The Family Journey Assessment: Tracking the

Impact of Family Support

Celia Serkin, Executive DirectorMontgomery County Federation of Families for Children’s Mental

Health301-879-5200

cserkin@mcfof.org

Family Journey Assessment Family Journey Assessment TeamTeam

Montgomery County Federation of Families for Children’s Mental HealthMontgomery County Federation of Families for Children’s Mental HealthADMINISTRATION:ADMINISTRATION:

Celia Serkin, Executive DirectorCelia Serkin, Executive DirectorMichele Banks, Family Service SupervisorMichele Banks, Family Service Supervisor

  FAMILY NAVIGATORS::FAMILY NAVIGATORS::

Joan CharqueroJoan CharqueroChristine DeeleyChristine DeeleyJanet LeeJanet Lee

FAMILY SUPPORT PARTNERS: FAMILY SUPPORT PARTNERS: Karina Funes Oviedo Karina Funes Oviedo Sari Hornstein Sari Hornstein Mary Kackley HarrisMary Kackley HarrisValerie OliverValerie Oliver

  PARENT ENGAGEMENT COORDINATOR/FAMILY SUPPORT PARTNER:PARENT ENGAGEMENT COORDINATOR/FAMILY SUPPORT PARTNER:

Melody SmithMelody Smith

Georgetown Center for Child and Human DevelopmentGeorgetown Center for Child and Human DevelopmentBruno AnthonyBruno AnthonyCourtney HollandCourtney Holland

Family OrganizationFamily Organization

The Montgomery County The Montgomery County Federation of Families for Federation of Families for Children’s Mental Health is Children’s Mental Health is non-profit organization run by non-profit organization run by family members who have family members who have children with emotional, children with emotional, behavioral, or mental health behavioral, or mental health challenges.challenges.

We help other family members We help other family members who are raising children with who are raising children with similar challengessimilar challenges..

Program StaffProgram StaffThey are family members who have children They are family members who have children with emotional, behavioral, or mental health with emotional, behavioral, or mental health needs. needs.

They are skilled and knowledgeable family They are skilled and knowledgeable family members who provide direct services to members who provide direct services to parents and other primary caregivers who parents and other primary caregivers who have children with similar challenges. have children with similar challenges. – peer-to-peer supportpeer-to-peer support– information and referralinformation and referral– advocacyadvocacy– group supportgroup support– educational programs educational programs – leadership opportunities leadership opportunities

The The staff help staff help family members progress in their journey family members progress in their journey towards self-advocacy and self-efficacy through the towards self-advocacy and self-efficacy through the acquisition of skills, knowledge and a network of support. acquisition of skills, knowledge and a network of support.

The staff work with families to identify targets and The staff work with families to identify targets and benchmarks for focused and individualized family peer-to-benchmarks for focused and individualized family peer-to-peer support. peer support.

The staff provide peer-to-peer support that helps families The staff provide peer-to-peer support that helps families resolve their own challenges and address their unique resolve their own challenges and address their unique needs, while moving them to a legacy stage where they needs, while moving them to a legacy stage where they assist other families with similar issues.assist other families with similar issues.

Family members have the opportunity to become involved Family members have the opportunity to become involved in local and state policy making. in local and state policy making.

In this model, family members become advocates for their In this model, family members become advocates for their own children as well as for other children. own children as well as for other children.

Family Support Model

Family Organizations and Family Organizations and AccountabilityAccountability

In a climate of results-based and outcome In a climate of results-based and outcome accountability, an emphasis on evidence-based accountability, an emphasis on evidence-based practices, and a challenging fiscal climate, it is practices, and a challenging fiscal climate, it is critical that family organizations measure:critical that family organizations measure:

What/How much they doWhat/How much they doHow well they do itHow well they do itIs anyone better offIs anyone better off

Motivation for Creating Family Motivation for Creating Family Journey Assessment Journey Assessment

Create a measure with items of relevance to the Create a measure with items of relevance to the important movement, process and experience of important movement, process and experience of family journey.family journey.

Key outcomes derived from family support experienceKey outcomes derived from family support experience– Activation (pursue options, something I can doActivation (pursue options, something I can do– Collaboration/Decision makingCollaboration/Decision making– AdvocacyAdvocacy– Self-efficacySelf-efficacy– Caregiver ImpactCaregiver Impact

Road to Self-Advocacy and Self-Efficacy

How Can We Track the Journey?How Can We Track the Journey?

What Happens on the Journey?What Happens on the Journey?

Gain Knowledg

e

Build Skills

Link to a Network of Support

Preparing for Action

Actions Actions and and successessuccesses

Establishing Establishing a legacy a legacy 

Stages of Growth

The Federation staff promote a family The Federation staff promote a family member’s movement along three member’s movement along three primary stages in the growth process:primary stages in the growth process:

– Preparing for action – A family member is Preparing for action – A family member is preparing to take specific action to improve preparing to take specific action to improve his/her situation. his/her situation.

– Actions and successes – A family member Actions and successes – A family member has taken different actions and has has taken different actions and has experienced successes.experienced successes.

– Establishing a legacy – A family member is Establishing a legacy – A family member is now moving to a legacy stage whereby now moving to a legacy stage whereby he/she chooses to advocate for other he/she chooses to advocate for other family members having similar family members having similar experiences and/or to provide support for experiences and/or to provide support for these families. these families.

Family Support LevelsFamily Support Levels

A family member may A family member may fall in one of five stages fall in one of five stages on a family support on a family support continuum: intensive, continuum: intensive, moderate, supportive, moderate, supportive, empowered, or legacy. empowered, or legacy.

The family member’s The family member’s movement on this movement on this continuum is fluid. A continuum is fluid. A family member may family member may move back and forth move back and forth from one stage to from one stage to another. another.

When providing peer-to-peer When providing peer-to-peer support, staff work in support, staff work in partnership with family partnership with family members to determine where members to determine where they are in their journey toward they are in their journey toward self-efficacy and self-advocacy self-efficacy and self-advocacy and how they are progressing. and how they are progressing. The Family Journey The Family Journey Assessment identifies the Assessment identifies the baseline and helps to track the baseline and helps to track the journey.journey.

The Federation staff provide a The Federation staff provide a specific level of peer-to-peer specific level of peer-to-peer support depending on the stage support depending on the stage the family member is in at a the family member is in at a particular point in time. particular point in time.

Conceptual FrameworkConceptual Frameworkand Developmentand Development

Conceptual FrameworkConceptual Framework::– The FJA’s content has been informed by the The FJA’s content has been informed by the

experiences of family members who have experiences of family members who have experienced the journey and provided support to experienced the journey and provided support to other families.other families.

DevelopmentDevelopment – Item creation, including its relation to other measures, Item creation, including its relation to other measures,

and its current structure and administrationand its current structure and administration

Steps in Scale DevelopmentSteps in Scale Development

Begin with a clear conceptualization of the target Begin with a clear conceptualization of the target constructs. constructs.

Creation of initial item poolCreation of initial item pool

Modification of poolModification of pool

Item pool/structure tested (iterative) with initial sample Item pool/structure tested (iterative) with initial sample (relatively small)(relatively small)

Larger scale testing of reliability and validityLarger scale testing of reliability and validity

Journey (continuum) towards self-advocacy and self-efficacy through the acquisition of skills, knowledge and a network of support.

Creation of FJA Item PoolCreation of FJA Item PoolWanted to be over-inclusive Wanted to be over-inclusive

Item wording needed careful attention (simple, Item wording needed careful attention (simple, straightforward)straightforward)

Subscales identifiedSubscales identified

Iterative process involving several periods of item Iterative process involving several periods of item writing and modification. writing and modification.

34 items34 items

Separate sets of items for families participating in Separate sets of items for families participating in Wraparound and those approaching the legacy Wraparound and those approaching the legacy stagestage

Family Journey Assessment: Examples of Items by Family Journey Assessment: Examples of Items by Cluster Cluster

Cluster 1: Self-Knowledge Cluster 1: Self-Knowledge – Communicates needs related to culture, language, Communicates needs related to culture, language,

learning and thinking styles in order to progresslearning and thinking styles in order to progress– Accepts and appreciates child’s challengesAccepts and appreciates child’s challenges– Sees challenges in an objective waySees challenges in an objective way

Cluster 2: Family Well-Being Cluster 2: Family Well-Being – Develops and maintains a daily routineDevelops and maintains a daily routine– Can contribute to the decision-making process around Can contribute to the decision-making process around

the child’s issuesthe child’s issues– Feels less isolated and aloneFeels less isolated and alone..

Family Journey Assessment: Examples of Items by Family Journey Assessment: Examples of Items by Cluster Cluster

Cluster 3: Seeking Information Cluster 3: Seeking Information – Seeks help by gathering information, resources, or Seeks help by gathering information, resources, or

materials to improve the situationmaterials to improve the situation– Has knowledge of child-serving systems Has knowledge of child-serving systems

Cluster 4: Collaborates with OthersCluster 4: Collaborates with Others– Asks for help and works with others to find supportsAsks for help and works with others to find supports– Accesses natural supportsAccesses natural supports– Connects with families having similar experiencesConnects with families having similar experiences– Shows/demonstrates empathy for othersShows/demonstrates empathy for others

Family Journey Assessment: Examples of Items by Family Journey Assessment: Examples of Items by Cluster Cluster

Cluster 5: Owns Newly Attained KnowledgeCluster 5: Owns Newly Attained Knowledge– Uses knowledge about resources in an effective wayUses knowledge about resources in an effective way– Attends, participates in, and speaks up during Attends, participates in, and speaks up during

meetingsmeetings– Communicates effectivelyCommunicates effectively

Cluster 6: Coping SkillsCluster 6: Coping Skills– Understands that having a range of feelings is normal Understands that having a range of feelings is normal

and is coping well neverthelessand is coping well nevertheless– Demonstrates resiliency and perseveranceDemonstrates resiliency and perseverance– Understands and takes care of selfUnderstands and takes care of self

AdministrationAdministrationAdministered by the family support staff in collaboration with Administered by the family support staff in collaboration with the family members.the family members.– A way to help track the progress of their work togetherA way to help track the progress of their work together

Semi-structured interview formatSemi-structured interview format– Begin with general open-ended questionsBegin with general open-ended questions– Suggested follow-up prompts Suggested follow-up prompts – Interviewer needs a thorough understanding of the test Interviewer needs a thorough understanding of the test

items and experience in conducting this type of interview.items and experience in conducting this type of interview.

Baseline and three month intervals/end of serviceBaseline and three month intervals/end of service

Consider “average” of past month Consider “average” of past month

AdministrationAdministration

Celebrate the successCelebrate the success

Expect that there will be fluctuations—may not be Expect that there will be fluctuations—may not be a linear processa linear process

Take into consideration factors such as Take into consideration factors such as – GenderGender– Life experiences;Life experiences;– Cultural heritage;Cultural heritage;– Socio-economic circumstances;Socio-economic circumstances;– Role models;Role models;– Beliefs/values.Beliefs/values.

Family Journey Assessment: Rating ScaleFamily Journey Assessment: Rating Scale

Intensive Moderate Supportive Empowered1 2 3 4

The family member finds it very difficult to make changes in to improve the current situation; requires active intervention from FSP/FN.

The family member needs extensive assistance and encouragement from FSP/FN to make changes necessary to improve the current situation.

The family member needs limited assistance from FSP/FN to make changes necessary to improve current situation.

The family member is making changes to improve the current situation without assistance from FSP/FN

Anchors: Communicates needs related to culture, Anchors: Communicates needs related to culture, language, learning and thinking styleslanguage, learning and thinking styles

Difficult to communicate in the Difficult to communicate in the dominant language; rarely dominant language; rarely verbalizes information that is verbalizes information that is necessary to address needs; not necessary to address needs; not aware of personal thinking styles, aware of personal thinking styles, feels intimidated by professionals, feels intimidated by professionals, difficulty communicating the difficulty communicating the family’s, and particularly, the family’s, and particularly, the child’s needs; has difficulty child’s needs; has difficulty articulating beliefs or expectations, articulating beliefs or expectations, does not connect to community does not connect to community resources. resources.

Communicates and verbalizes his Communicates and verbalizes his or her needs; actively seeks or her needs; actively seeks support, seeks educational support, seeks educational opportunities (e.g., workshops), opportunities (e.g., workshops), and peer to peer support. Very and peer to peer support. Very aware of the needs of the family aware of the needs of the family and the child, seeks out and the child, seeks out community resources, already community resources, already connected to natural supports, is connected to natural supports, is able to seek and connect to new able to seek and connect to new supports and resourcessupports and resources. .

Intensive Empowered

Parents/Caregivers Views of FJAParents/Caregivers Views of FJA

Keeps focus on goalsKeeps focus on goals

Better understanding of the systemsBetter understanding of the systems

Decrease sense of feeling overwhelmed Decrease sense of feeling overwhelmed and operating from crisis modeand operating from crisis mode

Greater sense of self-efficacyGreater sense of self-efficacy

Know how to make changesKnow how to make changes