Transcript Consumer Centered Family Consultation

Welcome
Consumer Centered Family Consultation
Webinar start time is June 2, 2010 at 12 o’clock
To download the three resources for this webinar go to:
nysfamilyinstitute.org
Decision Guide
PowerPoint
Brochure
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Webinar Resources
Family Institute for
Education, Practice & Research
New York State
Office of Mental Health
University of Rochester, Department of
Psychiatry, Rochester, NY
Department of Health
Albany, NY
Anne Smith, LMSW, Director
Anthony Salerno, PhD, Co-Director
Beth Hoh, LCSW-R, Faculty
Michael Holley, LCSW, Deputy Director
Evidence Based Practice Initiatives, NYS OMH
Bureau of Inspection & Certification, NYS OMH
James Evinger, MDiv, Research Coordinator
John Johnson, MA, LCSW-R, Director
Sherri Ladd, MHA, Information Analyst
Family Outreach Services, Creedmoor Psychiatric
Center, Queens, NY (1)
Doris Joy, RN, LCSW-R, Director
Family Services, South Beach Psychiatric Center,
Staten Island, NY (1)
(1) Faculty, Family Institute for Education, Practice &
Research
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Series of three webinars
Webinar 1: Engaging Consumers
Webinar 2: Engaging the Family
Webinar 3: Consumer Centered Family Consultation (CCFC)
The purpose of these webinars is to provide information and
practical tools and resources to assist agencies to meet quality
Practice standards
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Today’s Agenda
• Brief review of Webinar 1:
Engaging the Consumer
• Brief review of Webinar 2:
Engaging the family member(s)
• The CCFC Approach (CDP)
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Webinar 1 Review
Engaging the Consumer
• Open and frank discussion about involving
others (family, close friend) to support one’s
treatment and recovery
• Emphasis is on transparent description of
CCFC, especially showing the consumer what
information will be part of the consultation
• Use of a structured decision making guide that is
a tool for both the consumer and the clinician
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Defining CCFC with the Consumer
What is it?
This means defining the focus as well as the limits of the consultation
process
Why is this important?
• To insure that the expectations of the consumer are met. The consumers
decision was based on the clinicians description of the purpose and focus of
the CCFC
• To insure that the information about the CCFC services provided to family
members via the CCFC brochure and phone conversations will be honored.
• To insure that the CCFC will not evolve into family therapy which requires
more time and specialized clinician training and supervision.
• To keep the focus on the nature of consultation: Information, education and
general guidance
How is this done?
Describe the CCFC approach
Review the brochure
Give out informational handouts
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Keep to the agenda
Defining CCFC with the consumer:
Key points (con’t)
• CCFC is a brief service (1-3 meetings which is
decided on by all parties)
• There are limits to the CCFC service
– Highly meaningful concerns and issues that
go beyond the scope of the CCFC may be
addressed by other resources and services in
the agency or community
– CCFC is not designed to solve complex and
long standing problems and conflicts.
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Defining CCFC with the consumer:
key points (con’t)
• CCFC is primarily an approach that:
– Establishes a partnership among the consumer,
family members and clinician who is familiar with the
consumer
– Emphasizes information, education and general
guidance
– Enables the clinician and consumer to obtain family
member(s)experience and ideas that may contribute
to the quality of the service plan
– The consumer’s preferences and wants are at the
center of the CCFC approach
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CCFC Decision Guide: A Shared Decision Making
Tool to Inform and Engage the Consumer
• Designed to assist clinicians with the informing and
engagement process with consumers of mental health services
• Tool to aid the consumer with their decision making process on
the specifics of who to include (or not to include) in their
recovery process, when, where, how and for what purpose.
(This can be found on the FI website)
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Webinar 2 Review:
Engaging the Family Member(s)
• Provide family member(s) with a clear
understanding of the purpose and limits of a
CCFC
• Invitation to participate in a brief CCFC extended
by consumer, clinician or both
• Use of a CCFC brochure that provides family
member(s) with information that assists the
family member to make an informed decision
about getting involved
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Consumer Centered Family Consultation
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.
(This can be found on the FI website)
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Consumer Centered Family
Consultation
Multiple sources of information and
philosophies are embedded in the model
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Edie Mannion - Family Consultation of Berks County, PA
William McFarlane - Multifamily Psychoeducation Groups
Diane Marsh - Serious Mental Illness in the Family
Ian Falloon – Family Guidelines
Kim Mueser & Shirley Glynn – Behavioral Family Therapy
Lisa Dixon – PORT Study Recommendations
Others…Shared Decision Making, Motivational
Interviewing, Stages of Change
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Overview of the approach
The CCFC has three major aims:
– Identifying and engaging others to be part of the
consumers circle of support. It is an approach to
promote the initial & subsequent contact between
the family and the clinic. It could also serve as an
opportunity to reconnect with families whom you have
already had contact, in a formal manner
– Create an opportunity for the clinician to learn from
the experiences of the consumers family member(s)
– Offer family members information and guidance that
may increase their willingness and ability to support
their loved one’s treatment and recovery
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Consumer Centered Family Consultation
Short-term Intervention
1-3 meetings
– Consumer
– Family/chosen supports
– Clinician
Similar to other consultations
-Information & goals of the consultation are solicited from the
customer (consumer & family)
-Education is provided
-Information & choices are given
-Follow through is up to the customer (consumer & family)
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Basic Underlying Assumptions of
the CCFC Approach
Consumer’s benefit when…
• The people in their lives (family and friends)
have a better understanding of their mental
health problems, possible causes, treatment,
services and hope for recovery
• Family and friends have an opportunity to get
guidance and support
• CCFC is focused on partnership building
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PARTNERSHIP BUILDING
Consumer Centered Family Consultation
Consumer
Consultant
Family members
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CCFC: Gateway to other Family Services
on a Spectrum of Family Services Menu
• Agency Led Services
– Integrate family into the intake, assessment and ongoing care as agreed upon by
consumer
– Consumer Centered Family Consultation
– Family Support Groups
– Multifamily Groups
– Resource Library
– Family Information Nights
– Family Education Curriculum
– Behavioral Family Therapy
• Community Led Services
– National Alliance on Mental Illness
• Family to Family
• In our own Voice
• Monthly support groups
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Consumer Centered Family Consultation
CDP Method
Connect
Goal: Get to know each other-Social conversation to make everyone
comfortable. Express appreciation to the consumer and family
member(s)
Define & Prioritize Wants & Needs
Goal: Establish a focused agenda with the consumer & their family,
prioritize the merged agendas and get endorsement from the consumer
Provide and/or Plan Next Steps
Goal: Provide the consultation service that emphasizes information and
education that promotes understanding, guidance and access to mental
health related resources. Inform the parties of additional resources as
needed
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Connecting
What is it?
Connecting means the use of your personal communication
and listening skills to build rapport and establish trust
Beginning the meeting:
• Welcoming and appreciating the efforts of the consumer
and the family to attend this meeting
• Introduce self: role in the program and role as a family
consultant
• Social conversation- small talk to enhance comfort (note:
in some cultures there is a preference for the
professional to maintain a higher status and a more
formal demeanor)
• Ask family and consumer if they have any other
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questions about the CCFC meeting
Connecting
Throughout the engaging process and the
CCFC meetings, the clinician is continually
connecting with both the consumer and the
family member(s)
How?
– Receiving and giving information in a
transparent manner
– Emphasizing consumer strengths, family
strengths and hope for recovery
– Listening and empathizing
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DEFINING & PRIORITIZING WANTS & NEEDS
Acknowledging:
Communicates to consumers, family & supports state
their needs and wants are understood
Setting Goals:
Helps consumer, family & supports to convert their
needs and wants into achievable behavioral goals
Prioritizing:
Helps consumer, family & supports to establish which
needs and wants they will address first, based on the
criteria: safety, avoiding relapse, and facilitating
recovery.
Managing the Agenda:
Manages the agenda so that consumer, family &
supports can attain their goals and address needs and
wants that emerge during the consultation.
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Planning/Providing Next Steps
Receiving Information:
Communicates to consumer, family & supports that s/he
wants to receive information about changes in their needs
and wants and asks for continuous feedback about the value
of the consultation
Teaching:
Presents information about serious mental illness targeted to
the goals in a concise, understandable format. This may be
accomplished in one meeting
Referring:
Explains services that would help them attain their goals and
offers plans by the most efficient means of accessing other
services when they agree. Referrals may be to other areas
on the Spectrum of Family Services menu, either within the
agency or in the community
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Four major areas addressed in a
CCFC
Throughout the Consultation process there
are four major areas that may be addressed:
Area 1: Basic information about mental illness, treatment,
causes and services offered
Area 2: List of guidelines and tips on useful ways of
helping a relative with mental health problems
Area 3: Information about resources in the treatment
setting (agency) and the community for consumers
and family members
Area 4: Experiences and knowledge family members have
that may add value to the current service plan
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The Family Guidelines
1.
2.
3.
4.
5.
6.
Go Slow
Keep it Cool
Keep it Warm
Give each other space
Set Limits
Ignore what you can’t
change
7. Keep it simple
8. Follow the Tx. Plan
9. Carry on as usual
10. Take care of yourself
11. Avoid Street drugs &
alcohol
12. Pick up on early warning
signs
13. Solve problems step by
step
14. Lower expectations
temporarily
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Do’s of consultation
• Start each meeting with casual
conversation & review objectives
• End each meeting with casual
conversation and summarizing
• Collect information ahead of time with the
use of the Consumer & Family Needs
Assessment Survey
• Be prepared with handouts and other
educational materials
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Don'ts of consultation
• Stick too rigidly to the plan, remember
needs may change so be ready to adapt
and be flexible with the agenda
• Turn the meeting into family therapy
Note: There is a place for family therapy if
the consumer and family desire this, but not
in a CCFC- referrals can be made if needed
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If’s of consultation
• If you are asked a question you cannot
answer, say so and offer to find out the
answer and get back to them
• If there is a crisis, address it, but plan to
reconvene for the CCFC at a later time
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Sample Progress Note
Topic areas included on the Progress Note
include:
– Consumer’s indentifying information
– Engagement section
– Areas identified by the consumer and family
to be addressed in a consultation
– Consultation services provided
– Disposition
(this can be found on the FI website)
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Resources Available at
www.nysfamilyinstitute.org
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Decision Guide
CCFC Brochure
Consumer & Family Needs Assessment
Family Guidelines
Power Point slides of all three webinars
Recording of all three webinars
Library with many useful resources that
you can use in a CCFC
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For Information or Assistance
Anne Smith, LMSW
[email protected]
Family Institute for Education, Practice & Research
University of Rochester
Department of Psychiatry
315 Science Parkway Suite 400
Rochester, New York 14620
Telephone: 585-279-7903
www.nysfamilyinstitute.org
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