Maria Hernandez, M.S.W.,
Omayra Sellas-Lamberty, M.A.,
Stephanie H. Scott, Ph.D., A.C.S.W., M.S.S.W.,
What is Cherish The Family (CTF) ?
The goal of CTF is:
– to prevent the abandonment of children under age three who
are in the dependency system and who have been affected
by substance abuse and/or HIV/AIDS.
– Targets mothers with children (0-3) engaged in
the child welfare system
– Mothers confronting substance abuse and/or
HIV/AIDs
– Complex needs with limited access to resources
and supports that can help them
– Provide services to strengthen a parent’s ability
to care for their children, specifically promoting
family reunification and stability,
What are the theories behind
CTF?
Theoretical Frameworks
Attachment Theory:
• Kelly and Zucherman, 2003 stated
“children GROW AND THRIVE in the
context of close and dependable
relationships that provide love and
nurturance, security, responsive interaction
and encouragement for explorations.
Without at least one such relationship,
development is disrupted, and the
consequences can be severe and long
lasting. …Focusing on the caregiver-child
relationship is essential, not only because
caregivers’ interactions with their children
are developmentally critical, but also
because qualities of these relationships
need on going support.”
Theoretical frameworks
continued…
• strengthening emotional bonds, maximizing children’s
chances for optimal psychosocial development, and
interrupting the transmission of maladaptive parenting
practices across generations.
• Systems Approach
– Viewing the whole structure of systems and the
interrelationships across systems
• Trans disciplinary Approach
– Sharing roles against discipline boundaries
Staffing
•
•
•
•
1 Program Director (Part-time)
1 Program Manager
4 Master Levels Counselors
1 Data Entry/Administrative
Assistant
Training
• Master Level professionals with at
least two years of experience with
at risk families –HIV, mental Health
issues, Substance Abuse.
• Experience with children 0-5
• Counselors will be trained in
implementation of Mahoney, PSI,
and NCAST.
• Trained in promoting first
relationships curriculum.
• Solution-Focused Therapy
techniques through Reflective
Supervision
Services we offer …
• Therapeutic parenting by utilizing a
solution focused approach with the
Promoting First Relationships Curriculum
• Social emotional support
• Increasing their awareness of SA issues,
and mental health issues
• Multidisciplinary meetings
• Court Testimony
CTF’s Approach
• Collaboration with multiple
community providers
– This allows for additional types of
visits such as extended visits, sibling
visits, and visits at locations in the
community
• Links families with
– substance abuse to treatment
– mental health services
– job training and support
Partners
•
•
•
•
•
•
•
•
ChildNet
Broward regional Health Planning Council
Spectrum
Smith Community Mental Health
Broward Addiction Recovery Centers (BARC)
Healthy Start Coalition of Broward County
Workforce one
The Ounce Prevention of Florida
EVALUATION
Logic Model
Activities
Cherish the
Family:
•Case Mgmt
•Assessment
•Family
Advocacy
•Mental Health
Supportive Svcs
•Promoting First
Relationships
•Teaching the
Tough Skills
•Childcare
•Circle of
Parents
•Referral and
Follow-up
Long Term
Outcomes
Measures
90% of participants (26 sessions) will report
parenting behavior consistent with
decreased risk of child abuse and neglect
Safety Outcome 1:
Children are, first,
and foremost
protected from
abuse and neglect
Children not
reported in the
DCF Abuse
Registry (info
provided every 6
mths by ChildNet)
85% of families (26 sessions) will reduce
abuse, neglect, abandonment recidivism
rates
Safety Outcome 2:
Children are safely
maintained in the
home
Short Term Outcomes
80% of children will be placed in a stable,
safe home at the completion of the
program
80% of parents will report healthy levels of
engagement and self sufficiency
80% of participants will access support
services in the community
75% of parents will meet at least 75% of
their IFSP goals
Perm Outcome 1:
Children have perm
and stability in their
living situations
Perm Outcome 2:
Continuity of family
relationships and
connections
Wellbeing Outcome
1: Families have
enhanced capacity
N.C. Family
Assessment Scale
Mahoney
Children are
not removed
from the home
Children are in
home at 12
months
PSI
Logic Model Continued
Activities
Short Term Outcomes
Job Readiness
Training
80% of unemployed participants will
participate in job readiness training
Technical
Assistance for
teachers at the
Child Care
Centers
95% of teachers will apply knowledge of
child development, parental attachment,
and child needs in selecting activities for
targeted children
Community/System
To be determined
Long Term
Outcomes
Measures
Wellbeing Outcome
1: Families have
enhanced capacity
Participant
attendance and
certification
Wellbeing Outcome
2: Children receive
appropriate services
to meet their
educational needs
Mahoney
Behavioral Scale
To be determined
Online Survey
Instruments
• Parenting Stress IndexShort Form
• North Carolina Family
Assessment ScaleReunification
• Mahoney Behavioral Scale
Parenting Stress IndexShort Form
•
This measure is a brief version of the Parenting Stress Index
•
Underlying Assumptions
– Could identify and diagnose individual parent-child systems
under stress
•
Child Characteristics
•
“At Risk Screening Tool”
– Parent’s perception of impact of child’s behavior on parent
– Parent-child relationship could be a predictor of child’s later
adjustment
Scales
• Total Stress Score
– Primary score in guiding
professional judgments as to
whether professional
intervention might be
appropriate
• Parental Distress
– Reflects a parent’s perception
of child-rearing competence,
conflict with spouse, social
support, and stressors
associated with restrictions
placed on other life roles
Scales
• Difficult Child
– Surveys the parent’s view of the child’s
temperament, defiance, noncompliance, and
demandingness
• Parent-Child Dysfunctional Interaction
– Assesses a parent’s perception that the child
does not meet expectations and that
interactions with the child are not reinforcing
North Caroline Family Assessment ScaleReunification (NCFAS-R)
• Introducing the NCFAS-R
– Assessment and measurement of
family functioning in family based child
abuse and neglect
prevention/intervention programs.
– A worker administered rating scale
– Provides pre and post measurement of
families that are served by family-based
services providers
Scoring
• Each subscale is rated using a 6-point Likert-type
scoring strategy
• Each item is scored as follows:
–
–
–
–
–
–
+2 = Clear Strength
+1 = Mild Strength
0 = Baseline/Adequate
-1 = Mild Problem
-2 = Moderate Problem
-3 = Serious Problem
Mahoney Maternal Behavior Rating Scale
(MBRS)
• An observational instrument designed to assess the
quality of observed parent-child interactions
• Evaluates the quality of maternal interactive
behaviors
• Consists of a 10-minute video tape interaction
between the parent and child
MBRS
– 12 items utilize a 5-point Likert Scale which differ for
each domain
– 4 domains
• Responsiveness
• Affect
• Achievement
• Directiveness
Subscales
• Responsiveness
– Sensitivity to child’s interests: Parent seems
aware and understands the child’s activity or
play interests
– Responsivity: Appropriateness and
consistency of the parent’s responses to the
child-facial expression and signs of
discomfort.
– Effectiveness: Ability to engage child in play
interaction
Subscales
• Affect
– Acceptance: Approval of child and child’s
behavior
– Enjoyment: Parent’s enjoyment interacting
with the child
– Expressiveness: Tendency of caregiver to
react emotionally toward the child
– Inventiveness: Range of stimulation parent
provides to his or her child
– Warmth: Holding, caresses, kisses, hugs,
tone of voice, and verbal endearments
Subscales
• Achievement Orientation
– Achievement: Encouragement of
sensorimotor and cognitive achievement
– Praise: Amount of verbal praises
• Directive
– Directiveness: Frequency and intensity of
parent’s requests, commands, or attempts to
direct child’s immediate behavior
– Pace: Parent’s rate of behavior, regardless of
child’s rate
FINDINGS
Demographic Findings
• 76 CTF Participants
• 69 in comparison group
CTF Participant ages
Comparison Group Ages
Education
• There are a variety of
education levels in
both groups
• CTF participants have
higher levels of
education.
North Carolina Family Assessment
Scale-Reunification
• Child wellbeing was found to be
statistically significant at both time 1 and
time 2
– treatment group having significantly better
scores than the control group.
• Both groups made positive gains between
the three data points
– most notable gains were family safety, child
wellbeing, and readiness for reunification
North Carline Family Assessment
Scale-Reunification
–
–
–
–
–
–
–
–
1= clear strength
2= mild strength
3= baseline/adequate
4= mild problem
5= moderate problem
6= serious problem
7= not applicable
8= unknown
Treatment
(Time 1)
Control (Time 1)
Treatment
(Time 2)
Control
(Time 2)
Treatment
(Time 3)
Control
(Time 3)
Environment
3.76
3.79
3.20
3.00
2.85
5.54
Parental
Capabilities
4.48
4.13
3.45
2.95
2.51
2.58
Family Interaction
3.74
3.93
3.17
3.12
2.55
2.71
Family Safety
*3.38
4.02
2.52
3.00
2.58
2.39
Child Wellbeing
*3.92
4.21
*3.08
3.68
2.30
3.28
Caregiver/Child
Ambivalence
3.84
3.81
3.25
3.06
2.67
2.56
Readiness for
Reunification
4.69
4.75
3.58
3.17
3.02
2.52
Domain
Parenting Stress Index-Short
Form
• Scale
–
–
–
–
1=low stress (1-15 percentile)
2=normal (16-60 percentile)
3= Borderline stress (81-84 percentile)
4= Clinically Significant (85 and above)
• It is noteworthy that the scores below decreased
indicating that parents demonstrated
improvements in the areas of feeling healthier
and a reduction in overall stress.
Defensive Responding
Total Stress
Parental Distress
Dysfunctional Interaction
Difficult Child
30
25
20
Clinically Significant
15
Not Clinically Significant
10
5
0
Category 1
Category 2
Category 3
Maternal Behavior Rating Scale
• Rating Example
– 1=highly inexpressive
– 2=low overt expressiveness
– 3=moderate overt
expressiveness
– 4=overtly expressive
– 5=highly expressive
Domain
Time 1
Time 2 (6-
(Intake)
Months)
Responsivenes
s/Child
Oriented
Affect/Animatio
n
Achievement
Orientation
2.67*
3.29*
2.77
2.96
1.93
2.04
Directive
2.82
2.64
Maternal Behavior Rating Scale
Qualitative look at CTF
• Maternal behavior
– Before and after
Strengths
• Small case loads- 12 families which provide an opportunity to
work closely with family (engagement- support- and all the
therapeutic services).
• Promotes fair opportunities for parents to be reunified with their
children through referrals and one on one support.
• Systemic approach to problem solve issues the parent and family
faces.
• A solution focused approach that allows the family to strengthen
and build their strengths.
• Ensures effective coordination of services to support the family
(providers-foster placement and child advocate).
• Families feel they are learning, and the support
received has helped them to increase
awareness, communication, and achieve their
goals (remain engage in case plan.)
• The program has provided financial support to
families that have reunified.
• The program has facilitated payment for services
such as psychological evaluations, and
individual therapy.
In my words ….
•
“It’s nice to have someone support
me and look at me in a positive light.
The court looks at me like I’m a bad
person so it’s nice to have at least
one person on my side.” (Cherish the
Family Participant)
•
“If I was by myself, I wouldn’t think I
would get my children back.
Because I have someone helping me
through this, I’m hopeful that I will
get my kids back. Now I look at
things more positive. Before, I was
very negative and felt alone.” (Cherish
the Family Participant)
•
“I feel like I have someone on my
side, helping me through this
process.” (Cherish the Family
Participant)
QUESTIONS…