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

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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

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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?