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					Foster Care Assessment Program
       Evidence Based Approaches to Parenting Interventions –
 Overview of Implementation Practice and Procedures at
          Brigid Collins Family Support Center
                   Presenter Byron G. Manering, MSW
                      bmanering@brigidcollins.org


                   Seminar December 9, 2008
            Brigid Collins
        Family Support Center
                www.brigidcollins.org
 1231 N. Garden Street #200, Bellingham, WA 98225
360.734.4616 - 360.734.1763 FAX - contact@brigidcollins.org

     Now Open! Skagit Valley Family Support Center
           1500 E Broadway, Mount Vernon


                Byron G. Manering, MSW
               bmanering@brigidcollins.org
                          Mission
  To break the cycle of child
            abuse
  by preventing the onset of abuse and
promoting justice and healing when abuse
                  occurs

   Building a compassionate community that nurtures all its children
                                Menu of Services
                               for strong and healthy families
                                                   PREVENTION
                              Information, referrals and on-call professionals to
                              immediately engage families
                              Strength-focused service plans based on family &
                              individual needs
                              Cross-system care, case coordination, home visits
                              & follow up services
                              Bilingual, bicultural case management & support
 Serving over 1700 families   groups - Familia Latina
 each year, all Brigid        Parent education newsletter & monthly family
 Collins child abuse          activity nights
 prevention programs are      Parent support groups, education & skills building
 offered free of charge to
 families.                                        TREATMENT
                              Child sexual abuse needs assessments, education,
                              and therapy
                              Child-friendly investigation, prosecution, advocacy
                              & treatment of child abuse - Children’s Advocacy
                              Center
                              Foster family support groups & foster child support
                              services
                              Evaluation, assessment & medical services for child
                              abuse victims
                              Chemical dependency focused intensive case
                              management & behavioral health – Safe Babies, Safe
                              Moms Growing Together
    Brigid Collins
Family Support Center
BC Evidence Based Practices
and Best Practices
•   Healthy Families America Home Visitors - 1995
•   Wrap Around Case Management - 1997
•   Parent Trust for Washington’s Children Parenting Groups -1997
•   Parenting the First Year Newsletter – University of Wisconsin - 1997
•   Foster Care Assessment Program (FCAP) - 1998
•   Safe Babies, Safe Moms (pregnant/parenting mom’s w/ addiction) - 2000
•   Dialectical Behavioral Therapy (DBT) - 2000
•   National Children’s Alliance Children’s Advocacy Center - 2005
•   Parent Child Interaction Therapy (PCIT) - 2006
•   Incredible Years (IY) -2008
•   Positive Parenting Program (Triple P) - 2008
•   Motivational Interviewing (MI) - 2008
     BC Parenting Skills EBP’s
Parent Child Interaction Therapy (PCIT) 2006
                  Five coaches- 53 families annually


            Incredible Years (IY) 2008
                 Five providers – 4 groups annually


 Positive Parenting Program (Triple P) 2008
    Currently three providers in levels 4 and 5 – 2-3 families each
                   Level 2 and 3 training this year

    Motivational Interviewing (MI) 2008
                         20 providers trained
Commitment to Model Fidelity
        – Staff
        – QA
        – Supervision
        – Culture
        – Training
                                            Staff
Staff love an organizational commitment to EBP’s
• Smiles on their faces
• Constantly celebrating the progress are making with their families
• Euphoric addicted to success with families

Who does well with an EBP like PCIT? When hiring, keep in mind:
• It is a behavioral intervention, psychotherapist sometimes don’t do well with this approach
• People who look at the world systematically do well with systematic EBP interventions
• Look for people comfortable in a world where there is a right way and a wrong way to do things
• Those with a scientific background (like nurses), or DD providers, or teachers are good prospects
• Case Management experience is helpful for maintaining boundaries but not if Case Management is
   their first love.
• And yes FCAP evaluators tend to do well with this

BC staff…
PCIT -     Megan Brown, Carla Willis, Jenn Lockwood, Jalia xxxxxxx, Esther Grummel
IY –       Kathryn Lyons, Cheryl Greninger, Jaliaxxxxxxx, Marion Murray, Tory Allen-Potter
Triple P – Kathryn Lyons, Megan Brown, Jenn Flick, Tory Allen-Potter
                                             Staff
Staff love our organizational commitment to EBP’s
• Smiles on their faces
• Constantly celebrating the progress are making with their families
• Euphoric addicted to success with families

Who does well with an EBP like PCIT? When hiring, keep in mind:
• It is a behavioral intervention, psychotherapist sometimes don’t do well with this approach
• People who look at the world systematically do well with systematic EBP interventions
• Look for people comfortable in a world where there is a right way and a wrong way to do things
• Those with a scientific background (like nurses), or DD providers, or teachers are good prospects
• Case Management experience is helpful for maintaining boundaries but not if Case Management is
   their first love.
• And yes FCAP evaluators tend to do well with this

BC staff…
PCIT -     Megan Brown, Carla Willis, Jenn Lockwood, Jaylia Lewis, Esther Grummel
IY –       Kathryn Lyons, Cheryl Greninger, Jaylia Lewis, Marion Murray, Tory Allen-Potter
Triple P – Kathryn Lyons, Megan Brown, Jenn Flick
           Quality Assurance

• Fidelity Evaluation tool - ORS
• Case Manager Checklist
• Team case reviews in group setting –
  reinforces model
• Triple P QA Framework  Triple_P_QA_Framework_8-20-08_Draft[1].doc
                          Supervision
Role of supervision of EBP’s

• Because drift begins happening as soon as the individual walks out the
  door from a training, supervision is the key strategy for helping providers
  transform their new knowledge into technique and then into skill.
• One tool for supervising MI practitioners is the MI STEP: Motivational
  Interviewing Assessment: Supervisory Tools for Enhancing Proficiency.
• Another tool is being researched by Harborview/University of Oklahoma.
  The project is called, Using Technology to Augment the Implementation
  and Effectiveness of PCIT.
• Providers coming out of training, mimics what happens to families who go
  to traditional parenting classes. The knowledge is there but it is not
  integrated into behavior. Knowledge needs support, reinforcement and
  practice to transform behavior.
• Training and creating solid ‘fidelity’ culture, improves supervision clarity
  and goals and actually makes supervision easier.
                       Culture
Agency culture:
• Surrender to the systematic approach.
• A clear commitment/expectation to model fidelity is
  critical at all levels administration, supervision and
  provider – this level of commitment will transfer to
  client and they are more likely to commit.
• Culture of catching ‘drift’: expect to catch it, embrace
  it, and fix it – every time you do, it reinforces the
  culture of commitment to fidelity.
• Culture of success: success reinforces the process of
  fidelity. The systematic approach becomes addictive.
                         Training
• Have all staff oriented/versed in the EBP’s so in their work
  with the clients they are consistent and reinforce skill sets
  being taught by the EBP.
• EBP’s helps focus staff training so that it is targeted and
  minimally sufficient instead of a hodgepodge of topics.
• Supervisors should be trained in the EBP. Drift will not likely
  be identified unless by a supervisor. If the supervisory is not
  trained in the EBP they are not likely to catch the drift.
• Systematic training leads to systematic application of the
  EBP.
              Model Deviations
• Case by case deviations must have a reason, be
  thoughtful, and be planned. Such deviations should be
  done with consultation and supervision.

• Example: For one client we changed Triple P language
  from ‘Sessions’ to ‘Chapters’ because the client was
  using the word ‘Session’ to get out of work laid out in
  each ‘Chapter’.
                  Model Types
• Developed as a technique to enhance existing
  provider practice skills – MI

• Developed as a flexible tool to enhance existing
  provider program offerings – Triple P 2/3

• Developed as a stand alone service – Triple P 4/5, IY,
  and PCIT
                             Integrated Models
A lot of the clients (4) never actually showed up or contacted us in any way. Then there was
another woman who relapsed on drugs and could not continue coming. Then there are another
two clients whose attendance has been sporadic and the SW’s state those clients are not
following through with any services.



• Which EBP?                        Program_Grid(1) msw03.xls




• Family Treatment Court/Supervised Visitation
    Pathway_To_Reunification__Model_draft_10-29-08[1] msw 03.doc




• PCIT/Wrap Around                                   PCIT Case Management Expectations msw03.doc

				
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