Get Together FaST Final Report & Recommentations

 

The Department of Human Services' In Partnership Policy (1997) gives clear direction concerning the important role taken by family members and other carers in the provision of publicly funded mental health services. The Get Together FaST (GTF) Project conducted by The Bouverie Centre ('The Centre') between 1997 and 1999 was commissioned to implement this policy.

 

The Centre was funded to design and implement a statewide training program both to enhance family sensitive practice in mental health and related (e.g. disability) services and to promote better collaboration between stakeholders. The Project thus had the dual focus of enhancing skills of workers and developing services.

 

 

Funding was granted to conduct training for all mental health services in Adult, Aged Persons and Child and Adolescent Mental Health Services (CAMHS) and, via a separate grant, to psychiatric disability support services in the adult mental health area. It was decided to combine training programs for both clinical and disability support staff in the adult area.

 

The Project was based on a set of principles (non-blaming collaboration, congruence of process and content at all levels, systemic change and working with strengths and acknowledging local needs). It employed a set of strategies that maximised ownership of the initiative by key stakeholders (workers, carers and consumers).

 

 

The Project was independently evaluated by the School of Psychological Science at La Trobe University. The emphasis in this evaluation was primarily upon assessing the impact of training upon course participants. There were also some measures which reflected the impact of the courses upon the services or organisations from which participants were drawn. The major results of the evaluation are incorporated into the Final Report, with two separate reports providing more complete discussion of the evaluation (Evaluation Report) and detail of method and results.

 

 

Three Advisory Committees - Adult, Aged Persons and Child and Adolescent Mental Health Services - developed a curriculum for each course. All stakeholders, and in particular carers and consumers, were represented on these committees.

 

Three teams were established to conduct the three training streams. Each team included a Principal Consultant (responsible for overall development and implementation of the initiative), a Senior Facilitator (responsible for statewide implementation of training) and Course Facilitators who had extensive experience in mental health family therapy and adult education. The relevant team for each training stream also consulted closely with management of services in each area in which courses were to be conducted.

 

 

For each course a professionally produced individual Workbook was distributed to each participant. All courses had six modules - one for each half-day session - which incorporated a variety of teaching techniques (e.g. group discussions, role plays, lectures, audio visual presentations, 'exercises'). Participants were viewed as representatives of their agencies, whose role included transmission of the course material to their own agency and colleagues.

 

The three streams shared some common content areas, but course design also allowed for some flexibility in topics covered. The common themes included an emphasis on representing the viewpoint of carers and consumers, action based learned (including the development of projects by syndicate groups formed with each course), engagement of families, examining constraints to family sensitive practice and exploring the lived experience of families (in particular, as a response to external trauma).

 

Each stream made effective use of audio visual materials, in particular video tapes such as the FaST Video Kit, to present issues and promote discussion. Specialist topics were also offered in Adult and Aged Persons Mental Health Services streams, allowing participants to choose one or more modules which had particular applicability to their area, e.g. working with Koori families, single session work with families.

 

 

Every health care network or area was formally consulted by the relevant FaST team in order to provide information about the initiative and to gather information about local conditions, to develop joint goals and to enlist management support. A local convenor was appointed, usually from the lead or host agency, to organise details of the training course for that area.

 

 

Courses were delivered to all streams in every area of the State (except one Aged Persons service area). In a few rural areas, joint courses, incorporating different streams, were arranged.

 

 

The Project produced four newsletters, created and maintained a website, and facilitated access to The Bouverie Centre's library as part of this component of the initiative.

 

 

Consultation meetings were generally conducted with management once the evaluation was completed six weeks after a course's conclusion. The relevant GTF team gave feedback to services about that area's training program and also received feedback from managers. Each service's longer-term plans were discussed, with services being encouraged to establish a 12 month plan for improving family sensitive practice which specified relevant goals and targets and implemented projects developed within training courses.

 

 

Participation was extensive, with more than 884 mental health staff (including 160 from non-government agencies) from every Mental Health Services area participating in 44 courses throughout the State. Thirty-three carers and 23 consumers were also formally involved in the training.

 

Overall, the training was rated as worthwhile by participants, including carers and consumers and managers and team leaders of staff attending the courses. The formal evaluation concluded that in all three streams the training led to measurable improvement in workers' attitudes and self-reported practices in relation to families: participants were generally more positive about families and perceived families as less difficult, complex and troublesome at the end of training than before it began.

 

The evaluation also revealed some variations in the pattern of changes. For example, participants in the CAMHS stream responded somewhat differently to training than did participants in Adult and Aged Persons streams. There were also suggestions that some professional groups, in particular medical staff, staff of mobile services and staff with greater experience and seniority, may require specialised training.

 

A large number of projects were developed and implemented by syndicates formed within training courses: 165 projects were recorded in the Adult and Aged Persons stream and 46 in the CAMHS stream, and at six week follow up, most had been completed or were still in progress. These projects encompassed a wide range of initiatives including:

Many projects responded to expressed needs of families, for example, a desire to be more involved in the running of services as well as in the management of their own family member. A number of projects fulfilled the GTF's goal of promoting service development and more effective interagency collaboration around family sensitive practices.

 

The initiative introduced a number of high quality training materials which are currently being marketed to interstate and overseas locations. The FaST Video Series received particularly strong endorsement from participants.

 

 

The GTF Project aimed to implement the In Partnership policy by conducting a statewide service development initiative based on training mental health workers in family sensitive practice. Training was designed to enable participants to work more effectively and collaboratively with families, carers and consumers and to implement family sensitive practices in their respective workplaces and areas.

 

Participants embraced the training with enthusiasm, and many reported that the course provided a catalyst to improving their own practice as well as that of their organisation and local network of services. The GTF Project was clearly judged a success by those it targeted, while the independent evaluation confirmed that participants' attitudes and behaviour in relation to families were enhanced. Indirectly the Project's impact was even more extensive, as each participant undertook training as a representative of his or her organisation and agreed to share the course messages and content with colleagues.

 

The GTF Project demonstrated that more effective work with families can be promoted in the short term by family sensitive training courses. The Project moreover attempted to maximise this effect of training by incorporating a service development focus, for example, by an action oriented learning approach and delivery of training to local networks of services.

 

Whether this approach will result in sustainable, systemic enhancement of effective work with families cannot be assessed within the parameters of this Project. The experience of other projects and research suggests that over time changes in attitudes and behaviour tend to fade unless promoted by structural changes and adequate resourcing. Further work is clearly required both to set appropriate benchmarks for family sensitive practice and to determine the levels of resources required in Victoria to achieve these standards.

 

The Project highlighted a number of areas in which steps can be taken to maintain the momentum generated by this Project. The Final Report categorises these suggested initiatives in terms of four major categories:

Specific recommendations are made under each of these headings. Speedy implementation of initiatives such as those contained in these recommendations will be a key factor in determining whether the momentum for change toward working more effectively with families can be maintained and fostered.

 

The full report is available from the Bouverie Centre. For further information, please contact Brendan O'Hanlon either on 9385 5100 or by email at b.o'hanlon@latrobe.edu.au.