St. Louis County

1. St. Louis County Solution Focused Journey to Family Dependency Treatment Court

2. Agenda • Introduction • Inquiry • Family Engagement - Tools • Organization Challenges • Community Forum • Family Dependency Treatment Court – Drug Court • Video – Drug Court Participant • Video – Drug Court Team Member • Acknowledgements/References

3. Introductions • Mark Wilhelmson • Social Service Supervisor • St. Louis County Public Health & Human Services • wilhelmsonm@co.st-louis.mn.us • Mark Snyder • Social Service Supervisor • St. Louis County Public Health & Human Services • snyderm@co.st-louis.mn.us

4. Location DULUTH Map of U.S. /Minnesota/St. Louis County

5. Olympic Gold Medals • Miserable finish by Curling Team From Duluth  List of Countries and Medal Count

6. St. Louis County Golf Team Team: Mark Wilhemson, Mark Snyder, Tom Rendulich, Rick Benson, John Nachsheim, James Ellingson, Jenny Fick, Melissa Lehr Andrew Turnell – Honorary Team Member Golf Cap

7. Child Safety • Be Gentle With The Young • Juvenal (55 AD-127 AD) • Children begin by loving their parents; as they grow older they judge them; sometimes they forgive them • Oscar Wilde (1854 – 1900) • Always be nice to children because they are the ones who will choose your rest home • Phyllis Diller (1917 - )

8. Change • We must become the change we want to see.Mahatma Ghandi (1869 – 1948) • A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty. Winston Churchill • There is nothing wrong with change if it is in the right direction. Winston Churchill

9. Inquiry - The Journey Begins • Collaboration with Key Actors • Focus on safety • Language Change • Solution Building • Exploration for details • Search for exceptions • Individuals

10. Tools • Elicit, Amplify, Reflect, Start Over • 3 Houses • 3 Columns • Safety Plans • Words and Pictures • Time Line • Maps

11. ‘Three Houses’ Child Protection Risk Assessment Process to use with Children and Young People Created by Nicki Weld, Wellington NZ House of Worries House of Dreams House of Good Things On 3 separate pieces of paper draw with the children their experience and vision of each house. Use these drawings with the adults in deepening the assessment and planning process. More Info:www.signsofsafety.net/Around_the_World.html- New Zealand: Child Youth and Family

12. 3 Columns Rate the situation on a scale of 0-10, where 0 means things are so bad the family can no longer care for the children and 10 means that everything that needs to happen for the children to be safe in the family is happening

13. Safety plan (blank)

16. TIME LINE Safety plan developed w/ public health Nurse- Autumnno longer wants SS involved Sept 25. 09 PH notifys Liana that she has not seen Autumn in a few weeks- canceling appts possible drug use Oct 23. 09 Liana and Susan begin working with Autumn and Jacob- Destani to stay in hospital for 6 weeks Liana receives reports that Autumn is dealing and using meth- refused UA 1st report to IIU- Prenatal exposure- THC also left AMA 29weeks preg June 28 09 Domestic between Jacob and Autumn- Charged w/ domestic assault Aug 29 .09 Admin review… close case Feb 9.10 Oct 2009 June 2009 July 2009 Aug 2009 Sept 2009 Nov 2009 Dec 2009 Feb 2010 Mar 2010 Destani born Weighed 3 lbs 4 oz June 29 09 Destani discharged from hospital Autumn and Jacob successfully completed all hospital recommendations Aug 11.09 Jacob goes to NERCC on violation D.V. ADR-April 3, 2010 Autumn admits to using THC 2x since last visit- not going to 1st yesr- only met w/ PHN 2X Nov 23. 09 H.V. @ Autumns – Patrick admits to meth relapse – states he is homicidal/ suicidal during visit Dec 15, 09 Concerns about Autumns ability to care for child- *police hold* March 5 2010

17. Building Safety & Strengthening Families Practice Danger/Harm Risk Statement(s) Complicating Factors Safety Strengths/Protective Factors (Ahlquist 2000) 10 month old Sam was held by Judy when Pete punched Judy, she fell while holding Sam and Sam’s head hit a table causing a large bruise and bump Genogram Neighbors called 911 and Pete was arrested Aunt Rose has a spare bedroom for Judy & Sam Pete and Judy have argued before without threats or violence. Safety = Strengths Demonstrated As Protection Over Time. • Judy clearly loves Sam; he goes to her, they cuddle, she responds to him being upset • We are worried because this is the second time Pete has been physical with Judy and this time was more violent. • We are worried because Pete’s father punched both he and his mother and injured them, from the time Pete was 6 years old and until his father left the home when Pete was 14 • Judy’s aunt Rose lives close to her, is supportive of her and provides care for Sam so Judy & Pete can have a break Next Steps (Immediate Progress) Safety Protection Required Pete usually interacts well with Sam, plays with him and has never hurt him when caring for him • Pete and Judy have met separately with the social workers and both appear honest and open about what happened. Current Ranking • Pete has a job that pays well and he provides most resources for the family • Pete views the domestic violence as serious and believes he needs help. Judy has decided to spend some time with Sam at Rose’s house to see if Pete takes action 1 2 3 4 5 6 7 8 9 10 •Pete has no supportive family and no friends he is close to or can rely on. Pete’s boss has tried to befriend him and is a good example for Pete both on the job and at home Pete has told his boss about the incident & he will be part of a safety plan. Pete has contacted DAIP and will begin the Men’s education group. Focus/Purpose of Consultation Pete will visit Sam at Rose’s house and Rose will be in charge of the visit. Pete will provide financial resources to Judy and Sam, through Rose Enough Safety to Close

18. Organizational Practice • Intake transfers to case management; 1200 intakes in 2009 • Pre-petition Screening; 188 petitions for juvenile court

19. What is working, useful considered strengths? • SOS offers different ways to look at cases with a focus on safety with some discussion of absolute sobriety • SOS methods allow an opportunity to really develop a working relationship and find out what is going on in a family. SOS consult formats, 3 houses help develop the relationship • SOS allows to focus on impact of danger and harm on children and to set measurable behavioral goals for parents both short and long term. • Mapping forces Social Workers to focus on real concerns regarding impacts on child safety and parents behavior and helps develop goals as well as getting detail • Stronger working relationships mean better outcomes for families • 3 column used with care givers helps set small goals which result in success and the goals are generated by the care givers • Mapping limits story telling about families and situations • Words and pictures has been helpful for children • Skillful questioning for detail allows a balance look at the family • Detail helps direct case rather than formula response like placing all pre-natally exposed children

20. What are the concerns, worries? • Judges, Guardian ad Litems acceptance of practices is a worry • Judges may be concerned that the Social Workers relationship with care givers is more important than the safety of children • SOS takes more time than workers have ie Words and Pics, 3 houses 3 columns • SOS as practiced may be too focused on short term goals than safety (strengths re concern demonstrated over time) • Coordination of the use of tools from intake to ongoing, families or children ask why are we doing this again, we already did that? • Case mapping is not a friendly process, too long, too structured, too much of a critique of the mappee, mapper, not as purposeful as it could be • There are not enough opportunities to learn SOS • Safety plans are a joke...parents bring unsafe people to the network, do they really provide for safety, do they rely too much on the child to keep themselves safe (safety objects, logs) do they create an opportunity for secrets between child and care giver? The issue of secrets with parents could be confusing and give the wrong message. • Varied use of SOS creates questions from the parents and children • Lets use plain language, not buzz words like “appreciative inquiry” • With words and pictures, parents get defensive re what the child will be told and negotiation is required

21. Next Steps •  Specialized training should continue such as W & P DVD etc • Set up a library of resources • Training of the CP community, Judges, Foster Parents, GAL etc • Agency Conference as a training tool • Social Workers need materials for WP, etc.

22. Community Forum on Child Protection

23. Family Dependency Tx Court Purpose/Goal • National Model • Promote recovery through a coordinated response to participants dependent on alcohol and other drugs • Improve outcomes for alcohol and other drug addicted individuals in the courts through collaboration, thereby: • Enhancing public safety, ensuring participant accountability, and reducing costs to society system

24. FDTC – Team Members • Judge • Drug Court Coordinator • County Attorney • Public Defender • Guardian ad Litem • Public Social Services – Social Worker & Supervisor • Tribal Social Services – Social Worker • Clinical Providers

25. FDTC - Participants • Currently open in Juvenile Court • Screened by the Family Drug Court Team • Volunteers to participate in good faith • Signs terms of participation

26. FDTC Process - Phases • ONE: Assessment; Detox; Primary Treatment; Random Urinalysis; 12 weeks sobriety; weekly court attendance • TWO: Sobriety; After care; Relapse Prevention; Random Urinalysis; 12 weeks sobriety; every other week court appearance • THREE: Sobriety; Cognitive Behavioral Skills; Sober Parenting; Random Urinalysis; complete 52 weeks; ever third week court appearance

27. FDTC - Incentives • Praise/recognition by the Court • Gift certificates • Bus passes • Treatment medallions • Certificates of accomplishment • Clothing vouchers • Gas cards, • Respite care • Recognition of birthdays; birthdays of children

28. Sanctions • Civil Contempt of Court: reprimand – community service - incarceration • Graduation from FDC requires 52 consecutive weeks of clean Urinalyses • Any positive Urinalysis or documented use – back to phase one reporting • Any failure to call in for a Urinalysis, failure to report for a Urinalysis or failure to provide a Urinalysis will be deemed a positive and will result in sanctions.

29. St. Louis County Family Drug Court Participant: Date: March 18, 2010 Danger/Harm/Worries: History: Mother using methamphetamines, methadone, pot, adderral; connected to criminal element; arrested for possession of Meth; assaulted and abused by her partner; Daughter exposed; witnessed violence; expressed fear of mom’s partner and concern for her mother. Mom re-engaged with violent partner – phone calls & visit at jail; lied to drug court team; jailed. Ticketed for shoplifting. Recently: No concerns. Safety/Strengths/Working Well: Strong family support ties: Regular contact and visits with parents; honest discussion about relationships and addiction; reconnected with daughter’s father – their relationship appears amiable and supportive; He has been providing primary care for his daughter at times. All reports indicate complete sobriety – even in light of reconnection with ex-partner. Actively seeking employment. Engaged with daughter: baking, crafts, trips to events, shopping in the community, valentines day party at school. Purchased a puppy for daughter – teaching her to provide care. Daughter – regular attendance in pre-school – mom transports. Mom attending individual therapy - expresses anger, frustration, and some gratitude with team and family – this is a change. Developing a stronger relationship with sober graduate of family Drug Court Completed a court ordered peer review. Advanced to Phase II. Safety Team: Mother, Father, Brother, two sober friends, some Family Drug court team members, & sponsor; Plan: Family 3x weekly check in w/mom & daughter; 2x weekly face-to-face contact by friends and sponsor; weekly contact with SW; Court - 2x monthly appearance = ensure sobriety and primary care of daughter Complicating Factors:Mom’s father is seriously ill – creates stress and anxiety. Struggles with establishing and maintaining safe boundaries with ex-partner; does not recognized his negative impact on her family. Next Steps:1. Continue present efforts to work her recovery plan and care for daughter. 2. Find a job. 3. Continue individual therapy. 4. Continue Cognitive-Behavioral group at Bethel. 5. Continue Phase II. 6, Address shoplifting ticket. Scale How effective has FDTC been in helping you remain sober: 0 = drug court total waste of time; 10 = absolutely critical to my sobriety? Ans: 9; How come? Ans: Having to face people on the team and UA’s – Wish I could take them after FDTC is over. How has the drug court process work for you: 0 = not all all – 10 = fantastic; Ans: 3; How come: confused about roles – who does what, when and stuff like that; new UA procedure is confusing; don’t know the rules – some go to jail, others don’t – not always fair; and I never know what’s going to happen. 0________________________________________________10

30. St. Louis County Family Drug Court Participant: Date: March 18, 2010 Danger/Harm/Worries: History: Son born six-eight weeks premature; spent the first month in a neo-natal isolet; wore a heart lung monitor; diagnosed FASD – due to mom’s alcohol and drug use. Son is presently developmentally delayed. Mom recovered but relapsed after 10 months of sobriety alcohol and methamphetamines: Took son to the “seedy hotel” and bar while using – placing him in danger again: Recently: The present worry/concern is potential relapse which would place son at risk. Safety/Strengths/Working Well: Present safety is provided through a close monitoring/supervision by the Drug Court Team; Mom’s mother and extended family closely observe and would report in as flash – Mom lives with her mother. Mom sober for six months and cooperating with recovery – completed treatment and working on a recovery plan. Mom has followed through with action steps. Relationship with the social worker is more real – honest, straightforward; feels trusting and close. Completed a thorough sobriety plan. Cooperating in an individual therapy program/making progress. Has three sober friends and convenes a bi-monthly get together. Demonstrated responsibility: cared for her disabled sister over the holidays – bathed, toileted, fed, etc.; while performing the same duties with Robert. Participated in family traditions. Offered an apartment by the housing authority – turned it down; it was one block from the “seedy hotel” and neighborhood where she used – advocated for her self with the housing authority – they agreed and didn’t change her position on the waiting list. Identifies what she needs and does not need – articulates clearly her wants – expressed concerns about the sober parenting class. Complicating Factors: Poor – poverty; unemployed. Long history of alcohol and drug abuse; Son’s father – Mom’s ex-partner is a career criminal and drug abuser. Housing issue – a concern for some team members; although living with her mother provides safety, security, family connectedness, and nurturance. Little transportation other than public bus. Lacks a sober network of friends. Low self-esteem and unresolved clinical issues. . Safety Team/Safety Plan: Team: Mom’s mother, aunt and uncle, two former foster parents, program at Bethel, cousin, father in Grand Rapids, Minn., sponsor; Safety Plan: Relatives/Kin report to social worker weekly regarding status; personal face-to-face contact bi-monthly at minimum with son. Next Steps:1. Enlarge her sober network of friends 2. Remain in safe housing. 3. Seek employment. 4. Continue parent education/support Scale 0_________________________________________________________________10 How helpful has drug court been in maintaining your sobriety: 0 = not at all; 10 = most helpful. Ans: 8; how so? Ans: having relationships with people who care. Who? Ans: You just want me to say you; but then said team members. What else? Ans: Random UA’s – I don’t want to disappoint people. Who? Ans: Robert, my family and you. It got a little silly at this point.

31. SLC FDTC Drug Court Map

32. Drug Court Participant Video

33. Drug Court Team Member

34. Next Steps • Continued Mapping/Search for Detail With Families • Continued Sharing of Maps with Families and Team • Attach Maps and Safety Plans to Reports to Juvenile and Family Drug Court • Map Family Drug Court Process With Team Members • Combine Team Member Maps, Discuss at Retreat • Start Over

35. Special Thanks • Roxanne Esler – Drug Court Social Worker • Catherine Ramm – Drug Court Participant

36. Acknowledgements • Andrew Turnell • Rob Saywer & Sue Lorbach, Olmsted County Staff • Dan Koisolek & Michelle Sellinger Carver County Staff • Minnesota Department of Human Services • Dick Pingry & Children’s Division, St. Louis County • Special Assistance: Mary Ness, Jenny Fick & James Ellingson

37. References • Ellingson, James & Fick, Jenny – Time Line • Lorbach, Sue – Consultation Framework • Turnell, A. & Edwards, S. (1999). Signs of Safety: A Solution and Safety Oriented Approach to Child Protection Casework. New York: Norton & Company • Turnell, A. & Essex, S. (2006). Working with ‘Denied’ Child Abuse: The Resolutions Approach. Berkshire, England: Open University Press. • Weld, Nikki – 3 Houses