Family-Driven Care
Values in the Child/Family System
and Using Values in a Cultural
Context
Learning Objectives
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Define the core values of Family Driven
Care.
Demonstrate application of these core
values in practice.
Define resiliency and articulate its
application to working with children and
youth.
Articulate cultural differences in values.
2
Foundational Information
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Children who receive services in the mental
health system generally fit the following
criteria:
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They are considered seriously emotionally
disturbed - a term used to describe children with
significant difficulties.
The impairments can be emotional, mental and/or
behavioral.
The diagnosis meets the standard of DSM and
Includes significant disruption in a functional
domain.
Domains of Functional Impairments
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Family
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Educational
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Community Activities
Exercise – Identifying Functional
Impairments
Complicated Etiology
Generally no one thing causes SED.
 Factors that tend to predispose children
include:
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Biology
 Genetics
 Environment including family, peers,
siblings, school
 Natural developmental changes
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Developmental Process
It’s important to understand that serious
disorders emerge in the context of
an ongoing developmental process and
 shifting relationships within the family and
community.
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Developmental Factors
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Must be carefully evaluated and
addressed in order to:
Maximize healthy development
 Remediate functional impairments
 Enhance adult outcomes
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Service Delivery
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Children’s services can become quite
complicated as they are provided
among different types of service
providers.
School
 Mental health
 Juvenile justice
 Child welfare
 General health

Changing Models
Over the last several years the children’s
system of care has moved from a
“medical model” to a “social model”.
 This is primarily due to parent/caregiver
advocacy.
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Changing Model of Care
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Traditional Model
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Practitioner-based
Problem-based
Professional
dominance
Cure or cessation of
symptoms
Facility-based
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Family Driven Model
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Family-directed
Child-centered
Strengths-based
Skill acquisition
Quality of life
Community-based
Changing Model of Care
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Dependence
Regimented
Reactive
Professional
supports
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Empowerment
Least Restrictive
Preventative and/or
wellness-based
Natural supports
Education Program of the British Film Institute
Family-Driven Care
The MHSA states that family-driven care
will exist when:
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The beliefs, opinions and preferences of
every child, youth and their family/caregiver
are a deciding determinate in service
planning at the individual level.
Family-Driven Care
Children/youth and families are a
significant determinant in program
development at the agency level and
 They are integral to legislation and
appropriation at the policy level.
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Family-Driven Care
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Changes in the way children are served:
increased focus on families
 provision of services in natural settings
 greater cultural sensitivity
 a community-based system of care
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Important Principles
Families are the “expert” on their children.
 There is shared decision-making between
the provider and family/care-giver.
 Services are culturally appropriate/relevant.
 Family support is important.
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Important Principles
A holistic (integration of medical and social
model) approach is used.
 The focus is strengths-based.
 Care is individualized.
 The family is defined broadly.
 Peer Support is available for families.
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Cultural Relevance
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Child-centered services should be
culturally relevant and take into
consideration:
The family culture and norms
 Cultural identity of the family
 Ethnic identity of the family
 Whether the child is struggling to
incorporate family culture within the
dominant culture.
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Family Supports
Direct assistance with navigation,
education and information
 Practical support – help with SSI, food
stamps, respite care
 Support groups for information and
emotional support
 Hiring “parent partners”
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Exercise – Empowering Families
Considerations of the Child
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Recent research has focused on the
adaptability/resiliency of children.
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The child’s ability to self-right in the
presence of crisis or disruption to his/her
environment.
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The implication is that skills can be taught or
modeled to improve a child’s ability to adapt and
improve resiliency skills.
Resiliency
Thought to be an inborn trait.
 People have it to greater or lesser
degrees.
 Resiliency skills can be taught.
 Stressors can threaten resiliency.
 Protective factors can strengthen
resiliency.
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Resiliency
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It is thought that utilizing the
principles of family-driven care in
treatment will improve resiliency in
children.
The Seven C’s of Resiliency
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Developed by Kenneth Ginsburg, M.D.
Competence
 Confidence
 Connection
 Character
 Contribution
 Coping
 Control
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Resiliency
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In summary, the research shows that
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the development of resilience in children is
most affected by an adult in their life who
believes in them and loves them
unconditionally.
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Kids will live up or down to our expectations.
Exercise – Building Resiliency