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