This report is the result of a three way partnership, between the Australian Government (FACS) who funded the operational costs, the Baker Foundation funding the Action Research and Harrison providing the professional expertise.
A number of strategies were outlined by the Department of Family & Community Services to measure the activities of the project.
A discussion of those agreed activities against agreed performance indicators is included below,
STRATEGY NO 1.
To provide immediate support to families in crisis in the geographical area of Eastern Metropolitan Melbourne (Whitehorse, Maroondah, Yarra Ranges, Booroondara, Manningham, Monash and Knox municipalities)
1.1 Activities to Achieve Strategy
- To receive referral of approximately 80 young people and families over one year and respond to referrals / requests for support and assistance within 24-48 hours
1.2 Performance Indicators
- To provide support provided to approximately 80 young people and their families over the duration of the project (June 2004 – May 2005)
- To provide assessment and referral acceptance within 1 week of referral
- Between weeks 2-8, to provide intensive support services including referral to – family mediation, respite care, counselling, parenting program.
- Between weeks 8-12 providing to provide a continuation of counselling or therapy services
OUTCOME
- Client Numbers
- Performance Indicator: 80 families (June 2004 – May 2005).
- Actual Performance: 108 families (June 2004- March 2005).
- Geographic Location of Families Serviced By Uniting Families.
The Local Government Area of Knox and the Shire of Yarra Ranges account for 78% of referrals to the Uniting Families Program. In Harrison, since 2003 made a commitment to creating strong links with local secondary colleges. In conjunction with Regional Extended Family Services (REFS) Harrison developed strong ties with the Upper Yarra Secondary College school community and a decision was made based on the activities of United Extended Families to develop the same links with other Secondary Colleges. In the Shire of Yarra Ranges Harrison works in Upper Yarra Secondary College, Heallesville Secondary College and Monbulk Secondary College.
The development of these strong working relationships is further indicated when looking at the referral source for Uniting Families clients. 54% of all referrals have been made directly by schools. (See Table 1).
| Self |
family |
DHS |
Other Agency |
Schools |
| 1 |
44 |
2 |
3 |
58 |
| |
|
|
|
108 |
- Cultural background / Identity of Client Families.
The cultural identity of clients is captured on the referral form. Of the 96 clients 85 identified themselves as being of Anglo Saxon background. The cultural backgrounds of other clients is shown in Table 3.
Table 2. Cultural Identity of Families
| Cultural Identity |
No |
| Anglo Saxon |
88 |
| Italian |
2 |
| French |
1 |
| Dutch |
1 |
| German |
2 |
| Malaysian |
2 |
| |
96 |
- Response Times
The response time bench mark for making contact with families within 48 hours was achieved in 85 % of cases.
| Within 48 hours |
Within 1 week |
One Week Plus |
No Meeting Held |
| 36 |
44 |
21 |
7 |
| |
|
|
108 |
- Length of Interventions.
The targeted length of time to have a file active is three months. This was achieved with 76% of cases that were active and then closed throughout the project.
Graph 1
- Interventions.
The following graph shows the interventions utilised throughout the project. It was common for families to access more than one intervention.
Graph 2.
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STRATEGY NO 2.
Offer family mediation services
2.1 Activities to achieve strategy
- To provide family mediation service.
2.2 Performance Indicators
- Evidence documented of improvement in family circumstances after family mediation provided to families.
Families involved in mediation are given a typed copy of all agreements made. It is standard practice to review how the agreements have held in the second and subsequent mediations. If there have been some difficulties in family members meeting their agreements, further solutions are explored with the family prior to moving onto further negotiations.
This monitors the effectiveness of the mediation process and allows the mediators to assess in conjunction with the family whether this intervention is improving family circumstances.
Mediation is deemed to be successful when the family has met weekly and has the agreements in place.
Worker assessment of a families situation (in conjunction with the family), as case noted, is the formal recording mechanism for improved family circumstances.
A follow up and review/check is made of the family situation one month after the conclusion of mediation.
Formal evaluation of the improved circumstances occurs at case closure. Anonymous feedback is sought via a client feedback survey at case closure (see Attachment 2). This survey asks participants to give feedback on how they rate the service they received and about their changed family circumstances.
Over the period covered by this report eleven client surveys were returned. A summary of these responses is included (see attachment 3). The following, is a compilation of how respondents found the mediation process.
Q5. Did you find the mediation process helpful?
Please explain.
- I felt there was support for both sides and most times I did not feel isolated.
- I found the mediation process helpful by finding out what really causes me and my father to get into arguments and yelling at each other.
- I couldn't do the mediation process
- Helped us realise what was important and what was not
- The strategies that we put into place, I believe helped us enormously.
- Think it helped my daughter more than me. Some of the issues discussed, and agreed to try and resolve have been thrown out the window.
- Issues were dealt with only on the surface and not to the depth of the real problems
- It is useful to have a `neutral' person sit in on discussion
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STRATEGY NO 3.
Provision of Effective Parenting Courses.
3.1 Activities to achieve strategy
- Provision of Effective Parenting” courses
3.2 Performance Indicators
- Parenting courses are run regularly at Harrison's Head Office
- An average of 6 parents attending each session
- Feedback recorded from parents attending courses.
Three Effective Parenting Programs have been run throughout this project with some thirty seven participants.
The feedback forms have been summarized and are included (see attachment 4).
A recurring theme of feedback that parents give verbally to the facilitator is that prior to coming to Effective Parenting, parents have little, if any, support system in place within their community and if they do have one, it is very tired. Most groups make an agreement amongst themselves to meet independently after their group has concluded. As the following two extracts from the client surveys state:
- Yes I have more knowledge. I feel more confident and know that there is help for us at anytime. We are not alone.
- Because we realise that other parents have similar issues and therefore we're not alone. Also realise that we can get assistance should we need to go down that track.
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STRATEGY NO 4.
Provide Clinical Family Therapy / specialist services
4.1 Activities to achieve strategy
- Brokerage provided to facilitate Clinical Family Therapy / specialist services
4.2 Performance Indicators
- Referral provided to appropriate specialist support service
Nine families were referred to Family Therapy until November 2004.
Referrals to Family Therapy were made for families for the following reasons:
- Mediation is inappropriate due to the level of parental relationship conflict impacting on the family (4).
- Parent who's support needs for strategies were inappropriate to be addressed through mediation or one to one support (2).
- Entrenched family issues that require a direct intervention (3).
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STRATEGY NO 5.
Provide Short-term respite care
5.1 Activities to achieve strategy
- Short term respite care provided to families where appropriate
5.2 Performance Indicators
- Mediation is able to proceed where short term respite care is provided
- Number of families accessing respite care is documented.
Respite, as an intervention, was not formally used throughout the project.
Workers have identified the following reasons for this and include:
- Not informing parents that we have a respite house until it is assessed as necessary to do so.
- The tight criteria around accessing a respite placement including:
The case manager must ensure:
- The young person is engaged in productive daytime activity.
- There is an available bed
- The young person is able to abide by the rules of Kilsyth House
- Young person meets the house criteria
- Young person must go home for the weekends.
Before Respite can proceed:
- The House Rules must be signed by young person after meeting with the Lead Tenant
- Agreement to pay board for young person must be signed by parent and given to administration services to instigate invoicing.
- The Client Services Manager must authorise young person's placement in Respite.
Changes to the process for accessing respite.
- In the past workers could access respite in a much more informal way, via a discussion with the Team Leader. The process now requires authorisation by the Client Services Manager. This has the effect of slowing down the process of accessing respite. Respite is now a very planned process
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STRATEGY NO 6.
Appropriate supports in at case closure
6.1 Activities to achieve strategy
- Referral to relevant support / therapy provided to families
6.2 Performance Indicators
- Families are provided with appropriate referral at case closure
Graph 3.
The following is a list of support service types in place at case closure:
Nil – The file was closed with no ongoing supports in place.
School Supports are defined as school counselors / welfare coordinator / psychologist.
Internal Harrison Program – JPET / Adolescent Support / SAAP / Counsellor
Department of Human Services.
External Counselling – CAHMS / ECASA / external counselling organization
Community – Youth Worker / Youth program.
Case closure is a very planned phase of the interventions. Families are informed in advance of the limited nature of the intervention.
Family's case files are closed with an informal ongoing case plan. Strategies are in place for managing conflict and issues that may arise. Families have been taught conflict resolution techniques via mediation. Parents have their increased skills for parenting via their involvement in Effective Parenting. Families have been supported where necessary to access external support services to address specific issues.
28% of families files were closed with no ongoing supports in place. Where necessary case plans for young people are put in place with key people in their community. In the case of students, the student welfare coordinator is often a key support that is formally put in place before the file is closed.
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STRATEGY: ADVISORY COMMITTEE ESTABLISHMENT.
Membership to include: Research person, family representatives, school welfare co-coordinators, Harrison management and staff, family therapist, FACS representative.
An advisory committee was established in September 2004. The advisory committee had both internal Harrison representatives and external representatives.
All advisory committee members were stakeholders in this project. The advisory committee met three times. Terms of Reference were developed. These identified the roles and responsibilities of the committee throughout the project.
ADVISORY COMMITTEE TERMS OF REFERENCE
- The Uniting Families Advisory Committee will meet to consider the quarterly report and to monitor target numbers and strategies used by the program including:
- Crisis Response
- Family Mediation
- Family Therapy
- Respite Care
- And appropriate referral if required at case closure.
- The Uniting Families Advisory Committee will meet to review strategies used in service delivery and to provide suggestions for improvement in the delivery of the program.
- The Advisory Committee will receive regular updates from the appointed researcher and will review reports when provided.
Activities of the Advisory Committee.
All reports to FACS were circulated to committee members for their consideration.
The committee was instrumental in setting an agenda for Uniting Families workers and programmatic practise in a number of key areas.
A number of questions or clarification were sought by the committee on program components and practice within the project. These questions are listed below. Explanation of the work undertaken by staff will be discussed under staff development [workers tool kits]).
CRITERIA:
The program has clearly defined criteria. In reality what is the informal program criteria?
RESPITE:
The need for Respite Care has decreased over the years and this may be due to early intervention with the families, yet there is no documentation on the reasons for the decrease.
What strategies have reduced the need for respite?
The picture of respite is not accurate – no data was captured on the number of Kith & Kin placements.
Respite is an important option and the reduced use of it should not be taken as a sign of success in itself. In some cases the damage can be very harmful if the option is not available to them.
REASON FOR REFERRAL
Why people were referred to the program was not captured in the initial data collection –eg. Information that captures -
- What made them contact us now and not earlier?
- What sort of things will the program respond to?
- What sort of things won't the program respond to?
An amendment was made to the referral document to capture what event the family identified as the `trigger' event that lead them to make a referral to the Uniting Families Program. That information has been included in this report.
MEDIATION
Mediation and how it functions within this program needed to be documented. The way Harrison operates its mediation program is unique, it needed to be captured. A change to the word Mediation to 'Supported Mediation' would soften the clinic edge to the intervention and to acknowledge that the primary case manager plays the lead role in Family mediations within the program.
ACTIVE INITIAL ENGAGMENT
Documentation of 'Active Initial Engagement' is required as this is a vital part of working with the families and encouraging their trust in the first stages. This was seen as instrumental to the success of meeting the referral benchmarks.
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STAFF CONTRIBUTION TO PROGRAMMATIC DEVELOPMENT.
Staff were instrumental in the development of the documentation included in this report. After each committee meeting, questions on terminology and worker practice were taken back to the staff team of Carole Berendse, Tess Cawse, Helen Hunt, Kevin Maher and Paula Milburn for discussion and debate. The staff team met monthly to consider the following:
Components
- Respite
- Mediation
- Family Meetings
- Assessment and assessment tools
- Capturing of data
- Active Engagement
- Program Criteria
They also met twice with the researchers in a focus group.
Outcomes from these meetings have been instrumental in the sharing of practice wisdom with the advisory committee and also in the compilation of this report. Much of their work has informed the discussion included in this report on Respite, Mediation, Family Meetings, Assessment and assessment tools, capturing data and Active Engagement.
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Bibliography
Coote, Sherrie, Family Reconciliation Program Model of Practice & Outcomes, Melbourne, UnitingCare Harrison Community Services, 2000
UnitingCare Harrison Community Services UnitingCare Harrison Community Services Policy & Procedure Manual (SAAP), Melbourne, UnitingCare Harrison Community Services, 2000
L. Scorsonelli & M. Mayne, Evaluation of the Uniting Families Program – Draft Literature Review V2.0, Health Outcomes International Adelaide, 2005
L. Scorsonelli & M. Mayne, Evaluation of the Uniting Families Program – Draft Key Findings & Learnings Health Outcomes International Adelaide, 2005