Option 2Option 2
Rhoda Emlyn-Jones OBE MA.SW.DipRhoda Emlyn-Jones OBE MA.SW.Dip
Social Services Manager and Integrated Family Support Social Services Manager and Integrated Family Support Service advisor to Welsh Assembly GovernmentService advisor to Welsh Assembly Government
November 2009November 2009
Range of ProvisionRange of Provision Counselling ServicesCounselling Services Social Work TeamsSocial Work Teams Through care from Prison ServicesThrough care from Prison Services Drug Intervention ProgrammesDrug Intervention Programmes Training and Supervision Training and Supervision ProgrammesProgrammes Family and Child Protection ServicesFamily and Child Protection Services Family Support ServicesFamily Support Services Services for the Homeless / Complex Services for the Homeless / Complex
needs provisionneeds provision
Bridging the GapBridging the Gap
Children’s ServicesChildren’s Services
Child focussedChild focussedImmediate responseImmediate responseTransparencyTransparencyRisk eliminationRisk elimination
Substance Misuse ServicesSubstance Misuse Services
Adult focussed Adult focussed At the client’s paceAt the client’s paceConfidentialityConfidentialityHarm minimisationHarm minimisation
The ContextThe Context
AdultAdult ServicesServicesChildren’sChildren’sServicesServices
Transparent IntensiveTransparent IntensiveFamily ServiceFamily Service
Build on strengths Engage, build trust,Enhance motivation
The Context continuedThe Context continued
AssessmentAssessment | | Engagement Engagement
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Care PlansCare Plans | | Collaboration Collaboration
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MonitoringMonitoring | | Outcomes Outcomes
The Wider ContextThe Wider ContextThe core conditions for change are:The core conditions for change are: Confidence, Optimism, Self Efficacy and Confidence, Optimism, Self Efficacy and Commitment.Commitment. The context is:The context is: Dominated by assessmentDominated by assessment High thresholdsHigh thresholds Little collaboration across Adults andLittle collaboration across Adults and Children's ServicesChildren's Services Adults noticed more for the problems theyAdults noticed more for the problems they cause than the problems they facecause than the problems they face Doing good with a vengeanceDoing good with a vengeance Debilitating not RehabilitatingDebilitating not Rehabilitating Lack of trust and trustworthinessLack of trust and trustworthiness
The KeyThe Key
Empathic skilled relationship capable Empathic skilled relationship capable of exploringof exploring
“ “ The grit of change ”The grit of change ”
Service Design and DeliveryService Design and Delivery
Every element of service design Every element of service design maximisingmaximisingthe likelihood of:the likelihood of:
EngagementEngagement HopeHope OptimismOptimism CommitmentCommitment
Effective Service DeliveryEffective Service Delivery
1.1. Select credible interventionsSelect credible interventions
2.2. Intensive skill developmentIntensive skill development
3.3. Test the fidelity of deliveryTest the fidelity of delivery
4.4. Test the impact on the clientTest the impact on the client
Option 2’s AimOption 2’s Aim
To create a positive change in the way To create a positive change in the way families function, thus enabling families function, thus enabling children to remain safely at home children to remain safely at home wherever possible.wherever possible.
Research led models of Research led models of practicepractice
We bring together well evidenced interventions We bring together well evidenced interventions to focus on the families values and beliefs and to focus on the families values and beliefs and build on their strengths and resourcesbuild on their strengths and resources
Motivational InterviewingMotivational Interviewing Crisis TheoryCrisis Theory Solution Focussed Brief therapySolution Focussed Brief therapy C B TC B T Systems TheorySystems Theory
Option 2’s ModelOption 2’s Model
4 to 6 week intensive intervention in the family’s 4 to 6 week intensive intervention in the family’s homehome
Interventions planned on a flexible 24/7 basisInterventions planned on a flexible 24/7 basis
All agree clear behavioural outcomes All agree clear behavioural outcomes
The work is transparentThe work is transparent
Maintenance, follow up & boostersMaintenance, follow up & boosters
Option 2’s InterventionOption 2’s Intervention
Clear measurable, Clear measurable, behavioural goals behavioural goals are agreedare agreed
The family’s values The family’s values & strengths are & strengths are highlightedhighlighted
The family’s The family’s preferred future is preferred future is exploredexplored
Skills training is Skills training is provided in situprovided in situ
Average Maintained Change Average Maintained Change April 2000 – March 2009April 2000 – March 2009
VALE AND CARDIFF COMBINED FIGURES
-2
-1
0
1
2
TIME
LE
VE
L O
F G
OA
L
AC
HIE
VE
ME
NT
All goals exceeded or maintained 81%Substance related goals exceeded / maintained 79%Families staying together 76%
Goals set Closure 1 Month 3 Months 6 Months 12 Months
Some ImplicationsSome Implications
More Time Consuming – Short TermMore Time Consuming – Short Term Better Outcomes for Families – Long TermBetter Outcomes for Families – Long Term Changing Generational PatternsChanging Generational Patterns Reduced costs of a wide range of servicesReduced costs of a wide range of services Higher retention of skilled professional Higher retention of skilled professional
staffstaff
Impact on PolicyImpact on Policy
• The Policy context for change – The Policy context for change –
• Integrated Family Support ServicesIntegrated Family Support Services
Policy Mandate for ChangePolicy Mandate for ChangeWelsh Assembly GovernmentWelsh Assembly Government
Supportive environment for change where managed risk Supportive environment for change where managed risk is the normis the norm
National approach to transform Services that enhance National approach to transform Services that enhance the wellbeing of children and familiesthe wellbeing of children and families
Focus on outcomes as opposed to outputsFocus on outcomes as opposed to outputs Evidence based interventions delivered by highly skilled Evidence based interventions delivered by highly skilled
staff and systems that allow for the transfer of skillsstaff and systems that allow for the transfer of skills A cultural shift to bridge child and family systemsA cultural shift to bridge child and family systems Workforce: Invest in excellence in Professional PracticeWorkforce: Invest in excellence in Professional Practice
IFSS Team, Core skills, Models & approaches
Organisations, Developments &Skilled Workforce
Workforce Training
Voluntary Sector
Health
Local Authorities
Community Safety
Partnerships
Education
Workforce DevelopmentWorkforce Development
Change AgenciesChange Agencies
Legitimacy:Legitimacy:
empathic engagement is our empathic engagement is our legitimate rolelegitimate role
Adequacy:Adequacy:
we are skilled to deliver this wellwe are skilled to deliver this well Support:Support:
my manager, my supervisor, my my manager, my supervisor, my colleaguescolleagues
ConclusionsConclusions
• Innovative practice needs to engage with Innovative practice needs to engage with research and evaluation opportunitiesresearch and evaluation opportunities
• Best practice needs to be supported by Best practice needs to be supported by culture and leadership properly resourced culture and leadership properly resourced and supervisedand supervised
• Effective delivery requires a focus on Effective delivery requires a focus on design, structure and supportdesign, structure and support
It is as simple and as complex as thatIt is as simple and as complex as that
““I feel happy, you know the proper happy, I feel happy, you know the proper happy, from inside.”from inside.”
- K, a mother one month after the Option 2 Intervention.
““Option 2 has made me become the person I Option 2 has made me become the person I want to be, not the person I would have want to be, not the person I would have become, a druggie, hopeless, lost my kids and become, a druggie, hopeless, lost my kids and everything.”everything.”
- L, a mother on an Option 2 evaluation form.
““Without models that help us engage, we risk Without models that help us engage, we risk being too nice or too nasty”being too nice or too nasty”
- Social Worker