Post on 26-Dec-2015
CA’s Practice ModelWashington DSHS Children’s Administration (CA)
Created by the Practice Model Team in conjunction with Dr. Dana Christensen
Foundations of Practice
Developmental CompetencySW101-05 Ability to identify core principles and goals of the agency practice model such as building partnerships, focusing on pragmatic everyday life events, and targeting measurable prevention skills
By the End of This SessionYou will be able to:• Describe the reasons for having a practice model• State the four milestones that make the SBC practice
model• Explain the three basic tenets of the SBC practice model• List the three foundational theories of SBC• Navigate the research that shows the effectiveness of the
practice model• Explain how the practice model addresses
disproportionality
• Theoretical and values based
• Operationalizes specific casework skills/practices
• Provides a conceptual map to optimize the
safety, permanency, and well-being of children who enter the child welfare system
What is a Practice Model ?
Solution-Based Casework (SBC) is an evidence-informed practice model for Casework Management in Child Welfare and Juvenile Justice. The model provides a conceptual map for a family-centered practice from assessment through case closure. The SBC practice model is best thought of as the architecture that holds our practice to a consistent focus on our outcomes.
What is our practice model?Solution-Based Casework
Three Main Tenets of SBC
We Prioritize the Family Partnership
12
We Focus on Pragmatic Solutions
to Everyday Life Problems 3
We Help Families Document and
Celebrate Success
Integrated Framework from:
Relapse Prevention (Cognitive Behavioral Theory) (Marlatt & Gordon, 1985, Pithers, 1990, Beck, 1993)Cognitive
Behavior Therapy Solution-Focused Therapy
(Berg, 1994, DeShazer, 1988)
All three models have their own well-documented evidence base.
Solution Focused
Interviewing
Family Life Cycle Theory (Carter and McGoldrick, 1999)Family Life
Cycle Theory
Research on SBC in Child Welfare?
SUMMARY of OUTCOMES
• 30% reduction in removal of children• Over a 100% increase in goal attainment• 27% more workers contacted referral sources directly• 64% increase in identified client strengths• Families with chronic CPS involvement more likely to be successful• Clients with Co-morbidity also achieved more goals.• 35% reduction in recidivism referrals over 6 months• Full implementation of SBC met all 23 CFSR review items and the 7
outcomes of safety, permanency, and well-being (4500 cases)
(Antle et al, 2005, 2007, 2009, 2012)
More information on other studies at www.solutionbasedcasework.com
What is the SBC Evidence Base ?
(Antle et al, 2005, 2007)
(Antle et al, 2005, 2007)
Achievement of Goals• Families achieved significantly more case goals/outcomes when SBC was used• Chronic CPS families were even more likely to experience success with SBC• Families with all types of maltreatment and co-morbid factors achieved more goals with the
use of SBC
Worker Effort
(Antle et al, 2005, 2007)
(Antle et al, 2005, 2007)
Worker Attitude
Overview of Study
Research:• What is the relationship between implementation of SBC and
performance on federal review items and outcomes • What are the most critical points in the child welfare casework process to
use SBC in order to promote positive outcomes?
Sample: 4,559 cases over four-year time period (2004-2008)Procedure
• CQI Review Process• Merged data across four years• Extracted SBC items from review tool• Federal review items and outcomes mapped onto CQI tool by CFSR/PIP team in KY
(Antle et al, Child Abuse and Neglect, 2012)
Summary of Study 5
Solution-Based Casework is associated with significantly better scores on all 23 CFSR review items and the 7 outcomes of safety, permanency, and well-being
(Antle et al, Child Abuse and Neglect, 2012)
Well-being 1, 2, & 3Permanency 1 & 2Safety 1 & 2
• Family Centered wasn’t operationized: no systemic support• Investigations led to a list of problems, not solutions• Assessments were too interrogative, no consensus built• Assessments weren’t located in the details of family life• Case planning focused on service completion, i.e. compliance
(versus skill acquisition)
• Case planning was more worker-driven and “owned” • Caseworkers and Providers didn’t share a common map
Why was Solution-Based Casework Developed ?
Problem - Based
DEFINITION OF THE PROBLEM
Family Support
Mental HealthIn-home therapy
Drug Counseling
Health
In-home worker
Residential Staff
Foster Care
Anger Management
Family MembersCPS
Natural Supports Courts
School Counselor
Mom is Neglectful Mom needs Money Mom uses Drugs Son is Truant Son is Hyperactive Girl needs SA Counseling Baby has Med. Needs
Assessment of Problems
Assessment of Problems
Assessment of Problems
Assessment of Problems
Assessment of Problems
Assessment of Problems
Case Plan
Assessment & Referral to:
Referral & Assessment
Family Support Action
Plan
Drug Counselor Treatment Plan
SchoolAttendance
Plan
Impact Plus Service Plan
FPP’s Treatment
Plan
Comp Care Treatment
Plan
Comp Care Treatment
Plan
First Step Treatment
Plan
The Family
??
??
The All-Too-Familiar Approach
A Family-Friendly Interface
that Helps to Organize Complex Issues
and Multiple Partners
Mental Health: MH Clinic
Work Issues: Family & Child Support
School Attendance: School
Substance Use: AA Counselor
Supervision: Family Members
Home & Child Cleanliness: FPP
Protection issues: Courts and P & P
How is Solution-Based Casework Different ?
• Problem definition located in the difficult situations of everyday life (Family Life Cycle)
• Challenging situations are normalized, tracked, and contextualized
• Consensus building sought and guided from the very first interview
• Case planning targets NEW ways of handling those situations at both the Family and Individual level
• Outcome is measured by skill development in areas of concerns(Versus service compliance)
• Skill development is documented and celebrated.Ahh…that’s better
Organization
Of
Practice
Milestone 2 : Getting Organized on Objectives• Moving from Consensus to FLO & ILO• Building the Family and Community Team for
Change• Co-Developing a “Case Plan”
Milestone 1 : Building a Consensus• Family engagement• Gathering assessment information
(IA, FAR FA, CFE)• What has happened in the past?• What do we need to create change?
Milestone 3 : Specific ACTION Plans • Specific Plans of Action for Families and Youth• Documenting behavioral change• Using the Team to help
Milestone 4: Documenting and Celebrating• Documenting Progress and Change• Celebrating Small Steps of Success• Adjusting plans for progress
20
Making the practice real
CHILD SAFETY FRAMEWORK
SAFETY ASSESSMENTS
FAR FAMILY ASSESSMENT
FAMILY TEAM DECISION MAKING
MEETINGS
SHARED PLANNING MEETINGS
COMPREHENSIVE FAMILY
EVALUATION
Summary• What are some reasons for having a practice model?• Shout out the four milestones of our practice model• What are the three basic tenets of the SBC practice
model?• What are the three theories that make up SBC?• How do you think our practice model can address
disproportionality?