Foster Care Assessment Program

1. Foster Care Assessment Program Evidence Based Approaches to Parenting Interventions Seminar December 9, 2008 Overview of EBP Implementation Practice and Procedures at Brigid Collins Family Support Center Byron G. Manering, MSW bmanering@brigidcollins.org This PowerPoint presentation and attachments are available at www.brigidcollins.org

2. Discussion TopicsHow to create competence in EBP’sHow to determine what EBP match is best for a familyHow to offer or deliver EBP’s as a part of an effective treatment package

3. Byron G. Manering, MSW, Executive Director bmanering@brigidcollins.org Now Open! Skagit Valley Family Support Center 1500 E Broadway, Mount Vernon Brigid Collins Family Support Center www.brigidcollins.org 1231 N. Garden Street #200, Bellingham, WA 98225 360.734.4616 - 360.734.1763 FAX - contact@brigidcollins.org

4. The Brigid Collins mission isto break the cycle of child abuseby preventing the onset of abuse and promoting justice and healing when abuse occurs Building a compassionate community that nurtures all its children

5. Menu of Servicesfor strong and healthy families • PREVENTION • Information, referrals and on-call professionals to immediately engage families • Strength-focused service plans based on family & individual needs • Cross-system care, case coordination, home visits & follow up services • Bilingual, bicultural case management & support groups - Familia Latina • Parent education newsletter & monthly family activity nights • Parent support groups, education & skills building • TREATMENT • Child sexual abuse needs assessments, education, and therapy • Child-friendly investigation, prosecution, advocacy & treatment of child abuse - Children’s Advocacy Center • Foster family support groups & foster child support services • Evaluation, assessment & medical services for child abuse victims • Chemical dependency focused intensive case management & behavioral health – Safe Babies, Safe Moms Growing Together • Serving over 1700 families each year, all Brigid Collins child abuse prevention programs are offered free of charge to families. Brigid Collins Family Support Center

6. BC Evidence Based Practices and Best Practices • Healthy Families America Home Visitors - 1995 • Wrap Around Case Management - 1997 • Parent Trust for Washington’s Children Parenting Groups -1997 • Parenting the First Year Newsletter – University of Wisconsin - 1997 • Foster Care Assessment Program (FCAP) - 1998 • Safe Babies, Safe Moms (pregnant/parenting mom’s w/ addiction) - 2000 • Dialectical Behavioral Therapy (DBT) - 2000 • National Children’s Alliance Children’s Advocacy Center - 2005 • Parent Child Interaction Therapy (PCIT) - 2006 • Incredible Years (IY) -2008 • Positive Parenting Program (Triple P) - 2008 • Motivational Interviewing (MI) - 2008

7. BC Parenting Skills Program EBP’s Parent Child Interaction Therapy (PCIT) Five coaches- 53 families annually Incredible Years (IY) Five providers – 4 groups (30-40 families) annually Positive Parenting Program (Triple P) Currently three providers in Levels 4 and 5 – 2-3 families each Level 2 and 3 training early 2009 Motivational Interviewing (MI) 19 providers trained

8. Generating Organizational EBP Competence • Staff • Training • Supervision • QA • Culture

9. Staff Our staff love our commitment to EBP’s. • Smiles on their faces • Constantly celebrating the progress they are making with their families • Their success reinforces their commitment Who does well with an EBP like PCIT? When hiring, keep in mind: • It is a structured behavioral intervention. • People who look at the world systematically are often good candidates. • Look for people comfortable in a world where there is a right way and a wrong way to do things. • Those with a scientific background (like nurses), or DD providers, or teachers are good prospects. • Case management experience is helpful for maintaining boundaries but not if case management is their first love.

10. Training • EBP training requirements help focus staff training so that it is targeted and minimally sufficient instead of a hodgepodge of topics. • Supervisors should be trained in the EBP in order to catch drift. • Drift will not likely be addressed unless by a trained supervisor. • Systematic training expectations lead to systematic application of the EBP. • Start serving immediately after training, even if no contract in place! • Have all staff oriented/versed in the EBP’s so that in their concurrent work with clients they are consistent and reinforce skill sets being taught by the EBP.

11. Supervision • Drift begins as soon as the individual leaves training. • Supervisors need to be trained in the EBP because drift will not likely be addressed unless by a supervisor. • Supervision is the key strategy for helping providers transform their new knowledge into technique and then into skill. Like parents who attend parenting class, they gain knowledge but it is not integrated into their behavior. Providers need support and coaching too! • Specialized training for supervisors of EBP’s: • Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency • Using Technology to Augment the Implementation and Effectiveness of PCIT, HCSATS and the /Univ. of Oklahoma Center on Child Abuse and Neglect • Training and creating a ‘model fidelity’ culture, improves clarity and goals and actually makes supervision easier.

12. Quality Assurance PCIT Washington PCIT Training and Apprenticeship Model draft 3 msw03.doc Washington State Triple Leadership Team Triple_P_QA_Framework_8-20-08_Draft[1].doc Brigid Collins Family Support Center PCIT FIDELITY EVAL Plan10-08 msw03.doc

13. Culture • Surrender to the systematic approach. • A clear commitment/expectation to model fidelity is critical for all administrators, supervisors, providers, and contractors – this level of commitment will lead to client commitment and success. • Culture of catching ‘drift’: expect to catch it, embrace it, and fix it – every time you do, it reinforces the culture of commitment to fidelity, practice improves, and successful outcomes increase. • Culture of success: success reinforces the process of fidelity. The systematic approach becomes addictive.

14. Matching family with best EBP Fit • Used as a technique to enhance existing provider practice skills (MI) • Used as a flexible tool to enhance existing services (Triple P Levels 2/3) • Used as a stand alone program (PCIT, IY, and Triple P Levels 4/5)

15. Which EBP for which family? A side-to-side comparison of the EBP models is a handy tool when determining which EBP is the best fit for which family. • Program_Grid(1) msw03.xls

16. Intervention, Engagement, Assessment, Delivery • Clarify the specific reason(s) for System (CPS, Courts, etc) intervention or other referral source. • Engage the parent. • Determine unique parent/family characteristics (learning styles, personalities, resources, etc.) and match to best EBP fit. Then, match to best available EBP. • Deliver EBP as a part of an integrated Parenting Skills Building Treatment Package.

17. Who does what? FamilySystem (CPS, Courts, etc) Provider Engagement and Parenting Skills EBP Assessment Service Intervention Assessment EBP Parenting Skills Building Treatment Package Delivery

18. Delivering EBP’s as a Part of an Integrated Treatment Package Reasons for attrition in our first IY group… “A lot of the clients (4) never actually showed up or contacted us in any way. Then there was another woman who relapsed on drugs and could not continue coming. Then there are another two clients whose attendance has been sporadic and the SW’s state those clients are not following through with any services.” • PCIT/Home Visitor Program • Pathway to Reunification –Parent Child Visitation, Family Treatment Court, Parenting Skills EBP Program Model deviations, whether on a case by case situation or programmatically, must have a reason, be thoughtful, and be planned. Such deviations should be done with consultation and supervision.

19. PCIT/Home Visitor Program In 2007 Brigid Collins’ PCIT graduation rate was 54%, a 21% increase over our previous graduation rate of 33%. This improvement was the result of: • An assessment of each family’s “readiness level” for PCIT is conducted by the PCIT Program Coordinator.  • All PCIT participants are assigned a Brigid Collins case manager. The Case Manager: • builds a trusting relationship client • is MI trained and oriented to PCIT • uses a checklist to support client’s PCIT practice • meets weekly with PCIT Coaches to discuss family progress • Outreach to community partners. • An organizational commitment to providing PCIT services and adhering to model fidelity.

20. Pathway to Reunification Service Focus EBP Intervention Family Treatment Court Parent engagement Motivational Interviewing Visit Structure, Parenting Deficit Identification Rose Marie Wentz* Parenting Skills Interventions Triple P Levels 2 and 3 High level interventions Triple P Levels 4 and 5, PCIT, IY *Rose Marie Wentz, Planned, Purposeful and Progressive Parent Child Visitation http://www.uwtv.org/programs/displayseries.aspx?fid=5500   (Select the Planned Purposeful and Progressive link for Wentz model presentation.)

21. Pathway to Reunification Table of 10 Permanency Improvement Project – Skagit and Whatcom County* Initial Placement Phase / Staying connected to your child and making the commitment to change • Phone call with parent on day one • First visit begins within 48 hours • Two times a week for 4 – 6 weeks • MI and Triple P Levels 2 and 3 Reasonable Efforts Phase / Spending quality time with your child and practicing new ways to parent • 1 – 12 months • One time a week • MI and Triple P Levels 2, 3, 4 and 5 Final Permanency Decision Phase / Enjoying your relationship with your child and demonstrating your skills as a parent • 6 – 15 months • One time a week • May include high level interventions like Triple P Levels 4 and 5, PCIT, or IY *University of Washington Court Improvement Training Academy, Table of Ten, http://www.uwcita.org/CITAv1008/tablesoften.html , select Table of 10 link.

22. Foster Care Assessment Program Evidence Based Approaches to Parenting Interventions Seminar December 9, 2008 Overview of EBP Implementation Practice and Procedures at Brigid Collins Family Support Center Byron G. Manering, MSW bmanering@brigidcollins.org This PowerPoint presentation and attachments are available at www.brigidcollins.org