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«National Wraparound Initiative 2010 Webinar Series Webinar 2: Wraparound Practice April 20, 2010 Mary Jo Meyers, MS Wraparound Milwaukee Marlene ...»

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National Wraparound Initiative 2010

Webinar Series

Webinar 2: Wraparound

Practice

April 20, 2010

Mary Jo Meyers, MS

Wraparound Milwaukee

Marlene Matarese, MSW and Kimberly

Estep, MA

Innovations Institute, University of Maryland,

Baltimore

Goals for this Webinar

1. To provide information on the how and why of

implementing a team-based wraparound model

2. To provide an overview on the rationale for coaching

and training in wraparound

3. To describe elements of optimal training in wraparound

4. To describe elements for coaching and supervision of staff

5. To identify ways to use data to support implementation and training/coaching in wraparound

6. To provide an example wraparound practitioner certification model Why Teams?

Case Management Team Facilitator

• Assesses the problems & • Guides team needs of client development and oversees process & tasks

• Arranges, coordinates, of team members monitors and evaluates services based on • Child, family & identified needs community are central nucleus of services with

• Generally utilize a family & community categorical approach viewed as most effective means of support Categoral Approach

• Assess problems

• Look at services that are available

• Arrange services for the family Concerns Regarding Categorical

• Services reflect what is available and has been tried rather than what is needed

• System involved children often receive a “placement” rather than what they need to stay with their family Teams & Wraparound

• Three types of team members – Natural: connected to family by relationship – Informal: connected to family by citizenship – System: paid to help

• Potential team members are generated through initial conversations prior to first team meeting

• Families are encouraged to invite their supports to keep us on track

• Helps move the team conversation from “treatment” or “service” orientation to a “life” orientation Pat Miles Benefits of Teams

• Family benefits from a single plan of care; everyone on the same page

• Shared knowledge

• New ways of thinking

• Better use of resources

• More help and more strengths to build upon

• Shared responsibility and accountability

• Better representation and respect for family culture Most Common Misses

• Staff who do not know why or how

• Mistaking reluctance for resistance; thinking no always means no

• Telling families informal and natural supports are invited so we can work ourselves out of a job

• Team meetings run inefficiently and ineffectively

• Process doesn’t lead to a product

• Underestimating family and team engagement and not discerning between the two

• Mistaking fidelity to a process as quality care or success for a family Supporting Wraparound Practice

• In addition to the Principles and the Phases and Activities, we also need to ensure “Necessary Support Conditions”

These Necessary Support Conditions Include:

• Human resource development: Do we have the right jobs, caseloads, and working conditions? Are people supported with coaching, training, and supervision?

• Accountability: Do we use tools that help us make sure we’re doing a good job?

Walker, J. & Bruns, E. (2010). Overview to Wraparound: The Principles, practice model, evidence base and necessary implementation supports. National Wraparound Initiative presentation on March, 2010.

Implementation with High Fidelity Requires… State County Context Support & Readiness

–  –  –

Orientation & New Knowledge (Gingiss, 1992; Blase,) Training is a Core Component in Implementation Training in a high-quality wraparound practice model should

include the transfer of:

•Knowledge – History, theory, philosophy, and rationales for wraparound as a practice model

•Skills and Abilities – About the components of wraparound and demonstrating the practice elements – Followed by behavior rehearsal to practice the skills and receive feedback on the practice (Blase et al., 1984; Joyce & Showers, 2002;Kealey, Peterson, Gaul, & Dinh, 2000) (Fixsen, Naoom, Blase, Friedman, & Wallace, 2005) Components of Effective Training

• Training is delivered through lecture and discussion for knowledge dissemination and understanding of content.

• Training is most effective when it includes the presentation of information and the participants are given the opportunity for practice around key skills in the training setting (Joyce & Showers, 2002).

• Training combined with coaching create conditions in which quality implementation happens and are important components to achieve positive outcomes (Joyce & Showers, 2002).

(Fixsen, Naoom, Blase, Friedman, & Wallace, 2005) Components of Effective Coaching

• Coaching needs to be based on the practice model, readily available, and reflective

• Spouse (2001) described four main roles of

a coach:

• Supervision

• Teaching while engaged in practice activities





• Assessment and feedback

• Provision of emotional support (Fixsen, Naoom, Blase, Friedman, & Wallace, 2005) Use of Instruments that Provide Data to Guide Coaching

• Wraparound Fidelity Assessment System – Community Supports for Wraparound Implementation – Wraparound Fidelity Instrument IV – Team Observation Measures – Document Review Measure

• Caregiver/Youth satisfaction Surveys How WFAS Data Can Be Helpful

• Provides standards of quality for wraparound implementation

• Encourages best practices for care coordination & family support

• Encourages families to “be part of the solution” and reinforces family voice

• Directly impacts training and coaching strategies

• Influences procedural change within care management entities Data to Guide Training and TA Impact of Training and Technical Assistance (IOTTA)

• Standardized survey developed by Portland State RTC and Wraparound Evaluation Research Team

• Participants in training or professional development effort are sent email with link to a web survey on quality of training and impact on their work

• Survey is completed immediately after training and 2 months later

Innovations Institute Coaching Model:

Certification of Wraparound Practitioners

• Certification of Care Coordinators

• Certification of Family Peer-Support Partners

• Certification of Youth Peer-Support Partners

• Certification of Supervisors

• Certification of Coaches Steps in Developing a Model for Coaching and Certification

• Regular consultation with national experts

• Facilitation process with national experts in identification of key elements that are unique to wraparound

• Development of a matrix that outlined and defined key elements, skill sets, outcomes, and tools

• Repeated revisions and feedback from consultant group

• Development of a model for training and coaching in wraparound Overview of Innovations Model for Wraparound Practitioner Certification Overarching ecological framework (inclusion of action oriented teams and collaboration in this framework) Key elements of high quality practice in

wraparound include:

• Grounded in a strength-perspective

• Determined by families

• Driven by underlying needs

• Invested in accountability and results Innovation Institutes’ Model for WA Practitioner Certification Cont’d…

• Key elements were defined

• We went across the 4 phases of WA and identified key activities that should occur in connection with each element

• Connected those activities to essential skill sets

• Walked through training curricula and coaching model to ensure alignment with these elements, activities, and skill sets.

• Process continued for each certification group Tools Used in Certification

• Team Observation Measure

• Document Review Measure

• Wraparound Practice Improvement Tool Wraparound Practice Improvement Tool

• Designed to support supervisors and coaches in providing feedback to front-line workers.

• Focuses only on Phase 2 and 3 of wraparound (Initial Plan Development and Plan Implementation).

• Broken into 2 checklists each for Phase 2 and 3: the first is designed to monitor how the care coordinator is managing the details generally associated with effective wraparound implementation. The second is designed around the extent to which those elements reflect quality practice.

Process Used in Training and Coaching Coaching with Innovations staff will involve following supervisors and front-line staff as they partner with families utilizing the wraparound practice model and moving through the phases of wraparound. Thus, coaching will focus on supporting all staff to move toward high-fidelity and quality wraparound

practice during each phase as outlined below:

Phase 1: Engagement and Team Preparation

• Provide support and direction around engaging families

• Provide support and direction around engaging team members

• Synthesizing multiple perspectives to create a comprehensive family story

• Preparing for team meeting, including prepping the family and team members

• Create a sense of underlying needs and the direction the conversation should go within the Child and Family Team (CFT) Meeting utilizing a strengthsbased perspective and connection back to the family vision Coaching around phase 1 will occur during first face to face Meetings with the family, calls with potential team members, and during supervision with staff.

Process Used in Training and Coaching Phase 2: Initial Plan Development

• Provide support and direction around facilitation of CFTs

•Getting to the underlying need, ensuring ‘best-fit’ between steps in the process and strategies prioritized, and reaching consensus within the CFT

•Working with supervisors around how to support staff in these efforts Coaching around phase 2 will occur during prep meetings prior to the CFT, during the CFT, and debriefing after the CFT.

Coaching will also occur during staff supervision.

Process Used in Training and Coaching Phase 3: Implementation

• How to continually engage families and monitor task completion, progress toward need met, and movement toward achievement of family vision and team mission

• Facilitate a deeper understanding of underlying reasons behind situations and adapt strategies based on new information

• Continually working with supervisors around how to support staff in these efforts toward high-fidelity and quality practice Coaching around phase 3 will occur during face to face family meetings between CFTs, prep meetings prior to the CFT, during the CFT, and debriefing after the CFT. Coaching will also occur during staff supervision.

Process Used in Training and Coaching Phase 4: Transition

• How to communicate with families and team members that the formal wraparound process will end throughout the process

• Ensuring the family perspective of met need is used to identify and develop transition activities

• Did we make a difference? How to track progress made and celebrate the successes Coaching around phase 4 will occur during face to face family meetings between CFTs, prep meetings prior to the CFT, during the CFT, and debriefing after the CFT. Coaching will also occur during staff supervision.

Model for Certification Care Coordinator

• Minimum of one year coaching

• Completion of Core Training and Training Units categorized by knowledge, values and skills

• Demonstration of competency in all phases of wraparound

• Completion of 3 Passing Team Observations (1 by Innovations, 2 by supervisor)

• Completion of 3 Passing Document Review Forms (1 by Innovations, 2 by supervisor)

• Annual recertification is required

• All interactions with Innovations staff during coaching will include the direct supervisor of staff and the care coordinator. All staff must demonstrate proficiency in their role and develop an in-depth understanding of quality wraparound practice.

• This process would occur over an 18 - 24 month period

• Considering the testing of a simulated testing model

Model for Certification:

Supervisor

• Minimum of one year coaching and training – Same as CCs and in addition:

– Directive Supervision, Recruitment & Retention within the wraparound process and supervising utilizing the Wraparound Fidelity Assessment System

• Completion of a jointly completed TOM and DRF

• Completion of 2 TOMs and 2 DRFs for their team

• Supervisors must be present at all coaching sessions with Innovations staff. Supervisors will utilize the Wraparound Fidelity Assessment System (WFAS) tools in addition to the Wraparound Practice Improvement Tool (WPIT).

• This process would occur over an 18 – 24 month period Model for Certification Caregiver Peer-Support Staff

• Minimum of one year coaching

• Completion of Core Training and Training Units (SOCTI) – Same as CCs with the addition of Skills Building for Caregiver Peer Support Partners

• Completion of 3 Caregiver Peer Support Partner TOMs (in a revision process)

• Documentation Reviews (in a revision process) Model for Certification: Youth PeerSupport Partner

• Minimum of one year coaching

• Youth Leadership Retreats

• System of Care 101

• Wraparound 101

• Skill building for Youth Support Partners • 3 TUs in knowledge, skills, and values

Model for Certification:

Coaches/Trainers

• All coaches/trainers must complete the core trainings and participate in the same activities as required by the supervisors.



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