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Michael Botticelli, MEd, Co-PI Jen Parks, MSW Massachusetts Dept.

of Public Health Bureau of Substance Abuse Services

Norma Finkelstein, PhD Terri Bogage, LICSW Jordana Willers, MEd Institute for Health and Recovery

Jan Nisenbaum, MSW, Co-PI Kim Bishop-Stevens, LICSW Massachusetts Dept. of Children & Families

Deborah Garnick, ScD Margaret Lee, PhD Grant Ritter, PhD Brandeis University Heller School for Social Policy and Management

The Family Recovery Project
What is the Family Recovery Project (FRP)?
FRP provides intensive home-based services for DCF-involved families affected by substance use whose children have been removed or are at risk of removal. FRP also aims to increase communication and training across systems throughout the region, on behalf of its family recovery model.

This project is funded by a federal grant from the Children’s Bureau of the U.S. Administration for Children and Families

What are our goals?
•  Improve

the well-being, permanency outcomes and safety for

children. •  Improve parents’ stability in recovery, well-being, and family interactions. •  Improve children’s developmental outcomes. •  Improve system-level capacity and effectiveness in Hampden County. •  Sustain and disseminate FRP model and outcomes across the state and nationally.

“Recovery means finding out who I am and what I’m capable of. Every day is still recovering —what I lost; what I haven’t had. FRP changed my whole approach to staying clean.”
Service Coordination: •  FRP helps to engage families in community-based treatment services (for substance abuse, mental health, physical health, domestic violence, etc.) •  FRP matches families with supportive services (such as transportation, childcare, job training, employment, education, and parenting education).

Who does FRP serve?

Families who: •  Are currently struggling with substance use – they may be actively using, they may have tried and failed at treatment a number of times, or they are in early recovery, •  Are impacted by parental substance use and are not actively engaged in community-based treatment AND •  Who have children at imminent risk of placement, or children who are in out-of-home placement with the goal of reunification.

What is our treatment model?
Assertive outreach and engagement Family-centered, strengths-based, trauma-informed approach Ongoing intensive case management services: •  Substance use treatment •  Co-occurring disorder treatment •  Guidance and advocacy for the family •  Evidence-based models used: Motivational Interviewing (to engage parents in recovery) Child Parent Psychotherapy (to improve parent–child attachment) Nurturing Program (to improve parenting skills and empathy) Seeking Safety (to help heal the impact of trauma)

Advocacy with the child welfare system, the courts, the schools, and other service providers

What is our model for cross-systems collaboration?
•  The

Why In-Home vs. Community-Based Services?
•  Reduces

ambivalence •  Eliminates many barriers, including transportation, child care, and stigma •  Enables the clinician to work with other family members to support family recovery.

“If I got to talk to a legislator, I would say that this is a program that is very, very deeply needed because this program puts families back together, and it really works, and is very helpful.”
Outcomes Social Support, Trauma Symptoms and Psychological Distress at Baseline and Discharge Percent Reentries to Foster Care in < 12 Months Membership in Family Recovery Council of Hampden Co.

Family Recovery Council of Hampden County is comprised of providers from many different systems that work with families in recovery (including substance abuse treatment, child welfare, mental health, health care, Early Intervention, attorneys, corrections, domestic violence providers, community-based support services, schools, universities, law enforcement, etc.). •  The Council meets regularly to increase cooperation, communication, and collaboration across systems. •  The Council has hosted several Family Recovery Conferences, sponsored many cross-trainings among substance abuse and child welfare workers (as well as other providers, including attorneys), and developed a communication protocol which is being disseminated throughout Hampden County.

What are our outcomes?

Social Support, p<.05 Trauma Scale, p<.01 Psychological Distress, p<.05

Participants Organizations

(see graphs) •  Trauma symptoms are significantly reduced. •  Social supports are significantly increased. •  Psychological distress is significantly reduced. •  Children are less likely to re-enter foster care. •  Providers from many service systems are communicating and collaborating.

35 30 Mean Score Percent 25 20 15 10 5 0 Baseline Discharge
T-tests conducted for matched baseline to discharge, N=40. Data received by evaluation team as of 31 Mar. 2012. Social Support: Hight indicates more support. Highest possible is 42. Trauma Scale: Higher indicates more trauma symptoms. Highest possible is 68. Psychological distress measured with the BSI-18. Higher indicates more negative symptoms; scores range from 0 to 72.

35 30 25 20 15 10 5 0 FRP* Mass.† Hampden Co.† * FRP data received as of 9/30/11. † Children and Family Service Reviews (CFSR) measures for 12 mo. ending 12/31/11. 6.0% 16.2% 16.4%

Number of Orgs & Participants



150 120 90 60 30 0 2007 2012

Looking Ahead

Evaluation: •  Continue to collect and analyze data on service impact on child and family outcomes. •  Share results at the local, state, and national levels. Sustainability: •  Work with funding sources to sustain the FRP service model. •   Institutionalize collaborative processes and communication protocols to continue cooperation between substance abuse treatment and child welfare agencies. Replication: •  Institutionalize FRP’s service model in Hampden County and across Massachusetts, securing services for future children and families involved with the child welfare system. •  Disseminate lessons learned to statewide and national audiences.

Membership includes representatives from substance abuse treatment, child welfare, early intervention, legal system, mental health, health care, community-based programs, housing, and law enforcement.