Applying After-Action Reviews to Child and Family Teams to Improve Mental Health Service Linkage within Child Welfare Services

对儿童和家庭团队进行事后审查，以改善儿童福利服务中的心理健康服务联系

• 批准号: 10677045
• 负责人: GREGORY AARONS
• 金额: $ 17.9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-05 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677045
• 关键词: Acceleration; Acute; Address; Adolescent; Agreement; Behavioral; Caregivers; Child; Child Abuse and Neglect; Child Mental Health; Child Welfare; Child health care; Clinical; Communication; Competence; Complex; County; Data Sources; Development; Education; Effectiveness; Effectiveness of Interventions; Elements; Event; Excision; Family; Family member; Focus Groups; Funding; Impairment; Individual; Intention; Intervention; Interview; Language; Learning; Medical; Mental Health; Mental Health Services; Mental disorders; Methods; Military Personnel; Natural Language Processing; Needs Assessment; Outcome; Parents; Performance; Preparation; Process; Published Comment; Recording of previous events; Recurrence; Research; Risk; Services; Social Development; Source; Specific qualifier value; System; Testing; Transcript; Voice; Work; Youth; adverse childhood events; anxiety symptoms; child mental health service; child services; collaborative approach; depressive symptoms; early adolescence; effectiveness research; empowerment; implementation strategy; improved; innovation; meetings; member; novel; patient engagement; pediatric trauma; pilot test; pressure; satisfaction; service intervention; shared decision making; therapy development; tool; trauma symptom; traumatized children; treatment planning

PROJECT SUMMARY (R34#1 After Action Reviews in CWS) Half of child-welfare involved children and adolescents meet criteria for at least one current mental disorder1. Shared decision-making for Action Plans is vital to the mental health and wellbeing of children and families in Child Welfare Services (CWS), with fewer child removals and fewer recurrences2, thus resulting in decreased risk of child trauma, behavioral concerns, and mental health concerns. Yet, neither parents nor caseworkers perceive that Action Plans include mutual influence3, and parents feel they have no voice or input4. Child and family team (CFT) meetings are required for each child or youth within sixty days of entering CWS, and are family-centered and collaborative ways to develop individualized, effective service plans based on mutual agreement5. Relying on teamwork approaches, CFT meetings intend to give children and families a voice in creating and guiding their case plans6, suggest children do better when connected to their families and empower families to work with CWS agencies7,8, and address organizational need for teams to perform “complex, interdependent, dynamic, and ambiguous tasks.”9 Yet, in CWS CFT meetings, the quality of teamwork can be impaired by the inherent challenges of serving multiple needs and viewpoints that vary across family members and professionals, as well as the pressures and constraints of CWS. Innovations from team effectiveness research hold promise in facilitating improvements in shared decision-making within CWS. The after-action review (AAR) is a relatively simple, inexpensive, quick, and powerful tool to improve learning, performance, and the effectiveness of teams and individuals. AARs are active self-learning processes wherein team members reflect on specific performance episode to actively engage in self-discovery and improve learning in a non- punitive/non-judgmental manner. AARs have become a common tool that organizations have leveraged in military, medical, educational, and other applications, to improve individual and team performance by approximately 20-25%. This proposal aims to apply the team development intervention of the after-action review (AAR) to improve implementation of the Child and Family Team (CFT) meetings currently used in the CWS. This proposal will tailor and assess the impact of the AAR on enhancing CFT outcomes by addressing the following: Specific Aim 1. Conduct a qualitative needs assessment targeting the ongoing implementation of the CFT clinical intervention in a large, publicly funded, County CWS system; Specific Aim 2. Adapt and tailor the AAR team effectiveness intervention to address the CFT services intervention needs; Aim 3. Assess mechanisms of the AAR team effectiveness intervention for CFT implementation and a novel application of natural language processing methods. Aim 3.a. Pilot-test the AAR implementation strategy on improving CFT outcomes, and explore team mechanisms; Aim 3b. Identify and leverage CFT communication language data sources that are feasible, naturally occurring, and appropriate for the CWS context to submit to methods core for aggregation across projects.

项目总结（CWS中的R34#1行动后评审） 一半的儿童福利涉及儿童和青少年符合至少一个当前精神障碍的标准1。 行动计划的共同决策对儿童和家庭的心理健康和福祉至关重要， 儿童福利服务（CWS），减少了儿童迁移和复发2，从而减少了 儿童创伤风险、行为问题和心理健康问题。然而，无论是父母还是社工 认为行动计划包括相互影响3，父母觉得他们没有发言权或投入4。儿童和 每个儿童或青少年在进入CWS后60天内都需要参加家庭小组会议， 以家庭为中心的协作方式，根据相互的需求制定个性化、有效的服务计划。 协议5.依靠团队合作的方法，CFT会议打算让儿童和家庭在 创建和指导他们的案例计划6，建议孩子们在与家人联系时做得更好， 家庭与CWS机构合作7，8，并解决团队执行“复杂， 相互依赖、动态和模糊的任务。”9然而，在CWS CFT会议上，团队合作的质量可能会 由于服务于不同家庭成员的多种需求和观点的固有挑战而受损 和专业人员，以及CWS的压力和限制。创新源于团队效率 研究有望促进改进CWS内部的共同决策。事后 复习（AAR）是一种相对简单、便宜、快速和强大的工具，可以提高学习、表现和 团队和个人的有效性。阿尔斯是一种积极的自我学习过程， 反思具体的表现情节，积极参与自我发现，并在非 惩罚性/非评判性的方式。阿尔斯已成为组织在以下方面利用的常用工具： 军事、医疗、教育和其他应用，以提高个人和团队的绩效， 大约20- 25%。本建议旨在应用事后检讨的团队发展干预 (AAR)改进目前在妇女服务中心使用的儿童和家庭小组会议的执行情况。这 提案将通过解决以下问题，调整和评估AAR对增强CFT成果的影响： 具体目标1。进行定性需求评估，目标是正在实施的CFT临床 在一个大型的，公共资助的，县CWS系统的干预;具体目标2。调整和定制AAR团队 有效干预，以满足打击资助恐怖主义服务的干预需求;目标3。评估《公约》的机制 CFT实施的AAR团队有效性干预和自然语言的新应用 加工方法目标3.a.对AAR执行战略进行试点测试，以改善打击资助恐怖主义的成果， 探索团队机制;目标3b.识别和利用CFT沟通语言数据源， 可行的，自然发生的，适合于CWS上下文提交给方法核心进行聚合 跨项目。