impevidparent merged - children and family futures · grandparents. •kinshipis very important in...

8/20/2012

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Presenters:

Sharon DiPirro‐Beard, MFT, RD

Sacramento County Department of Health and Human Services

April Toineeta

ApsaalookeNation Housing Authority

Terri Bogage, LICSW

Institute for Health and Recovery

Jody Brook, PhD, LCSW

University of Kansas, School of Social Welfare

RPG Grantee MeetingRPG Grantee Meeting

August 22, 2012

Sharon DiPirro‐Beard, MFT, RD

Sacramento County Department of Health and Human Services

The Need for Celebrating Families

• Parenting in recovery– not your basic curriculum

• Damage to children– don’t talk, don’t feel, don’t trustdon t trust

• Resistance to change– road to relapse

• Cycle of addiction– foster youth now adult clients

• First five years– apparent delays

Goals of Celebrating Families

• Increase positive parent/child relationships

• Increase parenting knowledge, skills and efficacy

• Increase family communication skills

• Increase family organization

• Decrease family conflict and excessive physical punishment

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Celebrating Families Session Topics

1. Introduction

2. Healthy living

3. Nutrition

4. Communication

9. Goal Setting

10. Chemical Dependency Affects the Whole Family

11. Making Healthy Choices

H lth B d i5. Feelings and Defenses

6. Anger Management

7. Facts about ATOD

8. Chemical Dependency is a Disease

12. Healthy Boundaries

13. Healthy Friendships and Relationships

14. How We Learn

15. Our Uniqueness

16. Celebration

• Informal supervision only (0‐5 and SEI)

• Slow to start ‐ 8 graduates

• High drop‐out rate

• Incentives great food bus passes surveys phone

Our Humble Beginnings

• Incentives, great food, bus passes, surveys, phone calls, follow‐ups and many, many trainings

• Regular collaborative meetings

How We Evolved

• Participants in both FDCs (DDC & EIFDC)

• Social Worker referred

• Court compliance

R R S i li• Resource Recovery Specialists

• Better retention

• Trainings, trainings, trainings

• Continued collaborative meetings

Family Meal (Snack time) 30 min.

• Help them to buy in to the benefits

• Original discomfort ‐ how to model conversation

• Open ended questions

• Get to know your families

• Teach them to distract their children with activities

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Group (2 hours)

• Centering – all ages

• Review

• Acts of Kindness ‐ Children only – promotes awareness of others and personal self esteem – make a big deal in hi i fthis timeframe

• Acknowledgments and Announcements – Adults

• Lesson ‐ Children – act. 1 –physical activity, back to lesson plan, snack

• Closing

Connect with Families

• Child’s time to shine

• Family play time

• Interactive and gives another perspectiveanother perspective

Outcomes‐ 10/1/11 through 3/31/12

Client Data Number we planned to serve

New clients served

Children 60 163

Adults 40 133

Families 15 78

Graduated Left the program

Children 116 62

Adults 70 47

Families 51 0

The number discharged includes those who moved, entered residential, opted out of the program or were discharged for attendance problems/behavior issues. No entire family was discharged, only individual members of the family

RPG Grantee Meeting

August 22, 2012

April Toineeta

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What is Positive Indian Parenting (PIP)

•Positive Indian Parenting was developing by the National Indian Child Welfare Association (NICWA)

•PIP was designed to prepare Indian child welfare personnel to train Indian parents using a culturally specific approach.

•Participants receive instruction in how to conduct parent training, as well as instruction in parenting ways The instruction in parenting ways. The content of the materials draws on the strengths of historic Indian child‐rearing patterns and blends old parenting values with modern skills. Storytelling, cradleboards, harmony, lessons of nature, behavior management, and the use of praise are discussed.

•PIP assist clients in regaining a connection with their culture and learn a blend of old parenting patterns and new skills.

Utilizing Positive Indian Parenting and Adapting to the Apsaalooke Culture and Traditional Values

•The APIP utilizes the Apsaalooke way of life to design a Apsaalooke PIP curriculum utilizing a similar model as NICWA, however applying Apsaalooke Culture, Values and Beliefs in the 8 training sessions.

•The Apsaalooke PIP developed a program that instructs parents in the culture and history of the Apsaalooke Nation along with the Apsaalooke Parenting Techniques pasted down from generation.

•Designed to provide a brief, practical culturally specific training program for Apsaalooke parents to explore the values and attitudes expressed in traditional Indian child‐treating practices and then to apply those values to modern skills in parenting.

•The Apsaalooke Positive Indian Parenting (APIP) is modeled after the National Indian Child Welfare Association (NICWA)

Apsaalooke Positive Indian Parenting Program Traditional Parenting Sessions

First Session, the client’s are introduced to the facilitators, to each other, and to the curriculum and process. Spiritual Leaders are utilizing during this first session in establishing the spiritual cleansing and healing (smudging).

•During this session the group will share who they are and any relevant information that they would like to share during the talking circle. Each client will have an opportunity to share with the facilitator and spiritual leader.

•Each client will share their Indian name, their clans, and their district that they are from.

•Individuals that do not know their clan will know by the end of this session.

•Individuals that do not have an Indian name will be identified and the spiritual leader will work with the AFPP to identify the appropriate clan mother or father to bless the client with an Indian name at a later date.


First Session – Covers Lessons in Storytelling –Apsaalooke Creation Story

•Beginning with a brief welcome and the objective of the storytelling and overview of the goals of the session

•Explore the Value of storytelling as part of parenting•Examine Indian traditions to communicate with children•Explain how storytelling develops good judgment •Explain how storytelling develops good judgment and teaches values•Explain the importance of spending quality time with children•Practice using skills as storyteller

Second Session – Apsaalooke Migration

•Understanding where we come from as Apsaalooke is as important as a child or an adult understanding their origin.

•Discussion of lost identity and regaining an individuals culture through stories and traditional activities.

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Third Session – Apsaalooke Clan system

This session teaches why the clan system is significant to parenting techniques and the teaching of the clans to the children. How it relates to everyday life and future goals for a parent and child.

•Fourth Session – Apsaalooke Kinship System

•The Apsaalooke have a kinship system that is very The Apsaalooke have a kinship system that is very different from the Euro‐American. In the Apsaalooke system there are no cousins, aunts, or uncles. There are mothers, fathers, brothers, sisters, children, and grandparents.

•Kinship is very important in raising children. The old saying that it takes a village to raise a child is very relevant in the Apsaalooke way.

•Understanding why a child was raising by their grandparent or someone else in the family is important to share the understanding of the kinship and the responsibilities that each of the family members hold to raising a child in the Apsaalooke way.


Fifth Session – The Apsaalooke Language

•The Apsaalooke were known for speaking the language from the grandparents to the parents to the children, however in the last twenty five years the language is being lost with a new generation not being taught from the parents or grandparents. Many related the loss of the language to boarding schools, Mormon g g g ,placement, and foster care system.

•Assisting parents in understanding that it is an honor to be able to speak your language and there is no shame in speaking the Apsaalooke language is important to the parent and child to be proud of who they are as an Apsaalooke and work through any self esteem issues

•Assisting the parents with resources to learn their language and to be able to speak it and teach it to their children is very important part of the Apsaalooke parenting


Sixth Session – Apsaalooke Tribal Emblem

•The Teaching of the Crow Tribal Flag and the symbols of the flag. The emblem contains all the traditions and beliefs of the Apsaalooke. The teaching is relevant to the values and beliefs of the Apsaalooke people. Legends that parents should be passing down to their children as part of our value system.

•Parents will learn the Tribal traditions •Parents will learn the Tribal traditions, customs, legends, myths, history and ideas of the Apsaalooke Tribe of Indians who live in Montana, are all combined and represented in the Tribal Emblem.

•Parents will learn each major symbol in the Tribal Emblem and the flag stands for one of the four most sacred things that the Apsaalooke observe with the highest respect. They believe that by practicing and observing these four things with deep reverence they cannot go astray from the way of life of the Apsaalooke Tribe.


Seventh Session – Apsaalooke Survival Skills

•The teaching of Apsaalooke Survival Skills shares how the Apsaalooke would hunt for game, how they would provide shelter, transportation, and teaching these skills to th i hild Thi i ill l t d their children. This session will related modern day survival skills and teach additional skills in conjunction with the historical teaching.

•Financial literacy will be taught for skills in saving for a home, transportation, and pay bills•Job hunting skills and resume writing will also be part of this session•The session provides historical values of survival and relates it to modern day survival skills necessary for a parent and child to understand.

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•Eighth Session – Apsaalooke Healing Opportunity (AHO) Program

•In this session parents will learn the history of the horses and the place that a horse had in the Apsaalooke Tribe. This Session can provide referrals for an additional 6 sessions of Equine Therapy.

•This session teaches the parent and child •This session teaches the parent and child about themselves, mirror them through the relationship with the horse. •The client will be able to discuss how the horse resembles or relates to their parent or child’s personal life. •This session can be done in group session or family sessions. •The Parent will gain understanding of how they perceive themselves and how their child perceives him/her in a non judgmental environment

Apsaalooke Positive Indian Parenting Program Outcomes

The RPG Grant – Engaged with the Apsaalooke Positive Indian Parenting – 2010In 2010 the total number of adults registered in the APIP were 82 and 79 successfully completed the program There were 5 out of the 82 that returned to program. There were 5 out of the 82 that returned to completed the program.

In 2011 the total number of adults registered in the APIP were 68 and 65 successfully completed the program. There were 3 out of the 68 that returned to complete the program.

Impact: Apsaalooke Positive Indian Parenting

Apsaalooke parents are able to learn parenting skills through the knowledge of their culture and history of the Apsaalooke way of life. This model has been viewed as more successful than other approaches used in the past more successful than other approaches used in the past.

RPG Grantee Meeting

August 22, 2012

Terri Bogage, LICSW


[email protected]

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Nurturing Program for Families in Substance Abuse Treatment and Recovery

(On SAMHSA National Registry of Effective Programs & Practices)

Nurturing Program for Families in Substance Abuse Treatment & Recovery

Developed through PPWI‐CSAP demonstration project, 1990‐1995

Piloted at 2 residential women & children’s programs

B d D S h B l k’ N i P f Based on Dr. Stephen Bavolek’s Nurturing Program for Parents of Children Birth to 5 – on CSAP Promising Practices

Well documented, aimed at reducing abuse & neglect; had evaluation instrument ‐ AAPI


Adaptations Substantial additional information on substance abuse

Increase focus on empathyp y

Add material on self‐empathy & mutuality –relationship building

Add material focused on nurturing the parent

Create activities calling for more active participation


AAPI

Core domains: Appropriate developmental expectations

Empathy

Alternatives to corporate punishment

Appropriate roles

Oppressing children’s power & independence (added 1999)


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Summary of Outcomes Program A: Statistically significant improvement on all 4

domains

Program B:

Statistically significant improvement in lack of empathy & role reversal

Increased scores in inappropriate expectations & corporal punishment

Follow up on women who left treatment, survival analysis on relapse rates:

Completion of Nurturing Program related to longer lengths of abstinence

Average time to relapse = 14.7 months for completers vs. 9.4 months for non‐completers


Nurturing Program 3rd Edition

Trauma‐informed curriculum that integrates substance use/abuse, recovery, mental health issues, parenting and child development

3 new sessions for working with fathers & men

Incorporates concepts:

Child‐Parent Psychotherapy (Alicia Lieberman and Patricia Van Horn)y py ( )

Reflective Functioning (Nancy Suchman, et al.; Peter Fonagy)

Guide for individual use

In home‐based, residential or outpatient settings

With individuals or individual families


Core Concepts Guiding the Nurturing Program

Love of life & learning

Respect for self, others & the environment

Parenting is a relationship, not only a set of skills

N t i lf i th Fun & laughter

Recovery happens in families & in relationships, as well as in the individual

Nurturing oneself is the first step toward nurturing others


Parenting is not solely a set of skills: It is a relationship within a family


Nurture the Parent

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Nurturing the Parent

Provides structure

Encourages growth

Physical, mental & spiritual nourishmenty p

Creates opportunities to build connectedness

Creates a safe place for self‐exploration & building self‐awareness

Participation

Creativity and fun


Responds To

Array of learning styles

Literacy

Multiple intelligences

Exploration of cultural pheritage

Providing opportunities to explore & appreciate both own heritage & heritage of other participants


Topics

Hope

Growth & trust

Families

Feelings

Building structure

Managing stress

Setting boundaries

Schedules & routines Feelings

Self‐esteem

Making connections

Communication

Problem solving

Body talk

What babies teach us

Schedules & routines

Safety

Guiding behavior

Knowing our values

Recovery: love & loss

Having fun


States Where Replicated

38 states & 3 Canadian provinces

Other study states with positive results: positive results:

Florida, Rhode Island, California


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Use of the Nurturing Program in the Regional Partnership Grantee Program: Family Recovery

Project

Sessions used flexibly/adapted to needs of family

With individual parents

With parent and adolescentp

With parents and young children

Development of Individual Guide


Participant Evaluations

Family Relationships & Parenting:

“Most of what I learned had to do with ways I thought I should parent & that there really is no rulebook or manual to being a good parent. I also spent time learning about my child’s boundaries.”

“I’ve learned a lot of new ways to discipline, comfort, nurture, trust, love, care.”

“[I’ve learned] patience with my children, to think on their level.”

“I have learned that my child will learn different skills on her own time & not mine, and that I need to be patient & loving & supportive no matter what.”

“I don’t yell as much; I use time‐out instead of hitting.”

“I don’t have to yell or get stressed out with my kids. I have ways to relate.”


Strengthening Recovery

I learned:

“How to have fun as a clean & sober person, how to recognize certain feelings & situations & how I can deal with them; how to g ;interact with other people, & how to nurture myself, my family & friends, & feel comfortable with it.”

“How to handle many of life’s everyday issues & problems.”

“What nurturing is, how to nurture & care for myself as well as others; that I am a truly worthwhile human being who deserves safety, respect & happiness.”

“To take the initiative in my recovery.”


Selecting and Implementing Evidence Based Parenting Programs: Some Practical Considerations

Jody Brook, Ph.D./LCSWUniversity of Kansas, School of Social Welfare [email protected]

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Target Population• Understand needs of your clients ‐ what do target families look like? Are there unique struggles?

• Have realistic expectations of their ability to participate ‐especially in early recovery;

• What are the needs of the community?

• Identify strengths and

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Identify strengths and challenges;

• Plan for your challenges!

• The difference between availability of services and true access to services can be significant.

• Recovery status of participants.

• What do your community partners support?

• Can you solicit community input in the decision making/selection process?

• Community buy in can be a “deal maker or a deal breaker”

• What do your community partners support?

• Can you solicit community input in the decision making/selection process?

• Community buy in can be a “deal maker or a deal breaker”

Selection of an Evidence-Based Parenting Program

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• Review publicly available information

• Need to have a structure for comparing programs

• Pairing the curriculum to your needs and realities

• Understand the outcomes you’d like to see, and be able to articulate them and link them to the program of choice

Sample Considerations for Review of Evidence Based Parenting Programs

Program Name

Child Age

Description/Format

Intended Audience/cultural adaptations

Targets of Intervention

Level of Research Evidence

Studied in Child Welfare Population or FDC Population? What outcomes?

Cost/Required Training/training resources & Fidelity Monitoring

Program XYZ

Ages 3‐14, in groups 3‐8, 9‐14

Community setting, group format, 22 weekly sessions 1.5‐2 hours per session. Parent and

Young children at risk of exhibiting conduct problemsEffective with multi‐ethnic families; meets

Builds parent and child skills for reducing problem behavior in the home and classroom

“highest” ranking according to ……Level 1 CEBC

Yes: one studySafety, child/family well being

Video‐based series, Groups led by trained therapistsCertification required, includes implementation and fidelity

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Parent and child component

families; meets linguisticneeds

classroom, child involvement

Program 123

2‐6 Multi‐level parenting and family support system. Groups or individuals

Foster care parents

Encouragement of positive behavior, systematic consequences for neg. behavior, positive child/parent interactions

2.4 out of 4 on NREBPP

Y: randomized clinical trials Permanency

Prescribed treatment process, Masters level therapist trained in intervention……

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Common Implementation Challenges

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• Domestic violence

• Transportation of kids

• Meals-purchasing and preparing

• Systemic barriers-such as competing family tasks, or lack of buy in from another community partner, or “family fatigue”

• Target range for service was incorrect

• Difficulties with program developer

• Lack of sustainability

Presenter Contact Sharon DiPirro‐Beard, Program CoordinatorSacramento County Department of Health and Human ServicesDiPirro‐[email protected]

A il T i tApril ToineetaApsaalookeNation Housing [email protected]

Terri Bogage, LICSW


[email protected]

Jody Brook, Ph.D./LCSWUniversity of Kansas, School of Social [email protected]

impevidparent merged - children and family futures · grandparents. •kinshipis very important in...

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