St. Louis County

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St. Louis County

• Solution Focused Journey to Family Dependency
  Treatment Court

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Agenda

• Introduction
• Inquiry
• Family Engagement - Tools
• Organization Challenges
• Community Forum
• Family Dependency Treatment Court Drug Court
• Video Drug Court Participant
• Video Drug Court Team Member
• Acknowledgements/References

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Introductions

• Mark Wilhelmson
• Social Service Supervisor
• St. Louis County Public Health Human Services
• wilhelmsonm_at_co.st-louis.mn.us
• Mark Snyder
• Social Service Supervisor
• St. Louis County Public Health Human Services
• snyderm_at_co.st-louis.mn.us

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Location

• Map of U.S. /Minnesota/St. Louis County

DULUTH
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Olympic Gold Medals

• List of Countries and Medal Count

• Miserable finish by Curling Team From Duluth ?

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St. Louis County Golf Team

• Team Mark Wilhemson, Mark Snyder, Tom Rendulich,
  Rick Benson, John Nachsheim, James Ellingson,
  Jenny Fick, Melissa Lehr
• Andrew Turnell Honorary Team Member
• Golf Cap

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Child Safety

• Be Gentle With The Young
• Juvenal (55 AD-127 AD)
• Children begin by loving their parents as they
  grow older they judge them sometimes they
  forgive them
• Oscar Wilde (1854 1900)
• Always be nice to children because they are the
  ones who will choose your rest home
• Phyllis Diller (1917 - )

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Change

• We must become the change we want to
  see. Mahatma Ghandi (1869 1948)
• A pessimist sees the difficulty in every
  opportunity an optimist sees the opportunity in
  every difficulty. Winston Churchill
• There is nothing wrong with change if it is in
  the right direction. Winston Churchill

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Inquiry - The Journey Begins

• Collaboration with Key Actors
• Focus on safety
• Language Change
• Solution Building
• Exploration for details
• Search for exceptions
• Individuals

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Tools

• Elicit, Amplify, Reflect, Start Over
• 3 Houses
• 3 Columns
• Safety Plans
• Words and Pictures
• Time Line
• Maps

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Three Houses Child Protection Risk Assessment
Process to use with Children and Young
People Created by Nicki Weld, Wellington NZ
House of Dreams
House of Worries
House of Good Things
On 3 separate pieces of paper draw with the
children their experience and vision of each
house. Use these drawings with the adults in
deepening the assessment and planning process.
More Info www.signsofsafety.net/Around_the_World.
html - New Zealand Child Youth and Family
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• 3 Columns

Rate the situation on a scale of 0-10, where 0
means things are so bad the family can no longer
care for the children and 10 means that
everything that needs to happen for the children
to be safe in the family is happening
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• Safety plan (blank)

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TIME LINE
Safety plan developed w/ public health Nurse-
Autumn no longer wants SS involved Sept 25. 09
PH notifys Liana that she has not seen Autumn in
a few weeks- canceling appts possible drug
use Oct 23. 09
Liana and Susan begin working with Autumn and
Jacob- Destani to stay in hospital for 6 weeks
Liana receives reports that Autumn is dealing and
using meth- refused UA
1st report to IIU- Prenatal exposure- THC also
left AMA 29weeks preg June 28 09
Domestic between Jacob and Autumn- Charged w/
domestic assault Aug 29 .09
Admin review close case Feb 9.10
Oct 2009
Aug 2009
Sept 2009
Nov 2009
Dec 2009
Feb 2010
July 2009
June 2009
Mar 2010
Destani born Weighed 3 lbs 4 oz June 29 09
Destani discharged from hospital Autumn and Jacob
successfully completed all hospital
recommendations Aug 11.09
Jacob goes to NERCC on violation D.V. ADR-April
3, 2010
Concerns about Autumns ability to care for child-
police hold March 5 2010
Autumn admits to using THC 2x since last visit-
not going to 1st yesr- only met w/ PHN 2X Nov
23. 09
H.V. _at_ Autumns Patrick admits to meth relapse
states he is homicidal/ suicidal during
visit Dec 15, 09
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Organizational Practice

• Intake transfers to case management 1200 intakes
  in 2009
• Pre-petition Screening 188 petitions for
  juvenile court

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• What is working, useful considered strengths?
• SOS offers different ways to look at cases with a
  focus on safety with some discussion of absolute
  sobriety
• SOS methods allow an opportunity to really
  develop a working relationship and find out what
  is going on in a family. SOS consult formats, 3
  houses help develop the relationship
• SOS allows to focus on impact of danger and harm
  on children and to set measurable behavioral
  goals for parents both short and long term.
• Mapping forces Social Workers to focus on real
  concerns regarding impacts on child safety and
  parents behavior and helps develop goals as well
  as getting detail
• Stronger working relationships mean better
  outcomes for families
• 3 column used with care givers helps set small
  goals which result in success and the goals are
  generated by the care givers
• Mapping limits story telling about families and
  situations
• Words and pictures has been helpful for children
• Skillful questioning for detail allows a balance
  look at the family
• Detail helps direct case rather than formula
  response like placing all pre-natally exposed
  children

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• What are the concerns, worries?
• Judges, Guardian ad Litems acceptance of
  practices is a worry
• Judges may be concerned that the Social Workers
  relationship with care givers is more important
  than the safety of children
• SOS takes more time than workers have ie Words
  and Pics, 3 houses 3 columns
• SOS as practiced may be too focused on short term
  goals than safety (strengths re concern
  demonstrated over time)
• Coordination of the use of tools from intake to
  ongoing, families or children ask why are we
  doing this again, we already did that?
• Case mapping is not a friendly process, too long,
  too structured, too much of a critique of the
  mappee, mapper, not as purposeful as it could be
• There are not enough opportunities to learn SOS
• Safety plans are a joke...parents bring unsafe
  people to the network, do they really provide for
  safety, do they rely too much on the child to
  keep themselves safe (safety objects, logs) do
  they create an opportunity for secrets between
  child and care giver? The issue of secrets with
  parents could be confusing and give the wrong
  message.
• Varied use of SOS creates questions from the
  parents and children
• Lets use plain language, not buzz words like
  appreciative inquiry
• With words and pictures, parents get defensive re
  what the child will be told and negotiation is
  required

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• Next Steps
•  Specialized training should continue such as W
  P DVD etc
• Set up a library of resources
• Training of the CP community, Judges, Foster
  Parents, GAL etc
• Agency Conference as a training tool
• Social Workers need materials for WP, etc.

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• Community Forum on Child Protection

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Family Dependency Tx Court Purpose/Goal

• National Model
• Promote recovery through a coordinated response
  to participants dependent on alcohol and other
  drugs
• Improve outcomes for alcohol and other drug
  addicted individuals in the courts through
  collaboration, thereby
• Enhancing public safety, ensuring participant
  accountability, and reducing costs to society
  system

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FDTC Team Members

• Judge
• Drug Court Coordinator
• County Attorney
• Public Defender
• Guardian ad Litem
• Public Social Services Social Worker
  Supervisor
• Tribal Social Services Social Worker
• Clinical Providers

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FDTC - Participants

• Currently open in Juvenile Court
• Screened by the Family Drug Court Team
• Volunteers to participate in good faith
• Signs terms of participation

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FDTC Process - Phases

• ONE Assessment Detox Primary Treatment
  Random Urinalysis 12 weeks sobriety weekly
  court attendance
• TWO Sobriety After care Relapse Prevention
  Random Urinalysis 12 weeks sobriety every other
  week court appearance
• THREE Sobriety Cognitive Behavioral Skills
  Sober Parenting Random Urinalysis complete 52
  weeks ever third week court appearance

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FDTC - Incentives

• Praise/recognition by the Court
• Gift certificates
• Bus passes
• Treatment medallions
• Certificates of accomplishment
• Clothing vouchers
• Gas cards,
• Respite care
• Recognition of birthdays birthdays of children

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Sanctions

• Civil Contempt of Court reprimand community
  service - incarceration
• Graduation from FDC requires 52 consecutive weeks
  of clean Urinalyses
• Any positive Urinalysis or documented use back
  to phase one reporting
• Any failure to call in for a Urinalysis, failure
  to report for a Urinalysis or failure to provide
  a Urinalysis will be deemed a positive and will
  result in sanctions.

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• St. Louis County Family Drug Court
• Participant Date March 18, 2010
• Danger/Harm/Worries History Mother using
  methamphetamines, methadone, pot, adderral
  connected to criminal element arrested for
  possession of Meth assaulted and abused by her
  partner Daughter exposed witnessed violence
  expressed fear of moms partner and concern for
  her mother. Mom re-engaged with violent partner
  phone calls visit at jail lied to drug court
  team jailed. Ticketed for shoplifting.
  Recently No concerns.
• Safety/Strengths/Working Well Strong family
  support ties Regular contact and visits with
  parents honest discussion about relationships
  and addiction reconnected with daughters father
  their relationship appears amiable and
  supportive He has been providing primary care
  for his daughter at times. All reports indicate
  complete sobriety even in light of reconnection
  with ex-partner. Actively seeking employment.
  Engaged with daughter baking, crafts, trips to
  events, shopping in the community, valentines day
  party at school. Purchased a puppy for daughter
  teaching her to provide care. Daughter
  regular attendance in pre-school mom
  transports. Mom attending individual therapy -
  expresses anger, frustration, and some gratitude
  with team and family this is a change.
  Developing a stronger relationship with sober
  graduate of family Drug Court Completed a court
  ordered peer review. Advanced to Phase II.
  Safety Team Mother, Father, Brother, two sober
  friends, some Family Drug court team members,
  sponsor Plan Family 3x weekly check in w/mom
  daughter 2x weekly face-to-face contact by
  friends and sponsor weekly contact with SW
  Court - 2x monthly appearance ensure sobriety
  and primary care of daughter
• Complicating Factors Moms father is seriously
  ill creates stress and anxiety. Struggles with
  establishing and maintaining safe boundaries with
  ex-partner does not recognized his negative
  impact on her family.
• Next Steps1. Continue present efforts to work
  her recovery plan and care for daughter. 2.
  Find a job. 3. Continue individual therapy.
  4. Continue Cognitive-Behavioral group at Bethel.
  5. Continue Phase II. 6, Address shoplifting
  ticket.
• Scale
• How effective has FDTC been in helping you remain
  sober 0 drug court total waste of time 10
  absolutely critical to my sobriety? Ans 9 How
  come? Ans Having to face people on the team and
  UAs Wish I could take them after FDTC is over.
  How has the drug court process work for you 0
  not all all 10 fantastic Ans 3 How come
  confused about roles who does what, when and
  stuff like that new UA procedure is confusing
  dont know the rules some go to jail, others
  dont not always fair and I never know whats
  going to happen.
• 0________________________________________________1
  0

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• St. Louis County Family Drug Court
• Participant Date March 18, 2010
• Danger/Harm/Worries History Son born six-eight
  weeks premature spent the first month in a
  neo-natal isolet wore a heart lung monitor
  diagnosed FASD due to moms alcohol and drug
  use. Son is presently developmentally delayed.
  Mom recovered but relapsed after 10 months of
  sobriety alcohol and methamphetamines Took son
  to the seedy hotel and bar while using
  placing him in danger again Recently The
  present worry/concern is potential relapse which
  would place son at risk.
• Safety/Strengths/Working Well Present safety is
  provided through a close monitoring/supervision
  by the Drug Court Team Moms mother and extended
  family closely observe and would report in as
  flash Mom lives with her mother. Mom sober for
  six months and cooperating with recovery
  completed treatment and working on a recovery
  plan. Mom has followed through with action
  steps. Relationship with the social worker is
  more real honest, straightforward feels
  trusting and close. Completed a thorough
  sobriety plan. Cooperating in an individual
  therapy program/making progress. Has three sober
  friends and convenes a bi-monthly get together.
  Demonstrated responsibility cared for her
  disabled sister over the holidays bathed,
  toileted, fed, etc. while performing the same
  duties with Robert. Participated in family
  traditions. Offered an apartment by the housing
  authority turned it down it was one block from
  the seedy hotel and neighborhood where she used
  advocated for her self with the housing
  authority they agreed and didnt change her
  position on the waiting list. Identifies what
  she needs and does not need articulates clearly
  her wants expressed concerns about the sober
  parenting class.
• Complicating Factors Poor poverty
  unemployed. Long history of alcohol and drug
  abuse Sons father Moms ex-partner is a
  career criminal and drug abuser. Housing issue
  a concern for some team members although living
  with her mother provides safety, security, family
  connectedness, and nurturance. Little
  transportation other than public bus. Lacks a
  sober network of friends. Low self-esteem and
  unresolved clinical issues. . Safety Team/Safety
  Plan Team Moms mother, aunt and uncle, two
  former foster parents, program at Bethel, cousin,
  father in Grand Rapids, Minn., sponsor Safety
  Plan Relatives/Kin report to social worker
  weekly regarding status personal face-to-face
  contact bi-monthly at minimum with son.
• Next Steps1. Enlarge her sober network of
  friends 2. Remain in safe housing. 3. Seek
  employment. 4. Continue parent
  education/support
• Scale
• 0_________________________________________________
  ________________10
• How helpful has drug court been in maintaining
  your sobriety 0 not at all 10 most helpful.
  Ans 8 how so? Ans having relationships with
  people who care. Who? Ans You just want me to
  say you but then said team members. What else?
  Ans Random UAs I dont want to disappoint
  people. Who? Ans Robert, my family and you. It
  got a little silly at this point.

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• SLC FDTC Drug Court Map

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Drug Court Participant Video
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Drug Court Team Member
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Next Steps

• Continued Mapping/Search for Detail With Families
• Continued Sharing of Maps with Families and Team
• Attach Maps and Safety Plans to Reports to
  Juvenile and Family Drug Court
• Map Family Drug Court Process With Team Members
• Combine Team Member Maps, Discuss at Retreat
• Start Over

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Special Thanks

• Roxanne Esler Drug Court Social Worker
• Catherine Ramm Drug Court Participant

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Acknowledgements

• Andrew Turnell
• Rob Saywer Sue Lorbach, Olmsted County Staff
• Dan Koisolek Michelle Sellinger Carver County
  Staff
• Minnesota Department of Human Services
• Dick Pingry Childrens Division, St. Louis
  County
• Special Assistance Mary Ness, Jenny Fick James
  Ellingson

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References

• Ellingson, James Fick, Jenny Time Line
• Lorbach, Sue Consultation Framework
• Turnell, A. Edwards, S. (1999). Signs of
  Safety A Solution and Safety Oriented Approach
  to Child Protection Casework. New York Norton
  Company
• Turnell, A. Essex, S. (2006). Working with
  Denied Child Abuse The Resolutions Approach.
  Berkshire, England Open University Press.
• Weld, Nikki 3 Houses