screening and assessment for family engagement, retention ... · curricula and strategies ......

Screening and Assessment for Family Engagement, Retention and Recovery – SAFERR

Guidance for States and Communities Serving Families with Substance Use Disorders in Child

Welfare Services and Dependency Courts

Presented atPutting the Pieces Together for Children and

Families: The National Conference on Substance Abuse, Child Welfare and the Courts

February 1, 2007

Nancy K. Young, Ph.D., Director4940 Irvine Blvd, Ste 202Irvine, CA 92620Phone: 714-505-3525Fax: 714-505-3626Email: www.ncsacw.samhsa.gov

Developing since Summer 2003

Review and Input from Community Expert Panel Review at NCSACW Researchers’ Forum Shared with In-Depth TA State Teams Consultant Liaisons and States Provided

Input to Implementation Guide Edits and Rewrites

SAFERR is based on the premise that when parents misuse substances and maltreat their children, the only way to make sound decisions is to draw from the talents and resources of at least three systems: child welfare, alcohol and drugs, and the courts.

Principles The problems of child maltreatment and substance

use disorders demand urgent attention and the highest possible standards of practice from everyone working in systems charged with promoting child safety and family well-being.

Success is possible and feasible. Staff in child welfare, substance abuse, and court systems have the desire and potential to change individual lives and create responsible public policies.

Family members are active partners and participants in addressing these urgent problems.

Premises

1. The team is the tool, and people, not tools, make decisions

2. The family is the focus of concern

3. Problems don’t come in discrete packages; they are jumbled together

4. Assessment is not a one-person responsibility

Premises

5. Information is limited, and there is no research-based answer

6. There is no time to lose

7. ICWA creates specific guidelines for working with American Indian populations

8. Developing and sustaining effective collaborations is hard work

Organization of SAFERR

I. Building Cross-System Collaboration Creating the structure to create and sustain change

II. Collaboration Within and Across Systems What each system needs to know about itself and

its partners

III. Collaboration in Action: Working Together on the Front Line Presents activities that create cross-system practice

changes

Organization of SAFERR

A. Facilitator’s Guide Templates and exercises

B. Fact Sheets To educate administrators, legislators and

stakeholders about the initiativeC. Understanding the Needs of ChildrenD. Screening and Assessment Tools for

Substance Use Disorders

Organization of SAFERR Appendices

E. Substance Use, Abuse, Dependence Continuum, and Principles of Effective Treatment

F. Safety and Risk Assessments for Use by Child Welfare Staff

G. Sharing Confidential InformationH. Glossary of TermsI. Guide to Compliance with the Indian Child

Welfare Act (ICWA)

Assessment is a ProcessAssessment happens along a continuum to determine: Presence and Immediacy Is there an issue present? What is the immediacy of the issue?

Assessment is a ProcessAssessment happens along a continuum to determine: Presence and Immediacy

Is there an issue present?What is the immediacy of the issue?

Nature and Extent What is the nature of the issue? What is the extent of the issue?

Assessment is a ProcessAssessment happens along a continuum to determine: Presence and Immediacy


Nature and ExtentWhat is the nature of the issue?What is the extent of the issue?

Developing & Monitoring Change, Transitions & Outcomes of Treatment and Case Plans What is the response to the issue? Are there demonstrable changes in the issue? Is the family ready for transition? Did the Interventions Work?

Definitions of Terms and Processes

Screen Child Abuse Report

AOD Services CWS Services Court Services

Is there an issue?



Immediate Need Triage

In-Person Safety Assessment

Preliminary Protective Hearing


Is there an issue?

What is the immediacy of the issue?






Diagnosis In-Person Response/ Risk Assessment

Court Findings


Is there an issue?


What is the nature of the issue?






Diagnosis In-Person Response/ Risk Assessment

Court Findings

Multi-Dimensional Assessment

Family assessment

Petition Filed; Preliminary Protective Hearing


Is there an issue?


What is the nature of the issue?

What is the extent of the issue?

Treatment Plan

Case Plan Adjudication/Dispositional Hearing; Court-ordered Case Plan


What is the Response?

Treatment Plan


Treatment Monitoring

Case Plan Monitoring

Court Review Hearings



Is there demonstra-ble change?

Treatment Plan





Transition Planning

Permanency Determination

Permanency Hearing




Is family ready for transition?

Treatment Plan





Transition Planning


Permanency Hearing

Recovery Management

Family Well Being

Case Closed




Is family ready for transition?What is to happen after discharge?

Treatment Plan





Transition Planning


Permanency Hearing

Recovery Management

Family Well Being

Case Closed

Outcome Monitoring

Outcome Monitoring

Outcome Monitoring




Is family ready for transition?What is to happen after discharge?Did the intervention work?

Assessment Information must be Communicated

Assessment happens along a continuum to determine: Presence and Immediacy


Nature and ExtentWhat is the nature of the issue?What is the extent of the issue?

Developing & Monitoring Change, Transitions & Outcomes of Treatment and Case Plans What is the response to the issue? Are there demonstrable changes in the issue? Is the family ready for transition? Did the Interventions Work?

The SAFERR ModelDevelopment

Builds CrossSystem

Collaboration

Establishes Individual

and Cross System

Roles and Responsibilities

Identifies Front-Line

Collaborative Practice

Establishes and Monitors Individual and Cross-System Outcomes

GOVERNANCE Oversight

Committee Steering

Committee Subcommittees

Builds CrossSystem

Collaboration

Most senior officials from all systems

• Direct staff to give this priority• Provide overall direction• Meet 3-4 times a year• Receive interim reports


Committee Steering


Builds CrossSystem

Collaboration

Senior managers from within systems

• Co-chaired or use facilitator

• Have decision-making authority

• Receive materials in advance for discussion

• Make decisions during meetings

• Report collectively to the oversight committee


Committee Steering


Builds CrossSystem

Collaboration

Senior managers from within systems

• Co-chaired or use facilitator

• Have decision-making authority

• Receive materials in advance for discussion

• Make decisions during meetings

• Report collectively to the oversight committee

The Charge to the Steering Committee:

• Create a mission statement based on exploration of values and principles

• Enhance understanding of current systems & barriers to communication

• Establish goals, milestone, products & implement plan to achieve them

• Create and oversee subcommittees

• Identify training curricula and strategies

• Monitor progress and evaluate outcomes


Committee Steering


Builds CrossSystem

Collaboration

Establishes Individual and Cross System Roles and

Responsibilities

Identifies Front-LineCollaborative

Practice

The Subcommittee(s)

• Comprised of county front line and supervisory staff;

• Charged by Steering Committee to conduct specific tasks

• Participate in pilot tests of strategies

• Report to the Steering Committee

GOVERNANCE Oversight Committee Steering Committee Subcommittees

TASKS Mission &

Principles Shared

Understanding on Language & Processes Goals, Timetables,

Products Training

Curricula/Strategy

Builds CrossSystem

Collaboration


Responsibilities


Practice


TASKS Mission & Principles Shared Understanding

on Language & Processes

Goals, Timetables, Products

Training Curricula/Strategy

MONITORING Baseline Data Progress Reports Outcome Data

Builds CrossSystem

Collaboration


Responsibilities


Practice


Builds CrossSystem

Collaboration


and Cross System











CWS UnderstandsBasics of substance use & how use affects child developmentHow to screen for substance useTreatment system & how to help people stay in treatment Implications of tensions between Treatment Staff and CW timelines

Builds CrossSystem

Collaboration


Responsibilities


Practice







CWS Understands Basics of substance use & how use affects

child development How to screen for substance use Treatment system & how to help people stay in

treatment Implications of tensions between Treatment

Staff and CW timelines

Alcohol and Drug System Understands

How substance use puts children at risk & how CWS must respondChild maltreatment reporting requirementsHow to screen for child safety

Builds CrossSystem

Collaboration


Responsibilities


Practice










Staff and CW timelinesAlcohol and Drug System Understands

How substance use puts children at risk & how CWS must respond Child maltreatment reporting requirements How to screen for child safety

Court System UnderstandsBasics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration

Builds CrossSystem

Collaboration


Responsibilities


Practice







CWS Understands Basics of substance use & how use affects child

development How to screen for substance use Treatment system & how to help people stay in treatment Implications of tensions between Treatment Staff and CW

timelinesAlcohol and Drug System Understands

How substance use puts children at risk & how CWS must respond

Child maltreatment reporting requirements How to screen for child safety

Court System Understands Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration

Collaboratively all Three SystemsEstablish joint policies/procedures to share informationEstablish case plansDevelop shared indicators of progressMonitor progress and evaluate outcomes

Builds CrossSystem

Collaboration


Responsibilities


Practice


Builds CrossSystem

Collaboration


and Cross System

















Collaboratively all Three Systems Establish joint policies/procedures to share

information Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes

CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:

Screen for substance use and child maltreatment

Builds CrossSystem

Collaboration


Responsibilities


Practice

















Assess for substance use and child maltreatment

Builds CrossSystem

Collaboration


Responsibilities


Practice


















Develop and implement collaborative case plans

Builds CrossSystem

Collaboration


Responsibilities


Practice



















Monitor progress and evaluate results

Builds CrossSystem

Collaboration


Responsibilities


Practice



















Monitor progress andevaluate results

Builds CrossSystem

Collaboration


Responsibilities


Practice


Builds CrossSystem

Collaboration


and Cross System






Increased identification of substance use disorders among families reported for child maltreatment

Increased identification of potential child maltreatment for people assessed/treated for SUDS

Increased communication regarding screening and assessment for SUDS and child maltreatment

Informed decision making by CWS and CS regarding reunification, aftercare, terminations

Reduced duplication and burden with regard to case plan requirements

Increased engagement and retention of parents in treatment

Reduced risk of maltreatment of children

Increased family stability, reunification and well being

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