Relationship Based Collaboration

Mary Claire Heffron, Ph.DMargaret Rossoff, M.F.T

Early Childhood Mental Health ProgramDepartment of Developmental and Behavioral PediatricsChildren’s Hospital and Research Center, Oakland

MANY PROGRAMS, MANY DISCIPLINES

Pre school and child care educatorsWICSocial workers and case managers

(at CPS, teen parenting programs, TANF, etc.)

Pediatricians and nursesFirst responders (police, fire)

MANY PROGRAMS, MANY DISCIPLINES, continued

Staff at shelters for homeless families, victims of domestic violence, parents in recovery from substance abuse

Early interventionists—PT’s, OT’s, speech pathologists, developmental specialists

Mental health specialists

MULTIDISCIPLINARY FOCUS IN INTERVENTION requires collaboration among multiple systems

GOAL OF COLLABORATION:

Increased wellness and improved mental health in community

WHY COLLABORATE? BENEFITS TO FAMILIES

Many families can benefit from services of multiple agencies and providers

Coordination of services avoids gaps and overlaps for families

Coordination of services makes life easier for families with many challenges

Collaboration between providers can be a model for the family

WHY COLLABORATE? BENEFITS TO PROGRAMS AND PROVIDERS

Teamwork fosters creative new ideasCollaboration brings in perspectives from

different Cultures Professional disciplines Past experience

Collaborative projects are favored by funders, including foundations and government programs

Collaboration can mean more efficient use of scarce resources (staff and funding)

Teamwork reduces burnout

PITFALLS OF NON-COLLABORATION

Wasted dollarsLess effective servicesLost opportunities to increase staff

abilitiesSilo mentality vs. relationship

mentalityLone Ranger vs. team approach

COLLABORATIVE PROCESSES among systems and agenciesSystems and agencies

can work together to develop plans and address concerns chosen together

Requires communication and some level of trust

Requires time spent together

Process can build greater trust

POWER OF RELATIONSHIPS AMONG AGENCIES

Who do you go to?

How do they make you feel?

What do they do?

REFLECTIVE FUNCTIONING AND PERSPECTIVE TAKING ARE THE HEART OFCOLLABORATIVE WORK

RELATIONSHIP-BASED PRINCIPLES APPLY TO COLLABORATION:

Reflect on your experienceListen empathically—try to understand

before reactingRespect role boundariesCommunicate directly about

difficultiesValue different perspectivesGet support for your own feelings

USE OF SELF INCLUDES

Self awareness (of individual and program)Observation (beware of assumptions and

judgments)Reflection about the impact of collaboration

On family and child On participating agencies On agency staff On community

HOW YOU SEE THEM, HOW THEY SEE YOU

Try on the perspective of the other agency and its staff

Address and explore conflicts, different points of view

Expect differences and try to welcome them as opportunities for learning

ALL GOALS AND INTERVENTIONSSTRENGTH-BASED

Contacts among collaboratorssupport the competence of the family and of each other

BUILDING COLLABORATION

Take time to get to know each other What each program does Skills and perspectives of staff Mandates and funding constraints of each

program Agency “culture”

Build trust through shared activities, exchange of information and working together to develop shared purpose

CREATING SYSTEMS OF COLLABORATION

Coming together for joint purposesCreating common visionIdentifying strengths of participantsIdentifying problems and building

solutionsTaking credit together, appreciating

each other’s contributions

IN COLLABORATION

Start small if thinking big is too overwhelming

Focus on what will help both agencies and what will serve clients better

POSSIBLE LEVELS OF COLLABORATION

Communication among staff within an agency or department

Communication between individual providers at different agencies Providers working with the same family sharing

information and strategies (with family’s permission)

Consultations between staff at different agencies exchanging insights from different disciplines (can be about hypothetical vignettes or actual families with releases)

LEVELS OF COLLABORATION,continued

Pilot project with a small number of families

Agreement between agencies, spelled out in MOU (Memorandum of Understanding)

Integrated project, perhaps with external funding

System of care in a geographical area

WHAT ABOUT CONFIDENTIALITY?

Explain the benefits of the collaboration to family members

HIPAA requires written releases and specifies what to include

Develop a form for family members to sign that authorizes exchanges of information between collaborating programs (see examples of collaborative releases)

INVOLVE FAMILIES IN COLLABORATION

Include family members in meetings whenever possible

Share results of discussions with family members if they are not present

BARRIERS TO COLLABORATION

Territoriality and competitionTight discipline boundariesBelief in self or agency as center of the

universeFear of self evaluation and changeLimited time and moneyConstraints of funding sourcesLack of understanding of culture of other

agency

TYPICAL STAFF FEARS ABOUT COLLABORATION INCLUDE

I already don’t have enough time—how can I add to my job?

My job will change to something I can’t do or don’t like doing

“They” will undermine my workClients will pit us against one another“They” will take over my job, “they”

are better than I am

OVERVIEW: RELATIONSHIP-BASED COLLABORATION

Know your own program, including the limits of your power and influence

Understand each other’s skills and contributions

Find common ground—shared goalsRecognize differences as assets to

working togetherAppreciate the synergy of working

together

FOR SUCCESSFUL OUTCOMES

Listen as much as you talkBe willing to allow new solutions and

outcomes to emerge-don’t be too attached to one perspective

Imagine the point of view of othersFocus on joint outcomes, not just what you

needThink about needs of the family or the

community of families with young children