ACWA Conference 19 August 2008

1. ACWA Conference 19 August 2008

2. Outline Melissa Yim – Department of Child Safety • Evolve Interagency Services • Program Outcomes • Reflections Naomi Campling – Disability Services Qld • Case Study presentation

3. QLD Evolve Interagency Services

4. Evolve Program • Goal of Evolve • Evolve Therapeutic Services, Qld Health • Evolve Behaviour Support, DSQ • Intensive and long term intervention • Holistic and consistent approach in support and intervention

5. Evolve Program Outcomes • Review of Evolve • Significant decrease in challenging behaviours • Reduction of self harm and harm to others • Greater placement stability • Increased school participation and engagement

6. Performance Management Framework • Framework to support best practice • Report and evaluate program outcomes • Multi-layered approach • Client outcomes • Service performance • Process outcomes

7. Reflections…2 years on • ACWA 2006 – perceived individual and organisational challenges • Current challenges • Recruitment and retention of specialist staff • Capacity of Evolve • Increased demand

8. Reflections…2 years on • Community shift in perceptions • Renewed hope in closing the service gap • Availability of support • Increased referrals to other agencies • Strengthened collaborative relationships • Shared understanding and responsibility

9. The case • Adolescent male • Significant learning difficulties • Unable to read and write • Diagnoses of ASD, ADHD • Significant trauma and attachment issues • Living in one-on-one youth worker supported placement due to severe behaviour outbursts • Medicated since aged three (Ritalin, risperidone, endep)

10. Family and child protection history • Complex blended family - multiple fathers/ partners • Many children in family and all involved in child protection system • Significant history of neglect and domestic violence in family, as well as inappropriate sexual activity • Family has history of not engaging well with external agencies and has had negative impacts on placement stability

11. Presenting concerns • Aggressive and violent outbursts multiple times weekly • Not attending school regularly • Stealing • Poor hygiene • Limited internal locus of control • Erratic sleeping and eating patterns • Poor peer relationships • Absconding from home and school

12. Strengths of young person • Can be extremely polite • Friendly • Funny • Enjoys spending time with older people • Extremely protective of family, particularly younger brother • Good at art

13. Stakeholders Evolve Health School Evolve DSQ Young Person Family Child Safety Residential

14. Collaborative ProcessStep One - setting the scene • Evolve clinicians agreed on who would do what, boundaries and limitations of roles • Evolve clinicians undertook assessments and developed care plan • Established stakeholder team and agreed upon importance of meeting every four weeks to: • Maintain open communication • Establish and set group cohesiveness • Demonstrate commitment to young person and stakeholder process

15. Step Two - Planning and Goal Setting • Group identified goals linked to young person’s care plan - young person involved in this process • Goals were initially task focused, with each stakeholder identifying tasks that they were responsible for • Established sub (micro) teams to work on specific goals together and complete between stakeholder meetings

16. Stakeholder Group DChS EVOLVE HEALTH & DSQ • Financial support 1:1 placement • Open communication • Include SH in decisions • Attend SH meetings • 1:1 sessions with YP • Connect with biological family • Advocacy for family contact • Training & education to School & residential staff. FAMILY • Reinforced behaviour strategies • Available to provide feedback to SH RESIDENTIAL & SCHOOL • Attend SH meetings • Participate in training • Implement strategies • Flexible resourcing Step Three - Micro teams in Action What Collaboration Looks like?

17. Step Four - Ensuring that it works • Continued involvement of family - backing up behaviour support strategies. • Involved direct care workers (residential and school) - specific tasks to give them ownership of process. • Open, effective communication with ALL stakeholders • Respecting the roles of others - honoring the person. • Keep young person at the centre – active participation at stakeholder meetings (without the steak!)

18. Outcomes for young person • Attending school regularly • Member of school catering team • Aggressive behaviour has reduced • Appropriate sleep/wake cycles developed • Hygiene improved • Participating in menu planning and shopping • Insight into behaviour, including empathy and remorse • Beginning to read • Not medicated for nine months

19. What has been achievedfor stakeholders • Improved skill base, particularly for direct staff. • Increased understanding of other professionals. • Enhanced relationships between government and non government departments.

20. Where to from here • Transitioning young person to group residential facility • Continuing to work with young person to develop internal methods of regulating emotions • Furthering literacy and pre employment skills with view to part time work

21. Our Key Learnings • Communication is the key - needs to be effective, open, and with ALL stakeholders • Each person needs their own ‘work’ to do so that they feel and become a key member of the team • Never underestimate the power of a united team • A collaborative team is characterised by equal partnership and shared responsibility • Keep the young person as focus – the goal of Evolve is to support the young person

22. Collaboration is required to enable people with different skills and perspectives to come together to create a solution for, and with, each child that is beyond the capacity of each party alone.

23. Evolve Program Management Team • Melissa Yim, Department of Child Safety melissa.yim@childsafety.qld.gov.au • Jackie Bartlett, Queensland Health jackie.bartlett@health.qld.gov.au • Morag Gilchrist, Disability Services Qld morag.gilchrist@disability.qld.gov.au • Brett O’Connor, Department of Education Training and the Arts brett.oconnor@deta.qld.gov.au