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Drummond street’s Family Services Model Using evidence to inform best-practice in family service agencies Andrew Rush – General Manager: Family Services.

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Presentation on theme: "Drummond street’s Family Services Model Using evidence to inform best-practice in family service agencies Andrew Rush – General Manager: Family Services."— Presentation transcript:

1 drummond street’s Family Services Model Using evidence to inform best-practice in family service agencies Andrew Rush – General Manager: Family Services Sophie Aitken – General Manager: Implementation and Quality

2 drummond street services 125 year+ not for profit community service agency Our Vision: For individuals, families and communities in Australia, well-being is supported and promoted throughout their life-cycles, and not just in times of crisis Two core areas of work: 1.Provision of Services (responding to community need) 2.Contributing to the Knowledge-base (evidence)

3 Community Needs Current Evidence PracticeOrganisationOutcomes Identify gaps in evidence- base to inform research needs Contribute to evidence base to inform service sector, first-to-know agencies, and policy makers Using Evidence to Improve Practice

4 Evidence-informed Practice Frameworks Public Health Proportionate Universalism Early Intervention Family-based Approach Common Risk and Protective factors (across domains)

5 Proportionate Universalism “Focusing solely on the most disadvantaged will not reduce health inequalities sufficiently. To reduce the steepness of the social gradient in health, actions must be universal, but with a scale and intensity that is proportionate to the level of disadvantage. This is called proportionate universalism.” - Professor Sir Michael Marmot (2010) - Review of effective evidence-based strategies for reducing health inequalities in England

6 What does Early Intervention mean for our Model? Early intervention and prevention for children at risk of poor developmental outcomes: -Early in life (0-3 years) -Families with multiple family-level risk factors -Children displaying early signs of behavioural or emotional disturbance - Targeting key vulnerable family life transitions

7 Key Vulnerable Family Life Transitions Couple formation Transition to parenthood Parenting toddlers Starting Kinder/Child-care Starting Primary School/Secondary School Parenting adolescents Family separation Forming Step-families

8 Family-based Approach Investment in families important for improving health outcomes across life Family as the setting for promoting and building physical, mental and emotional, social, economic and cultural well- being (for children and adults) Increasing family functioning and well-being can have a positive impact on a range of risk factors such as mental illness, family violence, substance use, gambling

9 Risk and Protective Factor Domains for long-term health and well-being outcomes for children Individual Family Factors School Context Life Events & Situations Community and Cultural Factors

10 Components of Successful Early Intervention Programs for Families  Goal-directed programs, rather than those offering generic support  Target a number of risk factors, either simultaneously or sequentially  Offer a shared empowerment to families  Work with both parents and children, not necessarily together  Includes some home-based support  Programs that teach skills – focus on coaching to reinforce, apply & practice

11 Universal Promotion and Prevention of family well-being risk & protective factors Screening for Risk Early Intervention - lower risk (Brief Support) Early Intervention - multi-risk (Intensive Family Support) Pathway to Tertiary

12 Proportionate Universalism - Drummond Street Examples Universal Seminars & Groups Targeted Universal Early Intervention MyMob – app for keeping families connected – includes tips sheets Peer Education Program for African Parents 1:1 Intensive Family Support – therapeutic case-work Ready Steady Family (Just Families – Transition to Parenthood) Backyard Blitz – Outdoor program for vulnerable dads and their kids Parenting Anxious Kids Group Tantrums & Tiaras Reclaim Parenting – Parenting for Parents with Mental Illness HOPE program - home-based hands-on parenting education Working on Your Relationship Peer Education Program for Gay & Lesbian Parents BestMOOD – group program for parents and young people with depression, anxiety or drug use Raising Resilient Kids Family Literacy Program (CALD families) Circle of Security Group Parenting Teens Homework Club on Carlton Housing Estate 1:1 Parenting Support sessions Raising Happy Healthy Kids Supported Playgroups on Collingwood Housing Estate How to Talk so Kids will Listen, & Listen so Kids will Talk Making Stepfamilies WorkYoung Carers Break – Peer Support ATAPS Brief Psychological Interventions for Children and Queer Adults

13 Centralised Intake and Screening Brief or Short-term Service Individuals, Couples and lower-risk Families Seminars and Groups e.g. Parenting Groups and Seminars Activity-based Youth groups Mental Health Literacy Facilitated Playgroups Family Relationship Seminars and Groups 1:1 CaseWork e.g. Warm referrals Housing support Employment and Financial Management Linking to Community Supports 1:1 Counselling or Parenting Support (up to 6 sessions) Single Session Intensive Intake Brief Family Assessment and Case Plan Short-term parenting support Short-term counselling ATAPS (Child and Queer) Individual Specialist Psychological Counselling up to 12 sessions Intensive Family Support Families where children's well-being is at risk 1:1 Whole-of-Family Support for up to 12 months Whole of Family Assessment and Family Action Plan, may include counselling, relationship interventions, casework, parenting, peer support DIRECT ENTRY TO DSS: Community awareness and education programs, youth activities, community building & other engagement activities

14 Risk Factors Checklist 3 or more - referred for Intensive Family Support Family/Couple Frequent Conflict/Family Violence Recent Stressful/Traumatic Events Economic Deprivation/Homelessness Social Isolation of Family/Lack of Community Connections Parental Mental Health Symptoms Poor/Inadequate Parenting Parental Substance Abuse Emotional/Behavioural/Mental Health Symptoms in Child Poor Physical Health of Child Poor Interpersonal Skills/Relationships/peer group (Child) School Failure/Disengagement

15 6 Domains of Family Well-being Individual Well-being Connected Family Relationships Safe Family Environment Competent Parenting Material Security Connection to Community

16 Family Support Process Intake – Risk Screening & program matching Assessment against Family Well-being domains Family Action Plan developed with family - goals linked to outcomes for children (intentional) Supportive Interventions Ongoing Case Reviews Closure

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18 Implementing the Family Service Model Not enough to have a well-articulated model and program logic …

19 Pre-Implementation Considerations to Support Family Services Model Organisational Structure Identification of Staff Competencies e.g. Case work, Whole-of-family work, working with children, Parenting support, Group work/Seminars, Capacity to engage with at-risk groups) Identification of Fidelity Markers e.g. home visits conducted, all family members assessed, brief cases closed within 6 sessions, collaboration with other agencies, family action plan completed by 3 rd session, % of CaLD families etc Review of Policy and Procedures Purchase of resources such as data systems, additional staff cars/phones for outreach work

20 Core Implementation Components

21 Organisational Drivers Service Locations Co-locating with complementary services – Medicare Locals, Family Mediation Delivering services from public housing estates Organisational Restructure Integration of Family Services (counsellors, parenting support, youth workers, case-workers) Employment of Implementation Manager to drive the change Purpose Built Data System measure fidelity markers, staff performance, population outcomes Communication processes Regular meetings with leaders, supervisors and practitioners to facilitate implementation Facilitative Administration policies and procedures changed

22 Fidelity Markers Benchmarks Right Dose 80% of Brief cases closed within 6 sessions 100% of cases with 3 or more risk factors allocated to Intensive Family Support Home-based Support 80% of Intensive Family Support cases include some home-based support Whole of Family work 80% of cases all family members assessed Targeting At-Risk Groups 50% of cases from identified at-risk groups (CaLD, low SES, young parents, ATSI, parent with mental illness, single parents) Intentional Work focused on family well-being and outcomes for children 100% of cases have a Family Action Plan on file 80% of goals are realistic, achievable and measurable 100% of goals linked to outcomes for children and family well-being domains

23 Competency Drivers Identify Practitioner Competencies Case work, Whole-of-family work, working with children, Parenting support, Group work/Seminars, Capacity to engage with at-risk groups) Staff Training/Professional Development Supervision & Coaching Performance Management New Staff Selection

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25 Centre for Family Research and Evaluation (CFRE) – 2006 partnership between drummond street and Deakin University Example: Just Families Risk and Protective Factors for family violence in couples transitioning to parenthood Develop screening tool for couples to identify heightened risk Training of first-to-know MCHC’s Seminar for couples delivered via MCHC’s Evaluation showed significant positive effects National roll-out and app Evaluation - CFRE

26 Evaluation Framework Family Services Model Evaluation Strategy for Family Services Model to measure client level outcomes across six domains of family well-being Well-validated measures have been selected, to match LSAC data where possible, to allow for comparisons with national population - Pre-Intervention Surveys (collected at the time of Intake), - Intervention Surveys (collected at 8-16 weeks after Intake) and - Post-Intervention Surveys (collected 12 weeks after the Intervention surveys). Data analysis involves mixed-model longitudinal analysis, with interventions to be examined individually or in a dose-response manner for families who access multiple interventions

27 Are we there yet? No end point – a continuous cycle of adaptation to change What we’ve learned: Adaptability and flexibility are key Commitment to research, evaluation and implementation Use the data/evidence available to ensure CQI Share learnings to ensure maximum benefit to families

28 Andrew Rush, General Manager - Family Services Sophie Aitken, General Manager - Implementation & Quality drummond street services 100 Drummond Street Carlton VIC 3065 Ph: (03) 9663 6733 Andrew.Rush@ds.org.au Sophie.Aitken@ds.org.au


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