Uniting Families Project Report


The Project

1. The Project - Uniting Families Project

The Uniting Families is funded under the Commonwealth Department of Family and Community Services under the National Homelessness Strategy (NHS), Demonstration Projects.

The Uniting Families Project is a demonstration project based on the success of `Uniting Families' innovation, a youth homelessness, early intervention and prevention package.

The Uniting Families Project aims to reduce youth homelessness by stabilizing young people within their families.

The Objectives of the Uniting Families Project are:

  • To offer immediate support to families in crisis, a commitment to respond to a request for assistance where there is family conflict within 24 - 48 hours of a receipt of a referral.
  • To offer families mediation, preferably in their own homes.
  • To conduct `Effective Parenting Courses' regularly at Harrison's Head Office.
  • To provide brokerage of Clinical Family Therapy and/ or other specialist services when entrenched family issues are not amenable to mediation.
  • To offer community based short-term respite care where necessary to allow mediation to proceed.

The project was a three way partnership, with the Australian Government funding the operational costs, the Baker Foundation funding the Action research and Harrison's providing the professional expertise.

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2. The Agency.

Mission Statement

Harrison Community Services (Harrison) is a non-profit mission of the Uniting Church in Australia (Victoria) and exists to provide residential care and other services to people at risk of abuse, neglect and exploitation or in need of care for other reasons. Harrison's operates from Knox, a suburb in the Eastern Metropolitan area of Melbourne.

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3. Acknowledgements

This project has been the result of the efforts of a number of people whose input has been invaluable to the ongoing success of this project.

Harrison Community Services

  • Roger Gough Chief Executive Officer
  • Stephen McGarry Deputy Director
  • Stephanie Webber Client Services Manager and Line Manager for Uniting Families
  • Xanthe Whitney Team Leader Uniting Families
  • Carole Berendse Uniting Families
  • Tess Cawse Uniting Families
  • Helen Hunt Uniting Families
  • Kevin Maher Uniting Families
  • Paula Milburn Uniting Families
  • Doreen Stoves Family Therapist for Uniting Families.

Advisory Committee

  • Mr Roger Gough Chief Executive Officer
  • Mr Stephen McGarry Deputy Director
  • Stephanie Webber Manager,Client Services
  • Xanthe Whitney Team Leader
  • Helen Hunt Support Worker
  • Chris Timmerman Student Welfare Coordinator Rowville Secondary College
  • Doreen Stoves
  • Linda Griffin Parent Representative
  • Ms Fran Collinson & Mr Eamonn Cooke Family and Community Services (FACS)

Health Outcomes International Researchers

Baker Foundation

Parents and young people

Secondary Colleges Student Welfare Coordinators.

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Definitions 

Family

The Australian Bureau of Statistics (ABS) defines family as:

Two or more persons, one of whom is at least 15 years of age, who are related by blood, marriage (registered or de facto), adoption, step or fostering, and who are usually resident in the same household.1

Within the scope of this report Family is defined as at least one parent of an adolescent who is related by blood, adoption, step or fostering, and who are usually resident in the same household. Family refers to both the parent/s and young person throughout this report.

Adolescent

An adolescent, is defined in this report as a young person aged 12 – 17 yrs whose primary accommodation is within the family.

Programmatic Components.

  • Case Management
    Case Management is defined in this report by the Supported Accommodation & Assistance Program (SAAP) standards as stipulated by the National SAAP Case Management Practice Principles. This includes the following stages in case management:
    • Intake
    • Assessment
    • Case Planning & Direct Service
    • Monitoring and Review
    • Case Closure & Exit Process2
  • One on One Support
    One on One Support is used to describe case management activities and practice within the Uniting Families Project.

    Key element of this practice is that Case Management is:
    • Collaborative and Client Focused
    • Aimed at empowering, and meeting client needs
    • Incorporates direct client service, based on ongoing assessment, and support planning and coordinating access to and delivery of a range of appropriate services.
       
  • Case Manager
    A worker maintains case management responsibility for an allocated family throughout the life of a case within the Uniting Families project.
     
  • Mediation
    Within the Uniting Families Project mediation is defined as a structured process that enables parties in conflict to clarify issues / examine a range of possible solutions / resolve disagreements through negotiation / and uses joint decision making to arrive at possible solutions. This process is facilitated by two workers.
     
  • Effective Parenting Program
    Effective Parenting Program (EPP) is a support / educational group for parents struggling with their adolescent's behaviour. Effective Parenting Program is run each term at Harrison's Head Office. Each program runs for 7 weeks. The program aims to:
    • Facilitate a group process for parents experiencing difficulties in the parenting of their adolescent.
    • Provide peer support, empowering parents to find and implement fair and reasonable decisions that will lead to positive changes within their family.
    • Help parents in working together to find effective solutions to their particular situations, as well as overcoming any sense of personal isolation in the face of daily life stressors.
  • Respite
    Respite provides short term, temporary out-of-home placement for the young person and their family who is experiencing serious problems to allow time to negotiate family supports.

    Respite by definition is a pause, interval rest. It is by definition temporary.

    Respite as an intervention is explored with families when conflict within the family prevents young person from residing at home for a short period of time. It is identified that the family members need space to address appropriate strategies and solutions for the purpose of reconciliation.
     
  • Individual Counselling
    Counselling is a therapeutic intervention offered to individuals within a family when an issue or difficulty is held by the individual and resolution of the difficulty is necessary for further family work to be undertaken.
     
  • Family Therapy
    Clinical Family Therapy is a therapeutic intervention for family members as a group... Family Therapy recognises the family as a 'system'. It is a joint venture for all members of the family. It aims to pinpoint family areas of conflict, difficulty and to assist all family members work towards changing unhealthy patterns of interaction.
  1. Health Outcomes International (HOI) Draft Literature Review V2, 2005,
  2. Uniting Care Harrison community Services SAAP Policy & Procedures Manual 2000

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Executive Summary 

The Uniting Families project, as a demonstration project within the national Homelessness Strategy presents findings on a program successfully run by Harrison since the early 1990’s.

The Uniting Families program is an early intervention model of support for families in crisis, parents who are experiencing serious problems with their adolescent children and adolescents who are at risk of becoming homeless in the absence of intervention.3

It has been demonstrated that a range of factors can contribute to young people being at-risk of homelessness. In the majority of studies of homeless young people and those at-risk of homelessness, the breakdown of family and support networks were cited as the primary reasons for the outcome of leaving home early. Furthermore, studies have identified that young people often express a desire to re-establish connections with family members and peers after they have left home. Family structures are also changing and the concept and experiences of family members and young people in the family context is important to consider when assessing appropriate family interventions. To facilitate this, early intervention and mediation (both while the young person is at-risk and within a short-time frame of them leaving the home) should include both the young person and family members.4

It has been demonstrated that schools can play a large part in the prevention and early intervention of youth homelessness. The provision of information to students on risk factors, their choices and the implications of leaving home is an integral component of a prevention strategy for youth homelessness.5

Harrison’s has independently evaluated its Uniting Families Program. In 2000, it engaged Sherrie Coote to formally evaluate the program. Harrison believes its program components and service delivery to families and young people in crisis to be an effective model for early intervention and in the prevention of youth homelessness.

Harrison has trialed this program in a semi rural location (through Uniting Extended Families 2002 / 2003) and tested the transportability of its interventions).

Key findings included for discussion in this report include:

  • Developing Dialogue between schools and professional services regarding risk factors affecting adolescents and children
  • Reaching at risk young people in a timely manner
  • Service Provision in Remote Locations where fast responses provides challenges
  • Strategies to minimize disruption to schooling while support is provided
  • Marketing strategies for early intervention programs
  • The Best & most effective ways of reaching at-risk young people in a timely way.
  • Risk factors that contribute to homelessness for vulnerable adolescents
  • Theoretical basis for the Uniting Families Program
  1. Health Outcomes International (HOI) Draft Literature Review V2, 2005
  2. Health Outcomes International (HOI) Draft Literature Review V2, 2005
  3. Health Outcomes International (HOI) Draft Literature Review V2, 2005

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Model of Service Delivery 

Harrison's Early Intervention/Family Reconciliation Program (Uniting Families Program) is aimed at young people and their families, experiencing conflict and problems that if not addressed could result in the young person becoming homeless.

The Program operates with the following underlying philosophy:

Each family is unique; and every family knows what strategies/solutions and outcomes would best suit their needs (based on a shared history of relationships and experience).

The Program works with young people and their families to:

  • Address unresolved issues of conflict and problems that left unresolved could lead to the young person becoming homeless.
  • Support parents who are feeling isolated and unsure of how to manage their adolescent or where to turn to for help.
  • Develop supports / resources and strategies that will enable young people to remain living with their parents and family.

The Program works holistically with families, treating each with equal respect and with each member owning the strategies and outcomes that are best suited to their particular family. For statistical purposes and to identify suitable clients for the program the following young person client characteristic have been developed as the identified target group.

  • Eastern Metropolitan Region
  • 12-17 years of age
  • Living at home
  • Regular school attendance/willingness to look at options
  • Family (parents & young person) willing to work on issues
  • Drug and/or Alcohol usage at experimental stage

The program is designed to provide immediate, supports via a range of intervention strategies within an intensive period of support that is benchmarked at a maximum of three months for any case. ( See attachment 1- Program Document)

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Referrals

Referrals are received via Harrison Community Services central duty system. The referral is then allocated to a staff member by the team leader. It is usual practice for the allocated worker from this point to be the assigned case manager to the family.

Timelines for responding to Referrals

  • Uniting Families Project operates with no waiting list.
  • Benchmarks for response to a referral are set at 24-48hours. This means at the least direct conversation with the nominated family member listed on the referral for follow up.
  • An initial meeting (assessment) is required to be held within one week of the referral being made to Harrison's.

The Initial Meeting (Assessment).

The initial meeting is a critical moment for workers to engage with the family.

At the initial meeting the worker will facilitate a process that:

  1. Introduces the program
  • Allows all family members to outline their perception/understanding of the issues (it is anticipated that this will occur with both family and young people present, however, it is recognised that in some circumstances contact may need to be separate - this would be done only to engage the individuals' commitment to a joint meeting);
  • Identifies issues
  • Provides a case management framework and initial case plan
  • Facilitates a micro-conflict resolution strategy that identifies needs and fears behind the conflict;
  • Identifies other key players eg. DHS/Schools/significant others;
  • Develops in conjunction with the family a range of options/strategies to address at least one identified issue. It is important that the options/strategies are simple, easy and achievable, that maximises a family's success and abilities and provides a positive experience for them.

From the First Meeting

From the first meeting - a number of options are available:

  1. The provision of one to one support. The worker may continue to work with the family on a short-term basis (one month maximum), pursuing identified issues through an Action Plan. This may include enlisting the support/involvement of other key players, (e.g. school welfare coordinators) to support the family and young person to work on agreed strategies/options.
  2. Mediation to be organised.
  3. Refer to Effective Parenting
  4. Refer a family member for individual counselling
  5. Alternative support needs identified, eg referral to other Harrison program.
  6. Notification to Department of Human Services, if required. This must be authorised by the Team Leader.
  7. The presenting situation/issues are resolved allowing the worker to withdraw. No further action required.

At the conclusion of the Initial Meeting:

  • A case management framework and initial case plan developed with the family, identifying issues, actions to be undertaken and clearly specifying each person's tasks and responsibilities.

Mediation

Uniting Families uses a co mediator model, i.e. two mediators conducting at least the first session of mediation. It is common practice in this agency for the primary case manager to undertake the role of the major mediator or Mediator One as it is commonly referred to in the field.

Effective Parenting Program

Within the Uniting Families Program parents can be referred to Effective Parenting Program on the basis that parent/s:

  • Are in need of support as a result of the state of their family's functioning.
  • Are open to developing new strategies in the parenting of their teenagers.
  • Are committed to exploring and implementing fair decisions that will lead to less conflict and more positive interactions within their family.

Individual Counselling

When an issue or difficulty is held by the individual and resolution of the difficulty is necessary for further family work to be undertaken - a referral can be internally made to Harrison Counselling Service.

A referral can be made to the Counsellor for any family member of a current Uniting Families Client Family.

Counselling as part of the overall intervention can be made at any stage throughout the life of an open case file. It could be made:

  • To address issues held by an individual so that the family work can be undertaken.
  • To compliment the family work.
  • To address issues unresolved for an individual after completion of the family work.

Family Therapy

Within the Uniting Families Program Family Therapy is available for families for whom:

  • Mediation is inappropriate (e.g.. significant issues - one party refuses to participate / abuse / fear / illegal activities central to family conflict issues
  • Mediation has been attempted but broken down.
  • Issues are identified that require therapeutic intervention.

Respite

Respite Care is never provided as a standalone service. An integral part of Respite Care is that families are involved in practicing strategies and agreements from mediation or family therapy

File Closure

Closure of a file is negotiated with a family. The family is formally notified of the closing of their file by a formal letter highlighting their strengths and achievements within the program.

With the closure letter, a client survey is enclosed, inviting the family to provide anonymous feedback to the agency.6

  1. UnitingCare Harrison Community Services Uniting Families Program Document 1997

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Key Findings & Learning 

7.1 Developing Dialogue between schools and professional services regarding risk factors affecting adolescents and children

Programme Practice

Uniting Families over the previous 18 months have strategically built relationships with eight secondary schools via developing close working relationships with school Student Welfare Coordinators. Uniting Families Staff member was allocated to each of these eight schools.

The Secondary Colleges are:

Upper Yarra Secondary College - Shire Of Yarra Ranges

Healesville Secondary College - Shire Of Yarra Ranges

Monbulk Secondary College - Shire Of Yarra Ranges

Scoresby Secondary College - City Of Knox

Fairhills Secondary College - City Of Knox

Wantirna Secondary College -City Of Knox

Rowville Secondary College - Eastern Campus - City Of Knox

Rowville Secondary College - Western Campus - City Of Knox

Staff have a regular presence within some identified local Secondary Colleges, at least on a fortnightly basis. The purpose is to build solid working relationships with the schools for the purpose of Referral, Secondary Consultation and collaborative work for young people and their parents.

Research Findings

Early intervention approaches must also recognise and respond to the individual perspectives and needs of young people and their parents. Immediacy of response together with a flexible "toolbox" of strategies, are also critical for engaging young people and their families. The Victorian Youth Homelessness Action Plan (First Stage Report) suggests that early intervention service models should be "clear and strong" and include facets such as:

  • "Working with schools to identify and engage young people;
  • Timing of interventions;
  • Risk assessment in relation to the safety of a young person returning home or moving to other family options;
  • Working with communities around respite options;
  • Protecting young people from becoming more estranged from home or the community or engaging in escalating behaviours during the initial intervention period; and
  • Addressing behaviour factors where they have contributed to the young person being homeless.7

The reputation of Harrison Community Services in the sector and its working relationship with the community were seen as contributing factors to the overall success of the Program. As Harrison has been in the field for many years, the community and other agencies were aware of the agency, and trusted their ability to provide the service.

Student Welfare Coordinators have taken on a role as a "gatekeeper" for referrals into the Uniting Families Program. Among the nine former clients consulted, four families had become of aware of the program through the young person's school, through referral from the Student Welfare Coordinator. Harrison is normally engaged when the Student Welfare Coordinator can see that the student is having difficulties at the school which may be caused by problems in the family home.8

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7.2 Reaching at risk young people in a timely manner

Programme Practice

The Uniting Families Service Model incorporates a family resilience framework in which the intervention focuses on the family's strengths and building and reinforcing family relationships. A basic premise which guides the family resilience approach is that "stressful crises and persistent challenges influence the whole family, and in turn, key family processes mediate the recovery and resilience of vulnerable members as well as the family unit".

As a result, interventions aim to build family strengths as problems are addressed, which subsequently reduces the risk of crisis and vulnerability of family members. As the family becomes more "resourceful" in addressing the present crisis, their ability to meet future demands is enhanced; therefore Young People coming to the attention of the Student Welfare Coordinator can be referred to the Uniting Families Program. Young people can be seen by workers without needing to first undergo formal referral to the program. Programmatic experience has shown that young people establish rapport with a worker increases the success of engaging the young person and subsequently the parents whether it the outcome be an engagement within the Uniting Families Program or a facilitated referral to alternative specialist support services. Staff play a pivotal role in linking services to the school community.9

Research Findings

By targeting young people who are in conflict with their family, the Uniting Families Program is supported by the literature which states that family conflict is often the main reason for home leaving. Accordingly all family members are involved in service delivery.

Current research clearly identifies that many (subsequently homeless) young people leave home due to family conflict (both physical and emotional) and general instability in the family home. These conflicts can be brought on by the risk factors stated earlier, and can include "disputes" between parents and children (including step-parents and step children), and among spouses and partners themselves.10

The most effective service delivery models are those which comprise of a network of agencies to support clients. The network can consist of organisations such as

  • - Schools;
  • - Community based youth and family services;
  • - Those responsible for care and protection;
  • - Drug and alcohol services;
  • - Mental health agencies;
  • - Centrelink; and
  • - Police.

Each agency can then act as a "gateway" to other services within the community network as referrals are directed to the appropriate specialist service. Accordingly, research suggests that specialist early intervention workers/services should be closely networked with "first to know" agencies within a local or regional context.11

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7.3 Service Provision in Remote Locations where fast responses provides challenges


Program Practice

In 2000 Harrison Community Services successfully provided Uniting Families Services in Yarra Junction. Yarra Junction is a town in the Shire of Yarra Ranges. The shire of Yarra Ranges is located on Melbourne's outer eastern fringe. The Shire with an area of almost 2500 square kilometres is the largest Local Government area of any metropolitan or fringe council in the state.

The Shire has a mixture of urban and rural communities. Access to support services is a major issue for the Shire. There are limited agency resources providing services from within the Shire. Services are provided on an outreach basis to the Shire, whilst major agencies providing vital services to the Shire are based in Lilydale.

Harrison Community Services provided two staff at two days per week to run direct service delivery for young people & families. Staff became an integral part of the school welfare community. A key component of this involvement was via the school welfare meetings. Over a period of 12 months, United Extended Families involvement, the Welfare Meeting became an essential part of the structure of the school. It became a case management meeting, where students were referred to appropriate supports. The Welfare group made it a priority to attend. It was efficient and lessened the number of professionals involved in the young person's life.

In 2003 Harrison Community Services duplicated this program in Healesville and a number of local secondary colleges.

Harrison Community Services has continued to provide outreach services to these two remote locations from their central head office.

Key factors in the success of delivering services in this manner are:

  1. Relationship building
  2. Consistency of staffing
  3. Reliability of Service

Designated agency cars and mobiles are provided for staff outreaching to remote locations.

Research Findings

A quick response time (i.e. within the 24-48 hour window) can also be difficult to achieve due to travel in rural and remote locations. Agencies identify that homelessness can be particularly stigmatising for young people living in rural regions and, consequently, accessing these services in confidence, in rural areas is often difficult.

Outreach services to the client's home would also assist with confidentiality for families in rural areas, who do not wish to be seen accessing support services. However, outreach services utilise more resources than office-based services, particularly in rural areas. Resources such as a vehicle and mobile telephone are required in addition to training on worker safety in undertaking home visits and can be costly.

Distance and confidentiality in rural and remote areas inhibit access to services. Appropriate use of technology can overcome this barrier.

One approach to address rural barriers is the implementation of counselling teleconferencing for rural and remote regions.. Telephone counselling can provide an immediate intervention, modelled by the caller's needs and usually at a low cost (especially when compared to providing outreach services). The caller can control the length of the intervention and the service can be anonymous, with the caller maintaining confidentiality and specifying the amount of information they wish to disclose.

Telephone group work can also be utilised as it allows individuals in different locations to be brought together over the telephone to interact with others in a similar situation with a facilitator. This approach allows for increased accessibility, anonymity, and feelings can be expressed more openly when group members do not see one another. 12

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7.4 Strategies to minimize disruption to schooling while support is provided

Programme Practice

All support activities are negotiated with the family at mutually convenient times. Interventions are routinely offered outside of office hours. Assessment & after hours mediations are common.

Meetings with young people occur at locations they select and where they feel comfortable. These include:

  • Fast Food Outlets
  • Homes
  • Workplaces – during lunch breaks
  • Parks
  • Walking tracks

If staff are meeting students within schools, staff organize appointments through the Student Welfare Coordinators. Student Welfare Coordinators liaise with Year Level Coordinators and teachers to minimize disruption to students' learning and timetables.

Formal Respite takes place at Kilsyth House. Kilsyth House is located in the Maroondah Local Government area. This city is central in the Eastern Region of Melbourne. This house is near public transport and located where young people can access school.

Research Findings

Harrison has established a referral process with student welfare coordinators where a referral form is completed and then faxed to Harrison. Harrison follow up the referral by contacting the family, and informing the student welfare coordinators of the outcome (contact with the student welfare coordinators may also be made to acquire further information in processing the referral). All student welfare coordinators involved in the Uniting Families program stated that the current referral processes worked efficiently and effectively, and there were no difficulties.

In schools which have an allocated Uniting Families worker, feedback involves the worker reporting during school welfare meetings regarding the outcome of the referral. The worker also reports to the student welfare coordinators at the end of the allocated school day. Informal feedback involves general discussions about the case, requests for further information about the young person and the current support provided in the school. This is normally carried out via face-to-face or telephone. Student welfare coordinators identified that they receive continual feedback from the workers and are also informed once Harrison closes the case file. All discussions adhered to client confidentiality provisions.

Informal discussions between families/young person and the student welfare coordinators are also conducted to seek feedback on their experience within the program.

The schools will also continue to look after the student during engagement with Harrison, which facilitates for a "collaborative approach between the student welfare coordinators, Harrison and young person." Although not a formal process, Harrison may refer the student to the school's welfare team for ongoing support in the school, i.e. counselling, to identify the best solutions for support after case closure. 13

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7.5 Marketing strategies for early intervention programs


Programme Practice

The program is marketed via a variety of strategies. These strategies include marketing to young people, parents, service providers and community resources such as doctors' surgeries.

As previously discussed, Uniting Families Staff work closely with student welfare coordinators.

Uniting Families Workers participate in local Youth Service Provider networks to promote the project.

Routinely, Harrison Community Services brochures promoting the program are distributed to community agencies and services such as doctors' surgeries, community centres. (Brochure is attached as Attachment 10.5)

Staff accept invitations on a regular basis to present the program to schools, community interest groups and service clubs.

The program is included on Harrison Community Services website (www.harrison.org.au).

The program is included in Local Governments Community Services Guides, Youth Service Guides.

The program is also registered with emergency help lines including Kids Help Line, Parent Help Line and Life Line.

Research Findings

In the majority of schools involved within the Uniting Families Program, Harrison initiated contact by approaching the schools to discuss the program and the possibility of a collaborative approach to service delivery.

The Uniting Families Program is mainly promoted through the school community due to the strong linkages between the program and student welfare coordinators. The coordinators believe that from a school perspective, the current promotional processes are adequate and well conducted. The method of Harrison approaching schools and informing them of the services offered was seen as a "proactive" element to service delivery.

Currently, brochures detailing the Uniting Families program are placed in medical and dental surgeries, health centres, schools (via student welfare coordinators), community centres, and are also distributed to the Police Stations. Current brochures were described as "excellent" and allowed for Harrison to be promoted to other agencies in the area. Information about the program is also available via the Harrison website.

Stakeholders believed Harrison was doing all it could to promote their services, however, it will always be difficult to reach all families, especially those which are reluctant to identify that there is a problem.14

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7.6 The Best &most effective ways of reaching at-risk young people in a timely way.


Programmatic Practice

"QUICK RESPONSE"

Within the Uniting Families Program it is expected that the allocated worker will contact the family within 48 hours of the initial referral. An initial meeting with the family takes place within one week of contact.

  • Uniting Families Project operates with no waiting list.
  • Benchmarks for response to a referral are set at 24-48hours.
  • A Referral is made to Uniting Families when a family member identifies that the family is experiencing crisis.
  • This crisis can provide a catalyst for change within a family.
  • A delay in those families accessing services can equate to a loss of opportunity and exacerbate the problem.

ACCESSIBILITY

  • Families are contacted within 24 – 48 hours of a service request.
  • On making contact with a family member, staff arrange a meeting at the earliest convenient time for the family.
  • This appointment is not restricted to working hours, after hour appointments are routine.
  • Parent/s and young people are not expected to visit the office for this initial appointment. Locations that are acceptable and comfortable for the parent/s or young person are legitimate venues for the initial meeting. These may include:
    • Homes
    • Fast Food Outlets
    • Workplaces – during lunch breaks

EARLY INTERVENTION

The initial meeting is a critical moment for workers to engage with the family. Filling out of the assessment form is undertaken at the initial meeting. The Initial Meeting provides an opportunity for:

  • The family to tell their story. It provides an emotional release leading to a lowering of antagonism.
  • The family and the worker to identify and voice their Identified fears / concerns and explore common interests.
  • A range of possible strategies/options/identified family strengths/support networks.

APPROPRIATE ASSESSMENT & EFFECTIVE CASE MANAGEMENT

At the initial meeting the worker will facilitate a process that:

  1. Introduces the program.
  • Allows all family members to outline their perception/understanding of the issues (it is anticipated that this will occur with both family and young people present, however, it is recognised that in some circumstances contact may need to be separate – this would be done only to engage the individual's commitment to a joint meeting).
  • Identifies issues.
  • Provides a case management framework and initial case plan.
  • Facilitates a micro-conflict resolution strategy that identifies needs and fears behind the conflict.
  • Identifies other key players eg. DHS/Schools/significant others.
  • Develops in conjunction with the family a range of options/strategies to address at least one identified issue. It is important that the options/strategies are simple, easy and achievable, that maximise a family's success and abilities and provide a positive experience for them.
  • The worker who undertakes the assessment of the family and young person is, by default, the family case manager. The case manager holds responsibility for all interventions, case coordination, referrals, case review and case closure.

CONTINUUM OF SERVICES

The Uniting Families Service Delivery has nine distinctive components. These are:

  1. REFERRAL RESPONSE
  2. INITIAL MEETING
  3. ONE TO ONE SUPPORT
  4. MEDIATION
  5. EFFECTIVE PARENTING
  6. RESPITE CARE
  7. INDIVIDUAL COUNSELLING
  8. FAMILY THERAPY
  9. EXIT AND REVIEW

There is seamless movement between programmatic components. The family, in conjunction with the case manager, decides where they will commence.

THE ABILITY TO WORK WITH FAMILIES

The Program operates with the following underlying philosophy:
Each family is unique and every family knows what strategies/solutions and outcomes would best suit their needs (based on a shared history of relationships and experience).

The Program works holistically with families, treating each member with equal respect and with each member owning the strategies and outcomes that are best suited to their particular family. For statistical purposes, and to identify suitable clients for the program, the following young person client characteristics have been developed as the identified target group.

  • Living in the Eastern Metropolitan Region.
  • 12-17 years of age.
  • Living at home.
  • Regular school attendance/willingness to look at options.
  • Family (parents & young person) willing to work on issues.
  • Drug and/or alcohol usage at experimental stage.

INTER-AGENCY COLLABORATION

Harrison Community Service's Uniting Families Program has close working relationships both internally within the agency and externally with other key stakeholders. These include:

Internally

  • SAAP services
  • JPET Adolescent
  • Support Programs

Externally:

  • Department of Human Services Child Protection
  • Mental Health Services for Young People
  • Specialist Counselling Services eg. ECASA Schools.

Research Findings

The literature review Identified components of 'good practice' interventions strategies for the prevention and intervention of youth homelessness.15

QUICK RESPONSE

A "quick response" to referrals has been identified as vital to ensuring that the young person and the family can access services that will assist in re-establishing the connection between the young person and their family, school or community, and which can facilitate the young person remaining in the family home or living within their kith and kin network.

ACCESSIBILITY

The literature concludes that services to assist families and the young person at-risk need to be provided while the young person resides in the family home or shortly after the young person has left. Previous studies have found that Uniting Families successfully worked within the 24-48 hour window to respond to referrals, demonstrating that they are accessible to families in crisis.

EARLY INTERVENTION

The literature has been universal in its support for using early intervention as a framework for service delivery. In the evaluation of the Youth Homelessness Pilot Programme, good practice in engaging clients for early intervention was characterised by:

  • Immediacy of response (ideally within 24 hours);
  • Explicitly involving the family;
  • Outreach to make contact with clients where and when they felt most comfortable;
  • Meeting the immediate needs of clients in crisis situations;
  • Using language and approaches which are supportive to clients and clarifying and confirming values and principles; and
  • Providing flexible service delivery (i.e. having a "tool box" of intervention strategies available).

APPROPRIATE ASSESSMENT

Research has indicated that the assessment process should identify the immediate issues of the family and young person to be addressed in the course of the intervention. The case worker should be able to assess the issues of the family during the initial assessment process and then allocate the family to an appropriate internal intervention, or refer the family to an external service.

EFFECTIVE CASE MANAGEMENT

Case management refers to "the process used to assess client's needs, identify the strategies to be used, develop a plan with the client, coordinate services, monitor progress and ultimately close the case".

CONTINUUM OF SERVICES

The literature identifies that a continuum of services is an effective approach to preventing youth homelessness. Such services include such as mediation, counselling and family therapy.

THE ABILITY TO WORK WITH FAMILIES

The literature gives strong support to those interventions that are underpinned by a family-focus, particularly in terms of identifying and building on family-strengths and relationships

INTER-AGENCY COLLABORATION

Research stresses the importance of establishing inter-agency networks and collaborations to coordinate support services for young people and families. An integrated approach to youth service is critical to provide an effective response to young people, including those at-risk of homelessness, or who have already left the family home.

TRAINING AND PROFESSIONAL DEVELOPMENT

Skills and qualities all workers in the sector should have are presented in the table below:

  • Relationship with schools and Protective Services
  • Benchmarks For Responding to Referrals
  • Engaging the whole family
  • Pro Active Outreach
  • Consistency of Worker16

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7.7 Risk factors that contribute to homelessness for vulnerable adolescents


Program Practice

Harrison captured at referral and at assessment the trigger event that led to a referral being made to the Uniting Families Program. Families and young people in the Uniting Families Project listed these as critical issues.

Table 1. Identified triggers leading to families making a referral to Uniting Families.

Table 1. Identified triggers leading to families making a referral to Uniting Families.
  Identified Issue/ Incident Leading to Referral No. %
1 Personal Issues for Young person (Inc: self harm / substance usage) 24 22
2 Aggressive Behavior Incident Within Family 16 15
3 Change in Family Structure / Dynamics 16 15
4 School Refusal By Young Person 14 13
5 Young Person Run Away From Home 11 10
6 Impending Expulsion / Suspension 8 7.5
7 Parental Support Required & identified 8 7.5
8 Impending Legal Involvement – young person 7 6
9 Young Person’s Threat To Leave Home 4 4
    (108) 100

Research Finding

In recent years, there has been a growing recognition that youth homelessness is best understood as a "process", with a series of transitions from one experiential stage to the next, rather than as a single event. Within this context, sociologists use the term "career" to refer to "transitional stages involved in the development of any form of biographical identity." As such, the notion of a "homeless career" suggests that people will go through various stages before they develop a self-identity as a homeless person, and it draws attention to the factors which cause the movement from one stage to another. Therefore the individual may require different support services depending on their location on the "trajectory". The homeless career process is demonstrated in the following figure:

Figure 1: Model of the Youth Homelessness Career

The notion of homelessness as a process is important for the concept of "early intervention" as early intervention denotes that it "is possible to observe in the lives of people the early manifestations of the phenomenon in the making, and respond in such a way that progression to experiencing the phenomenon is halted or impeded".17 Accordingly, early intervention is dependent on the belief that homelessness is a process.

In 2001-02, the Victorian SAAP database identified the following reasons for seeking assistance:

  • Relationship or family breakdown (18.6%);
  • Eviction or previous accommodation ended (17%); and
  • Domestic violence (14.2% of young women).

The evaluation of the Youth Homelessness Pilot Program also found the main reason for home leaving was conflict with parents. The results are summarised below:

Table 1: Reasons nominated for leaving home.
Main Reason for Home Leaving Young Person (N=1401) Parents (N=774)
Conflict with parents 57% 63%
Physical or emotional abuse 9% 3%
Change in family structure 5% 4%
Evicted by family 5% 2%
Drug and alcohol abuse by young person 1% 5%
Other 20% 19%

The literature is almost universal in its recommendation that working with both the young person and the family is an integral part of service delivery in prevention and intervention strategies to address youth homelessness.

The Uniting Families service model incorporates a family resilience framework in which the intervention focuses on the family’s strengths and building and reinforcing family relationships. A basic premise which guides the family resilience approach is that "stressful crises and persistent challenges influence the whole family, and in turn, key family processes mediate the recovery and resilience of vulnerable members as well as the family unit".

  1. Health Outcomes International (HOI) Draft Literature Review V2, 2005
  2. Health Outcomes International Draft key Findings & Learning's 2005
  3. Health Outcomes International Draft key Findings & Learning's 2005
  4. Health Outcomes International Draft key Findings & Learning's 2005
  5. Health Outcomes International (HOI) Draft Literature Review V2, 2005
  6. Health Outcomes International Draft key Findings & Learning's 2005
  7. Health Outcomes International Draft key Findings & Learning's 2005
  8. Health Outcomes International Draft key Findings & Learning's 2005
  9. Health Outcomes International (HOI) Draft Literature Review V2, 2005
  10. Health Outcomes International (HOI) Draft Literature Review V2, 2005
  11. Crane, P., & Brannock, J. (1996). Homelessness among young people in Australia: Early intervention and prevention. National Clearinghouse for Youth Studies, Tasmania.

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Theoretical Basis of the Uniting Families Program 

The Uniting Families Service Model incorporates a family resilience framework in which the intervention focuses on the family's strengths and building and reinforcing family relationships. A basic premise which guides the family resilience approach is that "stressful crises and persistent challenges influence the whole family, and in turn, key family processes mediate the recovery and resilience of vulnerable members as well as the family unit". As a result, interventions aim to build family strengths as problems are addressed, which subsequently reduces the risk of crisis and vulnerability of family members. As the family becomes more "resourceful" in addressing the present crisis, their ability to meet future demands is enhanced; therefore having a prophylactic effect. Research states that the family resilience framework is applicable to a diversity of interventions including periodic family consultations and intensive family therapy. Research indicates that "psycho-educational" multifamily groups can emphasise the importance of social support and practical information, and offer guidelines for crisis management, problem solving, and stress reductions. Therapists are able to identify the specific stressors the family faces and assist them to develop more effective coping strategies.18

  1. Health Outcomes International Draft key Findings & Learning's 2005

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Report against Performance Indicators 

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

  1. Client Numbers
  • Performance Indicator: 80 families (June 2004 – May 2005).
  • Actual Performance: 108 families (June 2004- March 2005).
  1. 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
  2. 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
  3. 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
  4. 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
    Graph 1
  5. Interventions.
    The following graph shows the interventions utilised throughout the project. It was common for families to access more than one intervention.
    Graph 2.
    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.

Supports In Place At Closure

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

  1. 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.
  2. 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.
  3. 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

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Content Updated: 19 June 2012