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Site Index
About The Option 2 Intervention
Training and Consultancy Services
Reports, Reviews and Evaluation
The Option 2 Statistical Database
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The Option 2 Process
The Option 2 model is whole and complete in itself. It has been intensively researched and developed over 15 years in the USA and that research and development continues here in Wales. It is important for the success of the intervention that each of its core elements are adhered to. The sense of crisis, the brevity of the intervention, the relationship between therapist and client, the skilled workers, the tools and the structure. Each element locks into place.
A crisis state is self limiting; within four to six weeks it reaches some kind of resolution and burns out leaving people either with new behaviours or reverting to old ones. Often there will be a chain of crises when new behaviours are not appropriate or when behaviours have not changed. A feeling of crisis is vital to the success of this intervention. In a crisis, people are ready to change although they may have difficulty expressing this. So our intervention is brief and focused on using that state to achieve positive and appropriate change.
Our goal is to help families to learn new skills that will enable children to remain in the family home in safety. This is about empowering families and moving the children and their needs into the centre of the dynamic. The power for change resides in the family and we help people to access that power. We use Motivational Interviewing techniques to identify and build on the strengths in the family and beliefs about family life. We help the family to define and set an achievable number of clear realistic and personal goals. Using a variety of tools we work towards those goals step by step, helping families to learn and establish new behaviours during that crisis state.
Trouble has no timetable and Option 2 therapists are on call to families 24 hours a day, seven days a week. We work intensively with families and provide as regular and as long a session as is needed, 15 hours a week is not unusual. Obviously each therapist can only work with a small number of families at a time so that all their time and efforts can be focussed. This is really a years worth of therapy condensed into four weeks.
We work together in the family’s natural environment, the home, the family and the community. We do this at times that are appropriate to the families needs. We work together for four weeks. In certain circumstances we will extend this for up to two more weeks. Closure is built in to the intervention from the start. We will also offer up to two brief ‘booster’ sessions and make follow up contact at one, three, six and twelve months.
We don’t expect our intervention to work for every family, but we can never tell which families it will work with until we try. Families themselves report that our intervention has been of great benefit. We follow the progress of families for a year after our intervention. We collate information on their progress every six months and produce a comprehensive annual report each year. The results of our intervention have been very encouraging with the vast majority of our clients reaching their goals, creating positive and sustained change in their behaviour with the result that their children remain at home with them. The Option 2 Intervention has a very clear process. We might not use all of the elements outlined here and we may sometimes use them in a different order. The client family and their needs drive the process forward. However, a classic Option 2 Intervention looks like this: 1. A referral is made by a childcare social worker contacting us by telephone. We talk through the situation, collect information and fill in a referral form whether we are going to accept the referral or not. We make a decision about whether we are going to accept a referral based on the following referral criteria:
2. If these criteria are met and if we have a space, then we will make contact with the family within 24 hours. If we do not have an immediate space then the referrer will be informed and the case will not be taken. Our aim when contacting the family is to see the children and simply to be invited back to talk about how we may work together. At this point we just listen to the client’s story. 3. In the first 72 hours we look for immediate risks with the family and together we create a safety plan. Analysing the risks with the family, listening to their fears and concerns and making reference to the childcare professionals concerns. We look briefly at what resources, beliefs and strengths the family has that can overcome these risks in the short term. This safety plan is written down in detail and copies are given to the family and the referring social worker. In essence the safety plan is an agreement that describes risk behaviour and is clear about each person’s responsibility when risk behaviour happens. 4. We then look to see if there are any immediate practical problems – what practical blocks are there to the family making changes – no gas or electricity, depressing surroundings which challenge self-worth and lower expectations of success. If we can help to change this, we do. We give clients models of immediate action and hopefulness. We have a small budget allocated for use with each family; this is easily accessible to the therapist and can immediately dissolve obstacles which block progress. This is not about bailing people out; it is about creating hope and a belief that things can get better. 5. Using a card sort we look in depth at people’s values. What do they believe about family life? What are their hopes and dreams for their family? This exercise creates a cognitive dissonance, a difference between what people believe and what they do. This motivates people to change. It also opens communication and facilitates an honest exchange of beliefs, giving people the message that we actually care about what they believe and value their culture. If we value it, then they value it and are motivated to protect it. This exercise generates a long list of beliefs about family life. Families are encouraged to prioritise these beliefs and choose a small number of the most important things. This gives a clear focus on what is really important right now. 6. Using another exercise we look at the family’s strengths – what is positive around and about them. This exercise focuses on the positives of the individual, family, culture, and ecology. It provides feedback that things are not ALL bad, that there are plenty of good, positive and supportive aspects around them, personal or ecological strengths. Things that can help them to cope with change. These two processes build hope that change is possible and confidence that they are able to make those changes. They create a clear awareness of important beliefs that encourage change and an understanding of the strengths that will help to support and maintain that change. We usually find that at this point, about three days into the intervention, people are feeling much more positive, confident in talking honestly to us and hopeful about the future. 7. Using their growing confidence and hope, we help families to create positive achievable images of the future. Building on the existing strengths and values in the family we help the family to set goals which define clear behavioural outcomes and give clear expectations of change. We negotiate goal priorities and devise, scale and score these goals in a way that enables the therapist and the family to discuss and monitor progress towards them. They provide clear indicators of success. We work on just the most important goals for each family member, no more then three each. These also are fed back to the referring social worker so that they are clear about the route our intervention is taking and so that everybody in the system is clear about what changes we are working on. 8. Peoples goals are many and varied often include: giving up or changing drink or drug use, having better relationships with other family members, creating better routines for the children, managing children’s behaviour, having a cleaner and tidier home, being calmer, getting children to return to school, help to live with depression or anxiety and returning to work or education. Using the goal record sheets, the therapist devises a plan which looks at what happens in each of the four weeks. We break down the steps towards achieving those goals and together we address these particular issues by teaching new skills, such as behaviour or anger management, time management, crisis management tools, communication skills, relaxation skills. 9. Towards closure we start to look at maintenance. What services and resources are required to enable the family to continue their progress. This might mean referrals to other agencies providing a range of services. 10. We provide a comprehensive report to the family and the referring social worker and this would contain recommendations about further work and strategies that we feel would be useful to this family. 11. One month later we visit again and with the family we look at the goal sheets and re score them again according to where the family is at that time. Three six and twelve months later we do it again. At each stage it is noticeable that the majority of families will have reached their stated goals, a great number will have exceeded their own expectations and a smaller number will still be working toward those goals. This happens because the goals have not been imposed by anybody else, they are real, clear, personal and measurable and we have given them some tools and skills to move forward. Conclusion Change is inevitable. Our process helps to facilitate a positive change that enables more children to grow up in the families they belong to. Our ongoing research is showing that families we work with do change and children do remain at home. Our measures are taken from what families themselves say about change and from what social workers and child care case conferences do after our intervention is over. Independently of Option 2, Children’s names are taken of the Child Protection Register by Case Conferences. Childcare social work teams feel that cases no longer warrant their intervention and they are closed. Our annual report gives figures in detail and is available from our office. The Option 2 intervention is brief, focussed and effective in creating change, and so it is relatively cheap. Some families involved in criminal activities have stopped offending, their children are less likely to offend or misuse drugs or drink. Families focus on what they want out of family life, they become closer, more cohesive and more child oriented. Many children have avoided the care system and the variety of associated personal and social costs. The Therapeutic RelationshipThe client’s agenda is everything. People truly are the experts on their own situation and the therapist’s skill comes in listening. Creating a shared therapeutic experience. A rapport. Creating the conditions for change, building confidence and hope. Sometimes the simple act of mending a bicycle, a broken door lock, helping to choose wallpaper, fixing some furniture or a radiator can make the difference. Some practical show of caring about the client and their family which relieves pressure and models appropriate responses to stressful situations. A worker needs to be human enough to understand that life is rich, complex and multi-layered and the clients presenting problem is just a part of a whole life, rich with relationships, cares, values, beliefs and worries, understanding and misunderstandings, ideas, hopes and wants. Somebody open to their faith or spirituality which is massively important and yet so often overlooked because it is too scary, weird, personal or rigidly held. The way we relate to people influences the way they feel about themselves. If people are treated as worthless they come to feel worthless. If treated as worthy, people come to feel worthy. If people feel they have worth, then they have something worth looking after. Moods and feelings are contagious. From this initial model still used in Cardiff and the Vale of Glamorgan have sprung a variety of interpretations and practices that flourish across the UK. What you focus on GROWSStrengthsWeaknessesProblemsSuccessBehaviour
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