Family Partnership Model - CPCS FPM/Crispin... · 2011. 8. 21. · • Community and in-patient...
Transcript of Family Partnership Model - CPCS FPM/Crispin... · 2011. 8. 21. · • Community and in-patient...
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Family Partnership Model: Developments and Innovations
Dr Crispin DayCentre for Parent and Child Support, South London & Maudsley NHS Trust
CAMHS Health Service Research Unit, Institute of Psychiatry, King’s College,
London
University of Technology, Sydney
Friday July 30th, 2010
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The Centre for Parent & Child
Support
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Goals for the day
• To (re)connect with FPM
• To briefly overview the Family Partnership
Model and developments in practice, training,
and sustainability in the UK
• To explore the challenges of using FPM in
practice
• To introduce the FPM Reflective handbook and
have the chance to use it
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Outline of the day
Morning Session
• Introducing the Family Partnership Model– Overview and reflections on Family Partnership Model
– Developments in Family Partnership Practice, Training and Sustainability
– Identifying the Strengths and Challenges of FPM in Practice
• Australasian FPM research
Afternoon session
• Advancing and Sustaning FPM Practice – Addressing the Challenges of FPM in Practice
– Introduction to the FPM Reflective Practice Handbook
– Using FPM RP handbook in Practice:
– Summarise, Review and Finish
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What are the key components of the
Family Partnership Model for you?
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Family Partnership Model
Construction Processes
Helping
Process
Helper Skills
Outcomes
Helper Qualities
Partnership
Parent Characteristics
Service & Community Context
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The Helping Process
END
RELATIONSHIP BUILDING EXPLORATION
UNDERSTANDING
GOAL SETTING
STRATEGY PLANNING
IMPLEMENTATION
REVIEW
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Model
• Family strengths and expertise
• Experience and understanding of skills and qualities eg respect, judgement
• Roles of the helper
• Balance between relational and problem management tasks of the FPM Helping Process
• Points of change for families during the FPM
• Clearer view about review– Are you making progress towards your goal?
– What sort of relationship do we have?
– Am I being helpful?
• Learn more about how it is actually used and incorporated into practice
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Relationships and roles
• Expert
• Dependent
• Friendship
• Adversarial
• Avoidant
• Partnership
• Being supportive
– To sustain, encourage, care & shore
up
• Being connected
– To hit off, hook up with and to get
along
• Being facilitative
– To make possible, make easy, to
make happen
• Being influential
• To have some bearing on, to inspire
and to change
• Being purposeful
– To be focussed, determined and persistent
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FPM Practice and outcomes
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The Spread of FPM
• Integration into national, state and local area health and social care policy, for example,
– UK DH Healthy Child Programme (DH, 2009)
– Action on Health Visiting – Model of Practice (DH/CPHVA, 2010)
– Child safety and safeguarding (Barlow 2010)
– Australasian state policies
• Service implementation within UK, Europe and Australasia (Day, Davis &Hind 1998; Day & Davis, 1999)
– Universal, targeted and specialist
• UK– Active dissemination across many NHS community health, social care, early
years and children’s centre services
• Australia– FPM Australasian Board
– Every Australian State and Territory
– Community Health, Child Safety and NGOs
– Indigenous communities
• National programme in New Zealand– Community health
– Plunckett Society
– Work and Incomes
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Practice
• FPM Reflective practice handbook
• Limits of core training esp problem management, review, ending
• New adaptations of FPM– Helping Families Programme
– Adult mental health practitioners
– Adult learning disability
– Schools and education
• Partnerships with communities – EPEC
• Practical tools as well as principles of practiceeg goal star
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Examples of FPM applications I
• Child disability and child mental health
• Encopresis manual for children with learning disability (Lawes et al, 2008)
• People with severe learning disability and challenging behaviour
• Promotion of early parental adaptation and infant well-being and prevention of early childhood abuse and neglect (Oxford/EEPP)
– Ante/Post natal Promotional Interview training
– National SureStart Unit:- Personal, Social and Emotional Development (PSED) Training materials
• Collaborations with other parenting programmes– Nurse intensive visiting programme/FNP (Olds)
– Parents Under Pressure (Harnett & Dawe)
– Incredible Years
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Examples of FPM applications II
• National Academy of Parenting Research:
– High need families research programme (Day
et al, in press)
– Collaboration with Paul Harnett (UQ), & Sharon
Dawe (Griffith U)
• Parents with severe mental health
disorders
– Adaptation of FPM for CMHT social workers
and CPNs
• Partnerships with communities – EPEC
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Outcomes
• Parents of children with severe and multiple disabilities (Davis & Rushton, 1991), RCT
• Parents of children with emotional and behavioural difficulties (Davis & Spurr, 1998), CT
• Preterm infants (Avon Premature Infant Project, 1998)
• Promotion of early parental adaptation and infant outcomes: European Early Promotion Project (Davis et al., 2005; Puura et al., 2005)
• Prevention of childhood neglect and abuse: Oxford Home Visiting Project (Barlow et al., 2003; Barlow et al., 2007; Brocklehurst et al., 2004, Kirkpatrick et al., 2007)
• Children with severe behaviour problems and risk of school exclusion lving in families with complex psychosocial difficulties (Day et al., 2010; in prep)
• Community partnerships – EPEC (Day et al, in prep)
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Impact of Family Partnership Model:
Child and Family Outcomes
• Controlled evaluation of intervention with pre-school children with emotional and behavioural problems
• Inner city population, high levels of family need, low incomes, low educational attainment
• Sig. improvements in – Child behaviour (CBCL) (EF=0.8)
– Parenting stress (PSI) (EF=0.6)
– Parental mental health (GHQ) (EF=0.6)
– Parental self esteem (FG) (EF=1.0)
– Home environment (HOME) (EF=1.0)
• High levels of engagement and reduction in wider service use
(Davis & Spurr, 1998)
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Impact of Family Partnership Model:
Child and Family Outcomes
• Controlled evaluation of intervention with children with disabilities
• Bangladeshi population in East London
• Sig. improvements in– Child behaviour (EF=0.6)
– Child development (EF=0.3)
– Parental self esteem (EF=1.1)
– Parental relationship (EF=1.5)
• See www.cpcs.org.uk for more outcome studies
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FPM Training
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Practitioners Trained
• Health Visitors, Child and Family Nurses, Paediatric and School Nurses
• Therapists: Speech, Physios, & OTs
• Paediatricians, Clinical psychologists, Psychotherapists
• Teachers: All Ages and Special Needs
• Early Years and Child Care mangers and staff
• Youth Workers
• Child and family Social Workers
• Educational psychologists, Educational welfare officers, Learning mentors
• Parents and Voluntary Agency Staff
• Police
• Adult mental health community nurses and social workers
• Community and in-patient adult learning disability nurses
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Impact of Family Partnership
Model: Training outcomes
• Sig. improvement in practitioner skills,
qualities and self-efficacy (Rushton &
Davis, 1991, Davis et al., 1997)
• More accurate at identifying family
needs (Papadopoulou et al, 2005)
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Training
• FPM Reflective Practice Handbook and integration into training– Paper describing use
• Developing training methods eg seminar tasks– Session 10 planning tasks
• Goal orientated approach to participant progress
• Measurement– About FPM - Knowledge quiz,
– Feedback and Evaluation forms
– FPM in Practice EOT/FWU
• Advanced practice sessions
• Accreditation – positive impact
• Supervisor course 3+2
• Facilitator training reflect changes in Foundation Course
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FPM Training: Outcomes
0
20
40
60
80
Know Confd Equip Committ
Before (0-100)
After (0-100)
About Family Partnership: Pre/post score p=.000
All increases p=.000
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FPM Training: Course feedback
0
20
40
60
80
Not
at a
ll
A li
ttle
A lo
t
Ver
y m
uch
%
Encouraged
0
20
40
60
80
No
t a
t a
ll
Qu
ite
Inte
res
tin
g
Ve
ry
inte
res
tin
g
%
Interesting
0
2040
60
80
Not
at a
ll
Qui
te
Use
ful
Ver
y Use
ful
% Useful
0
20
40
60
80
Unl
ikel
y
Not
/sure
Rec
mm
d
Hig
hly
% Recommend
Data from 1007 participants (CPCS, 2008); See also Jackiewicz, 2004
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FPM sustainability
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FPM Sustainability: An example
• 3 yr programme
• Began with initial visit to meet senior managers
• FPM Foundation training for senior practitioners
• Multidisciplinary group with personal and professional impact
• Trained FPM supervisors
• High impact – set up reflective practice meetings
• Trained FPM facilitators
• High impact – identify key pracs to train and organised plan for achieving take-up
• Stories of impact disseminated across organisation
• Open and non defensive approach by practitioners
• Assistant Director champion
• Support from senior clinicians
• Consistent with policy and service aims
• Identified resources and money
• Set up Family partnership team
• Change in documentation and procedures of practice
• Informal diffusion by AD and other champions
• Training certificates handed out by CEO
• Regular, active and good relationship with CPCS
• Press coverage
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Day & Davis
CPCS
CPCS Team
State FPM
Facilitators/
Supervisors
CPCS/
Supporting
organisations
Family Partnership
Diffusion
Org structure/position
Org readiness
Adopted by practitioners
Implementation
ConsequencesOuter org/policy context
Inner org system
Dissemination
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Using FPM to work effectively with families
who have multiple needs: What works
• Ensuring time & resources are available for practitioners to
adopt & use FPM effectively
• Maintaining a culture of open, reflective practice
• Easy practitioner access to FPM support & supervision
– FPM Reflective Practice Handbook
• Developing and maintaining the commitment of service
leaders, managers and supervisors to use FPM to bring
about service improvement and better outcomes for children
and families
– Supervisor & Facilitator trainings, Manager briefings
• Routine monitoring of implementation, progress and
outcomes
– With families and with practitioners
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What are the strengths and challenges
of using FPM with parents and
families?
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– What are the outcomes that you want to
achieve in relation to the challenge?
– Use the FP Model, its components and
processes to think through how that outcome
can be achieved, concentrating on what you in
your position as a prac/facilitator/manager/etc.
can achieve
– What are the skills and processes involved in
achieving this outcome?
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The Outcomes of Reflective
FPM Practice• My FPM Model
• My work tasks and practice
• (My) Self as an FPM practitioner
• Do no harm
• Know and build on my strengths and to know my challenges
• Help to clarify and manage problems and challenges
• Build and participate in reflective relationships
• To have a better understanding
• To be more knowledgeable
• To be more skilful and capable
• To feel more comfortable and confident
• To have great sense of efficacy
• Skills and qualities of a reflective practitioner
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Family Partnership Model:Reflective Practice Handbook
• Developed as part of materials available to people trained in FPM
• Fits in between the Foundation course and ‘Working in Partnership’ (2002)
• Support for practitioners– Help to make FPM tangible and focussed
– Reflect on the use of FPM with parents
– Reflect on the process & progress
– Review FPM work
– Plan sessions with parents
– Use as a framework in supervision and case discussion
– Predict and manage strengths and problems that occur during the helping process
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Family Partnership Model:Reflective Practice Handbook
• Handbook contains details of the
Family Partnership Approach
– Session plans
– Family Partnership Session sheet
– Reflective Practice sheets
• Examine and evaluate the benefits of
its use in practice and during
supervision
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• Think of a parent/family/colleague/ with whom you have had a recent contact
• Complete the summary sheet by thinking about tasks on which you spent your time and effort in the contact
• Now complete the relevant reflective practice sheets
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• Three goals for using the Family Partnership Model in my
practice
• Choose one goals, either the easiest or the most important,
what are the possible strategies that you could use to help
reach
• Put together a plan of the steps involved that you need to
take to achieve the goal you’ve chosen.
• What help or support you need from your colleagues,
managers or others to help you complete the steps involved.
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Further Information
www.cpcs.org.uk
Centre for Parent and Child Support
South London & Maudsley NHS Trust
Guy’s Hospital
Snowsfields
London SE1 3SS
Tel: +44 (0) 203 228 9751