Introducing Safety-Organized Practice Day 3 Reunification and Organizational

Introducing Safety-Organized Practice Day 3: Reunification and Organizational Considerations

Plan for the Day • Look back at yesterday • Including children in this work » Three Houses » Safety House • Applying this work to reunification » Best practices in reunification » Connection to visitation • Building this forward in your county/organization » How does uptake of new innovations really work? » A vision of implementation » Action steps • Debriefing and goodbye

Safety-Organized Practice GOOD WORKING RELATIONSHIPS • Solution-focused interviewing • Strategies for interviewing children CRITICAL THINKING • Mapping • Structured Decision Making® (SDM) assessments ENHANCING SAFETY • Harm and danger statements • Well-formed goals • Building safety networks • Collaborative planning

Interviewing Children

Interviewing at Our Best • Think about a time when you interviewed a child and felt really good about it—a time it really made a difference. Tell your partner this story. • What in particular in your stories do you think each of you did that made the biggest difference?

Interviewing at Our Best • Makes children’s voices and perspectives a meaningful part of the process. • Children are likely witnesses to all that goes on in a house, and therefore … • Children’s perspectives are vital to gathering information about what is happening. Therefore, children need to be our partners in assessment. • Children can be, and often need to be, partners in their own safety planning.

What Can Children Tell Us About … Safety Assessment • Safety threats/danger • Protective capacities • Immediate safety planning Risk Assessment • Child factors • Parent factors • Household factors • Caregiver characteristics Family Strengths and • Child characteristics Needs Assessment • Continuing safety planning Risk Reassessment • Progress on family service plan

Domains of an Interview With a Child School Basic Needs Discipline Health Interviewing children should cover… Morning/ Evening Routines Culture and Community Friend/Peer Relationships

Stages of an Interview With a Child Information Exchange Orientation Engagement • Explain purpose of interview • Connecting with the child • What is going well? • Can be playful • What are the worries? • Tolerant of child ways of being Wrap Up • What next steps will occur?

Engaging Children • Get down to the child’s level—the floor is your friend! • Break down language into words and questions the child can understand. • Incorporate breaks and check-ins, and view “side trips” as valuable parts of the conversation. • Allows children to look away, fidget, wiggle, face away from you, be under the coffee table, in a different room— anything, as long as you have evidence that they are participating. • Look for what works and do more of it. • Incorporate playfulness as much as possible. • Tools: What objects are in your travel kit? • Setting: How do you make the best of the chaos?

Two Practices for Working With Children Three Houses Safety House Engage child in danger statement and safety assessment Engage child in safety planning

Three Houses Nicki Weld and Maggie Greening

Three Houses Example DAD 10 8 12 9 Example from San Diego, California

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Before the Child Interview Obtain permission from parents • IF safe • IF forensic considerations are not compromised Select a conducive location Decision: With parents or without? Have paper and drawing tools with you Decision: One sibling or more?

Introducing the Three Houses Explain to the child: • “In the first house, we will include things that you like in your life. That is the house of good things. ” • “In the second house, we will write or draw your worries. That is the house of worries. ” • “In the third house, we will write or draw how things would be if they got better. That is the house of dreams. ”

During the Drawing Clarification, details “And then what happened? ” Awareness of child’s process “Do you want to take a break? ” Developmental awareness “Tell me what the word ‘hurt’ means. ” Non-leading “What else do you think I should know about? ” Above all: It is a conversation!

Talking to Caregivers About the Three Houses How to share it with parent? • Show whole drawings? • Summarize? • Hold some information that could be incendiary until child safety is secure? If sharing … • Start with house of good things • Worries presented as things child is worried about (vs. “truth”) Become partners in thinking through the implications • “CPS must act ‘as if’ until proven otherwise. ” • “How do you think I should react if I see this as true? ” • “What do you imagine I will need to see happen next? ” Parent reaction IS information

Safety House

The Safety House A method for including the child’s voice in safety planning

The Safety House Rules of the Safety House Who lives in the house? Who can Who should not be allowed in visit? Safety path (scaling)

The Safety House • Overview: This is your house in the future, when you always feel safe. • Inner circle: Who lives with you in this house? • Outer circle around the house: Who can come visit? • Red circle to the side: Who should not be allowed in? • The roof: What kind of rules does a house like this need to make sure you always feel safe? • The path: If the beginning of the path is where everyone is worried and [known danger is happening] and the end of the path is where this Safety House exists and no one is worried, where are you now? What do adults need to do so you can be one step closer to this house?

Example Created with 10 -year-old “Zoe” as part of planning for her reunification (with Sonja Parker)

Example: Who lives in the house?

Example: Rules

Example: Who can visit?

Example: Who cannot come in?

Bringing Three Houses Into SDM Using the first Three Houses example, talk about how the information you gathered would affect: • Items on the SDM safety assessment; and • Items on the SDM risk assessment. What else would you need to know? What else would the information prompt you to ask a supervisee during supervision?

Reflecting on these new practices In pairs: Think about a child with whom you are working now or with whom you worked in the past who you believe would have benefited from Three Houses or Safety House. Share the story of working with the child with your partner and then answer these questions. • What worked well about what you did with the child? • What were the challenges in working with the child? • How would the child have benefited from one of these strategies? • What would you need to be cautious or careful about?

Reunification and Visitation

Reunifying Families Think about a time you or someone you know helped to support a family reunification that went really well. • • • What did you do that contributed to its success? What did the family do? What did the child do? What did the extended family/network do? What did your organization do? What else helped?

Reunifying Families Now think about a time when you or someone you know worked very hard to make a reunification work, but something got in the way and it did not turn out as hoped. • • What do you think got in the way? And what else? What key elements or actions are needed to promote successful reunifications?

Challenges of Reunification Parent and Family Factors Staff Factors Organizational Factors

Challenges of Reunification: Staff Factors “The single most important factor in minimizing error in child welfare … is to admit that you might be wrong. ” – Eileen Munro • Easy to let our (or others’) judgments take hold • Easy to let our anger take hold • Easy to let placements continue • Easy to lose urgency rigor

Challenges of Reunification: Parent/Caregiver Factors • • • Kids come into care for a reason Easy to lose hope May be some benefits

Challenges of Reunification: Parent/Caregiver Factors “The hopelessness and sense of powerlessness felt by many parents can and does interfere with timely and successful reunification. Parents who feel they have no real control lose hope and stop trying to make the changes that allow reunification. ” —Hess and Proch (1993), p. 122

Challenges of Reunification: Organizational and System Factors Workload System can be set up to promote continued stays Location, location Programs are not always family centered

Lessons From Research Children will have contact even after years of separation and adoption. Regularly scheduled visits are associated with shorter placements and higher rates of reunification. Non-office locations increase parental participation in visits. Children’s discomfort and reactions are the norm.

What Helps? Reunification Begins on Day One

Working With Families During Reunification 1. Keep a sense of urgency: Reunification begins on Day One 2. Orient the parents 3. Expand the network 4. Create planned, purposeful, progressive contacts and visits that take family wishes and culture into account 5. Create opportunities for parents to demonstrate “acts of protection” during visits 6. Expect challenges and the “uneven path”

Orienting Families to the Reunification Process • • Explain the process (why, what, how). Review and clarify the harm/danger statements. Review and clarify the safety goal. Talk with families about … Demonstrating Safety Developing the Network Reunification Assessment • Think together: how can the parent demonstrate acts of protection during this time? • Who cares about the child and parent? • How can we get them involved? • Share the danger statements and safety goals. • Starting risk level • Progress toward goals • Actions during visits • Changes in safety

How do we expand the network? • Ask about networks with the children and family directly. • It becomes even more important to identify an expanded family network once a child is removed. • In many situations, families are reluctant to let formal service providers know who their informal supports are. Remember that trust develops slowly, but be on the lookout for opportunities that can connect you to informal supports. Child/parent People who already know People who know a little People who know nothing

From Professionally Ensured Safety to “Family and Network” Ensured Safety is assured because a professional is there 0 Safety is assured because “family and network” is there 10

Visitation Visits are still a time to build and demonstrate protection.

Scaling Questions for Family and Network Visitation Plans On a scale from 0 to 10, where 0 is the danger statement would be happening all the time if the child were alone with his/her parent during a visit and 10 is the safety goal would be happening all the time if the child were alone with his/her parent during a visit, where do we think things are? What can the parents, network, and agency do during visits so this number can go up by one? Up by two? 0 Danger Statement 10 Safety Goal

Planned, Purposeful, Progressive Connections Partnership • Build a plan together, but hold to bottom lines for safety Who supervises? • Move from professionals to network What activities will be done? Where will they take place? • Address the danger statement • Cultural consideration • Increasingly into “real world” challenging contexts Length and frequency Debrief with parents • Increase over time • Use the Three Questions! Adapted from Rose Wentz (wentztraining. com).

Scale for Visitation Planning and Progress What might Cheryl be doing at a 2, 5, or 8? 0 10 Danger Statement Supervised visits by agency Cheryl is distracted, does not focus on children, cries for entire visit. Visit takes place in office. Supervised visits by network Cheryl plays with the children on visit, talks about their interests, asks for help once from network when she gets overwhelmed. Visits take place at local park. Safety Goal Unsupervised visits Cheryl regularly asks for help if needed and has multiple strategies for managing hard feelings. Takes kids home for hours at a time, helps them with homework.

Expect Challenges as You Increase Visitation • Do not expect a straight line • Reconvene the network • Map; update the danger statement and safety goal • Practice “dry runs” • Appropriately include the child » » » Three Houses Safety House Safety guidelines for the visits

Visitation Planning Exercise 0 10 Danger Statement Safety Goal One month after the child first came into care: On a scale from 0 to 10, where 0 is the danger statement would be happening all the time if the child were alone with his/her parent during a visit and 10 is the safety goal would be happening all the time if the child were alone with his/her parent during a visit, where do we think things are? What could the parents, network, and agency do during visits so the number can go up by one? Up by two?

Implementation

Click to edit Master title style Implementing “Providing a practical means for accomplishing something. ”

Fatalities Among British Sailing Crews, 1500 s

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An Experiment in Lancaster’s Crew, 1601

Fatalities Among Lancaster’s Crew, 1601

Disseminating Innovation So naturally, every ship started to carry lemons, every sailor had lemon juice daily, and survival rates increased immediately. Yeah, no…

What actually happened?

What actually happened? • 146 years passed before anyone did anything • 1747: Replication of Lancaster’s experiment showed same results • 48 more years passed • British Navy ordered lemons be carried on all ships; scurvy virtually eliminated among British Navy. • 70 more years passed • British Board of Trade adopted practice in 1865 264 years from innovation to universal adoption!

And in our field? Some studies indicate that only 10 to 13% of learning transfers, resulting in a skill dollar loss of 87 to 90 cents of each training dollar (Baldwin & Ford, 1988). Curry, D. , Dellmann-Jenkins, M. , & Mc. Carragher, T. (2005). Training, transfer, and turnover: Exploring the relationship among transfer of learning factors and staff retention in child welfare. Children and Youth Services Review, 27(8), 931– 948.

The nature of the change The kinds of individuals involved The context of the change

The Science of Diffusion of Innovation: The Change Itself Perceived benefit of change Compatible with: values, beliefs, past history, and current needs Simplicity Trial-ability Observe-ability

The Individuals Involved Innovators Early adopters Early majority • Venturesome • Risk tolerant • Novelty • Leave the village to learn • Maybe a little disconnected locally • Opinion leaders • Well connected locally • Do not search as widely as innovators • Connect with innovators • Self-conscious experimenters • Watched • Local in perspective • Learn from people they know well • Rely more on relationship than science and theory • More risk averse • More interest in why change is valuable locally than why it is a good idea generally Early Implementers Later Implementers

The Individuals Involved Early majority Late majority Traditionalists Early Adopters Innovators

Click to edit Master title style “Changes appear to acquire their own momentum, often between 15% and 20% adoption. ”

Context: Where the Change Takes Place What organizational factors support the spread of innovation? High expectations Feeling cared about Opportunities to contribute meaningfully

Leaders and Organizations That Support Innovation… Find sound innovations. Identify and support innovators and early adopters. Make early adopter activity observable. Trust and enable reinvention; create slack for change and development. Lead by example.

San Diego County: 2010– 2012 Pre. Implementation Self. Sustainability

CRC trains managers 3/10 6/10 Early adopter/ supervisor TFT on modules 11/10 2011 12/11 Coaching starts Modules start All supervisors trained 8/10 50 trained early adopters Sof. S books to staff Minnesota gathering San Diego County Timeline 1/12

Click to edit Master title style How do we start?

Training and Coaching Training • Introduces core ideas to large groups of people. • Good for ensuring fidelity. • A beginning. • Based in idea of expertise and content delivery. Coaching • Allows for practice close to the work. • Supports ongoing transfer of learning. • Supports unique uptake dilemmas. • Based on ideas of appreciative inquiry, facilitation, and dialogue.

Potential Flow for Implementation Period: Coaching Early adopters meet with practice leaders and office management to (re)introduce SOP Agree on overall plan of what parts of safety-organized practice will be tried Coach could conduct mini-training with early adopters and others in the office Coach, early adopters, and management discuss results Get more coaching as needed Early adopters try new practice element Try something new!

Potential Coaching Activities • Mapping cases with workers and families • Practice with workers, in the office and in the field • Small “stand deliver” trainings as needed on particular content areas • Ongoing SDM assessment practice • Quality-improvement leadership and participation • Regular meetings with units • Short turn-around time so field can have multiple sessions

How can you contribute? Starting now… • Plan to use some of the practices we worked on some of the time. • Try the Three Questions, mapping, and harm and danger statements. Learn to get the most of the SDM assessments. • Meet with others in your office to make a plan. • Try it and see what you learn! • Get together again. Discuss what worked, what did not, and what you want to try next. Act Plan Study Do

How can you contribute? • Solution-focused interviewing • Safety mapping (as consult, in supervision, and with families) • Harm and danger statements (creating them and sharing them) • Working with children » Three Houses » Safety House » Words and pictures • Enhancing a safety network • Setting safety goals • Ongoing safety planning • Links to SDM system

What Could Go Wrong: A Tale of Two Offices Office #1 Atmosphere of experimentation and learning Supervisors make sure the unit has exposure to new practices Supervisors look for opportunities to encourage supervisees to “try on” ideas (“Did you write a danger statement? ”) Really wanted to hear from supervisees: “Can this help us improve? ” Office #2 Atmosphere of fear and compliance Supervisors regularly feel forced to try things they do not fully understand or support Supervisors saw this as “one more thing we have to do” and said: “Do this or you will get us in trouble. ”

What Could Go Right: Potential Benefits Enhancing the work: Working with new tools/strategies that could help everyone do their work better. Enhancing office culture: Participating in a “learning project” that will enhance the practice of reflection, appreciation, and ongoing learning in your office/team. Being a part of building something: Being part of a group committed to finding out how these strategies could work best in your county. Contributing to the field: Nationally, people are looking at safetyorganized practice to see if it can this work. How does it work? Dare to dream: Better outcomes for children and families and greater satisfaction in the work.

Making a Plan: What Needs to Happen Next? Purpose Make a plan to go from these training days to your action steps back in the office Agreements Agree to disagree, scribe, your first but not your last conversation about this, pass rule Questions for the Small Groups • What have you heard in the last three days that you really value? • What two to four practices/tools do you wish you could implement right now? • What kind of help would you need to begin this journey? • What will be our very first step?

Where We Have Been: SDM System • Developed by CRC in mid-1980 s • Now used in United States, Canada, Australia, and Bermuda • Refers to a suite of assessments and related casemanagement decisions • Objectives of the SDM system are to: » » Identify crucial decision points; Increase consistency; Increase accuracy; and Target resources to families with greatest need.

Where We Have Been: Safety-Organized Practice GOOD WORKING RELATIONSHIPS • Solution-focused interviewing • Strategies for interviewing children CRITICAL THINKING • Mapping • SDM assessments ENHANCING SAFETY • Harm and danger statements • Well-formed goals • Building safety networks • Collaborative planning

Click to edit Master title style Safety Mapping Rigorous and Collaborative Safety Planning With Network SDM Initial Assessments Clinical Judgment Research. Based Equity SDM Ongoing Assessments • Strengths and Needs • Reunification Family. Centered Strengthening Child Welfare Practice Key Decisions Points • Screening and Response • Safety • Risk Reliability Work With Children Validity Collaboration Solution. Focused Interviewing Rigor Risk-Based Service Standards (SDM) • Three Houses • Words and Pictures

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Click to edit Master title style The Final Word on Implementation … From the “Dancing Guy”