CONTEXT OF PRACTICECONTEXT OF PRACTICE

• Geelong is the largest regional city in Victoria, with a population of 198,000

• Geelong is situated approximately 75 kms, southwest of Melbourne

• The region has a diverse range of coastal, urban, rural and semi rural living options.

• Geelong is also known for its farming, manufacturing, heavy industry, tourism and wine growing

• Geelong is the traditional home of the Wathaurong Community

GLASTONBURY – IN THE BEGINNINGGLASTONBURY – IN THE BEGINNING

• In 1854, Glastonbury was established as a children’s orphanage

• Two co-founders, James Austin, a successful businessman and property owner William Hingston Baylie, who was also the Mayor of Geelong

• An orphanage was deemed necessary due to the gold rush which saw many abandoned, neglected and orphaned children

• Only other avenue of “care” was under the Vagrancy Act, which saw children arrested, brought before the Courts and often imprisoned or placed in large children homes in Melbourne

• In the 1950’s a Geelong historian suggested that the children’s home be renamed as “Glastonbury” to honour the 100 year association of the Austin family to the children’s home

• From the mid 1960’s the profile of children placed in care changed, with more focus being on physical, sexual, emotional abuse and neglect

• In the late 1970’s Glastonbury established family group homes with a view of closing the children’s home

• In the mid 1980’s the children’s home was closed with the establishment of 10 family group homes

• In the early 1990’s Glastonbury diversified it’s program profile, establishing a family support program and case work service, whilst maintaining the family group homes.

• 2003 saw the amalgamation o f several family support programs, allowing for a continuum of service response, flexible interventions tailored to meet the needs of children and their family’s.

GLASTONBURY – IN THE BEGINNING Cont...GLASTONBURY – IN THE BEGINNING Cont...

TRADITIONAL FAMILIES FIRST MODELTRADITIONAL FAMILIES FIRST MODEL

PROGRAM DESCRIPTION

This program was Initially modelled on the “Homebuilders” program operating in the US since 1974

Underpinned by Family Preservation principles, providing intensive family based service to high risk families during a time of crisis when:

An out of home placement of child/children is probable (placement prevention)

Or

Planned reunification of children with their families (Reunification)

Program offers both therapeutic and concrete interventions to assist families to overcome difficulties that place their children at risk of harm

The work is intensive (up to 20 hours per week), and of a brief duration of up to six weeks

SERVICE CHARACTERISTICS

TRADITIONAL FAMILIES FIRST MODELTRADITIONAL FAMILIES FIRST MODEL

Focus on family strengths – not problems

Limited to families where children are at risk of placement unless the identified protective concerns are resolved

Flexible scheduling (7 day week availability)

On call crisis component

Small caseloads (2 families) per worker

Intensive intervention (5 – 20 hours per week as needed)

Services delivered in client’s home and community

PRACTICE WISDOMPRACTICE WISDOM

In 1999 an integrated approach was adopted with staff working a mixed case load of one FF and several FRP families

Adopted to enable continuity of worker as many interventions did not succeed because of the transfer of the worker relationship

Further key issues from practice and annual reviews, giving rise to a more extended form of reunification process:

Parents who had not adequately sorted out their personal issues hit crises, which resulted in children being returned to care

Paradoxically this was often at the point when the client had engaged with the staff member and the crisis could be used to make change. This often resulted in the program withdrawing and the client losing the opportunity to consolidate or move towards change.

On occasions when a Family Resource Worker had been involved in the family this had been beneficial in establishing routines, practical care/life skills tasks. It was felt that this approach could be usefully commenced prior to the family having the stress of children returning to care.

PRACTICE WISDOM Cont...PRACTICE WISDOM Cont...

• Need to work with wider family members than just the immediate family unit. Many families had experienced trans-generational trauma and work often defaulted to include grandparents, new partners, aunts/uncles etc.

• Parents who had experienced substance abuse and mental health issues tended to require long term interventions - practice observations suggest that it took some time to establish a trusting relationship and that an earlier form of intervention

LITERATURE REVIEWLITERATURE REVIEW

REUNIFICATION SUCCESS

• Chronic conditions, such as long term relationship difficulties, substance abuse and multi-generational trauma suggest long term service works best (Ainsworth 2001, Atkin & Gregorie 1997, Tristekiotis 1993, Hohman & Butt 2001)

• Repeated, multiple at tempts at reunification reduce the likelihood of ultimate likelihood of success (Tristekitotis 1993, Department of Human Services - Victoria 2003)

• Re-entry into foster care following reunification can be reduced by service provision both before and after a child’s discharge from care (Festinger, cited in Ainsworth 2001, McCarrt-Hess, Folaron, & Buschcmann 1994)

• Parental substance abuse is a key predictor of neglect and likelihood of children being removed from parental care (Hoffman & Rosenheck 2001, Department of Human Services - Victoria 2003)

• Planning for reunification needs to be prompt and purposeful with clear understanding of the outcomes/behaviours that parents need to demonstrate (Tristekitoitis 1993, Hohmann & Butt 2001, McCarrt, Folaron & Buschmann 1994)

INTERVENTION APPROACHES

• Transgenerational trauma can impact the present thereby supporting a whole family approach (Bekir, McLellan, Childress & Gariti 1993, Chaitin 2003)

• Positive relationships with key workers facilitates successful reunification, particularly in the area of substance abuse (Hoffman & Rosenheck 2001)

• Intervention approaches need to include practical support, such as education about child development, parenting skills, problem solving, family/friends/community support, brokerage for child care, housing and transport (Sun 2000, Ainsworth 200, Hohman & Butt 2001)

• Preparation of all family members contributes to the success of reunification and this needs to include learning/practising new behaviours prior to reunification (McCartt, Folaron & Buschmann 1994, Tilbury 2003)

LITERATURE REVIEW Cont...LITERATURE REVIEW Cont...

CASE WORKER/RESOURCE WORKER ROLES CASE WORKER/RESOURCE WORKER ROLES UNDER THE 2 WORKER MODELUNDER THE 2 WORKER MODEL

CASEWORKER FAMILY RESOURCE WORKER

Qualifications Bachelor of Social Work Psychology Diploma of Welf are Studies or Equivalent

Skills in f amily therapy, short termcompetency based practice

Case management Case direction tasks Counselling intervention Development of protective plans Risk assessment Coordination of service systems Crisis intervention

Assessment/ service plans Advocacy Macro Education Report writing Taking lead/ decision making role in

two worker model

Qualifications Experience in child and family welf are Tertiary qualifi cations in human

services desirable but not aprerequisite

Practical material aid tasks Role modelling work General support ie. budgeting and

household management, routines Assisting in the coordination of

meeting appointments

Crisis work, usually in consultationwith case worker

Micro

CASE EXAMPLE 1CASE EXAMPLE 1

AUGUST 1998 – MARCH 2001

Mary, a single mother aged 24 Two boys aged 4 & 6 years

At time of intervention eldest child had experienced six placements and the youngest five

Commenced as reunification in FF then transferred to FRP. Placement of both boys subsequently broke down and they returned to foster care

Technically this should have been closed, as Mary did not have the children in her care

However as reunification was case planned to occur promptly decision was made to remain involved

Focus moved to a counselling intervention for the mother with interventions around cognitive approaches (journal, crisis planning), narrative solution focused (therapeutic letter writing) projective/object relationship work, normalising/ reframing. Interventions in regard to parenting were also utilised around behaviour modification, time out, protective plans, identifying strengths, and family activity time.

Mother very isolated – no family support.

Intervention occurred over a two and a half-year time frame with the boys being reunified after 18 months in care and 12 months for youngest child. Family support continued for eight months post reunification and four months post Child Protection withdrawal.

Returned with planned recurrent respite.

Child Protection were satisfied with the progress that they revoked the order six months early.

Follow up two years post closure – both boys still at home. More tellingly family had not been visited by Child Protection in that time.

Lesson was that once Mother’s significant trauma issues had been addressed there was space for her to prioritise her children’s needs.

CASE EXAMPLE 1 Cont...CASE EXAMPLE 1 Cont...

In August 2003 the agency underwent a major re-development of its Family BasedServices Programs, which was operationalised in November 2003. The EnhancedFamilies First model was included as part of this process and at this stage is very much a “work in progress”.

CASE EXAMPLE 2CASE EXAMPLE 2Enhanced Families First ModelEnhanced Families First Model

JANUARY 2003 – CURRENT

Jemima, single mother of two children

10 year old girl (Ester) & four year old boy (Sam)

Ten year old has had multiple placements usually with maternal grandparents. This has in effect been co-parenting in many instances.

Extended family support

Issues around neglect (inadequate supervision, environmental neglect, verbal abuse, running away

Protective issues around physical abuse hitting with objects, smacking

After a complicated family conflict over the care of Ester and abuse incident by Jemima, Ester was placed in a Glastonbury placement in May 2003.

Again rather than withdraw the agency’s input decision was made to maintain the family in a pre care model. This enabled work to continue with regards to Sam’s safety and to work towards Ester returning to her mother’s care.

CASE EXAMPLE 2 Cont...CASE EXAMPLE 2 Cont...Enhanced Families First ModelEnhanced Families First Model

PROGRESS

Use of Family Resource work intervention meant hygiene, routine and household management issues could be established and maintained for sufficient time for Sam’s Supervision Order to be withdrawn.

The agency’s early intervention program for pre-schoolers (Peach) was implemented along with attendance at the agency’s parenting group. In addition Counselling occurred around family systems & dynamics, relationship issues, personal safety and family of origin with Jemima.

During this time Jemima had limited contact from her parents and sought support from extended family members.

Counselling commenced with Ester with the goals of helping her settle into placement, working through anxiety related t o recent familial conflict issues around court and prepare Ester for more specialised counselling.

Family appeared on track for reunification of Ester to occur although clear work was identified and required in relation to anger management issues for Jemima, before this could occur safely.

CASE EXAMPLE 2 Cont...CASE EXAMPLE 2 Cont...Enhanced Families First ModelEnhanced Families First Model

NEW DYNAMIC

In September 2003 a request for custody and contact with Ester came from her Father, who had no previous involvement with Ester since she was 2.

The program had input into the planning and facilitation of this process.

A period of weeks went into the successful preparation of this new introduction of Ester to her Father and his new family. This included casework staff meeting the Father, his wife and family.

Ester’s counselling continued with a disclosure occurring around sexual abuse from her brother’s father: (NB: Sam’s no longer in Australia).

Abuse denied by mother to both casework staff and Child Protection.

Subsequent to this supervision issues again emerged for Ester on access along with unsupervised contact with maternal grandparents, which was in breach of Child Protection Orders.

Jemima withdraws from the program following making threats to Ester’s father and withdrew from other services, such as the Peach program and child care.

Ester’s counselling is maintained.

Ongoing intervention with Mother’s sibling and family and Ester’s father.

CASE EXAMPLE 2 Cont...CASE EXAMPLE 2 Cont...Enhanced Families First ModelEnhanced Families First Model

CURRENT SITUATION

Counselling for Ester to stop due to a change in her access with her mother and maternal grandparents

Pattern of this effectively meaning that Ester is not safe and unable to disclose the “hard stuff” that she wants to talk about

Referral for Ester’s father to undertake reunification preparation for the possibility of Ester coming to live with her Father and family

There are some blended family issues pertaining to this occurring and being successful

Current placement “safe”

Maintaining extended family input into Ester’s life, eg staying together during school holidays, contributing to education and leisure expenses.

ADVANTAGES and DISADVANTAGES of ADVANTAGES and DISADVANTAGES of Enhanced Families First Model for Case Example TwoEnhanced Families First Model for Case Example Two

ADVANTAGES DI SADVANTAGES

Continuity of service delivery for child

Avoidance of reunification by default

Child’s extended f amily are in the loop and inf ormed

I nclusive of all f amily members

Avoids separation and f ragmentation

As child protection workers change there is a “keeperof the process”

Careful consideration of whether or not areunification to f amily is appropriate

Disclosure in counselling has f reed up inf ormationaround viability or return to Mother that waspreviously unknown (unintended)

Multiple roles requires sensitivity to boundaries andpositioning

Legal considerations given issue will return to court

Time consuming

Skill needed to keep f ocused on casework andtherapeutic issues rather than vested interests andconfl ict.

PRE CARE MODELPRE CARE MODEL

CRITERIA

Parents with significant childhood abuse histories – sexual & physical

Previous unsuccessful reunification attempts

Children are safe

Children in care/transient arrangements eg. Relatives who frequently step in and care for the children

Willingness and preparedness to make changes

Extended family involvement an advantage

AFTER CARE MODELAFTER CARE MODEL

CRITERIA

History of past unsuccessful reunifications

History of chronic social/emotional functioning that preceded child rearing and impacts on ability to parent

Need for period of consolidation of skills to move into maintenance behaviours

To assist parents with permanency planning regarding the children

Top up service to past clients

Pre Care Reunification After Care

I ndividual counselling – parent, child Ranges f rom 4 – 12 weeks of traditionalintensive Families First work

Up to 18 months f amily resource work.Focus on moving f amilies toindependence

Transgenerational casework eg.Grandparent mother, f amily mediation

Reunification readinessSix week reunification (solo) or plus sixweek placement prevention

May include a number of interventions. Solo counselling child or parent Family work/ therapy J oint casework/ f amily support work Solo f amily support/ f amily aide On call capacity

Family resource work eg routines, childdevelopment

Up to 20 hours per week with on callcapacity

Relinquishment work if services notviable

Family work – access preparation Behaviour modification – safety plans,crisis management

Family Group Conferencing

Relinquishment work Family Group Conferencing

Family Therapy

Family Group Conferencing

INTERVENTION OFFERED UNDER INTERVENTION OFFERED UNDER Enhanced Families First ModelEnhanced Families First Model

Team approach

STAFFING MODELSTAFFING MODEL

Four combined Families First/Family Based Services caseworkers

One counsellor

One Family Resource Worker (family support worker)

Staff can be used at various stages of the model – staff may be used interchangeable at different points of the model

THEORETICAL PERSPECTIVESTHEORETICAL PERSPECTIVES

Ecological perspective

Family Systems Theory

Crisis Intervention Theory

Social Learning Theory

Developmental perspective

Competence-based practice

The solution focussed intervention

A permanency-planning perspective

  Central Intake – Linked with Coordinated Regional Intake System

   “Flexipac” – range of flexible service packages responsive to family/community needs.

(Individually tailored “mix” from “pool” of varying length of service/low, medium, high intensity/multiple interventions)

Referrals DHS & Community - Self - Professional

Central Intake

Duty Screening/initial assess’t for appropriate intervention Com’ty/DHS Consultation, Case Conference, Notification if required Weekly Intake & Allocation meetings Risk/Need Assess’t, Assertive Outreach, S/T case management/Waiting list Referral – internal/external

Client Needs Key

Level 1 -Preventative with needs

Level 2 - Med needs, Preventative/ protectective concerns (low)

Level 3 - Med-high needs, protective concern diversion

(Enhanced FF) - Intensive Reunification/Placement Prevention, med/ high risk, low intensity pre/post FF

Client Needs Key

Level 1 -Preventative with needs

Level 2 - Med needs, Preventative/ protectective concerns (low)

Level 3 - Med-high needs, protective concern diversion

(Enhanced FF) - Intensive Reunification/Placement Prevention, med/ high risk, low intensity pre/post FF

Family Support Services

(current Strengthening Families)

ENHancedFamilies First

(*Fig 2)Community Development & Outreach /Service Network Options

Level 1

up to 3 mths

Level 2 Level 3

up to 6 mths, small % of long term

Level 54,6,8,10,12 wks % of pre/post FF

Exit SafetyNet Re entry “Top ups”

Referral to other Services

Closure

Community Development & Outreach

Service Network OPtions

Groupwork Agency & joint C’ty

Joint Initiatives eg Co located Mental Health Worker, Best Program

Service Network Groups eg. Best Start, Batforce, RAG, NAG

Early Intervention-HIPPY/PEACH

“Pool” of Intervention Options

Case Management/Casework In Home Support Enhanced Families First Advocacy Assessment Plans Practical Assistance Consultation/Assess’t/ServiceProviding information, Parenting Support /Skills Reunif’n Readiness/ PP (Pre)Youth Resource Work Family Resource work Reunifiication/Placement Prevent’nCo working/ Linking Double Interventionswith other services Brokerage Aftercare

Group work Family Group ConferencingCounselling Range of AgencySingle session work /Community groupsShared C’sling Secondary ConsultationParenting IssuesIndividualCouple MediationFamily within family/extended family

Figure 1. Concept Diagram:

Proposal for Continuum of Glastonbury Family Based Services incorporating

Glastonbury Child & Family Services

222 Malop Street

GEELONG VIC 3220

Phone: (03) 5222 6911

Fax: (03) 5222 6933

admin@glastonbury.org.au