a blueprint guide for building or re-designing your family...
TRANSCRIPT
Advancing the FDC Movement2017
Jane Pfeifer, MPA| MeghanWheeler
July 9, 2017 | NADCP
A Blueprint Guide for Building or Re-Designing
Your Family Drug Court
Improving
Family
Outcomes
Strengthening
Partnerships
Acknowledgement
This presentation is supported by:
The Office of Juvenile Justice and Delinquency Prevention Office of Justice
Programs(2016-DC-BX-K003)
Points of view or opinions expressed in this presentation are those of thepresenter(s) and do not necessarily represent the official position orpolicies of OJJDP or the U.S. Department of Justice.
Advancing the FDCMovement2017
• Highlight key decision and planning points for all Family Drug Courts
• Identify key steps in developing the Planning Team, including membership and planning process
• Learn tips and strategies on how to use the Planning Guide in your jurisdiction
Learning Objectives
Improving
Family
Outcomes
Strengthening
Partnerships
Advancing the FDCMovement2017
Why a Planning Guide for FDCs?
First Family Drug Courts Emerge – Leadership of Judges Parnham &McGee
Systems Change Initiatives
Practice Improvements – Children Services,
Trauma, Evidence-Based Programs
Grant Funding – OJJDP, SAMHSA, CB
Six Common Ingredients Identified (#7 added in 2015)
Institutionalization,
Infusion, Sustainability
19
94
20
02
20
07
20
04
20
14
FDC Movement
10 Key Components and Adult Drug Court Model
National Strategic Plan
Nex
t
To download a copy today visit our website:
http://www.cffutures.org/files/publications/FDC-Guidelines.pdf
FDC Guidelines
The Big 7
Key practices leading to better family outcomes:
• System of identifying families
• Earlier access to assessment and treatment services
• Increased management of recovery services and compliances
• Improved family-centered services and parent-child relationships
• Increased judicial or administrative oversight
• Systemic response for participants –contingency management
• Collaborative non-adversarial approach across service systems and courts
Who Should Use the Planning Guide?
• For anyone in the process of instituting a FDC
• Key decision makers can utilize the guide to recruit and motivate the multidisciplinary planning team necessary for implementation
• Any professional across the three primary systems can use this guide and present the FDC concept to decision makers and educate them about the tasks involved
Purpose
• The FDC Planning Guide provides step-by-step instructions about the planning process and tasks involved
• Team members work through the chapters and worksheets
• Completion of the entire planning process across multiple meetings/full-day retreats will lead to the creation of a FDC in a jurisdiction
How Do You Use the Planning Guide?The amount of work to launch a Family Drug Court in your jurisdiction might seem overwhelming.
• How do you lay a solid foundation to effectively plan your program?
• How do you identify the right partners for collaboration?
• How do you assemble teams to create and maintain your program?
• How do you garner sustained support and buy-in?
• How do you develop protocols and practices to ensure efficient implementation?
• How do you pay for all of the services for parents and children? How do you sustain it into the future?
• How do you improve your operational components and process as you go forward to generate better outcomes?
• How do you evaluate the program?
Planning Guide Overview
• Chapters cover different topics essential to planning
• Appendices include sample documents, reference material, and other helpful links to support local efforts and provide national resources to further support the planning, development, and implementation
• Worksheets include practical activity components designed to complement the guide
CHAPTER ONE
The Planning Process
Drug Court Hearings
Therapeutic Jurisprudence
Enhanced Family-Based
Services
Intensive Case Management &
Recovery Support
FDC Model
Judicial Oversight Comprehensive Services
Governance Structure
• The Planning Team – This team gathers information, develops an operational
plan, and evolves to resolve policy and procedure issues that arise once the
Family Drug Court becomes operational. Because this team is established to
set-up a Family Drug Court, it will eventually disband
• Executive Oversight Committee – This committee is comprised of high-level
administrators across agencies who have the authority for their organization to
shape practice and policy, and ensure program sustainability
• The Steering Committee – This committee sets major policy directions, identifies
and finds solutions to barriers, and secures resources for the Family Drug Court
• The Operational Team – This team works day-to-day in the Family Drug Court
with the participants
Three-Tiered Structure
Oversight/Executive
Committee
DirectorLevel
Quarterly
Ensure long-term sustainability and final
approval of practice and policy changes
Steering
Committee
Management Level
Monthly or
Bi-Weekly
Remove barriers to ensure program success and achieve project’s
goals
FDC Team
Front-Line Staff
Weekly
Staff cases; ensuring client
success
Membership
Meets
Primary Functions
Informationflow
Information flow
CHAPTER TWO
Understanding Addiction and
Substance Use Disorder Treatment
Addiction affects the
whole family
Developmen-tal impact
Psycho-social impact
Impact on parenting
Generation-al impact
FDC Practice Improvements
Approaches to child well-being in FDCs need to change
Child-focused
assessments and
services
In the
context of
parent’s recovery
Family-
centered
treatmentincludes
parent-child
dyad
Focusing only on parent’s recovery without addressing
the needs of children…
Can threaten parent’s ability to achieve and
sustain recovery and establish a healthy
relationship with their children, thus risking:
Recurrence of maltreatment
Re-entry into out-of-home care
Relapse and sustained sobriety
Additional substance-exposed infants
Additional exposure to trauma for
child/family
Prolonged and recurring impact on child
well-being
Continuum of Family-Based Services
Services for parent(s) with substance use
disorders.Treatment
plan includes family issues and family
involvement
Parent’s Treatment
with Family
Involvement
Goal: improved
outcomes forparent(s)
Children accompany parent(s) to treatment. Children
participate in child care but
receive no therapeutic
services. Only parent(s) have treatment plans
Parent’s Treatment with
Children Present
Goal: improved
outcomes forparent(s)
Children accompany parent(s) to treatment.
Parent(s) and attending
children have treatment plans and
receive appropriate
services.
Parent’s and Children’s
Services
Goals: improved
outcomes for parent(s) and
children, better parenting
Children accompany parent(s) to treatment;
parent(s) and children have
treatment plans. Some
services provided to other family
members
Goals: improved
outcomes for parent(s) and
children, better parenting
Each family member has a treatment plan and receives
individual and family services
Family-Centered
Treatment
Goals: improved
outcomes for parent(s),
children, and other family
members;better
parenting andfamily
functioning
Family Services
Scope of Services
FDCs should provide the scope
of services needed to address the
effects of parental substance use
on family relationships – family
based and family – strengthening
approaches towards recovery.
Family is the Focus
Adopted by the ASAM Board of Directors 4/12/2011
• Addiction is characterized by inability to consistently
abstain, impairment in behavioral control, craving,
diminished recognition of significant problems with one’s
behaviors and interpersonal relationships, and a
dysfunctional emotional response
• Like other chronic diseases, addiction often involves cycles
of relapse and remission
• Without treatment or engagement in recovery activities,
addiction is progressive and can result in disability or
premature death
ASAM Definition of Addiction
Brain imaging studies show physical changes in areas
of the brain that are critical to:
• Judgment
• Decision-making
• Learning and memory
• Behavior control
These changes alter the way the brain works, and
help explain the compulsion and continued use
despite negative consequences.
Adopted by the ASAM Board of Directors 4/12/2011
A Chronic, Relapsing Brain Disease
Treatment is an individualized and a dynamic process designed to meet
the specific and unique needs of each client. Processes commonly found in
treatment:
• Early identification, screening and brief interventions
• Comprehensive assessment of an individual’s substance use disorder
and co-occurring health, mental health and other issues
• Stabilization via medically supervised detoxification, when necessary
• Timely and appropriate substance use disorder treatment – both
acute and chronic care
• Continuing care and recovery support
Overview of Treatment Processes
Effective Substance Use Disorder Treatment
National Institute on Drug Abuse, 2012
• Is readily available
• Attends to multiple needs of the individual
(vs. just the substance use)
• Uses engagement strategies to keep clients
in treatment
• Uses counseling, behavioral therapies (in
combination with medications if necessary)
• Addresses co-occurring conditions
• Uses continuous monitoring
The best treatment programs provide a combination of therapies and other
services to meet the needs of the individual patient.
Full Spectrum of Treatment and Services
Family Engagement and Ongoing Support
Ensure family treatment and recovery success by:
• Understanding, changing and measuring the cross-system
processes for referrals, engagement and retention in treatment
• Recruiting and training staff who specialize in outreach and
motivational (e.g. Motivational Interviewing) approaches and who
monitor processes of recovery and aftercare
• Jointly monitoring family progress through a combination of case
management, coordinated case planning, information sharing,
timely and ongoing communication
• Aftercare, Community and Family Supports and Alumni Groups
CHAPTER THREE
Setting Direction
Mission, Vision & Goals
Components of a Mission Statement:
• Understanding each other’s values
• Shared principles
• Shared outcomes to measure whether the mission is
achieved
✓Client outcomes
✓ Priority groups of parents and children
✓Cost savings
Understanding the Legal Mandates of Each System
• Adoption and Safe Families Act (ASFA)
• 42 Code of Federal Regulations (CFR) Part 2
(information-sharing!)
• Health Insurance Portability and Accountability Act
(HIPAA)
• Additional federal and state regulations governing
your jurisdiction
Time to Treatment Matters
Child Welfare –
12-month timetable for
reunification
Conflicting Timetables
Treatment and Recovery –
Ongoing process that may
take longer
Early engagement in treatment is crucial.
Strategies to improve timely access include:
• Screening and identification
• Service linkage and matching to parent need
• Warm hand-off to assessment
FDC Planning Timeline
First, you will have to establish the who. Identify the members of your steering
committee who will provide direction and oversight, and the members of the
planning team who will conduct the planning, development, and implementation.
Second, you will establish the what. Set the roles of everyone involved,
remembering that some roles can be shared to enhance team functioning. Have
your team identify the key tasks that will serve as milestones.
Finally, you will establish the when by setting deadlines for those milestones. To
maintain momentum during the planning process, your team members will also need
to agree on how often the planning team will meet and how much time they can
commit. Completing these tasks will give you a timeline for the implementation
process.
CHAPTER FOUR
Structuring Your Family Drug
Court
Key Decision Points
Mission Target
Population
Model
Service
Array
Partnerships
Outcomes
(e.g., Boles & Young, 2011; Carey et al., 2010a, 2010b; Worcel et al., 2007)
Who Do FDCs Work For?
Studies Show Equivalent or Better Outcomes:
• Co-occurring mental health problems
• Unemployed
• Less than a high school education
• Criminal history
• Inadequate housing
• Risk for domestic violence
• Methamphetamine, crack cocaine, or alcohol
• Previous child welfare involvement
How well do you know
your target population?
CWS population
FDC population
Your community
Identifying Needs and Existing Capacity
Services
Match Services to Needs
Needs
Monitor Progress
Map out the Needs and Services
Other Service Enhancements
• Therapeutic-based parent-child interventions
• Trauma-focused interventions
• Developmental and behavioral interventions
• Quality visitation and family time
• Family functioning assessment tools – N. Carolina Family Assessment Scale (NCFAS)
Connecting Families to an
Evidence-Based Parenting Program
• Knowledge of parenting skills as well as a basic understanding of child development has been identified
as a key protective factor against abuse and neglect (Geeraert, 2004; Lundahl, 2006; & Macleod and
Nelson, 2000)
• The underlying theory of parent training is that (a) parenting skills can improve with training, (b) child
outcomes can be improved, and (c) the risk of child abuse and neglect can be reduced (Johnson, Stone,
Lou, Ling, Claassen, & Austin, 2008). Characteristics of effective parenting include (a) interaction style
with their child, (b) warmth and affection towards their child, and (c) parenting strategies used (Johnson,
et al., 2008)
EBPs for trauma survivors:
• Addiction and Trauma Recovery Integration
Model (ATRIUM)
• Essence of Being Real
• Risking Connection
• Sanctuary Model
• Seeking Safety
• Trauma, Addictions, Mental Health, and
Recovery (TAMAR) Model
• Trauma Affect Regulation: Guide for
Education and Therapy (TARGET)
• Trauma Recovery and Empowerment Model
(TREM and M-TREM)
Treatment Should Be Evidence-Based
Aftercare and Ongoing Support
Ensure aftercare and recovery success beyond FDC and CWS participation:
• Personal Recovery Plan – relapse prevention, relapse
• Peer-to-peer support – alumni groups, recovery groups
• Other relationships – family, friends, caregivers, significant others
• Community-based support and services – basic needs (childcare, housing, transportation),
mental health, physical health, medical care, spiritual support
• Self-sufficiency – employment, educational and training opportunities
• More frequent review hearings
• Judicial Oversight
• Responses to behavior
• Case Staffings
• Drug testing
Monitoring Cases
Responses to Behavior
Safety
• A protective response if a parent’s behavior puts the child at risk
Therapeutic
• A response designed to achieve a specific clinical result for parent in treatment
Motivational
• Designed to teach the parent how to engage in desirable behavior and achieve a stable lifestyle
Therapeutic Jurisprudence
• Engage directly with parents vs. through attorneys
• Create collaborative and respectful environments
• Convene team members and parents together vs. reinforcing adversarial nature of relationship
• Rely on empathy and support (vs. sanctions and threats) to motivate
Lens, V. Against the Grain: Therapeutic Judging in a Traditional Court. Law & Social Inquiry. American Bar Association. 2015
CHAPTER FIVE
Sustaining Your Program
Who collects data, where is it stored, who uses it, who “owns” the data,
levels of access
Assess effectiveness of system in achieving its
desired results or outcomes
Monitoring Outcomes
How do you know….. How will you…..
• How are families doing?
• Doing good vs. harm?
• What’s needed for families?
• Monitor and improve performance?
• Demonstrate effectiveness?
• Secure needed resources?
DataThe importance of
Data Dashboard
• What needles are you trying move?
• What outcomes are the most important?
• Is there shared accountability for “moving the needle” in a
measurable way, in FDC and larger systems?
• Who are we comparing to?
Developing a Funding Plan
• Negotiate with Participating Agencies
• Negotiate Directly with the City or County
• Network with Other Family Drug Courts in Your State
• Implement a Fee Schedule
• Build Relationships with Managed Care Organizations
• Apply for Federal Enhancement Grants
Creating a Legacy
Parents and their children can break free of intergenerational
substance use disorder patterns when they experience living in a
stable setting with concrete and emotional supports. By providing
access to these supports to participants, children, and families,
your new FDC shows parents alternative and stable ways of living
where they and their children can feel secure. With the help of
your new program, families can experience success—in social
interactions, academic pursuits, physical health, and specific tasks
of daily functioning.
Q&A and Discussion
Advancing the FDC Movement2017 Family DrugCourtTraining & Technical AssistanceResources
Build Evidence Base
Ensure Quality
Implementation
Expansion
of FDC
Reach
Family Drug Court National StrategicPlan
Vision:Every family in the child welfare
system affected by parental/caregiver substance use disorders will have timely access
to comprehensive and coordinated screening,
assessment and service deliveryfor family’s success.
www.cffutures.org/fdc@
Family Drug Court Learning Academy
www.cffutures.org@• Over 40 webinar presentations
• 5 Learning Communities along FDC development
• Team Discussion Guides for selected presentations
Family Drug Court Blog
www.familydrugcourts.blogspot.com@• Webinar Recordings
• FDC Resources
• FDC News
Discussion Guide Understanding Treatment
www.cffutures.org@
• For Child Welfare and Court
Professionals
• Build stronger partnerships with
treatment
• Ensure best treatment fit for
families
Family Drug Court Online Tutorial
• Self-pace learning
• Modules cover basic
overview of FDC Model
• Certificate of Completion
@ www.cffutures.org
2nd Edition – Research Update
Family Drug Court Guidelines
@ www.cffutures.org/fdc/
King County,
WA
Baltimore City,
MDJackson County,MO
Chatham County,
GA
Pima County,
AZ
Wapello County,
IA
Miami-Dade,FL
Dunklin County,
MO
Jefferson County,AL
Family Drug Court Peer Learning Court Program
Family Drug Court Orientation Materials
Discipline Specific
Child Welfare | AOD Treatment | Judges | Attorneys
@ www.cffutures.org/fdc
Measure the
Difference
You Are Making
Collaborate with Children and Family Futures to Design and Implement Your Evaluation
CFF is a leading provider of Research and Evaluation support to national,
state, and county efforts to address the needs of children andfamilies
For more information visit: www.cffutures.org/evaluation or
Resources
FREE CEUs!
NCSACW Online Tutorials Cross-Systems Learning
@ www.ncsacw.samhsa.gov/.org
Understanding Substance Abuse and Facilitating Recovery: AGuidefor Child Welfare Workers
Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals
Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals
Contact Information
Improving
Family
Outcomes
Strengthening
Partnerships
Advancing the FDCMovement2017
Jane Pfeifer
Senior Program Associate Children and Family Futures (714) [email protected]
Meghan M. Wheeler
Senior ConsultantNational Drug Court Institute (419) [email protected]