Collaboration Between Collaboration Between Agencies to Enhance Client Agencies to Enhance Client

SuccessSuccessFRESH (Family Recovery Engagement FRESH (Family Recovery Engagement

Support of Hampden County) StartSupport of Hampden County) Start

Family Recovery ProjectFamily Recovery Project

““I probably would have got treatment way I probably would have got treatment way sooner but I was afraid to lose my kids. I wish sooner but I was afraid to lose my kids. I wish I would have had someone to help me through I would have had someone to help me through that, to work with me to get in to detox and that, to work with me to get in to detox and then a program without having to sign over my then a program without having to sign over my kids”kids”

Partners in Family RecoveryPartners in Family Recovery Tx providers—co-occurring disorders (SUD, MH, Tx providers—co-occurring disorders (SUD, MH,

trauma)trauma) Child Protection Services-DCYFChild Protection Services-DCYF Part C services--Family Centered Early Supports and Part C services--Family Centered Early Supports and

Services (FCESS) Services (FCESS) Prenatal providers and birth hospitalsPrenatal providers and birth hospitals Legal System and CorrectionsLegal System and Corrections Domestic Violence Domestic Violence

It takes time and effort to build relationships with each other and It takes time and effort to build relationships with each other and it worksit works

Collaboration or Building a Family Collaboration or Building a Family Recovery TeamRecovery Team

At Systems Level e.g. cross and joint training, At Systems Level e.g. cross and joint training, increasing collaboration and communication increasing collaboration and communication between providers, workgroups, protocol between providers, workgroups, protocol development development

At Family Level e.g. consents, family team At Family Level e.g. consents, family team meetings, sharing of service/safety/relapse meetings, sharing of service/safety/relapse prevention plans, joint goals, regular contact prevention plans, joint goals, regular contact with providers, joint appointmentswith providers, joint appointments

Barriers to CollaborationBarriers to Collaboration

Time and moneyTime and money Different values, foci, goalsDifferent values, foci, goals Different language and knowledge baseDifferent language and knowledge base Fear and loathingFear and loathing What else?What else?

All You Ever Wanted to Know All You Ever Wanted to Know About CollaborationAbout Collaboration

National Center on Substance Abuse and Child National Center on Substance Abuse and Child Welfare http://www.ncsacw.samhsa.gov/Welfare http://www.ncsacw.samhsa.gov/

Children and Family Futures Children and Family Futures http://www.cffutures.org/http://www.cffutures.org/

National Alliance for Drug Endangered National Alliance for Drug Endangered ChildrenChildren

http://www.nationaldec.org/http://www.nationaldec.org/

Developing a Shared Knowledge Developing a Shared Knowledge BaseBase

Cross-trainingCross-trainingFree, trade, formal and informalFree, trade, formal and informalUse staff meetings and annual conferences, Family Recovery Use staff meetings and annual conferences, Family Recovery

Fairs at child welfare officesFairs at child welfare officesGet on training mailing lists for other disciplinesGet on training mailing lists for other disciplinesOn-line trainingsOn-line trainingsAddress what you do, methods for connecting with staff, Address what you do, methods for connecting with staff,

relapse and child safetyrelapse and child safety Substance Abuse Treatment: Levels of CareSubstance Abuse Treatment: Levels of Care DCF and the Legal ProcessDCF and the Legal Process 42CFR and communication limitations42CFR and communication limitations

•Joint TrainingJoint Training

Topics for trainings should evolve in response to Topics for trainings should evolve in response to recognized needs, and to stated requests. recognized needs, and to stated requests.

Topics include identification and referral, client Topics include identification and referral, client engagement, fetal alcohol spectrum disorders engagement, fetal alcohol spectrum disorders (preventing and working with adults with FASD), (preventing and working with adults with FASD), trauma informed care, recovery and parenting, and trauma informed care, recovery and parenting, and working with families with substance exposed working with families with substance exposed newborns, and families in MAT.newborns, and families in MAT.

Planning a conference across disciplines is a strong Planning a conference across disciplines is a strong relationship-building activity relationship-building activity

Consider This…Consider This… Relapse is potentially an opportunity for growth given appropriate safety planning Relapse is potentially an opportunity for growth given appropriate safety planning

and supportand support The presence of a parental substance use disorder does not solely determine good The presence of a parental substance use disorder does not solely determine good

or bad parenting.or bad parenting. Substance use is just a piece of the puzzle.Substance use is just a piece of the puzzle. The quality of the care giving relationship is key to children’s long-term The quality of the care giving relationship is key to children’s long-term

development.development. Keeping children safe is a responsibility that belongs to all of us.Keeping children safe is a responsibility that belongs to all of us. We all share in the responsibility of helping families thrive. We all share in the responsibility of helping families thrive. Modeling trust, communication, and collaboration benefits clients, families, and Modeling trust, communication, and collaboration benefits clients, families, and

providers.providers. How we relate to others is what can empower them to change.How we relate to others is what can empower them to change. Look beyond the challenge of the moment to see the potential of the family.Look beyond the challenge of the moment to see the potential of the family. Look beyond the challenge of the moment to see the potential of the collaboration.Look beyond the challenge of the moment to see the potential of the collaboration. Every family has strengths.Every family has strengths. Individuals exist in the context of family, community, and culture.Individuals exist in the context of family, community, and culture. We need to understand, value and support each other’s work.We need to understand, value and support each other’s work. Collaboration and communication between providers is key in supporting families.Collaboration and communication between providers is key in supporting families. Every person has something to learn and something to offer.Every person has something to learn and something to offer.

Training and Other Resources—Training and Other Resources—Free CEUsFree CEUs

Abandoned Infants’ Act Resource CenterAbandoned Infants’ Act Resource Center

www.aia.berkeley.eduwww.aia.berkeley.edu

National Center on Substance Abuse and Child WelfareNational Center on Substance Abuse and Child Welfare

www.ncsacw.samhsa.govwww.ncsacw.samhsa.gov

Children and Family FuturesChildren and Family Futures

http://www.cffutures.org/http://www.cffutures.org/

The National Alliance for Drug Endangered ChildrenThe National Alliance for Drug Endangered Children

www.nationaldec.orgwww.nationaldec.org

““Best Practices in Communication: A Guide for DCF and SA Best Practices in Communication: A Guide for DCF and SA Treatment Providers”Treatment Providers”

Areas Addressed:Areas Addressed:

Screening and EngagementScreening and Engagement

▼▼

Referral and Consent FormsReferral and Consent Forms

▼▼

AssessmentAssessment

▼▼

Treatment & Ongoing CollaborationTreatment & Ongoing Collaboration

▼▼

Discharge & Aftercare PlanningDischarge & Aftercare Planning

Included in the Guide:Included in the Guide: Best Practices protocolBest Practices protocol

New tools to aid communication – for example:New tools to aid communication – for example:o List of Local Treatment ProvidersList of Local Treatment Providerso Information to Be Shared at ReferralInformation to Be Shared at Referralo Assessment Form for DCFAssessment Form for DCFo Treatment Status Form for DCFTreatment Status Form for DCF

Existing tools Existing tools (e.g. safety plan samples)(e.g. safety plan samples)

Resources Resources (re: DCF, BSAS, Legal, Collaboration)(re: DCF, BSAS, Legal, Collaboration)

DCF Phone Directory DCF Phone Directory and and Western MA Substance Abuse Western MA Substance Abuse Treatment DirectoryTreatment Directory

Family Recovery Council:Family Recovery Council:MAT & Pregnancy/Postpartum WorkgroupMAT & Pregnancy/Postpartum Workgroup

GoalGoal: To establish best practices across all systems (DCF, : To establish best practices across all systems (DCF, treatment providers, hospitals, etc.) to support families with treatment providers, hospitals, etc.) to support families with moms in Medication Assisted Treatment during the moms in Medication Assisted Treatment during the pregnancy, birth, and postpartum periods.pregnancy, birth, and postpartum periods.

Action StepsAction Steps::

1) Identify challenges1) Identify challenges

2) Troubleshoot; identify solutions2) Troubleshoot; identify solutions

3) Develop a “Best Practices Protocol”3) Develop a “Best Practices Protocol”

4) Develop a “Parent Information Packet”4) Develop a “Parent Information Packet”

5) Evaluate, revise, disseminate5) Evaluate, revise, disseminate

Example of Collaboration at Family Level for Mothers Example of Collaboration at Family Level for Mothers in MATin MAT

Begin as a team with consentsBegin as a team with consents Ongoing relationship, not just in times of crisisOngoing relationship, not just in times of crisis Prepare all materials when woman is pregnantPrepare all materials when woman is pregnant——

tests, letters from providers, contact info for tests, letters from providers, contact info for providersproviders

Contact postpartum social worker at hospital, Contact postpartum social worker at hospital, DCYF if there is an open caseDCYF if there is an open case

Bring two sets of materials to hospital, one goes Bring two sets of materials to hospital, one goes to DCYF with filing of 51Ato DCYF with filing of 51A

Follow-up on FCESS referral and be at Follow-up on FCESS referral and be at assessmentassessment

Collaboration with Collaboration with Other ProvidersOther Providers

Child Safety and Family RecoveryChild Safety and Family Recovery

ConsentsConsents

Develop Relationship and Exchange PlansDevelop Relationship and Exchange Plans

Supporting Family Centered Early Supports and Services Supporting Family Centered Early Supports and Services (FCESS) (FCESS)

Family ConferencesFamily Conferences

Collaboration with partnersCollaboration with partnersCooperative Family ConferencesCooperative Family Conferences

Helps with engagement and recoveryHelps with engagement and recovery Educates providers about addiction and parenting Educates providers about addiction and parenting Expectation of providing resource is meeting togetherExpectation of providing resource is meeting together Identify what you have to offerIdentify what you have to offer Identify common goalsIdentify common goals Assign responsibilitiesAssign responsibilities Discuss relapse triggers and custody datesDiscuss relapse triggers and custody dates Billing codesBilling codes

Decision-Making QuestionsDecision-Making Questions

What worries us?What worries us? What works well?What works well? What needs to happen?What needs to happen?

Safety MappingSafety Mapping

Tool for case conferencesTool for case conferences Invites multiple perspectivesInvites multiple perspectives Gets people on same pageGets people on same page Structure to bridge disagreements Structure to bridge disagreements Helpful for clientsHelpful for clients

Supporting Strengths

What’s working well? What are we worried about?

Signs of Safety Assessment and Planning Guide

DANGER List all indicators of Past Harm, Present Harm or Future Harm

SAFETY List all indicators of Acts of Protection, Caregiver Capacities, and Supporting Strengths

Complicating Factors

Acts of Protection (Directly related to danger)

Safety and Context Scale Safety Scale: Given the danger and safety information, rate the situation on a scale from 0-10, where 0 means reoccurrence of similar or worse abuse/neglect is certain and 10 means there is sufficient safety to close the case.

Context Scale: Rate this case on a scale of 0-10, where 10 means no action is necessary and 0 means this is the worst case of child abuse/neglect that the agency as seen.

Past or Present Harm to Child

Guiding PrinciplesGuiding Principles

Addiction and recovery happen within the context Addiction and recovery happen within the context of a family.of a family.

Single greatest motivation for recovery: retaining Single greatest motivation for recovery: retaining the right to parent one’s children.the right to parent one’s children.

Reinforcing the capacity to parent is important to Reinforcing the capacity to parent is important to recovery.recovery.

Sobriety, and even recovery, is not enough to Sobriety, and even recovery, is not enough to make a great parent.make a great parent.

Systems work must happen concurrently.Systems work must happen concurrently.

Building Relationships with ClientsBuilding Relationships with Clients

Taking time & making effort to engageTaking time & making effort to engage Providing concrete resourcesProviding concrete resources Showing respectShowing respect Being honestBeing honest AdvocatingAdvocating EmpoweringEmpowering

Engagement StrategiesEngagement Strategies

PeersPeers Help with DCYF and noncustodial supportHelp with DCYF and noncustodial support Warm handoffs for referralsWarm handoffs for referrals Mother-baby groups with critical mass of Mother-baby groups with critical mass of

women in recoverywomen in recovery ““I really needed to learn how to be a parent, I I really needed to learn how to be a parent, I

never had that in my own childhood, I just never had that in my own childhood, I just didn’t even know where to start”didn’t even know where to start”

GroupsGroups Lessen isolationLessen isolation Increase parent-child attachmentIncrease parent-child attachment Reinforce role of mother Reinforce role of mother Build recovery Build recovery community for familiescommunity for families Increase use of Increase use of FCESSFCESS Expose children to early Expose children to early education and careeducation and care

Recruitment & CollaborationRecruitment & Collaboration

When 2 or more agencies collaborate on a group:When 2 or more agencies collaborate on a group: Equal representation with facilitatorsEqual representation with facilitators Emphasis on team approachEmphasis on team approach Identify the “common thread”- ( i.e. we are all Identify the “common thread”- ( i.e. we are all

mothers here)mothers here) Each agency staff recruit but no differentiation Each agency staff recruit but no differentiation

between participantsbetween participants

Lessons LearnedLessons Learned Reach for the phone or the keyboard!Reach for the phone or the keyboard! Listen to each other. Tolerating the discomfort of differing points Listen to each other. Tolerating the discomfort of differing points

of view builds trust and respect.of view builds trust and respect.

Balance process and product by identifying the problems and then Balance process and product by identifying the problems and then focusing on possible solutions (take action!).focusing on possible solutions (take action!).

Be role models: cross-systems partners should plan, lead, and Be role models: cross-systems partners should plan, lead, and participate in meetings equally.participate in meetings equally.

Reinforce common goals and understanding: “Relapse is a Reinforce common goals and understanding: “Relapse is a recovery AND a safety issue.”recovery AND a safety issue.”

• Each family provides an opportunity to improve collaboration. As Each family provides an opportunity to improve collaboration. As challenges arise, we can identify the larger systems issues and then challenges arise, we can identify the larger systems issues and then advocate for change!advocate for change!

Contact InformationContact Information

Debra BercuvitzDebra Bercuvitz

Debra.bercuvitz@state.ma.usDebra.bercuvitz@state.ma.us

413-887-1761413-887-1761

FRP websiteFRP website: : www.familyrecoveryma.orgwww.familyrecoveryma.org