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 DHS News April 2013   

Conferencing and Teaming: Inside the Process 

Michael’s case is tough, there’s no doubt.

Still in high school, he is the father of a newborn and is frequently truant. He has anger management issues, some of which become evident during a meeting convened by the Department of Human Services as he snapped at people during discussions.

But he has strengths. In the meeting, also attended by his mother, father and a representative of a program that is helping him succeed in school, Michael’s team learns that when he is at school, he mostly gets good grades. When he talks about certain classes, he perks up.

He has genuine concerns about his baby and his future, those involved in his case say.

His goal is “to graduate and not be a bum,” Michael tells the people joined around a table at the Human Services Building to discuss his case.

The meeting with Michael (not his real name), came about because of a recent change in practice at DHS, called Conferencing and Teaming.

Kicked off on April 1, Conferencing and Teaming is now being used with new cases accepted for service by Children, Youth and Families’ Central Office.  Plans are to roll it out gradually to the North, East, South and Mon Valley offices, respectively. 

The method is part of DHS’ continuing integration of service delivery across all human services areas. The goal of integration is to ensure those getting services are involved with identifying and planning for their needs and for all professionals to coordinate their work effectively and efficiently.

Eight “Peer Coach Specialists” are now training Children, Youth and Family Supervisors and Caseworkers in Conferencing and Teaming in the central regional office.

Those who are implementing the practice acknowledge that using it poses a sea change in thinking and daily work habits. But it portends good outcomes for clients, they say.

Conferencing and Teaming will join clients, families, agencies and others cohesively to help clients learn “how to help themselves instead of us coming up with an approach,”said Tracey Nichol, a peer coach specialist.

“When everyone comes together around the table at once, everyone knows what has to get done,” Tracey said.  Conferencing and Teaming sessions will bring together mandatory paperwork and people from many spheres in the client’s life to brainstorm.

There will not be multiple service plans for each area of need, such as mental health or drug and alcohol rehabilitation. She recalled one case that resulted in having 26 plans.

“Who can follow 26 plans?” she said, adding that besides the paperwork, having providers understand the nuances of so many approaches can be an issue. For example, someone might have a relapse in drug and alcohol use while in treatment. With multiple plans, someone in the case-management chain might not understand relapse is a part of recovery and feel the need to take unwarranted action, Tracey said.

Using Michael’s case, she demonstrated how Conferencing and Teaming works.

The Prep Meeting 

A Prep Meeting conducted by a Caseworker with the client kicks it off.  

Prep Meetings can be imagined as an extensive meet and greet: Getting to know the client’s goals, hopes and personality. Caseworkers sketch the client’s life story, using prompts.

The Prep questionnaire asks, for example: “Can you tell me what led you where you are today?”

It queries and documents strengths and needs, and prioritizes goals. It asks the client what he or she needs to reach those goals, and what may stand in the way.

It asks a “Miracle Question,” which is “If you woke up tomorrow and everything was perfect, what would it look like?”

Tracey said the answers by clients to that question have been unexpected.

“I thought that would be, ‘I want to be rich. But it comes down to, ‘I want to be functioning without issues.”’

Answers need to be functional. If someone says her strength is, “I’m a good mom,” then the Caseworker has to ask, “Well, how are you a good mom?” The answer could be, “I get the child up and get them a good breakfast,” Tracey said.

Some questions are designed to elicit specific details vital to proceeding with Conferencing and Teaming.

For example, ground rules for the next C&T meeting, called simply a Conference, are established (“People will speak one at a time,” for example). “Non-negotiables” – details of court orders -- and confidentiality rules are reviewed.   The first “meeting” is called a conference and the follow up ones are team meetings.

Importantly, the Prep Meeting also involves listing who the client wants to have on his team, the support group that will work with him in devising and implementing specific steps toward his or her goals.

Teams can include anyone – clergy, friends, family members, therapists, teachers, employers –who can offer input, Tracey said. Choices are not always obvious and the Caseworker will contact everyone suggested to make sure he or she wants to participate.

Usually the teams end up being about five to eight people, she said, although she has seen one of about 30, where the Conference had to be held in a church. Some show up just for support, not to speak, she said.

The Conference 

Michael’s Conference meeting included a program specialist who is helping him catch up in school.

With a series of easel Post-It pages, Tracey worked through the information gathered from Michael’s Prep Meeting: Goals, strengths, ground rules.

At the Conference meeting’s start, with tensions high, some arguing broke out. Reminding the team about the rule to speak one at a time calmed it down.

Talk proceeded to what steps Michael could take to get back in the swing at school: Turn in assignments by Wednesday, the end of the grading period. Meet with the guidance counselor on Thursday to figure out grades and what he needed to do to finish the school year.

Throughout, Tracey guided the conversation back to what Michael wanted and how that could be accomplished, rather than saying he should be taking this step or that. She posed questions, instead of making statements.

“Would you be willing to do the research?” she said at one point.

“Yes, I’ll do that,” Michael said.

“This is your plan, so I don’t want to force it on you,” she said at another point to make it clear to him the focus of the meeting.

When it became apparent that the meeting was sapping Michael’s emotional strength, Tracey asked him if he wanted to stop. He did, and another meeting was scheduled to review what he had accomplished and to talk about new steps toward his goals. Subsequent team meetings are held within 30 days of the first, but no longer than 90 days afterward.

Michael shook his head at one point and said he wondered if meetings would help. There were so many in his life, he said.

Tracey pointed out that once issues are resolved, and progress is made toward the goals Michael devised, meetings will be fewer and fewer.

“This is going to be the new way we do casework, at the door. It is not a referral,” she later explained.

“I think pointing out strengths is the turning point and what’s so cool about this model. I had one woman say, ‘I was dreading you (CYF) coming, but I feel good.’We were looking at her story in a positive light.”

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