Exploring Practice Tools in Family Support

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Exploring Practice Tools in Family Support

• Dr. Pat Dolan
• HSE/NUI Galway
• Child and Family Research and Policy Unit
• June 10th 2005

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Aims of Presentation

• To explore Reflective Practice and family support
  with particular emphasise on worker and service
  settings
• To put reflective practice into real world
  context
• Present as an illustration a tool kit model for
  worker and service Reflective Practice- Self
  Appraisal Programme (SAP)
• Lessons and messages for consideration

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Think of your what we look for from others in
relationships

• Warmth and caring
• Responsiveness to need
• Dependability
• Stickability
• Help when sought

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Think of your experience of Using Services

• Interventions with families are primarily human
  to human interactions!
• Workers paid the same with same experience and
  training may do their job completely differently
• Genuine capacity to care
• How worked with as important as what is done
• (Stein and Rees, 2000)

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• Working With Mad Hatter Colleagues and Agencies
  can be hard than working with families
  experiencing problems

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Huge Commonality in what is deemed as appropriate
and wanted
What we want in our own relationships And in our
use of Services
What Professionals encourage among Children
their Families and Communities
What Families want from Professionals and
Services
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Child in Need
Worker intervention
'Know of' (Theory)
'Know How' (Skill)
'Know to' (Practice)
Needs met or unmet
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A Cupped Model for Understanding Family
Support  Child ACHIEVING RIGHTS /
MEETING NEEDS Nuclear Family     Other Family
/ Friends School / Community / Leisure
Interests    Semi Formal / Formal Family Support
Practitioners   Community / Voluntary /
Statutory Agencies / Services /
Organisations  National Policy / Legislation
           
 
 
 
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1Building Belonging Through Practice in Family
Support Services

• Targeting - Clarifying the need for a prevention
  project in a community
• Engaging - Offering End Users responsive
  experiences which are positive and available
  through the programme
• Caring Ensuring service or end user has a sense
  of belonging and being cared for (Note Standards
  in Family Support and Self-Appraisal Model)
• Supporting - Helping those targeted to cope and
  in practical ways
• Strengthening - Building resilience in child,
  family community (group), agency, and/or staff
• 1 (Adapted from Brown M. (2003) TCD Childrens
  Research Centre)

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• Planning and Organisation Service Goal Model

Targeting
Strengthening
Engaging
Caring
Supporting
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Working With Adolescents and their Social
Networks Reflective Practice Messages

• Identify and value family
• friends and peers as key sources of help
• Use Strategies to enlist
• their positive support

• Remember the centrality of
• practical support measures
• for young people
• Certain contexts/life
• events determine
• specific need and support

• Practitioners need
• not necessarily assume
• the role of a central network
• Authentic relationships
• between practitioners
• and youth can be key
• to successful interventions

Dolan and McGrath (2005 Forthcoming )
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Twofold approach to Effective Support

• What worker brings
• Caring capacity, skills and commitment Brady et
  al 2004)
• What service or agency offers
• Culture, child/family centered, Service user led
  rather than Service need led (Reder et al 1997)

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Relationship between Children and Families, staff
and agency and Resilience/Strengths based practice

• Resilient children cope and often come from
  families and communities who become resilient
• e.g. overcome a problem in a way they can
  self-cope in the future
• Children/families/communities are supported by
  staff who are resilient within their own practice
  
• e.g. can work prospectively as well as
  retrospectively with children and families
• Resilient staff come from agencies who are
  supportive and resilient within a policy and
  provision culture
• e.g. Service User Led not Service Led

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Key Message for understanding why Reflective
Practice is important

• Critical practice offers the prospect of
  transformation by not being bound by the status
  quo (Adams, 2002 p.87 cited in Gardner
  forthcoming)
• This means that Workers and a service be
  quality assured they are doing their best
• And..
• In a respectful way to children/families, staff
  and agency alike

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Agency and Worker Threshold of Commitment to
Service User
Needs being met
Problem/need Of Person
Progression Trajectory
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Needs being met
Agency Threshold of Commitment to Service User
Problem/need Of Person
Carers willingness/ability to continue caring
for person Worker Threshold
Progression Trajectory
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Agency support and culture Resilience Bound
Burn out
Worker motivates
Freeze in
Service user Needs met or unmet
Conceptual Model for Reflection in Working with
Families
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Four Step Staff tool kit for Reflective Practice
(SAP)

• Co-develop a set of work practice standards
  (brief no more than 20 Know of)
• Develop a practice work manual to match each
  standard (tool pack in know how )
• Self base line/follow up measure of appraisal
  active change monitored/assisted through
  supervision know to)
• Reconsider and review regularly
• See SSI Report 2003 CFRPU website

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Set of Family Support Standards
Annual Formal Self-Appraisal (Voluntary)
Supported through Regular and Clear Supervision
A Practice Manual to meet each Standard
Underpinned and grown by management, (Agency
Culture) and (Professional Principles) Staff
desire for best practice
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Range of Practice Standards
Confidentiality
Assisting Service User overcome Adversity
Range of Materials in Practice Manual to reach
Standard
Assessment Intervention Evaluation Tool Sets
Induction Procedure for Staff
Progression Trajectory
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Using Response Scales in developing your own
Measures

• Likert-type Scales generally used and measure
  frequency How Much/How Often
• Hudson (1992) developed a standardised rating
  scale across 7 Points

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Cutronas Model of Optimal Matching Support
Provided Support Needed (2000)

• Types
• Concrete
• Emotional
• Esteem
• Advice

• Quality
• Closeness
• Reciprocity
• Durability

• Source (Networks)
• Informal Help from Family Friends etc
• Formal - Help from Professionals
• Note Importance of Reciprocal Matching Support
  Schools
• Model RCT Evidence by Dryfoos et al 2005

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• Service Self Appraisal Model
• Based on the same principles as individual worker
  model
• Service Review with some external quality
  assurance
• Ideally both should occur in unison
• Two Case Examples NYP, Foyle Trust

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Targeting Towards those in most need (Hardiker
Levels 3/4)
Refocused Aims Objectives

• Individual Work
• Contractual Time Ltd Models
• Resiliency Building
• Increase in turnover of work
• Greater use of Mentoring.

Reflective Practice Self-Appraisal for staff
towards Quality of Care
NYPs Strengthening Existing Practice/ Building
Future Capacity

• Group Work
• Intervention matched to need
• More intensive group work with smaller nos.
• New Models
• More Conjoint Working

Research Ongoing research on effectiveness of the
NYP Programme

• Parents Families Communities
• Quota of work with Parent(s)
• Crisis Support to Family in life events
• Enhanced working with Services and Community

Better Information Implemented Management
Information System
Activity Levels Enhanced Out of Hours Service
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Refocused Aims Objectives
Family Support Orientation Move away from risky
practice towards positive risk taking for families
Targeting Towards those in most need (Hardiker
Levels 3/4)
Better Case Management Case Weighting Model
New Beginnings Programme Foyle Trust Derry
Research On Implementation of Programme
Equitable Use of Resources Family Need led rather
than Service Need led
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Using the Hardiker Model as an Active tool in
Reflective Practice For Worker and Service alike
1. Match intervention level to need level of
service user 2. Assists worker to consider the
nature and level of difficulty of intervention
required (ongoing) - as part compensation for
stress induced 3. Attunes Manager and Agency
towards level of worker input required
(regardless of poor resource options) 4. Should
dictate policy maker/academic agenda
Family Support by Levels of Need
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e.g. Service Model of Intervention
Evaluation/Inventory
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Some Closing Considerations

• Staff need training and support (Know of and
  know how)
• Shared/Common use of Reflective Practice Method
  (SAM)- Vital issue for developing Know to in
  workers
• Tools alone dont make the worker effective The
  responsive worker uses the tools to good effect
• Practical human skills in working with children
  and families need to be taught/ cannot be assumed
  Major training issue
• Just as best practice will change, the range and
  type of tools will need to change (work in
  progress)
• Core issue of working a model with consensus
  across family support services Body of Knowledge
  Learning - Development of a National Family
  Support Network (National Family Support
  Strategy/ FSA)

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• Sometimes what is most apparent is often
  overlooked!
• (Know ofKnow How and KnowTo.)
• Core Reflective Self-Questions
• Is this how I would Like to be worked with?
• Would this work for me?