Collaboration Between Agencies to Enhance Client Success FRESH (Family Recovery Engagement Support of Hampden County) Start Family Recovery Project

“I probably would have got treatment way sooner but I was afraid to lose my kids. I wish I would have had someone to help me through that, to work with me to get in to detox and then a program without having to sign over my kids”

Partners in Family Recovery Tx providers—co-occurring disorders (SUD, MH, trauma) Tx providers—co-occurring disorders (SUD, MH, trauma) Child Protection Services-DCYF Child Protection Services-DCYF Part C services--Family Centered Early Supports and Services (FCESS) Part C services--Family Centered Early Supports and Services (FCESS) Prenatal providers and birth hospitals Prenatal providers and birth hospitals Legal System and Corrections Legal System and Corrections Domestic Violence Domestic Violence It takes time and effort to build relationships with each other and it works

Collaboration or Building a Family Recovery Team At Systems Level e.g. cross and joint training, increasing collaboration and communication between providers, workgroups, protocol development At Systems Level e.g. cross and joint training, increasing collaboration and communication between providers, workgroups, protocol development At Family Level e.g. consents, family team meetings, sharing of service/safety/relapse prevention plans, joint goals, regular contact with providers, joint appointments At Family Level e.g. consents, family team meetings, sharing of service/safety/relapse prevention plans, joint goals, regular contact with providers, joint appointments

Barriers to Collaboration Time and money Time and money Different values, foci, goals Different values, foci, goals Different language and knowledge base Different language and knowledge base Fear and loathing Fear and loathing What else? What else?

All You Ever Wanted to Know About Collaboration National Center on Substance Abuse and Child Welfare National Center on Substance Abuse and Child Welfare Children and Family Futures Children and Family Futures National Alliance for Drug Endangered Children National Alliance for Drug Endangered Children

Developing a Shared Knowledge Base Cross-training Cross-training Free, trade, formal and informal Use staff meetings and annual conferences, Family Recovery Fairs at child welfare offices Get on training mailing lists for other disciplines On-line trainings Address what you do, methods for connecting with staff, relapse and child safety Substance Abuse Treatment: Levels of Care Substance Abuse Treatment: Levels of Care DCF and the Legal Process DCF and the Legal Process 42CFR and communication limitations 42CFR and communication limitations

Joint TrainingJoint Training Topics for trainings should evolve in response to recognized needs, and to stated requests. Topics include identification and referral, client engagement, fetal alcohol spectrum disorders (preventing and working with adults with FASD), trauma informed care, recovery and parenting, and working with families with substance exposed newborns, and families in MAT. Planning a conference across disciplines is a strong relationship-building activity

Consider This… Relapse is potentially an opportunity for growth given appropriate safety planning and support Relapse is potentially an opportunity for growth given appropriate safety planning and support The presence of a parental substance use disorder does not solely determine good or bad parenting. The presence of a parental substance use disorder does not solely determine good or bad parenting. Substance use is just a piece of the puzzle. Substance use is just a piece of the puzzle. The quality of the care giving relationship is key to children’s long-term development. The quality of the care giving relationship is key to children’s long-term development. Keeping children safe is a responsibility that belongs to all of us. Keeping children safe is a responsibility that belongs to all of us. We all share in the responsibility of helping families thrive. We all share in the responsibility of helping families thrive. Modeling trust, communication, and collaboration benefits clients, families, and providers. Modeling trust, communication, and collaboration benefits clients, families, and providers. How we relate to others is what can empower them to change. How we relate to others is what can empower them to change. Look beyond the challenge of the moment to see the potential of the family. Look beyond the challenge of the moment to see the potential of the family. Look beyond the challenge of the moment to see the potential of the collaboration. Look beyond the challenge of the moment to see the potential of the collaboration. Every family has strengths. Every family has strengths. Individuals exist in the context of family, community, and culture. Individuals exist in the context of family, community, and culture. We need to understand, value and support each other’s work. We need to understand, value and support each other’s work. Collaboration and communication between providers is key in supporting families. Collaboration and communication between providers is key in supporting families. Every person has something to learn and something to offer. Every person has something to learn and something to offer.

Training and Other Resources— Free CEUs Abandoned Infants’ Act Resource Center National Center on Substance Abuse and Child Welfare Children and Family Futures The National Alliance for Drug Endangered Children

“Best Practices in Communication: A Guide for DCF and SA Treatment Providers” Areas Addressed: Screening and Engagement Screening and Engagement▼ Referral and Consent Forms ▼ Assessment Assessment▼ Treatment & Ongoing Collaboration Treatment & Ongoing Collaboration▼ Discharge & Aftercare Planning Discharge & Aftercare Planning

Included in the Guide: Best Practices protocol Best Practices protocol New tools to aid communication – for example: New tools to aid communication – for example: o List of Local Treatment Providers o Information to Be Shared at Referral o Assessment Form for DCF o Treatment Status Form for DCF Existing tools (e.g. safety plan samples) Existing tools (e.g. safety plan samples) Resources (re: DCF, BSAS, Legal, Collaboration) Resources (re: DCF, BSAS, Legal, Collaboration) DCF Phone Directory and Western MA Substance Abuse Treatment Directory DCF Phone Directory and Western MA Substance Abuse Treatment Directory

Family Recovery Council: MAT & Pregnancy/Postpartum Workgroup Goal: To establish best practices across all systems (DCF, treatment providers, hospitals, etc.) to support families with moms in Medication Assisted Treatment during the pregnancy, birth, and postpartum periods. Goal: To establish best practices across all systems (DCF, treatment providers, hospitals, etc.) to support families with moms in Medication Assisted Treatment during the pregnancy, birth, and postpartum periods. Action Steps: Action Steps: 1) Identify challenges 2) Troubleshoot; identify solutions 3) Develop a “Best Practices Protocol” 4) Develop a “Parent Information Packet” 5) Evaluate, revise, disseminate

Example of Collaboration at Family Level for Mothers in MAT Begin as a team with consents Begin as a team with consents Ongoing relationship, not just in times of crisis Ongoing relationship, not just in times of crisis Prepare all materials when woman is pregnant — tests, letters from providers, contact info for providers Prepare all materials when woman is pregnant — tests, letters from providers, contact info for providers Contact postpartum social worker at hospital, DCYF if there is an open case Contact postpartum social worker at hospital, DCYF if there is an open case Bring two sets of materials to hospital, one goes to DCYF with filing of 51A Bring two sets of materials to hospital, one goes to DCYF with filing of 51A Follow-up on FCESS referral and be at assessment Follow-up on FCESS referral and be at assessment

Collaboration with Other Providers Child Safety and Family Recovery Child Safety and Family Recovery Consents Consents Develop Relationship and Exchange Plans Develop Relationship and Exchange Plans Supporting Family Centered Early Supports and Services (FCESS) Supporting Family Centered Early Supports and Services (FCESS) Family Conferences Family Conferences

Collaboration with partners Cooperative Family Conferences Helps with engagement and recovery Helps with engagement and recovery Educates providers about addiction and parenting Educates providers about addiction and parenting Expectation of providing resource is meeting together Expectation of providing resource is meeting together Identify what you have to offer Identify what you have to offer Identify common goals Identify common goals Assign responsibilities Assign responsibilities Discuss relapse triggers and custody dates Discuss relapse triggers and custody dates Billing codes Billing codes

Decision-Making Questions What worries us? What worries us? What works well? What works well? What needs to happen? What needs to happen?

Safety Mapping Tool for case conferences Tool for case conferences Invites multiple perspectives Invites multiple perspectives Gets people on same page Gets people on same page Structure to bridge disagreements Structure to bridge disagreements Helpful for clients Helpful for clients

Guiding Principles Addiction and recovery happen within the context of a family. Addiction and recovery happen within the context of a family. Single greatest motivation for recovery: retaining the right to parent one’s children. Single greatest motivation for recovery: retaining the right to parent one’s children. Reinforcing the capacity to parent is important to recovery. Reinforcing the capacity to parent is important to recovery. Sobriety, and even recovery, is not enough to make a great parent. Sobriety, and even recovery, is not enough to make a great parent. Systems work must happen concurrently. Systems work must happen concurrently.

Building Relationships with Clients Taking time & making effort to engage Taking time & making effort to engage Providing concrete resources Providing concrete resources Showing respect Showing respect Being honest Being honest Advocating Advocating Empowering Empowering

Engagement Strategies Peers Peers Help with DCYF and noncustodial support Help with DCYF and noncustodial support Warm handoffs for referrals Warm handoffs for referrals Mother-baby groups with critical mass of women in recovery Mother-baby groups with critical mass of women in recovery “I really needed to learn how to be a parent, I never had that in my own childhood, I just didn’t even know where to start” “I really needed to learn how to be a parent, I never had that in my own childhood, I just didn’t even know where to start”

Groups Lessen isolation Lessen isolation Increase parent-child attachment Increase parent-child attachment Reinforce role of mother Reinforce role of mother Build recovery Build recovery community for families community for families Increase use of Increase use of FCESS FCESS Expose children to early Expose children to early education and care education and care

Recruitment & Collaboration When 2 or more agencies collaborate on a group: Equal representation with facilitators Equal representation with facilitators Emphasis on team approach Emphasis on team approach Identify the “common thread”- ( i.e. we are all mothers here) Identify the “common thread”- ( i.e. we are all mothers here) Each agency staff recruit but no differentiation between participants Each agency staff recruit but no differentiation between participants

Lessons Learned Reach for the phone or the keyboard! Reach for the phone or the keyboard! Listen to each other. Tolerating the discomfort of differing points of view builds trust and respect. Listen to each other. Tolerating the discomfort of differing points of view builds trust and respect. Balance process and product by identifying the problems and then focusing on possible solutions (take action!). Balance process and product by identifying the problems and then focusing on possible solutions (take action!). Be role models: cross-systems partners should plan, lead, and participate in meetings equally. Be role models: cross-systems partners should plan, lead, and participate in meetings equally. Reinforce common goals and understanding: “Relapse is a recovery AND a safety issue.” Reinforce common goals and understanding: “Relapse is a recovery AND a safety issue.” Each family provides an opportunity to improve collaboration. As challenges arise, we can identify the larger systems issues and then advocate for change! Each family provides an opportunity to improve collaboration. As challenges arise, we can identify the larger systems issues and then advocate for change!

Contact Information Debra Bercuvitz FRP website: