RE: service continuum family by family

["Sharry Erzinger" <serzinge@xxxxxxxxxxxxxxxxxxx>]

What a great project!  It really addresses frustration with only treating
abuse/neglect after-the-fact rather than upon recognition by the parent who
wants to DO SOMETHING.

Any attempt to put these parents into similar categories with those who have
CPS referral(s) ignores a basic premise about human behavior:  People vary
in their readiness on the trajectory of change.

The Transtheoretical Model of Change has been utilized to tailor programs
that demonstrate effectiveness in programs to address 12 problem behaviors
including smoking cessation, safer sex, and recently have been at least
theoretically applied to Batterer treatment programs.

The focus on services, service delivery, better service delivery is
misplaced whenever we assume that the clients are the same.  Without some
awareness and integration of the degree to which the person/family  is open
to the services because they are in a high/low change mode could add greatly
to the effectiveness of service delivery.

Check out these references on the Transtheoretical Model of Change, and
let's start applying the change process to the families we serve:

Daniels, JW & Murphy, CM 1997 Stages and processes of change in batterers'
treatment.  Cognitive and Behavioral Practice, 4, 123-145.

Prochaska, JO, Velicer, WF., Rossi, JS et al 1994 Stages of Change and
Decisional Balance for 12 Problem Behaviors. Health Psychology 13(1): 39-46


Sharry Erzinger, Dr.P.H.
<serzinge@carbon.cudenver.edu>
phone/fx 303-988-3270



-----Original Message-----
From: owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu
[mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu]On Behalf Of
David Stuart Crampton
Sent: Monday, August 07, 2000 9:53 AM
To: Child Maltreatment Researchers
Subject: service continuum family by family



I am working on an evaluation of a program that offers voluntary in home
services to families who do not legally qualify for CPS intervention (they
are not investigated or if they are, their case is not substantiated).

It probably comes as no surprise to you all that since the services were
put in place, calls to CPS have increased dramatically, many are
self-referrals from families who want the service.  Of course the demand
for services is creating a budget crunch and frustration expressed by the
funders about whether the families are best served in this way or whether
they are more appropriate for community mental health, public social
services, private social services, or something else. This frustration
leads to the question: are all the human service providers essentially
serving "the same families"?  Is money wasted giving families inadequate
help over and over?

We have pretty good data on the families served by this program and the
referrals that are made elsewhere, but don't have a lot of information
about where they may have received services in the past or what they might
use in the future.

We are faced with the question of whether we can map the whole service
continuum family by family to better understand the perceived
inefficiencies in service delivery.  Has anyone done something like this?
How did you address confidentiality across systems?  Did you use a point
in time sample or did you attempt a cohort study?  Any qualitative
studies that asked families how they access services?  Any advice would be
appreciated.  Thank you.