Protect All Children Today

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Evolve working with children and young people
with severe and complex psychological and
behavioural problems
Protect All Children Today 26 March 2009
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Outline

• Evolve Interagency Services overview
• The use of collaborative practice in the Evolve
  model
• Learnings, outcomes of this approach
• Future challenges
• Client outcomes
• The model in action a case study

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Background and Rationale

• CMC
• Collaborative model
• Unique service new model of service, no
  precedents, ongoing learning.
• Changing and growing cohort

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Underpinnings of the Evolve model

• Collaborative approach
• Multidisciplinary approach
• Child centred and Inclusive approach to ensure
  child, family and carers involved in planning and
  implementing intervention goals
• Capacity building to support sustained change for
  both the child and their support network
• Evidence based practice

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Evolve Locations
Far Nth Qld
North Qld
Central Qld
Sunshine Coast
North Brisbane
Logan
Gold Coast
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Evolve Interagency Services Model
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Evolve Program

• Goal of Evolve
• Multiple agencies
• Therapeutic Behavioural Support Services,
  intensive and long term intervention
• Holistic and consistent approach in support and
  intervention

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Developmental effects of abuse and neglect inform
intervention approach
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Principles of therapeutic mental health services
Saunders, B.E., Berliner, L., Hanson, R.F.,
2004 Cook, A., Blaustein, M., Spinazzola, J.,
van der Kolk, B., 2003.
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Positive behaviour support model
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Evolve Program Learnings Outcomes
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Evolve Program Learnings Outcomes
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Future Challenges

• Capacity of Evolve and increased demand
• Recruitment of specialist staff
• Information sharing
• Educating and engaging stakeholders
• Links with other elements of the service system
• Managing expectations
• Research and Evaluation

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Evolve client outcomes
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Evolve client outcomes
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Evolve Program Client Outcomes

• Client Benefits
• Review of Evolve
• Significant decrease in challenging behaviours
• Reduction of self harm and harm to others
• Greater placement stability
• Increased participation and engagement in
  educational programs

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Achieving outcomes for childrenthrough
collaboration

• A Case Study
• Jack

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Referral

• Referred to EIS 2007.
• 13 year old male
• Multiple placements
• Aggressive/violent outbursts
• Absconding from home and school
• Limited school attendance
• Dysfunctional sleeping and eating patterns
• Impaired activities of daily living
• No peer relationships
• Forensic History theft, wilful damage, assault
• Emotional dysregulation

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Referral cont.

• Significant learning difficulties
• Illiterate
• Diagnoses of ASD, ADHD
• Significant trauma and attachment issues
• Medication (Ritalin, risperidone, endep)

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Family and child protection history

• Parental drug and alcohol misuse, domestic
  violence, homelessness
• Complex blended family - multiple fathers/
  partners/siblings
• Family known to Department of Child
  Safety/multiple levels of intervention
• Significant history of neglect, trauma and abuse
  including sexual abuse of children
• Family has history of non engagement,
  litigiousness, and sabotage of interventions.

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Evolve Interagency Services program

• Allocated to Primary Service Provider
• Allocation of roles
• Assessment process
• How to, responsibilities, formulation and
  development of treatment plan
• Treatment process
• Identification of and establishment of
  stakeholder team, frequency of meetings, roles,
  and responsibilities
• Maintain open communication
• Establish and set group cohesiveness
• Demonstrate commitment to young person and
  stakeholder process

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Stakeholders
Evolve Therapeutic Service
Education
Evolve Behaviour Support
Young Person
Child safety
Family/Other
Residential
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Planning and Goal Setting

• Stakeholders identified goals
• linked to Jacks treatment plan
• Jacks involvement /engagement sought
• Goals set initially task focused
• with each stakeholder identifying tasks that they
  were responsible for
• Establishment of sub (micro) teams
• to work on specific goals together for completion
  between stakeholder meetings

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Micro Teams in Action
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Outcomes for Jack

• Aggressive behaviour has reduced
• No further involvement with criminal justice
  system
• Attending school regularly/engaged in community
• Beginning to read
• Improved ability to manage activities of daily
  living
• Insight into behaviour, including empathy and
  remorse
• Medication free
• Peer relationships
• Family relationships
• Placement

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Medium to long term goals for Jack

• Continuing development, peers, literacy,
  mainstreaming
• Development of emotional regulation, empathy and
  social skills
• Pre-employment skills with view to part time work
• Transition to supported/independent living

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Outcomes for stakeholders

• Improved skill base, particularly for direct
  staff.
• Increased understanding of other professionals.
• Enhanced relationships between government and non
  government departments.

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Key factors to successful collaboration amongst
stakeholders

• Willingness of all parties to engage in process
• Open, effective communication with ALL
  stakeholders
• Continued involvement of family - backing up
  behaviour support strategies.
• Involvement of direct care workers (residential
  and school) - specific tasks to give them
  ownership of process.
• Respecting the roles of others - honoring the
  person.
• Keep young person at the centre active
  participation at stakeholder meetings

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Our Key Learnings

• Communication is the key - needs to be effective,
  open, and with ALL stakeholders
• Each person needs their own work to do so that
  they feel and become a key member of the team
• Never underestimate the power of a united team
• A collaborative team is characterised by equal
  partnership and shared responsibility
• Keep the young person as focus the goal of
  Evolve is to support the young person

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Collaborative PartnershipsOngoing Challenges

• Interagency collaboration is
• Multidimensional
• Interactional
• Developmental
• and a lot of planning and continued hard work is
  needed for it to be successful!
• (Johnson, Zorn, Tam, Lamontagne Johnson,
  2003)

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Evolve Program Management Team

• Melissa Yim, Department of Child Safety
• melissa.yim_at_childsafety.qld.gov.au
• Jackie Bartlett, Queensland Health
• jackie.bartlett_at_health.qld.gov.au
• Morag Gilchrist, Disability Services Qld
• morag.gilchrist_at_disability.qld.gov.au
• Brett OConnor, Department of Education Training
  and the Arts brett.oconnor_at_deta.qld.gov.au
• Erica Russ, Department of Child Safety
• erica.russ_at_childsafety.qld.gov.au