introducing family connections - new york€¦ · 1 outline for today •how was the model ......
TRANSCRIPT
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What is Family Connections?
introducing
Family ConnectionsDiane DePanfilis, Ph.D., MSWFamily Connections Developer
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ImplementationStaffing, supervision, training, fidelityassessment, implementation support5
OUTCOMESIntermediate and Final Outcomes4
TARGET POPULATIONRisk of maltreatment and/or out-of-home placement, Families withchildren Birth to age 18
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CORE COMPONENTSIntake, Outreach, Concrete Needs, FamilyAssessment, Outcome Driven ServicePlanning, Change Focused Intervention,Evaluation of Change, Service Termination
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OVERVIEW
• History• Underlying Philosophy
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OUTLINE for Today
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• How was the model developed?
Home & Community Based Social Work Practice Model
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Interdisciplinary & Consumer Involvement
Implementation Science
Intervention Research
Prevention Science Conceptual Framework forDevelopment
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History of Family Connections
*Federal Demonstrations
-OCAN-SAMHSA
*FederalSupported
Replications*SAMHSA support to
develop TA-FC
*Rated as Promising Practice
*Special Issue of Protecting Children
*JBA Final Report*Implementation
in CA, MD, MI, NJ, TX
*Major implementations in NYC & Florida
*Numerous papers published
*Studies on implementation*Reflection on what supports
are essential for implementation
1996-2002
*Expansion of QA capacity by
replicating sites
*Data sharing
2003-20092010-2012
2013-20142015-2016
2017-2019
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Theories that Guide The Intervention
• Psychosocial Theory• Problem-Solving Theory• Life Model Theory• Crisis Theory• Systems Theory• Role Theory• Cognitive Theory
• Empowerment Approach
• Trauma Theory• Attachment Theory• Trans Theoretical Model
of Change
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CulturalCompetence
EcologicalDevelopmental
Framework
Empowerment &Strengths BasedPractice
CommunityOutreach
Philosophical Principles
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Practice Principles
Philosophical
Focus onPractitionerFamily
Assessment& Tailored
Intervention
Outcome Driven PlansWith SMARTGoals
HelpingAlliance
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Core Components
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Family Connections (FC)
• FC Core Components– Intake– Outreach & engagement– Concrete services– Comprehensive family
assessment (assessment instruments)
– Outcome driven case plans with SMART goals
– Change focused intervention• Direct facilitation of change• Advocacy/service facilitation
– Evaluation of Change(at least every 90 days)
– Case Closure
Is a multi-faceted community-based program that works with vulnerable families in their homes, in the context of their neighborhoods, to help them meet the basic needs of their children and prevent child maltreatment.
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Outreach & Engagement•Within 1 business day CP conducts face to face visit
with family
2nd
CASI
Comprehensive Family Assessment (CFA)
•30-45 days from signing for services
Outcome Drive Service Plan w/SMART goals
•14 days after completion of CFA
Emergency & Concrete Services
•Ongoing Assessment throughout life of services
Change Focused Intervention
•Facilitation of Change•Advocacy/service
facilitation
Service Plan Evaluation•Evaluation of Change
form completed 90 days after service plan
Intake•Complete Intake &
Screening Form
CASI•2nd-3rd visit
Administer 3rd CASI if needed•2nd Evaluation of Change
form
Negotiate new Service Plan with family
Case Closure•Complete 7 point case
closure
Case Closure•Complete 7 point case
closure
Family Connections Flow Chart
Achieved
Insufficient change
Comprehensive Family Assessment Process CFA Product
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• Target Population
Families with children from birth to age 18 at risk of maltreatment and/or placement
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Outcomes
Child & Family, Program
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Original Logic Model - Family Connections
Inputs
Diverse Funding
Eligibility Criteria and
Referral Procedures
Trained &Supervised
Staff
InterventionManual
Intermediate Outputs
Emergency Assistance
Comprehensive FamilyAssessment
SMART Case Plan
Change Focused Counseling & Advocacy
Case Plan Evaluation
FinalOutputs
Number offamilies
who complete services
Short-Term/ Intermediate Outcomes
Increase Protective Factors
• Parenting Attitudes• Parenting Competence• Social Support
Decrease Risk Factors
• Life Stress• Parenting Stress• Parental Depressive
Symptoms
Long-Term Outcomes
Increase childsafety
Increase childwell-being
Increase childpermanency/
stability
Intake,Outreach/Engagement
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Summary Results: Risk Factors
• Comparing all caregivers baseline to 6 months post intervention, significant reduction in:
ü Risk FactorsüCaregiver depressive symptoms
üParenting stressüLife stress
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Summary Results: Protective Factors
• Comparing all families baseline to 6 months post intervention, significant increase in:
üProtective FactorsüParenting attitudes
üParenting satisfactionüSocial support
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Summary Results: Child Safety
• Significantly Improved: Physical Care– Household furnishings
– Overcrowding– Household sanitation
• Significantly Improved: Psychological Care– Mental health care
– Caregiver teaching stimulation of children
• Fewer CPS reports & CPS indicated reports
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Summary Results: Child Behavior
• Comparing all families baseline to 6 months post intervention,
significant decrease in:
ü Total behavior problemsüInternalizing behavior problemsüExternalizing behavior problems
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Replication of Family Connections
• Formal replication in 8 sites in the U.S. with support from the U.S. DHHS Children’s Bureau
• Cross-site evaluation of implementation process, fidelity, cost, & outcomes
Snapshots of findings abstracted from: James Bell Associates, Inc. (2011, September).National Cross-Site Evaluation of the Replication of Family Connections: Final EvaluationReport. Submitted to the Office on Child Abuse and Neglect, Children’s Bureau, ACYF, ACF, HHS
Conducted by James Bell Associates (JBA)
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Summary Outcomes: Change Over Time
• Significant improvement in Risk Factors– Decreased caregiver depressive symptoms (CESD)– Decreased parenting stress (PSI)
• Significant improved child well-being– Decreased scores on children’s externalizing and
internalizing behaviors (CBCL)
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Summary Outcomes: Change Over Time
• Significant improvement in Protective Factors– Appropriate Nurturing & Parenting Attitudes
(AAPI) - higher scores on 5 sub-scales: Developmental Expectations, Empathy, Corporal Punishment, Role Reversal, and Power Independence
– Social Support (SFS) – decreased need for support in the areas of emotional support, daily living, and child rearing
– Family Functioning (FAF) – improved family functioning scores
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Moderating Effect of Fidelity
• Families at sites with higher fidelity scores on program structure reported significantly greater reductions in parenting stress, caregiver depressive symptoms, and need for support.
• Families at sites with higher philosophical principle fidelity scores showed less need for social support over time and decreases in the number of critical dimensions of family functioning.
• Families at sites with higher administrative activities fidelity scores demonstrated greater reductions in child internalizing behaviors and improvements in parental attitudes but less improvement on family functioning.
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Implementation Supports
Staffing, Supervision, Length of Service, Training, Fidelity Monitoring, Implementation Collaborative
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STAFFING
SUPERVISION
LENGTH of SERVICE
TRAINING
FIDELITY
Implementation
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Local Capacity
National Coordination
CombinedResources
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ACTION for Child Protection staff and consultants provide training, technical assistance, and implementation support.
Each replication is individualized and tailored