Welcome Consumer Centered Family Consultation

1. Welcome Consumer Centered Family Consultation • Webinar start time is June 2, 2010 at 12 o’clock • To download the three resources for this webinar go to: • nysfamilyinstitute.org • Decision Guide • PowerPoint • Brochure

2. Webinar Resources Family Institute for Education, Practice & Research University of Rochester, Department of Psychiatry, Rochester, NY New York State Office of Mental Health Department of Health Albany, NY Anne Smith, LMSW, Director Beth Hoh, LCSW-R, Faculty James Evinger, MDiv, Research Coordinator Sherri Ladd, MHA, Information Analyst Anthony Salerno, PhD, Co-Director Evidence Based Practice Initiatives, NYS OMH Michael Holley, LCSW, Deputy Director Bureau of Inspection & Certification, NYS OMH John Johnson, MA, LCSW-R, Director Family Outreach Services, Creedmoor Psychiatric Center, Queens, NY (1) Doris Joy, RN, LCSW-R, Director Family Services, South Beach Psychiatric Center, Staten Island, NY (1) (1) Faculty, Family Institute for Education, Practice & Research 2 2

3. Series of three webinars Webinar 1: Engaging Consumers Webinar 2: Engaging the Family Webinar 3: Consumer Centered Family Consultation (CCFC) The purpose of these webinars is to provide information and practical tools and resources to assist agencies to meet quality Practice standards 3 3

4. Today’s Agenda • Brief review of Webinar 1: Engaging the Consumer • Brief review of Webinar 2: Engaging the family member(s) • The CCFC Approach (CDP)

5. Webinar 1 ReviewEngaging the Consumer • Open and frank discussion about involving others (family, close friend) to support one’s treatment and recovery • Emphasis is on transparent description of CCFC, especially showing the consumer what information will be part of the consultation • Use of a structured decision making guide that is a tool for both the consumer and the clinician

6. Defining CCFC with the Consumer What is it? This means defining the focus as well as the limits of the consultation process Why is this important? • To insure that the expectations of the consumer are met. The consumers decision was based on the clinicians description of the purpose and focus of the CCFC • To insure that the information about the CCFC services provided to family members via the CCFC brochure and phone conversations will be honored. • To insure that the CCFC will not evolve into family therapy which requires more time and specialized clinician training and supervision. • To keep the focus on the nature of consultation: Information, education and general guidance How is this done? Describe the CCFC approach Review the brochure Give out informational handouts Keep to the agenda

7. Defining CCFC with the consumer:Key points (con’t) • CCFC is a brief service (1-3 meetings which is decided on by all parties) • There are limits to the CCFC service • Highly meaningful concerns and issues that go beyond the scope of the CCFC may be addressed by other resources and services in the agency or community • CCFC is not designed to solve complex and long standing problems and conflicts.

8. Defining CCFC with the consumer:key points (con’t) • CCFC is primarily an approach that: • Establishes a partnership among the consumer, family members and clinician who is familiar with the consumer • Emphasizes information, education and general guidance • Enables the clinician and consumer to obtain family member(s)experience and ideas that may contribute to the quality of the service plan • The consumer’s preferences and wants are at the center of the CCFC approach

9. CCFC Decision Guide: A Shared Decision Making Tool to Inform and Engage the Consumer • Designed to assist clinicians with the informing and engagement process with consumers of mental health services • Tool to aid the consumer with their decision making process on the specifics of who to include (or not to include) in their recovery process, when, where, how and for what purpose. (This can be found on the FI website)

10. Webinar 2 Review:Engaging the Family Member(s) • Provide family member(s) with a clear understanding of the purpose and limits of a CCFC • Invitation to participate in a brief CCFC extended by consumer, clinician or both • Use of a CCFC brochure that provides family member(s) with information that assists the family member to make an informed decision about getting involved

11. Consumer Centered Family Consultation 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. (This can be found on the FI website)

12. Consumer Centered FamilyConsultation Multiple sources of information and philosophies are embedded in the model • Edie Mannion - Family Consultation of Berks County, PA • William McFarlane - Multifamily Psychoeducation Groups • Diane Marsh - Serious Mental Illness in the Family • Ian Falloon – Family Guidelines • Kim Mueser & Shirley Glynn – Behavioral Family Therapy • Lisa Dixon – PORT Study Recommendations • Others…Shared Decision Making, Motivational Interviewing, Stages of Change

13. Overview of the approach The CCFC has three major aims: • Identifying and engaging others to be part of the consumers circle of support. It is an approach to promote the initial & subsequent contact between the family and the clinic. It could also serve as an opportunity to reconnect with families whom you have already had contact, in a formal manner • Create an opportunity for the clinician to learn from the experiences of the consumers family member(s) • Offer family members information and guidance that may increase their willingness and ability to support their loved one’s treatment and recovery

14. Consumer Centered Family ConsultationShort-term Intervention 1-3 meetings • Consumer • Family/chosen supports • Clinician Similar to other consultations -Information & goals of the consultation are solicited from the customer (consumer & family) -Education is provided -Information & choices are given -Follow through is up to the customer (consumer & family)

15. Basic Underlying Assumptions of the CCFC Approach Consumer’s benefit when… • The people in their lives (family and friends) have a better understanding of their mental health problems, possible causes, treatment, services and hope for recovery • Family and friends have an opportunity to get guidance and support • CCFC is focused on partnership building

16. PARTNERSHIP BUILDING Consumer Centered Family Consultation Consumer Consultant Family members

18. CCFC: Gateway to other Family Services on a Spectrum of Family Services Menu • Agency Led Services • Integrate family into the intake, assessment and ongoing care as agreed upon by consumer • Consumer Centered Family Consultation • Family Support Groups • Multifamily Groups • Resource Library • Family Information Nights • Family Education Curriculum • Behavioral Family Therapy • Community Led Services • National Alliance on Mental Illness • Family to Family • In our own Voice • Monthly support groups

19. Consumer Centered Family ConsultationCDP Method Connect Goal: Get to know each other-Social conversation to make everyone comfortable. Express appreciation to the consumer and family member(s) Define & Prioritize Wants & Needs Goal: Establish a focused agenda with the consumer & their family, prioritize the merged agendas and get endorsement from the consumer Provide and/or Plan Next Steps Goal: Provide the consultation service that emphasizes information and education that promotes understanding, guidance and access to mental health related resources. Inform the parties of additional resources as needed

20. Connecting What is it? Connecting means the use of your personal communication and listening skills to build rapport and establish trust Beginning the meeting: • Welcoming and appreciating the efforts of the consumer and the family to attend this meeting • Introduce self: role in the program and role as a family consultant • Social conversation- small talk to enhance comfort (note: in some cultures there is a preference for the professional to maintain a higher status and a more formal demeanor) • Ask family and consumer if they have any other questions about the CCFC meeting

21. Connecting Throughout the engaging process and the CCFC meetings, the clinician is continually connecting with both the consumer and the family member(s) How? • Receiving and giving information in a transparent manner • Emphasizing consumer strengths, family strengths and hope for recovery • Listening and empathizing

22. DEFINING & PRIORITIZING WANTS & NEEDS Acknowledging: Communicates to consumers, family & supports state their needs and wants are understood Setting Goals: Helps consumer, family & supports to convert their needs and wants into achievable behavioral goals Prioritizing: Helps consumer, family & supports to establish which needs and wants they will address first, based on the criteria: safety, avoiding relapse, and facilitating recovery. Managing the Agenda: Manages the agenda so that consumer, family & supports can attain their goals and address needs and wants that emerge during the consultation.

23. Planning/Providing Next Steps Receiving Information: Communicates to consumer, family & supports that s/he wants to receive information about changes in their needs and wants and asks for continuous feedback about the value of the consultation Teaching: Presents information about serious mental illness targeted to the goals in a concise, understandable format. This may be accomplished in one meeting Referring: Explains services that would help them attain their goals and offers plans by the most efficient means of accessing other services when they agree. Referrals may be to other areas on the Spectrum of Family Services menu, either within the agency or in the community

24. Four major areas addressed in a CCFC Throughout the Consultation process there are four major areas that may be addressed: Area 1:Basic information about mental illness, treatment, causes and services offered Area 2:List of guidelines and tips on useful ways of helping a relative with mental health problems Area 3: Information about resources in the treatment setting (agency) and the community for consumers and family members Area 4: Experiences and knowledge family members have that may add value to the current service plan

25. Go Slow Keep it Cool Keep it Warm Give each other space Set Limits Ignore what you can’t change Keep it simple Follow the Tx. Plan 9. Carry on as usual 10. Take care of yourself 11. Avoid Street drugs & alcohol 12. Pick up on early warning signs 13. Solve problems step by step 14. Lower expectations temporarily The Family Guidelines

26. Do’s of consultation • Start each meeting with casual conversation & review objectives • End each meeting with casual conversation and summarizing • Collect information ahead of time with the use of the Consumer & Family Needs Assessment Survey • Be prepared with handouts and other educational materials

27. Don'ts of consultation • Stick too rigidly to the plan, remember needs may change so be ready to adapt and be flexible with the agenda • Turn the meeting into family therapy Note: There is a place for family therapy if the consumer and family desire this, but not in a CCFC- referrals can be made if needed

28. If’s of consultation • If you are asked a question you cannot answer, say so and offer to find out the answer and get back to them • If there is a crisis, address it, but plan to reconvene for the CCFC at a later time

29. Sample Progress Note Topic areas included on the Progress Note include: • Consumer’s indentifying information • Engagement section • Areas identified by the consumer and family to be addressed in a consultation • Consultation services provided • Disposition (this can be found on the FI website)

30. Resources Available atwww.nysfamilyinstitute.org • Decision Guide • CCFC Brochure • Consumer & Family Needs Assessment • Family Guidelines • Power Point slides of all three webinars • Recording of all three webinars • Library with many useful resources that you can use in a CCFC

31. For Information or AssistanceAnne Smith, LMSW AnneM_Smith@urmc.rochester.edu Family Institute for Education, Practice & Research University of Rochester Department of Psychiatry 315 Science Parkway Suite 400 Rochester, New York 14620 Telephone: 585-279-7903 www.nysfamilyinstitute.org