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Developing an evidence informed context for Family Service intervention and evaluation. Julie Boffa, Project Manager, NEMC&FSA John Cheshire, Senior Manager,

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Presentation on theme: "Developing an evidence informed context for Family Service intervention and evaluation. Julie Boffa, Project Manager, NEMC&FSA John Cheshire, Senior Manager,"— Presentation transcript:

1 Developing an evidence informed context for Family Service intervention and evaluation. Julie Boffa, Project Manager, NEMC&FSA John Cheshire, Senior Manager, Community & Family Services, Brotherhood of St Laurence; Executive representative, NEMC&FSA ACWA 2010

2 North East Metropolitan Child and Family Services Alliance About the project Began from a re-occurring frustration when Family Services team leaders met: what can we do to help children when parents don’t change? Began from a re-occurring frustration when Family Services team leaders met: what can we do to help children when parents don’t change? Lead to the idea of a research project exploring interventions that make a difference Lead to the idea of a research project exploring interventions that make a difference A partnership between the NEMC&FSA and the PRC, substantially funded by a grant from the Ian Potter Foundation A partnership between the NEMC&FSA and the PRC, substantially funded by a grant from the Ian Potter Foundation

3 North East Metropolitan Child and Family Services Alliance Who is the NEMC&FSA? North East Metro Child & Family Services Alliance 9 community service agencies, in partnership with Child Protection, bound by MOU 9 community service agencies, in partnership with Child Protection, bound by MOU Formed in 2007 to provide Integrated Family Services for children at risk of report to Child protection, or with substantial difficulties Formed in 2007 to provide Integrated Family Services for children at risk of report to Child protection, or with substantial difficulties Supported by central intake, Child FIRST Supported by central intake, Child FIRST Services 5 LGAs - population the size of Tasmania; highest metro Aboriginal pop; many indicators of disadvantage. Services 5 LGAs - population the size of Tasmania; highest metro Aboriginal pop; many indicators of disadvantage.

4 North East Metropolitan Child and Family Services Alliance Our clients in brief For , 89% of families referred to Child FIRST had one or more complex characteristic: For , 89% of families referred to Child FIRST had one or more complex characteristic: Child Protection involvement Child Protection involvement Mental illness Mental illness Substance abuse Substance abuse Family violence Family violence Physical or intellectual disability Physical or intellectual disability Sexual assault Sexual assault Juvenile Justice involvement Juvenile Justice involvement 46% had known prior or current Child Protection involvement at the point if intake 46% had known prior or current Child Protection involvement at the point if intake Children may demonstrate a range or emotional and behavioral issues Children may demonstrate a range or emotional and behavioral issues

5 North East Metropolitan Child and Family Services Alliance What is the Parenting Research Centre? Australia's only independent national Centre dedicated to research and development in parenting support Australia's only independent national Centre dedicated to research and development in parenting support Core business is developing, delivering and supporting parenting programs Core business is developing, delivering and supporting parenting programs Specialises in bridging the research to practice gap through dissemination of evidence based solutions Specialises in bridging the research to practice gap through dissemination of evidence based solutions Numerous large scale national projects Numerous large scale national projects

6 North East Metropolitan Child and Family Services Alliance Project objective To develop “A blueprint for family support intervention and evaluation” To develop “A blueprint for family support intervention and evaluation” That draws upon and generates research evidence That draws upon and generates research evidence Through continuous input and feedback from our workers, resourced by access to evidence through the PRC Through continuous input and feedback from our workers, resourced by access to evidence through the PRC

7 North East Metropolitan Child and Family Services Alliance What is a blueprint? “Photographic print representing final stage of engineering or other plan, (fig) detailed outline or plan” (Pocket Oxford) Blueprints may be multi aspect contours (8) or technical drawings or specifications (9) Our blueprint will include aspects of both, while recognising that the finishing, like the art of practice, is an unique combination of families, practitioners and context

8 North East Metropolitan Child and Family Services Alliance Multi aspect contours

9 North East Metropolitan Child and Family Services Alliance Technical Drawings

10 North East Metropolitan Child and Family Services Alliance What is the art of practice? Recognises that 70% of difference between models or techniques is due to worker & client factors (Wampold, 2001) Recognises that 70% of difference between models or techniques is due to worker & client factors (Wampold, 2001) Practice therefore cannot be prescribed, but can be informed… Practice therefore cannot be prescribed, but can be informed…

11 North East Metropolitan Child and Family Services Alliance An informed art “There is an art to social work practice, but it is an informed art, born of a balance between the structured, general knowledge that prepares the practitioner for categories of concern, and the intuitive, improvisatory understanding that is expressed in the immeasurable details of being fully present to another human being” (Graybeal, 2007:514) “The cumulative evidence supports a comprehensive, artistic, improvisatory, and relational conception of practice, informed by structured feedback and evaluation” (Graybeal, 2007:514) Structured feedback and evaluation: Are we dong what we said? Does it make a difference? Improves clinical outcomes by as much as 50% (Miller, Duncan, Sorrell & Brown 2005 cited by Graybeal, 2007:520)

12 North East Metropolitan Child and Family Services Alliance Family Worker Evidence informed practice Evidenced based practice Characteristics and consequences established through research that inform what a practitioner can do to produce a desired outcome (Dunst 2009) Evidence for practice Art of practice: Improvisation Knowledge-wisdom-values What works for who, when, where, why Practice based evidence Individual & collective wisdom across contexts; Concurrent evidence gathering of service effectiveness (Moore 2010) Evidence from practice

13 North East Metropolitan Child and Family Services Alliance Access to evidence Lack of access is a barrier to research dissemination and uptake in practice Lack of access is a barrier to research dissemination and uptake in practice Workers are time poor and become easily over-whelmed by options (Lewig, Arney and Scott, 2006) Workers are time poor and become easily over-whelmed by options (Lewig, Arney and Scott, 2006) There is plenty of research There is plenty of research The question is: What fits for who, when, where - and how? The question is: What fits for who, when, where - and how?

14 North East Metropolitan Child and Family Services Alliance What fits for who, when, where? We have drawn heavily on the PRC to shape our answer through: We have drawn heavily on the PRC to shape our answer through: Meetings with Team Leaders and senior practitioner on a number of occasions over 2009 for PRC to understand the context of our practice and bring offerings from theirs – research of relevance to the workers’ world Meetings with Team Leaders and senior practitioner on a number of occasions over 2009 for PRC to understand the context of our practice and bring offerings from theirs – research of relevance to the workers’ world Culminating in a “Model Development Day”, also involving agency managers, to scrutinise and select research applicable to our objectives Culminating in a “Model Development Day”, also involving agency managers, to scrutinise and select research applicable to our objectives

15 North East Metropolitan Child and Family Services Alliance How ? - the driving question The PRC constantly pushed workers to move past describing who they worked with and what were their roles to describe ‘how’: The PRC constantly pushed workers to move past describing who they worked with and what were their roles to describe ‘how’: When you engage with a family what do you say? When you engage with a family what do you say? When you want parents to change their behaviour what do you do? When you want parents to change their behaviour what do you do? Why did you decide to do that then? Why did you decide to do that then?

16 North East Metropolitan Child and Family Services Alliance Not programs but ‘kernels’ Many ‘programs; have research support, albeit to varying degrees, for example Many ‘programs; have research support, albeit to varying degrees, for example Family Nurse Partnerships – antenatal – 2years Family Nurse Partnerships – antenatal – 2years Project Safe Care – 0-5 years Project Safe Care – 0-5 years Mulitisystemic therapy – years Mulitisystemic therapy – years ‘Programs’ however are too narrow for our context- children & young people across multiple ages, multiple presentations & multiple agencies ‘Programs’ however are too narrow for our context- children & young people across multiple ages, multiple presentations & multiple agencies Quest instead for ‘kernels’ - active ingredients to change, common across multiple programs (Embrey & Biglan, 2008) Quest instead for ‘kernels’ - active ingredients to change, common across multiple programs (Embrey & Biglan, 2008)

17 North East Metropolitan Child and Family Services Alliance Where have we got to? Blueprint contours Blueprint contours Family Services roles Family Services roles Family Services context: professional development, supervision, management endorsement, & more Family Services context: professional development, supervision, management endorsement, & more Blueprint technical drawings Blueprint technical drawings ‘Evidence informed actions for family services’ ‘Evidence informed actions for family services’

18 North East Metropolitan Child and Family Services Alliance Getting started Address barriers, build motivation to change, joining with family Agreeing roles, goals and feedback Clarity of roles & purpose; Feedback driven assessment; strengths Multi modal developmental guidance Child development - Parent skills – Parent-Child interactions Practical support Material aide, immediate supports, advocacy Bolstering inclusion Strengthen family, community and professional connections, multi- agency work Emotional support Strengthen positive self attitudes & activities, demonstrate warmth Helping parents provide physical & emotional safety Interface with specialist focused services, safety plans Unravel blocks to change Personal, inter-generational, systemic, organisational Family Services roles

19 North East Metropolitan Child and Family Services Alliance Evidence informed actions Best research evidence to resource workers with actions that make a difference Best research evidence to resource workers with actions that make a difference Not comprehensive across all roles, but identified as key based on re-occurring prominence in literature and areas NEMC&FSA identifies as priorities Not comprehensive across all roles, but identified as key based on re-occurring prominence in literature and areas NEMC&FSA identifies as priorities To be supported by detailed implementation plan and sustainable, routine measurement To be supported by detailed implementation plan and sustainable, routine measurement

20 North East Metropolitan Child and Family Services Alliance Blueprint: Family services roles with evidence informed actions Building commitment to change Building commitment to change Motivational interviewing Motivational interviewing 25 year review of 119 Motivational Interview studies (Lundahl et al, 2009) found MI significantly increased clients’ engagement in treatment and their intention to change 25 year review of 119 Motivational Interview studies (Lundahl et al, 2009) found MI significantly increased clients’ engagement in treatment and their intention to change

21 North East Metropolitan Child and Family Services Alliance Phase two: Implementation of evidence informed actions Implementation to be supported by: Ongoing PRC role providing Ongoing PRC role providing In-service training In-service training Ongoing coaching & consultation Ongoing coaching & consultation Staff & performance evaluation Staff & performance evaluation NEMC&FSA management endorsement NEMC&FSA management endorsement Governance through Executive sub committee Governance through Executive sub committee Sign-off of implementation plan Sign-off of implementation plan Routine reporting and feedback about progress Routine reporting and feedback about progress

22 North East Metropolitan Child and Family Services Alliance References Embrey, D.E. & Biglan A Evidence Based Kernels: fundamental units of behavioral change Clinical Child &Family Psychological Rev 11:75–113 Embrey, D.E. & Biglan A Evidence Based Kernels: fundamental units of behavioral change Clinical Child &Family Psychological Rev 11:75–113 Graybeal C.T Evidence for the Art of Social Work Families in Society: The Journal of Contemporary Social Services, 88(4): Graybeal C.T Evidence for the Art of Social Work Families in Society: The Journal of Contemporary Social Services, 88(4): Lewig, K, Arney, F. & Scott, D Closing the research-policy and research-practice gap: Ideas for child and family services Family Matters, No. 74, Institute of Family Studies Lewig, K, Arney, F. & Scott, D Closing the research-policy and research-practice gap: Ideas for child and family services Family Matters, No. 74, Institute of Family Studies Blueprints retrieved on 14 June from Blueprints retrieved on 14 June from & & 1&ie=UTF&source=univ&ei=NEEWTNrxGMSeceGGzZcM&sa=X&oi=imag e_result_group&ct=title&resnum=4&ved=0CDMQsAQwAw 1&ie=UTF&source=univ&ei=NEEWTNrxGMSeceGGzZcM&sa=X&oi=imag e_result_group&ct=title&resnum=4&ved=0CDMQsAQwAw 1&ie=UTF&source=univ&ei=NEEWTNrxGMSeceGGzZcM&sa=X&oi=imag e_result_group&ct=title&resnum=4&ved=0CDMQsAQwAw 1&ie=UTF&source=univ&ei=NEEWTNrxGMSeceGGzZcM&sa=X&oi=imag e_result_group&ct=title&resnum=4&ved=0CDMQsAQwAw


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