“A framework for facilitating collaborative problem-solving.”
What is System of Care and the Child and Family Team Meeting Model?
According to the North Carolina State Collaborative for Children, Youth, and Families, the definition of Child and Family Teams (CFTs) “are family members and other supports, that come together to create, implement, and update one plan of action to help a youth and their family. Families can build collaborative plans that are focused on the strengths of the child, youth, and family that addresses their unique needs, desires, and dreams.” Through collaboration CFT participants agree to respect each other and have confidential brave spaces to express their thoughts, feelings, observations, and future planning. The model is akin to restorative justice circle practiced by indigenous peoples (https://www.edutopia.org/article/building-community-restorative-circles/). In a sense this model can be interactional, transactional, and transformational.
System of care (SOC) is an organizational approach to problem-solving where a network of communities and agencies come together to meet the needs of families on the community and social systems level. CFT is a micro approach to (SOC) where families (parents, extended relatives, and siblings), and paid professional support (school staff, counselors, etc.) collaborate to help a youth and their families succeed.
Planning and Preparation
Deciding who should be present for the CFT is important to the process. I know I don’t like surprises and families generally like to know ahead of time who will be joining them as supportive participants. This could be mom, dad, godparents, aunts, uncles, siblings, teachers, coaches, grandparents, or church pastors. It’s also helpful to include paid support like teachers, healthcare providers, social services, or therapists as they may have an important role to play in plan implementation as well.
Families and their respective helpers interact with one another to create their own universe. I have found this model can be just as effective in the outpatient therapy setting as well. The idea is that if one family member changes their thoughts, feelings, and behaviors then the entire family dynamic changes along with them. Even the attempt to enact or deny change is change. All members in a family system are responsible for, and can be involved in the process.
Implementation of the Child and Family Team Model
Start with a family opening.
This could be an icebreaker, prayer, spoken word, or something to share with the group. This usually sets the tone for the meeting by allowing for an atmosphere of openness and creativity.
Gather information and start with what’s going well.
Identify the strengths of the family, child, and things that are going well. We all like hearing good things about ourselves from time to time and these good things can help us brainstorm other goals and solutions.
Share concerns or safety issues.
Identify weaknesses and areas of growth. Usually this looks like 1-3 main concerns that may include safety issues or situations where there is ongoing conflict between multiple parties.
Develop an agreed upon plan with action steps.
Every member is involved in the process or development of the action plan. People generally use the strengths of the family to inform each person’s individualized action steps they could commit to in the next 45-90 days. Sometimes families include individuals at the table who they feel could help them succeed in this process (this could include counselors, extended relatives, pastors, etc.).
CFT and Collaborative Problem-Solving in Action
I have found it can be very helpful to examine a vignette of a hypothetical family to better illustrate the efficacy of the Child and Family Team approach from the different perspectives of the family members in relation to the overall model.
The Example Family
Miguel is a 16-year-old Hispanic heterosexual cisgender male residing with his mother Maria (45) and his two younger sisters Olive (12) and Juanita (14) in Raleigh, NC. Since Miguel’s father Juan moved out of the family home 6 months ago, Miguel’s grades in school have declined and he’s been more argumentative at home with his mother and sisters. Maria is worried about Miguel completing school assignments, and occasionally skipping classes with a few negative peers. Maria started working with a family therapist Vickie to assist them in healing from the family separation while developing more effective coping strategies. Vickie has opted to be the family CFT facilitator and coordinated the meeting with Maria.
The family opted to start each session with a fun fact that happened to them that week. Maria reported the family is Catholic and sometimes she would lead the family in a prayer or meditation as a warm-up to start once all family members were present.
In this process each family member would go around the room, in a round robin fashion and say 1-3 things that were going well with them that week and a few strengths about Miguel and the family. During this process we found out that Miguel is very athletic and loved playing soccer. He also excelled in his acting class at school. The family used to host game nights and cookouts weekly which reportedly made them feel closer as a family unit. The siblings also reported they were very close and would help each other with homework and other creative activities.
Areas of Growth, Concerns, and Safety Issues
The family shared the overall sentiment that if Miguel’s grades continued to decline and he skipped school that he may be at risk of repeating the 11th grade. Maria worried that this would impact his overall self-esteem and his future pursuits after high school. She also reported that his behavior may jeopardize the family’s financial stability. Maria reported she worried that if Miguel were to get suspended from school for skipping class, then that would impact her job as a medical assistant at a local hospital. Miguel and his siblings are now considered latch key kids since Juan left the home. Juan used to work mornings, and he was present for his family during the afternoon and evening timeframes; however, that was no longer the case and Maria now has supervision, and monitoring concerns to consider.
Agreed Upon Action Steps
The family therapist/facilitator can now create a list with the participants’ consent by building on the family strengths and commitments. Here are three examples of action steps the family could take in the next 30-45 days to ensure that ideas generated from the plan have a positive impact and address the necessary concerns and safety issues respectively.
- Miguel agreed to check in with his acting teacher Ms. Smith (who he has a positive relationship with) daily. This may ensure he as a point person at school to touch base with about completion of his school assignments besides his mother.
- The family will plan 2-3 connection activities a month including movie night, game night, camping, or cookouts as a family so they can spend quality time together.
- Maria agreed to research community club soccer leagues to offer more leisure and prosocial activities.
- Therapist will research affordable tutoring opportunities for Miguel and his sisters to have added to their weekly schedule, so he and his siblings could have prosocial activities to do after school on a more regular basis.
The child and family team (CFT) model has been used to include both family and agency representatives that could help the family succeed. There is power in centering the needs of the family to cultivate their own unique resilience. The model is so versatile it can be successfully tailored to work in the outpatient and family therapy sessions respectively. CFT is a beneficial resource for fostering connections, building on the strengths of the youth and family, and action planning to where all participants have accountability to the plan. The main reflection that can come from the CFT process is the understanding that all family interactions and roles are powerful enough to generate their own solutions. Family therapists can use the CFT approach to facilitate meaningful collaboration and change work.
- The North Carolina Collaborative for Children, Youth, and Families, December 2006. Revised October 2008. Revised January 2017. An Introduction to Child and Family Teams: Cross System Training from the Family’s Perspective. https://nccollaborative.org/
- North Carolina State University Center for Family and Community Engagement: www.cfface.org