Jane Pfeifer, MPA

Rosemary Soave MSW, LCSW

Christine Munroe, BSW

Tara Doaty-Mundell, PhD

Hilary Kushins, MSW, JD

NADCP | July 2015

Children and Families

Family Drug Courts

Stronger Together

Recovery Support in Your FDC:

Building and Sustaining Hope

Through Creative Partnerships

This presentation is supported by:

The Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs

(2013-DC-BX-K002)

Points of view or opinions expressed in this presentation are those ofthe presenter(s) and do not necessarily represent the official positionor policies of OJJDP or the U.S. Department of Justice.

Acknowledgement

Mission: to improve outcomes for children and families by providing training and technical assistance that supports planning and implementation of comprehensive Family Drug Courts.

National Family Drug

Court TTA Program

• Understand the importance of providing parents comprehensive recovery support services to achieve goals of safety, reunification, and permanency

• Learn strategies to implement a peer mentor program and the community context for intervention and role in sustaining long-term recovery

• Identify strategies to leverage local resources to design and implement an evaluation of a mentor parent program for FDC

Learning Objectives

Rethinking Treatment

Readiness

Addiction as an elevator

Re-thinking “rock bottom”

“Raising the bottom”

Brain Science

of Addiction

We know more about

ASAM Definition of Addiction

“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”

Adopted by the ASAM Board of Directors 4/12/2011

A Treatable Disease

• Substance use disorders are a preventable, treatable disease

• Discoveries in the science of addiction have led to advances in drug abuse treatment that help people stop abusing drugs and resume their productive lives

• Similar to other chronic diseases, addiction can be managed successfully

• Treatment enables people to counteract addiction's powerful disruptive effects on brain and behavior and regain areas of life function

Functions of Recovery SupportLIAISON

• Links participants to ancillary supports;

identifies service gaps

TREATMENT BROKER

• Facilitates access to treatment by addressing

barriers and identify local resources

• Monitors participant progress and compliance

• Enters case data

ADVISOR

• Educates community; garners local support

• Communicates with FDC team, staff and

service providers

Titles and Models

• Recovery Support Specialist

• Substance Abuse Specialist

• Recovery Coach

• Recovery Specialist

• Parent Recovery Specialist

• Peer Mentor

• Peer Specialist

• Peer Providers

• Parent Mentor

What does our program and community need?Your FDC needs to ask:

Experiential Knowledge,

ExpertiseExperiential Knowledge, Expertise +

Specialized Training

102130

151

200

0

50

100

150

200

250

No Parent SupportStrategy

Intensive CaseManagement Only

Intensive CaseManagement and

Peer/ Parent Mentors

Intensive CaseManagement andRecovery Coaches

Median in Days

Median Length of Stay in Most Recent Episode of Substance Abuse

Treatment after RPG Entry by Grantee Parent Support Strategy

Combinations

46% 46%

56%63%

0%

10%

20%

30%

40%

50%

60%

70%

No Parent SupportStrategy

Intensive CaseManagement Only

Intensive CaseManagement and

Peer/ Parent Mentors

Intensive CaseManagement andRecovery Coaches

Substance Abuse Treatment Completion Rate by

Parent Support Strategies

Holding Hope Peer Mentors in the

Family Treatment Drug Court

Rhode Island

Family Treatment Drug Court

Presenters:

Rosemary Soave, LCSW

Christine Munroe, BSW

History of RI FTDCSteering Committee 2001 – Key Stake Holders, State and Community Leaders

• Chief Judge, RI Family Court

• Child Protective Services Staff

• Department of Human Services

• Department of Behavioral Health Developmental Disabilities and Hospitals

• Offices of RI legal Services and Public Defender

• Court Appointed Special Advocate (CASA)

• Brown Center/VIP program

Funding of RI FTDC

Inaugural FTDC hearing September 2002

• DHHS SAMHSA/CSAT – funded the design and implementation of the FTDC 2002 – 2004 new court

• DOJ/OJP Grant Award 2005

• HRSA/Abandoned Infants Act Grant 2001- 2009 Partnership between RI Family Court and WIH

• RI State Funding 2009 - present

• DOJ/OJP Expansion Grant Award 2013 – 2016 increased FTDC staff and program (45 participants)

Getting Started at RI FTDC

• Reside in Rhode Island, parents of children newborn to age 18

• Substance use and or history of substance use

• CPS involvement, goal of DCYF case plan is reunification

• Voluntary Program-consent to participate

Criteria for Participation

• Treatment Providers

• Self-referral

• Family Court

• Community Agencies

• Women & Infants Hospital

Referrals

FTDC is available to moms and dads

FTDC Collaboration and Intervention

• Comprehensive case management – Intensive case monitoring by FTDC Clinical Care Coordinator (CC’s)

• Frequent court status reviews, CC’s keep current on parental progress to assess strengths and vulnerabilities to make recommendations about permanency planning

• Submits progress reports at status hearings to FTDC Team members (Judges, CASA, Attorneys, CPS)

• Expedite additional referrals so families have access to services they need in their work towards reunification

Therapeutic, case management, team approach, non-punitive

Integrating Evaluation and Services

• “Self-correcting” model of evaluation

• Evaluator attends FTDC staff meetings and monthly FTDC court hearings

• Evaluation team provides reports to staff re: active participants, phases

• Outcome data reports provided at least semi-annually

2013 – OJJDP Grant Award

• National focus on the role of peers in recovery

• RI received federal grant for a Peer Recovery Center (Anchor)

Expanded FTDC Staffing and Resources

Designed and Implemented FTDC Peer Mentor Component

Past attempts in implementing a mentor component encountered numerous challenges (parental availability, transportation, and child care)

• Clinical Care Coordinators

• Peer Mentor Coordinator

• Toxicology Technician

• Parent Handbook

Peer Mentor Coordinator

Qualifications

• Lived experience

• Certified Peer Recovery Specialist

• Supervised by the FTDC Coordinator

Responsibilities

• Screen and train Peer Mentors

• Supervise Peer Mentors

• Attend all staff meetings/integrated with the team

Peer to Peer Mentors

The Peer to Peer Mentor’s role is to:

• Share their personal experience of the Family Treatment Drug Court

• Answer questions about the process

• Support, encourage and empower FTDC families

Peer Mentor Qualifications

• Must be committed to a recovery lifestyle

• Must be a graduate of the RI Family Treatment Drug Court

• Must have placement of their children with no CPS involvement

• Must have no pending criminal cases or charges

Peer Mentor Responsibilities

• Work in collaboration with the FTDC Clinical Care Coordinators and Peer Mentor Coordinator

- Supervision with the Peer Mentor Coordinator

• Attend trainings

- Confidentiality, Boundaries, Ethics, Roles…

• Provide recovery support information

- Self-help meetings, bus schedules, recovery centers

• Assist in obtaining other resources

- Emergency vouchers, food pantries, furniture banks, etc.

Peer Mentor Program Challenges

• Conflicts with parent’s work and/or school schedule

• Transportation

• Conflict with pick up time for school age children

• Child Care for infant and toddlers

• Mentor relapse

HOPE Questions

• An attempt to capture the role that Peer Mentors can play in facilitating an increase in hopefulness as a result of treatment and participation in FTDC services

• Adapted from the HOPE Screen developed by Anadarajah. G. & Hight. E. (2000). Spirituality and medical practice: Using the HOPE questions as a practical tool for spiritual assessment. www.aafp.org/

• Administered by Peer Mentor Coordinator at enrollment and 6 months follow-up

RI FTDC HOPE Screen

Spiritual Resources: What are your sources of HOPE or comfort? What helps you during difficult times?

Organized Religion: Are you a member of an organized religion? What religious practices are important to you?

Personal Spirituality: Do you have spiritual beliefs, separate from organized religion? What spiritual practices are most helpful to you

Effects on Treatment: Is there any conflict between your beliefs and treatment you are receiving? Do you hold beliefs or follow practices that you believe that may affect your treatment?

H

PO

E

HOPE Screen Findings

• Often a difficult conversation at enrollment, many new to recovery have a fear of religion and fear of judgment

• Highlights lack of supports, resources of participants

• Participants misunderstand difference between spirituality and religion

• Peer Mentor prompted questions about holistic practices and meditation, still difficult

Community Collaboration

Behavioral Health Treatment Providers

• Specialized residential, day, outpatient programs for women

• Providers of co-occurring behavioral health treatment

• Other substance abuse treatment providers

• Medically Assisted Treatment (methadone, suboxone)

Services

• Peer Recovery Services

• Home-Based Services

• Community Visitation Programs

• Community Health Centers

Current Context for Services

• FTDC provides for therapeutic, comprehensive care coordination in a unique team approach. Participants do not have to continue to tell their “story”. Coordinated collaboration across service systems

• Care Coordination includes tracking progress and facilitating additional services/resources (if required) as case progresses

• Current lack of treatment resources – with increased availability of health insurance, demand for services has put pressure on system

• Role of FTDC team in sustaining HOPE when services are not available

Lessons Learned from RI FTDC

• Intervene Early

- Maximize parents’ opportunities to engage in services

- Instill hope

• Connect families to services matched to their identified needs

• Provide ongoing support – consistent staff

• Coordinate with all social and ancillary service providers to increase collaboration

Future Goals/Opportunities

• Evaluate success of Peer Mentor Program

• Identify additional supports needed for Peer Mentors and participants

• Expand use of parent handbook (“home work”)

• Offer social activities

• Enhance integration with community resources

Skills Building – Key Takeaways

• Involve your Evaluator – integral part of the team

• Importance of clinical and team supervision

• Leverage former participants - provide support and advocacy; navigate recovery community

• Don’t re-create the wheel – learn from what others have done and developed

Contact Information

Rosemary Soave, LCSWFamily Treatment Drug Court CoordinatorRI Family Treatment Drug CourtOne Dorrance PlazaProvidence RI 02903401-458-5012r.soave@courts.ri.gov

Christine Munroe, BSWPeer Mentor CoordinatorRI Family Treatment Drug CourtOne Dorrance PlazaProvidence RI 02903401-458-5019cmunroe@courts.ri.gov

The Role of Recovery Support Specialist in FDCTara Doaty-Mundell, PhD, Clinical Supervisor, The Family Recovery Program, Inc. Baltimore, Maryland

The Family Recovery Program of Baltimore, Maryland

• Baltimore City has been classified as the “heroin capital of America”

• In 2009, heroin accounted for 48% of all drug-related deaths in Baltimore City

• Estimated that 66% of children in foster care in Baltimore City have a direct linkage to parental substance abuse

(NIDA, 2013)

“To help parents who have lost custody of their children because of drugs and/or alcohol break free from addiction and reunite their families quickly by connecting parents with substance abuse treatment and a full range of supportive services, including mental health care, transportation, housing assistance and case management”

Primary Goal:

Long-term family reunification

FRP Mission

The Family Recovery Program of Baltimore, Maryland

Eligibility

• Over age 18

• Have children between ages of 0-10

• Child(ren) removal has to be for at least one night from the Baltimore City Department of Social Services for reasons substantially related to substance abuse

The Family Recovery Program of Baltimore, Maryland

• Demographics:

– Located in East Baltimore City

– The only FDC in Baltimore City

– Two locations—Baltimore City and Washington, DC

– Majority of clients reside below the poverty line

– Over 50% of clients have criminal records

• Executive Director

• Program Supervisor

• Clinical Supervisor

• Community Resource Specialist

• Case Managers

• Recovery Support Specialists

• Program Liaison/Court Coordinator

• Urinalysis Technician

• Peer Recovery Advocate/Re-Engagement Specialist

Staff

The Role of the Recovery Support Specialist

• Provide comprehensive assistance to clients at various stages of recovery

• Co-facilitate the creation and implementation of a client’s Recovery Plan

• Participate in collaborations with partner agencies

Recovery Plan

• Completed within 30 days; 1:1

• Expand view of recovery beyond just treatment – includes reunification and other domains

• Uploaded into system; accessible to team

• Client progress referenced during staffing

• Updated every 30 days

Domains

• Drug treatment

• Mental health

• Education & employment

• Visitation

• Sober activities

• Housing concerns

Building Skills – A Checklist

Acknowledge expertise of specialist

Importance of clinical supervision

Train for trauma

Client survey and benchmarks

Importance of follow-up plan

Contact Information

Tara Doaty-Mundell, PhD, Clinical Supervisor

The Family Recovery Program, Inc. Baltimore, Maryland

taradoaty@gmail.com

MENTOR PARENT PROGRAMHilary Kushins, MSW, JD

Dependency Advocacy Center

Drug Court & Training Programs Manager

Santa Clara County, California

DEPENDENCY WELLNESS COURT (DWC)

• Started in1998

• Judge, attorneys, Social Services, Dept. of Alcohol and Drug Services, attorneys

• Voluntary program

• Limited resources and few participants

• Off the record, informal. Same judge for legal and drug court hearings (unless contested)

1998

DWC, CONTINUED• In 2007, received 5 year federal grant to

expand drug court, Family Wellness Court

• First Five matching funds

• Expanded partners from original drug court, including DAC and Mentor Parents, First Five, domestic violence/trauma specialist, CASA, and mental health

• The Oversight Committee met monthly, consisting of heads of all represented agencies on drug court team to address issues as they arose in drug court on a policy level

• Grant ended in 2012. Partners committed to continuing model, with strong judicial leadership

DEPENDENCY WELLNESS COURT (DWC)

2007

DWC NOW

• Merged drug court from 1998 and federal grant drug court to one drug court, DWC, in 2012 when federal grant ended

• Voluntary program

• Separate drug court and legal hearings with different judicial officers (parallel model)

• 120 active parents at any given time

• 2 full days per week

• Challenges of evaluating DWC

• Oversight Committee continues to meet on a regular basis

DEPENDENCY WELLNESS COURT (DWC)

Today

• Peer mentoring program

• Employees of parents' attorney firm (Dependency Advocacy Center)

• Communications with clients covered under attorney client privilege

• 5 mothers, 3 fathers

• Director and clinical supervisor

• Average caseload 25 clients

• Work 30 hours per week

MENTOR PARENTS

• Committed to clean and

sober lifestyle and raising

healthy families

• Successful graduate of

dependency drug court

• Successfully reunified with

their children and had their

dependency case dismissed

• No pending criminal cases

or charges

• Willing to share their story

CRITERIA TO BE A MENTOR

• Recruit eligible parents into DWC

• Establish professional boundaries

• Provide only referrals or facilitate service delivery of court ordered programs directly related to recovery

• Provide support at drug court and legal hearings and throughout dependency court process

• Maintain confidential communications (protected under attorney client privilege)

ROLES AND RESPONSIBILITIES

• Participate in various trainings, including DFCS, CASA

• Integral part of committees where policy gets decided (Oversight)

• Educate new DWC team members

• Participate in trainings for DFCS (court report writing, engaging fathers), CASA (birth parent perspective, understanding addiction)

ROLE THEY PLAY IN THE SYSTEM

Leading by example

• Began as one volunteer for 5 hours a week, first drug court graduate

• Dept. of Alcohol and Drug Services (DADS) first funder and focused on mothers

• Mentors included in 2007 federal grant: 4 mentors (inc. 2 fathers) and one manager

• Dept. of Mental Health (DMH) then funded 2 more mentors in 2009

• Federal Evaluation - mentor program one of the most effective pieces of the drug court program

• Federal grant expired, Santa Clara Board of Supervisors (BOS) continued funding for Mentor Parent Program

• Current funding: 70% BOS, 24% DMH, 6% DADS

FUNDING

EVALUATION –PARTNERED RESEARCH

• The CW-PART is a collaborative project between School of Social Work at SJSU and local agencies working with children and families

• Teams of students work under supervision of faculty to focus on research questions defined as priorities to local agencies

• Development was funded through California Social Work Education Center

CHILD WELFARE PARTNERSHIP FOR RESEARCH AND TRAINING CW-PART

• Faculty leads work with agency to define research projects

• Students complete research over academic year

• Findings are provided to county through research summaries

HOW IT WORKS

WHY THE PARTNERED MODEL?

• It provides learning opportunities for students

• Helps address questions of interest to agencies

• Supports capacity building

CAPACITY BUILDING - CONSULTATION

• Assistance in development of logic model

• Problem-solving related to evaluation infrastructure and protocols

• Development and piloting of evaluation instruments for DAC/MPP

- Client satisfaction survey

- Self-sufficiency assessment

RESEARCH/EVALUATION PROJECTS

• Evaluation of unique contribution of mentor parent program

‒Qualitative interviews/surveys with stakeholders

‒Client satisfaction and client engagement surveys

• Evaluation of outcomes

‒Re-unification and re-entry

‒ Increase self-sufficiency

• Website: https://sites.google.com/a/sjsu.edu/cw-part/

THEORY: EXCERPTS FROM MPP “LOGIC MODEL”

SHORT-TERM OUTCOMES

•Engagement and retention in DWC

•Engagement in MPP support services

•Access to treatment and other services

LONG-TERM OUTCOMES

• Successful reunification at MPP program completion

• Reduction in recurrence of maltreatment/ reduced days in foster care

• Long-term sobriety

INTERIM OUTCOMES

• Increased self-sufficiency in recovery, legal status, social support, and other life domains

• Engagement in self-help/recovery

• Abstention/ reduction in substance abuse

ILLUSTRATION: MEASURING SELF-SUFFICIENCY PROJECT

• Identification of domains through focus groups with Mentor Parents

• Pilot adapted version of Self-Sufficiency Matrix

• Report back and feedback on challenges, and/or discoveries in administering the Self-Sufficiency Matrix

SELF-SUFFICIENCY MATRIX FINDINGSBaseline Scores Post scores

(12 months)

Self-Sufficiency Domains Mean (SD) Mean (SD) p-value

Housing 1.55 (0.85) 3.47 (1.39) <.001

Employment 1.09 (0.39) 2.16 (1.29) <.001

Mobility (transportation) 1.34 (0.60) 2.69 (1.42) <.001

Life Skills 2.39 (1.09) 4.00 (1.02) <.001

Family/Social Relations 2.22 (1.04) 3.66 (1.07) <.001

Community Involvement 1.87 (0.88) 3.71 (0.96) <.001

Parenting Skills 1.93 (1.08) 3.78 (0.94) <.001

Legal 2.84 (1.49) 3.77 (1.28) <.004

Substance Abuse 2.38 (1.43) 4.56 (0.88) <.001

HIGHLIGHTS OF PARTNERSHIP OUTCOMES

• Documentation of MPP impact on DWC engagement and increased self-sufficiency

• Documentation of relationship between MPP participation/contact hours and reunification

• Evaluation findings used in report to funders

• Parallel consultation to address data collection instruments and infrastructure with DWC; influencing practice in other therapeutic courts

BOTTOM LINE – SKILLS BUILDING

• Create visibility with your mentors. What committees can they sit on? Who should they meet with? Where does policy get decided?

• Who can the mentors train? Social workers? Judges? Team members? Increases visibility of the program and establishes support from stakeholders.

• Evaluate your program. What do you want to measure? How will you measure it? What data do you need to collect? Who can help you get that data?

• Create mutually beneficial partnerships to sustain program. Which university / college / community college is near you? Is there a school of social work near you?

• Have both hard data to back up your program and a mentor to publicly share their story: a winning combination for potential funders.

CONTACT INFORMATION

Hilary Kushins, MSW, JDDependency Advocacy CenterDrug Court and Training Programs Manager111 W. Saint John Street, Ste. 333CSan Jose, CA 95113Phone: (408) 999-0311hkushins@sccdac.org

Q&A AND DISCUSSION

COMPLETE YOUR EVALUATION

Complete online by August 21st!

Session SB-23

Children & Family FuturesNADCP | July 2015

Children and Families

Family Drug Courts

Stronger Together

Visit our Exhibit Table!

FDC Guidelines

http://www.cffutures.org/files/publications/FDC-Guidelines.pdf

To download a copy today visit our website:

FDC Discipline Specific Orientation Materials

Child Welfare | AOD Treatment | Judges | Attorneys

Please visit: www.cffutures.org/fdc/

Resources

FAMILY DRUG COURTPEER LEARNING COURT

PROGRAM

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CONTACT US FOR MORE INFORMATION:

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Family Drug Court Learning Academy Webinar Series

March 12th Building Your FDC - Design or Default?

April 16th Leading the Team - So Who Wants to Be an FDC

Coordinator?

May 14th Leading from the Front Line - Case Managers

in the FDC and Why You Need Them

June 11th Leading Change - Prevention & Family

Recovery Project

Aug. 13rd Peer Learning Courts - TED Talks

Sept. 10th Leading Change - State System Reform Project

Leading Change 2015

FDC Learning Academy Webinars! Join Us!To for more information,

including registration, please visit:

www.familydrugcourts.blogspot.com

• FDC Peer Learning Court

• FDC Podcasts

• Leadership Resources

• FDC Video features

• Webinar registration information

FDC Learning Academy Blog

Leading Change

www.familydrugcourts.blogspot.com

2015

1. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers

2. Understanding Child Welfare and the Dependency Court: A Guide for Substance Abuse Treatment Professionals

3. Understanding Substance Use Disorders, Treatment and Family Recovery: A Guide for Legal Professionals

Please visit: http://www.ncsacw.samhsa.gov/

NCSACW Online Tutorials

Resources

Family Drug Court Online Tutorial

FDC 101 – will cover basic knowledge of the FDC model and operations

Jane Pfeifer, MPASenior Program AssociateChildren and Family Futures(714) 505-3525jpfeifer@cffutures.org

Contact Information