This article originally appeared in the July-August 1998 Children's Advocate newsmagazine, published by Action Alliance for Children.
By Kyra Gottesman Evans
Four years ago, a Santa Clara County mental-health agency pioneered an innovative approach to treating kids with severe emotional and behavioral problems. Instead of taking them away from their families and pouring resources into treating them in group homes, the agency decided to use available funds to wrap services around the children and families, so the kids could remain at home.
Joining forces with Santa Clara County's social-services, mental-health, and juvenile-probation departments, the Campbell-based nonprofit Eastfield Ming Quong (EMQ) created Program UPLIFT (Uniting Partners to Link and Invest in Families Today). Two years later, in 1996, the state passed legislation allowing the county to fund the program with money allocated for foster care and group homes.
Program UPLIFT has achieved impressive results. Among its 5- to 18-year-old clients, 86 percent have been able to stay with—or return to—their families. The children not only stayed home, but got better. Of the 51 children discharged in the first three years, 34 no longer receive social-service or mental-health funding. Of the 28 discharges in 1996, 86 percent were successful graduates from the program.
Impressed with this success, the legislature last year passed a new law allowing other counties to use foster-care funds for similar programs, with the permission of the state Department of Social Services.
To achieve these results, Program UPLIFT turned around some of the typical ways professionals work with troubled children and families.
Children entering the program "qualify for what's called Level 14 Residential Placement, the highest placement that's not a locked facility. All the kids in the program have previous placement failures. That is, they didn't make it where they were. The majority of them have anywhere from two to eight placement failures, some as many as 15," said Roberto Favela, vice president of clinical services for EMQ and Program UPLIFT administrator.
When a child enters Program UPLIFT, a core team of specialists forms to work with the family. The head of the team, though, is the child's parent or primary caretaker. The team also includes a mental-health clinician, a family specialist, and anyone else who might be helpful — family members, close friends, teachers, clergy, probation officers, etc.
"The parent is the head of that team. Then we basically ask them to tell us who else is important. As the head of the team, the parent has voice and access to what's happening, and that leads to ownership. In most places, plans or programs are created for them and they just go along," explained Favela.
Another key player on the family team is a parent who has been through (or is going through) UPLIFT. These "parent partners" are employees of the program and serve as advocates for other parents.
"These are people who can speak out on behalf of the family. The family may be nervous or afraid to speak up and may just be going along but not really buying into the plan we are creating," said Favela. "They are people who can say to other parents, 'Hey, I've already walked this road. You don't have to do it alone.'"
For Rosa Fernandez (not her real name), whose son Antonio was one of the first children served in the program, being part of the process instead of the target of the process was an empowering and a difficult position. At six, Antonio had been placed in residential care for explosive and violent behavior after having failed in foster placement. He was about to come home after two years, and Fernandez was worried.
"I knew I was going to have a hard time adjusting to him being home again, and so was he, and so were his younger brother and sister. I also knew that I had to work on the relationship Antonio and I lost when he was taken away," said Fernandez.
Fernandez had already divorced Antonio's abusive father and knew she wanted to find a job and make a normal life for herself and her children. As head of her family's Program UPLIFT team, she began developing a plan to reach those goals.
"I met with the program director, a parent partner, and a family facilitator. We went through what I wanted and needed for my family and what I had to focus on to get there," recalled Fernandez. "It threw me off at first. I said, 'What do you mean, what do I need? What do I want?' It was a totally different approach, and it took a while to get used to. But then it felt really good, really empowering."
The team's job is to support the parent in setting goals for the child and family, then wrap the necessary services and resources around the family. Services range from formal mental-health treatment to informal parent-to-parent support, special family outings, employment services, respite care, mentoring, transportation, and just about anything else the family needs—from an immigration lawyer to a box of emergency food. Since each family is different, so is each plan.
"Most of the time, an assessment is done to see where families fit into the available programs. We look at the family first, what the family needs to be successful, and create a plan around those needs," explained Favela. "The program is needs-driven and based on unconditional care for the family. Whatever it takes is what we do. Whatever it takes."
These services must fit with the family's culture and language. "This is critical to keeping the child, family, and whoever else is involved in communication," said Favela.
Program UPLIFT teams assess the family by looking at its strengths. "We've gotten away from theassessment of pathology, which leaves people feeling like they have just gotten a tongue lashing," said Favela. "Instead, we look at what does your family do best? For example, say a kid just got out of juvie and this kid's mouth gets him in trouble all the time. We look at that as a strength and say that kid has a strong ability to articulate. Now, how do we use that ability to work in the kid's favor instead of against him? You can take almost anything from the pathology and reframe it to use as a strength."
After years of dealing with social-service agencies, Fernandez was all too accustomed to being made to feel, not only wrong, but powerless. "I had social-service workers say, 'I have power over your child, you have nothing.' I was scared, really worried, and really hurt because my baby was missing from me. He was gone. I cried every night," said Fernandez. "This was very blaming. This was not empowering. In a sense, the Program UPLIFT people told me I do have control. It took some time to believe, but when I did, I realized that, hey, these people do care about me and Antonio. They want things to work for us. That is totally different."
After participating in the program for nearly eight months, Fernandez got a job as a parent partner. While Antonio, now 10, still struggles, he has successfully graduated from the program, rarely explodes, and is interested in school. Fernandez, a single mom at 32, is working to help other parents meet their goals for their families.
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