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CAC MDT Research Project Update Children’s Justice Act Quarterly Meeting January 13, 2017
CAC MDT Research Project Update
Children’s Justice Act Quarterly Meeting
January 13, 2017
Project Goals
• Evaluate the MDT model and the MDT Enhancement Program (MEP)
• Develop recommendations, tools, and strategies to strengthen the MDT approach to investigating and prosecuting child abuse cases within CACs
• Focused analysis on three key elements critical to enabling effective MDTs, strong case development, and positive child and family outcomes
– Time-sensitive Coordination
– Interagency Relationships
– Team Interaction Process
Four Guiding Objectives
• Identify systemic barriers to effective collaboration and information sharing
• Highlight existing practices associated with strong case development and positive case outcomes across diverse CACTX member organizations
• Evaluate the multiple impacts of the MDT Enhancement Program on case development and child-family outcomes
• Develop specific recommendations for policy modifications and team process interventions
Data Collected
Data Collected to Date
Methodology Data Collected Population Method Focus
Qualitative 25 Focus Groups
2 Interviews
Homogenous: 8
Heterogeneous: 17
Individuals: 2
Interagency RelationshipsTeam Interaction Processes
Interagency Relationships
Quantitative 1,327 Surveys 1,327 from 69 CACs
MDT Communication and Work Dynamics
• All initial data collection is complete, except one remaining focus group to be conducted in February
• A second round of surveys will be sent out in February
Key Findings from Focus Groups:
What MDT Partners Told Us About Their MDTs
Knowing who to contact at CPS makes all the difference…
…we have regular contact and get
into a rhythm……
…it would be helpful for my office to have
some of the information CPS folks
find out a little bit earlier.
…the earlier we reach out to law
enforcement, the better…
…the team works when everyone is
accountable…
…if you’re accountable, I can
trust you…
…we build relationships, we're all in the trenches
for one cause…
…all these informal relationships make
it happen…
What makes an effective MDT?
Knowing who to contact at CPS makes all the difference…
…we have regular contact and get into a
rhythm……
…read the intakes and make sure no
one is falling through the
cracks…
…she has access to all the intakes
CPS filters through…
…the glue holding all the relationships
together…
…she manages the team
relationships day to day…
How can the MDT Coordinator
help you in your role?
…being the go-between who keeps us all on
task and informed…
…she bridges the gap between us
and law enforcement…
My case load is ___.
MDT partners reported 3 factors
as key to team functioning:
Team Composition
Interactive Communication
External Context
Team Composition
Membership Types
Turnover
Roles
Coordination
Resources
Inter-connectedness or hierarchy among
the rolesFrequency of membership
changeHow clearly
members understand specifics,
benefits, and limitations of each
other’s roles
Coordination efforts to maintain team functioning (e.g.
reminders, agendas, etc.)
Resources within the team such as
bilingual team members,
professional experience
Interactive Communication
Addressing Each Other
Flexibility
Work-life Interface
Emotion Norms
Translation
How team members address each other (e.g. by name or by role); referring to team as “family”, etc.
Willingness to accommodate or
try different things
Intersection of work and private life;
talking about personal lives; not being able to talk
about work at home
Openness of members to emotional
displays within team
Willingness of members to explain technical aspects of
their jobs to each other
External Context
Location
Teammates’ Affiliation
Image of the MDT
Size of area served; co-location of
team
Support from peers and mgt.
and other impacts on MDT
How the work done by the
MDT is perceived by
outsiders
Selected Survey Findingsrelated to the
MDT Enhancement Program
All MDT Partners Participated
1,327 total surveys completed
65% of Survey Respondents Were Aware of the SWI Initiative
Among those knowledgeable about it there was strong
support for the SWI Initiative
The Statewide Intake (SWI) Initiative is a great tool for the MDT model
Among those knowledgeable about it there was strong
support for the SWI Initiative
I think the new Statewide Intake (SWI) Initiative will help our MDT to serve more
children
Among those knowledgeable about it there was strong
support for the SWI Initiative
I have a clear understanding of what the Statewide Intake (SWI) Initiative means for
my work on the MDT
Preliminary Data Analysis
Analysis
• What makes CAC multidisciplinary teams work?
• Systemic barriers to effective collaboration and information sharing
• Predictors of Practices associated with positive outcomes
Key Areas of Analysis
• Social Support and Resilience
• Occupational/Structural Barriers, Vicarious Trauma, and Emotional Support
• Location
• Impact of MDT Enhancement Program/Occupational Differences
Three Levels of Communication & Temporal Analysis
• Micro—Language at the Individual Level
– Linguistic features (e.g., subconscious use of words)
• Meso—Interaction at the Team Level
– Team practices/discussion (e.g., shared reflection around key themes)
• Macro—Self-Report Data about Work-Based Structures
– Private judgements about external communication structures and experiences
Social Support & Resilience
Micro Meso Macro
Relational language and key words about relationship
Role Clarity and appreciation, adaptation, composition, support from supervisors, support from peers (MDT and CAC), colocation, social support and “family”
Higher performing teams also reported greater role understanding and appreciation, more feedback, psychological safety
EVERY measure of social support was found to be associated with lowered incidence of burnout for MDT members
Occupational/Structural Barriers, Vicarious Trauma, & Emotional
Support
Micro Meso Macro
Occupationalstereotyping and professional identity formation; language that degrades teamwork and relationships (e.g., names vs. positions)
What helps and hinders—composition, communication,and context (themes in discussion that are used when members talk about their team)
Supervisory support
CPS workers had higher burnout than all othersDoctors and prosecutors had higher burnout than other partners (excluding CPS)
Location
Micro Meso Macro
Members of co-located teams use more in-groupreferences to describe other agencies and teams that are not co-located use more out-group references to describe other agencies
Teams that are more dispersed describe more tension
Commute did not predict performance, but did affect burnout
Physical proximity allows for teams to develop shared cognitive processes
Impact of MDT Enhancement Program/Occupational Differences
Micro Meso Macro
Positive language about the CAC MDT Coordinator
Value of ‘insiders’ for the MDT Coordinator position
Therapists overloaded
Disconnect for prosecutors in the number of filings seen vs. amount of investigations
MDT Coordinators provide team leadership
65% of MDT members were aware of MEP
Strong support for MEP among those who were aware of it
More similarities than differences in perception of social and task climate across agencies
Law enforcement more satisfied with inter-agency communication; reported greater MDT unity and performance
Qualities of Higher Performing MDTs
• High quality of interaction with other partner agencies
–MDT works well together
–Contributions are valued
–Team communication quality
–Others understand the challenges they face
• Quality of feedback received
– Is the team doing well?
– Are they making a difference?
• Safe emotional climate within MDT
– Being able to ask for help
– Being supported
– Being able to make a mistake
– Being valued
Qualities of Higher Performing MDTs
• EVERY measure of team quality/support was found to be associated with a lowered incidence of burnout for MDT members.
– Social support, High quality communication across agencies, MDT resilience, psychological safety within their MDT, spending time with their MDT outside of work, liking their MDT, unified goals within their MDT, being a member of a higher performing MDT, receiving feedback on their MDT performance
The Importance of MDT Climate
Next Steps
Next Steps
• Spring 2017: Final report and recommendations
• Summer 2017: Additional deliverables and tools for CACs and their MDTs
– MDT Coordinator Toolkits
• General MEP Toolkit
• Process Management Toolkit
• Team Management Toolkit
– Time Type Indicator
– MEP Case Study Narrative
– MEP Teaching Case
CACTX Vision
To provide the full array of professionally recommended services, at the highest standard of care, to all children within the case acceptance criteria of Texas CACs.
Every Child. Every Service. Every Effort.
