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Family Advocacy Program Services

Purpose

Customers receiving Family AdvocacyProgram Services gain newcompetencies, improve individual andfamily functioning and resiliency, makeconnections in their community, andreduce their risk for family violence.

DEFINITION

Family Advocacy Program (MIL-FAP) Services include a continuum ofcoordinated services for families at risk of, or who have experienced, familyviolence including domestic abuse and/or child abuse and neglect. Servicesinclude prevention, advocacy, identification, assessment, treatment,rehabilitation, and follow-up to prevent future occurrences of family violence.

Note: The term "survivor" is used in these standards to encourage servicedelivery that empowers the customer experiencing family violence.

Note: Please see MIL-FAP Reference List for a list of resources thatinformed the development of these standards.

Note: The MIL-FAP standards were revised in September 2017 to reflectcurrent practice. For more information see the MIL-FAP Update Summary.

Table of Evidence

Self-Study Evidence

- Provide any information you would like the Peer Review Team toknow about the MFR program's FAP services.

- As applicable, a list of groups or classes including, for each group orclass: a. the type of group/class;b. whether the group/class is short-term or ongoing;c. how often the group/class is offered;d. the average number of participants per session of the group/class,

in the last month; ande. the total number of participants in the group/class, in the last

month.- A list of any programs that were opened, merged with other programs

or services, or closed- A list or description of MIL-FAP outcomes and outputs being

measured

On-Site Evidence

No On-Site Evidence

On-Site Activities

No On-Site Activities

Council on Accreditation - Copyright 2018


Purpose


MIL-FAP 1: Service Philosophy

The MFR program's delivery of FAP services is guided by a servicephilosophy that:

a. establishes the foundational principles that inform all aspects of servicedelivery;

b. is based on the best available evidence of service effectiveness;c. reflects the input of the MFR program's customers and community

partners;d. is family focused, trauma informed, and designed to identify and build on

strengths, supports, and protective factors;e. establishes a comprehensive, community approach to family violence

prevention, intervention, and treatment;f. is grounded in the social and cultural context of the military community;

andg. is understood by staff.

Related: MIL-AM 1.06, MIL-AM 5.04

Table of Evidence

Self-Study Evidence

- MIL-FAP service philosophy

On-Site Evidence

- Evidence base for selected interventions, when applicable

On-Site Activities

- Interview: a. MFR program directorb. Relevant staffc. Customers



Purpose


MIL-FAP 2: Family Violence Prevention Services

The FAP implements comprehensive education and awareness programsand activities designed to prevent family violence.

Related: MIL-AM 4.03

Interpretation: Examples of topics that may be addressed by preventionservices include parenting; anger management; conflict resolution; problemsolving and decision making; stress management; interpersonalrelationships and communication; and safety.

Note: Implementation of the MIL-FAP 2 standards will be reviewed andrated based on how MFR staff implement education and awarenessprograms designed to prevent family violence. For some MFR programs,family violence prevention may be included as part of its broader Personaland Family Life Education services (MIL-MLSE 8).

Table of Evidence

Self-Study Evidence

- Description of FAP prevention services (MIL-FAP 2.01, MIL-FAP2.02)

On-Site Evidence

- Prevention programming curricula or other informational material(MIL-FAP 2.01, MIL-FAP 2.02, MIL-FAP 2.03)

- Evidence or research base for selected interventions, whenapplicable (MIL-FAP 2.02)

On-Site Activities

- Interview: a. MFR program directorb. Relevant staff (MIL-FAP 2.02)c. Customers

MIL-FAP 2.01

Prevention services are provided in a variety of formats including:

a. educational classes, workshops, and seminars;b. New Parent Support Program, as applicable;c. one-on-one counseling sessions; andd. public awareness campaigns.



Purpose


Note: Services may be provided directly by the FAP or through referral toanother provider or program.

MIL-FAP 2.02

The MFR program implements prevention services that:

a. focus on identifying and reducing risk factors and enhancing protectivefactors;

b. are evidenced-based and offered at a frequency and durationappropriate to the type of intervention;

c. are tailored to the needs and characteristics of the target audience,taking into account the environmental context in which customers live;and

d. promote active participation.

Interpretation: When designing services for a specific group is not possibleor appropriate, implementation of element (c) can be demonstrated by usinginclusive language and acknowledging differences within the targetaudience such as gender, race, and age. Examples of environmentalcontext include the family unit, the community, and the military.

Research Note: The literature emphasizes that, regardless of the issue ortopic being addressed, prevention programs are more effective when theyare sustained over time and have multiple points of contact with reinforcingmessages. In fact, some literature suggests that programs with no continuitymay be detrimental as they do not offer the opportunity for appropriatefollow-through.

Research Note: Interventions that focus only on identifying deficits havelimited effectiveness. Instead, programs should focus on identifying andbuilding upon existing assets and resources to ensure customers have theskills and resources they need to respond with resilience to futurechallenges.

MIL-FAP 2.03

As part of its public awareness campaign, the MFR program educatescommunity members, mandated reporters, professional groups, andrelevant organizations about:

a. risk factors for family violence;b. protective factors associated with reduced risk of child abuse and

neglect, increased family strengths, and optimal child development;c. the effect that exposure to domestic abuse can have on children;



Purpose


d. recognizing and responding to signs of family stress;e. recognizing the signs of family violence;f. problems experienced by the survivors of family violence;g. reporting procedures for suspected child abuse and neglect including

requirements and means of reporting to multiple agencies orjurisdictions, when applicable;

h. reporting options for survivors of domestic abuse; andi. who to call when you wish to access services.

Interpretation: Examples of military and civilian providers that can betargeted by public awareness campaigns include law enforcement and legalservices; behavioral and physical health care providers; child protectiveservice agencies; shelters; child care providers; MFR program staff;commanders; officers and senior noncommissioned officers. Examples ofpublic awareness campaign strategies include: telephone calls, mailings,information packets, brochures, electronic media, and announcements atlocal programs and events.

Research Note: Protective factors are individual, family, or communitycharacteristics or conditions that reduce risk and promote child and familyhealth and well-being, even in the presence of adversity. StrengtheningFamilies(TM), a research-informed approach to program design and servicedelivery for child and family service programs identifies five protectivefactors, including knowledge of parenting and child and youth development,parental resilience, social connections, concrete supports, and the socialand emotional competence of children.

Research Note: Research has shown the impact of exposure to domesticabuse can be as harmful to children in the home as being abused orneglected themselves. Exposure to domestic abuse can result in physicalharm, neglect, and psychological effects such as anti-social behaviors,poorer academic performance, and fearful or inhibited behaviors. Over thelong-term, exposure can result in depression, trauma-related symptoms, lowself-esteem, substance abuse, and violent behavior. The effect thatexposure to domestic abuse may have on a child will vary given thepresence of protective factors, severity of the violence, the age of the child,the length of time they were exposed, and whether or not the childexperienced other adverse events such as child abuse and neglect.

Research Note: One common disincentive to reporting domestic abuse isfear of negative career consequences that could put the family in economicjeopardy. Many military spouses are dependent on the Service member forhousing, economic support, and other services such as insurance and



Purpose


health care. When the Service member is the survivor of domestic abuse,they may fear that they will be viewed as weak or undeserving of promotion.



Purpose


MIL-FAP 3: New Parent Support Program (NPSP) HomeVisiting Services

Home visitors work with at-risk families to improve parenting behaviors andfamily functioning by:

a. implementing a protective factors approach to service delivery;b. helping the customer to establish a formal and informal support network;c. providing relevant referrals to resources and needed services;d. promoting nurturing and attachment; ande. conducting educational and skill building activities to promote positive life

course development.

Research Note: A protective factors approach to home visiting can beembedded into any chosen program model to mitigate risk and support theachievement of positive outcomes.

Table of Evidence

Self-Study Evidence

- A description of the New Parent Support Program (MIL-FAP 3.02,MIL-FAP 3.03, MIL-FAP 3.06)

- Procedures for linking customers to services and providing ongoingmonitoring and follow-up (MIL-FAP 3.04)

On-Site Evidence

- Educational curricula and/or materials (MIL-FAP 3.05, MIL-FAP 3.07,MIL-FAP 3.08, MIL-FAP 3.09, MIL-FAP 3.10)

- Program model (MIL-FAP 3.01 MIL-FAP 3.02, MIL-FAP 3.06)- Customer files (MIL-FAP 3.02, MIL-FAP 3.03, MIL-FAP 3.04,

MIL-FAP 3.07, MIL-FAP 3.08, MIL-FAP 3.09, MIL-FAP 3.10)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 3.05, MIL-FAP 3.06)b. Relevant staff (MIL-FAP 3.05, MIL-FAP 3.06)c. Customers (MIL-FAP 3.06)

MIL-FAP 3.01

Home visits are guided by an established, evidence-based model that is thebasis for all program decisions including:



Purpose


a. assessment content;b. number of visits per year;c. length of visits;d. qualifications of the home visitor;e. staff training and supervision; andf. curriculum content, as applicable.

Research Note: Research on the effectiveness of home visiting programsidentifies model fidelity as critical to achieving desired outcomes.

Note: Please see MIL-FAP 6 for additional assessment criteria.

MIL-FAP 3.02

The frequency, intensity, and duration of services are adjusted as needed:

a. based on each customer's needs, risks, strengths, and circumstances;and

b. to support the acquisition of skills through repetition and practice.

Note: Please see MIL-FAP 7 for additional service planning and monitoringcriteria.

MIL-FAP 3.03

Customers are helped to reduce social isolation and develop positiveconnections with others by:

a. maintaining and strengthening their relationships with others within thefamily, including the extended family when desired and appropriate; and

b. developing and expanding their informal networks, including connectionswith friends, neighbors, and other members of their community.

MIL-FAP 3.04

Customers are helped to access needed services that:

a. meet basic needs and help them care for their children;b. promote competency and positive life course development;c. address family stressors;d. support the child's healthy development; ande. address behavioral health needs and concerns that may impede

effective parenting.



Purpose


Research Note: Some home visiting research suggests that the presenceof behavioral health and domestic abuse issues may limit the effectivenessof interventions intended to reduce the incidence of child abuse and neglectand emphasizes the importance of ensuring that providers are prepared to:(1) recognize the presence of these risk factors, and (2) respond by linkingcustomers with all needed services.

MIL-FAP 3.05

Educational interventions, materials, and curricula are adapted based onchild and family characteristics, the input of customers and otherstakeholders, and in accordance with the chosen program model.

Related: MIL-CR 1.08, MIL-CR 1.09

Interpretation: Examples of child and family characteristics include age,developmental level, special needs, race, culture, ethnicity, language, andliteracy level.

MIL-FAP 3.06

Home visitors assist customers in developing needed skills through varied,interactive experiences including modeling, role play, verbal and writtenpractice, and discussion as appropriate to the needs of the family and inaccordance with the chosen program model.

(FP) MIL-FAP 3.07

Home visitors educate parents on child development and child rearingtopics including, as appropriate to the familiy's needs and program model:

a. basic caregiving routines;b. child growth and development, including physical, cognitive, and social

development;c. environmental safety and injury prevention;d. meeting children's health and emotional needs; ande. age-appropriate behavioral expectations and effective discipline for

children.

MIL-FAP 3.08



Purpose


Home visitors work with the customer to improve personal functioning andpromote positive development by addressing the following, as appropriateto the family's needs and program model:

a. problem solving and decision-making;b. anger management;c. time, budget, and household management;d. communication skills;e. developing supportive networks;f. life transitions;g. personal growth and future aspirations; and/orh. effectively utilizing available resources.

MIL-FAP 3.09

Home visitors promote secure attachment and nurturing behaviors byproviding the following, as appropriate to the family's needs and programmodel:

a. information on the relationship between secure attachment and nurturingbehaviors and positive child development;

b. examples of infant and child care strategies that promote bonding andattachment;

c. opportunities to practice and obtain feedback on parent-childinteractions; and

d. strategies for involving fathers and other important adults when availableand appropriate.

MIL-FAP 3.10

Home visitors promote parental resilience as appropriate to the family'sneeds and program model by partnering with the parent(s) to:

a. recognize stress and identify triggers;b. develop strategies to prevent stress;c. develop and utilize stress management techniques; andd. access formal stress management resources or services when indicated.



Purpose


MIL-FAP 4: Access to Services

The MFR program handles all reports, referrals, and contacts fromprospective customers in a prompt and consistent manner, and:

a. initiates FAP services; orb. makes a referral to a provider or program better suited to meet their

needs.

Table of Evidence

Self-Study Evidence

- A description of the access point for reporting suspected child abuseand neglect (MIL-FAP 4.01)

- Procedures for ensuring 24-hour access to services for survivors ofdomestic abuse (MIL-FAP 4.02)

- Reporting policies and procedures (MIL-FAP 4.03, MIL-FAP 4.04,MIL-FAP 4.05)

- Procedures for initial contact (MIL-FAP 4.06, MIL-FAP 4.07, MIL-FAP4.08, MIL-FAP 4.09)

On-Site Evidence

- Informational materials provided to the community/prospectivecustomers (MIL-FAP 4.01)

- MOUs/agreements with community telephone networks oremergency response centers, if applicable (MIL-FAP 4.02)

- Customer files (MIL-FAP 4.06, MIL-FAP 4.09)

On-Site Activities

- Interview: a. MFR program directorb. Relevant staff (MIL-FAP 4.03, MIL-FAP 4.04, MIL-FAP 4.05,

MIL-FAP 4.08)c. Customers (MIL-FAP 4.03, MIL-FAP 4.04, MIL-FAP 4.05,

MIL-FAP 4.08)

(FP) MIL-FAP 4.01

A well-publicized, 24-hour access line is available to receive reports ofsuspected child abuse and neglect.



Purpose


Interpretation: When the MFR program is not the point of contact forreporting cases of suspected child abuse and neglect, standardimplementation is demonstrated by ensuring the mechanisms for reportingare still well publicized by the MFR program.

(FP) MIL-FAP 4.02

The MFR program ensures 24-hour access to services for domestic abuseand sexual assualt survivors directly or through a community telephonenetwork or emergency response center that:

a. employs trained individuals;b. returns calls within timeframes set by DoD or Service policy, not to

exceed 15 minutes; andc. has procedures that address how phone calls are returned without

increasing risk to survivors.

(FP) MIL-FAP 4.03

MFR program staff:

a. follow all reporting requirements as required by law and in accordancewith DoD and Service policy;

b. ensure survivors understand the various reporting options that areavailable to them and the risks and benefits of each; and

c. consult their supervisor and legal counsel as needed when determiningwhen a report must be made to law enforcement without the survivor'sconsent.

Related: MIL-HR 2.03, MIL-CR 2.07

Research Note: State definitions of child abuse and neglect vary and staffshould familiarize themselves with state laws governing whether exposureto domestic abuse, alone, constitutes child abuse and neglect.

MIL-FAP 4.04

Reporters of family violence are informed about:

a. the MFR program's responsibilities, including protection of the reporter'sidentity and the family's confidentiality to the extent authorized under lawor regulation;

b. what information the reporter will or will not have access to regarding the



Purpose


status of the report including any limitations imposed by the Privacy Act;c. the process that will be followed to respond to the report; andd. any ongoing role of the reporter.

(FP) MIL-FAP 4.05

Upon initial contact, alleged offenders are informed of:

a. the allegations being reviewed; andb. the process that will be followed to respond to the report.

NA The MFR FAP provides education, information and referral, and safetyplanning only and is not authorized to provide clinical treatment services.

NA The MFR program does not provide services in cases meeting DoDcriteria for domestic abuse or child abuse and neglect.

(FP) MIL-FAP 4.06

The MFR program's procedures for initial contact:

a. support timely initiation of services; andb. give priority to urgent needs or prospective customers at greatest risk.

MIL-FAP 4.07

The MFR program:

a. recognizes when customers have needs or concerns the MFR programis not prepared to address; and

b. connects those customers with resources, services, and supports.

MIL-FAP 4.08

Prospective customers who contact the MFR program receive informationnecessary to make an informed decision about using the MFR program'sservices including:

a. what services will be available and when;b. how the MFR program's services can support the achievement of



Purpose


desired outcomes;c. the benefits, risks, alternatives, and consequences of planned services;

andd. what information will be shared with the agency that made the initial

referral, if applicable.

Related: MIL-AM 1.07

MIL-FAP 4.09

A system is in place to document initial customer contacts regardless ofwhether a case is opened.



Purpose


MIL-FAP 5: Safety Planning

Following a report of domestic abuse or child abuse and neglect, providerswork with customers to:

a. evaluate whether immediate threats to safety exist;b. determine if ongoing efforts are needed to promote safety and

strengthen families; andc. develop a comprehensive safety plan designed to manage immediate

and ongoing safety concerns.

Table of Evidence

Self-Study Evidence

- Safety assessment procedures (MIL-FAP 5.01, MIL-FAP 5.02,MIL-FAP 5.05, MIL-FAP 5.09)

- Safety assessment tool(s) (MIL-FAP 5.02, MIL-FAP 5.03, MIL-FAP5.04, MIL-FAP 5.09)

- Safety planning procedures (MIL-FAP 5.05, MIL-FAP 5.06, MIL-FAP5.07, MIL-FAP 5.08, MIL-FAP 5.09)

On-Site Evidence

- Regulatory or administrative requirements that define intervals forsafety assessments (MIL-FAP 5.09)

- Customer files (MIL-FAP 5.01,MIL-FAP 5.02, MIL-FAP 5.03, MIL-FAP5.04, MIL-FAP 5.05, MIL-FAP 5.06, MIL-FAP 5.07, MIL-FAP 5.08,MIL-FAP 5.09)

- List of local and national resources made available to survivors andnon-offending parents (MIL-FAP 5.08)

On-Site Activities

- Interview: a. MFR program directorb. Relevant staffc. Customers

(FP) MIL-FAP 5.01

The MFR program follows-up with the customer according to the followingguidelines:

a. every child and domestic abuse survivor determined to be in imminent



Purpose


danger is seen immediately; andb. in all other cases, children and domestic abuse survivors are seen in

accordance with timeframes established by DoD or Service policy, butnot to exceed 24 hours to ensure their safety.

Interpretation: In some cases, authority to make an initial in-person visitmay be delegated to other professionals, such as law enforcement officialsor child protective services workers. When contact is delegated, the MFRprogram demonstrates standard implementation by providing any neededfollow-up and initiating its internal assessment process within establishedtimeframes.

MIL-FAP 5.02

Safety assessments are conducted using a standardized tool that is widelyrecognized as a valid safety assessment tool.

Interpretation: Assessment tools may be provided by ServiceHeadquarters.

MIL-FAP 5.03

Immediately following a report of child abuse and neglect, the MFR programengages the customer in the safety assessment process that will informdevelopment of a safety plan and considers:

a. the presence, or threat, of serious harm including lethality risk;b. the family's ability to protect the child including family strengths,

resources or characteristics that mitigate threats of serious harm to thechild; and

c. the child's vulnerability.

Interpretation: Examples of child attributes that can impact vulnerabilityinclude age; developmental level and mental disability; physical disabilityand illness; the visibility of the child to others such as caregivers, teachers,or doctors; the child's ability to communicate; and the child's ability to meettheir own basic needs.

NA The MFR program does not provide services in cases meeting DoDcriteria for suspected child abuse and neglect.



Purpose


MIL-FAP 5.04

Immediately following a report of domestic abuse, the MFR programengages the customer in a safety assessment that:

a. informs development of a safety plan;b. addresses factors that may limit a survivor's willingess to provide

complete and accurate information;c. identifies immediate needs including medical and dental care, legal

assistance, financial assistance, food, shelter, and clothing;d. considers lethality risk; ande. identifies safety factors for any involved family members.

Interpretation: Examples of factors that may limit a survivor's willingness toprovide complete and accurate information include fear of further violence ifhis or her partner finds out; his or her financial dependency on theperpetrator; fear that the report will jeopardize the family's sole source ofincome and insurance; or fear that his or her children will be removed fromthe home or that they may lose custody.

Interpretation: Examples of factors that can contribute to lethality risk indomestic abuse cases include:

a. increased frequency or severity of violence;b. ease of access to weapons and previous use of, or threats of using,

weapons;c. threats to harm or kill the partner, oneself, or someone else;d. evidence of excessive use of alcohol or other drugs;e. presence of extreme jealousy, possessiveness, monitoring behaviors,

obsession or stalking;f. attempts to control daily activities;g. previous acts or attempts of forced or coerced sex;h. previous attempts to strangle the survivor;i. survivor attempts or makes statements to leave the relationship;j. whether or not the survivor is pregnant and the perpetrator's attitude

toward the pregnancy; andk. whether or not the survivor fears that the perpetrator will harm the

survivor or another person.

MIL-FAP 5.05

Whenever the safety of the customer is in question, the MFR program:

a. makes a referral to military law enforcement, the command, or child



Purpose


protective services as appropriate; and/orb. take steps to encourage the customer to go to a safe location.

MIL-FAP 5.06

Survivors of domestic abuse guide the development of anassessment-based safety plan that:

a. reflects their stated needs and goals;b. is tailored to their particular strengths, needs, risks, abilities, resources,

and circumstances;c. builds on realistic possibilities and options;d. prepares them to promote their safety in various circumstances and

places including preparing for immediate escape, if necessary;e. is adaptable to changing circumstances; andf. responds to the needs of their children, as applicable.

Research Note: Literature highlights the importance of helping survivorsdevelop safety plans regardless of whether they: (1) have left theperpetrator, (2) are in the process of leaving the perpetrator, or (3) willremain involved with the perpetrator.

MIL-FAP 5.07

The customer is involved in the development of an assessment-basedsafety plan for allegations of child abuse and neglect that:

a. identifies those strategies and services that can be provided immediatelyto ensure the child's safety;

b. describes how the plan will be implemented and monitored; andc. stays in effect until there is no longer serious harm, or the threat of

serious harm with insufficient protective capacities.

NA The MFR program does not provide services in cases meeting DoDcriteria of suspected child abuse and neglect.

MIL-FAP 5.08

Survivors of domestic abuse, or the non-offending parent in allegations ofchild abuse and neglect, are offered contact information for local andnational resources.



Purpose


MIL-FAP 5.09

An on-going, informal assessment of safety occurs at every contact andsafety assessments and plans are formally updated:

a. at least quarterly;b. following allegations of a new incident of domestic abuse or child abuse

and neglect;c. following the initiation of command or legal involvement;d. during significant transition periods in treatment;e. following significant changes to the home's composition or its finances;f. following significant events such as deployment, pregnancy, or job loss;g. when clinically relevant issues are uncovered such as childhood trauma;h. according to regulatory or administrative requirements; andi. prior to case closing.



Purpose


MIL-FAP 6: Needs Assessment

Customers who receive ongoing services participate in a strengths-based,individual- or family-focused, culturally-responsive needs assessment thatinforms the development of the services plan.

Note: Refer to the Assessment Matrix - MFR for additional assessmentcriteria. The elements of the matrix can be tailored according to the needsof specific customers or service design.

Note: While the safety assessment standards in MIL-FAP 5 address theidentification of immediate safety concerns following allegations of domesticabuse or child abuse and neglect, MIL-FAP 6 is focused on the identificationof broader service needs including services and support that will addressthe underlying conditions or behaviors. Both MIL-FAP 5 and MIL-FAP 6should be conducted if ongoing treatment or support will be provided incases of domestic abuse or child abuse and neglect.

Table of Evidence

Self-Study Evidence

- Needs assessment procedures (MIL-FAP 6.01, MIL-FAP 6.02, MIL-MIL-FAP 6.05)

- Needs assessment tool or instruments (MIL-FAP 6.02, MIL-FAP 6.03,MIL-FAP 6.04, MIL-FAP 6.06)

- Procedures for promoting physical, psychological, and emotionalhealth and safety of customers (MIL-FAP 6.06)

On-Site Evidence

- Customer files (MIL-FAP 6.03, MIL-FAP 6.04, MIL-FAP 6.05,MIL-FAP 6.06)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 6.01)b. Relevant staff (MIL-FAP 6.01)c. Customers (MIL-FAP 6.06)

(FP) MIL-FAP 6.01

The needs assessment process for family violence cases minimizes



Purpose


duplication of effort, thereby reducing trauma to the customer.


MIL-FAP 6.02

All needs assessments are:

a. completed within timeframes established by the MFR program;b. directed at concerns identified in the original report, referral, or initial

contact;c. conducted using standardized assessment tools or instruments;d. used as a basis for developing and updating the services plan and goals;

ande. updated periodically including when there are significant changes to the

home composition and prior to case closing.

Interpretation: Assessment tools may be provided by ServiceHeadquarters.

MIL-FAP 6.03

The MFR program works with customers to complete a comprehensive,culturally-responsive needs assessment that:

a. identifies the customer's strengths, protective factors, and needs;b. takes into account the developmental level of children living in the home;c. includes a description of the reason for referral/report or the customer's

reason for contacting the program, any history of violence, and any otherrelated risks;

d. facilitates the identification of customers with co-occurring conditions thatmay require a referral;

e. facilitates the identification of the co-occurrence of domestic abuse andchild abuse and neglect;

f. identifies underlying issues that may contribute to family stress;g. determines the risk for future abuse;h. identifies potential events that may trigger the onset of abuse, as

applicable;i. evaluates the impact of the problem on children, as applicable, and their

need for assistance; andj. identifies resources that can increase service participation and support

the achievement of agreed upon goals.



Purpose


Interpretation: Examples of considerations that contribute to a culturallyresponsive needs assessment include attention to geographic location,language of choice, age and developmental level, and the customersreligious, racial, ethnic, and cultural background.

Interpretation: Factors that increase the risk for future domestic abuseinclude, but are not limited to:

a. a perpetrator who blames the survivor for his or her abusive acts;b. a demonstrated lack of motivation to change his or her behavior;c. physical or emotional abuse of children;d. previous criminal behaviors unrelated to domestic abuse;e. financial problems; andf. mental health issues or disorders.

MIL-FAP 6.04

In cases of domestic abuse, the needs assessment considers the context inwhich the violence took place including:

a. exacerbating factors such as why violence is being used and whatinjuries, if any, have been inflicted; and

b. mitigating factors such as whether or not violence was used asself-defense or to protect others within the household.


(FP) MIL-FAP 6.05

When needs assessment reveals the need for specialized or intensiveservices beyond the scope of the FAP, such as a co-occuring behavioralhealth issue:

a. a referral and assistance connecting to services is provided; andb. ongoing collaboration and coordinated service planning occurs to the

greatest extent possible and appropriate given identified needs andservice goals.

Research Note: Research has shown that domestic abuse and substanceuse conditions are often co-occurring in perpetrators and one issue oftenexacerbates the other. As such, the most effective prevention and treatmentprograms are those that address the issues of domestic abuse and



Purpose


substance use or misuse concurrently.

(FP) MIL-FAP 6.06

The MFR program promotes the physical, psychological, and emotionalsafety of customers by:

a. screening customers for histories involving violence or other trauma;b. monitoring the service population for emerging physical, psychological,

and emotional safety needs; andc. making changes to the service environment or procedures as necessary

to respond to the safety needs of customers.

Interpretation: Regarding element (c), examples of mechanisms that canbe used to respond to the safety needs of customers include usingstaggered scheduling and separate entrances to ensure safety andanonymity; monitoring interactions among customers and staff to ensurethey remain respectful, calming, and empowering; establishing andenforcing rules for the service environment; and soliciting and responding tofeedback from customers regarding their perceived safety in the serviceenvironment.

Research Note: The National Council for Behavioral Health and theSubstance Abuse and Mental Health Services Administration identify aphysical environment that promotes a sense of safety and collaboration asone of the key domains for implementing a trauma-informed approach tocare, and a fundamental component of service accessibility for customerswho have experienced trauma.

NA The MFR program provides services where screening for historiesinvolving violence or other trauma would be inappropriate for the servicemodel.



Purpose


MIL-FAP 7: Service Planning and Monitoring

Customers who receive ongoing services work with providers to developand review services plans that are the basis for delivery of needed servicesand support.

Table of Evidence

Self-Study Evidence

- Service planning and monitoring procedures (MIL-FAP 7.01, MIL-MIL-FAP 7.03, MIL-FAP 7.04, MIL-FAP 7.05, MIL-FAP 7.06, MIL-FAP7.07, MIL-FAP 7.08, MIL-FAP 7.09)

On-Site Evidence

- Documentation of case review (MIL-FAP 7.07, MIL-FAP 7.08)- Customer files (MIL-FAP 7.01, MIL-FAP 7.02, MIL-FAP 7.03,

MIL-FAP 7.04, MIL-FAP 7.06)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 7.05)b. Relevant staff (MIL-FAP 7.05)c. Customers

MIL-FAP 7.01

A services plan is:

a. developed within established timeframes and expedited service planningis available when crisis or urgent need is identified;

b. based on the findings of the assessment; andc. individualized to meet the unique needs of the customer.

MIL-FAP 7.02

Customers fully participate in the development of a services plan thatincludes:

a. the customer's stated goals, desired outcomes, and timeframes forachieving them;



Purpose


b. agreed-upon services and supports to be provided, and by whom;c. timeframes for evaluating progress, when applicable; andd. documentation of the customer's participation, including children when

appropriate, in developing the plan.

Interpretation: Generally children age six or over are to be included inservice planning if clinically appropriate and agreed to by the parent or legalguardian.

MIL-FAP 7.03

Customers fully participate in the development of a services plan that istailored to meet their unique needs and stated goals by:

a. building on their strengths and resources;b. addressing risks including factors that contribute to family stress such as

deployment or frequent relocation;c. addressing family relationships and informal social networks;d. reflecting their cultural needs and the role that cultural traditions can play

in addressing presenting concerns;e. reflecting the developmental needs of children in the home;f. supporting the development of protective factors; andg. reflecting their description of resources, concerns, and priorities.

Interpretation: Examples of factors that should be addressed by theservices plan include the gender of the perpetrator, grief, substance use ormisuse, co-occurring domestic abuse and child abuse and neglect, theexistance of trauma, and deployment.

Research Note: Some research suggests that survivors of domestic abusefind services more helpful and effective when they have a greater sense ofcontrol and when staff listen to and respect them.

MIL-FAP 7.04

When the assessment identifies a need for multiple service interventions,the services plan should integrate services provided by cooperating serviceproviders to the greatest extent possible when its in the best interest of thecustomer and with his or her consent.

Related: MIL-CR 2.04



Purpose


MIL-FAP 7.05

Extended family members and significant others, as appropriate to theneeds of the customer and with his or her consent, are advised of ongoingprogress and invited to participate in case conferences and MFR programservices.

MIL-FAP 7.06

Service planning in family violence cases addresses:

a. strategies to change behaviors and conditions that led to the abuse;b. services and supports available to address the effects of abuse and to

prevent future abuse;c. how the MFR program can support the achievement of child and partner

safety and child and family well-being; andd. expectations and potential consequences of non-compliance with the

service plan.


MIL-FAP 7.07

The provider, the customer, and others as appropriate to the wishes of thecustomer regularly review progress toward achievement of agreed upongoals and make revisions to service goals and plans.

Interpretation: Timeframes for reviews may be set by DoD or Servicepolicy. In the absence of such guidance, the MFR program should establishtimeframes for review that are appropriate to the needs of the customer andthe frequency and intensity of services provide.

MIL-FAP 7.08

The provider and a supervisor, or a service or peer team, review the case atleast quarterly to assess:

a. services plan implementation;b. the customer's progress toward achieving goals and desired outcomes;

andc. the continuing appropriateness of indentified goals.



Purpose


Interpretation: Timeframes for services plan review should be adjusteddepending upon the issues and needs of customers, and the frequency andintensity of services provided.

(FP) MIL-FAP 7.09

If new concerns arise about the safety of individuals residing in the home atany point during service delivery, the MFR program immediately:

a. initiates a safety plan if one does not already exist;b. obtains resources or services to address unmet basic needs; andc. makes a referral to military law enforcement, the command, or child

protective services as appropriate.

Interpretation: Examples of basic needs include food, clothing, financialresources, and shelter. In some cases, treatment or services should also beinitiated immediately.



Purpose


MIL-FAP 8: Child Abuse and Neglect Case ManagementServices

The MFR program arranges, provides, and coordinates the delivery ofservices to ensure child safety, promote well-being, and keep familiestogether whenever possible.

NA The MFR FAP is not responsible for manageging cases meeting DoDcriteria for child abuse and neglect.

Table of Evidence

Self-Study Evidence

- A description of case management services (MIL-FAP 8.01)- Guidelines or procedures regarding regular in-person contact with the

customer (MIL-FAP 8.02)

On-Site Evidence

- Community resource and referral list (MIL-FAP 8.01)- Customer files (MIL-FAP 8.01, MIL-FAP 8.02)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 8.02)b. Relevant staff (MIL-FAP 8.02)c. Customers (MIL-FAP 8.02)

MIL-FAP 8.01

The MFR program directly provides, refers, contracts, or otherwise arrangesfor needed therapeutic, educational, and supportive services, as appropriateto the needs of the customer, including:

a. parent education and family support;b. homemaker or home health aide services;c. child care;d. respite care;e. non-medical, individual and family counseling services; andf. education, employment, and housing services.



Purpose


(FP) MIL-FAP 8.02

In-person contact with the customer is made at least monthly, or morefrequently as appropriate to the needs of the customer, to:

a. establish effective working relationships;b. assess safety and well-being;c. monitor service delivery including confirmation that services were

initiated, that they continue to meet the needs of the customer, and thatthey are responsive to complaints or problems that develop regardingservice delivery; and

d. measure and support the achievement of agreed upon goals.

Interpretation: When other providers are visiting the customer, and allproviders are effectively sharing information, the MFR program maydecrease the frequency of in-person contact.



Purpose


MIL-FAP 9: Domestic Abuse Advocacy and SupportServices

Survivors and their children, as applicable, receive a range of supportiveservices that promote well-being and self-determination.

Table of Evidence

Self-Study Evidence

- A description of domestic abuse advocacy and supportservices (MIL-FAP 9.02, MIL-FAP 9.03, MIL-FAP 9.04, MIL-FAP9.06, MIL-FAP 9.07)

- Procedures for linking survivors to services and providing ongoingmonitoring and follow-up (MIL-FAP 9.01, MIL-FAP 9.02)

- Procedures for collaborating with child protective services agencies(MIL-FAP 9.05)

- Procedures for protecting the safety of survivors when perpetratorsare involved in services, if applicable (MIL-FAP 9.07)

- Record keeping procedures for domestic abuse survivors (MIL-FAP9.08)

On-Site Evidence

- Community resource and referral list (MIL-FAP 9.01, MIL-FAP 9.02,MIL-FAP 9.03)

- Training curricula for educational offerings (MIL-FAP 9.01, MIL-FAP9.03)

- Educational material and information (MIL-FAP 9.01, MIL-FAP 9.03)- Customer files (MIL-FAP 9.01, MIL-FAP 9.02, MIL-FAP 9.03,

MIL-FAP 9.04, MIL-FAP 9.05, MIL-FAP 9.06)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 9.04, MIL-FAP 9.05, MIL-FAP

9.06)b. Relevant staff (MIL-FAP 9.04, MIL-FAP 9.05, MIL-FAP 9.06)c. Customers

MIL-FAP 9.01

Survivors receive assistance with the following, as appropriate to the needsof the customer:



Purpose


a. finding a safe, stable living arrangement;b. working with law enforcement and the courts;c. locating an attorney;d. obtaining needed educational or training services;e. conducting an effective job search;f. accessing child care, transportation, healthcare and other needed

military or civilian resources and benefits;g. managing a household;h. budgeting and money management, including credit and debt

counseling; andi. accessing food and nutrition assistance or resources.

Interpretation: Educational offerings may be provided through referral toanother program.

Interpretation: Examples of appropriate living arrangements include findinga new residence and living independently in a new community, residing withfriends or relatives, transitional housing, emergency shelter, and returninghome with available legal and command protections when necessary.

Research Note: Literature suggests that one of the main reasons survivorshave limited options for improving or attaining safety is a lack of financialresources.

MIL-FAP 9.02

Counseling services are available as needed, either directly or by referral,for survivors and their children and include:

a. clinical-counseling;b. support groups; andc. behavioral health consultations.

MIL-FAP 9.03

Survivors with children have access to educational material and support inthe following areas, as appropriate to the needs of the customer;

a. the effects of exposure to domestic abuse on children;b. services that promote child resiliency;c. parenting children who have experienced trauma; andd. repairing or strengthening their relationship with their children and

fostering supportive parenting and secure attachments.



Purpose


Interpretation: Examples of services that may benefit children who havebeen exposed to domestic abuse include counseling, recreationalopportunities, and opportunities to set goals and feel accomplished.

MIL-FAP 9.04

Survivors are helped to develop and expand their informal supportnetworks, including connections with friends, extended family, and othermembers of their community.

MIL-FAP 9.05

When a survivor's children are involved with child protective services, theMFR program collaborates with the child protective services agency inaccordance with applicable laws to:

a. provide needed education to child protective workers about thedynamics of domestic abuse;

b. ensure that needs are addressed in a cohesive and comprehensivemanner; and

c. promote the best interests of both survivors and their children.


MIL-FAP 9.06

Services for children who have been exposed to domestic abuse focus on:

a. meeting the specific needs of the child;b. assisting the child in safety planning that is coordinated with that of his or

her non-offending parent;c. identifying and understanding the dynamics of domestic abuse;d. providing a venue to share his or her story;e. learning alternatives to violence in conflict resolution; andf. realizing that abuse is not their fault.


MIL-FAP 9.07



Purpose


When the survivor wishes to involve the perpetrator in services, the MFRprogram assists survivors in exploring the risks and potential benefits oftheir involvement and, when perpetrators are involved in services:

a. the MFR program has procedures to promote the safety and well-beingof survivors and their children; and

b. the survivor's safety plan addresses issues specific to perpetratorinvolvement.

Interpretation: This standard does not require MFR programs to involveperpetrators in services.

MIL-FAP 9.08

Customer files for survivors of domestic abuse are maintained in a way thatprotects confidentiality and eliminates risk to survivors.

Research Note: Because it can be difficult to know what information mightbe damaging to survivors if disclosed, as in the case of a subpoena,literature suggests that record keeping should be limited to essentialinformation, avoiding unnecessary detail and refraining from editorializing orrecording opinions.

Research Note: Because it can be difficult to know what information mightbe damaging to survivors if disclosed, as in the case of a subpoena,literature suggests that record keeping should be limited to essentialinformation, avoiding unnecessary detail and refraining from editorializing orrecording opinions.



Purpose


MIL-FAP 10: Clinical Rehabilitative Treatment

The MFR program provides clinical rehabilitative treatment that fostersbehavior change among customers with a history of abusive behavior.


Table of Evidence

Self-Study Evidence

- A description of clinical rehabilitative treatment services (MIL-FAP10.01, MIL-FAP 10.02, MIL-FAP 10.03, MIL-FAP 10.04)

- Blank copy of the treatment contract (MIL-FAP 10.06)

On-Site Evidence

- Tools and/or criteria used to assess appropriateness of groupservices for each participant (MIL-FAP 10.05)

- See group information indicating treatment group sizes in theMIL-FAP service narrative (MIL-FAP 10.05)

- Tools and/or criteria used to monitor and assess behavioraladjustments and improvements (MIL-FAP 10.07)

- Customer files (MIL-FAP 10.03, MIL-FAP 10.04, MIL-FAP 10.05,MIL-FAP 10.06, MIL-FAP 10.07)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 10.01, MIL-FAP 10.02)b. Relevant staff (MIL-FAP 10.01, MIL-FAP 10.02)c. Customers (MIL-FAP 10.01, MIL-FAP 10.02)

MIL-FAP 10.01

The MFR program implements rehabilitative interventions that are respectfuland foster the development of a strong therapeutic alliance.

MIL-FAP 10.02

The MFR program implements rehabilitative approaches that focus onfostering internal motivation to change behaviors by working with customers



Purpose


to identify:

a. the positive effects of change; andb. the challenges or barriers to change.

MIL-FAP 10.03

The MFR program's clinical rehabilitative treatment programs educatecustomers about domestic abuse including:

a. what domestic abuse is and the common dynamics of domestic abuse;b. the potential for re-abuse, signs of abuse escalation, and the normal

tendency to regress toward previous abusive behaviors;c. the socio-cultural basis for violence;d. the relationship between gender role socialization and domestic abuse;e. the correlation between substance use or misuse and domestic abuse; f. the impact that exposure to domestic abuse has on children in the home;g. the correlation between domestic abuse and suicide.

MIL-FAP 10.04

The MFR program's clinical rehabilitative treatment programs assistcustomers in replacing abusive behaviors with positive relationship skillsand coping mechanisms by working with customers to:

a. take responsibility for their actions;b. identify and confront their issues of power and control, when applicable;c. identify thoughts, emotions, and behaviors that facilitate or trigger their

abusive behavior;d. identify social and relationship skills that need further development; ande. learn and practice pro-social behaviors including empathy,

assertiveness, problem solving, and conflict resolution.

MIL-FAP 10.05

When the MFR program provides rehabilitative treatment in a group setting:

a. the facilitator regularly assesses the ongoing appropriateness of thetreatment modality for each participant; and

b. groups contain a maximum of 12 participants.



Purpose


NA The MFR program does not offer rehabilitative treatment in a groupsetting.

MIL-FAP 10.06

When rehabilitative treatment is court or command directed, the customerand the clinician sign a treatment contract that includes:

a. treatment goals as identified in the services plan;b. time and attendance requirements;c. a plan for handling crisis situations;d. customer rights and responsibilities; ande. consequences of contract violations.


MIL-FAP 10.07

The MFR program has a standardized process in place for monitoring andassessing behavioral adjustments and improvements in customers ratherthan simply tracking compliance with services such as attendance atsessions.



Purpose


MIL-FAP 11: FAP Counseling for Survivors

FAP Counseling is appropriate to the request or need for service and:

a. recognizes the customer's values, goals, and right to self-determination;b. accommodates variations in life style; andc. emphasizes personal growth, development, and positive functioning.


Note: The standards in MIL-FAP 11 address the practices associated witheffectively providing FAP counseling services. Implementation of theMIL-FAP 11 standards will be reviewed and rated based on how counselingis used to prevent or treat family violence.

Table of Evidence

Self-Study Evidence

- A description of counseling services (MIL-FAP 11.01)- Procedures for evaluating level and intensity of care (MIL-FAP 11.03)- Procedures for making referrals and following up as needed

(MIL-FAP 11.03)

On-Site Evidence

- See service philosophy provided in MIL-FAP 1 (MIL-FAP 11.01,MIL-FAP 11.02)

- Customer files (MIL-FAP 11.01, MIL-FAP 11.02, MIL-FAP 11.03)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 11.01, MIL-FAP 11.02, MIL-FAP

11.03)b. Relevant staff (MIL-FAP 11.01, MIL-FAP 11.02, MIL-FAP 11.03)c. Customers (MIL-FAP 11.01, MIL-FAP 11.02)

MIL-FAP 11.01

Interventions, including individual, family, or group counseling, are tailoredto the unique needs of the customer and assist them to:

a. explore and clarify the reason for accessing services;b. identify successful coping or problem solving strategies based on



Purpose


identified strengths and protective factors and formal and informalsupports; and

c. realize ways of maintaining and generalizing gains.

Research Note: Literature suggests that the most successful interventionsare those that are driven by the goals of the customer and utilize strengths,coping mechanisms, and support networks to solve an identified problem.Assisting customers to identify the concern that brought them to the FAP,their service goals, and the tools they have to successfully accomplish theirgoals leads to greater competency and fewer service needs in the future.

MIL-FAP 11.02

Counseling staff engage and motivate individuals by demonstrating:

a. sensitivity to their needs and personal goals;b. a receptive, non-threatening manner;c. recognition and respect for their autonomy, confidentiality, socio-cultural

values that support violence free relationships, personal goals, life stylechoices, and complex family interactions;

d. flexibility; ande. ethical boundaries.

MIL-FAP 11.03

Clinical staff:

a. determine the need for a different level or intensity of care;b. use written criteria for determining when the involvement of a specialist

is indicated;c. follow up when a referral is made; andd. coordinate care with other service providers when it's in the best interest

of the customer and with his or her consent.



Purpose


MIL-FAP 12: Case Closing and Aftercare

Case closing is a planned, orderly process, and the MFR program providesan opportunity for customers to develop a plan for obtaining follow-upservices when desired.

Table of Evidence

Self-Study Evidence

- Case review procedures (MIL-FAP 12.01)- Case closing procedures (MIL-FAP 12.02, MIL-FAP 12.03)- Aftercare/follow-up procedures (MIL-FAP 12.04)

On-Site Evidence

- Customer files (MIL-FAP 12.01, MIL-FAP 12.02, MIL-FAP 12.03,MIL-FAP 12.04)

On-Site Activities

- Interview: a. MFR program director (MIL-FAP 12.04)b. Relevant staff (MIL-FAP 12.04)c. Customers

(FP) MIL-FAP 12.01

The MFR program evaluates the need to keep each domestic or child abuseand neglect case open at least quarterly and uses criteria that considersafety and risk factors to determine when to close a case.

Interpretation: Regular evaluations may be conducted at intervals set byDoD or Service policy, but cannot exceed three months.

MIL-FAP 12.02

Planning for case closing:

a. is a clearly defined process that includes assignment of staffresponsibility;

b. begins at service initiation;c. involves the provider, the customer, and others, as appropriate to the

needs and wishes of the customer; and



Purpose


d. includes discussion about successful changes in behaviors and reducedrisk of abuse, and plans and strategies for maintaining those changes.

MIL-FAP 12.03

Upon case closing, the MFR program notifies any collaborating serviceproviders as needed and in accordance with applicable privacy andconfidentiality laws.


MIL-FAP 12.04

Customers have the opportunity to develop an aftercare plan that:

a. addresses short- and long-term needs, preferences, and goals;b. facilitates the initiation or continuation of needed supports and services;

andc. helps identify sources of informal and social support.


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