WrapCT PRESENTS:
PLANNING AND MANAGING
TRANSITIONS
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TRANSITION PLANNING
BEST PRACTICES:
• Begins on day one
• Utilizes the family’s expertise in problem solving
• Is discussed and planned for at each plan of care
meeting
• Requires exceptional crisis/safety planning
• Utilizes the Wraparound process in a planful and
concise manner
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TRANSITION PLANNING BEST
PRACTICES CONT’
• Instills hope for a better future
• Utilizes a well balanced team consisting mostly of
natural/informal supports
• Community resources and available supports are
explored well before ending
• Success is celebrated soon and often
• Empowers the Youth and Family to mobilize their
own team as needed
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
NECESSARY SKILLS FOR
FACILITATORS
• The ability to communicate and behave with
confidence and reassurance
• Good planning and organizational skills
• Encouragement and support are provided to the
family in a genuine manner
• The ability to be introspective about who’s needs
are being met and who’s really having
abandonment issues
• The ability to be understood and plan around
underlying needs
• Outcome oriented
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
FAMILIES DESERVE TO KNOW
THEY ARE TRANSITIONING
TO SOMETHING
RATHER THAN AWAY
FROM SOMETHING
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TIPS FOR TRANSITION PLANNING
• Negotiate transition with the full team
• Allow Family voice to be heard about
transition
• Plan for interventions to fade over time
• Set clear transition benchmarks
• Use life domains as a guide for system exit
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TIPS FOR TRANSITION PLANNING
• Keep track of incremental progress – no
matter how small the increments
• Let the family acquire its own sense of
agency and urgency
• There will be set backs – look for the learning
opportunity
• Celebrate transitions the family’s way
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
THE FOUR PHASES OF THE
WRAPAROUND PROCESS –
TRANSITION FOCUSED
1.
Engagement – Learning about the family’s
support system
2.
Planning – Bringing existing supports in and
deciding how to build new supports
3.
Implementation – Building bridges to the
community, enhancing or enlarging competency,
creating opportunities for a better life
4.
Transition – Help is in place. Team is mobilized to
act when needed.
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TEAMS & TRANSITION
• Assumptions & Values
• People working together can generate more solutions
• People working together can generate more creative
solutions
• People/Families who are hurting deserve all of the people in
their lives to be on the same page
• The best teams combine the expertise of the system with
the compassion of the family’s people
• In order to have full participation of informal/natural
supports, system people will need to accommodate & invite
• Wraparound teams should be learning & doing groups
• Healing comes from acting together
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
CONNECTIONS AND SUPPORT
MAP
Family
Friends
Self
Community
Mary Jo Meyers-2011
[email protected]
Work/School
Learning Collaborative
WrapCT.org
FIRST PHASE OF WRAPAROUND:
TEAM DEVELOPMENT
• Meet with family & stakeholders
• Get the story
• Gather perspectives on strengths & needs
• Assess for safety & rest
• Provide or arranges stabilization response if safety is
compromised
• Explain the Wraparound process
• Identify, invites & orients Child & Family Team members
• Complete strengths summaries & inventories
• Arrange initial Wraparound team planning meeting
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
SECOND PHASE:
PLAN DEVELOPMENT
• Hold an initial (or 2) Child & Family Team Plan Development
Meeting
• Introduce process & team members
• Present strengths & distribute strength summary
• Solicit additional strength information from gathered group
• Lead team in creating a mission/vision
• Introduce needs statements & solicits additional perspectives
on needs from team
• Create a way for team to prioritize those needs that will
accomplish mission/vision
• Lead the team in generating brainstormed methods to meet
needs
• Solicit or assigns volunteers
• Document & distribute the plan to team members
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
RESPONSIVE CRISIS PLANS:
• Tells team members how to react immediately and
responsively to the events at hand
• Are practical and realistic
• Builds on functional strengths of the team and
community
• Include as many natural and informal supports as
possible
• Keeps everybody involved safe
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
PROACTIVE SAFETY PLANS:
• Aim is to prevent crisis
• Focuses on what to do instead of what not to do
• Is based on needs identified in the plan of care
• Works towards uncovering underlying needs
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
EFFECTIVE CRISIS/SAFETY PLANS:
• Describe specifically the unsafe behavior
• Analyze function (unmet need) of the unsafe
behaviors
• Take the physical aspects of the setting into account
• Describe specifically safe alternative behaviors
• New strategies reflect functional strengths, culture
and choices of those involved
• Steps are specific and written in order of use, least
restrictive to most
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
HELPFUL HINTS:
• Keep the plan focused
• Include rules of household, school or
community
• Discuss rewards and consequences for safe
vs. unsafe behavior
• Consult with people who specialize in
needed area of concern
• Watch and plan for regression during
stressful times
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
FAMILY VISION: A DEFINITION
• Definition: The family’s vision represents their
goals, hopes & dreams for their own family
• What are the benefits of identifying a family vision?
• It helps families recognize the legitimacy of their
own perspective & voice
• It creates meaning & purpose for families
• It helps professionals validate the right to the
family to have their own perspective
• It helps professionals understand the family’s
sense of themselves beyond services & systems.
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
REMEMBER
• Systems have no obligation to
accomplish a family vision.
• Systems create joint goal or
mission statements with families
but families have a right to “own”
their vision even if professionals
disagree.
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
STRENGTHS DISCOVERY
• Look for functional. A list of
attributes does not allow you to
plan
• Are the key to any transition
• Lead to sustainable plans
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
NEEDS
• Check first to see if the needs identified
when met will lead to the family’s vision
• Uncovering underlying needs leads to a
more precise fit of strategies
• Families deserve to have their real
concerns addressed
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
STRATEGIES
• Look to functional strengths first
• Should be written in a manner
in which all team members
know what their job is
• Should be reviewed for progress
at least monthly
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
THIRD PHASE: MANAGING
ONGOING PLAN OF CARE
MEETINGS
1.
Accomplishments – Check with family first
2.
Assess progress – Check for needs met not just
services delivered
3.
Adjust the plan – Remember you are planning for
transition
4.
Assign new tasks – Use the team!
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
ESTABLISH YOUR ANCHORS
• Anchors may be
• Goals
• Results
• Outcomes
• Define what life would like if the identified
need were met
• Allows you and the team to define the
destination
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TIPS FOR ESTABLISHING
YOUR ANCHORS
• Create a view
• Future view of a household
• “Normalized” view of a typical situation
• Create easy “counts”
• Avoid anything that makes too much work
• Percentages work/impression counts
• Identify the frequency of summary
• Weekly, monthly, at least quarterly
• Ask the team to review the “facts”
• Summarize the details
• Graphs or Charts
• Bring a summary to the meeting
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TIPS FOR CREATING
YOUR ANCHORS
• Avoid the control and compliance view
• Rather than he must go to school it should be he
will attend school because …
• Keep teams from going off track
• Avoid over complicating
• Limit your indicators to no more than five
• Impressions count, ask the family to give you a
report
• Use your outcomes to guide the team
• Bring your summary, discuss it rather than falling
into the detail trap
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
FOURTH PHASE OF WRAPAROUND:
PLAN COMPLETION & TRANSITION
• Hold meetings
• Solicit all team members sense of progress
• Chart sense of met need
• Has team discuss what life would be like after Wraparound
• Review underlying context/conditions that brought family to
the system in the first place to determine if situation has
changed
• Discuss the what if?
• Facilitate approach of “post-system” Wraparound resource
people
• Formalize structured follow-up if needed
• Record accomplishments; what worked, didn’t work
• Create a commencement ritual appropriate to family & team
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
FOURTH PHASE OF WRAPAROUND:
PLAN COMPLETION & TRANSITION
• Completed Products
• Written Transition Plan that details how to access
ongoing services/supports if necessary
• Written crisis plan that details who & how to contact
individuals
• Follow up phone numbers for team members
• Formal Discharge Plan detailing strengths &
interventions that were successful & those that weren’t
• Written letters of introduction for anticipated next
formal service access
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
ELEMENTS OF GOOD TRANSITION
WHEN COMPLETING THE FORMAL
WRAPAROUND PROCESS
• Families have some sense of what comes next
• Families have increased confidence in their own
abilities to make their own vision real
• Families have a sense of connection to various team
and community members
• Families know what to do if things go wrong
• Families are able to chart & recognize their sense of
progress since the beginning of formal Wraparound
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TRANSITION PORTFOLIO
• Transition portfolio contains the plan including a
crisis/safety plan and all supporting documentation
• It has multiple purposes:
• Help the family see what they have accomplished
• Remind the family of effective recovery strategies
they can use
• Help other agencies down the line know what
worked, what didn’t and who to call
• Help the family know who to call
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
EFFECTIVE TRANSITION PLANS
• Begin early in the Wraparound Process
• Build on what has been accomplished
• Shift the balance of activity from the system to the
community
• Assure needs and outcomes have been met
• Answers the questions of what will it take for the child
to do well at home, in school and in the community
• Support rather than abandon the family
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
FOUR BAD REASONS FOR
TRANSITIONING OUT OF
WRAPAROUND
• Team is out of money
• Team is out of ideas
• Team is out of hope
• Team is out of patience
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
TRANSITION:
CHALLENGES AND
SOLUTIONS ACTIVITY
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org
WrapCT
LEARNING COLLABORATIVE
Our vision as a statewide learning collaborative is that all children,
youth, and families are able and capable of achieving optimal levels of
functioning at home, in the community, at school and/or work.
WrapCT Steering Team
•
Jan Bendall, Rushford; Ray Bieber, Child & Family Guidance; Tim Bowles,
SEMHSOC; Jill Coffin , U CF S; Dorothy Contrastano, FAVOR; Tim Cunningham,
Wellpath; Paloma Dee, NAMI, CT; Nicole DeRobertis, MFCGC; Hal Gibber,
FAVOR; Victor Gonzalez, Wheeler Clinic-Hrtfd; Gabrielle Hall, Clifford Beers; Mary
Held, Waterbury FFP; Katy Keegan, West Haven – Bridges; Virginia Lopez, Child &
Family Guidance; Tim Marshall, DCF; Tabor Napiello, Wheeler Clinic-Plainville;
Kristen Penta, Bridgeport Schools; Mark Plourd, Wheeler Clinic-Hrtfd, Cheryl
Tedesco, Child & Family Guidance; Paige Trevethan, Bridges; National
Consultants: Verneesha Banks, Wraparound Milwaukee; Mark Horwitz, Westfield
State Univ.; Mary Jo Meyers, Wraparound Milwaukee
Contact information for WrapCT: Tim Marshall 860-550-6531; [email protected]
Contact for training material: Mary Jo Meyers 414-251-7521; [email protected]
Mary Jo Meyers-2011
[email protected]
Learning Collaborative
WrapCT.org