Rachel (Province) Brockhouse, MS, CWCM
Central Florida Behavioral Health Network
Erica Smith, LMHC
BayCare Behavioral Health
April 29, 2016
Managing Entity
Community Based Care ( ex. Eckerd)
 Child Protection Investigation
 Judiciary
 Family
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About 60% or more of parents in the child
welfare system have a substance use
disorder- many with co-occurring
The majority of children in out of home care
have families with a substance use disorderthey stay longer as well
Substance use disorders may negatively
impact child-parent relationship and
caregiver protective capacity



Need an intentional focus on both parental
treatment for substance use disorders and
the other supports necessary for families.
Must integrate treatment, parenting
interventions and recovery supports to make
a difference.
Behavioral change takes time and needs to be
supported over time.
• Subjective Decision Making
• No Definitions for Risk
Levels
• Lack of Decision Supports
• Maltreatment Driven
Decisions
Risk
Low Risk
No
Services
Prevention
Diversion
“Family
Support”
Moderate
Risk
In-Home
NonJudicial
High Risk
In-Home
Judicial
Out of
Home
Placemen
t
• Consistent Decision Making
• Efficient Decision Supports
• Decisions Based on Present
and Impending Danger
• Teaming Model
Safety
Management
Safety
Decision
Safe
Unsafe
Protective
Actions
Safe
Home
No
Services
In Home
Safety Plan
Prevention
Diversion
“Family
Support”
In-Home
NonJudicial
Out of Home
Safety Plan
In-Home
Judicial
Out of
Home
Placement
6

Joint Accountability with CBC/CMO’s/CPI’s/Providers

Shared Outcomes

Information Sharing/Data

Cross Systems Training and Education

Communication and Collaboration

Parent Child Focus

Quarterly Integration Meetings

Alliance Meetings

Lock-Out Calls

Trainings/Presentations- Pre-service with CPI’s

Weekly YFA CMO Leadership Meeting

Contract Measures-CBC/CMO’s/CPI’s/Providers

Scorecard-CBC/CMO’s/CPI’s/Providers

Accountability- How does my role effect this outcome?

Examples: Reunifications, re-entries, re-abuse, etc….
 Universal
 Florida
Release of Information
Safe Families Network Access (FSFN)
 Electronic
Medical Records Access
 Collaborative
Quality Assurance Reviews
 Speaking
 Ongoing
the same language
Communication
 Pre-Service
 Mental
Training
Health First Aid
 Florida’s
Child Welfare Practice Model for Providers
Family Intensive Treatment
Teams and Clinical Integration-
Example of Child
Welfare/Behavioral Health
Integration
FITTeam
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The FIT model is to ensure that every family involved in services is supported and
engaged with one team and one common planning process with one communitywide system of care.
FIT is designed to collaboratively engage and assess the entire family at an intense
level, integrate care to the entire family unit, treat behavioral health and Caregiver
Protective Capacities, and create a mechanism of shared accountability across the
Provider Agencies, the Managing Entities and the Community Based Care
organizations.
This includes an integrated approach to treatment planning, information gather
for the Family Functioning Assessment, and case planning.
Clinical Integration
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Behavioral health providers/clinicians need to be aware of and consider the
dependency system’s legal requirements, judicial process and timelines.
These events and timelines create a sense of urgency that does not necessarily
align with traditional clinical approaches.
Equally important, child welfare professionals have basic knowledge of mental
health and substance use disorders, appreciate the challenges that these disorders
create for parents, and the treatment approaches that are of benefit.
Other Critical Elements

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
Trauma Informed Practice
Teaming
Collaborative Planning

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Coordination of services received by all family members
Alignment with family needs and treatment
Focus on child-parent relationship
Treating the whole family
Shift in focus and moving away from traditional treatment
approaches
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Peer Support-increase engagement, retention in treatment,
involvement in recovery related activities
Case Management-coordination of services
Other Support Services
◦ Medical and dental care
◦ Domestic violence services
◦ Basic needs-food, housing, transportation
◦ Educational and Vocational resources
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Coordination at all levels-emphasis on
direct service; Involvement of Child
Protective Investigator (CPI) and Case
Manager
Collaboration-partnership at front end
Communication-formalized plans for
communication across multiple levels
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Engagement-building capacity for peer
support, higher level of attempts to engage
child welfare involved families, MDT
staffings
Critical points of integration-FFA, Progress
Updates, Safety Analysis and Planning,
Treatment plan reviews, case closure
•
•
•
Rapid Access to Services
Engage - in the family environment - multiple
attempts
Activation
 Engage
= occupy, attract, or involve an individual’s or
groups interest or attention.
 Activation
= Individual or group understands their role in
the process, and has the knowledge, skill, and confidence
to carry it out.
•
Re-Engagement
•
Peer Positions
•
Collaborative Effort

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Addressing caregiver protective
capacities and child needs
Assessments to provide
comprehensive information on client
and family needs and dynamics


Treatment Interventions-are they
addressing behavioral change, and how is
progress or lack of progress communicated
to child welfare?
Aligning time frames
Protective Capacity
1) Demonstrates
impulse control
Best Practice
1) CBT, Matrix Model,
Living in Balance
Intervention
1) Early Schema
Exercise
2) Demonstrate
adequate skill to
fulfill caregiver
responsibility
2) Psych Ed classes,
Parenting, Peer
Support
2) Develop a feeding
schedule for infant
with FIT family and
post on refrigerator
3) Articulate a plan to 3) Psycho - education,
protect child
CBT, CPP, Circle of
Security

3) Role playing of
unsafe situations and
parent demonstrates
how they would be
protective
Protective Capacity
4) Able to meet own
emotional needs
Best Practice
Intervention
4) CBT, Moral
4) Setting healthy
Recognition Therapy
boundaries
(MRT), Family
group/session
Behavior Model
5) Resilient as a
caregiver
5) DBT Skills, Solution
Focused Therapy,
CBT, Circle of
Security
5) Distress tolerance
exercise
◦ Housing
(permanent/transitional/emergency)
◦ Utilities and Food
◦ Education (GED, Vocation,
College/Certificate programs,
Professional License Renewal)
◦ Healthcare (PCP, Medications, Wellness,
etc.)
◦ Transportation (bus passes, peer
provided transportation, bikes etc.)
◦ Home Safety Kit
Lesson’s Learned
If you change the way you look at
things, the things you look at change.
Wayne Dyer
Joint
Account
Outcomes
Success
Common
and
Language
Discharge
Child
Parent
Screen
Family
Relationship
and
Centric
Assess
Holistic
Engage
Training
Plan
and
Treat
WF Dev.

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Sustaining relationships and ongoing
communication/collaboration between Behavioral Health
providers and Child Welfare
Ensuring assessments and interventions are appropriate to
meet the needs of the family

Identifying clear expectations for service delivery

Multi-disciplinary approach is critical

Safe Children and Healthy Families