Connecting Circles of Care

A System of Care:A cultural diverse family driven program for children with severe emotional disturbances

Jlg CCOC

Connecting Circles of CareHow does this system of care work to change

the current services? Culturally and Linguistically Competent Providers

and Practices Family and Youth Driven Services Wraparound Strength Based Services Multi-agency, Coordinated, Community Based Care Respite Care

What are Wraparound Services?

An approach to care planning and service provision that organizes and manages the delivery of multiple services, treatments, and supports to a child and the child’s family in ways that are flexible, individualized, strengths-based, family driven, culturally responsiveresponsive and effective. Wraparound processes are organized around all key life domains (home, school, and community living).

Wraparound team

Systems of care blend clinical services and natural supports.

CCOC Wraparound teams consist minimally of:

A Parent/Family Partner A Family Support Worker A Licensed Therapist

THE HONOR OF ONE

IS THE

HONOR OF ALL

Wraparound

Integrates culture into wraparound

Trains staff to respect and understand family viewpoints and then adapt services to the culture

Trains staff in the principle of cultural competence in 4-40 hours

Focuses on culturally competent techniques of staff to develop therapeutic relations

Culture-based Wraparound

Integrates wraparound into the youth and family’s culture

Staff are culturally matched and view the world through the eyes of a family’s culture

Expertise in a particular culture requires decades of immersion

Realizes that a youth or family member’s perceptions of, and level of trust, for staff from different cultures may impair relationship formation no matter how culturally competent staff may be

Wraparound

Often does not offer youth and families the choice to have culturally and linguistically matched professionals

Translation with a qualified interpreter is considered sufficient

Culture is often seen as a family’s traditions and ways of doing

Wraparound is accountable to families and local agencies

Culture-based Wraparound

Offers youth and families the choice to have culturally and linguistically matched professionals

Fully bilingual staff provided to ensure that true meanings are not lost and family members can emotionally process easier in their first language

Culture is seen as part of traditions in cultural groups (specific family traditions are honored and valued, but not seen as culture)

Wraparound is accountable to families, cultural communities, cultural organizations, and local agencies

Rural Butte County

Butte County is located in the Central Valley north of the state capital, Sacramento. The Census bureau’s last estimate in 2008 has our population as 220,337. The county seat is Oroville.

Butte County is watered by the Feather and Sacramento Rivers. Butte and Big Chico Creeks are tributaries to the Sacramento River. It is the site of Feather Falls, the sixth largest waterfall in the United States. Lake Oroville is located east (and upriver) of the city of Oroville. The lake’s dam is the largest earthen dam in the U.S.

Underserved demographics

Farmlands ~ valley Rural unincorporated towns Foothills Indian reservations Tribal Housing

Butte County Census 2008 http://quickfacts.census.gov/qfd/states/06/06007.html

Butte County CA

White 88.8% 76.6% Black 1.7% 6.7% American Indian / Alaska Native 2.2% 1.2% Asian 4.1% 12.5% Native Hawaiian / Other Pacific Islander

0.2% 0.4% Persons reporting two or more races

3.1% 2.6% Hispanic or Latino origin 12.9% 36.6% White not Hispanic, 76.9% 42.3%

Economic Characteristics

Butte County % CA %

Families below poverty level

11.6 9.6

Individuals below poverty level

18.2 13.2

Unemployment Jan 2010

15.1 13.2

Housing

CALIFORNIA RANKS

Extent of child homelessness 48Child well-being 15Risk for child homelessness 28State policy and planning and adequateOverall rank 40*

*States ranked 1-50 1=best, 50=worst ~The National Center on Family Homelessness

Barriers to Service Lack of trust of services and providers Poverty/low income Language Transportation “mountain” stigma Child Care Weather Disasters Lack of services in their local zip code Lack of Cultural competency by providers Poor housing (or lack thereof) PTSD or other mental health diagnosis’ Soul Wound

Intergenerational and Historical trauma Research

Intergenerational trauma was first written about in 1966 when mental health professionals were seeing large numbers of children of holocaust survivors.

Children of survivors have consciously and unconsciously absorbed their parents’ trauma.

The trauma experience becomes a family legacy.

Common Manifestations of Intergenerational Trauma

& Coping Skills

Military entrance Gang Affiliation Substance Abuse Domestic Violence Depression

Mistrust of governmental and other agency systems – fear of the oppressor

Child Abuse Suicide

Community as essential part of program development

Dinner and lunch and follow up with local African American Pastors and their congregations

Met with Hmong Civic leaders Met with Providers serving the Latino

communities Gathering of Native Americans Meeting with rural communities who survived fire

disaster with follow up services at their local school

Governance Body includes community members, family and youth.

Considerations when working with

rural communities Recognize that even well adjusted individuals have been impacted by intergenerational trauma

Recognize that lack of trust is usually systematic and not personnel

Understand definitions of how communities view themselves

Understand definitions of family

Considerations when working with

rural communities Understand that entering a families’ home is

entering a sacred place. Understand that what you are teaching or

assisting a family with must be complimentary to their culture for it to work

Understand that your family has strengths and your job is to augment those strengths

Lessons Learned

Food served must be acceptable to all cultures

Diversity within the racial or ethnic cultures (traditional vs. non traditional)

Ensure that ‘new’ staff understand program and the ‘thinking outside the box’

Connecting Circles of CareButte County, CA

Butte County Behavioral HealthNorthern Valley Catholic Social Services

Feather River Tribal Health, Inc.

www.connectingcircles.com