Transcript Slide 1

Foster Care Assessment Program
Evidence Based Approaches to Parenting Interventions –
Overview of Implementation Practice and Procedures at
Brigid Collins Family Support Center
Presenter Byron G. Manering, MSW
[email protected]
Seminar December 9, 2008
Brigid Collins
Family Support Center
www.brigidcollins.org
1231 N. Garden Street #200, Bellingham, WA 98225
360.734.4616 - 360.734.1763 FAX - [email protected]
Now Open! Skagit Valley Family Support Center
1500 E Broadway, Mount Vernon
Byron G. Manering, MSW
[email protected]
Mission
To break the cycle of child
abuse
by preventing the onset of abuse and
promoting justice and healing when abuse
occurs
Building a compassionate community that nurtures all its children
Menu of Services
for strong and healthy families
Serving over 1700 families
each year, all Brigid
Collins child abuse
prevention programs are
offered free of charge to
families.
Brigid Collins
Family Support Center
PREVENTION
Information, referrals and on-call professionals to
immediately engage families
Strength-focused service plans based on family &
individual needs
Cross-system care, case coordination, home visits
& follow up services
Bilingual, bicultural case management & support
groups - Familia Latina
Parent education newsletter & monthly family
activity nights
Parent support groups, education & skills building
TREATMENT
Child sexual abuse needs assessments, education,
and therapy
Child-friendly investigation, prosecution, advocacy
& treatment of child abuse - Children’s Advocacy
Center
Foster family support groups & foster child support
services
Evaluation, assessment & medical services for child
abuse victims
Chemical dependency focused intensive case
management & behavioral health – Safe Babies, Safe
Moms Growing Together
BC Evidence Based Practices
and Best Practices
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Healthy Families America Home Visitors - 1995
Wrap Around Case Management - 1997
Parent Trust for Washington’s Children Parenting Groups -1997
Parenting the First Year Newsletter – University of Wisconsin - 1997
Foster Care Assessment Program (FCAP) - 1998
Safe Babies, Safe Moms (pregnant/parenting mom’s w/ addiction) - 2000
Dialectical Behavioral Therapy (DBT) - 2000
National Children’s Alliance Children’s Advocacy Center - 2005
Parent Child Interaction Therapy (PCIT) - 2006
Incredible Years (IY) -2008
Positive Parenting Program (Triple P) - 2008
Motivational Interviewing (MI) - 2008
BC Parenting Skills EBP’s
Parent Child Interaction Therapy (PCIT) 2006
Five coaches- 53 families annually
Incredible Years (IY) 2008
Five providers – 4 groups annually
Positive Parenting Program (Triple P) 2008
Currently three providers in levels 4 and 5 – 2-3 families each
Level 2 and 3 training this year
Motivational Interviewing (MI) 2008
20 providers trained
Commitment to Model Fidelity
– Staff
– QA
– Supervision
– Culture
– Training
Staff
Staff love an organizational commitment to EBP’s
• Smiles on their faces
• Constantly celebrating the progress are making with their families
• Euphoric addicted to success with families
Who does well with an EBP like PCIT? When hiring, keep in mind:
• It is a behavioral intervention, psychotherapist sometimes don’t do well with this approach
• People who look at the world systematically do well with systematic EBP interventions
• Look for people comfortable in a world where there is a right way and a wrong way to do things
• Those with a scientific background (like nurses), or DD providers, or teachers are good prospects
• Case Management experience is helpful for maintaining boundaries but not if Case Management is
their first love.
• And yes FCAP evaluators tend to do well with this
BC staff…
PCIT Megan Brown, Carla Willis, Jenn Lockwood, Jalia xxxxxxx, Esther Grummel
IY –
Kathryn Lyons, Cheryl Greninger, Jaliaxxxxxxx, Marion Murray, Tory Allen-Potter
Triple P – Kathryn Lyons, Megan Brown, Jenn Flick, Tory Allen-Potter
Staff
Staff love our organizational commitment to EBP’s
• Smiles on their faces
• Constantly celebrating the progress are making with their families
• Euphoric addicted to success with families
Who does well with an EBP like PCIT? When hiring, keep in mind:
• It is a behavioral intervention, psychotherapist sometimes don’t do well with this approach
• People who look at the world systematically do well with systematic EBP interventions
• Look for people comfortable in a world where there is a right way and a wrong way to do things
• Those with a scientific background (like nurses), or DD providers, or teachers are good prospects
• Case Management experience is helpful for maintaining boundaries but not if Case Management is
their first love.
• And yes FCAP evaluators tend to do well with this
BC staff…
PCIT Megan Brown, Carla Willis, Jenn Lockwood, Jaylia Lewis, Esther Grummel
IY –
Kathryn Lyons, Cheryl Greninger, Jaylia Lewis, Marion Murray, Tory Allen-Potter
Triple P – Kathryn Lyons, Megan Brown, Jenn Flick
Quality Assurance
• Fidelity Evaluation tool - ORS
• Case Manager Checklist
• Team case reviews in group setting –
reinforces model
• Triple P QA Framework
Triple_P_QA_Framework_8-20-08_Draft[1].doc
Supervision
Role of supervision of EBP’s
• Because drift begins happening as soon as the individual walks out the
door from a training, supervision is the key strategy for helping providers
transform their new knowledge into technique and then into skill.
• One tool for supervising MI practitioners is the MI STEP: Motivational
Interviewing Assessment: Supervisory Tools for Enhancing Proficiency.
• Another tool is being researched by Harborview/University of Oklahoma.
The project is called, Using Technology to Augment the Implementation
and Effectiveness of PCIT.
• Providers coming out of training, mimics what happens to families who go
to traditional parenting classes. The knowledge is there but it is not
integrated into behavior. Knowledge needs support, reinforcement and
practice to transform behavior.
• Training and creating solid ‘fidelity’ culture, improves supervision clarity
and goals and actually makes supervision easier.
Culture
Agency culture:
• Surrender to the systematic approach.
• A clear commitment/expectation to model fidelity is
critical at all levels administration, supervision and
provider – this level of commitment will transfer to
client and they are more likely to commit.
• Culture of catching ‘drift’: expect to catch it, embrace
it, and fix it – every time you do, it reinforces the
culture of commitment to fidelity.
• Culture of success: success reinforces the process of
fidelity. The systematic approach becomes addictive.
Training
• Have all staff oriented/versed in the EBP’s so in their work
with the clients they are consistent and reinforce skill sets
being taught by the EBP.
• EBP’s helps focus staff training so that it is targeted and
minimally sufficient instead of a hodgepodge of topics.
• Supervisors should be trained in the EBP. Drift will not likely
be identified unless by a supervisor. If the supervisory is not
trained in the EBP they are not likely to catch the drift.
• Systematic training leads to systematic application of the
EBP.
Model Deviations
• Case by case deviations must have a reason, be
thoughtful, and be planned. Such deviations should be
done with consultation and supervision.
• Example: For one client we changed Triple P language
from ‘Sessions’ to ‘Chapters’ because the client was
using the word ‘Session’ to get out of work laid out in
each ‘Chapter’.
Model Types
• Developed as a technique to enhance existing
provider practice skills – MI
• Developed as a flexible tool to enhance existing
provider program offerings – Triple P 2/3
• Developed as a stand alone service – Triple P 4/5, IY,
and PCIT
Integrated Models
A lot of the clients (4) never actually showed up or contacted us in any way. Then there was
another woman who relapsed on drugs and could not continue coming. Then there are another
two clients whose attendance has been sporadic and the SW’s state those clients are not
following through with any services.
• Which EBP?
Program_Grid(1) msw03.xls
• Family Treatment Court/Supervised Visitation
Pathway_To_Reunification__Model_draft_10-29-08[1] msw 03.doc
• PCIT/Wrap Around
PCIT Case Management Expectations msw03.doc