Katie A.: Effective Approaches to Implementation Challenges of the Core Practice Model

1. Katie A.: Effective Approaches to Implementation Challengesof the Core Practice Model CMHACY Presentation

2. Agenda • Engagement & Assessment • Workshop • Families • Planning & Implementation • Workshop • Families • Monitoring and Adapting • Workshop • Families • Transition • Workshop • Families

3. Ice Breaker: Clock Activity Make a Clock Stand up and meet as many different people as you can. For each person, get an appointment on the hour. **Remember- you must be theirs at the same time they are yours**

4. Check-In

5. Engagement & AssessmentCore Practice Model Overview “We’re doing that already.” How is the CPM different? Model

6. Engagement & AssessmentCore Practice Model Overview • Implementing the CPM in our Community-Based Outpatient Program • Brief background • Needs of youth/families we serve • Engagement • Hope and Motivation • Natural Supports & Successful Outcomes

7. Engagement & = Assessment Planning & = Implementation Monitor & = Adapting 4. Transition = 1. Intake & Assessment 2. Treatment Planning 3. Treatment 4. Discharge Planning Engagement & AssessmentFour Phases

8. 1. Engagement & Assessment Intake meeting & engagement Orient family to services Stabilize crises/Safety Planning Engage Community Partners Strength Needs Cultural Discovery Create Family Vision Identify Priority Needs 3. Monitoring and Adapting Child Family Team meetings Monitoring and Adapting Functional Assessment & Crisis Plan Prepare for Transition Engage Natural Supports Strength Needs Cultural Discovery Update Individualized Plan 2. Services Planning & Implementation Initial Child Family Team meeting Interventions and strategies Strengths Needs Cultural Discovery Utilize Family Vision Identify Natural Supports Create the Treatment Plan Create the Individualized Plan 4.Transition Transition Child Family Team Mtg Transition to Natural Supports Prepare family for success Linkage Create Relapse Prevention Plan Utilize the FIT Transition Plan Review of CPMPhases and Activities

9. Engagement & AssessmentCPM Meetings & Documents

10. Engagement • Engagement is the KEY • Youth & families • Community Partners • Challenges with Engagement • Historical racism and historical trauma • Common Principles • Family-Centered • Strength-Based • Team-Based • Needs-Based

11. Engagement & Assessment Initial Meeting - Intake • Orienting to services: Program explained clearly in a way the family understands – including what to expect • Role Clarification & team-based approach • Answer questions so the family feels comfortable making an informed decision regarding services • Gain commitments • Confidentiality & Mandated Reporting • Complete brief Functional Assessment & Crisis Plan • Brief Assessment for Provisional Dx

12. Engagement Planning Transition Implementation

13. Engagement & AssessmentIntroducing Services • Individual Therapy/Family Therapy • EBPs • Collateral Services • Not if, but when • Minimum should equal how often we see the youth • Psychiatric Services • Child Family Team meetings (CFTs& ICC-CFTs) • Intensive Home-Based Services • Case Management Services

14. Engagement & Assessment SNCD • Strength, Needs, and Cultural Discovery • What • When • Why • How – Activity

15. Planning & ImplementationVision • Working within a team environment, providing culturally relevant and trauma-informed system of supports and services that is responsive to the strengths and underlying needs of families being served jointly by child welfare and mental health. • Commitment?

16. Planning & ImplementationFamily Vision • What is the Family Vision? This will drive your plan! • How do you envision life being when things are going well? • Family Vision Example: • Joey will be off of probation, graduated from Middle School, and the family will be together. • Commitments: Each Child and Family team member makes an individual commitment to helping the family achieve their vision

17. Planning & ImplementationTeaming

18. Planning & ImplementationCFT Priority • All families will receive the following: • Initial CFT • At least 1 Implementation CFT • Transition CFT • Katie A. Sub-Class Requirements • ICC-CFTs every 90 days minimum • CPS SW invited • Facilitator AND Therapist attends • Family Partner Invited

19. Planning & ImplementationInitial CFT • Purpose: Get all team members together, discuss 1-2 priority needs, review the family vision and develop the Treatment Plan and FIT Plan • Challenges: • Time: this can be a very long meeting • Special needs of youth and family • Siblings (small children) • Solutions: • Prepare board • Bring snacks • Bring coloring books/art supplies • Problem identified • Family Vision identified • Needs identified • Utilize SNCD to help prepare meeting • Facilitator & Therapist must attend • Family Partner invited • Other relevant team members invited (Child Welfare, etc.)

20. Planning & ImplementationWhat are Needs Statements?

21. Planning & ImplementationWriting a Priority Need • Example: • Problem: Excessive fighting, intimidation of others, and destruction of property at school. • Family Vision: The youth will be off probation and the family will be celebrating youth’s 8th grade graduation together. Everyone living together and able to spend time together. • CANS/Needs: Mother selects “legal”, youth selects “anger control” They agree on both. • Priority Need 1 (Anger Control): Youth will learn to express her feelings in a safe manner. • Priority Need 2 (Legal): Youth will be able to attend school regularly and meet all requirements for school conduct.

22. Planning & ImplementationIndividualized Plans • Integrated Plans: • Treatment Plans vs FIT Plans

23. Monitoring & Adapting Working within a team environment, providing culturally relevant and trauma-informed system of supports and services that is responsive to the strengths and underlying needs of families being served jointly by child welfare and mental health. Still the Vision?

24. Trauma is RealThe Impact is Real ReMoved Simply removing a child out of immediate danger does not in itself reverse or eliminate the wa y that he or she has learned to be fearful. The child’s memory retains thoughts and memories that can elicit ongoing fear and anxiety.

25. Trauma-Informed: It Takes Commitment A trauma-informed youth and family service system is one in which all parties involved recognize and respond to the impact of traumatic stress on those within the system – including youth, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They collaborate with all those involved, using the best available science, to facilitate and support the recovery and resiliency of the youth and family.

26. Monitoring & Adapting CFTs • Monitoring and Adapting… • Follow-up on the plan developed at Initial CFT • Still the Needs? • Still the Vision? • Gain commitment • Differences will exist, but in general, CFT meetings should be predictable and consistent in: • Length • Frequency • General agenda format

27. Monitoring and AdaptingEvaluating Progress • Problem: Excessive fighting, intimidation of others, and destruction of property at school. • Family Vision:The youth will be off probation and the family will be celebrating youth’s 8th grade graduation together. Everyone living together and able to spend time together. • CANS/Needs: Mother selects “legal”, Youth selects “anger control” – They agree on both. • Priority Need 1 (Anger Control): Youth will learn to express her feelings in a safe manner. • Goal 1: Youth and caregiver will report that youth expressed her feelings safely for 3 weeks in a row with no incidents of property destruction. • Priority Need 2 (Legal): Youth will be able to attend school regularly and meet all requirements for school conduct. • Goal 2: Youth will meet all school conduct requirements for 2 consecutive months.

28. Transition • Transition CFT: • Should schedule a minimum of 1 Transition CFT to develop a Transition (Discharge) Plan • First Transition CFT should be scheduled preferably 2 months prior to estimated D/C date

29. Transition • During Transition Phase: • Update SNCD to reflect lessons learned and successes made • Provide linkage to needed services or resources • Update Crisis Plan to utilize if needed after D/C • Review skills learned and Relapse Prevention Plan • Schedule a celebration that matches the youth/families culture, values and traditions • Provide youth/family a Resource Binder with info re: • Skill worksheets • Completed work • Resources • Plans

30. Outcomes & Case Examples Ebony (Family and Executive Team) Stephanie (Supervisor) Tamieka (Direct-Care)

31. 1. Engagement (Assessment) Intake meeting & engagement Orient family to services Stabilize crises/Safety Planning Engage community partners Strength Needs Cultural Discovery Create Family Vision Identify Priority Needs 3. Implementation (Treatment) Child Family Team meetings Monitoring and Adapting Functional Assessment & Crisis Plan Prepare for Transition Engage Natural Supports Strength Needs Cultural Discovery Update Individualized Plan 2. Planning (Treatment Planning) Initial Child Family Team meeting Interventions and strategies Strengths Needs Cultural Discovery Utilize Family Vision Identify Natural Supports Create the Treatment Plan Create the Individualized Plan 4.Transition (Discharge Planning) Transition Child Family Team Mtg Transition to Natural Supports Prepare family for success Linkage Create Relapse Prevention Plan Utilize the FIT Transition Plan Review of CPMPhases and Activities

32. Questions?

33. THANK YOU!!!! • For further information or training: • Stephanie Kelly, LMFT • skelly@youthsolutions.org • 916-417-4783 • Tamieka Paveglio • thilliard@youthsolutions.org • 916-869-3225 • Ebony Chambers • echambers@youthsolutions.org • 916-240-5936