Transcript Collaboration Between Agencies to Enhance Client Success

Collaboration Between
Agencies to Enhance Client
Success
FRESH (Family Recovery Engagement
Support of Hampden County) Start
Family Recovery Project
“I probably would have got treatment way
sooner but I was afraid to lose my kids. I wish
I would have had someone to help me through
that, to work with me to get in to detox and
then a program without having to sign over my
kids”
Partners in Family Recovery
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Tx providers—co-occurring disorders (SUD, MH,
trauma)
Child Protection Services-DCYF
Part C services--Family Centered Early Supports and
Services (FCESS)
Prenatal providers and birth hospitals
Legal System and Corrections
Domestic Violence
It takes time and effort to build relationships with each other and
it works
Collaboration or Building a Family
Recovery Team
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At Systems Level e.g. cross and joint training,
increasing collaboration and communication
between providers, workgroups, protocol
development
At Family Level e.g. consents, family team
meetings, sharing of service/safety/relapse
prevention plans, joint goals, regular contact
with providers, joint appointments
Barriers to Collaboration
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Time and money
Different values, foci, goals
Different language and knowledge base
Fear and loathing
What else?
All You Ever Wanted to Know About
Collaboration
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National Center on Substance Abuse and Child
Welfare http://www.ncsacw.samhsa.gov/
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Children and Family Futures
http://www.cffutures.org/
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National Alliance for Drug Endangered
Children
http://www.nationaldec.org/
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Developing a Shared Knowledge
Base
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Cross-training
Free, trade, formal and informal
Use staff meetings and annual conferences, Family Recovery
Fairs at child welfare offices
Get on training mailing lists for other disciplines
On-line trainings
Address what you do, methods for connecting with staff,
relapse and child safety
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Substance Abuse Treatment: Levels of Care
DCF and the Legal Process
42CFR and communication limitations
•Joint Training
Topics for trainings should evolve in response to
recognized needs, and to stated requests.
Topics include identification and referral, client
engagement, fetal alcohol spectrum disorders
(preventing and working with adults with FASD),
trauma informed care, recovery and parenting, and
working with families with substance exposed
newborns, and families in MAT.
Planning a conference across disciplines is a strong
relationship-building activity
Consider This…
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Relapse is potentially an opportunity for growth given appropriate safety planning
and support
The presence of a parental substance use disorder does not solely determine good or
bad parenting.
Substance use is just a piece of the puzzle.
The quality of the care giving relationship is key to children’s long-term
development.
Keeping children safe is a responsibility that belongs to all of us.
We all share in the responsibility of helping families thrive.
Modeling trust, communication, and collaboration benefits clients, families, and
providers.
How we relate to others is what can empower them to change.
Look beyond the challenge of the moment to see the potential of the family.
Look beyond the challenge of the moment to see the potential of the collaboration.
Every family has strengths.
Individuals exist in the context of family, community, and culture.
We need to understand, value and support each other’s work.
Collaboration and communication between providers is key in supporting families.
Every person has something to learn and something to offer.
Training and Other Resources—
Free CEUs
Abandoned Infants’ Act Resource Center
www.aia.berkeley.edu
National Center on Substance Abuse and Child Welfare
www.ncsacw.samhsa.gov
Children and Family Futures
http://www.cffutures.org/
The National Alliance for Drug Endangered Children
www.nationaldec.org
“Best Practices in Communication: A Guide for DCF and SA
Treatment Providers”
Areas Addressed:
Screening and Engagement
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Referral and Consent Forms
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Assessment
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Treatment & Ongoing Collaboration
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Discharge & Aftercare Planning
Included in the Guide:
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Best Practices protocol
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New tools to aid communication – for example:
List of Local Treatment Providers
Information to Be Shared at Referral
Assessment Form for DCF
Treatment Status Form for DCF
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Existing tools (e.g. safety plan samples)
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Resources (re: DCF, BSAS, Legal, Collaboration)
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DCF Phone Directory and Western MA Substance Abuse
Treatment Directory
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Family Recovery Council:
MAT & Pregnancy/Postpartum Workgroup
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Goal: To establish best practices across all systems (DCF,
treatment providers, hospitals, etc.) to support families with
moms in Medication Assisted Treatment during the pregnancy,
birth, and postpartum periods.
Action Steps:
1) Identify challenges
2) Troubleshoot; identify solutions
3) Develop a “Best Practices Protocol”
4) Develop a “Parent Information Packet”
5) Evaluate, revise, disseminate
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Example of Collaboration at Family Level for Mothers
in MAT
Begin as a team with consents
Ongoing relationship, not just in times of crisis
Prepare all materials when woman is pregnant—
tests, letters from providers, contact info for
providers
Contact postpartum social worker at hospital,
DCYF if there is an open case
Bring two sets of materials to hospital, one goes
to DCYF with filing of 51A
Follow-up on FCESS referral and be at
assessment
Collaboration with
Other Providers
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Child Safety and Family Recovery
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Consents
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Develop Relationship and Exchange Plans
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Supporting Family Centered Early Supports and
Services (FCESS)
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Family Conferences
Collaboration with partners
Cooperative Family Conferences
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Helps with engagement and recovery
Educates providers about addiction and parenting
Expectation of providing resource is meeting together
Identify what you have to offer
Identify common goals
Assign responsibilities
Discuss relapse triggers and custody dates
Billing codes
Decision-Making Questions
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What worries us?
What works well?
What needs to happen?
Safety Mapping
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Tool for case conferences
Invites multiple perspectives
Gets people on same page
Structure to bridge disagreements
Helpful for clients
Signs of Safety Assessment and Planning Guide
SAFETY
DANGER
List all indicators of Past Harm, Present Harm or Future Harm
What are we worried about?
Past or Present Harm to Child
List all indicators of Acts of Protection, Caregiver Capacities, and Supporting Strengths
What’s working well?
Acts of Protection
(Directly related to danger)
Complicating Factors
Safety and Context Scale
Supporting Strengths
Safety Scale: Given the danger and safety information, rate the situation on a scale from 0-10, where 0 means
reoccurrence of similar or worse abuse/neglect is certain and 10 means there is sufficient safety to close the case.
Context Scale: Rate this case on a scale of 0-10, where 10 means no action is necessary and 0 means this is the worst
case of child abuse/neglect that the agency as seen.
Guiding Principles
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Addiction and recovery happen within the context
of a family.
Single greatest motivation for recovery: retaining
the right to parent one’s children.
Reinforcing the capacity to parent is important to
recovery.
Sobriety, and even recovery, is not enough to
make a great parent.
Systems work must happen concurrently.
Building Relationships with Clients
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Taking time & making effort to engage
Providing concrete resources
Showing respect
Being honest
Advocating
Empowering
Engagement Strategies
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Peers
Help with DCYF and noncustodial support
Warm handoffs for referrals
Mother-baby groups with critical mass of
women in recovery
“I really needed to learn how to be a parent, I
never had that in my own childhood, I just
didn’t even know where to start”
Groups
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Lessen isolation
Increase parent-child attachment
Reinforce role of mother
Build recovery
community for families
Increase use of
FCESS
Expose children to early
education and care
Recruitment & Collaboration
When 2 or more agencies collaborate on a group:
 Equal representation with facilitators
 Emphasis on team approach
 Identify the “common thread”- ( i.e. we are all
mothers here)
 Each agency staff recruit but no differentiation
between participants
Lessons Learned
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Reach for the phone or the keyboard!
Listen to each other. Tolerating the discomfort of differing
points of view builds trust and respect.
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Balance process and product by identifying the problems and
then focusing on possible solutions (take action!).
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Be role models: cross-systems partners should plan, lead, and
participate in meetings equally.
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Reinforce common goals and understanding: “Relapse is a
recovery AND a safety issue.”
Each family provides an opportunity to improve collaboration.
As challenges arise, we can identify the larger systems issues
and then advocate for change!
Contact Information
Debra Bercuvitz
[email protected]
413-887-1761
FRP website: www.familyrecoveryma.org