Integrated Safety-Organized Practice

1. Integrated Safety-Organized Practice • Module Six: • Harm Statements, • Danger Statements, • and Safety Goals Children’s Research Center A nonprofit social research organization and division of the National Council on Crime and Delinquency www.nccdglobal.org www.nccd-crc.org

2. Our Thinking Draws Fromthe Legacy of Others Insoo Kim Berg Steve de Shazer AndrewTurnell SteveEdwards Sonja Parker CRC Staff Rob Sawyer Sue Lohrbach Susie Essex Nicki Weld Carver County John Vogel Sophia Chin Heather Meitner …and we hope YOU will continue to build on these ideas and approaches.

3. Safety-Organized Practice Safety is: Actions of protection taken by the caregiver that mitigate the danger demonstrated over time. Adapted from Boffa, J., and Podesta, H. (2004) Partnership and risk assessment in child protection practice, Protecting Children, 19(2): 36–48. Turnell, Andrew & Susie Essex Working with Denied Child Abuse, Open University Press, 2006.

4. Agreements • “Try on.” • Everyone always has the right to pass. • Silence is a contribution. • We agree to share airtime and stick to time limits. • We agree to speak personally, for ourselves as individuals. • We agree to disagree and avoid making assumptions or generalities. • We agree to allow others to finish speaking before we speak and avoid interrupting and side conversations. • We will work together to hold to these agreements and authorize the trainer to hold us to them.

6. Agenda • Harm Statements • Danger Statements • Safety Goals • Use with Families • Linking SDM and Danger Statements and Safety Goals • Let’s Practice!

7. The Safety-Organized Practice Process

8. Essential Question Are the children safe? What Are the Worries? What’s Working Well? What Happens Next? SFQ’s Impact Detail Position Sort SDM SFQ’s Impact Detail Position Sort SDM SFQ’s Impact Detail Position Sort SDM

9. Checking In • What have you tried from the module last month? • What worked well? • What were your challenges? • How did you handle those challenges?

10. Let’s Get Started! • Think of a family you or someone you know is working with now or in the recent past who has been involved with CWS between six months and ten years. • How confident are you that you can state exactly why the family is involved with CWS? • How confident are you that the FAMILY understands and can state exactly why the family is involved with CWS?

11. Let’s Get Started #2! • How confident are you that you can state EXACTLY what the family needs to do differently so you will know the children are safe? • How confident are you that the FAMILY understands and can state what needs to happen so that everyone knows their children are safe?

12. Definitions • Harm Statements: Clear and specific statements about the harm or maltreatment that has happened to the child. • Danger Statements: Simple behavioral statements of the specific worry we have about this child now and into the future. • Safety Goals:Clear, simple statements about what(not how) the caregiver will DO that will convince everyone the child is safe now and into the future. • These are little gems of clarity.

13. What’s It All About? DANGER STATEMENT: What we worry will happen next HARM STATEMENT: What already happened GOAL STATEMENT: What we hope happens instead NOW

14. What’s It All About? DANGER STATEMENT: Why we need to STAY involved HARM STATEMENT: Why we GOT involved GOAL STATEMENT: What will tell us we can STOP NOW

15. Value of Harm, Danger, and Goal Statements FOCUS *Turnell, A. and Edwards S. (1999). Signs of Safety. New York: Norton

16. Moving to Best Practice • While creating harm statements, danger statements, and safety goals in the office is a great place to start, EXTRA VALUE comes when we can co-create these with families!

17. Harm Statements It’s essential to get agreement from the person before using his/her name in a harm statement.

18. The Question That the Harm Statement Answers • “What exactly has been reported that the caregivers did to hurt the children physically, developmentally, or emotionally?”

19. Harm Statements Clear and specific statements about the harm or maltreatment that has happened to the child.

20. Harm Statement Example • Doctor Bones reported that Adam’s dad, Matt, hit Adam several times with an open hand and a closed fist last Sunday, causing several bruises on Adam’s head and back.

21. Harm Statement Tips • The harm statement needs to include specific details: who has reported the concern (when it is possible to share this), what exactly happened, and the impact on the child. • They should be written in honest, detailed, non-judgmental “just the facts” language. • Screener narratives could include a provisional harm statement based on the facts marked on the SDM screening tool.

22. Harm Statement Practice Wendy, age 4, runs around her apartment complex during the day while her mother, Beth, sleeps. The apartment manager recently found her playing with glass from a broken window. Wendy’s right hand was cut from the glass, requiring stitches.

23. Danger Statements

24. The Question That the Danger Statement Answers • “What is CWS most worried will happen to the children if they are in the care of their parents and nothing else happens to mitigate the danger?”

25. Danger Statements Simple behavioral statements of the specific worry we have about this child now and into the future.

26. Danger Statement Example • CWS, Doctor Bones, the police, and Adam’s mom, Tonya, are worried that Adams’ dad, Matt, may hit Adam again, leaving him with bruises and even more serious injuries.

27. Danger Statement Uses • Danger statements clearly identify what the professionals are worried may happen if there are not enhanced actions of protection by the family and network. • Sharing danger statements with the family (and within the agency!) helps create a sharpened focus on the key issues that need to be addressed so the family can make changes and demonstrate actions of protection. This can also prevent “case drift.”

28. Danger Statement Tips • Be real. If you raise the stakes, don’t get carried away. • They should be written in honest, detailed, non-judgmental “just the facts” language. • If no harm already happened, the danger is about what ALMOST happened, or is LIKELY to happen, based on caregiver actions. • SDM safety assessment items that were marked could be resources for ideas on what we are worried about.

29. The Value of Danger Statements Internally: • Enhanced clarity in our own thinking as we start to think about our cases. • Greater clarity as cases get moved from one unit to another. • Helps facilitate discussions between supervisor and worker, manager and supervisor, perhaps even legal and clinical! • A process, not an event, and can be refined over time. Danger Statements & Genograms are like vital signs at shift change in the hospital. “what stands out to me about these harm and danger statements are no beating around the bush, and everything is out on the table.” - New worker just practicing H+D statements

30. Crafting the Statements • Use the formula (But don’t get stuck in it!) • Behavioral detail • Family language • Impact on child • Make sure all concerns are listed

31. Danger Statement Practice Wendy, age 4, runs around her apartment complex during the day while her mother, Beth, sleeps. The apartment manager recently found her playing with glass from a broken window. Wendy’s right hand was cut from the glass, requiring stitches.

32. Safety Goals

33. The Question That the Safety Goal Answers “What does CWS need to see the parents doing differently with their children so everyone will know the children are safe?” (not services)

36. Or think of them like book ends Danger Statement Safety Goal

37. Goal Statements Clear, simple statements about what the caregiver will DO that will convince everyone the child is safe now and into the future. Actions of protection taken by caregiver that mitigate the danger Demonstrated over time

39. Example of a Safety Goal Matt will work with CWS and his safety network (family, friends, and professionals) to show everyone he will always discipline Adam in ways that do not injure him (such as using time-outs, taking away Adam’s Gameboy, and giving incentives like earning a toy).CWS will need to see this safety plan in place and working continuously for a period of six months so that everyone is confident that the safety plan will keep working once CWS withdraws.

40. How Long?

41. How Long? SDM RISK REASSESSMENT

42. Two Kinds of Safety Goals

43. Mistake services for safety • Intervention drift • Lack motivation to make hard changes • Hard to measure progress

44. Safety Goal Tips

45. Safety Goal Tip:Avoid “Dead Man’s” Goals

46. Well-Formed Goals Safety Goal Tip:Avoid “Dead Man’s” Goals • Mr. Smith will always make sure there is a supportive and safe adult who can look after Billy. • Mr. Smith will always discipline Billy in ways that won’t hurt him.

47. Safety Goal Practice Wendy, age 4, runs around her apartment complex during the day while her mother, Beth, sleeps. The apartment manager recently found her playing with glass from a broken window. Wendy’s right hand was cut from the glass, requiring stitches.

48. Example Safety Goals Ongoing Safety Goal for Return Home: Beth agrees to work with her neighbor and her best friend Joy to show everyone that she can stay awake during the day and childproof her home to make it safe for Wendy when she returns home. Ongoing Safety Goal for Case Closure: Beth agrees to work with her neighbor, her landlord and her best friend Joy to show everyone that she can supervise Wendy whenever she is outside playing. This plan will be in place for at least 3 months.

49. Use With Families

50. The Value of Family-Generated Danger Statements and Safety Goals • With families: • Increase family clarity and understanding about agency fears and goals • Greater sense of family ownership and more buy-in and commitment to change • Important even in this attempt to engage the family not to give up agency “bottom lines”