Child Safety Interagency Therapeutic and Behaviour Support Services

1. Child Safety Interagency Therapeutic and Behaviour Support Services

2. Outline of Presentations • Overview of the modelYvonne D’Occhio • Interagency collaboration how we did and continue to do it lessons learnt and implications for practice • Successes and challenges on the Sunshine Coast Colin Smith • Outcomes for childrenStephen Bell • Case scenarioBronwyn Hartnett

3. Crime and Misconduct Commission Report“Protecting Children: An Inquiry Into Abuse of Children in Foster Care” 110 Recommendations

4. Recommendation 7.5 • The CMC report recommends…. ”that more therapeutic treatment programs be made available for the children with severe psychological and behavioural problems. Successful programs should be identified, implemented and evaluated”.

5. Target Group • Children and young people in care with severe psychological and behavioural problems, targeting those with the most extreme and complex needs • DSQ: for children/young people with a disability, need to be eligible to receive services under the Queensland Disability Services Act, 2006

6. Interagency response between Department of Child Safety, Queensland Health, Disability Services Queensland, Department of Education and the Arts Education and the Arts Child Safety Child Safety Interagency Therapeutic and Behaviour Support Services Health Disability Services

7. Objective To increase mental health, behaviour support and participation in education for children and young people in the care of the Department of Child Safety.

8. Role of Dept Child Safety • Sole source of referrals • Case management • Support integrated model of service delivery through linking therapeutic & behaviour support planning with Case Planning processes • Chair of local and state-wide steering committees & local Panels

9. Role of Dept Education & the Arts • Core member of State-wide and Local Interagency Steering Committees and Interagency Panel • Support integrated model of service delivery through linking therapeutic & behaviour support planning with Education Support Planning processes

10. Role of Queensland Health • Mental Health-Child Safety Therapeutic Support Teams (9) • Assessment • Crisis response • Short term intervention • Medium to long term therapy • Carer support • Consultation – liaison • Specialist professional development and training

11. Role of Disability Services Qld • Child Safety Behaviour Support Teams (6) • Assessment Services • Behaviour Support (med – long term) • Information • Education and training • Consultation

12. Intent of the Interagency Initiative • Promoting partnerships • Capacity to do more of what is already done • Capacity to provide new services • Increased knowledge and understanding of unique needs of target group

13. Principles • Culture of shared responsibility and ‘owning’ solutions • Integrated approach • Child focused and family centred practice • Professionalism

14. Principles Cont… • Information sharing and service provision • Timeliness • Accountability

15. InteragencySteering Committees • Local • State-wide

16. Child Safety Interagency Therapeutic and Behaviour Support Services Panel Membership Core members (required to attend all meetings) • Department of Child Safety – Manager or Senior Practitioner • Queensland Health –Team Leader, Mental Health-Child Safety Therapeutic Support Team • Disability Services Queensland - Team Leader, Child Safety Behaviour Support Team • Department of Education and the Arts – Senior Guidance Officer

17. Child Safety Interagency Therapeutic and Behaviour Support Panel Invited members may include: • Indigenous Representation – Recognised Indigenous Entity • Department of Communities, Youth Justice Service Centre - Case Worker • Non-Government Organisation, Youth Worker Coordinator • Private Practitioner, e.g. Psychologist, Psychiatrist, Counsellor

18. Panel Functions • Referrals from DChS • Intake and prioritisation • Interagency care planning • Monitoring and review • Case closure

19. Evaluation • Model function: How well is the model as described in the manual working? • Model difference: How is this model different from and ‘better’ than current practice? • Model scaling-up: What needs to be done to implement the model across Queensland? • Child & Carer experience: What are the perceived experiences of the referred children/young people and their carers?

20. Collaboration is………. • A process where parties see different aspects of a problem and can explore their differences while searching for a solution that is beyond the vision of the individual parties (Darlington, Feeney, & Rixon, 2004)

21. Interagency collaboration is… • Multidimensional • Interactional • Developmental… and a lot of planning and continued hard work is needed for it to be successful! (Johnson, Zorn, Ram, Lamontagne & Johnson, 2003)

22. We know there are barriers… • Departmental service boundaries • Philosophical barriers Individual and • Differing theoretical organisational backgrounds barriers • Perceived threats to professional integrity/value • Interagency competition • Presence of “us and them” attitude (McCartney 1999; Bolland & Wilson 1994; Foster-Fishman, Salem, Allen & Fahrbach 2001; Darlington, Feeney & Rixon, 2004)

23. We know there are barriers… • Lack of understanding • Unrealistic expectations about other agencies • Prioritisation • Consent Differing • Confidentiality processes • Information sharing

24. We know there are barriers… • Lack of coordination • Lack of policies and procedures • Lack of resources “Collaboration costs!!”

25. Implications for Practice Mutual awareness and understanding • One of 4 key intents • Serious pre-planning • Implementation support • Interagency manual • Interagency orientation training • Do not expect miracles • Be comfortable with robust conversations • Professional learning can be challenging

26. Implications for Practice Coordination and accountability • Funding from Department of Child Safety • Strong leadership from key decision makers • Local Interagency Steering Committees • State-wide Interagency Steering Committee • Child Safety Directors Network • Directors-General • Memorandum of Understanding • Implementation support • Adequate resources - $$, knowledge, skills

27. Implications for Practice Shared goals and outcomes • Promote shared care not ‘ownership’ of the child • Structured processes – communication and documentation; interagency care plan • Shared trouble shooting – steering committee, panel and stakeholder team • Always keeping each other informed about decisions that have a major impact on the child

29. Shared Goals and Outcomes Getting the PictureSharpening our perspective from good systems to starting with the empowerment of marginalised children and young people

30. Shared Goals and Outcomes • The Child or Young Person who is experiencing trauma, extreme disadvantage, devaluation, alienation & marginalisation in their everyday lives is the central focus of this project. • The values of inclusivity, shared responsibility, professional co-operation, balancing supportive care and self determination are central

31. Shared Goals and Outcomes • The intention of the Sunshine Coast Steering Committee and the Interagency Panel is to support the co-operative processes between departments, professionals & clients to best serve the complex needs of the child & young person in care

32. An Emerging Art… • BRAND NEW TERRITORY • Catching a glimpse of new way of doing things • Plans taking shape … learning to make them real so they do change things • Can become impatient … change comes slowly • Nothing is really happening until life is better for these most disadvantaged young people • Still learning

33. It all starts happening! • Stepping through the process – client teams, assessments, interagency care plans • Workloads growing – stretching resources • Raising the bar on referrals • Challenge of engagement with clients • Looking for, and seeing tangible changes • Child Safety Officer’s lives becoming different – specialist support, part of a wider team • GETTING IT! This is a Child Protection Service. Part of us!

34. Shared Goals and OutcomesWhat has worked! The way we work together (a developing art) • Promoting: One Combined Service • Not left alone any more … shared responsibility • Approaching as a Team as far as possible and avoiding demarcations

35. Shared Goals and OutcomesWhat has worked! • Focus on contributing varied frameworks, holistic assessment, coming up with solutions • Honouring of difference vs competing for primacy • Encouraging staff in Child Safety Service Centres to shift our ways of working

36. Shared Goals and OutcomesWhat has worked! Best Possible Knowledge….Good information • Assessments – new span of knowledge, expanded scope in planning • Able to regulate across complex themes and environments • Integrated assessment and response drawing on 4 departments and more • Each agency is able to focus on maximising their specialist skills and knowledge

37. Mutual Awareness & UnderstandingWhat has worked! • Talking through our varied perspectives • Learning each other’s language and frameworks • Openness to seeing through other’s eyes • Honest dialogue within the team

38. Mutual Awareness & UnderstandingWhat has worked! • Mixing with our partners within Child Safety Service Centres • Working through criteria, ensuring we hit the mark • Clarifying roles – between teams, within teams, panel, steering committee

39. Challenges / Learnings • Quality referral information • Getting sharper so we waste less time • All accepting that change for these young people is a slow process, but still needs to be marked by real markers • Still learning how to be clear about outcomes • How do we plan for long term therapeutic outcomes?

40. Challenges / Learnings • Getting the idea of a fully collaborative service • Keeping on working on breaking down demarcations across departments and within each of our teams

41. What’s worked from my perspective Learning heaps (unchartered territory) • Value what I see the other agencies bringing to our children and young people’s lives • Access to new ideas and possibilities • Learning what we didn’t realise we lacked

42. Agents of Healing and Bringing Together • These kids are the MOST marginalised, disenfranchised, invisible except as problems • New program … able to stamp a focus on bringing hope to excluded and marginalised children and young people • No longer falling between the gaps (mostly) • Need fresh chances only possible through creative rethinking of paradigms • More sustainable model • Ramifications for wider community • Challenge to keep it alive and fresh as it can become calcified

44. Outcomes of working together • Outcomes for children and young people are enhanced when we work together better • Holistic assessment and response • No one person / department has to hold everything or coordinate everything • Getting the best out of each other

45. TANGIBLE OUTCOMESLearning to articulate them • Changes across environments • Carers less reactive – reduced stress, greater coping • Engagement • Attendance in therapeutic environment • Emotions more regulated • Relationships enhanced • Placements stabilised • Increased school attendance

46. Harry • 9 years old • Diagnoses • Reactive Attachment Disorder • Mixed disorder of conduct and emotions • 8 placement changes in past 2 years • 5 different schools attended in local area. Expelled from school early this year

47. Harry • 7 stakeholder meetings to develop and maintain the interagency care plan • Multidisciplinary / multi-agency assessment • Speech and language assessment by Education Queensland • Psychiatrist reviews re medication • Functional OT assessment • WISC

48. Harry Goals • Engagement in therapeutic process to address anxiety, social skills and anger management • Support the maintenance of a stable placement • Graduated exposure to support transition into school

49. Harry Interventions (Mental Health team identified as primary service provider) • Graduated exposure to support interaction with peers • Life story work to assist development of identity • To address significant traumatic events when Harry ready to disclose

50. Harry • Outcomes • Now attending School ½ day 4 days week • No suspensions or exclusions for 3/12 • Stable placement for 6/12 • Despite acting out support network can cope