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: 10406508
• 负责人: GREGORY AARONS
• 金额: $ 16.42万
• 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/10406508
• 关键词: 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; Effectiveness; Effectiveness of Interventions; Elements; Event; Excision; Family; Family member; Focus Groups; Funding; Impairment; Individual; Intention; Intervention; Interview; Language; Lead; Learning; Medical; Mental Health; Mental Health Services; Methods; Military Personnel; Natural Language Processing; Needs Assessment; Outcome; Parents; Participant; Performance; Preparation; Process; Psyche structure; Published Comment; Recording of previous events; Recurrence; Research; Risk; Services; Source; Specific qualifier value; System; Testing; Transcript; Trauma; Voice; Well in self; Work; Youth; adverse childhood events; anxiety symptoms; base; child mental health service; child services; collaborative approach; depressive symptoms; early adolescence; effectiveness research; implementation strategy; improved; innovation; meetings; member; novel; pediatric trauma; pilot test; pressure; satisfaction; service intervention; shared decision making; social; therapy development; tool; trauma symptom; 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.

项目摘要（在CWS中进行的行动审查后R34＃1） 一半的儿童福利涉及儿童和青少年符合至少一种当前精神障碍的标准1。 行动计划的共同决策对于儿童和家庭的心理健康和福祉至关重要 儿童福利服务（CWS），儿童降低和收入较少，因此导致下降 儿童创伤，行为问题和心理健康问题的风险。但是，父母和案例工作者均未 认为行动计划包括相互影响3，父母觉得他们没有声音或输入4。孩子和 每个儿童或青年都需要在进入CWS的60天内需要家庭团队（CFT）会议，并且是 以家庭为中心和协作的方式来制定基于相互的个性化，有效的服务计划 协议5。依靠团队合作的方式，CFT会议意图使儿童和家人发表声音 制定和指导他们的案件计划6，建议孩子在与家人建立联系并授权时做得更好 与CWS机构合作的家庭7,8，并满足组织的需求，使团队执行“复杂， 9然而，在CWS CFT会议上，团队合作的质量可以是 服务于多种需求和观点的固有挑战所损害，这些需求和观点各不相同 和专业人士，以及CWS的压力和约束。团队有效性的创新 研究有望支持CWS内共享决策的改进。后表演 评论（AAR）是一种相对简单，廉价，快速和强大的工具，可改善学习，表现和 团队和个人的有效性。 AAR是积极的自学过程，团队成员 反思特定的表现情节，以积极参与自我发现并改善非 - 惩罚性/非判断方式。 AARS已成为组织所利用的常见工具 军事，医学，教育和其他应用，以通过 约20-25％。该建议旨在应用后行动审查的团队发展干预措施 （AAR）改善CWS目前使用的儿童和家庭团队（CFT）会议的实施。这 提案将通过解决以下内容来量身定制和评估AAR对增强CFT结果的影响： 具体目的1。进行定性需求评估，以持续实施CFT临床实施 干预大型，公共资助的县CWS系统；特定目标2。适应和量身定制AAR团队 有效干预以满足CFT服务干预需求；目标3。评估机制 AAR团队有效性干预CFT实施和自然语言的新颖应用 处理方法。目标3.A.试点测试AAR实施策略，以改善CFT结果，并 探索团队机制；目标3B。识别和利用CFT通信语言数据源 可行的，天然发生的，适合CWS上下文提交方法核心的核心 跨项目。