Module 4: Strategies

MODULE 4: The Basics for Engaging Families

strategies:

The Basics for Engaging Families Strategies 

To facilitate long-term success for youth and families, executive leaders of the organization commit to family engagement as a crucial priority. Successful family engagement is built upon the board and leadership at all levels of an organization having a strong commitment to engaging and meaningfully including families in all aspects of the organization. Effective organizations view youth in the context of the family rather than the context of residential intervention. Program practices and staff skills address the urgency to reunite youth with their families in their homes and communities as soon as possible after admission.

Develop a strategic plan focused on family engagement. An effective organization has a comprehensive strategic plan for family-driven care and family engagement. The plan identifies specific program practices for each staff role in the organization. Such strategic plans are focused on building the staff’s skills and education and increasing understanding and expertise for all employees in successfully engaging, partnering with, supporting, and offering culturally responsive [1] skill building for families. This commitment to family-driven care and family engagement can be further stated in all organizational documents, starting with the mission and values of the organization, and addressed in all areas of workforce development (e.g., interviewing and hiring processes, orientations, ongoing training, mentoring, supervision, and evaluation).

Effective residential leaders commit to ensuring an urgent focus on permanency practices . Ensure an urgent focus on permanency for youth with no identified family members; develop a full range of permanency practices to support finding permanent families quickly. It is critical that youth do not linger in a residential program when interventions could happen in the child’s home and community. When residential interventions become too long, children lose hope for a normal life. They become increasingly frustrated and experience subsequent dysregulation⎯often resulting in the types of behaviors that lead staff to use controlling and coercive practices, including restraints. It is difficult for residential programs to have a strong focus on family engagement when they are using controlling and coercive practices that are often re-traumatizing for children.

Take every opportunity to work in the family’s home and in the community. Ensure that the focus of the residential intervention is about family skill-building in a home environment, rather than about the child’s behavioral improvements within the residential program. With the goal of fostering long-term success for youth and families at home and in their communities, all “work” that happens with a residential intervention connects to partnering with families to build the skills and put in place the supports needed to be successful in the home and community. A focus on children’s behavior in the residential milieu is only teaching the child how to live in congregate care. Working with the family at home provides a valuable lens through which to learn how to modify or personalize interventions, and to help the parent, siblings, and extended family equips themselves with new techniques that they can use to be successful at home long-term, without the help of staff.

To be family-driven, hire Family/Parent Partners and engage them as decision-makers within the organization. Family-inclusive organizations hire, value, and fully integrate into their organizations Family/Parent Partners.  who represent the cultures and ethnicities of the families served. Hiring culturally relevant and sensitive [6] Family/Parent Partners is the single most effective strategy to ensure organizations that will successfully engage families. Family members can benefit from speaking to Family/Parent Partners who have been in their shoes. Family/Parent Partners can help families to self-advocate and ensure that the residential intervention is meeting the needs of the youth and the family.

Provide a strong focus on the cultural and linguistic competence of, as well as equity, inclusion, and diversity among, staff who work with families (CLC/EDI[7] ). It is ideal for the backgrounds of staff to represent the ethnicities and cultures of the youth and families they serve, and for staff to speak the languages spoken by children and families. By hiring with attention to these areas, programs will be positioned to more successfully engage families.

Train, coach, supervise, and evaluate all organizational staff on basic customer service skills for engaging families. Programs can provide training on the importance of engaging families and the basics of how to do this (e.g., conveying respect, listening, reaching out frequently to families) for all staff during orientation. Programs can then build on this initial training during regular training updates. It is important to ensure that clinical supervisors have advanced knowledge and skills in engaging, partnering, supporting, and offering skill-building opportunities for families. Then, clinical supervisors can more effectively support staff in problem-solving challenges staff encounter in successfully engaging families.

Do the research; learn from other programs with expertise; and study different promising, best, and evidence-based practices for engaging families. Develop a foundation of expected staff skills and program practices that can provide clear guidance to staff. Support staff in having tools to successfully engage, partner with, support, and offer skill-building opportunities for families.

Involve parents from pre-admission, provide ongoing support, and treat them with dignity and respect. It is important for residential staff to understand that families may make statements that may seem harsh. However, do not mistake anger by parents as a hindrance to moving forward. It is the clinician’s/professional’s job to help heal hearts during interventions. Approach this by problem-solving, without judgment or blame⎯only understanding and support. One example of how to set the tone for family engagement is for programs to provide families with a guided tour prior to admission and then again on the day of admission so families understand what to expect. Another example is for residential staff, ideally, a Family/Parent Partner, to call the family at the end of the first day to share how their child is doing, to inquire about how they are, and to offer verbal support, as leaving a child in a residential program is hard and emotionally draining for families. Provide parents with a direct contact number and the contact name of someone they can reach twenty-four hours a day.

Provide parents with complete information so they can make informed decisions. Ask parents what has been tried in the past, including what was helpful and what was not helpful. To successfully engage families, ask them for their perspectives and opinions. Staff should not presume that everything in the child’s file is accurate; family members add additional context, and it is critical to understand their perspectives on family dynamics and situations. Effective service plans are individualized for this child and this family, drawing from what families articulate about their needs, goals, and priorities.

Ensure respectful, two-way communication. Families wish to collaborate with providers who listen and value their input in a respectful and strength-based way. Clearly explain all aspects of the residential intervention, and get to know family members⎯take time to learn about their strengths, interests and hobbies, cultural backgrounds, goals, challenges, and the daily, weekly, and monthly rhythms/celebrations of the family. Explore with them what skill sets they believe they need, and support them in increasing their understanding and knowledge about the specific challenges their child faces.

Expect parents to be the parents. Include parents in all decisions about their child. This includes Child and Family Team meetings (i.e., meetings do not occur without the parent physically present; do not rely on parents calling in; instead, schedule the meetings at a time and place that is convenient for the family, and have staff who are not able to be present call in). Include parents in educational decisions, selection of food offerings, types of “amends” preferred if a child does something that negatively impacts others or the environment, medication decisions, medical appointments, haircuts⎯everything. Staff can inadvertently make parents feel sidelined when their child is receiving a residential intervention. Extra effort to engage, involve, and support parents will keep them engaged and will yield better long-term outcomes.

Communicate with families often, and include good news as well as concerns. Provide hope for the future, and help families to adjust to the new parenting reality they enter when they start a residential intervention. The trauma of separation can be overwhelming for the entire family. Minimize the impact. Many programs have different staff call and/or email parents at least once daily, throughout the duration of the residential intervention. Some programs require a certain number of contacts weekly (e.g., ten or every day).

Acknowledge the family’s loss and trauma. When residential interventions are needed, family members have already experienced significant loss and trauma. Acknowledge and empathize with this trauma, and understand that family members may have a range of responses to initial attempts at engagement. Foster a sense of hope and resilience at first contact with the family, and continuously.

Preserve normalcy for the family. To effectively engage families, residential organizations involve them in the day-to-day lives of their children⎯not as “visitors” but as parents. Encourage children to call their parents multiple times daily. Also, encourage youth to be in touch with siblings, important extended family members, and/or important and approved fictive kin as often as helpful for each individual child. One of the key goals of residential interventions is to not just maintain but to heal and strengthen these connections. Eliminate rules on visiting hours; limit phone calling times; and require youth to “earn” time with family members at home, in the community, and/or at the program. If safety issues are a concern, prepare and make staff available to be with the child and family.

Beginning pre-admission, plan for aftercare and discharge, including connecting with community providers. The goal of residential intervention is to support long-term success for the family at home. If possible, programs can stay engaged with families for several months post-discharge; they can also establish connections with community providers at an early stage to plan for a seamless transition.