Expanding your Toolkit for Building Safety and Wellbeing with Families with High Needs

1. Expanding your Toolkit for Building Safety and Wellbeing with Families with High Needs Svea van der Hoorn Genevieve Whitlam

2. How we think people are organised - structurally Thanks to Meg Wheatley for use of her slide

3. How people really organise - complex interactions Thanks to Meg Wheatley for use of her slide

4. Intensive Family Support Options (IFSO) • 8-12 week, in-home visiting, family therapy service • Solution focused brief therapy approach • High availability of therapists (e.g. mobile phone, out-of-hours) • Target group for the program • Families with a child who has a disability (or children) • Complex families with a high level of stress • Family at risk of requiring an out-of-home placement for their child/ren • Concerns of neglect/abuse of children

5. When the going gets complex, the resilient get resourceful Can you see a giraffe in this picture? Trying Hard is sometimes not enough … Mastery emerges from taking actions, however small, and succeeded, in the face of adversity. Mastery does NOT emerge from receiving positive strokes (self-esteem)

6. An assessment task What we notice is what we base our decisions and actions on Q: How can we expand what we notice so we increase options? Q: How can we sweep in multiple perspectives so we increase options?

7. How many passes does team in white make?

8. Our hopes for sharing our work with you: • Benefits of starting with resource-activation (Gassman and Grawe, 2006) • Benefits of noticing possibilities and developing these into Small Wins • Benefits of focusing on best hopes and better futures as described by the family • Benefits of remembering that many paths lead to good enough solutions • Benefits of combining bottom lines with many options

9. Rayya Ghul - Occupational Therapist

10. 1. Focus on what IS possible • How has the family responded to stress / change previously? • Q. What helped them to manage? • When they have created positive changes for themselves, how did they do that? • Q. What changes fit with the family, considering their values, cultural and socio-economic circumstances? • Q. Is the change the family motivated to work towards difficult for the worker to support, but ok with the family • “What changes do you think you need to make that will assure the court/agency/your worker that you are managing well enough at the moment?” • Environmental changes as a place to start - simpler and easier than personality overhauls or family reconstruction

11. 2. Promote the well-being of all family members to create safety for all children • Eg. Family goal – go on a holiday – multiple services worked together to arrange respite for the child with a disability, accommodation for the family, $$ for petrol and food • Eg. Preparing for when things are at their worst – safety card • Scaling - Confidence Scale; Willingness Scale

13. Scaling relationships between confidence and willingness

14. 3. Help families to navigate community and support systems • Mapping multiple supports and the purpose and benefits of each support • Social Isolation → re-connect with school, extended family, local neighbourhood resources

15. Mapping service options - what does each offer?

16. Mapping Services in relation to family’s goals Purposeful intervention…Coherent, co-ordinated support

17. 4. Many paths lead to good enough solutions • Q. So you believe that you’d be less stressed if you had more respite? Just in case more respite isn’t possible, what else can help you to have some downtime? • Q. When do you feel less stressed? • Families with complex needs often need to think of a number of good enough solutions and then sort and select in relation to their circumstances. • Eg. Dogs - children at risk, obvious solution vs families chosen solution • Least energy and effort for significant benefit

18. Maintaining hopefulness despite good reasons to despair • Optimistic work with families (Bronwen Elliott, 2000) = “active stance that looks for possibilities for change even when the situation appears hopeless” • “A focus on the possible and changeable is more helpful than a focus on the hopeless and intractable” – source unknown • Just when we think it’s all hopeless – they surprise us. • Expect the unexpected

19. 6. Preserving Gains while continuing to Build Improvements • Q. What needs to happen for you to maintain this change? • Eg. Clearing clothes; bedroom make-over complete – maintained, even though more to improve • Eg. Medication review – resulted in no more self-harming behaviour and parents still wanted to work towards improving his self-regulating behaviour • Using text messages as simple reminders to keep going • Being brief = creating beginnings

20. 7. Supporting ourselves through reflection • Q: What can I do / did I do that focused families on their resources and possibilities rather than on their deficits and stuckness? • Q: What can I do / did I do that encourages the family to think about future possibilities? • Q: How can I / did I help them to picture a concrete description of a better future (that is legal and signals well-being) • Q: Which of my thoughts/opinions about this family help me to work well with them? Which hinder our work? How can I change my approach to increase the chances of the work together being useful? • Q: What support from colleagues or managers do I need to keep myself and the family safe as we work together? • “We do not learn from experience; we learn by reflecting on experience” – David Boud

21. “Never underestimate the power of a small group of committed and dedicated people to change the world. In fact, it’s the only thing that ever does.” Margaret Mead Thanks to Meg Wheatley for use of her slide

22. Resources and references • Berg, I (1991) Family preservation: a brief therapy workbook. London: BT Press • Cade, B & O’Hanlon, WH (1993) A brief guide to brief therapy. New York: WW Norton • Gassman,D & Grawe,K (2006) General change mechanisms: the relation between problem activation and resource activation in successful and unsuccessful therapeutic interactions. Clinical Psychology and Psychotherapy, 13, 1-11 • Hardy, F & Darlington, Y (2008) What parents value from formal support services in the context of identified child abuse. Child and Family Social Work, 13, 252-261 • Macdonald, A (2007) Solution-focused therapy: theory, research & practice. London: Sage • Seligman,M (1995) The optimistic child. Sydney: Random House • Simon, J & Nelson, T (2007) Solution-Focused brief practice with long-term clients in mental health services. New York: Haworth Press

23. Thank you for attending. Please leave us your e-mail details so we can send you a resource list and some notes

24.  Making home a safe and comfortable place • When you fill this in, try to use words that DESCRIBE what a video camera • would see and hear if it films in your home -  • for example, “It will film me smiling”, rather than “I will be happy”

25. If it ain’t broke, don’t fix it. • Change is inevitable • Do more of what works • Complex problems may respond to doing something different, however small or simple • Amplifying / Lifting up partial competence gives more hope than pointing out incompetence or what’s wrong • Expanding current coping and drawing on existing resources is easier than overhauling a family or introducing alien ways of being a family • Assume that almost all parents want a reasonable future for their children - even when their behaviours contradict this

26. Expanding your toolkit for building safety and well-being with families with high & complex needs • Focus on what IS possible; environmental changes simpler sometimes than family functioning overhauls • Promote the safety and well-being of ALL family members - look for inter-connections between people’s needs and interests • Map services and support systems - to enable navigation by family • MANY paths lead to good enough solutions - sweep in options • Maintain hopefulness - resource- & possibility spotting stance • Focus on preserving small wins - maintenance of gains • Worker self-care … learning from experience through reflection Svea van der HoornGenevieve Whitlam