It is not often that someone in our field is asked by government to have one’s research form the basis of a national model and/or programme. This is what happened to Rhoda Emlyn-Jones OBE when the Welsh government set about trying to integrate all professional groups concerned with health and social problems, with an emphasis on families and reducing the number of children in care. They wanted Rhoda’s Option 2 approach and associated research to form the basis of their Integration Model. Here is a post focusing on the resulting Integrated Family Support Services (IFSS).
Integrated Family Support Services (IFSS) [10’50”]
Wulf describes how Rhoda migrated into Integrated Family Support Services (IFSS), which was something that the Welsh government had embraced and encouraged her to do as part of a much wider piece of work with social workers across the whole of Wales.
Rhoda says that the money for Option 2 came from the Drug & Alcohol funding stream. However, she has always emphasised that the Option 2 approach isn’t just important for issues relating to drug and alcohol problems. It is relevant to any issues that are impacting negatively on a family’s functioning. Her team, working with the most extreme situations, have shown that the Option 2 approach leads to true generational change.
When the team conducted their longitudinal studies they could find their control group families very easily. They had initially been referred into Option 2, but as no space was available they moved on to other services. The researchers found all these control group families still in the system years later. In contrast, the researchers struggled to find Option 2 families in the system, presumably because they were now not experiencing problems.
Rhoda describes one family who participated in the programme, where the husband was attacked by someone with a machete, and then went and attacked someone else with a machete, a week prior to starting Option 2. At the time, he and his wife were injecting drugs into their groin and feet. The family completed the Option 2 programme and later became leaders in the family community.
When the Welsh government set about trying to integrate all professional groups concerned with health and social problems, with an emphasis on families and reducing the number of children in care (which were extremely high in the country), they found Rhoda’s Option 2 research and asked her if this could be the basis of their proposed Integration Model. Rhoda agreed and set about thinking what the structure should look like, who would be involved, and how they would relate to the pathways into their own professions, and how they would function.
The idea was that Community Psychiatric Nurses (CPNs), drug and alcohol specialists, social workers, occupational therapists and health visitors would form one team. The team would look at new referrals and only one person would visit the family, since they were all doing the same thing. They would then bring their specialist knowledge together in their team’s reflective groups. In this approach, the family would only see one person and would not get muddled up by multiple visitors from different siloed professions often with very different philosophies.
Rhoda emphasises that their model had always been about consultation. When any professional rang into the team, they had a truly skilled consultation around what’s going on for the family, the strengths in the family, the family’s priority risk, and what they (the family) hoped for in terms of an outcome. They wouldn’t start the work until they were sure that the worker referring wasn’t just working on family deficits.
‘We engaged with that worker as a human being, empathised with them, their stress, their worries, their fears, and not treat them as someone who doesn’t understand.’ If the team was going to have collaborative approaches, they really needed to respect and empathise with each other right from the beginning. Once this referral came in and was discussed amongst the team, one worker would go out to the family. The team also had a philosophy that all IFSS members would be trained, and then learn to be trainers of others, so they could deliver training themselves—learning would therefore always be rippling out.
Rhoda recently had the joy of attending an IFSS workshop in North Wales with Wulf. The team had been running for ten years and she was thrilled to see that the model and approach had not drifted at all from the original philosophy. She saw the same results as she had previously seen, and met family members who said they wouldn’t have their children, or their lives, if it wasn’t for the IFSS team. ’True fidelity,’ says Rhoda with a huge smile.
Two IFFSS workers approached her after the workshop and said, “I am so thrilled to be in the IFSS because I had a placement there, it took me five years to get in because there were no vacancies.” Rhoda says, ‘The reason there’s no vacancies, people are doing their best work.’
She points out that it was so special to hear that, because in the social care industry in Wales a massive number of workers are losing their mojo. Wulf points out that a lot of people want to do drug and alcohol work or be involved in similar occupations—‘I just want to help people’—but they then find themselves in a job where they are just processing paperwork, rather than doing the things they thought they would be doing.