Advancing the FDC Movement2017

Jane Pfeifer, MPA| MeghanWheeler

July 9, 2017 | NADCP

A Blueprint Guide for Building or Re-Designing

Your Family Drug Court

Improving

Family

Outcomes

Strengthening

Partnerships

Acknowledgement

This presentation is supported by:

The Office of Juvenile Justice and Delinquency Prevention Office of Justice

Programs(2016-DC-BX-K003)

Points of view or opinions expressed in this presentation are those of thepresenter(s) and do not necessarily represent the official position orpolicies of OJJDP or the U.S. Department of Justice.

Advancing the FDCMovement2017

• Highlight key decision and planning points for all Family Drug Courts

• Identify key steps in developing the Planning Team, including membership and planning process

• Learn tips and strategies on how to use the Planning Guide in your jurisdiction

Learning Objectives

Improving

Family

Outcomes

Strengthening

Partnerships

Advancing the FDCMovement2017

Why a Planning Guide for FDCs?

First Family Drug Courts Emerge – Leadership of Judges Parnham &McGee

Systems Change Initiatives

Practice Improvements – Children Services,

Trauma, Evidence-Based Programs

Grant Funding – OJJDP, SAMHSA, CB

Six Common Ingredients Identified (#7 added in 2015)

Institutionalization,

Infusion, Sustainability

19

94

20

02

20

07

20

04

20

14

FDC Movement

10 Key Components and Adult Drug Court Model

National Strategic Plan

Nex

t

To download a copy today visit our website:

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

FDC Guidelines

The Big 7

Key practices leading to better family outcomes:

• System of identifying families

• Earlier access to assessment and treatment services

• Increased management of recovery services and compliances

• Improved family-centered services and parent-child relationships

• Increased judicial or administrative oversight

• Systemic response for participants –contingency management

• Collaborative non-adversarial approach across service systems and courts

Who Should Use the Planning Guide?

• For anyone in the process of instituting a FDC

• Key decision makers can utilize the guide to recruit and motivate the multidisciplinary planning team necessary for implementation

• Any professional across the three primary systems can use this guide and present the FDC concept to decision makers and educate them about the tasks involved

Purpose

• The FDC Planning Guide provides step-by-step instructions about the planning process and tasks involved

• Team members work through the chapters and worksheets

• Completion of the entire planning process across multiple meetings/full-day retreats will lead to the creation of a FDC in a jurisdiction

How Do You Use the Planning Guide?The amount of work to launch a Family Drug Court in your jurisdiction might seem overwhelming.

• How do you lay a solid foundation to effectively plan your program?

• How do you identify the right partners for collaboration?

• How do you assemble teams to create and maintain your program?

• How do you garner sustained support and buy-in?

• How do you develop protocols and practices to ensure efficient implementation?

• How do you pay for all of the services for parents and children? How do you sustain it into the future?

• How do you improve your operational components and process as you go forward to generate better outcomes?

• How do you evaluate the program?

Planning Guide Overview

• Chapters cover different topics essential to planning

• Appendices include sample documents, reference material, and other helpful links to support local efforts and provide national resources to further support the planning, development, and implementation

• Worksheets include practical activity components designed to complement the guide

CHAPTER ONE

The Planning Process

Drug Court Hearings

Therapeutic Jurisprudence

Enhanced Family-Based

Services

Intensive Case Management &

Recovery Support

FDC Model

Judicial Oversight Comprehensive Services

Governance Structure

• The Planning Team – This team gathers information, develops an operational

plan, and evolves to resolve policy and procedure issues that arise once the

Family Drug Court becomes operational. Because this team is established to

set-up a Family Drug Court, it will eventually disband

• Executive Oversight Committee – This committee is comprised of high-level

administrators across agencies who have the authority for their organization to

shape practice and policy, and ensure program sustainability

• The Steering Committee – This committee sets major policy directions, identifies

and finds solutions to barriers, and secures resources for the Family Drug Court

• The Operational Team – This team works day-to-day in the Family Drug Court

with the participants

Three-Tiered Structure

Oversight/Executive

Committee

DirectorLevel

Quarterly

Ensure long-term sustainability and final

approval of practice and policy changes

Steering

Committee

Management Level

Monthly or

Bi-Weekly

Remove barriers to ensure program success and achieve project’s

goals

FDC Team

Front-Line Staff

Weekly

Staff cases; ensuring client

success

Membership

Meets

Primary Functions

Informationflow

Information flow

CHAPTER TWO

Understanding Addiction and

Substance Use Disorder Treatment

Addiction affects the

whole family

Developmen-tal impact

Psycho-social impact

Impact on parenting

Generation-al impact

FDC Practice Improvements

Approaches to child well-being in FDCs need to change

Child-focused

assessments and

services

In the

context of

parent’s recovery

Family-

centered

treatmentincludes

parent-child

dyad

Focusing only on parent’s recovery without addressing

the needs of children…

Can threaten parent’s ability to achieve and

sustain recovery and establish a healthy

relationship with their children, thus risking:

Recurrence of maltreatment

Re-entry into out-of-home care

Relapse and sustained sobriety

Additional substance-exposed infants

Additional exposure to trauma for

child/family

Prolonged and recurring impact on child

well-being

Continuum of Family-Based Services

Services for parent(s) with substance use

disorders.Treatment

plan includes family issues and family

involvement

Parent’s Treatment

with Family

Involvement

Goal: improved

outcomes forparent(s)

Children accompany parent(s) to treatment. Children

participate in child care but

receive no therapeutic

services. Only parent(s) have treatment plans

Parent’s Treatment with

Children Present

Goal: improved

outcomes forparent(s)

Children accompany parent(s) to treatment.

Parent(s) and attending

children have treatment plans and

receive appropriate

services.

Parent’s and Children’s

Services

Goals: improved

outcomes for parent(s) and

children, better parenting

Children accompany parent(s) to treatment;

parent(s) and children have

treatment plans. Some

services provided to other family

members

Goals: improved

outcomes for parent(s) and

children, better parenting

Each family member has a treatment plan and receives

individual and family services

Family-Centered

Treatment

Goals: improved

outcomes for parent(s),

children, and other family

members;better

parenting andfamily

functioning

Family Services

Scope of Services

FDCs should provide the scope

of services needed to address the

effects of parental substance use

on family relationships – family

based and family – strengthening

approaches towards recovery.

Family is the Focus

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

• Addiction is characterized by inability to consistently

abstain, impairment in behavioral control, craving,

diminished recognition of significant problems with one’s

behaviors and interpersonal relationships, and a

dysfunctional emotional response

• Like other chronic diseases, addiction often involves cycles

of relapse and remission

• Without treatment or engagement in recovery activities,

addiction is progressive and can result in disability or

premature death

ASAM Definition of Addiction

Brain imaging studies show physical changes in areas

of the brain that are critical to:

• Judgment

• Decision-making

• Learning and memory

• Behavior control

These changes alter the way the brain works, and

help explain the compulsion and continued use

despite negative consequences.

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

A Chronic, Relapsing Brain Disease

Treatment is an individualized and a dynamic process designed to meet

the specific and unique needs of each client. Processes commonly found in

treatment:

• Early identification, screening and brief interventions

• Comprehensive assessment of an individual’s substance use disorder

and co-occurring health, mental health and other issues

• Stabilization via medically supervised detoxification, when necessary

• Timely and appropriate substance use disorder treatment – both

acute and chronic care

• Continuing care and recovery support

Overview of Treatment Processes

Effective Substance Use Disorder Treatment

National Institute on Drug Abuse, 2012

• Is readily available

• Attends to multiple needs of the individual

(vs. just the substance use)

• Uses engagement strategies to keep clients

in treatment

• Uses counseling, behavioral therapies (in

combination with medications if necessary)

• Addresses co-occurring conditions

• Uses continuous monitoring

The best treatment programs provide a combination of therapies and other

services to meet the needs of the individual patient.

Full Spectrum of Treatment and Services

Family Engagement and Ongoing Support

Ensure family treatment and recovery success by:

• Understanding, changing and measuring the cross-system

processes for referrals, engagement and retention in treatment

• Recruiting and training staff who specialize in outreach and

motivational (e.g. Motivational Interviewing) approaches and who

monitor processes of recovery and aftercare

• Jointly monitoring family progress through a combination of case

management, coordinated case planning, information sharing,

timely and ongoing communication

• Aftercare, Community and Family Supports and Alumni Groups

CHAPTER THREE

Setting Direction

Mission, Vision & Goals

Components of a Mission Statement:

• Understanding each other’s values

• Shared principles

• Shared outcomes to measure whether the mission is

achieved

✓Client outcomes

✓ Priority groups of parents and children

✓Cost savings

Understanding the Legal Mandates of Each System

• Adoption and Safe Families Act (ASFA)

• 42 Code of Federal Regulations (CFR) Part 2

(information-sharing!)

• Health Insurance Portability and Accountability Act

(HIPAA)

• Additional federal and state regulations governing

your jurisdiction

Time to Treatment Matters

Child Welfare –

12-month timetable for

reunification

Conflicting Timetables

Treatment and Recovery –

Ongoing process that may

take longer

Early engagement in treatment is crucial.

Strategies to improve timely access include:

• Screening and identification

• Service linkage and matching to parent need

• Warm hand-off to assessment

FDC Planning Timeline

First, you will have to establish the who. Identify the members of your steering

committee who will provide direction and oversight, and the members of the

planning team who will conduct the planning, development, and implementation.

Second, you will establish the what. Set the roles of everyone involved,

remembering that some roles can be shared to enhance team functioning. Have

your team identify the key tasks that will serve as milestones.

Finally, you will establish the when by setting deadlines for those milestones. To

maintain momentum during the planning process, your team members will also need

to agree on how often the planning team will meet and how much time they can

commit. Completing these tasks will give you a timeline for the implementation

process.

CHAPTER FOUR

Structuring Your Family Drug

Court

Key Decision Points

Mission Target

Population

Model

Service

Array

Partnerships

Outcomes

(e.g., Boles & Young, 2011; Carey et al., 2010a, 2010b; Worcel et al., 2007)

Who Do FDCs Work For?

Studies Show Equivalent or Better Outcomes:

• Co-occurring mental health problems

• Unemployed

• Less than a high school education

• Criminal history

• Inadequate housing

• Risk for domestic violence

• Methamphetamine, crack cocaine, or alcohol

• Previous child welfare involvement

How well do you know

your target population?

CWS population

FDC population

Your community

Identifying Needs and Existing Capacity

Services

Match Services to Needs

Needs

Monitor Progress

Map out the Needs and Services

Other Service Enhancements

• Therapeutic-based parent-child interventions

• Trauma-focused interventions

• Developmental and behavioral interventions

• Quality visitation and family time

• Family functioning assessment tools – N. Carolina Family Assessment Scale (NCFAS)

Connecting Families to an

Evidence-Based Parenting Program

• Knowledge of parenting skills as well as a basic understanding of child development has been identified

as a key protective factor against abuse and neglect (Geeraert, 2004; Lundahl, 2006; & Macleod and

Nelson, 2000)

• The underlying theory of parent training is that (a) parenting skills can improve with training, (b) child

outcomes can be improved, and (c) the risk of child abuse and neglect can be reduced (Johnson, Stone,

Lou, Ling, Claassen, & Austin, 2008). Characteristics of effective parenting include (a) interaction style

with their child, (b) warmth and affection towards their child, and (c) parenting strategies used (Johnson,

et al., 2008)

EBPs for trauma survivors:

• Addiction and Trauma Recovery Integration

Model (ATRIUM)

• Essence of Being Real

• Risking Connection

• Sanctuary Model

• Seeking Safety

• Trauma, Addictions, Mental Health, and

Recovery (TAMAR) Model

• Trauma Affect Regulation: Guide for

Education and Therapy (TARGET)

• Trauma Recovery and Empowerment Model

(TREM and M-TREM)

Treatment Should Be Evidence-Based

Aftercare and Ongoing Support

Ensure aftercare and recovery success beyond FDC and CWS participation:

• Personal Recovery Plan – relapse prevention, relapse

• Peer-to-peer support – alumni groups, recovery groups

• Other relationships – family, friends, caregivers, significant others

• Community-based support and services – basic needs (childcare, housing, transportation),

mental health, physical health, medical care, spiritual support

• Self-sufficiency – employment, educational and training opportunities

• More frequent review hearings

• Judicial Oversight

• Responses to behavior

• Case Staffings

• Drug testing

Monitoring Cases

Responses to Behavior

Safety

• A protective response if a parent’s behavior puts the child at risk

Therapeutic

• A response designed to achieve a specific clinical result for parent in treatment

Motivational

• Designed to teach the parent how to engage in desirable behavior and achieve a stable lifestyle

Therapeutic Jurisprudence

• Engage directly with parents vs. through attorneys

• Create collaborative and respectful environments

• Convene team members and parents together vs. reinforcing adversarial nature of relationship

• Rely on empathy and support (vs. sanctions and threats) to motivate

Lens, V. Against the Grain: Therapeutic Judging in a Traditional Court. Law & Social Inquiry. American Bar Association. 2015

CHAPTER FIVE

Sustaining Your Program

Who collects data, where is it stored, who uses it, who “owns” the data,

levels of access

Assess effectiveness of system in achieving its

desired results or outcomes

Monitoring Outcomes

How do you know….. How will you…..

• How are families doing?

• Doing good vs. harm?

• What’s needed for families?

• Monitor and improve performance?

• Demonstrate effectiveness?

• Secure needed resources?

DataThe importance of

Data Dashboard

• What needles are you trying move?

• What outcomes are the most important?

• Is there shared accountability for “moving the needle” in a

measurable way, in FDC and larger systems?

• Who are we comparing to?

Developing a Funding Plan

• Negotiate with Participating Agencies

• Negotiate Directly with the City or County

• Network with Other Family Drug Courts in Your State

• Implement a Fee Schedule

• Build Relationships with Managed Care Organizations

• Apply for Federal Enhancement Grants

Creating a Legacy

Parents and their children can break free of intergenerational

substance use disorder patterns when they experience living in a

stable setting with concrete and emotional supports. By providing

access to these supports to participants, children, and families,

your new FDC shows parents alternative and stable ways of living

where they and their children can feel secure. With the help of

your new program, families can experience success—in social

interactions, academic pursuits, physical health, and specific tasks

of daily functioning.

Q&A and Discussion

Advancing the FDC Movement2017 Family DrugCourtTraining & Technical AssistanceResources

Build Evidence Base

Ensure Quality

Implementation

Expansion

of FDC

Reach

Family Drug Court National StrategicPlan

Vision:Every family in the child welfare

system affected by parental/caregiver substance use disorders will have timely access

to comprehensive and coordinated screening,

assessment and service deliveryfor family’s success.

www.cffutures.org/fdc@

Family Drug Court Learning Academy

www.cffutures.org@• Over 40 webinar presentations

• 5 Learning Communities along FDC development

• Team Discussion Guides for selected presentations

Family Drug Court Blog

www.familydrugcourts.blogspot.com@• Webinar Recordings

• FDC Resources

• FDC News

Discussion Guide Understanding Treatment

www.cffutures.org@

• For Child Welfare and Court

Professionals

• Build stronger partnerships with

treatment

• Ensure best treatment fit for

families

Family Drug Court Online Tutorial

• Self-pace learning

• Modules cover basic

overview of FDC Model

• Certificate of Completion

@ www.cffutures.org

2nd Edition – Research Update

Family Drug Court Guidelines

@ www.cffutures.org/fdc/

King County,

WA

Baltimore City,

MDJackson County,MO

Chatham County,

GA

Pima County,

AZ

Wapello County,

IA

Miami-Dade,FL

Dunklin County,

MO

Jefferson County,AL

Family Drug Court Peer Learning Court Program

fdc@cffutures.org@

Family Drug Court Orientation Materials

Discipline Specific

Child Welfare | AOD Treatment | Judges | Attorneys

@ www.cffutures.org/fdc

Measure the

Difference

You Are Making

Collaborate with Children and Family Futures to Design and Implement Your Evaluation

CFF is a leading provider of Research and Evaluation support to national,

state, and county efforts to address the needs of children andfamilies

For more information visit: www.cffutures.org/evaluation or

Resources

FREE CEUs!

NCSACW Online Tutorials Cross-Systems Learning

@ www.ncsacw.samhsa.gov/.org

Understanding Substance Abuse and Facilitating Recovery: AGuidefor Child Welfare Workers

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

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

Contact Information

Improving

Family

Outcomes

Strengthening

Partnerships

Advancing the FDCMovement2017

Jane Pfeifer

Senior Program Associate Children and Family Futures (714) 505-3525jpfeifer@cffutures.org

Meghan M. Wheeler

Senior ConsultantNational Drug Court Institute (419) 295-6086mwheeler@nadcp.org