Maria Hernandez, M.S.W., Omayra Sellas-Lamberty, M.A.,

1. Maria Hernandez, M.S.W., Omayra Sellas-Lamberty, M.A., Stephanie H. Scott, Ph.D., A.C.S.W., M.S.S.W.,

2. What is Cherish The Family (CTF) ?

3. The goal of CTF is: • to prevent the abandonment of children under age three who are in the dependency system and who have been affected by substance abuse and/or HIV/AIDS. • Targets mothers with children (0-3) engaged in the child welfare system • Mothers confronting substance abuse and/or HIV/AIDs • Complex needs with limited access to resources and supports that can help them • Provide services to strengthen a parent’s ability to care for their children, specifically promoting family reunification and stability,

4. What are the theories behind CTF?

5. Theoretical Frameworks Attachment Theory: • Kelly and Zucherman, 2003 stated “children GROW AND THRIVE in the context of close and dependable relationships that provide love and nurturance, security, responsive interaction and encouragement for explorations. Without at least one such relationship, development is disrupted, and the consequences can be severe and long lasting. …Focusing on the caregiver-child relationship is essential, not only because caregivers’ interactions with their children are developmentally critical, but also because qualities of these relationships need on going support.”

6. Theoretical frameworks continued… • strengthening emotional bonds, maximizing children’s chances for optimal psychosocial development, and interrupting the transmission of maladaptive parenting practices across generations. • Systems Approach • Viewing the whole structure of systems and the interrelationships across systems • Trans disciplinary Approach • Sharing roles against discipline boundaries

7. Staffing Training • Master Level professionals with at least two years of experience with at risk families –HIV, mental Health issues, Substance Abuse. • Experience with children 0-5 • Counselors will be trained in implementation of Mahoney, PSI, and NCAST. • Trained in promoting first relationships curriculum. • Solution-Focused Therapy techniques through Reflective Supervision • 1 Program Director (Part-time) • 1 Program Manager • 4 MasterLevelsCounselors • 1 Data Entry/AdministrativeAssistant

8. Services we offer … • Therapeutic parenting by utilizing a solution focused approach with the Promoting First Relationships Curriculum • Social emotional support • Increasing their awareness of SA issues, and mental health issues • Multidisciplinary meetings • Court Testimony

9. CTF’s Approach • Collaboration with multiple community providers • This allows for additional types of visits such as extended visits, sibling visits, and visits at locations in the community • Links families with • substance abuse to treatment • mental health services • job training and support

10. Partners • ChildNet • Broward regional HealthPlanning Council • Spectrum • Smith Community Mental Health • BrowardAddictionRecovery Centers (BARC) • HealthyStartCoalition of Broward County • Workforceone • TheOuncePrevention of Florida

11. Evaluation

12. Logic Model Long Term Outcomes Activities Short Term Outcomes Measures Children not reported in the DCF Abuse Registry (info provided every 6 mths by ChildNet) • Cherish the Family: • Case Mgmt • Assessment • Family Advocacy • Mental Health Supportive Svcs • Promoting First Relationships • Teaching the Tough Skills • Childcare • Circle of Parents • Referral and Follow-up Safety Outcome 1: Children are, first, and foremost protected from abuse and neglect 90% of participants (26 sessions) will report parenting behavior consistent with decreased risk of child abuse and neglect Safety Outcome 2: Children are safely maintained in the home 85% of families (26 sessions) will reduce abuse, neglect, abandonment recidivism rates N.C. Family Assessment Scale Mahoney 80% of children will be placed in a stable, safe home at the completion of the program Perm Outcome 1: Children have perm and stability in their living situations Children are not removed from the home Children are in home at 12 months 80% of parents will report healthy levels of engagement and self sufficiency Perm Outcome 2: Continuity of family relationships and connections 80% of participants will access support services in the community Wellbeing Outcome 1: Families have enhanced capacity 75% of parents will meet at least 75% of their IFSP goals PSI

13. Logic Model Continued Activities Short Term Outcomes Long Term Outcomes Measures Job Readiness Training 80% of unemployed participants will participate in job readiness training Wellbeing Outcome 1: Families have enhanced capacity Participant attendance and certification Technical Assistance for teachers at the Child Care Centers 95% of teachers will apply knowledge of child development, parental attachment, and child needs in selecting activities for targeted children Wellbeing Outcome 2: Children receive appropriate services to meet their educational needs Mahoney Behavioral Scale Community/System To be determined To be determined Online Survey

14. Instruments • Parenting Stress Index-Short Form • North Carolina Family Assessment Scale-Reunification • Mahoney Behavioral Scale

15. Parenting Stress Index-Short Form • This measure is a brief version of the Parenting Stress Index • Underlying Assumptions • Could identify and diagnose individual parent-child systems under stress • Child Characteristics • Parent’s perception of impact of child’s behavior on parent • “At Risk Screening Tool” • Parent-child relationship could be a predictor of child’s later adjustment

16. Scales • Total Stress Score • Primary score in guiding professional judgments as to whether professional intervention might be appropriate • Parental Distress • Reflects a parent’s perception of child-rearing competence, conflict with spouse, social support, and stressors associated with restrictions placed on other life roles

17. Scales • Difficult Child • Surveys the parent’s view of the child’s temperament, defiance, noncompliance, and demandingness • Parent-Child Dysfunctional Interaction • Assesses a parent’s perception that the child does not meet expectations and that interactions with the child are not reinforcing

18. North Caroline Family Assessment Scale- Reunification (NCFAS-R) • Introducing the NCFAS-R • Assessment and measurement of family functioning in family based child abuse and neglect prevention/intervention programs. • A worker administered rating scale • Provides pre and post measurement of families that are served by family-based services providers

19. Scoring • Each subscale is rated using a 6-point Likert-type scoring strategy • Each item is scored as follows: • +2 = Clear Strength • +1 = Mild Strength • 0 = Baseline/Adequate • -1 = Mild Problem • -2 = Moderate Problem • -3 = Serious Problem

20. Mahoney Maternal Behavior Rating Scale (MBRS) • An observational instrument designed to assess the quality of observed parent-child interactions • Evaluates the quality of maternal interactive behaviors • Consists of a 10-minute video tape interaction between the parent and child

21. MBRS • 12 items utilize a 5-point Likert Scale which differ for each domain • 4 domains • Responsiveness • Affect • Achievement • Directiveness

22. Subscales • Responsiveness • Sensitivity to child’s interests: Parent seems aware and understands the child’s activity or play interests • Responsivity: Appropriateness and consistency of the parent’s responses to the child-facial expression and signs of discomfort. • Effectiveness: Ability to engage child in play interaction

23. Subscales • Affect • Acceptance: Approval of child and child’s behavior • Enjoyment: Parent’s enjoyment interacting with the child • Expressiveness: Tendency of caregiver to react emotionally toward the child • Inventiveness: Range of stimulation parent provides to his or her child • Warmth: Holding, caresses, kisses, hugs, tone of voice, and verbal endearments

24. Subscales • Achievement Orientation • Achievement: Encouragement of sensorimotor and cognitive achievement • Praise: Amount of verbal praises • Directive • Directiveness: Frequency and intensity of parent’s requests, commands, or attempts to direct child’s immediate behavior • Pace: Parent’s rate of behavior, regardless of child’s rate

25. Findings

26. Demographic Findings • 76 CTF Participants • 69 in comparison group

27. CTF Participant ages

28. Comparison Group Ages

29. Education • There are a variety of education levels in both groups • CTF participants have higher levels of education.

32. North Carolina Family Assessment Scale-Reunification • Child wellbeing was found to be statistically significant at both time 1 and time 2 • treatment group having significantly better scores than the control group. • Both groups made positive gains between the three data points • most notable gains were family safety, child wellbeing, and readiness for reunification

33. North Carline Family Assessment Scale-Reunification • 1= clear strength • 2= mild strength • 3= baseline/adequate • 4= mild problem • 5= moderate problem • 6= serious problem • 7= not applicable • 8= unknown

34. Parenting Stress Index-Short Form • Scale • 1=low stress (1-15 percentile) • 2=normal (16-60 percentile) • 3= Borderline stress (81-84 percentile) • 4= Clinically Significant (85 and above) • It is noteworthy that the scores below decreased indicating that parents demonstrated improvements in the areas of feeling healthier and a reduction in overall stress.

35. Defensive Responding

36. Total Stress

37. Parental Distress

38. Dysfunctional Interaction

39. Difficult Child

40. Maternal Behavior Rating Scale • Rating Example • 1=highly inexpressive • 2=low overt expressiveness • 3=moderate overt expressiveness • 4=overtly expressive • 5=highly expressive

41. Maternal Behavior Rating Scale

42. Qualitative look at CTF • Maternal behavior • Before and after

43. Strengths • Small case loads- 12 families which provide an opportunity to work closely with family (engagement- support- and all the therapeutic services). • Promotes fair opportunities for parents to be reunified with their children through referrals and one on one support. • Systemic approach to problem solve issues the parent and family faces. • A solution focused approach that allows the family to strengthen and build their strengths. • Ensures effective coordination of services to support the family (providers-foster placement and child advocate).

44. Families feel they are learning, and the support received has helped them to increase awareness, communication, and achieve their goals (remain engage in case plan.) • The program has provided financial support to families that have reunified. • The program has facilitated payment for services such as psychological evaluations, and individual therapy.

45. In my words …. • “It’s nice to have someone support me and look at me in a positive light. The court looks at me like I’m a bad person so it’s nice to have at least one person on my side.” (Cherish the Family Participant) • “If I was by myself, I wouldn’t think I would get my children back. Because I have someone helping me through this, I’m hopeful that I will get my kids back. Now I look at things more positive. Before, I was very negative and felt alone.” (Cherish the Family Participant) • “I feel like I have someone on my side, helping me through this process.” (Cherish the Family Participant)

46. Questions…