Transcript Building community and client

Building community and client-level
relationships to support families with
infants or young children affected by
substance abuse
Lessons Learned from
Abandoned Infants Assistance
Projects
Amy Price, MPA
National AIA Resource Center
University of California at Berkeley
510-643-8383
[email protected]
Oneta Templeton McMann, LCSW
Children's Mercy Hospitals & Clinics
Social Work & Community Services Department
Kansas City, MO
816-234-3113
[email protected]
AIA Legislation
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In 1988 Congress passed the Abandoned
Infants Assistance Act to address needs of
infants or young children who are abandoned
or at-risk of abandonment due to HIV and/or
substance abuse
Act reauthorized in 1991 and 1996.
In 2003, AIA Act reauthorized through FY
2008 as part of the Keeping Children and
Families Safe Act
National AIA Resource Center
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Funded by Children’s Bureau since 1991
Part of UC Berkeley’s Center for Child & Youth
Policy
Mission: to enhance the quality of social and
health services delivered to children who are
abandoned or at-risk of abandonment due to the
presence of drugs and/or HIV in the family. The
Resource Center provides training, information,
support, and resources to service providers who
assist these children and their families.
Brief Description of AIA Projects
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Projects funded by Children’s Bureau in
4-year cycles since 1991
Currently 26 AIA projects in 18 states and
DC
20 comprehensive services, 4 kinship
caregiver projects, and 2 recreation projects
Flexible funding
Comprehensive, home-based services
General Goal of AIA Projects
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Prevent abandonment and promote
permanency, well-being, and safety for
children affected by substance abuse and/or
HIV/AIDS
Cross-Site Evaluation
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AIARC contracts with University of
Missouri-Kansas City, Institute for Human
Development to conduct annual client-level,
cross-site evaluation—client characteristics,
services, completion rates, basic outcomes
Description of Clients Served
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Referred from health care providers, child
welfare agencies or treatment providers
Single women with infants/young children
Multiple Risk Factors:
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Poor and uneducated with limited resources
Almost one-quarter with no prenatal care
Drug use during pregnancy
Client Risk Factors continued…
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Domestic Violence reported for more than 50%
More than one-third have history of abuse,
psychiatric illness, criminal conviction, and/or
history of child removed from custody
29% of children low or very low birth weight
Majority involved in CPS at intake
Primary Service Needs
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Primary medical care
Parenting support
Mental health services
Drug treatment/recovery support
Transportation
Financial support/food/clothing
Housing
Child development services
Case management/service coordination
Example: The TIES Program
Team for Infants Endangered by Substance Abuse
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Funded as demonstration under federal AIA and
local COMBAT tax
Governed by multi-agency consortium with single
identified grantee agency
Intensive, home-based, community focused
intervention with families affected by substance
abuse or HIV
Professional staff provide direct services and care
coordination of myriad agency services
TIES Program Objectives
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To enhance continuing community collaboration
To identify/address needs of all children in enrolled
families
To develop an individualized, comprehensive, culturally
appropriate plan with each family
To promote permanency for each child in enrolled
families
TIES Program Components
Professional social work staff provides:
 In-home counseling
 Transportation
 Parenting education
 Linkage to community services
 Drug treatment support
 Women’s Support Group
Key Issue: Relationship Building
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With community partners
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Formal and informal
To address community needs
To address individual families’ needs
With families
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With gatekeeper
With extended family as possible
With family service providers
Involves rapport building and service provision
Parallel Process
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Parallel processes in work with community partners
and individual families
 Build rapport/address trust issues
 Establish goals
 Identify strengths and challenges
 Acknowledge long term or chronic barriers
 Build positive supports
 Internal and External
 Re-assess
Identifying Community Partners
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What do your clients need that you can’t
provide?
Does someone in the community provide it?
Why should they collaborate with you?
Don’t forget independent landlords and
employers; religious and fraternal
organizations
Establishing Partnerships
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Develop shared mission
Clarify roles and expectations
Establish process for information sharing
and regular communication
Conduct cross-training/education
Form multi-agency advisory boards or task
forces
Fostering Collaborative
Relationships
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Hold regular meetings
Provide training, education, outreach
Participate in local task forces or
“transagency” collaboratives
Be responsive and respectful
Lessons Learned In Building
Collaboration
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Involve action oriented decision makers from key
organizations
Build trust, but not at the expense of compromising
professional values
Affirm professional differences, welcome dialogue that
engenders more thoughtful decisions and plans of action
Recognize that health care, child welfare, and AOD
treatment philosophies have different premises
Create an environment where problem solving is the norm
and group is action oriented
Create or fine tune existing data collection system to meet
the needs of the planning and implementation process
More Lessons Learned
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Record your goals, philosophy and action plans
Meet regularly and track all action plans to resolution
or revise the plan
Be prepared to handle conflict, embrace it -- it is your
friend!
Heighten recognition of windows of opportunity for
collaboration and seize them when they occur
Pay attention to the regulatory details, and advocate
for legislation when needed
Recognize accomplishments and celebrate victories
Strategies for Building
Relationships with Families
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Peer workers & mentors
Small caseloads
Couple new participants with more
seasoned program participants
Provide concrete services to address
immediate needs
Motivational interviewing and solution
focused therapy
Core Issues in Relationships
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Do not judge
Respect families
Ask families and listen to what they say
Allow families to set their own goals
Work with families, not for them
Recognize strengths and expertise of families
Provide clear, honest information
Interpersonal or Counseling
Strategies
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Identify current interpersonal strengths
Build a relationship of positive regard without accepting
destructive behavior by:
 Being consistent & persistent
 Balancing confrontation with support
 Communicating honestly about difficult issues
 Encouraging behavior related to family goals
Support alcohol and other drug treatment
Provide parenting training and coaching
Encourage discussion of relinquishment of children,
when appropriate
Build Positive External Support
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Identify existing support network
Connect family’s efforts with positive
consequences
Role model problem-solving & social skills
Work with significant other & extended family
members
Promote adult and child health care
Promote family planning
Encourage other healthy social supports
Provide opportunities for family to “give back”
IT’S ALL
ABOUT THE
RELATIONSHIP