parent support & training (pst)...
TRANSCRIPT
1
Tools for
Parent Support & Training (PST) Best Practices
A training manual for community mental health team implementation of the PST Best Practices Protocol
2
Acknowledgements
We are grateful to numerous stakeholders within the Kansas children’s mental health system who contributed to development of the Kansas Tools for Parent Support and Training (PST) Best Practices.
Significant credit goes to all of the PST providers who shared their expertise and wisdom over the years on providing parent support.
We are appreciative of all families who shared their experiences as recipients of the service, thus providing a crucial perspective that helps new service providers understand how PST best practices are experienced by families in real life.
We are especially indebted to Pam McDiffett of the Kansas Department of Aging and Disability Services-Behavioral Health Services (KDADS-BHS) for her support as a committed advocate for this project.
We are grateful to members of the Kansas Unified Training Advisory Group (UTAG), Kansas Children’s Training Advisory Group (TAG), Kansas CBS Directors, and the Wichita State University Technology and Training Team (T3) for freely sharing their time and talent.
We thank KU School of Social Welfare colleagues Rick Goscha, Monika Eichler, Ally Mabry and Mary Lee Robbins for feedback and guidance on the development of implementation materials and procedures.
Last but definitely not least, we are thankful for KU School of Social Welfare Associate Dean Tom McDonald for his patience, guidance, and support for the last few years on the project.
With many thanks to all! The KU School of Social Welfare PST Training Team: Kathy Byrnes, Sharah Davis-Groves, Lori Daly, and April Patton.
Cover Picture: Kid's Training Team. (2007). The Ideal PST [Photographs]. Wichita, KS: Wichita State University, Training & Technology Team. Reprinted with permission.
3
Table of Contents
Acknowledgements ....................................................................................................................................... 2
About the Trainers ........................................................................................................................................ 4
1. Introduction .......................................................................................................................................... 5
2. History & Development of PST Services in Kansas ............................................................................... 7
3. What is Family Driven? ....................................................................................................................... 11
4. The PST Code of Ethics ........................................................................................................................ 13
5. Development of the PST Best Practices Service Model ...................................................................... 16
6. Theory of Change for the PST Best Practices Service Model .............................................................. 18
7. PST Best Practices Protocol Basics ...................................................................................................... 22
8. Protocol Section I: Referral Process/Understanding Needs of Families ............................................ 25
9. Section II: Initial Engagement and Immediate Priorities ................................................................... 29
10. Protocol Section III: PST Interventions............................................................................................... 31
11. Individualizing the PST Best Practices Protocol .................................................................................. 33
Online Training Wrap-Up ............................................................................................................................ 35
Section I: Referral Process/Understanding Needs of Families ................................................................... 42
Section II: Initial Engagement and Immediate Priorities............................................................................ 47
Section III: PST Interventions ..................................................................................................................... 53
References .................................................................................................................................................. 61
4
About the Trainers
Kathy Byrnes
Sharah Davis-Groves
Lori Daly
April Patton
Kathy has extensive experience within the Kansas children’s public mental health system as a provider, researcher and family member. She has worked at the University of Kansas School of Social Welfare for the past 7 years as a Project Coordinator and trainer/consultant, with particular focus on developing, implementing and evaluating the Kansas Parent Support & Training (PST) Best Practices Service Model. Previously, Ms. Byrnes provided PST services for 7 years at a Kansas community mental health center. Ms. Byrnes has also worked as a therapist in child welfare and healthcare settings. Her research interests include family driven/youth guided systems of care; and community-based participatory research.
Sharah is a Project Manager at the University of Kansas, School of Social Welfare in Lawrence Kansas. She has worked in many capacities throughout her social work career as program evaluator, consultant/trainer, and home visitor. Sharah’s professional research experiences for the past 11 years at the School of Social Welfare have focused on managing a variety of research projects that evaluate and promote family-driven, children’s mental health policies and services. For the past 7 years, her research and development efforts have focused on defining and supporting the expansion of effective Parent Support and Training Services in Kansas.
Lori is a Technical Assistance Coordinator for the KU Parent Support Study, School of Social Welfare, and Children’s Mental Health. Lori provides extensive experience collaborating with community partners to connect important resources for families seeking assistance. Lori has been involved for over 20 years providing a wide range of services including, Targeted Case management, Wrap around facilitation, Employment specialist support for those enrolled in the Workforce Investment Act. Lori’s most recent experience comes from providing Parent Support and Training services to families in South Central Kansas.
April has been involved in the human services field since 1986, working primarily in the field of developmental disabilities first as a Direct Care Professional then as a Case Manager until she began working as a Parent Support Specialist in south central Kansas 5 years ago. April has 8 years’ experience as a therapeutic foster care provider to many SED children. She has parental experience with navigating the foster care and mental health systems and advocating for the educational, medical and social needs of children with special needs. She is very excited about family driven care as she has a sister who receives services as well. April has been a longtime advocate for those with special needs as a sibling, parent and provider.
5
1. Introduction
The PST online and live trainings were developed by the University of Kansas School of Social Welfare PST Training Team. We're excited to have this opportunity to work with you! We look forward to supporting you on your road to becoming an expert PST service provider. Our goal for the Parent Support and Training (PST) training is to prepare you to provide PST services effectively to families through your community mental health center (CMHC). The training is required so your CMHC can be reimbursed by Medicaid for the PST services you provide. The Kansas Department of Aging and Disability Services-Behavioral Health Services (KDADS-BHS) contracts with us (KU School of Social Welfare) to conduct this training. Implementing the best practices of PST services will occur in 3 phases:
Phase One: Online Training
Pre-requisite to live training
Available on the Training Teams website, www.trainingteams.org
Must be completed within 60 days of the service start date* when you began providing PST services
Phase Two: Live Training
Apply after completion of online training
Conducted in partnerships with Kansas CMHCs
Must be completed within 1 year of service start date* Phase Three: Field Mentoring & Coaching
Conducted in partnership with Kansas CMHCs
Provide bi-monthly statewide technical assistance conference calls
Provide individualized supports via email, conference calls, and/or onsite visits as requested by individual CMHCs
Conduct onsite implementation (fidelity) reviews
*KDADS-BHS requirement associated with this service All three training phases for PST will show you how to put into practice a structured service model containing the Best Practices of PST.
6
The trainings will show you how to:
Engage families effectively in PST services
Get the best PST results (outcomes) possible with families
Meet standards set by the Medicaid definition of PST service If you already have experience providing mental health services to youth and families, some things covered in training may be familiar. In that case, the training should reinforce your skills. If you are new to providing mental health services to youth and families, you will be exposed to new information and concepts. We encourage you to pace yourself through the training. Take your time. Before starting the KU PST Basic Online Training, you should have completed 2 online trainings offered by Wichita State University on the Training Teams website:
Basics of Community Based Services for Youth (1 course)
CBS-CSS Core (8 courses) You took a pre-training quiz at the very beginning of this online course. A post-training quiz is included at the end of the course. Activities that reinforce your learning follow each lesson in the course. The post-training quiz is included make sure you understand specific background information about the PST Best Practices Service Model. __ CEU credits are available upon successfully passing the post-training quiz. The quiz questions are multiple choice. You are encouraged to contact the PST Training Team at any time during this training that you have questions or need assistance. We are here to provide technical assistance and support so you can have a successful training experience. We can be reached at [email protected].
You’re ready to begin the PST Basic Online Training!
7
2. History & Development of PST Services in Kansas
Prior to the 1980s, child-serving professionals tended to blame caregivers for their children's mental health-related problems. In the 1980s, a paradigm shift occurred where caregivers began to be considered as valuable and necessary members of their children's mental health treatment. This shift greatly influenced future development of mental health services for children and their families. In 1993, five CMHCs in southeast Kansas applied for a federal grant to develop a system of care for families of children with serious emotional disturbance (SED).
Community Mental Health center of Crawford County
Family Life Center (now Spring River Mental Health and Wellness)
Four County Mental Health Center
Labette Center for Mental Health Services
Southeast Kansas Mental Health Center The group's first grant application was not awarded due to lack of family involvement and input in the grant planning process. The second grant proposal was awarded after families were invited to be involved in the planning and development of the project, with help from leading family member Barbara Huff. The project was named KanFocus. (A Kansas Department of Social and Rehabilitation Services (SRS) Press Release about the KanFocus project is located at the end of this lesson on page 9.) Families at a KanFocus grant planning meeting facilitated by Barbara Huff described what they needed from mental health services, which included:
Someone to talk to who will understand and listen.
Someone to provide support at court, school and other meetings.
Most importantly, that the person providing support be a parent who has walked in their shoes.
A parent-to-parent support service was crafted from this information to meet the needs that families described. The PST service role became part of KanFocus, which established a model for a system of care in Kansas children's mental health services.
8
KanFocus data was then used to secure funding to expand community based services in Kansas.
The Medicaid Home and Community Based Services, Serious Emotional Disturbance (HCBS-SED) Waiver Program was established in 1997.
Family Centered System of Care grants to Kansas CMHCS in 1999. PST services became a billable service on the new HCBS-SED Waiver. Also, Family Centered System of Care grants provided for hiring of PST providers at each Kansas CMHC.
Many of the CMHC staff involved in the KanFocus project still work in Kansas CMHC children's community-based
programs today!
Kansas SRS - 10/6/00 Press Release
http://replay.waybackmachine.org/20050208110739/http://www.srskansas.org/SRSPress/2000/10600.htm[9/24/2010 3:20:45 PM]
October 6, 2000 - KanFocus project in Southeast Kansas cited byfederal government for "going beyond funding obligations" by usingdata findings to improve services
A report issued by the federal Center for Mental Health Services has recognized theKanFocus project in Southeast Kansas as one of the most successful in the country inusing data evaluation findings to improve services to children and families. The KanFocusproject, which began in 1994, provides mental health services to children with severeemotional disturbance and their families.
Originally funded by the federal government, KanFocus is one of six projects nationwiderecognized for "going beyond their funding obligations in the use of data-drivenevaluation reports to become true data-driven systems," according to the report. Thereport is intended to take an in-depth look at how six programs used data to "stimulatechange and to manage, improve, and sustain services."
The recognition was especially important because of the historic difficulty of using dataand outcome measures to determine best methods for providing service in the field ofsocial service. Department of Social and Rehabilitation Services Secretary JanetSchalansky said SRS and private, not-for-profit mental health agencies in Kansas havelearned a lot about how to use data to improve services for children and families fromKanFocus.
"The KanFocus project, with its commitment to gauging the effectiveness of local servicesthrough data analysis, has helped us as an agency improve services to children andfamilies," Secretary Schalansky said. "We have been able to show that when childrenreceive community-based services, when there is collaboration at the local level andfamilies are involved, children get better. We were only able to show that by coming upwith good data."
In the federal report, called "System of Care, Promising Practices in Children’s MentalHealth", the authors pointed to the problem faced by social service systems.
"Providers and evaluators of mental health services to children and their families areoften challenged by the task of translating evaluation findings into clear and meaningfulreports that can illustrate the resources, gaps, expenditures, and outcomes of theirprograms."
But they say the six programs identified in the report, including KanFocus, show thatdata can be used to improve services.
The report says: "The major ‘take-away’ messages of these evaluation reports have been(a) outcome information can be a powerful catalyst for changing and developing
AUG FEB JUL
82003 2005 2008
16 captures8 Mar 01 - 5 Jul 08
Close
Help
Kansas SRS - 10/6/00 Press Release
http://replay.waybackmachine.org/20050208110739/http://www.srskansas.org/SRSPress/2000/10600.htm[9/24/2010 3:20:45 PM]
programs; (b) data are pivotal to improving individualization and effectiveness of servicedelivery; and (c) evaluation can provide compelling evidence of accomplishments tosupport sustainability and to build an evaluation culture."
Laura Howard, assistant secretary of Health Care Policy for SRS, also said the servicemodel used by KanFocus in serving families with children who have serious emotionaldisturbance should be praised. She said the concept of "wrapping" services aroundfamilies through interagency coordination -- along with an emphasis on parentalinvolvement -- made it possible for many children to remain in their communities andwith their families.
"The KanFocus model, along with the positive outcome data provided, was instrumentalin the Kansas Legislature’s decision to allocate $5 million in grants to the communitymental health system statewide," Howard said. The statewide grant program is called theFamily Centered System of Care.
Headquartered in Parsons, KanFocus serves about 3,000 youths and families in a 13-county rural area of southeast corner of Kansas. Jim Rast is the KanFocus Site Director.There are five mental health centers that cover the region and are involved in the project.These are Four County Mental Health Center, Labette Center for Mental Health Services,Southeast Kansas Mental Health Center, Family Life Center, and Community MentalHealth Center of Crawford County.
Feedback | Search
Home | Services | Locations | Publications | Career Center | About Us
Page Last Updated: May 29, 2001
11
3. What is Family Driven?
The National Family Movement in Children’s Mental Health began in the 1980s when the paradigm shift occurred (described in Lesson 2). As the KanFocus project was taking off, Barbara Huff left Kansas to help establish the Federation of Families for Children’s Mental Health (FFCMH), a national family-run organization for families of children with serious emotional disturbance. FFCMH drafted and introduced a Definition of Family Driven Care and its 10 Guiding Principles. (An FFCMH document with full description of each is located at the end of this lesson on page 12.) The FFCMH defines family-driven as families having a primary decision-making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory, and nation. This includes:
Choosing culturally and linguistically competent supports, services, and providers.
Setting goals.
Designing, implementing, and evaluating programs.
Monitoring outcomes.
Partnering in funding decisions. In brief, the 10 guiding principles of family driven care are:
1. Shared decision making process. 2. Families have accurate information. 3. Family voice is assured. 4. Peer support is offered to decrease isolation/build connection. 5. Provide direction for funding decisions. 6. Providers take steps to promote Family Driven Care. 7. Administrators support with resources, staff, and time. 8. Removes barriers and discrimination created by stigma. 9. Culture is celebrated and mental health disparity is decreased. 10. Culturally responsive and reflective.
Working Definition of Family-Driven Care January 2008
National Federation of Families for Childrens Mental Health Child, Adolescent and Family Branch 9605 Medical Center Drive, Suite 280 Center for Mental Health Services Rockville, MD 20850 1 Choke Cherry Road (240) 403-1901 www.ffcmh.org Rockville, MD 20857 (240) 276-1980
Definition of Family-Driven Care Family-driven means families have a primary decision making role in the care of their
own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes:
Choosing culturally and linguistically competent supports, services, and providers; Setting goals; Designing, implementing and evaluating programs; Monitoring outcomes; and Partnering in funding decisions.
Guiding Principles of Family-Driven Care 1. Families and youth, providers and administrators embrace the concept of sharing
decision-making and responsibility for outcomes.
2. Families and youth are given accurate, understandable, and complete information necessary to set goals and to make informed decisions and choices about the right services and supports for individual children and their families.
3. All children, youth, and families have a biological, adoptive, foster, or surrogate family voice advocating on their behalf and may appoint them as substitute decision makers at any time.
4. Families and family-run organizations engage in peer support activities to reduce isolation, gather and disseminate accurate information, and strengthen the family voice.
5. Families and family-run organizations provide direction for decisions that impact funding for services, treatments, and supports and advocate for families and youth to have choices.
6. Providers take the initiative to change policy and practice from provider-driven to family-driven.
7. Administrators allocate staff, training, support and resources to make family-driven practice work at the point where services and supports are delivered to children, youth, and families and where family and youth run organizations are funded and sustained.
8. Community attitude change efforts focus on removing barriers and discrimination created by stigma.
9. Communities and private agencies embrace, value, and celebrate the diverse cultures of their children, youth, and families and work to eliminate mental health disparities.
10. Everyone who connects with children, youth, and families continually advances their own cultural and linguistic responsiveness as the population served changes so that the needs of the diverse populations are appropriately addressed.
13
4. The PST Code of Ethics
The Kansas PST Code of Ethics was developed by the Kansas Statewide PST Network* when they formed in 2001. It represents standards of conduct designed to clarify the role of parent-to-parent PST providers as professional service providers. The Code of Ethics was helpful for parent-to-parent PST providers during the early days of PST services when CMHC staff and parents transitioned from traditional provider-consumer roles to those of colleagues. It was a time of great change for all. PST services in Kansas have changed over the years since their development in KanFocus. All CMHCs still offer PST services. However, not all PST providers are parents/caregivers of children with SED or special needs. Despite this change, the PST Code of Ethics remains relevant, regardless of PST provider personal experience. The PST Code of Ethics covers the following topics:
Standards of Conduct
Dual Relationships
Confidentiality
Boundaries
Respect and Rights of Others
Conflict of Interest The full content of the PST Code of Ethics follows below with the Standards of Conduct section. You have already completed the Training Teams core course of Ethics where these topics were discussed for all CBS providers. Information in this section will reinforce these ethics concepts--particular as they relate to providers of PST.
Standards of Conduct Standards for conduct are designed to clarify the role of the PST providers who are employed to assist other parent/caregivers to inform, educate and support them in accessing CMHC *More on the Kansas Statewide PST Network later in the training.
14
services, parenting education and community services appropriate in their efforts to meet the needs of their child with behavioral/mental health issues. The ethical standards apply to work-related activities of the PST providers from conducting initial interviews through the role they perform in helping CBS client parents cope with the added stresses they are facing. These roles include:
Broadening the parent/caregiver knowledge of behavior, which includes teaching the parent/caregiver what age appropriate behaviors are for their child.
Provide knowledge and support to the caregiver/parent(s) so they may make informed choices concerning CMHC services, educational rights, benefit programs and community involvement.
Respect and protect human and civil rights while also showing caregiver consideration of cultural diversity and family differences.
Seek competent advice from appropriate sources when anticipating and facing ethical dilemmas.
Boundaries PST providers strive to maintain high standards of competence in their work and recognize the limitations of their expertise. PST providers provide only those services for which they are qualified for through educational training and personal life experiences. PST providers attempt to clarify their roles, to represent the best interest of the client, in performing appropriately in accordance with their job description. PST providers have respect for the fundamental rights, dignity and worth of all people. PST providers show sensitive regard for the moral, social and religious standards of clients and communities. PST providers avoid imposing their beliefs on others although they may express them when appropriate in the process of relating the coping skills they have learned as the parent/caregiver of a seriously emotionally disturbed (SED) child.
Dual Relationships PST providers avoid improper and potentially harmful dual relationships. They recognize the boundaries between client and friend and do not bring client relationships into social interaction. When meeting a client or client family in a social setting the PST provider will not divulge the nature of the acquaintance to others. If the client does so, the PST provider does not expound on that subject area.
15
Respect and Rights of Others PST providers respect the rights of individuals to privacy, confidentiality, self-determination and autonomy. They are mindful of individual, role and cultural preferences and differences; including age, gender, race, ethnicity, national origin, religious, sexual orientation, disability, language and socioeconomic status. PST providers do not knowingly participate in or condone discriminatory practice. PST providers seek to contribute to the betterment of those they serve respecting the parent's right to choose what they deem most beneficial for their child and family. PST providers train and encourage parents to advocate for their child to gain the best outcomes possible from their child's education and service providers. PST providers maintain a current knowledge of community resources and an ongoing rapport with service providers so they may make referrals and suggest resources pertinent for answering specific family needs.
Confidentiality PST providers respect the confidentiality of client information and the client's right to privacy. PST providers are cognizant of legal responsibilities and other obligations that may lead to conflicts in the exercise of client rights. PST providers comply with the law and policies of their workplace. All communications from and pertaining to clients are treated with professional confidence, stored in a secure manner and only the first names are used when relating to the client in supervision or consultation. No information is disclosed to anyone, except as mandated by law, to prevent a clear and immediate danger to self or others.
Conflict of Interest PST providers refrain from accepting goods, services and other remuneration from clients in return for services because such arrangements create inherent potential for conflict, exploitation and distortion of the professional relationships. PST providers are careful to represent facts truthfully to clients' benefit and referral sources and not misrepresent any available services. PST providers may not represent an immediate member of their own family in their professional capacity as it would limit the parent's ability to be objective in securing needed services for their child and could compromise them professionally and ethically.
16
5. Development of the PST Best Practices Service Model
Mental health service providers can deliver effective, high-quality service like PST when training is based on a structured model that clearly describes how to implement the service. Training to provide a service according to a model ensures providers receive the basic recipe and ingredients needed to achieve desired results (outcomes) with their clients. A well-defined model for Kansas PST services was established in 2010 following an extensive research process. The model includes practices that a broad group of people with an expertise in PST services (stakeholders) said are the most important for providing effective PST services. The group included:
Families who received PST services & family advocates
PST providers
CMHC staff (providers & administrators)
State level mental health administrators The step-by-step process that was carried out by researchers at the KU School of Social Welfare to develop the PST Best Practices Service Model included:
1. People with an expertise in PST services (stakeholders) were interviewed about what they considered to be the Best Practices associated with PST services.
2. The interviews were analyzed and a list generated of the Best Practices identified most
frequently by stakeholders.
3. A large group of stakeholders from across the state who had experience with PST services were then invited to rate each Best Practice on:
how important it is to effective PST practice
how frequently they had observed it in real life
4. Results of the ratings provided a statewide consensus (agreement) on those Best Practices considered most important for delivering effective PST services.
5. The final step involved constructing a PST Best Practices Protocol, an instructional
manual that describes how to carry out the Best Practices of effective PST practice identified through the statewide consensus process.
Next, implementation of the PST Best Practices Protocol was piloted across teams of children’s community-based service providers at four CMHCs in 2011.
17
The four CMHCs were selected based on interest expressed by their children’s community-based program directors. The children’s community-based teams were able to implement the protocol with a high level of fidelity (accuracy). Results indicated that the PST Best Practices Protocol is ready for statewide implementation. Several of the lessons that follow introduce you to the PST Best Practices Protocol.
18
6. Theory of Change for the PST Best Practices Service
Model A theory of change describes how interventions like the PST Best Practices Service Model influence results (outcomes) of people receiving the intervention. Understanding the theory of change for an intervention is important because it drives effective program implementation and evaluation. The theory of change for the PST Best Practices Service Model is that effective family engagement in PST services results in:
Increased caregiver engagement
Increased effective caregiving
Increased family empowerment
Decreased caregiver strain
Increased social support
Increased home stability
Effective Family Engagement The first tasks of a PST provider are to:
Spend time getting to know parents.
Help parents feel comfortable.
Establish trust. Families often are guarded about themselves due to the effects of stigma associated with parenting a child with SED. A PST provider seeks to gain parents' trust by listening, more than anything else, as he or she gets to know parents in order to appreciate where they are coming from. A PST provider works to understand parents' concerns, priorities and needs related to parenting their children. During this initial engagement time, a PST provider who has lived the experience of parenting a child with SED may share this in an effort to build trust. Development of a trusting relationship with parents lays the foundation for a successful PST intervention. Increased effective family engagement results in:
Increased Caregiver Engagement
Increased Family Empowerment
Increased Effective Caregiving
19
As trust develops, the PST provider increases engagement by offering to walk alongside parents at they participate in their children's treatment. This approach provides on-the-spot opportunities for the PST provider to empower parents and increase effective caregiving by offering relevant information and strategies as events unfold. By attending meetings (e.g., wraparounds, IEPs) with parents, the PST provider is able to help parents understand and advocate for the right services to help their children. The PST provider ensures that treatment plans, goals and crisis plans make sense to parents. The PST provider is able to do this by ensuring that goals accurately reflect what parents say they need and coaching parents about ways to be involved. The PST provider conveys a sense of possibility by providing examples of how other parents have successfully been involved. The PST provider shares others' stories to illustrate ways to overcome parenting challenges. According to some parents, PST providers have been especially helpful when educating them on how to handle a crisis that puts the child at risk for out-of-home placement. The PST provider coaches parents on utilizing the crisis plan and describes crisis management skills other families have used. Also, the PST provider coaches parents on working with other team members in a crisis. As parents feel more hopeful, empowered and supported, they are ready and motivated to try new parenting strategies and coping skills for themselves and their families. An example of how family empowerment occurs:
"You are constantly being bombarded with information from your case manager and your therapist and your school. Sometimes it's overwhelming. I go to my parent support and ask her what she thinks. I'll lay it out. In my mind it's sometimes scrambled. So I come to her when I'm really confused. I'm like I don't understand this. Help me. I'll lay it out and she's the one that helps me understand it. She's the one that pushes me sometimes to even well, yeah, that's a good plan and I heard that too, but why don't we ask for this and this, too, to help get to the goal? And we could go to the goal if we go this way. This is a shortcut to the goal. So I've got somebody there thinking for me and with me."
--Caregiver who received PST services
20
Decreased Caregiver Strain With new strategies in place, a greater sense of empowerment, and the trusted support of PST providers, parents begin to feel less strain. They may also begin to experience fewer depressive symptoms, reactivity to their children's behaviors, sadness, worry and guilt. PST providers encourage parents to take time for themselves, exercise, utilize respite, and seek therapy, if needed, so that they are re-charged and have more energy to cope with daily life with their children and families. The PST provider may also share stories of how other parents have been able to do this.
Increased Social Support Once parents experience the benefits of a trusting, helping relationship with a PST provider, the next step is to help them increase social support with others which can be sustained over time. The PST provider facilitates an increase in social support by encouraging involvement with other parents, such as attending parent support groups or other gatherings of parents with children with SED. This involvement with other parents helps decrease the sense of isolation parents may feel and fosters parents' feelings of hope. The social events and groups enable parents to get together and de-stress, share ideas and build a sense of community that can be sustained over time. An example of how decreased caregiver strain and an increase in social support occur:
"You helped me with a community that was hostile. The whole community was, I won't say openly hostile, but not supportive of my situation. You helped me find ways of reaching out where I could get support. You were able to listen to my situation and ask questions so that I could think. That, plus getting me connected with the community that was a little more tolerant. Seeing the kids as kids rather than as a problem. Huge!"
--Caregiver speaking to a PST provider
Increased Home Stability All of these interventions lead to a more stable home environment where parents' crisis intervention skills are enhanced, which results in fewer or no law enforcement contacts, restrictive placements and days in foster care.
21
If the child does go to a more restrictive placement, the PST provider can be there to help walk the parents through the difficult time. The PST provider can help the parents prepare and reflect on what worked and what didn't so that when the child returns, the parents are ready. The PST Best Practices Protocol contains the Best Practices carried out by PST providers that support families to achieve the intended results (outcomes) associated with the PST theory of change:
Increased caregiver engagement
Increased effective caregiving
Increased family empowerment
Decreased caregiver strain
Increased social support
Increased home stability An introduction to the PST Best Practices Protocol follows in the next lesson.
22
7. PST Best Practices Protocol Basics
Now we will describe the basics of the PST Best Practices Protocol. The PST Best Practices Protocol is an instructional manual that describes how to carry out the Best Practices of effective PST service. The protocol is organized into 3 sections: Section I: Referral Process/Understanding Needs of Families Focuses on: Actions taken by CMHC staff to identify when families might benefit from PST services & then start the referral process. Section II: Initial Engagement & Immediate Priorities Focuses on: Steps PST providers take to make contact with and engage families. Section III: PST Interventions Focuses on: Specific activities PST providers carry out to help families meet their children's treatment goals and have positive outcomes. With each protocol section, information is presented about the Best Practices carried out by PST providers to achieve the focus/purpose of that section. There are 34 Best Practices in all. One issue that mental health service providers have with using structured service models is how flexible a model is so they can individualize their practice and still be able to carry out the model accurately (with fidelity). For example, in Kansas, there are several factors that influence how a PST provider carries out PST Best Practices. They include:
Family preferences (makes this family-driven)
PST preferences
CMHC procedures and resources
Community and family customs, culture, preferences, and needs. Having choices within the Best Practices helps PST providers take these influences into account. Choices are available by having different possible action steps for each Best Practice. PST providers achieve a Best Practice by carrying out at least one of its possible action steps. The PST provider and family can choose the action step(s) that works best for their situation. Carrying out one action step equals carrying out the Best Practice.
23
For example, let's look at Best Practice #21: The PST encourages the family to participate in their child's treatment. The possible action steps for this Best Practice are:
The PST asks the parent(s) about ways they are involved in their child's treatment.
The PST gives the parent(s) examples and/or coaches them on ways they can be involved in their child's treatment.
Many of the Best Practices also have quotes of what parents say. The quotes describe how the Best Practices are experienced by parents. The comments help illustrate for new PST providers how Best Practices look in real life service delivery. The parent quote for the Best Practice #21 is:
"She was very knowledgeable about the way my center works, and when I thought my son might need medicine, she volunteered to go in with me to talk to the doctor."
24
Welcome to the PST Best Practices Protocol!
The next 3 lessons will introduce you to the main focus of our training--The PST Best Practices Protocol.
25
8. Protocol Section I: Referral Process/Understanding Needs of Families
The first section of the PST Best Practices Protocol is labeled Referral Process/ Understanding Needs of Families. It focuses on how CMHC providers identify families who might benefit from receiving PST services and then refer the families to the service. Previous study of Kansas PST service indicates that:
PST service is typically reserved for families with the highest needs.
Parents are isolated, under stress, experiencing crisis, or having difficulty with parenting when they are referred to PST services.
Many are single-parent households.
Referred families often experience obstacles to effective service delivery as a result of poverty or difficulty navigating the child welfare system.
Best Practices #1-8 are all steps in the referral process that make up Protocol Section I. All but Best Practice #6 are considered essential for an effective, high-quality referral process. Best Practice #6 applies only to those CMHCs that have more than one PST provider available to serve the same community. Go to Section I Best Practices associated with the referral process, the possible action steps for each Best Practice and what parents say about the referral process on pages 45-46 in this manual. When you review each Best Practice, think about the referral practices you have seen in your CMHC already. This reflection will help you start connecting the PST Best Practices Protocol to your real-life experiences providing PST services at your CMHC. The referring person's role is crucial because he/she starts the process of helping a PST provider connect successfully with a family. There is no one set way to do this! The referring provider depends on your CMHC's procedures. He/she may be a case manager, therapist, intake person, wraparound facilitator, or other CMHC staff. The Best Practices in Protocol Section I are carried out mostly by the person(s) in the CMHC who refer families to PST services.
26
The timing on when the referral is made may happen when a family first qualifies for the SED waiver or later on, depending on how that works at your CMHC. Timing is also influenced by family choice. Sometimes families do not agree the first time PST is offered, but may consent at a later time when re-approached. There is no one way this can happen. Ever family is unique.
PST Needs Assessment The PST Needs Assessment is a practice tool to use during the referral process to PST services. This tool serves three purposes:
Describes the PST service
Describes issues PST services can help with
Assists the referring provider and family to individualize the PST service so that it targets specific needs of the family (makes the process family driven)
The provider making the referral to PST services is encouraged to use the PST Needs Assessment as early in the referral process as possible. Review the Needs Assessment on the next page and reflect on how the provider can use this tool to carry out Section I Best Practices #1-5 (see page after next).
27
Needs Assessment for Referral to Parent Support and Training Services
Parent Support and Training (PST) is a service provided to parents of children with a serious emotional disturbance (SED). This service is intended to provide training and support to 1) help families actively participate in their child’s mental health services; 2) increase their ability to provide a safe and supportive environment for their child; and 3) help implement and reinforce skills learned in the mental health treatment process. Listed below are some tasks/activities PST Services can help with. Please check all tasks that may be helpful at this time for you as a caregiver of a child with SED. My family needs:
Support to help choose and prioritize treatment goals.
Help identifying ways to participate in my child's treatment.
A support person to be in contact with me at least once a month to talk about what my family needs.
A support person to listen to my concerns so I feel heard.
Information, resources, and strategies to help meet my families' needs.
Support to help me feel hopeful about parenting a child with mental health needs.
Information about parenting skills and strategies.
Information and coaching about behavior management skills and strategies.
Information and coaching about using coping skills.
Support and coaching about using my child's crisis plan.
Information about my child's medication or diagnoses.
Help understanding choices or services given by other providers.
Help working with my child's school to help them succeed.
Help working with my child's other mental health providers.
Help with the SED Waiver process/paperwork.
Other ______________________________________________
Caregiver/Parent Signature_________________ Date _______________
28
The PST Needs Assessment can also be used by the PST provider as a way to prepare for the first meeting with the family (Section I Best Practice #7). Review of the completed Needs Assessment by the PST provider serves as an action step for carrying out this Best Practice.
In summary, use of the PST Needs Assessment during the referral process will carry out all but two of the Best Practices in Protocol Section I!
29
9. Section II: Initial Engagement and Immediate Priorities
The second section of the PST Best Practices Protocol is labeled Initial Engagement and Immediate Priorities. It focuses on Best Practices PST providers carry out to make contact with and effectively engage families. Previous study of Kansas PST services indicates that managing the therapeutic relationship with parents is the key to successful PST services. Qualities of effective PST providers include being engaging, authentic, non-threatening, accessible, flexible, purpose-driven and committed.
In Protocol Section II, PST providers and parents quickly develop a mutual connection during their first contacts, especially when the PST provider is or has been a parent of a child with SED. PST providers quickly set the stage to carry out activities that help families meet their children's treatment goals and have positive outcomes. Section II includes Best Practices #9-19. All but Best Practice #16 are considered essential for effective, high-quality contact and engagement. (NOTE: Best Practice #16 is used only at the discretion of PST providers who are parents of children with SED/special needs.) Go to Section II Best Practices associated with initial engagement, the possible action steps for each Best Practice, and what parents say on pages 50-52 in this manual. When you review each Best Practice, think about engagement strategies you have seen in your CMHC already. This reflection will help you start connecting the PST Best Practices Protocol to your real-life experiences providing PST services at your CMHC. The Best Practices in Section II are NOT organized in any particular order. Instead, they are carried out in a way that helps support a family's immediate priorities and needs rather than on a particular timeline. For example, if the immediate priority is managing a crisis when the PST provider and family first meet, it may take more than the first appointment for the PST provider to spend time getting to know the family (Best Practice #9). The Best Practices in this initial engagement and immediate priorities section are completed by the PST provider, except #19 which involves the family's treatment team.
30
The PST Needs Assessment can be reviewed again when families periodically during Section II activities. See page 27 again in Lesson 8 to review the Needs Assessment. As you gain a family's trust and engage them effectively, they may become more open to sharing needs and concerns that weren't revealed earlier. Check in with the family to make sure "Did I get this right?" (are you correctly understanding the family's needs?) Review the following Section II Best Practices while considering how use of the PST Needs Assessment can satisfy each.
31
10. Protocol Section III: PST Interventions
The third and last section of the PST Best Practices Protocol is labeled PST Interventions. It focuses on specific activities PST providers carry out to help families meet their children's treatment goals and have positive outcomes. Previous study of PST services indicates that PST providers perform several important roles and functions with parents. The two most important functions are providing:
affirmation and emotional support
encouraging families to work with their treatment teams on crisis intervention and prevention strategies and activities
Other tasks PST providers carry out most often are:
educating parents on school issues
linking families with needed resources
educating parents on specific parenting techniques
establishing peer support networks
helping families work with providers effectively Go to Section III Best Practices associated with PST Interventions, the possible action steps for each Best Practice, and what parents say on pages 57-60 of this manual. When you review each Best Practice, think about interventions such as parenting and behavior management skills training being used in your CMHC already. This reflection will help you start connecting the PST Best Practices Protocol to your real-life experiences providing PST services at your CMHC. The Best Practices in the PST Interventions section are NOT organized in any particular order. Some are carried out in a way that helps support a family's immediate priorities and needs rather than on a particular timeline. For example, if the immediate priority is managing a crisis when the PST and family first meet, it may be a few appointments later before the PST has a chance to support the family on choosing their own goals (Best Practice #20). Several of the Best Practices in the PST interventions section are carried out based on what interventions a family needs and agrees to receive to achieve their child's goals on the treatment plan.
32
They are implemented when a parent or a provider working with the family indicates the need and the following happens:
If a provider suggests or recommends the intervention, the PST will collaborate with the provider on delivering the right services to help the family.
The PST begins the new intervention only when the family is ready for it. Several resources and trainings are available free of charge or at low cost on a variety of topics that support implementation of some PST interventions included in this section, such as behavior management, parenting, crisis coaching, school issues, the SED waiver, community-based services, and diagnoses and medications. Listed below are some of the Kansas organizations that provide resources and trainings relevant to PST interventions: Kids Training Team http://www.kidstraining.org/kidsTraining4.0/ Families Together, Inc. http://www.familiestogetherinc.org/ Keys for Networking http://www.keys.org/ NAMI-Kansas http://www.nami.org/MSTemplate.cfm?Site=NAMI_Kansas Another source of trainings and resources on PST intervention-related topics is the Kansas Statewide PST Network. The Network is open to PST providers employed within the Kansas CMHC system. For more information on the Network, contact Pam McDiffett, Consumer Affairs-Child and Family, KDADS-BHS, 785-296-3471 or [email protected]. PST providers in Kansas implement a variety of parenting and behavior management skills training programs with parents, depending on the match between families’ needs and what programs offer, as providers carry out Best Practices #26 and 27.
26. The PST educates the family on parenting skills. 27. The PST educates the family on how to use behavior management skills.
Examples of some programs that PST providers have used:
Parenting with Love and Logic
1, 2, 3 Magic
Conscious Discipline
Common Sense Parenting
When Being a Good Parent is Not Enough
33
11. Individualizing the PST Best Practices Protocol
What if you want to carry out a Best Practice in a way that isn't on the list of possible action steps? There are unlimited ways to do so! The protocol is designed so that new action steps could be created to meet the needs of families, providers, CMHCs and communities. For example, while only 3 action steps are listed in for Best Practice #11 (see page 50 of manual)….. Best Practice 11. The PST asks the family how Parent Support Services can help. Frequency: Occurs at least once and as needed to achieve goals on the treatment team. Possible Action Steps
PST asks parent(s) what she/he can do that would be helpful.
PST explains that PST services vary according to what a family needs.
PST gives examples of ways that Parent Support Services have helped other families. What Parents Say "My PST gave me some examples. She said if we decide to pursue an IEP that she would help us with that. She's done a lot, like giving suggestions of support groups, helping me find places to look for more resources. So it's kind of like I'm here to help you, so you tell me what you think you need." ....many other action steps are possible. Some individualized action steps used at CMHCs to carry out Best Practice #11:
PST listens and then offers a variety of suggestions, watching parent body language to assess which direction they want to head with what she offered.
PST provides information to parent that illustrates ways she can help with needs that parent has.
PST facilitates wraparound and plan of care development where discussion includes ways that PST can help.
PST offers assistance to address needs caregiver has not been able to resolve herself.
PST learns what parents already know about situation and as needed shares information to help them look at what else is needed that PST can help with.
PST asks questions in a non-invasive way that does not put parent on guard.
34
To create a new action step, consider the following:
Will the purpose of the Best Practice be met by carrying out the proposed new action step?
Will the needs or preferences of the family, provider, CMHC, & community be met by carrying out the proposed new action step?
Will the proposed new action step be able to help the family achieve at least one of the intended results (outcomes) associated with the PST service? Review the theory of change on page 18 of this manual:
o Increased caregiver engagement o Increased effective caregiving o Increased family empowerment o Decreased caregiver strain o Increased social support o Increased home stability
Practice: Based on the parent quote in the What Parents Say column below, describe the individualized action step carried out by the PST provider to implement Best Practice #14. You are encouraged to be creative and "think outside the box" as you carry out this exercise. Best Practice 14. The PST listens to the family in a way that helps the family feel like they are "being heard." Frequency: Occurs each time the PST and family meet. Possible Action Steps
PST pays attention by looking at family members as they talk.
PST encourages family members as they talk by nodding or saying "yes" or "uh huh." What Parents Say "I always feel like I'm being heard because it would be a few weeks later and well, 'How's it going?' Like she could remember it. She looks at you when you're talking to her. She hears me because of how she always remembers, even if it's a few weeks down the line. So she knows and she asks about how it's going." Review: Check out other individualized action steps used for Best Practice #14 above. Are any of them similar to the one you described?
Family is open with PST provider about life, goals, challenges, etc.
Parent described concerns & issues to PST provider during initial PST visit even though parent initially refused the service.
Parent consistently confided experiences & concerns to PST provider during visits.
PST provider follows up and asks about things discussed with parent during previous visits.
35
Basic Training Wrap-Up
Online training gives you valuable information about the services you provide. However, it is only the beginning of what you need to know for your career as a Medicaid provider. Supervisors and team leaders play a major role in helping you implement and apply your online learning to the work you do. Make good use of their experience, wisdom and guidance!
Acknowledgements
36
PST Best Practices Protocol Parent Support and Training (PST) Best Practices Service Model for Kansas Community-Based Mental Health Services Teams for Children and Families Kathy Byrnes, M.A., LMSW, Sharah Davis-Groves, LMSW, Kaela Byers, LMSW, Toni Johnson, Ph.D., and Tom McDonald, Ph.D. University of Kansas School of Social Welfare, Office of Child Welfare and Children’s Mental Health Copyright © 2010-2014 by the University of Kansas School of Social Welfare All Rights Reserved This project was supported through a contract with the Kansas Department of Aging and Disability Services-- Behavioral Health Service
Acknowledgements
37
Acknowledgements
We are grateful to numerous stakeholders within the Kansas children’s mental health system who contributed to development of the Kansas Parent Support and Training (PST) Best Practices Service Model for Kansas Community-Based Mental Health Services Teams.
Significant credit goes to all of the PST providers (PSTs) who shared their expertise and wisdom on providing parent-to-parent support. In addition, families who shared their experiences as recipients of the service provided crucial perspectives toward the development of the PST Model.
We are especially indebted to Pam McDiffett of the Kansas Department of Aging and Disability Services-Behavioral Health Services (KDADS-BHS) for helping coordinate research engagement efforts with the PST Statewide Network and for her support as a committed advocate for this project.
Thanks to Sherri Luthe, who championed this project through her role as family advocate and as Director of the Parent Advocacy and Support Services Program of the Mental Health Association of South Central Kansas.
We recognize the unique contribution made by Virginia Standley at Labette Center for Mental Health. As one of the first PSTs who pioneered development of the service within a Kansas community mental health center (CMHC), Virginia’s historical knowledge and expertise gained over the past fifteen years influenced the emerging model in countless ways.
We are grateful to all CMHC staff who offered their insights on the team and agency perspectives of PST practices, including direct service providers, supervisors, and administrators. In particular, we thank Matt Atteberry, Ric Dalke, Beth Engels, and Marla Lira for their support and feedback as we examined the integration of a professional parent role within a mental health service delivery system.
Thanks to the PST Services Study Team’s Research Assistants for their involvement in PST model development: Ashley Hutchison, Sarah Pilgrim, Megh Chakrabarti, and Carolyn Bruner.
Acknowledgements
38
Thanks to Erica Parkinson-Arnold for her editorial assistance.
Lastly, we thank the innovators of the historic Kan Focus project who collaborated with families in 1994 to create the PST service as part of a pilot program in southeast Kansas for a family-oriented, community-based system of care for children living with severe emotional disturbance (SED) and their families. The success of Kan Focus led to statewide expansion of the newly crafted system of care, which has now been sustained for a decade. It is our hope that the PST Best Practices Model reflects what the parents of Kan Focus said they needed:
Someone to talk to who will listen and understand.
Someone to provide support at court, school, and other meetings.
Most importantly, that the person providing support be a parent who had walked in their shoes. Cover Picture: Kid's Training Team. (2007). The Ideal PST [Photograph]. Wichita, KS: Wichita State University, Training & Technology Team. Reprinted with permission.
How to Use the PST Best Practices Protocol
39
How to Use the PST Best Practices Protocol Overview The PST Best Practices Protocol contains the steps involved in providing effective, high-quality PST services. The components are research-based and developed from expert knowledge and feedback provided by parents receiving PST services, PST providers (PSTs), PST supervisors, community mental health center (CMHC) administrators, family advocates, and state-level administrators. The steps are organized into three sections that follow the same chronological order in which PST services occur with families. It starts with the steps a CMHC provider takes to make a referral (Section I: Referral Process/Understanding Needs of Families), moves next to the steps PSTs take to make contact with and engage families (Section II: Initial Engagement and Immediate Priorities), and ends with specific activities PSTs carry out to help families meet their children’s treatment goals and have positive outcomes (Section III: PST Interventions). Within each section, information about the steps and how to carry them out is presented in three columns for quick and easy viewing (see Figure 1 on next page for an example):
a) The first column has the best practices that are the standards of practice for each step. They are written in a way that makes them observable and measurable so you can tell whether they have been done. The best practices represent the essential core components of PST practice.
b) The middle column has possible action steps. CMHC procedures and resources, community and family customs, culture, preferences, and needs all influence how a best practice is accomplished. Choices in how the step may be carried out help CMHCs accommodate these influences. Only one action step needs to be carried out to meet the best practice. CMHCs can select an action step from the list or develop their own. Space is provided to enter action steps a CMHC may develop. For individualized action steps, technical assistance will be provided by KU School of Social Welfare staff to ensure a good fit between CMHC practice needs and the protocol.
How to Use the PST Best Practices Protocol
40
c) The last column—what parents say—has quotes that describe how a step is experienced by parents. These comments help illustrate how the best practice looks in actual practice.
Figure 1
How to Use the PST Best Practices Practice Protocol
Each section includes background information and things to know when carrying out the protocol steps. Space is provided to jot down notes about practices at your CMHC related to that section. For example, there is a place in Section I: Referral Process/Understanding Needs of Families to write down your CMHC’s procedures for referring families to PST services.
Some best practices will occur only once while others happen more often, sometimes every time a PST has contact with a family. The frequency that each best practice will likely occur is described in the same box as the best practice (See Figure 1).
Best Practice Possible Action Steps What Parents Say
31. The PST helps the family understand choices or services given by other providers.
Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST reviews with the parent(s) information given by other providers about choices and services to help answer any questions they may have.
PST coaches the parent(s) on ways to talk with other providers so they can get their questions answered about choices and services given by other providers.
___________________________________ ___________________________________
“Providers explain their services based on their perspective, and when a family is in crisis, you don’t process/understand information well. A PST who has ‘been there/done that’ is able to explain it in ‘parent terms’ and the implications—both positive and negative—of the service/choice. It’s like taking someone with you to the doctor when there is complex or difficult news.”
How to Use the PST Best Practices Protocol
41
Support for Implementation
The PST Best Practices Protocol is written in a way intended to support implementation of effective, high-quality PST services in a CMHC.
The PST Team at the KU School of Social Welfare will provide:
o Online Training Pre-requisite to live training Available on the Training Teams website at http://trainingteams.org/trainingTeams4.0/ Must be completed within 60 days of the service start date*
o Live Training
Follows completion of online training Conducted in partnership with Kansas CMHCs Must be completed within 1 year of service start date*
o Field Mentoring & Coaching Conducted in partnership with Kansas CMHCs Provide bi-monthly statewide technical assistance conference calls Provide individualized supports via email, conference calls, and/or onsite visits as requested by individual
CMHCs Conduct onsite implementation (fidelity) reviews
The PST Team at the KU School of Social Welfare are available at email [email protected]. * KDADS-BHS requirement associated with this service
Referral Process/Understanding Needs of Families
42
Section I: Referral Process/Understanding Needs of Families Background
Previous study (Davis-Groves, Barfield, McCave, & Corrigan, 2007) indicates that PST services are typically reserved for families with the highest needs. Parents are isolated, under stress, experiencing crisis, or having difficulty with parenting when they are referred to PST services. Many are single-parent households. Furthermore, families referred to PST services often experience obstacles to effective service delivery as a result of poverty or difficulty navigating the child welfare system. Things to Know
This section: o Focuses on how CMHC providers identify families who might benefit from receiving PST service and make referrals.
o Includes PST Best Practices 1 through 8. All but Best Practice 6 are considered essential for an effective, high-quality
referral process. (NOTE: Best Practice 6 applies only to those CMHCs that have more than one PST serving the same community.)
The best practices in this section: o Are carried out mostly by the person(s) in each CMHC who refer families to PST services. This person’s role is crucial
because it sets the stage for a PST provider to connect successfully with a family. o Are organized in chronological order, although several may occur simultaneously or in rapid succession. For example,
a parent says “I need a lot of support!” when meeting with a Qualified Mental Health Professional (QMHP) for intake of her daughter to receive case management services. The QMHP calls a PST and asks her to join them so she can meet the parent and help describe PST services. This rapid sequence covers Best Practices 1 through 3. If the parent agrees she wants the service and schedules an appointment with the PST, Best Practices 4 through 8 have occurred in rapid order as well. This example of an entire referral process could take place in as little as 15 minutes.
Referral Process/Understanding Needs of Families
43
The PST Needs Assessment* is a practice tool to use during the referral process to PST services. This tool serves three purposes:
o Describes the PST service. o Describes issues PST services can help with. o Assists the referring provider and family to individualize the PST service so that it targets specific needs of the family
(makes the process family driven).
The provider making the referral to PST services is encouraged to use the PST Needs Assessment as early in the referral process as possible. The provider can carry out Section I Best Practices #1-5 in this way. The PST provider who receives the referral can carry out Best Practice #7 by reviewing the completed assessment prior to initiating contact with the family. *see Tools for PST Best Practices manual page 27
Other things to know: o The provider making the referral may be a case manager, therapist, intake person, or other CMHC staff, depending on
how it’s done at your CMHC.
o Timing of the referral may happen when a family first enrolls in case management services or later on, depending on how that works at your CMHC.
o Timing is also influenced by family choice. Sometimes families do not agree the first time PST is offered, but may
consent at a later time when re-approached.
o There is no one way this can happen. Every family is unique.
Referral Process/Understanding Needs of Families
44
Things to Know About the Referral Process and Understanding Needs of Families at My CMHC
o Referrals are made by the following people at my CMHC: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o Referrals are made in the following way(s) at my CMHC (examples: referral form, referring provider tells PST provider, etc.): _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o At my CMHC, the amount of time a PST has to contact a family once a referral is received is: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Referral Process/Understanding Needs of Families
45
Best Practice Possible Action Steps What Parents Say
1. The provider talks to the family about their needs before making a referral. Frequency: Occurs at least once.
Provider talks to the family about what they need. ___________________________________
___________________________________
“At the intake when they said ‘yes he qualifies for our services,’ that’s when they told me ‘we have parent support services.’ I was like, ‘I need support!’”
2. The provider considers how PST service can help support the family’s needs when thinking about making a referral. Frequency: Occurs at least once.
Provider documents how PST service can help support the family’s needs.
Provider discusses family’s needs with PST. Provider discusses family’s needs with supervisor. ___________________________________
___________________________________
“We had an initial meeting when they sat me down with a whole bunch of people and said ‘these are the things that we think that could really help your son. These are the types of services that we can offer for these specific things’ and the PST service was one of them.”
3. The provider adequately describes to the
family the service and how it can help the family before making a referral. Frequency: Occurs at least once.
Provider describes some of the things PST can do to help parent(s) with the child.
Provider describes that PST service would be for the parent(s) and the rest of the family, as opposed to other services that focus primarily on the child.
Provider describes that PST is a veteran parent (if applicable). Provider gives parent(s) a written description of PST services. ___________________________________
___________________________________
“Tell parents to give PST services a chance. You could be having the worst day, week, whatever and then you talk to your PST. She has a lot of positives and helpful advice and recommendations.”
4. The family agrees to be referred to the PST service. Frequency: Occurs at least once.
Provider checks with parent(s) to confirm that they want to be referred.
___________________________________ ___________________________________
“They came in and told me the different services that I could receive for my son and they gave me options and I went ahead and picked the PST and a couple of the other ones that they offered.” “Our therapist recommended. She asked if I would give permission for her to recommend.”
5. The provider refers the family to PST service. Frequency: Occurs at least once.
Provider completes referral form and submits to appropriate person in the agency.
Provider introduces parent(s) to PST in person. Provider tells PST that family is being referred. ___________________________________
___________________________________
“The intake person told me about the service and the PST came in during the meeting.”
Referral Process/Understanding Needs of Families
46
Best Practice Possible Action Steps What Parents Say
6. The provider chooses a PST who will be a good match for the family’s needs. Frequency: Occurs at least once.
Provider refers parent(s) to a specific PST who shares similar characteristics or experiences with the family (if available).
___________________________________ ___________________________________
“It’s important for parents to know if the PST has had children that have a mental illness, that have been there in your shoes or walked a certain road, maybe not the same, but have had the same feelings.”
7. The PST prepares for the first meeting with the family. Frequency: Occurs at least once after PST receives referral.
PST talks about the family with at least one provider who will be working with them before contacting the family for the first time.
PST reads child’s chart before contacting the parent(s) for the first time.
___________________________________ ___________________________________
“It is important for the PST to have information about a family’s background to form an initial connection.”
8. The PST quickly makes contact with the family to schedule the first appointment. Frequency: Occurs once after PST receives referral.
PST contacts parent(s) by phone to set up first appointment. Provider introduces parent(s) to PST in person. ___________________________________
___________________________________
“The therapist contacted children’s services at the center and then the PST contacted me to set up a meeting time.”
Initial Engagement and Immediate Priorities
47
Section II: Initial Engagement and Immediate Priorities Background
Previous study (Davis-Groves, et al., 2007) indicates that managing the therapeutic relationship with parents is the key to successful PST services. PSTs and parents quickly develop a mutual connection during their first contacts, especially when the PST is or has been a parent of a child with a serious emotional disturbance (SED). Qualities of effective PST providers include being engaging, authentic, non-threatening, accessible, flexible, purpose-driven, and committed. Things to Know
This section: o Focuses on steps PSTs take to make contact with and engage families. PSTs quickly set the stage to carry out activities
that help families meet their children’s treatment goals and have positive outcomes when they attend to these steps.
o Includes PST Best Practices 9 through 19. All but Best Practice 16 are considered essential for effective, high-quality contact and engagement. (NOTE: Best Practice 16 is used only at the discretion of PSTs who are parents of children with SED/special needs.)
The best practices in this section: o Are completed by the PST. One Best Practice (19) also directly involves other members of the family’s treatment
team.
o Are NOT organized in any particular order.
o Are carried out in a way that helps support a family’s immediate priorities and needs rather than on a particular timeline. For example, if the immediate priority is managing a crisis when the PST and family first meet, it may take more than the first appointment for the PST to spend time getting to know the family (Best Practice 9).
Initial Engagement and Immediate Priorities
48
The PST Needs Assessment (see Tools for PST Best Practices manual page 27) can be reviewed again with families periodically during Section II activities. As a PST gains a family’s trust and engages them effectively, they may become more open to sharing needs and concerns that weren’t revealed earlier. The PST can check in with the family to make sure “Did I get this right?” (Are you correctly understanding the family’s needs?) The PST can carry out Section II Best Practices #9-11 and #13 by reviewing the PST Needs Assessment periodically with a family.
Other things to know: o Contact between PSTs and families occurs both in person and by phone. When you see the word meeting in a Best
Practice, it does not mean face-to-face contact only. Meetings can also take place by phone for a variety of reasons, including family preference (Best Practice 9).
Initial Engagement and Immediate Priorities
49
Things to Know About Initial Engagement and Immediate Priorities with Families at My CMHC
o My CMHC’s policies and procedures about the times (which days, what times of the day) and locations that community-based workers can meet with families: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o My CMHC’s policies and procedures about meeting with parents by phone: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o Personal information I am willing to share with families to help them trust me (For PSTs who are also parents of children with SED/special needs): _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Initial Engagement and Immediate Priorities
50
Best Practice Possible Action Steps What Parents Say
9. The PST spends the first appointment getting to know the family. Frequency: Occurs during the first meeting that PST and family have time to get to know each other. May occur over a few visits, depending on family’s immediate priorities and needs when PST service begins.
PST shares basic information about the PST service and himself or herself to help the family feel comfortable.
PST invites parent(s) to talk about themselves in a way that is comfortable for them.
___________________________________ ___________________________________
“The first time we met, I just wanted to get to know the PST. I’m not comfortable with just talking to somebody until I get to know them.” “I wanted to be able to share with my PST the first time we met how things are at home. With somebody who would understand what it’s like to have somebody that’s got problems living with you. That’s not easy. She could relate and I like that.”
10. The PST asks and talks to the family about their needs. Frequency: Occurs at least once and as needed to achieve goals on the treatment plan.
PST asks parent(s) what they feel their strengths and challenges are.
PST asks parent(s) what they feel they need help with. ___________________________________
___________________________________
“She helps me with everything. Anything that I need. If I call her and I need something, she’ll help me with it. I mean anything.”
11. The PST asks the family how Parent Support Services can help. Frequency: Occurs at least once and as needed to achieve goals on the treatment plan.
PST asks parent(s) what she/he can do that would be helpful. PST explains that PST services vary according to what a family
needs. PST gives examples of ways that Parent Support Services have
helped other families. ___________________________________
___________________________________
“Whatever works for you as a parent, that’s what decides how [your PST can] be helpful. It is what you’re needing.” “My PST gave me some examples. She said if we decide to pursue an IEP that she would help us with that. She’s done a lot, like giving suggestions of support groups, helping me find places to look for more resources. So it’s kind of like I’m here to help you, so you tell me what you think you need.”
12. The PST and family meet in a way that is comfortable for the family. Frequency: PST attempts to arrange each family meeting in a way that is comfortable for the family.
PST meets with the family at a location that is comfortable for the family.
PST meets with the family at a time that is comfortable for the family.
___________________________________ ___________________________________
“I usually saw her at the center because she would be at the office during the times that I would bring him in for an appointment. So I usually saw her probably about once a week.” “I think it’s more relaxed at home and I feel like I can talk to her about anything about the kids. Anything that’s going on in my life.”
Initial Engagement and Immediate Priorities
51
Best Practice Possible Action Steps What Parents Say
13. The PST begins new interventions only when the family is ready for them. Frequency: Occurs each time PST suggests a new intervention to help family achieve goals on the treatment plan.
PST suggests new intervention to help address a challenge or need identified by parent(s).
PST respects the choice of the parent(s) about whether to try suggested new intervention.
___________________________________ ___________________________________
“When there’s a problem and she comes over, on her Wednesdays and ‘what’s new, what’s going on,’ I’ll start telling her. She’ll say, ‘Well, have you done this’ or she’ll sit there and wait for a minute, and just kind of contemplate. And then she’ll say ‘well, maybe you should try this’ or ‘I’ve done this’ and I’ll give it a shot. And then when she comes back again, ‘Well, how did that go?’ You know, she always checks the next time she comes to see how things went.”
14. The PST listens to the family in a way that helps the family feel like they are “being heard.” Frequency: Occurs each time the PST and family meet.
PST pays attention by looking at family members as they talk. PST encourages family members as they talk by nodding or
saying “yes” or “uh huh.” ___________________________________
___________________________________
“I’m the one seeking help so to just listen and believe me and not try to minimize what I am saying is important.” “She listens to me and she shows that she’s caring and that she’s paying attention to what I’m saying by looking at me. She’s not saying the hour is up.”
15. The family does not feel judged by the PST. Frequency: Occurs each time the PST and family meet.
PST listens to the family in a way that helps the family feel like they are “being heard.” (Best Practice 14)
PST normalizes the family’s experience by sharing common experiences from other families with youth with SED.
___________________________________ ___________________________________
“The PST looks at the whole picture and she’s like ‘okay, I see.’ With others, you don’t even have to say two words and they start giving opinion. It’s like they’re quick to judge someone rather than to look at what is really going on.” “I just wanted to find out if what I was feeling, experiencing, going through, and everything was normal. One of my questions was, ‘do you know any woman raising a child like this that has it all together’? And she was just,’ it varies from day to day with all of them.’ I was like, ‘oh thank goodness!’ Because you feel like why can’t I get better at this?”
Initial Engagement and Immediate Priorities
52
Best Practice Possible Action Steps What Parents Say
16. PSTs who are also parents of children with SED/special needs may share personal information with the family to help trust the PST. Frequency: Occurs at PST’s discretion.
PST gives the parent(s) information about his or her personal experience caring for a youth with SED/special needs as it relates to the needs or challenges of the parent(s).
___________________________________ ___________________________________
“Hearing the experience of our PST was helpful in that I realized that I’m not crazy, nor am I alone. It felt good to know that she had walked in my shoes.” “My PST gives me somebody to talk to and vent on that knows what I’m talking about. It really helps to have someone that does understand and is coming from the same thing that I can relate what’s going on. She can give me tips on things that she tried [when] her kids were doing whatever [my kids are doing] and it’s really helpful. It makes me a lot more comfortable with her. I feel more at ease when I can tell her things and I know that she truly understands what I’m saying.”
17. The PST describes his or her role to the family and how it is different from a friendship. Frequency: Occurs at least once.
PST describes to the parent(s) how their relationship is professional and confidential, the same as the other treatment team staff the family works with.
___________________________________ ___________________________________
“Rather than a friendship...it's a resource because here's someone who isn't just a friend but they really understand the situation in depth personally and professionally."
18. The PST describes to the family how he or she work with the other providers on the family’s treatment team (case manager, therapist, etc.). Frequency: Occurs at least once and as needed to achieve goals on the treatment plan.
PST describes how he or she talks with other providers working with the family to coordinate how they each will help the family reach their goals.
PST and other providers meet jointly with the family to discuss how they work together to help the family reach their treatment goals.
___________________________________ ___________________________________
“We actually just had a meeting with the therapist, [case manager], [PST] and the wraparound facilitator. So everybody is in close-knit of what’s going on and she [PST] talked to [case manager], she talks to [therapist]. She’s involved. She puts her feedback in, and so everybody is kind of a close-knit-like little family.”
19. The PST and the other members of the family’s treatment team work together to provide the right services to help the family. Frequency: Occurs at least once with treatment team and PST and as needed to provide the right services so child and family can achieve goals on the treatment plan.
PST talks with other providers about what each is working on with the family.
___________________________________ ___________________________________
“I know they all work together. They, you know, interact. My daughter’s on the wraparound program where they can all talk amongst each other and they meet and explain where this is going, this is going. So they all talk to each other and everything….”
PST Interventions
53
Section III: PST Interventions Background
Previous study (Davis-Groves et al., 2007) indicates that PSTs perform several important roles and functions with parents. The two most important functions are providing: (1) affirmation and emotional support, and (2) encouraging families to work with their treatment teams on crisis intervention and prevention strategies and activities. Other tasks PSTs carry out most often are educating parents on school issues, linking families with needed resources, educating parents on specific parenting techniques, establishing peer support networks, and helping families work with providers effectively. Things to Know
This section: o Focuses on specific activities PSTs carry out to help families meet their children’s treatment goals and have positive
outcomes.
o Includes PST Best Practices 20 through 34.
The best practices in this section: o Are carried out by the PST.
o Are NOT organized in any particular order.
o Some are carried out in a way that helps support a family’s immediate priorities and needs rather than on a particular
timeline. For example, if the immediate priority is managing a crisis when the PST and family first meet, it may be a few appointments later before the PST has a chance to support the family on choosing their own goals (Best Practice 20).
PST Interventions
54
o Several are completed based on the support and training a family needs to achieve their child’s goals on the treatment plan. These best practices are carried out when a parent or a provider working with the family indicates the need and the following happens:
If a provider suggests or recommends the intervention, the PST will collaborate with the provider on delivering the right services to help the family (Best Practice 19).
The PST begins the new intervention only when the family is ready for it (Best Practice 13).
Other things to know: o Several resources and trainings are available free of charge or at low cost on a variety of topics that support
implementation of some PST interventions included in this section, such as behavior management, parenting, crisis coaching, school issues, the SED waiver, community-based services, and diagnoses and medications. Listed below are some of the Kansas organizations that provide resources and trainings relevant to PST interventions:
Kids Training Team, www.trainingteams.org Families Together, Inc., www.familiestogetherinc.org Keys for Networking, www.keys.org NAMI-Kansas, http://www.nami.org/MSTemplate.cfm?Site=NAMI_Kansas
In addition, trainings and resources on PST intervention-related topics are presented regularly at meetings of the Kansas Statewide PST Network. The Network is open to PSTs employed within the Kansas CMHC system. For more information on the Network, contact Pam McDiffett, Consumer Affairs-Child and Family, KDADS-BHS, 785-296-3471 or [email protected].
o PSTs in Kansas implement a variety of parenting and behavior management skills training programs with the parents they serve, depending on the match between families’ needs and what the programs offer. Information was gathered previously on the various programs offered by PSTs to parents individually and in classes (Davis-Groves et al., 2007). The five programs reported most frequently by PSTs were:
PST Interventions
55
Parenting with Love and Logic 1, 2, 3 Magic Conscious Discipline Common Sense Parenting When Being a Good Parent Is Not Enough
PST Interventions
56
Things to Know About PST Interventions at My CMHC
o Parenting and/or behavior management skills programs utilized at my CMHC with families: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o Crisis intervention programs utilized at my CMHC with families: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o Crisis intervention skills training available at my CMHC for families: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
o _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PST Interventions
57
Best Practice Possible Action Steps What Parents Say
20. The PST supports the family in choosing their own goals. Frequency: Occurs at least once and as needed to achieve goals on the treatment plan.
PST asks the parent(s) to identify the most important goals they are working on in their child’s treatment.
PST gives examples and/or coaches the parent(s) to help them identify the most important goals to work on in their child’s treatment.
PST coaches the parent(s) on ways to talk to other treatment team members about working on the goals that are most important to them in their child’s treatment.
___________________________________ ___________________________________
“We have a list of goals. Then she talks about how things are going, if anything has happened between the last time we talked and the time that we, in the time we’re not together. So we do talk about goals. She asked me what my goals are. It’s not just about [child’s] goals because he has his own set and I have mine.”
21. The PST encourages the family to participate in their child’s treatment. Frequency: Occurs at least once and as needed to achieve goals on the treatment plan.
PST asks the parent(s) about ways they are involved in their child’s treatment.
PST gives the parent(s) examples and/or coaches them on ways they can be involved in their child’s treatment.
___________________________________ ___________________________________
“She was very knowledgeable about the way my center works, and when I thought my son might need medicine, she volunteered to go in with me to talk to the doctor.”
22. The PST is available to the family as needed. Frequency: Occurs at least once a month and more often, as needed, to achieve goals on the treatment plan.
PST has contact with the parent(s) at least once a month to talk about how they are doing and what they need. (Best Practice 10)
PST gives the parent(s) information on how to contact the PST when the parent(s) need.
___________________________________ ___________________________________
“I had a job opportunity. She said, ‘well, I’ll just wait and hold off before I make any more appointments with you and I’ll just call you like in two weeks and see really what’s going on and where we go from there.’” “PSTs are pretty much there for everybody that has problems. You can call them and, if they’re there, they’ll help you the best as they can and they’ll get back with you if they’re not there.”
23. The PST listens to the family’s concerns. Frequency: Occurs each time the parent indicates the need to talk about concerns and/or feelings.
PST listens to parent(s) describing concerns and/or feelings so they feel like they are “being heard.” (Best Practice 14)
___________________________________ ___________________________________
“The PST service is something for you, not just for your child. Just for you to vent or just release some stress and to have somebody else listen that understands what you’re feeling.” “Sometimes the family just needs the PST to listen versus saying, ‘What about…’ or ‘Did you do this?’”
PST Interventions
58
Best Practice Possible Action Steps What Parents Say
24. The PST gives the family information, resources, and strategies. Frequency: Occurs when parent or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST gives the parent(s) information, resources, and/or strategies to help address a challenge or need identified by parent(s).
PST coaches parent(s) on ways to successfully use the information, resources, and/or strategies to help address a challenge or need identified by parent(s).
___________________________________ ___________________________________
“She networks with a lot of parents, and so she can tell me, ‘well I know one woman whose son is about your son’s age, and this is what they’re doing.’ So, she brings into my house a lot of information that I may not otherwise come across, because I don’t know all these people and I’m not talking to them. She is, you know. So she’s connecting us all by crossing over things, information.” “She’s done a lot like giving suggestions of support groups, helping me find places to look for more resources. So it’s like, ‘I’m here to help you, so you tell me what you think you need.’”
25. The PST helps the family feel hopeful. Frequency: Occurs at least once and as needed to achieve goals on the treatment plan.
PST tells the parent(s) about how other families with youth with SED who have faced similar situations have learned to cope successfully.
PST reinforces strengths and capabilities of parent(s) to successfully care for their youth.
PST shares stories (his or her own and others) that illustrate ways to overcome challenges of parenting youth with SED.
___________________________________ ___________________________________
“When my PST talked about things that were bad, she would make sure I knew she was serious but yet she would make it where it didn’t bother her. She made it look like, you know, she made it feel like it didn’t bother her, even though there was bad things going on with her life. But she always made it like ‘hey, I got over this bump in the road and I’m still going.’ So it made me feel better.” “It gives me some kind of peace hearing that I’m not the only one out there that has kids with problems, you know.”
26. The PST educates the family on parenting skills. Frequency: Occurs when parent or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST educates, coaches, and/or gives examples on various parenting skills that can help address a challenge or need identified by the parent(s).
___________________________________ ___________________________________
“I called [PST] one evening because I didn’t know what to do with my son. I didn’t know where he was at. He hadn’t come home and so I called her, and she said, okay, these are the steps you need to take. You have options of how you’re going to handle this… She kind of broke it down and said, okay, these are your choices of how you can handle it. It helped.”
PST Interventions
59
Best Practice Possible Action Steps What Parents Say
27. The PST educates the family on how to use behavior management skills. Frequency: Occurs when parent or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST educates, coaches, and/or gives examples of behavior management skills that can help address a challenge or need identified by the parent(s).
___________________________________ ___________________________________
“She gives me information on things I could do and charts that we could make so he can do his chores because he doesn’t want to do that.”
28. The PST educates the family on coping skills. Frequency: Occurs when parent or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST describes to the parent(s) coping skills used by other families with youth with SED who have faced similar situations.
PST coaches the parent(s) on using coping skills that can help address a challenge or need identified by the parent(s).
___________________________________ ___________________________________
“She’s given me roundabout stories of things that have happened with her and her son to try to help me better understand and help me better help with [my son] and stuff. But she would tell me, you know, that every parent gets stressed out and she would tell me different stories about how her son would push her limits and things she did to help take care of those situations.”
29. The PST educates the family on skills to handle a crisis. Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST coaches the parent(s) on how to use their child’s Crisis Plan to address a challenge or need identified by the parents.
PST describes crisis management skills used by other families with youth with SED.
PST coaches the parent(s) on ways to talk to other treatment team members about their child’s Crisis Plan.
___________________________________ ___________________________________
“She just said that if it gets very bad on a crisis situation one I could call the [CMHC] and call her and they would get a hold of me or be right here to help me to get him calmed down. There’s also ways of just like for our children it works best just to grab then and secure them and let them know that they are safe and nothing is going to happen to them."
30. The PST gives the family information about the child’s medication or diagnoses. Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST gives the parent(s) educational materials and resources about the child’s medication prescribed by the doctor and/or diagnoses given by the therapist or doctor.
PST coaches the parent(s) on ways to talk to the doctor and/or therapist about the child’s medication or diagnoses.
___________________________________ ___________________________________
“She knew the situation I was in because her son had to have the medicine too. And my husband was against me, my mom was against me. My daughter’s aunt on her dad’s side, on her grandfather’s side was against me. Oh, no, it’s going to kill her and everything. So it was kind of neat to have somebody else there that can support me and said, well, you know, know how it can work because my son also goes through it. So it was very helpful.”
PST Interventions
60
Best Practice Possible Action Steps What Parents Say
31. The PST helps the family understand choices or services given by other providers. Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST reviews with the parent(s) information given by other providers about choices and services to help answer any questions they may have.
PST coaches the parent(s) on ways to talk with other providers so they can get their questions answered about choices and services given by other providers.
___________________________________ ___________________________________
“Providers explain their services based on their perspective, and when a family is in crisis, you don’t process/understand information well. A PST who has ‘been there/done that’ is able to explain it in ‘parent terms’ and the implications—both positive and negative—of the service/choice. It’s like taking someone with you to the doctor when there is complex or difficult news.”
32. The PST helps the family work with the school to help their child succeed. Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST educates, coaches, and/or gives examples to the parent(s) on ways to work with the school that can address a challenge or need identified by the parent(s).
___________________________________ ___________________________________
“There was a period of time when we were going through the IEP process where my PST and I did talk a lot more about what was going on with the school.”
33. The PST helps the family work with other mental health providers to meet their needs. Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST educates, coaches, and/or gives examples to the parent(s) on ways to work with other mental health providers to address a challenge or need identified by the parent(s).
___________________________________ ___________________________________
“She’s very helpful and says to me…’You should talk this person about, and you should talk to [therapist] about this and you should talk to…. the coordinator and what question are you going to ask the therapist? So she really kind of gives me ideas of who to talk to about what.”
34. The PST helps the family with the SED waiver process. Frequency: Occurs when parent(s) or provider* indicates the need. *If provider indicates the need, PST begins intervention once family has agreed to it.
PST educates, coaches, and/or gives examples to the parent(s) on any part of the SED waiver process that is a challenge or need identified by the parents.
___________________________________ ___________________________________
“Some of that paperwork really makes you feel stupid and finally they said hey, we need to get this done. This is [PST]. We’re going to make an appointment and get it done…. And it’s important to find somebody that’s not going to judge you or not have that feeling of judgmental-ness.... When you fill out the, I mean it’s very important not to feel judged when you’re sitting there filling out all that kind of paperwork."
61
References
1. Davis-Groves, S. A., Barfield, S. T., McCave, E., & Corrigan, S. K. (2007). Parent support: Building structures that support and assist children. Lawrence, KS: University of Kansas School of Social Welfare, Office of Child Welfare and Children’s Mental Health.