Families Matter: A CCFC approach to helping ACT recipients achieve their recovery-oriented goals

1. Families Matter: A CCFC approach to helping ACT recipients achieve their recovery-oriented goals • Thomas Jewell, PhD • Pascale Jean-Noel, LMSW • October 23, 2012

2. Consumer Centered Family Consultation 2 2 2 2 2 2

4. Engagement and Planning Engagement conversation(s) with consumer Pre-planning Meeting(s) with consumer Outreach conversation(s) with family/supports

6. Similar to other types of consultations… • Information and goals of the consultation are solicited from the customer • Education is provided • Information & choices are given • Follow through is up to the customer

9. Pre-Planning Meeting • 1-2 conversations between consumer and practitioner • Emphasis: Consumer is in the “driver’s seat” and has choices • Plan: the goals/issues to discuss during CCFC (and what not to discuss) • Plan: outreach method to family/supports • Prep: the family often wants to share some perspectives and experiences • Discuss: how to handle “curveballs”

10. Decision guide for involving family or friends to support treatment and recovery What is this guide about? This guide helps adults with mental health concerns and their clinicians. It’s a tool for making decisions about whether and/or how to involve family members or friends in support of recovery goals and treatment.

12. Review Decision GuideCopies of the Decision Guide are available on theFamily Institute website (see “Resources”):www.nysfamilyinstitute.org

13. How many conversations did it take to engage a consumer before s/he said “yes” to CCFC? • 2.43 conversations (on average) • 19% indicated an average of 1 time • 9% indicated an average of 1.5 times • 34% indicated an average of 2 times • 8% indicated an average of 2.5 times • 17% indicated an average of 3 times • 10% indicated an average greater than 3 times • Anyeffort made by the clinicians to engage with consumers about expanding their circle of support adds value to the service provided Less than one-quarter of consumers said “yes” after initial engagement attempt

14. Tips for Outreach with Family/Supports • Set aside enough time to discuss CCFC • Introduce yourself with a focus on your role in helping consumer • Share some personal aspect(s) of yourself to foster genuine relationship building • Explain that this is a proactive phone call and not crisis oriented • Make sure to tell them that this is not family therapy • Explain the CCFC model (e.g., may help to use the brochure)

15. Tips for Outreach with Family/Supports (Con’t) • Explain: this is consumer driven and their loved one has given permission for everyone to talk with one another • Ask if they are interested in participating in the recovery of their loved one in a specific way. Let them know it’s time-limited. • If interested, set up a time and work out logistics (date, time and location) • If not interested, ask if you can call them again in the future and give them your phone number for them to call if they change their mind • Thank them for their time and consideration and end with comments that instill hope

16. CCFC Brochure • A brief service for consumers of mental health services, their chosen support system, and their clinician – all working together to support the consumers’ recovery process. CCFC brochure is available on the Family Institute website (see “Resources”): www.nysfamilyinstitute.org

17. Phone contacts with families… • What proportion of clinicians indicated there were usually phone contacts with families during the CCFC process? • 85% said “YES” (there were phone contacts) • Of those, how many phone calls typically took place per family? • 2.36 phone calls, on average Note: 87% indicated there were typically 3 phone calls or less

18. Phone contacts with families (cont)… • When phone contacts occurred, how long did each call typically last (in minutes)? • Mean Score = 13.38 min. (SD = 7.21) • Approximately one-half (49%) of respondents indicated 10 minutes or less • 38% indicated more than 10 minutes but less than or equal to 20 minutes • 12% indicated between 21-30 minutes

19. Sample Progress Note Consumer Name: _______________________ Date of consultation: _________________________ ID number: ____________________________ Session duration: ____________________________ Consumer present? (circle) Yes No Family Member(s):__________________________ Location: __________________________ Family Consultation: (circle session number) Relationship(s) to Consumer: _____________ (1) (2) (3) Other____________________ Consumer Engagement: Date in which the consumer signed the release of information: _________ Consumer’s expectation/wants regarding the consultation with family: _______________________ ________________________________________________________________________________ Service plan goal to be supported by the consultation? ____________________________________ Presenting goals/needs/wants: Please check all that apply and provide a brief summary. ___ Information about the consumer’s mental health issues (e.g., diagnosis, causes, treatments) ___ Problem solving (specific issue) ___ Family relationships (e.g., communication, coping strategies) ___ Support (e.g., options for linkage to professional and community sources of support) ___ Practical assistance and advocacy (e.g., navigating the mental health system) ___ Other problems/ needs/wants __________________________________________________ Consultation services provided: Please check all that apply and provide a brief summary.

20. Family Work as Best Practice People with mental health concerns who have on-going contact with their families (or wish to) should be offered a family based intervention which provides a combination of: • education about the illness • family support • crisis intervention • problem solving skills training • practical guidance Schizophrenia PORT Treatment Recommendations

21. Why do it? Preliminary evidence for the impact of CCFC Feedback from 51 clinicians described improvements in the following: • Family understanding of mental illness and substance use • Family involvement in supporting treatment and recovery • Family perception that they are better supported • Family communication and comfort with treatment staff • Consumer communication with family (quality and quantity) • Consumer comfort with and value of family involvement • Consumer perception of support/understanding by others • Consumer communication and comfort with treatment staff • Consumer treatment engagement/involvement • Consumer recovery-oriented outcomes

22. In addition to CCFC, what othersupports are available? • The Spectrum of Family Services • Community Led Services • NAMI - many services (www.naminys.org) • Family to Family Education Program • Monthly support groups • Information nights • Agency Led Services • Integrate family into the intake, assessment and ongoing care as agreed upon by consumer • CCFC (additional meetings) • Family Support Groups • Resource Library • Family Information Nights • Family Education Curriculum • Family Therapy/Behavioral Family Therapy

25. Contact Information for Presenters • Thomas Jewell, PhD • jewellt@nyspi.columbia.edu • 585-474-8684 • Pascale Jean-Noel, LMSW • jeannoe@nyspis.columbia.edi • 212-543-5464