maria hernandez, m.s.w., omayra sellas-lamberty, m.a.,
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Maria Hernandez, M.S.W., Omayra Sellas-Lamberty, M.A., Stephanie H. Scott, Ph.D., A.C.S.W., M.S.S.W., . What is Cherish The Family (CTF) ?. The goal of CTF is :. - PowerPoint PPT PresentationTRANSCRIPT
Maria Hernandez, M.S.W., Omayra Sellas-Lamberty, M.A., Stephanie H. Scott, Ph.D., A.C.S.W., M.S.S.W.,
What is Cherish The Family (CTF) ?
The goal of CTF is:– to prevent the abandonment of children under age three who
are in the dependency system and who have been affected by substance abuse and/or HIV/AIDS.
– Targets mothers with children (0-3) engaged in the child welfare system
– Mothers confronting substance abuse and/or HIV/AIDs
– Complex needs with limited access to resources and supports that can help them
– Provide services to strengthen a parent’s ability to care for their children, specifically promoting family reunification and stability,
What are the theories behind CTF?
Theoretical FrameworksAttachment Theory:
• Kelly and Zucherman, 2003 stated “children GROW AND THRIVE in the context of close and dependable relationships that provide love and nurturance, security, responsive interaction and encouragement for explorations. Without at least one such relationship, development is disrupted, and the consequences can be severe and long lasting. …Focusing on the caregiver-child relationship is essential, not only because caregivers’ interactions with their children are developmentally critical, but also because qualities of these relationships need on going support.”
Theoretical frameworks continued…
• strengthening emotional bonds, maximizing children’s chances for optimal psychosocial development, and interrupting the transmission of maladaptive parenting practices across generations.
• Systems Approach– Viewing the whole structure of systems and the
interrelationships across systems
• Trans disciplinary Approach – Sharing roles against discipline boundaries
Staffing• 1 Program Director (Part-time)• 1 Program Manager• 4 Master Levels Counselors • 1 Data Entry/Administrative
Assistant
Training• Master Level professionals with at
least two years of experience with at risk families –HIV, mental Health issues, Substance Abuse.
• Experience with children 0-5• Counselors will be trained in
implementation of Mahoney, PSI, and NCAST.
• Trained in promoting first relationships curriculum.
• Solution-Focused Therapy techniques through Reflective Supervision
Services we offer …
• Therapeutic parenting by utilizing a solution focused approach with the Promoting First Relationships Curriculum
• Social emotional support• Increasing their awareness of SA issues,
and mental health issues• Multidisciplinary meetings• Court Testimony
CTF’s Approach• Collaboration with multiple
community providers– This allows for additional types of
visits such as extended visits, sibling visits, and visits at locations in the community
• Links families with – substance abuse to treatment– mental health services– job training and support
Partners
• ChildNet• Broward regional Health Planning Council• Spectrum• Smith Community Mental Health• Broward Addiction Recovery Centers (BARC)• Healthy Start Coalition of Broward County• Workforce one• The Ounce Prevention of Florida
Logic Model
Activities Short Term Outcomes Long Term Outcomes Measures
Cherish the Family:• Case Mgmt• Assessment• Family
Advocacy• Mental
Health Supportive Svcs
• Promoting First Relationships
• Teaching the Tough Skills
• Childcare• Circle of
Parents• Referral and
Follow-up
90% of participants (26 sessions) will report parenting behavior consistent with decreased risk of child abuse and neglect
Safety Outcome 1: Children are, first, and foremost protected from abuse and neglect
Children not reported in the DCF Abuse Registry (info provided every 6 mths by ChildNet)
85% of families (26 sessions) will reduce abuse, neglect, abandonment recidivism rates
Safety Outcome 2: Children are safely maintained in the home
N.C. Family Assessment Scale
Mahoney
Children are not removed from the home
80% of children will be placed in a stable, safe home at the completion of the program
Perm Outcome 1: Children have perm and stability in their living situations
Children are in home at 12 months
75% of parents will meet at least 75% of their IFSP goals
Perm Outcome 2: Continuity of family relationships and connections80% of participants will access support
services in the community
80% of parents will report healthy levels of engagement and self sufficiency
Wellbeing Outcome 1: Families have enhanced capacity
PSI
Logic Model Continued
Activities Short Term Outcomes Long Term Outcomes
Measures
Job Readiness Training
Technical Assistance for teachers at the
Child Care Centers
Community/System
80% of unemployed participants will participate in job readiness training
95% of teachers will apply knowledge of child development, parental attachment, and child needs in selecting activities for targeted children
To be determined
Wellbeing Outcome 1: Families have enhanced capacity
Participant attendance and certification
Wellbeing Outcome 2: Children receive appropriate services to meet their educational needs
Mahoney Behavioral Scale
To be determined Online Survey
Instruments
• Parenting Stress Index-Short Form
• North Carolina Family Assessment Scale-Reunification
• Mahoney Behavioral Scale
Parenting Stress Index-Short Form
• This measure is a brief version of the Parenting Stress Index
• Underlying Assumptions
– Could identify and diagnose individual parent-child systems under stress
• Child Characteristics– Parent’s perception of impact of child’s behavior on parent
• “At Risk Screening Tool”– Parent-child relationship could be a predictor of child’s later adjustment
Scales• Total Stress Score
– Primary score in guiding professional judgments as to whether professional intervention might be appropriate
• Parental Distress– Reflects a parent’s perception
of child-rearing competence, conflict with spouse, social support, and stressors associated with restrictions placed on other life roles
Scales
• Difficult Child– Surveys the parent’s view of the child’s
temperament, defiance, noncompliance, and demandingness
• Parent-Child Dysfunctional Interaction– Assesses a parent’s perception that the child
does not meet expectations and that interactions with the child are not reinforcing
North Caroline Family Assessment Scale- Reunification (NCFAS-R)
• Introducing the NCFAS-R– Assessment and measurement of
family functioning in family based child abuse and neglect prevention/intervention programs.
– A worker administered rating scale– Provides pre and post measurement of
families that are served by family-based services providers
Scoring• Each subscale is rated using a 6-point Likert-type
scoring strategy• Each item is scored as follows:
– +2 = Clear Strength– +1 = Mild Strength– 0 = Baseline/Adequate– -1 = Mild Problem– -2 = Moderate Problem– -3 = Serious Problem
Mahoney Maternal Behavior Rating Scale (MBRS)
• An observational instrument designed to assess the quality of observed parent-child interactions
• Evaluates the quality of maternal interactive behaviors
• Consists of a 10-minute video tape interaction between the parent and child
MBRS– 12 items utilize a 5-point Likert Scale which differ for
each domain– 4 domains
• Responsiveness• Affect• Achievement• Directiveness
Subscales
• Responsiveness– Sensitivity to child’s interests: Parent seems
aware and understands the child’s activity or play interests
– Responsivity: Appropriateness and consistency of the parent’s responses to the child-facial expression and signs of discomfort.
– Effectiveness: Ability to engage child in play interaction
Subscales• Affect
– Acceptance: Approval of child and child’s behavior
– Enjoyment: Parent’s enjoyment interacting with the child
– Expressiveness: Tendency of caregiver to react emotionally toward the child
– Inventiveness: Range of stimulation parent provides to his or her child
– Warmth: Holding, caresses, kisses, hugs, tone of voice, and verbal endearments
Subscales• Achievement Orientation
– Achievement: Encouragement of sensorimotor and cognitive achievement
– Praise: Amount of verbal praises
• Directive– Directiveness: Frequency and intensity of
parent’s requests, commands, or attempts to direct child’s immediate behavior
– Pace: Parent’s rate of behavior, regardless of child’s rate
Demographic Findings
• 76 CTF Participants• 69 in comparison group
CTF Participant ages
Comparison Group Ages
Education• There are a variety of
education levels in both groups
• CTF participants have higher levels of education.
North Carolina Family Assessment Scale-Reunification
• Child wellbeing was found to be statistically significant at both time 1 and time 2 – treatment group having significantly better
scores than the control group. • Both groups made positive gains between
the three data points– most notable gains were family safety, child
wellbeing, and readiness for reunification
North Carline Family Assessment Scale-Reunification
– 1= clear strength– 2= mild strength– 3= baseline/adequate– 4= mild problem– 5= moderate problem– 6= serious problem– 7= not applicable– 8= unknown
Domain Treatment (Time 1)
Control (Time 1) Treatment (Time 2)
Control (Time 2)
Treatment (Time 3)
Control (Time 3)
Environment 3.76 3.79 3.20 3.00 2.85 5.54
Parental Capabilities 4.48 4.13 3.45 2.95 2.51 2.58
Family Interaction 3.74 3.93 3.17 3.12 2.55 2.71
Family Safety *3.38 4.02 2.52 3.00 2.58 2.39
Child Wellbeing *3.92 4.21 *3.08 3.68 2.30 3.28
Caregiver/Child Ambivalence 3.84 3.81 3.25 3.06 2.67 2.56
Readiness for Reunification 4.69 4.75 3.58 3.17 3.02 2.52
Parenting Stress Index-Short Form
• Scale– 1=low stress (1-15 percentile)– 2=normal (16-60 percentile)– 3= Borderline stress (81-84 percentile)– 4= Clinically Significant (85 and above)
• It is noteworthy that the scores below decreased indicating that parents demonstrated improvements in the areas of feeling healthier and a reduction in overall stress.
Defensive Responding
Total Stress
Parental Distress
Dysfunctional Interaction
Difficult Child
Category 1 Category 2 Category 30
5
10
15
20
25
30
Clinically SignificantNot Clinically Significant
Maternal Behavior Rating Scale• Rating Example
– 1=highly inexpressive– 2=low overt expressiveness– 3=moderate overt
expressiveness– 4=overtly expressive– 5=highly expressive
Domain Time 1 (Intake)
Time 2 (6-Months)
Responsiveness/ChildOriented
2.67* 3.29*
Affect/Animation 2.77 2.96
Achievement Orientation 1.93 2.04
Directive 2.82 2.64
Maternal Behavior Rating Scale
Qualitative look at CTF
• Maternal behavior– Before and after
Strengths
• Small case loads- 12 families which provide an opportunity to work closely with family (engagement- support- and all the therapeutic services).
• Promotes fair opportunities for parents to be reunified with their children through referrals and one on one support.
• Systemic approach to problem solve issues the parent and family faces.
• A solution focused approach that allows the family to strengthen and build their strengths.
• Ensures effective coordination of services to support the family (providers-foster placement and child advocate).
• Families feel they are learning, and the support received has helped them to increase awareness, communication, and achieve their goals (remain engage in case plan.)
• The program has provided financial support to families that have reunified.
• The program has facilitated payment for services such as psychological evaluations, and individual therapy.
In my words ….• “It’s nice to have someone support
me and look at me in a positive light. The court looks at me like I’m a bad person so it’s nice to have at least one person on my side.” (Cherish the Family Participant)
• “If I was by myself, I wouldn’t think I would get my children back. Because I have someone helping me through this, I’m hopeful that I will get my kids back. Now I look at things more positive. Before, I was very negative and felt alone.” (Cherish the Family Participant)
• “I feel like I have someone on my side, helping me through this process.” (Cherish the Family Participant)