Collaboration Between Agencies to Enhance Client Success

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Collaboration Between Agencies to Enhance Client
Success

• FRESH (Family Recovery Engagement Support of
  Hampden County) Start
• Family Recovery Project

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

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Partners in Family Recovery

• Tx providersco-occurring disorders (SUD, MH,
  trauma)
• Child Protection Services-DCYF
• Part C services--Family Centered Early Supports
  and Services (FCESS)
• Prenatal providers and birth hospitals
• Legal System and Corrections
• Domestic Violence
• It takes time and effort to build relationships
  with each other and it works

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Collaboration or Building a Family Recovery Team

• At Systems Level e.g. cross and joint training,
  increasing collaboration and communication
  between providers, workgroups, protocol
  development
• At Family Level e.g. consents, family team
  meetings, sharing of service/safety/relapse
  prevention plans, joint goals, regular contact
  with providers, joint appointments

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Barriers to Collaboration

• Time and money
• Different values, foci, goals
• Different language and knowledge base
• Fear and loathing
• What else?

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All You Ever Wanted to Know About Collaboration

• National Center on Substance Abuse and Child
  Welfare http//www.ncsacw.samhsa.gov/
• Children and Family Futures http//www.cffutures.o
  rg/
• National Alliance for Drug Endangered Children
• http//www.nationaldec.org/

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Developing a Shared Knowledge Base

• Cross-training
• Free, trade, formal and informal
• Use staff meetings and annual conferences, Family
  Recovery Fairs at child welfare offices
• Get on training mailing lists for other
  disciplines
• On-line trainings
• Address what you do, methods for connecting with
  staff, relapse and child safety
• Substance Abuse Treatment Levels of Care
• DCF and the Legal Process
• 42CFR and communication limitations

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Joint Training

• Topics for trainings should evolve in response to
  recognized needs, and to stated requests.
• Topics include identification and referral,
  client engagement, fetal alcohol spectrum
  disorders (preventing and working with adults
  with FASD), trauma informed care, recovery and
  parenting, and working with families with
  substance exposed newborns, and families in MAT.
• Planning a conference across disciplines is a
  strong relationship-building activity

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Consider This

• Relapse is potentially an opportunity for growth
  given appropriate safety planning and support
• The presence of a parental substance use disorder
  does not solely determine good or bad parenting.
• Substance use is just a piece of the puzzle.
• The quality of the care giving relationship is
  key to childrens long-term development.
• Keeping children safe is a responsibility that
  belongs to all of us.
• We all share in the responsibility of helping
  families thrive.
• Modeling trust, communication, and collaboration
  benefits clients, families, and providers.
• 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 collaboration.
• Every family has strengths.
• Individuals exist in the context of family,
  community, and culture.
• We need to understand, value and support each
  others work.
• Collaboration and communication between providers
  is key in supporting families.
• Every person has something to learn and something
  to offer.

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Training and Other ResourcesFree CEUs

• Abandoned Infants Act Resource Center
• www.aia.berkeley.edu
• National Center on Substance Abuse and Child
  Welfare
• www.ncsacw.samhsa.gov
• Children and Family Futures
• http//www.cffutures.org/
• The National Alliance for Drug Endangered
  Children
• www.nationaldec.org

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Best Practices in Communication A Guide for
DCF and SA Treatment ProvidersAreas Addressed

• Screening and Engagement
• ?
• Referral and Consent Forms
• ?
• Assessment
• ?
• Treatment Ongoing Collaboration
• ?
• Discharge Aftercare Planning

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Included in the Guide

• Best Practices protocol
• New tools to aid communication for example
• List of Local Treatment Providers
• Information to Be Shared at Referral
• Assessment Form for DCF
• Treatment Status Form for DCF
• Existing tools (e.g. safety plan samples)
• Resources (re DCF, BSAS, Legal, Collaboration)
• DCF Phone Directory and Western MA Substance
  Abuse Treatment Directory

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Family Recovery CouncilMAT Pregnancy/Postpartu
m Workgroup

• Goal To establish best practices across all
  systems (DCF, treatment providers, hospitals,
  etc.) to support families with moms in Medication
  Assisted Treatment during the pregnancy, birth,
  and postpartum periods.
• Action Steps
• 1) Identify challenges
• 2) Troubleshoot identify solutions
• 3) Develop a Best Practices Protocol
• 4) Develop a Parent Information Packet
• 5) Evaluate, revise, disseminate

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Example of Collaboration at Family Level for
Mothers in MAT

• Begin as a team with consents
• Ongoing relationship, not just in times of crisis
• Prepare all materials when woman is
  pregnanttests, letters from providers, contact
  info for providers
• Contact postpartum social worker at hospital,
  DCYF if there is an open case
• Bring two sets of materials to hospital, one goes
  to DCYF with filing of 51A
• Follow-up on FCESS referral and be at assessment

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Collaboration with Other Providers

• Child Safety and Family Recovery
• Consents
• Develop Relationship and Exchange Plans
• Supporting Family Centered Early Supports and
  Services (FCESS)
• Family Conferences

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Collaboration with partnersCooperative Family
Conferences

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

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Decision-Making Questions

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

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Safety Mapping

• Tool for case conferences
• Invites multiple perspectives
• Gets people on same page
• Structure to bridge disagreements
• Helpful for clients

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Guiding Principles

• Addiction and recovery happen within the context
  of a family.
• Single greatest motivation for recovery
  retaining the right to parent ones children.
• Reinforcing the capacity to parent is important
  to recovery.
• Sobriety, and even recovery, is not enough to
  make a great parent.
• Systems work must happen concurrently.

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Building Relationships with Clients

• Taking time making effort to engage
• Providing concrete resources
• Showing respect
• Being honest
• Advocating
• Empowering

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Engagement Strategies

• Peers
• Help with DCYF and noncustodial support
• Warm handoffs for referrals
• Mother-baby groups with critical mass of women in
  recovery
• I really needed to learn how to be a parent, I
  never had that in my own childhood, I just didnt
  even know where to start

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Groups

• Lessen isolation
• Increase parent-child attachment
• Reinforce role of mother
• Build recovery
• community for families
• Increase use of
• FCESS
• Expose children to early
• education and care

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Recruitment Collaboration

• When 2 or more agencies collaborate on a group
• Equal representation with facilitators
• Emphasis on team approach
• Identify the common thread- ( i.e. we are all
  mothers here)
• Each agency staff recruit but no differentiation
  between participants

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Lessons Learned

• Reach for the phone or the keyboard!
• Listen to each other. Tolerating the discomfort
  of differing points of view builds trust and
  respect.
• Balance process and product by identifying the
  problems and then focusing on possible solutions
  (take action!).
• Be role models cross-systems partners should
  plan, lead, and participate in meetings equally.
• Reinforce common goals and understanding
  Relapse is a recovery AND a safety issue.
• Each family provides an opportunity to improve
  collaboration. As challenges arise, we can
  identify the larger systems issues and then
  advocate for change!

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Contact Information

• Debra Bercuvitz
• Debra.bercuvitz_at_state.ma.us
• 413-887-1761
• FRP website www.familyrecoveryma.org