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6/15/2010 1

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Family Drug Court Learning Academy g y Module 1: Mission and Underlying Values

Children and Family Futures Office of Juvenile Justice and

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Office of Juvenile Justice and Delinquency Prevention Family Drug Court Technical Assistance Program 4940 Irvine Blvd, Suite 202 Irvine, CA 92620 714.505.3525 www.cffutures.org

This project is supported by Award No. 2009-DC-BX-K069 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs

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Welcome!

AGENDA

• Opening Remarks
• Opening Remarks
• Introductions
• Synthesis of Cross System Values and Principles: A

National Perspective

• Mission and Underlying Values
• How do the Dynamics of Addiction, Treatment and

Relapse Impact Values?

• Bringing it all Together: How do we work together to

resolve the “Hot Button” issues?

• Panel Discussion: Lessons Learned

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Introductions

• Nancy Young, PhD, MSW

Director Children and Family Futures Director, Children and Family Futures

• Phil Breitenbucher, MSW

Program Director, Children and Family Futures

• Theresa Lemus, RN, MBA

Program Associate, Children and Family Futures

• Honorable Nicolette Pach

Honorable Nicolette Pach Consultant, Children and Family Futures

• John Passalacqua, JD

Children and Parent’s Counsel

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Overview of Learning Academy Module Format

• Polling Questions
• Live Questions & Discussion
• Webinar Evaluations

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How do I ask questions?

For your convenience, there are two ways to ask questions during this ways to ask questions during this webinar presentation:

• 1. Type and send your questions

through the Question and Answer log located on the bottom half on your panel/dashboard. 2 There will also be time at the end

• 2. There will also be time at the end
• f the webinar for you to ask

questions via the conference line.

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Polling Question #1 How did you hear about this webinar?

• I’m an OJJDP FDC grantee
• I’m a RPG grantee
• IDTA program
• At the NADCP conference
• Other

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Synthesis of Cross System Values and Principles: A National Perspective

Nancy Young, PhD

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Background

• Statement on shared values and principles to

develop collaborative solutions for cross develop collaborative solutions for cross- system issues

• Intent: Capture a set of ideal practices that can

guide and inform collaborative practice

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Background

Six NCSACW Consortium Organizations:

• American Public Human Services Association
• American Public Human Services Association
• Child Welfare League of America
• Children and Family Futures
• National Association of State Alcohol and Drug

Abuse Directors

• National Council of Juvenile and Family Court

Judges

• National Indian Child Welfare Association

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Shared Values and Guiding Principles

• 1. Joint Accountability and Shared Outcomes

2 P i i l f D il P ti

• 2. Principles of Daily Practice
• 3. Information and Data Sharing
• 4. Training and Staff Development
• 5. Budgeting and Sustainability
• 6. Working with Related Agencies

g g

• 7. Working with Community and Families

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Mission and Underlying Values

Nancy Young, PhD

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6/15/2010 7 What is a mission statement?

A concise statement - built by consensus - f h t i t b hi d

• f what is to be achieved

Sometimes includes how it will be reached Example from CFF: Example from CFF: To improve the lives of children and families, particularly those affected by substance use disorders

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Polling Question #2 Together, our team has developed a i i t t t mission statement.

• Yes, we developed a mission statement

that our FDC team believes in. No we have a mission statement but it

• No, we have a mission statement but it

was not developed collaboratively with

• ur team members.

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6/15/2010 8 What do values have to do with our mission?

A values inventory reveals important diff i b li f b t differences in beliefs about:

• Parenting and substance use and

abuse

• Treatment efficacy

Daily practice issues: screening

• Daily practice issues: screening,

assessment, client engagement and services to families

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Barriers to A Shared Mission: Policy Issues

• Difference in perceptions of the primary client:

The “Hot Buttons”

Difference in perceptions of the primary client: the parent, the child

• Difference in perception of the target

population

• Different “clocks” among service systems

I tibl i f ti t

• Incompatible information systems
• Perceptions of confidentiality regulations
• Missing data
• Categorical funding streams

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Barriers to A Shared Mission: Practice Issues

• Knowledge gaps among staff working in the

The “Hot Buttons”

Knowledge gaps among staff working in the systems

• Lack of effective communication

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What is a Mission Statement?

Components of a Mission Statement:

• Understanding each other’s values
• Shared principles
• Shared outcomes to measure whether

the mission is achieved

• Client outcomes
• Priority groups of parents and children
• Cost savings

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But we’ve already done this!

Mission statements developed in the early stages

• f a project may benefit from being revisited,

p j y g , since:

• Staff turnover happens
• Fiscal changes affect staffing
• The grant writer may have been removed

from some operational issues from some operational issues

• Fundamental values issues may have been
• verlooked
• Initial mission statements are sometimes set

forth in vague and abstract language

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Temporary Assistance for Needy Families (TANF)

• 24 months work participation

The Five Clocks

24 months work participation

• 60 month lifetime

Adoption and Safe Families Act (ASFA)

• 12 months permanency plan
• 15 of 22 months in out-of-home care must petition

for Termination of Parental Rights (TPR) Recovery

• One day at a time for the rest of your life

Child Development

• Clock doesn’t stop
• Moves at the fastest rate from prenatal to age 5

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The Most Important Clock

• The 5th Clock: The one that’s ticking on us

H l d h t t if

• How long do we have to act if
• ur families have
• 24 months to work and
• 12 months to reunify?
• Taking this clock seriously means
• Taking this clock seriously means

that we take aggressive action to reconcile the clocks on children and families

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Polling Question #3 What steps has your team taken to il th l k ? reconcile the clocks?

• Established an advisory board
• Developed a shared mission and principles
• Developed a policy or memorandum of

understanding

• Cross-system training
• All of the above

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GOVERNANCE

Oversight Committee Steering Committee Subcommittees

CWS UNDERSTANDS

Basics of substance use & how use affects child

development

How to screen for substance use Treatment system & how to help people stay in

CWS, SUDS and CS Have Collaborative Policies, Procedures and Tools to:

Builds Cross System Collaboration Establishes Individual and Cross System Roles and Responsibilities Identifies Front-Line Collaborative Practice

TASKS

Mission & Principles Shared Understanding on

Language & Processes

Goals, Timetables,

Products

Training

Curricula/Strategy MONITORING

Treatment system & how to help people stay in

treatment

Implications of tensions between Treatment Staff

and CW timelines ALCOHOL & DRUG SYSTEMS UNDERSTANDS

How substance use puts children at risk & how

CWS must respond

Child maltreatment reporting requirements How to screen for child safety

COURT SYSTEM UNDERSTANDS

Screen for substance use

and child maltreatment

Assess for substance use

and child maltreatment

Develop and implement

collaborative case plans M it d

Baseline Data Progress Reports Outcome Data Basics of substance use & child maltreatment Its role in requiring assessments The authority to prompt/require collaboration

COLLABORATIVELY ALL 3 SYSTEMS

Establish joint policies/procedures to share

information

Establish case plans Develop shared indicators of progress Monitor progress and evaluate outcomes Monitor progress and

evaluate results

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How do the dynamics of addiction relapse How do the dynamics of addiction, relapse and recovery impact the groups mission and underlying values?

Theresa Lemus, RN, MBA

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Barriers to Understanding Values: Policy Issues

• Difference in perception of ability to succeed

The “Hot Buttons”

Difference in perception of ability to succeed in treatment

• Difference in understanding the addiction

spectrum in the context of child safety

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Barriers to Understanding Values: Practice Issues

• Lack of consensus in monitoring progress and

The “Hot Buttons”

• Lack of consensus in monitoring progress and

evaluating results

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The proportion of parents who will succeed in treatment for alcohol and

• ther drug problems is approximately (N=831):

35 40 Child Welfare (N=379) Court System (N=284) 15 20 25 30 Court System (N=284) Substance Abuse Treatment (N=168) 5 10 15 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

A Values Inventory Reveals Important Differences in Beliefs about Treatment

• Most of the respondents from Substance

Abuse Services estimated 60% of Abuse Services estimated 60% of parents will succeed in treatment for alcohol and other drug problems.

• Most of the respondents from Child Welfare

Services estimated 30% of parents will succeed in treatment for alcohol and other succeed in treatment for alcohol and other drug problems.

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Polling Question #4 There is no way that a parent who abuses l h l th d b alcohol or other drugs can be an effective parent

• Strongly Agree
• Somewhat Agree

Somewhat Disagree

• Somewhat Disagree
• Strongly Disagree

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SPECTRUM OF ADDICTION

A Problem for Child Welfare and Court Officers: The most frequently used marker of substance abuse problems in child welfare and family court does not tell you anything about the individual’s place on the spectrum

EXPERIMENT AND USE

ABUSE DEPENDENCE

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Children Living With One or More Substance Abusing Parent .

10.6

Used Illicit Drug in Past Year

7.5 8.3 8.4 10.6

Dependent on Alcohol Dependent on AOD Dependent on Alcohol and/or Needs Treatment for Illicit Drugs Used Illicit Drug in Past Month

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4.5 2.8 6.2 2 4 6 8 10 12

Need Treatment for Illicit Drug Abuse Dependent on Illicit Drugs Dependent on Alcohol In millions

Different Situations for Children

• Parent uses or abuses alcohol or other

drugs (AOD) drugs (AOD)

• Parent is dependent on AOD
• Parent involved in trafficking
• Parent involved in preparing or growing

illicit drugs

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illicit drugs

• Mother uses AOD while pregnant

Source: Nancy Young, Ph.D., Testimony before the U.S. House of Representatives Government Reform Subcommittee on Criminal Justice, Drug Policy, and Human Resources, July 26, 2005

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• Each situation poses different risks and

Different Situations for Children

requires different responses

• Child welfare workers need to know the

different responses required

• The greatest number of children are exposed

through a parent who uses or is dependent on

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g p p the drug

Source: Nancy Young, Ph.D., Testimony before the U.S. House of Representatives Government Reform Subcommittee on Criminal Justice, Drug Policy, and Human Resources, July 26, 2005

To access this publication please publication, please visit the National Institute on Drug Abuse: www.drugabuse.gov

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Treatment Works!

Thirty years of research on the outcomes of substance abuse treatment, with multiple studies in multiple sites have found that effective substance abuse treatment produces significant reductions in:

• Alcohol Use and Drug Use
• Medical Problems
• Criminal Behavior
• Conflicts in Family and Social Relationships
• Conflicts in Family and Social Relationships
• Psychological Problems
• Employment-Related Problems

But How Does That Affect Child Safety, Permanency & Well Being?

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Principles of Effective Drug Treatment

• No single treatment appropriate for all
• Is readily accessible
• Is readily accessible
• Attends to multiple needs of the individual
• Modifies treatment regimen as needed
• Ensures adequate time in treatment
• Includes both counseling and other behavioral

g therapies

• Includes medications as important elements
• Treats coexisting mental disorders in an

integrated way

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Principles of Effective Drug Treatment

• Views medical detoxification as only a first

stage of treatment that does little to change g g long-term drug use

• Does not need to be voluntary to be effective
• Continuously monitors drug use during

treatment

• Provides assessment for infectious diseases
• Provides assessment for infectious diseases
• Recognizes recovery can be a long-term

process that frequently requires multiple episodes of treatment

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Polling Question #4 People who abuse alcohol and other d h di f hi h th drugs have a disease for which they need treatment.

• Strongly Agree
• Somewhat Agree

Somewhat Disagree

• Somewhat Disagree
• Strongly Disagree

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Compliance with Medical Treatment

Insulin Dependent Diabetics Insulin Dependent Diabetics

Compliant with medication < 60% Compliant with diet and foot care < 30% Retreated in 12 months 30 - 50%

Hypertensives

Compliant with medication < 40% Compliant with diet < 30% Retreated in 12 months 50 - 70%

Source: McLellan, A.T., et al. (2000). Drug Dependence, A Chronic Medical Illness Implications for Treatment, Insurance, and Outcomes Evaluation. Journal of American Medicine Association, 284(13), 1-28.

.

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> 50% of “re-occurrence” was

Compliance with Medical Treatment

> 50% of re-occurrence was due to lack of compliance > 50% of medical patients are dishonest about compliance dishonest about compliance

Source: McLellan, A.T., et al. (2000). Drug Dependence, A Chronic Medical Illness Implications for Treatment, Insurance, and Outcomes Evaluation. Journal of American Medicine Association, 284(13), 1-28. .

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Key Questions for Practice

How do our values impact treatment for families?

• Are treatment services readily accessible?
• Are treatment services comprehensive enough to

meet the multiple needs of families?

• Are treatment services timely?
• Do treatment services include a counseling
• Do treatment services include a counseling

component?

• Do treatment services include medication?

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Polling Question #6 How are you monitoring the quality of t t t i ? treatment services?

• Site visits
• Outcome summaries from substance abuse

treatment providers

• Regularly monitor access to treatment

g y

• Ensure that substance abuse treatment

providers are nationally accredited

• Other

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H d k t th t l th How do we work together to solve the “Hot Button” issues?

Phil Breitenbucher, MSW

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Let’s Re-Visit the “Hot Button” Issues Who is the primary client and target l ti ? population?

• Competing clocks
• Confidentiality
• Understanding of the substance use

and abuse continuum in the context of and abuse continuum in the context of child safety

• Treatment efficacy

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6/15/2010 23

Different Goals and Values

Primarily concerned with the safety, well-being, and permanency outcomes of children whose parents are in treatment. Goal: Is the parent Child Welfare p p moving toward sobriety to meet legal deadlines? Primarily concerned with parents’ (who may not even be identified as parents) recovery as they progress through treatment, on a different timetable than the court or child welfare system. Monitor treatment against legal deadlines Welfare Treatment Providers Judicial

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Monitor treatment against legal deadlines. May have very different perspectives on what information should be shared. Officers Parent or Child Attorney

Polling Question #7 Dealing with the problems caused by l h l d th d h ld b alcohol and other drugs should be one

• f the highest priorities for funding

services.

• Strongly Agree
• Somewhat Agree
• Somewhat Agree
• Somewhat Disagree
• Strongly Disagree

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The Collaborative Values Inventory (CVI)

• A CVI can identify agreements and

disagreements on the underlying values that disagreements on the underlying values that collaboratives need to address

• e.g. beliefs in treatment effectiveness, beliefs about

parenting capacity, beliefs about accountability for results

• Values consensus forms the basis for a good

statement of principles for the collaborative

• Colorado and Minnesota are examples of

sites that have developed strong statements

• f principles

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CVI Issues and Challenges

• Includes enough responses from members of

different groups child welfare treatment different groups—child welfare, treatment, courts—to compare responses from each group

• Facilitation needs to ask the group to think

about how differences can be negotiated

• Sometimes agreeing to disagree is helpful to
• Sometimes agreeing to disagree is helpful to

the group, showing that disagreements can be surfaced instead of buried

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Polling Question #8 Are we ready to do a CVI?

• Huh, what’s a CVI?
• Maybe, with a little help.
• Yes, definitely!
• No way!

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Panel Discussion: Lessons Learned Panel Discussion: Lessons Learned

Honorable Nicolette Pach Phil Breitenbucher, MSW Theresa Lemus, RN, MBA John Passalacqua, JD

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What’s next? What s next?

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Theresa Lemus, RN, MBA

Next Steps

• Statement on shared values: Synthesis of Cross

System Values and Principles, a National Perspective System Values and Principles, a National Perspective

• Collaborative Values Inventory
• Example of mission statements:

http://www.ncsacw.samhsa.gov/improving/underlying- values.aspx

• One on one follow-up from the OJJDP FDC Team
• To access these materials, visit:

http://www.cffutures.com/webinars

• More of the Learning Community!

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Hot off the press! Registration for Module 2: Principles of C ll b ti P ti i N O ! Collaborative Practice, is Now Open! https://www1.gotomeeting.com/register/ 795004705

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Nancy K. Young, PhD, MSW Director Phil Breitenbucher, MSW Program Director

Contact Information

Director Children and Family Futures E-mail: ncsacw@cffutures.org Children and Family Futures OJJDP FDC TA Project Phone: (714) 505-3525 Email: pbreitenbucher@cffutures.org Theresa Lemus, RN, MBA Program Associate FOR RESOURCES Please visit our website: Program Associate Children and Family Futures Phone: (714) 505-3525 E-mail: tlemus@cffutures.org Please visit our website:

http://www.cffutures.org/projects/family- drug-courts

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Questions and Discussion Questions and Discussion

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Phil Breitenbucher, MSW

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Evaluation Please take a moment to complete our

• evaluation. You will be re-directed to

the evaluation after exiting this webinar. Thank you! Thank you!

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