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An Outsider’s Inside Approach Engaging Substance Abusing Women Involved with Child Welfare :

An Outsider’s Inside Approach Engaging Substance Abusing Women Involved with Child Welfare :. Lessons Learned From Kentucky’s Targeted Assessment Program Presented by: Tracey Ellerbe, MSW Melissa Brown, MA. ASFA – 1997 Modifications to Existing Law. Lessening of Reasonable Efforts

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An Outsider’s Inside Approach Engaging Substance Abusing Women Involved with Child Welfare :

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  1. An Outsider’s Inside ApproachEngaging Substance Abusing Women Involved with Child Welfare: Lessons Learned From Kentucky’s Targeted Assessment Program Presented by: Tracey Ellerbe, MSW Melissa Brown, MA

  2. ASFA – 1997 Modifications to Existing Law • Lessening of Reasonable Efforts • Foster Kids on Fast Track To Adoption • De-emphasis on Family Preservation

  3. Shortcomings of ASFA • Placed Blame Solely on Child Welfare System • Relied on Anecdotal Accounts of Child Fatalities Due to Lack of Data • Reasonable Efforts, if Any, Subjectively Defined • Fiscal Incentives Discourage Reunification (Stein, 2003)

  4. Barriers to Safety in the Literature • Maternal Substance Abuse 54% • Intimate Partner Abuse & Violence 40% • Depression 65% • Mood, Anxiety, Psychotic D/O 80% • Learning Problems 25% - 50% (Miller, et. al, 1999), (Martin, et..al, 2002), (Barusch, et. al, 1999)

  5. Targeted Assessment Program(TAP) A unique initiative funded by: KENTUCKY’S CABINET FOR HEALTH & FAMILY SERVICES

  6. Targeted Assessment Program Sites CAMPBELL BOONE KENTON GALLATIN BRACKEN PENDLETON GRANT CARROLL MASON TRIMBLE GREENUP LEWIS ROBERT ‘ SON OWEN HARRISON HENRY OLDHAM BOYD FLEMING NICHOLAS CARTER SCOTT FRANKLIN BOURBON SHELBY ROWAN JEFFERSON BATH ELLIOTT LAWRENCE FAYETTE WOODFORD MONTGOMERY SPENCER ANDERSON BULLITT CLARK MENIFEE MEADE MORGAN JESSA MINE JOHNSON MARTIN POWELL HANCOCK NELSON MERCER BRECKINRIDGE HENDERSON WOLFE MAGOFFIN MADISON ESTILL WASHINGTON DAVIESS HARDIN UNION GARRARD BOYLE FLOYD LEE MARION BREATHITT MCLEAN PIKE LARUE WEBSTER LINCOLN OHIO OWSLEY GRAYSON JACKSON KNOTT CRITTENDEN TAYLOR ROCKCASTLE PERRY CASEY HOPKINS HART MUHLENBERG GREEN LIVINGSTON BUTLER EDMONSON CLAY LETCHER CALDWELL LAUREL LESLIE ADAIR PULASKI BALLARD McCRACKEN LYON METCALF WARREN BARREN RUSSELL CHRISTIAN KNOX HARLAN MARSHALL CARLISLE TODD LOGAN CUMBERLAND WAYNE TRIGG WHITLEY GRAVES ALLEN SIMPSON BELL McCREARY CLINTON MONROE HICKMAN CALLOWAY FULTON

  7. WHATEVER IT TAKESTargeted Assessment Specialistsprovide these services: • Assessment • Case Management • Referral, Service Connection & Follow-up • Home Visits and Transports • Consultations for DCBS Staff • Trainings for DCBS/Other Agency Staff • Community Collaboration

  8. First Keys to TAP’s Success • Program Flexibility • Community Councils • On-site Location • Outreach Focus • Unique Clinical Approach

  9. TAP Outreach Contacts for 1st Response Letters 2457 Phone Calls 5762 Home Visits 1905 Office Appointments 2676 Professional Collaterals 11,453 Personal Collaterals 597 Total Contact Attempts 25,035 Average # to Reach 1 Client 5

  10. Guiding Principlesof Assessment and Engagement • Holistic • Gender Sensitive • Client-Centered • Collaborative

  11. Holistic ApproachAssess for Co-existing Barriers • Mental Health • Domestic Violence • Learning Problems • Substance Abuse

  12. Gender Sensitive ApproachFemale Substance Abuse is Different • Societal Expectations/Identification • Relationship Issues • Violence & Trauma • Physiological Differences • Mental Health Problems

  13. Client-Centered ApproachEstablish an Effective Partnership • Develop a Trusting Relationship • Approach Client Respectfully • Admit We Don’t Have All the Answers • Listen Well to Client’s Story • Identify Client’s Strengths • Meet the Client Where She is • Avoid Criticism and Confrontation.

  14. Collaborative ApproachEstablish Effective Partnerships • Develop Trusting Relationships • Be Respectful and Open-minded • Admit We Don’t Have All the Answers • Ask Partners for Help and Feedback • Listen Well and Use Partner Suggestions • Avoid Criticism and Confrontation

  15. Collaborating with Child WelfareBecoming Embedded • Expertise • Screening • Expectations • Boundaries • Trust • One of the gang…sort of

  16. Roles Within Child Welfare • Role model • Counselor • Consultant/Trainer • Mediator • Messenger • Taxi

  17. Collaborating with Child WelfareCreative Strategies • Family Conferences • Negotiating Case Plans • Least vs. Most Restrictive Level of Care • Community Connections • Family Courts • Case Management/Follow-up Services

  18. Collaborating with Clients Involved with Child WelfareSpecial Considerations • Basic Mistrust of Systems • Fear of Losing Children, Childcare • Hopelessness, Sense of Powerlessness • Sabotage by Partner (IPV) • Respite • Confidentiality • ASFA

  19. Collaborating with Clients Involved with Child WelfareCreative Strategies • Negotiating Case Plans • Negotiating Services • Client Control/Involvement in Plan • Strengths-based Assessment Summaries • Community Connections • Information • Pretreatment

  20. Advocacy • Attorneys and Court • Family Conferences • Service Providers/Community Partners

  21. More Keys to TAP’s Success: • Holistic Approach • Engagement Efforts - Assumption of Omission • Hand-holding vs. “Enabling” • Modeling • Intensive Case Management • Transportation • Persistent Follow-up • Community Relationships

  22. Q & A

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