STANDARDS

tHE frn fAMILY iNVOLVEMENT sTANDARDS

Family Resource Network Standards Involving
Participant-Identified “Significant People” In
Mental Health Treatment and Recovery Programs

Brief Standards
Full Standards

Introduction:
The 2009-2010 Annual Plan of the Philadelphia Department of Behavioral Health/Mental
Retardation Services (DBH/MRS) states: “Renewed emphasis on family inclusion is
perceived as a key element required for the success of system-wide recovery
transformation efforts.”
The Family Resource Network (FRN) recommends that service providers in the
behavioral health system make a priority of adopting the following set of FRN family
involvement standards. Adopting these standards will benefit service participants and
their families and other “significant people” in their social support system by providing
and maintaining a high quality level of services.

DOES YOUR PROGRAM MEET THE FRN FAMILY INVOLVEMENT STANDARDS?
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Definitions:
The term “participant” as used here is meant to apply to those who participate in and
receive behavioral health services, also known as consumers, persons in recovery,
clients, etc.

The term “significant people” (SP) includes everyone (other than treatment staff) who
may be important in a positive or negative way to participants’ recovery and treatment:
family members, friends, relatives, roommates, spouses/partners, clergy, etc.
Identifying important significant people to involve in participants’ recovery is a collaborative
process between participants and staff members, always subject to obtaining a release
of information from the participant.

Brief Standards
>>Click on any heading to see full standard description<<

At provider agencies or programs adopting the FRN family involvement
standards, the agency/program involves significant people in agency treatment,
case management, and other services by adopting, at a minimum, the following
as formal policies and procedures:

1. Provider staff members help participants identify "significant people,"
and obtain "family friendly" releases of Information

2. Provider staff contact every Identified significant person in a timely fashion,
with participant approval

3. With participant approval, provider staff members include appropriate significant
people in treatment team recovery planning and encourage their ongoing efforts to
help the participant meet recovery goals.

4. Provider staff members offer ongoing support and educational resources or
referrals to families and other involved SP’s.

5. Provider staff members document all steps taken regarding significant people
in formal records.

6. Provider agencies and programs routinely review documentation of the
inclusion and support of significant people as part of their continuing quality
assurance effort, discuss results, and implement needed improvements.

7. All provider staff—therapists, case managers, and other assigned staff--who work
with significant people have adequate training and experience in working with SP’s,
and receive ongoing clinical supervision in doing so.

8. Provider staff members familiarize significant people with agency and program
services

9. Provider staff recruit representatives of significant people to serve on policy
and/or feedback committees or groups.

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Full Standards

1. Provider staff members help participants identify "significant people,"
and obtain "family friendly" releases of Information
During the intake process or soon after, all participants are encouraged by staff members
to identify and provide “family friendly” signed releases for SP’s who may have a positive
or negative impact on their recovery. Staff members also help identify people who may
help or hinder the participant’s treatment and recovery.

After staff members are assigned to work with participants, these staff members continue
to make efforts to help participants identify people who can be significant to their recovery,
as well as continuing to make efforts to obtain permission to talk to family members and
other SP’s who the clinician sees as important to the participant’s recovery.
This is not a one-shot, “mention once at intake” process.

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2. Provider staff contact every Identified significant person in a timely fashion,
with participant approval
Assigned staff members continue the collaborative process of identifying important SP’s,
and with the participant’s approval contacts them by phone as soon as possible to
answer questions, seek information, and ask for their involvement and support in the
participant’s recovery.

lt is emphasized that clinicians initially contact significant people “by phone” due to
the difficulty many family members and other SP’s have in making a workday trip to the
staff member's office—especially if reliable transportation is not available, the SP has
few financial resources, and/or has difficulty getting time off from his/her work.

A primary purpose for the initial phone call is to ask significant people about their concerns,
to offer information about the agency and its programs, to offer information about sources
of family support and education, and to ask for support in assisting the participant in
his/her recovery.

The assigned staff should also asks for any critical information on a participant’s past
treatment problems and successes that may be vital to his/her recovery.
The inability or unwillingness of family members or other SP’s to travel to the agency
site for personal interviews is never a reason for the absence of family contacts or
continued outreach.

NOTE: Listing ”emergency contacts” for participants is not “family involvement” unless
those contacts are called routinely and not just in emergencies. “Emergency contacts”
are by definition only for emergencies, and are usually not for helping participants in their
recovery. Lists of emergency contacts are not lists of SP’s.

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3. With participant approval, provider staff members include appropriate significant
people in treatment team recovery planning and encourage their ongoing efforts to
help the participant meet recovery goals.
Assigned clinicians make the earliest possible participant-approved arrangements for
family members and other SP’s to be included in at least some treatment team recovery
and discharge planning meetings concerning the participant’s recovery.

Families and other SP’s are included in making contingency plans and other planning
meetings that may have an impact on SP’s and call for their understanding and/or cooperation.
With participant permission, results of such meetings should be communicated to SP’s
who couldn’t attend but are a vital part of the participant’s recovery.
This is especially important when changes in service such as discharges or
transfers are planned.

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4. Provider staff members offer ongoing support and educational resources or
referrals to families and other involved SP’s.
Provider staff members offer ongoing support and educational resources or referrals
to families and other involved SP’s (as opposed to family therapy).
This may include discussions of the participant’s diagnosis (with participant permission)
and the implications for treatment and recovery. The staff offers families written materials
concerning family resources (such as the FRN Family Resources Packet) and other
up-to-date information.

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5. Provider staff members document all steps taken regarding significant people
in formal records.
Documentation includes releases, efforts to obtain releases, staff contacts of any kind with
SP’s, and staff/participant plans for future and ongoing involvement of SP’s. Documentation
includes explanations of why there is no staff contact with any SP, if that is the case.

Documentation includes timely updates and descriptions of efforts involving SP’s in the
progress notes. The documentation provides enough detail to allow quality of care reviewers
to judge the quality and amount of SP-related effort.

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6. Provider agencies and programs routinely review documentation of the
inclusion and support of significant people as part of their continuing quality
assurance effort, discuss results, and implement needed improvements.
Providers routinely review at least a sample of randomly-chosen records looking for
evidence of participant documentation in all agency programs. Program staff members
are made aware of strengths and weaknesses of the documentation in a timely fashion,
and any problems are addressed promptly and results/improvements documented.

Providers have regular meetings that include administrative level staff to review the
overall effectiveness of FI efforts, and to plan and implement improvements.

Providers regularly survey at least a sample of participants, staff members, and
significant people and ask them about their awareness of specific practices occurring
(To an SP: “Did a staff member call you within two weeks of your participant being
admitted to the day program?”), and their level of satisfaction with FI practices and policies.
Since most people in human services surveys report high levels of satisfaction no
matter what, satisfaction surveys are not a substitute for finding out what practices are
actually occurring.

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7. All provider staff—therapists, case managers, and other assigned staff--who work
with significant people have adequate training and experience in working with SP’s,
and receive ongoing clinical supervision in doing so.
Clinicians have at least one year of supervised family/SP liaison work, or they have received
training in outreach to SP’s (especially family members), engaging SP’s in support of the
participant’s recovery efforts, and knowing of and offering resources for SP’s including
families--and the clinicians have demonstrated competence in these areas.

All clinicians working with families and SP’s receive at least monthly ongoing clinical
supervision that includes discussions of SP involvement and support issues.

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8. Provider staff members familiarize significant people with agency and program
services
Provider staff familiarize SP’s with agency and program services through conversations
(asking for any questions that SP’s may have) and literature. SP’s are informed of the
procedure for appealing decisions with which they disagree. SP’s are informed who
program administrators are. Any students or others in training inform SP’s of their
student status and who their supervisor is (as required by professional ethics).

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9. Provider staff recruit representatives of significant people to serve on policy
and/or feedback committees or groups.
Staff proactively recruit family representatives to serve on policy or feedback committees,
and to participate in QA/QI interviews and surveys.

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