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Families Matter: A CCFC approach to helping ACT recipients achieve their recovery-oriented goals Thomas Jewell, PhD Pascale Jean-Noel, LMSW October 23, 2012 Consumer Centered Family Consultation 2 Consumer Centered Family Consultation (CCFC) • Brief, education-based engagement and consultation service completed in 1-3 sessions • Consumers are at the center of all decisions – Who to invite; which topics to discuss and not to discuss • There are several distinct phases/components • It is characterized by collaboration that promotes an equal partnership between consumers, families and providers (all are present for CCFC meetings) - It’s for consumers and/or families at all stages of illness - It’s for professionals with varying degrees of experience Engagement and Planning Engagement conversation(s) with consumer Pre-planning Meeting(s) with consumer Outreach conversation(s) with family/supports CCFC Approach (Face-to-Face Mtgs) Connect Receive Information Supporting Offering Hope Empathizing Define & Prioritize Wants & Needs Understanding Acknowledging Prioritizing with All Stakeholders Setting/Refining Goals Managing the Agenda Plan and/or Provide Next Steps Education Support Practical Guidance Problem-Solving Connecting with Resources Referring (e.g, NAMI) Similar to other types of consultations… • Information and goals of the consultation are solicited from the customer • Education is provided • Information & choices are given • Follow through is up to the customer Guiding Principles Natural Supports Collaboration Shared Decision Making Self-Directed Recovery Flattened Triangle Approach • All parts of the treatment triangle (consumer, family & provider) collaborate • Not hierarchical • Level playing field • Each person has expertise Pre-Planning Meeting • 1-2 conversations between consumer and practitioner • Emphasis: Consumer is in the “driver’s seat” and has choices • Plan: the goals/issues to discuss during CCFC (and what not to discuss) • Plan: outreach method to family/supports • Prep: the family often wants to share some perspectives and experiences • Discuss: how to handle “curveballs” Decision guide for involving family or friends to support treatment and recovery What is this guide about? This guide helps adults with mental health concerns and their clinicians. It’s a tool for making decisions about whether and/or how to involve family members or friends in support of recovery goals and treatment. Consumer Centered Family Consultation Decision Guide • The guide integrates the principles of shared decision making • The guide provides the consumer and clinician with an easy to understand, practical step by step approach to decision making • The guide offers a framework to begin a conversation with consumers about including others in their recovery process • The transparency of a written guide helps to build safety and trust in the therapeutic relationship Review Decision Guide Copies of the Decision Guide are available on the Family Institute website (see “Resources”): www.nysfamilyinstitute.org How many conversations did it take to engage a consumer before s/he said “yes” to CCFC? • 2.43 conversations (on average) – – – – – – 19% indicated an average of 1 time 9% indicated an average of 1.5 times 34% indicated an average of 2 times 8% indicated an average of 2.5 times 17% indicated an average of 3 times 10% indicated an average greater than 3 times Less than one-quarter of consumers said “yes” after initial engagement attempt • Any effort made by the clinicians to engage with consumers about expanding their circle of support adds value to the service provided Tips for Outreach with Family/Supports • Set aside enough time to discuss CCFC • Introduce yourself with a focus on your role in helping consumer • Share some personal aspect(s) of yourself to foster genuine relationship building • Explain that this is a proactive phone call and not crisis oriented • Make sure to tell them that this is not family therapy • Explain the CCFC model (e.g., may help to use the brochure) Tips for Outreach with Family/Supports (Con’t) • Explain: this is consumer driven and their loved one has given permission for everyone to talk with one another • Ask if they are interested in participating in the recovery of their loved one in a specific way. Let them know it’s time-limited. • If interested, set up a time and work out logistics (date, time and location) • If not interested, ask if you can call them again in the future and give them your phone number for them to call if they change their mind • Thank them for their time and consideration and end with comments that instill hope CCFC Brochure • A brief service for consumers of mental health services, their chosen support system, and their clinician – all working together to support the consumers’ recovery process. CCFC brochure is available on the Family Institute website (see “Resources”): www.nysfamilyinstitute.org Phone contacts with families… • What proportion of clinicians indicated there were usually phone contacts with families during the CCFC process? – 85% said “YES” (there were phone contacts) • Of those, how many phone calls typically took place per family? – 2.36 phone calls, on average Note: 87% indicated there were typically 3 phone calls or less Phone contacts with families (cont)… • When phone contacts occurred, how long did each call typically last (in minutes)? – Mean Score = 13.38 min. (SD = 7.21) • Approximately one-half (49%) of respondents indicated 10 minutes or less • 38% indicated more than 10 minutes but less than or equal to 20 minutes • 12% indicated between 21-30 minutes Sample Progress Note Consumer Name: _______________________ ID number: ____________________________ Consumer present? (circle) Yes No Location: __________________________ Relationship(s) to Consumer: _____________ Date of consultation: _________________________ Session duration: ____________________________ Family Member(s):__________________________ Family Consultation: (circle session number) (1) (2) (3) Other____________________ Consumer Engagement: Date in which the consumer signed the release of information: _________ Consumer’s expectation/wants regarding the consultation with family: _______________________ ________________________________________________________________________________ Service plan goal to be supported by the consultation? ____________________________________ Presenting goals/needs/wants: Please check all that apply and provide a brief summary. ___ Information about the consumer’s mental health issues (e.g., diagnosis, causes, treatments) ___ Problem solving (specific issue) ___ Family relationships (e.g., communication, coping strategies) ___ Support (e.g., options for linkage to professional and community sources of support) ___ Practical assistance and advocacy (e.g., navigating the mental health system) ___ Other problems/ needs/wants __________________________________________________ Consultation services provided: Please check all that apply and provide a brief summary. Family Work as Best Practice People with mental health concerns who have on-going contact with their families (or wish to) should be offered a family based intervention which provides a combination of: education about the illness family support crisis intervention problem solving skills training practical guidance Schizophrenia PORT Treatment Recommendations Why do it? Preliminary evidence for the impact of CCFC Feedback from 51 clinicians described improvements in the following: • • • • Family understanding of mental illness and substance use Family involvement in supporting treatment and recovery Family perception that they are better supported Family communication and comfort with treatment staff • • • • • • Consumer communication with family (quality and quantity) Consumer comfort with and value of family involvement Consumer perception of support/understanding by others Consumer communication and comfort with treatment staff Consumer treatment engagement/involvement Consumer recovery-oriented outcomes In addition to CCFC, what other supports are available? • The Spectrum of Family Services – Community Led Services • NAMI - many services (www.naminys.org) – Family to Family Education Program – Monthly support groups – Information nights – Agency Led Services • Integrate family into the intake, assessment and ongoing care as agreed upon by consumer • CCFC (additional meetings) • Family Support Groups • Resource Library • Family Information Nights • Family Education Curriculum • Family Therapy/Behavioral Family Therapy Hope is embedded in the CCFC model… • Hope is critical to recovery • Hope offers a sense of connection, support & relief • Hope gives you company… you have one another to help combat the illness • Consumers AND families need to hear the message of hope… and that they all can have an important role in recovery Contact Information for Presenters Thomas Jewell, PhD [email protected] 585-474-8684 Pascale Jean-Noel, LMSW [email protected] 212-543-5464