Eric J. Bruns and Elizabeth Feldman University of Washington

Enhancing Implementation of Enhancing Implementation of Evidence Based TreatmentsEvidence Based Treatments

Wraparound, Care Coordination,Wraparound, Care Coordination,Family Engagement, and Family SupportFamily Engagement, and Family Support

Eric J. Bruns and Elizabeth FeldmanEric J. Bruns and Elizabeth FeldmanUniversity of WashingtonUniversity of WashingtonDivision of Public Behavioral Health and Justice PolicyDivision of Public Behavioral Health and Justice [email protected]@u.washington.edu / / [email protected]@u.washington.edu

Jeanette BarnesJeanette BarnesMental Health Division and Mental Health Transformation ProjectMental Health Division and Mental Health Transformation [email protected]@dshs.wa.gov

Evidence Based Practice Institute ForumEvidence Based Practice Institute ForumLacey, WashingtonLacey, WashingtonMarch 13, 2009March 13, 2009

Enhancing Treatment! 2

Goals for this sessionGoals for this session

Identify common barriers to positive outcomes Identify common barriers to positive outcomes for children, youth, and families who seek helpfor children, youth, and families who seek help

Review several Review several treatment enhancement treatment enhancement strategiesstrategies that are becoming more common in that are becoming more common in Washington and nationallyWashington and nationally– Family engagement strategiesFamily engagement strategies– Wraparound care coordinationWraparound care coordination– Family advocacy and peer-to-peer supportFamily advocacy and peer-to-peer support

Implications for clinicians in Washington StateImplications for clinicians in Washington State


The The BigBig Picture Picture

What are the What are the needsneeds of youth of youth and families you work with?and families you work with?What needs get met?What needs get met?

What needs do What needs do notnot get met? get met?


What families need vs. getWhat families need vs. get

Special Ed svcs

Psychologist

Counselor

Respite

Parent Support

Sibling Support

Advocacy svcs

Need

86%

85%

84%

85%

83%

65%

65%

Get

77%

81%

74%17%

53%

15%

31%

Difficult?

48%

41%

43%

74%

66%

69%

64%Friesen & Huff, 1996


We have treatments with evidence We have treatments with evidence for effectiveness for… for effectiveness for…

Anxious or Avoidant Anxious or Avoidant BehaviorsBehaviors

Attention and Attention and Hyperactive DisordersHyperactive Disorders

Autistic Spectrum Autistic Spectrum DisordersDisorders

Disruptive and Disruptive and Oppositional BehaviorsOppositional Behaviors

Self-harming BehaviorsSelf-harming Behaviors

Assaultive and Aggressive Assaultive and Aggressive BehaviorsBehaviors

Sexually Aggressive Sexually Aggressive BehaviorsBehaviors

Traumatic StressTraumatic Stress

Interpersonal problemsInterpersonal problems

Substance useSubstance use

Delinquent behaviorDelinquent behavior

History of abuse and neglectHistory of abuse and neglect


Evidence based treatmentsEvidence based treatments

Well-definedWell-definedUsually ManualizedUsually ManualizedResults of rigorous research Results of rigorous research studies show that they are more studies show that they are more effective than some other optioneffective than some other optionHowever… they often do not work However… they often do not work in “real world” settingsin “real world” settings


In the Real World,Treatments Have Little to no Effect

In the Real World,Treatments Have Little to no Effect

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

Smith &Glass,1977

Shapiro&

Shapiro,1982

Casey &Berman

Weisz etal., 1987

Kazdinet al.,1990

Weisz etal., 1995

Weisz etal, 1995

Mea

n E

ffec

t S

izes

fo

un

d in

M

eta-

An

alys

es o

f T

her

apie

s

Weisz et al., 1995

Children & Adolescents MH

Treatment Studies: University Research

Children & Adolescents MH

Treatment Studies: University Research

Adult MH treatment studies:

University Research

Adult MH treatment studies:

University Research

Clinic settingsClinic settings


Why do Treatments Have Little to No Effect in the “Real World”?

Lack of resources for community providersLack of resources for community providers

Child and family needs are very complexChild and family needs are very complex– Multiple and overlapping child problem areasMultiple and overlapping child problem areas– Unmet basic family needs Unmet basic family needs

Families are not engaged in treatmentFamilies are not engaged in treatment– Leads to treatment dropouts and missed Leads to treatment dropouts and missed

opportunitiesopportunities


Child issues are often very complexChild issues are often very complex

WRAPAROUND MILWAUKEE

N = 960

2004 Data


Family Issues are often very complexFamily Issues are often very complex

WRAPAROUND MILWAUKEE: FAMILIES EXHIBITING CONCERNS

2004 Data

n = 952


Families are not engaged in treatmentFamilies are not engaged in treatment

No show rates as high as 50% are No show rates as high as 50% are commoncommonUp to 60% of families drop out of Up to 60% of families drop out of services before they are finishedservices before they are finished

– Kazdin et al., 1997Kazdin et al., 1997

Children from vulnerable populations Children from vulnerable populations are less likely to stay in treatmentare less likely to stay in treatment

– Kazdin, 1993Kazdin, 1993


The Research: Barriers to Involvement in Child The Research: Barriers to Involvement in Child Mental Health Interventions (Urban Settings)Mental Health Interventions (Urban Settings)

Triple threatTriple threat: : PovertyPoverty

StressStress Single Parenthood Single Parenthood

Concrete obstacles: time, transportation, child care, competing Concrete obstacles: time, transportation, child care, competing prioritiespriorities

Attitudes about mental health, stigmaAttitudes about mental health, stigma

Previous negative experiences with mental health or institutionsPrevious negative experiences with mental health or institutions

2 3

1


The Research: Barriers to Involvement in Child The Research: Barriers to Involvement in Child Mental Health Interventions (Rural Settings)Mental Health Interventions (Rural Settings)

Scarce mental health resourcesScarce mental health resources

TransportationTransportation

Stigma associated with mental illness and Stigma associated with mental illness and seeking careseeking care

Concerns about confidentialityConcerns about confidentiality

IsolationIsolation


Some solutions to these problemsSome solutions to these problems

For families seeking help and entering For families seeking help and entering treatment: Better treatment: Better engagementengagement in the in the process and process and problem solvingproblem solving around around barriersbarriersFor youth and families with very complex For youth and families with very complex and overlapping needs: and overlapping needs: Care coordination Care coordination (sometimes called(sometimes called Wraparound Wraparound))For all youth and families who would For all youth and families who would benefit: benefit: Parent/Youth Support and Parent/Youth Support and AdvocacyAdvocacy

Empirically supported Empirically supported engagement interventionsengagement interventions

Telephone Engagement Telephone Engagement Strategies to Address Strategies to Address

BarriersBarriers

““First Telephone First Telephone Contact”Contact”


Telephone Engagement Telephone Engagement InterventionIntervention

Goals: Goals:

1) Clarify the need for mental health care 1) Clarify the need for mental health care

2) Increase caregiver investment and efficacy2) Increase caregiver investment and efficacy

3) Identify attitudes about previous experiences 3) Identify attitudes about previous experiences with mental health care and institutions with mental health care and institutions

4) 4) PROBLEM SOLVE! PROBLEM SOLVE!PROBLEM SOLVE! PROBLEM SOLVE! around around concrete obstacles to careconcrete obstacles to care


First Session Engagement Process


4 Basic Elements 4 Basic Elements Clarify the helping process for the clientClarify the helping process for the client

Develop the foundation for a Develop the foundation for a collaborativecollaborative working relationshipworking relationship

Focus on immediate, practical concernsFocus on immediate, practical concerns

Identify and problem-solve around barriers Identify and problem-solve around barriers to help seekingto help seeking


First Interview Study MethodsFirst Interview Study Methods

Outcome of interest: # of families that Outcome of interest: # of families that came to initial and ongoing appointmentscame to initial and ongoing appointments

Setting: Outpatient child mental health Setting: Outpatient child mental health clinicclinic

Sample: Sample: NN=107=107

Design: Random assignment to conditionDesign: Random assignment to condition


First Interview ResultsFirst Interview Results

0

20

40

60

80

100

120

Accepted 1st Appt. 2nd Appt. 3rd Appt.

% for first interview(n=33)% for comparison(n=74)

The Wraparound Care The Wraparound Care Coordination ProcessCoordination Process


Why Wraparound?Why Wraparound?

Intervening effectively with youth with Intervening effectively with youth with complex emotional and behavioral complex emotional and behavioral disorders (EBD) has proven very difficult disorders (EBD) has proven very difficult and outcomes have been poor. Why?and outcomes have been poor. Why?– Child and family needs are complexChild and family needs are complex

Youths with serious EBD typically have multiple Youths with serious EBD typically have multiple and overlapping problem areas that need attentionand overlapping problem areas that need attentionFamilies often have unmet basic needs Families often have unmet basic needs

– Families are rarely fully engaged in servicesFamilies are rarely fully engaged in servicesLeads to treatment dropouts and missed Leads to treatment dropouts and missed opportunitiesopportunities


Why Wraparound?Why Wraparound?

Systems are in “siloes”Systems are in “siloes”– Special education, mental health, primary health care, Special education, mental health, primary health care,

juvenile justice, child welfare each are intended to juvenile justice, child welfare each are intended to support youth with special needssupport youth with special needs

– However, the systems also have different However, the systems also have different philosophies, structures, funding streams, eligibility philosophies, structures, funding streams, eligibility criteria, and mandatescriteria, and mandates

These systems don’t work together well for These systems don’t work together well for individual families unless there is a way to bring individual families unless there is a way to bring them togetherthem together– Youth get passed from one system to another as Youth get passed from one system to another as

problems get worseproblems get worse– Families relinquish custody to get helpFamilies relinquish custody to get help– Children are placed out of homeChildren are placed out of home


What’s different in wraparound?What’s different in wraparound?

Big differences: “collaborative,” “family-driven,” Big differences: “collaborative,” “family-driven,” “plan,” natural supports“plan,” natural supports– Wraparound brings the systems together at the family Wraparound brings the systems together at the family

level – Plans are designed and implemented by a level – Plans are designed and implemented by a team of people important to the familyteam of people important to the family

– The plan is The plan is driven by and “owned” by the family and driven by and “owned” by the family and youthyouth

– Strategies in the plan include supports and interventions across multiple life domains and settings (i.e., behavior support plans, school interventions, basic living supports, family supports, help from friends and relatives, etc)

– Plans include supports for adults, siblings, and family members as well as the “identified youth”


For which children and youth is For which children and youth is wraparound intended?wraparound intended?

Youth with needs that span home, school, and community

Youth with needs in multiple life domains– (e.g., school, employment, residential stability,

safety, family relationships, basic needs)

Youth for whom there are many adults involved and they need to work together well for him or her to succeed


Wraparound Process Wraparound Process PrinciplesPrinciples

1.1. Family voice and choiceFamily voice and choice2.2. Team-basedTeam-based3.3. Natural supportsNatural supports4.4. CollaborationCollaboration5.5. Community-basedCommunity-based6.6. Culturally competentCulturally competent7.7. IndividualizedIndividualized8.8. Strengths basedStrengths based9.9. UnconditionalUnconditional10.10. Outcome-basedOutcome-based

See the Resource Guide to Wraparound at www.wrapinfo.org for detailed descriptions


Wraparound:Wraparound:Principles are not Always Enough Principles are not Always Enough

A review of wraparound teams showed that:A review of wraparound teams showed that:

Fewer than 1/3 of teams Fewer than 1/3 of teams maintained a plan with maintained a plan with team goalsteam goals

Fewer than 20% of teams Fewer than 20% of teams considered >1 way to considered >1 way to meet a needmeet a need

Only 12% of interventions Only 12% of interventions were individualized or were individualized or created just for that familycreated just for that family

Natural supports were Natural supports were represented minimallyrepresented minimally– 0 natural supports 60%0 natural supports 60%– 1 natural support 32%1 natural support 32%– 2 or more natural support 2 or more natural support

8%8%

Effective team processes Effective team processes were rarely observedwere rarely observed

Walker, Koroloff, & Schutte, 2003Walker, Koroloff, & Schutte, 2003


A practice model:The Four Phases of Wraparound

Time

Engagement and Support

Team Preparation

Initial Plan Development

Implementation

Transition

Phase1A

Phase1B

Phase2

Phase3

Phase4


The Activities of Wraparound: The Activities of Wraparound: Phase 1Phase 1

Phase One: Engagement and Team Phase One: Engagement and Team PreparationPreparationMeets with family & stakeholdersMeets with family & stakeholdersGathers perspectives on strengths & needsGathers perspectives on strengths & needsAssess for safety & restAssess for safety & restProvides or arranges stabilization response if Provides or arranges stabilization response if

safety is compromisedsafety is compromisedExplains the wraparound processExplains the wraparound process Identifies, invites & orients Child & Family Team Identifies, invites & orients Child & Family Team

membersmembersCompletes strengths summaries & inventoriesCompletes strengths summaries & inventoriesArranges initial Wraparound planning meetingArranges initial Wraparound planning meeting

Phase 1 A and BPhase 1 A and B


The Activities of Wraparound: The Activities of Wraparound: Phase 2Phase 2

Phase Two: Initial Plan DevelopmentPhase Two: Initial Plan DevelopmentHolds an initial Plan of care MeetingHolds an initial Plan of care Meeting Introduces process & team membersIntroduces process & team membersPresents strengths & distributes strength Presents strengths & distributes strength

summarysummarySolicits additional strength information from Solicits additional strength information from

gathered groupgathered groupLeads team in creating a missionLeads team in creating a mission Introduces needs statements & solicits additional Introduces needs statements & solicits additional

perspectives on needs from teamperspectives on needs from teamCreates a way for team to prioritize needsCreates a way for team to prioritize needsLeads the team in generating brainstormed Leads the team in generating brainstormed

methods to meet needsmethods to meet needsSolicits or assigns volunteersSolicits or assigns volunteersDocuments & distributes the plan to team Documents & distributes the plan to team

membersmembers

Phase 2Phase 2


The Activities of Wraparound: Phase The Activities of Wraparound: Phase 33

Phase Three: Plan Implementation & Phase Three: Plan Implementation & RefinementRefinement Sponsors & holds regular team meetingsSponsors & holds regular team meetings Solicits team feedback on accomplishments & Solicits team feedback on accomplishments &

documentsdocuments Leads team members in assessing the planLeads team members in assessing the plan

For Follow ThroughFor Follow Through For ImpactFor Impact

Creates an opportunity for modificationCreates an opportunity for modification Adjust services or interventions currently providedAdjust services or interventions currently provided Stop services or interventions currently providedStop services or interventions currently provided Maintain services or interventions currently providedMaintain services or interventions currently provided

Solicits volunteers to make changes in current plan arraySolicits volunteers to make changes in current plan array Documents & distributes team meetingsDocuments & distributes team meetings

Phase 3Phase 3


The Activities of Wraparound: Phase The Activities of Wraparound: Phase 44

Phase Four: TransitionPhase Four: Transition Holds meetingsHolds meetings

Solicits all team members sense of progressSolicits all team members sense of progress Charts sense of met needCharts sense of met need Has team discuss what life would like after WraparoundHas team discuss what life would like after Wraparound

Reviews underlying context/conditions that brought family Reviews underlying context/conditions that brought family to the system in the first place to determine if situation has to the system in the first place to determine if situation has changedchanged

Identifies who else can be involvedIdentifies who else can be involved Facilitates approach of “post-system” Wraparound Facilitates approach of “post-system” Wraparound

resource peopleresource people Creates or assigns rehearsals or drills with a “what if” Creates or assigns rehearsals or drills with a “what if”

approachapproach Formalizes structured follow-up if neededFormalizes structured follow-up if needed Creates a commencement ritual appropriate to family & Creates a commencement ritual appropriate to family &

teamteam

Phase 4Phase 4


When wraparound is When wraparound is implemented as intended…implemented as intended…

High-quality teamwork and flexible funds leads to High-quality teamwork and flexible funds leads to enhanced creativity, better plans, and better fit between enhanced creativity, better plans, and better fit between family needs and services/supportsfamily needs and services/supports

– This in turn leads to greater relevance for families, less dropoutThis in turn leads to greater relevance for families, less dropout

Strengths, needs, and culture discovery and planning Strengths, needs, and culture discovery and planning process leads to more complete engagement of familiesprocess leads to more complete engagement of familiesAs family works with a team to solve its own problems, As family works with a team to solve its own problems, develops family members’ self-efficacydevelops family members’ self-efficacyIndividualization and strengths focus enhances cultural Individualization and strengths focus enhances cultural competence, relevance, and acceptabilitycompetence, relevance, and acceptabilityFocus on setting goals and measuring outcomes leads to Focus on setting goals and measuring outcomes leads to more frequent problem-solving and more effective plansmore frequent problem-solving and more effective plans


Outcomes from Wraparound Outcomes from Wraparound MilwaukeeMilwaukee

– After Wraparound Milwaukee assumed After Wraparound Milwaukee assumed responsibility for youth at residential level responsibility for youth at residential level of care (approx. 700-1000 per year)…of care (approx. 700-1000 per year)…

Average daily Residential Treatment population Average daily Residential Treatment population reduced from 375 placements to 70 placementsreduced from 375 placements to 70 placementsPsychiatric Inpatient Utilization reduced from 5000 Psychiatric Inpatient Utilization reduced from 5000 days per year to under 200 days (average LOS of 2.1 days per year to under 200 days (average LOS of 2.1 days)days)Reduction in Juvenile Correctional Commitments from Reduction in Juvenile Correctional Commitments from 325 per year to 150 (over last 3 years) 325 per year to 150 (over last 3 years)

(Kamradt et al., 2008)


Results from Nevada:Results from Nevada:Impact on Residential PlacementImpact on Residential Placement

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Traditional svcs Wraparound

Group

Pe

rce

nt

of

Yo

uth

More Restrictive Less Restrictive

Bruns et al. (2006)


Results from Clark County, WAResults from Clark County, WAImpact on juvenile justice outcomesImpact on juvenile justice outcomes

ConnectionsConnections (wraparound) group (N=110) (wraparound) group (N=110) 3 times 3 times less likelyless likely to commit felony offense than to commit felony offense than comparison group (N=98)comparison group (N=98)

ConnectionsConnections group took group took 3 times longer3 times longer on average on average to commit first offense after baseline to commit first offense after baseline

ConnectionsConnections youth showed “significant youth showed “significant improvement in behavioral and emotional problems, improvement in behavioral and emotional problems, increases in behavioral and emotional strengths, increases in behavioral and emotional strengths, and improved functioning at home at school, and in and improved functioning at home at school, and in the community”the community”

Pullman et al. (2006)


Findings from a meta-analysis of Findings from a meta-analysis of seven controlled studiesseven controlled studies

Strong results in favor of wraparound found for Strong results in favor of wraparound found for Living Situation outcomes (placement stability Living Situation outcomes (placement stability and restrictiveness)and restrictiveness)A small to medium sized effect found for:A small to medium sized effect found for:– Mental health (behaviors and functioning)Mental health (behaviors and functioning)– School (attendance/GPA), andSchool (attendance/GPA), and– Community (e.g., JJ, re-offending) outcomesCommunity (e.g., JJ, re-offending) outcomes

The overall effect size of all outcomes in the 7 The overall effect size of all outcomes in the 7 studies is about the same (.35) as for “evidence-studies is about the same (.35) as for “evidence-based” treatments, when compared to services based” treatments, when compared to services as usual (Weisz et al., 2005)as usual (Weisz et al., 2005)

Suter & Bruns (2008)


Wraparound in WashingtonWraparound in Washington

The wraparound process has been attempted in many The wraparound process has been attempted in many projects in WAprojects in WA– Current projects include Three Rivers Wraparound (Benton-Current projects include Three Rivers Wraparound (Benton-

Franklin), CCS in Pierce County, several agencies in King Co.Franklin), CCS in Pierce County, several agencies in King Co.– Other projects (e.g., King County Blended Funding) were Other projects (e.g., King County Blended Funding) were

promising but ultimately de-fundedpromising but ultimately de-funded– House Bill 1088 funded three wraparound pilots being overseen House Bill 1088 funded three wraparound pilots being overseen

by MHD that began in 2008 and are being implemented in by MHD that began in 2008 and are being implemented in Skagit, Cowlitz, and Grays HarborSkagit, Cowlitz, and Grays Harbor

– King County plans to hire 30 new wraparound facilitators to King County plans to hire 30 new wraparound facilitators to serve 900 youth as part of its Mental Illness and Drug serve 900 youth as part of its Mental Illness and Drug Dependency (MIDD) Strategic Plan Dependency (MIDD) Strategic Plan

– Yakima County has a new SAMHSA system of care grant that Yakima County has a new SAMHSA system of care grant that will be employing the wraparound care coordination processwill be employing the wraparound care coordination process

Family Peer-to-Peer SupportFamily Peer-to-Peer Support


Parent peer-to-peer support: One Parent peer-to-peer support: One DefinitionDefinition

Parent-to-parent support is a consumer delivered service in which parents providing support have experiential knowledge (i.e., shared experiences) with the parent receiving support.Parents providing support have shared similar experiences with those receiving support and were previously or are currently consumers of similar services.Those utilizing consumer provided services report high satisfaction and perceived improvement for outcomes of satisfaction, quality of life, and social functioning

(Solomon & Draine, 2001).


Another definitionAnother definition(Keys for Networking, Topeka, KS)(Keys for Networking, Topeka, KS)

Parent SupportParent Support is an individually tailored is an individually tailored service that connects a parent seeking service that connects a parent seeking help for a child with emotional, behavioral, help for a child with emotional, behavioral, or mental health issues with a trained and or mental health issues with a trained and experienced peer who guides and experienced peer who guides and coaches them to find their own strengths, coaches them to find their own strengths, define their own goals and needs, locate define their own goals and needs, locate reliable information and resources, and reliable information and resources, and develop their own voice to advocate on develop their own voice to advocate on behalf of their child and family.behalf of their child and family.


Parent peer-to-peer support:Parent peer-to-peer support:The theory baseThe theory base

Self-efficacy is the belief that one has the capabilities to manage prospective situations. For example, a person with high self efficacy may engage in a more health related activity when an illness occurs, whereas a person with low self efficacy would harbor feelings of hopelessness.Bandura (1997) detailed four main sources from which individuals build self-efficacy:– Enactive mastery experiences (prior successful experiences)– Vicarious experiences (learning from others)– Verbal persuasion (understanding from peers)– Physiological and affective state (stress affects self-efficacy)

Parent-to-parent programs generally provide support in each of these areas.

– Rivera et al., 2008


Family-based services: A review of Family-based services: A review of the research the research (Hoagwood, 2005)(Hoagwood, 2005)

Studies that have been rigorously examined Studies that have been rigorously examined demonstrate unequivocal improvements in:demonstrate unequivocal improvements in:– retention in servicesretention in services– knowledge about mental health issuesknowledge about mental health issues– self-efficacyself-efficacy– family interactions.family interactions.

““Linkage of effective family-based interventions Linkage of effective family-based interventions to delivery of evidence-based services is likely to to delivery of evidence-based services is likely to amplify the impact of those services and improve amplify the impact of those services and improve outcomes for youth and families.”outcomes for youth and families.”


The Best Family/Youth Partners The Best Family/Youth Partners

Represent a perfect blend of who they are Represent a perfect blend of who they are with what they can do, a mix between skill with what they can do, a mix between skill and personality. and personality.

Family/Youth Partner training gives Family/Youth Partner training gives parents/caregivers/youth a chance to parents/caregivers/youth a chance to practice skills and approaches to working practice skills and approaches to working with families, youth and professionals prior with families, youth and professionals prior to doing the work.to doing the work.


CODE OF ETHICSCODE OF ETHICS

We tell our own story when it can help other We tell our own story when it can help other families/youth.families/youth.We support other families/youth as peers with a We support other families/youth as peers with a common background and history rather than as common background and history rather than as experts who have all the answers.experts who have all the answers.We acknowledge that each family/youth’s We acknowledge that each family/youth’s answers may be different than our own.answers may be different than our own.We take responsibility for clarifying our role as We take responsibility for clarifying our role as Family/Youth Partners and as a parent of a child Family/Youth Partners and as a parent of a child with special needs or a youth with special needs.with special needs or a youth with special needs.


CODE OF ETHICSCODE OF ETHICS

We build partnerships with others including We build partnerships with others including professionals who are involved in the care of professionals who are involved in the care of children/youth.children/youth.We commit to honesty with each other and all We commit to honesty with each other and all involved with the care of a child/youth and involved with the care of a child/youth and expect the same from others.expect the same from others.We are committed to a non-judgmental and We are committed to a non-judgmental and respectful attitude in our dealings with & respectful attitude in our dealings with & discussions regarding families/youth.discussions regarding families/youth.We are committed to non-adversarial advocacy We are committed to non-adversarial advocacy in our roles within systems. in our roles within systems.


COMMON TRAPS FOR COMMON TRAPS FOR FAMILY/YOUTH PARTNERS FAMILY/YOUTH PARTNERS

Focus on access to service rather than Focus on access to service rather than access, voice, & ownership.access, voice, & ownership.Becoming a traditional advocate.Becoming a traditional advocate.Staying on the outside.Staying on the outside.Choosing up sides.Choosing up sides.Losing focus.Losing focus.Forgetting the “long haul.”Forgetting the “long haul.”


OVERVIEW OF SKILL SETSOVERVIEW OF SKILL SETS

#1 Telling your own story when it can help #1 Telling your own story when it can help others.others.#2 Supporting families/youth as peers rather #2 Supporting families/youth as peers rather than as experts with all of the answers.than as experts with all of the answers.#3 Acknowledge each family/youth’s answers #3 Acknowledge each family/youth’s answers are different.are different.#4 Clarify role as a family/youth partner & #4 Clarify role as a family/youth partner & parent/caregiver of a child with special needs or parent/caregiver of a child with special needs or a youth with special needs.a youth with special needs.


SKILLS (Cont.)SKILLS (Cont.)

#5 Building partners with others including #5 Building partners with others including professionals.professionals.

#6 Committing to honesty in self & others.#6 Committing to honesty in self & others.

#7 Committing to non-Judgmental & #7 Committing to non-Judgmental & respectful attitude.respectful attitude.

#8 Providing non-adversarial advocacy.#8 Providing non-adversarial advocacy.


Parent peer to peer support in Parent peer to peer support in Washington stateWashington state

A small number of parents have become certified peer A small number of parents have become certified peer counselors.counselors.An even larger number are Family support Partners An even larger number are Family support Partners following the Wraparound Parent Partner curriculumfollowing the Wraparound Parent Partner curriculumSAFE-WA is initiating a pilot program with JRA/DASA to SAFE-WA is initiating a pilot program with JRA/DASA to provide parent partners who will join with families as provide parent partners who will join with families as children transition from JRA/DASA facilities.children transition from JRA/DASA facilities.SAFE-WA in partnership with interested family and youth SAFE-WA in partnership with interested family and youth organizations are working with WIMHRT to create a organizations are working with WIMHRT to create a Certified Peer Counseling curriculum that better meets Certified Peer Counseling curriculum that better meets the needs of youth and families.the needs of youth and families.An “evidence based” parent empowerment and An “evidence based” parent empowerment and engagement model (PEP) is being piloted in Thurston engagement model (PEP) is being piloted in Thurston and Mason countiesand Mason counties

Eric J. Bruns and Elizabeth Feldman University of Washington

Documents

Transcript of Eric J. Bruns and Elizabeth Feldman University of Washington