
Safety 1 & 2
Permanency 1
Permanency 2
Permanency 1 & 2
Well Bein g
Well Being 2
Well Being 3
Well-being 1, 2, & 3
(Antle et al, Child Abuse and Neglect, 2012)
Why was Solution-Based Casework Developed ?
•
•
•
•
•
Family Centered wasn’t operationized: no systemic support
Investigations led to a list of problems, not solutions
Assessments were too interrogative, no consensus built
Assessments weren’t located in the details of family life
Case planning focused on service completion, i.e. compliance
(versus skill acquisition)
• Case planning was more worker-driven and “owned”
• Caseworkers and Providers didn’t share a common map
In-home therapy School Counselor Mental Health
Natural Supports
Courts
Drug Counseling
Residential Staff
DEFINITION OF
THE PROBLEM
Family Support
Anger Management
Foster Care
Health
CPS
Family Members
In-home worker
The All-Too-Familiar
Approach
Referral & Assessment
Mom is Neglectful
Mom needs Money
Mom uses Drugs
Son is Truant
Son is Hyperactive
Girl needs SA Counseling
Baby has Med. Needs
Assessment &
Referral to:
Assessment of
Problems
Assessment of
Problems
Assessment of
Problems
Assessment of
Problems
Assessment of
Problems
Assessment of
Problems
Case Plan
Family
Support
Action Plan
Drug Counselor
Treatment Plan
School
Attendance
Plan
Impact Plus
Service Plan
Comp Care
Treatment
Plan
First Step
Treatment
Plan
FPP’s
Treatment
Plan
?
The Family
?
Comp Care
Treatment
Plan
?
?
Mental Health: MH Clinic
Work Issues: Family & Child Support
Supervision: Family Members
School Attendance: School
Substance Use: AA Counselor
Home & Child Cleanliness: FPP
Protection issues:
Courts and P & P
A Family-Friendly
Interface
that Helps to Organize
Complex Issues
and Multiple Partners
How is Solution-Based Casework Different ?
• Problem definition located in the difficult situations of everyday life
(Family Life Cycle)
• Challenging situations are normalized, tracked, and contextualized
• Consensus building sought and guided from the very first interview
• Case planning targets NEW ways of handling those situations at
both the Family and Individual level
• Outcome is measured by skill development in areas of concerns
(Versus service compliance)
• Skill development is documented and celebrated.
Milestone 1 : Building a Consensus
•
•
Organization
•
•
Family engagement
Gathering assessment information
(IA, FAR FA, CFE)
What has happened in the past?
What do we need to create change?
Milestone 2 : Getting Organized on Objectives
Of
•
•
•
Moving from Consensus to FLO & ILO
Building the Family and Community Team for
Change
Co-Developing a “Case Plan”
Milestone 3 : Specific ACTION Plans
Practice
•
•
•
Specific Plans of Action for Families and Youth
Documenting behavioral change
Using the Team to help
Milestone 4: Documenting and Celebrating
•
•
•
Documenting Progress and Change
Celebrating Small Steps of Success
Adjusting plans for progress
20
Making the practice real
CHILD SAFETY
FRAMEWORK
SAFETY
ASSESSMENTS
FAR FAMILY
ASSESSMENT
COMPREHENSIVE
FAMILY
EVALUATION
SHARED
PLANNING
MEETINGS
FAMILY TEAM
DECISION MAKING
MEETINGS
Summary
• What are some reasons for having a practice model?
• Shout out the four milestones of our practice model
• What are the three basic tenets of the SBC practice
model?
• What are the three theories that make up SBC?
• How do you think our practice model can address
disproportionality?