come on in: running groups for mothers and their children debra bercuvitz, mph debra bercuvitz, mph...
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Come On In: Running GroupsCome On In: Running Groupsfor Mothers and their Childrenfor Mothers and their Children
Debra Bercuvitz, MPHDebra Bercuvitz, MPH Debbie Flynn-Gonzalez,M.EdDebbie Flynn-Gonzalez,M.Ed Ruth Karacek, RN, MPHRuth Karacek, RN, MPH
History of FRESH Start (FS)History of FRESH Start (FS)
FRESH (Family Recovery Engagement Support of Hampden County) Start
Joint initiative with Mass Dept. of Public Health and Mass Dept. of Children and Families since 2008 with funding from Children's Bureau (CB) through a competitive grants authorized by the Abandoned Infants Assistance Act (AIA) of 1988
Project builds upon and expands the state’s Substance Exposed Newborn initiative and the Regional Partnership Grant initiative
Service ModelService Model
FS combines peer mentoring, a major component of the program, support,and advocacy with clinical guidance andtreatment
Staff provide case management,as well as direct recovery and parenting assistance.
Staff partner with child welfare, early intervention, and substance use disorder tx providers to increase client engagement with their services
History of FS GroupsHistory of FS Groups
Peer model works well in pre-contemplation and contemplation stages
Clients benefit from peer support in a group context
As clients move forward, need more from their community
SENs bring a different dynamic to children in groups
Often, groups are the first opportunity to actively mother or mother in sobriety
Groups follow client progressionGroups follow client progression
Run parent- child groups that promote attachment and recovery
FS goal to move clients through• Individual work with peer mentor• Parenting groups (Active Parenting /infant
massage less threatening)• Nurturing Program (NP) - more introspective
and intense• Community based support groups (NA, MITH or
MotherWoman)
Philosophy of CarePhilosophy of Care
Strength basedStrength based Family focusedFamily focused Evidence basedEvidence based Consumer directedConsumer directed Trauma informedTrauma informed Culturally relevantCulturally relevant
GroupsGroups
Lessen isolationLessen isolation Increase parent-child attachmentIncrease parent-child attachment Reinforce role of mother Reinforce role of mother Build recovery community for familiesBuild recovery community for families Increase use of Early Intervention (EI) Increase use of Early Intervention (EI)
servicesservices Expose children to early education and Expose children to early education and
carecare
RecruitmentRecruitment
Assess the client’s readiness for groupAssess the client’s readiness for group Stage of recoveryStage of recovery Impulse control, self-regulationImpulse control, self-regulation Significant mental health issuesSignificant mental health issues
• Major depressionMajor depression• Untreated bipolarUntreated bipolar• Severe anxietySevere anxiety• PTSDPTSD
Recruitment & CollaborationRecruitment & Collaboration
When 2 or more agencies collaborate on a When 2 or more agencies collaborate on a group:group:
Equal representation with facilitatorsEqual representation with facilitators Emphasis on team approachEmphasis on team approach Identify the “common thread”- ( i.e. we Identify the “common thread”- ( i.e. we
are all mothers here)are all mothers here) Each agency staff recruit but no Each agency staff recruit but no
differentiation between participantsdifferentiation between participants
Getting there…Getting there… Identify / Name group & talk it up!Identify / Name group & talk it up! Develop non-threatening flyer with Develop non-threatening flyer with
welcoming name of groupwelcoming name of group Call providers to offer more info, get staff Call providers to offer more info, get staff
“buy in”“buy in” Have staff bring in client for first group, Have staff bring in client for first group,
meet client outsidemeet client outside Prepare clients for how they are getting Prepare clients for how they are getting
there, remindersthere, reminders
Opening the door…Opening the door… Prepare client for what to expectPrepare client for what to expect
• Who will be thereWho will be there• What to expectWhat to expect• Format of the group (don’t have to share, Format of the group (don’t have to share,
confidentiality)confidentiality)• Process of groupProcess of group• Develop a “need a break” signDevelop a “need a break” sign• Just “check it out”, if you hate it don’t Just “check it out”, if you hate it don’t
have to come back! Prepare client for have to come back! Prepare client for what to expectwhat to expect
EngagementEngagement
Once they are in, how do we keep them Once they are in, how do we keep them “in”?“in”?
Create a welcoming environment Create a welcoming environment • Have a welcome person at door, another Have a welcome person at door, another
parentparent• Ideally start with a family style meal, Ideally start with a family style meal,
coffee / café stylecoffee / café style• Post or hand out schedulePost or hand out schedule• Welcome “gift”Welcome “gift”
EngagementEngagement
Well, we’re here…Well, we’re here… First group should “sell itself”First group should “sell itself”
• Atmosphere of respect, strength basedAtmosphere of respect, strength based• Focus on being mothers, not just people in Focus on being mothers, not just people in
recoveryrecovery• Point out strengths, gently step in to offer Point out strengths, gently step in to offer
help when needed help when needed • Members choose guidelines and pick Members choose guidelines and pick
topics of interest when appropriatetopics of interest when appropriate• Clear plan for next groupClear plan for next group
EngagementEngagementBeen there…come back…Been there…come back… Debrief with client after groupDebrief with client after group Point out benefits to childrenPoint out benefits to children Share positive observationsShare positive observations Assign a “buddy” to remind about next groupAssign a “buddy” to remind about next group Assign a group taskAssign a group task Validate their presence in the groupValidate their presence in the group
• ““Thanks for sharing”, “what you said helped Thanks for sharing”, “what you said helped someone else”, “I know that was hard for someone else”, “I know that was hard for you”, send a thank you noteyou”, send a thank you note
When it is not working…When it is not working…
When someone is clearly not ready, do not When someone is clearly not ready, do not see it as a failuresee it as a failure• End with a success- what did you End with a success- what did you
contribute, what did your child learn, contribute, what did your child learn, introduction to a group experience, introduction to a group experience, celebrate brief separation from child as celebrate brief separation from child as successsuccess
• Identify other things to focus onIdentify other things to focus on• See it as a future goal, point out See it as a future goal, point out
different paths to recoverydifferent paths to recovery
Tackling the hurdles Tackling the hurdles (the “Big Three”(the “Big Three”
ChildcareChildcare TransportationTransportation FoodFood
ChildcareChildcare
Prepare for care of SENs, children with Prepare for care of SENs, children with multiple traumas (foster care placement, multiple traumas (foster care placement, parental d.v. and substance use, abuse & parental d.v. and substance use, abuse & neglect), attachment disordersneglect), attachment disorders
Start with parent-child time, prepare for Start with parent-child time, prepare for transitionstransitions
Recognize parental difficulty with Recognize parental difficulty with separation separation
Intro to early education & careIntro to early education & care
Childcare (cont’d)Childcare (cont’d)
Including non-custodial parents/ arranging Including non-custodial parents/ arranging for visitation during groupsfor visitation during groups
Get creative with childcare workersGet creative with childcare workers Identify existing community Identify existing community
supports/servicessupports/services Gain a better sense of child’s development Gain a better sense of child’s development
to help with service coordinationto help with service coordination Conclude group with parent/child closing Conclude group with parent/child closing
activityactivity
Non-custodial visitation
Use groups as opportunity for visit in community, modeling parenting skills
New concept for child welfare workers—their trust in you, your sharing info
Plan for child not showing up “Some people are here with their children
and some people aren’t”
TransportationTransportation
Give rides first time and then put other Give rides first time and then put other options in placeoptions in place
Encourage public transportation- give bus Encourage public transportation- give bus passes, plan out route, go together on bus passes, plan out route, go together on bus as a home visit activity “dry run”as a home visit activity “dry run”
Connect neighbors, car-poolingConnect neighbors, car-pooling Van services from early education, Early Van services from early education, Early
Intervention transportationIntervention transportation Consider weather, time of group, safety Consider weather, time of group, safety
issuesissues
FoodFood Honoring diverse culturesHonoring diverse cultures Healthy food optionsHealthy food options Encouraging trying new foodsEncouraging trying new foods Child friendly foodsChild friendly foods Encourage & model family meal timeEncourage & model family meal time Optional pot lucks with program providing Optional pot lucks with program providing
main coursemain course Seeking out church groups, ladies groups, Seeking out church groups, ladies groups,
exchange clubs, to donate/serve meals exchange clubs, to donate/serve meals
When it works…When it works…
2012 Graduates of Recovery Coach Academy
In Conclusion…In Conclusion…
““Nobody can go back and start a Nobody can go back and start a new beginning but anybody can new beginning but anybody can start today and make a new start today and make a new ending”. ending”.
Marla RobinsonMarla Robinson
