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The ABLE Health Model
Support Families
in the Community
The ABLE team helps families whose children have special Both civic and religious traditions have strived to provide a safe refuge for those special-needs persons who are most in need. But even in the Western World, that population often falls through the cracks and that’s while under the care of single or multi-agency services. Short of natural or built-in safety, this small minority, perhaps less than 2%, (> 15-20,000 children) requires protective encirclement as they learn how to develop their own natural networks. Over many years of providing services to this population, the ABLE clinical staff, Community and Family Health Services of the Utah State Health Department, has observed that a small gathering or core-team approach which fosters connections, builds upon existing competency and highlights change and progress toward goals, assures this process by surrounding a client with care from multiple systems. This process shares and develops people strengths including the strengths of agencies. It allows families an opportunity to change their stories from frustration and hopelessness to resilience and strength.
The ABLE team has found the strength-based core team or small gathering approach to be the most effective. Resilience has been described as a tendency to rebound or recoil in the process of recovery. Communal support is often required in building family resiliency. ABLE personnel hold firmly that communities themselves can make a difference for children and families by coupling their positive adaptations with their losses and burdens and thus engender hope, voice-strength and cultural validation. Families can then view their unique situations from outside perspectives generating new meanings in dialogue with a community audience. Best collaborative practices encourage both the child and the family in obtaining greater power, control, motivation, and creativity in their lives. It assures them access to needed community services while using their individually owned internal resources. THE ABLE CORE TEAM OR GATHERING PROCESS Enabling and empowering entire families has been the directive throughout ABLE Clinic’s 25-year history, and continues to be it’s driving force. The wide range of chronic health problems, the various learning deficits of memory, attention, sensory-processing, language, cognition, as well as the emotional and behavioral problems are all addressed, with a strong focus on how they particularly relate to the family. Child as well as family resilience and recovery were always the proposed outcome. The ABLE Program has developed a comprehensive model for activating community resources, which in culturally- competent ways, rejoins and reconnects disengaged individuals and families using a gathering of caring persons or core team process. This team approach consists of and requires carefully selected community team players. Elevating hopes, knowledge and skills is both an art as well as a science, and must be customized for each unique situation. By placing families in the center of the change process and assisting them in finding and valuing their own helpers, they are empowered in recruiting and maintaining community players. From this gathering, frequently a core team leader comes. Strengthened families can be encircled by their rejuvenated purposes and dreams, and can be energized with new strategies on how to fulfill them. The process offers the gift of hope, future, learning opportunity and new growth, as well as an audience to motivate, encourage and befriend them. It is through this participation and support that the multiple needs of children with chronic health problems are met with solution-focused as well as problem-solving practices. Primary and secondary prevention intervention encourages not only the building of skills but also the increase of life-protection factors in the environment. The ABLE model focus is on protection through enhancing existing resources either within the client or through the environment by direct referrals. Increasing personal and family skills and strengths, prevents growth of secondary problems.
SHARING THIS PROCESS IN THE COMMUNITY From decades of clinical experience the ABLE program has observed the practical validity of a collaborative, multi-contextual team model and offers the conviction that it can and must be shared in the community with local and natural support givers. The use of collaboration is in alignment, not only with best practices but also such national initiatives as IDEA (Individuals with Disabilities Education Improvement Act of 2004), Surgeon General’s Healthy People 2010 and the President’s New Freedom Commission on Mental Health 2003. ABLE clinic tools are generic and applicable to helpers wherever caregivers come together in communities to relieve the burdens of overstressed families. The community “toolbox” can promote the "how" of assessment and treatment planning for the many challenges of trauma, disability and limited finances. It recognizes and encourages multi-disciplinary and multi-faceted interventions, utilizing combinations of such disciplines as health, education, psychology, speech, language, school, social work, human services, nursing, community health, other potential health supports, medical home, religious leaders, friends, neighbors, and foremost, the family with all of their recognized strengths. All of these supports and helping agents are potentially available within diverse communities.
Because the gathering approach of a core team has been so successful, the ABLE team is excited to encourage expanded use of ABLE personnel who can function as consultants when parents and professionals are first developing the full or partial use of this approach. ABLE currently models a weekly outreach to schools in the Salt
Lake Valley, offering consultation to already-established teacher-assistance
and student-success teams established through school principals
(See letter to
School Principals). The ABLE model invites another look at the existing Utah “memorandums of understanding” inviting all public agencies for children to talk, coordinate, and partner together. The proposed legislative initiative to rewrite the Families, Agencies and Communities Together as a new statute would give authority to this multi-agency collaborative process establishing Coordinated Services for Families with Children at Risk. ABLE’s twenty-five years of dedication to finding better outcomes for special-needs children include personal human resources that are readily available on the basis of compassionate care giving. These seamless wraparound practices or services, consider child and family needs across life domains. They are informed by strength-discoveries, role sharing, team counsel, collaboration and efficient interagency communication. They can be recruited and used by most any helping agency. ABLE's on-line information website resource is dedicated to special-needs families and their helpers. Given the reality of shortage of financial and other instrumental resources, ABLE staff proposes adding statewide team-building options to certain low-resource complex families’ treatment plans. More importantly, this website is for community self-help and team-building education is to expand options for other family-public partnerships. In times of economic turndowns, society often allows the most needy to fall between the cracks. The needs of at-risk families have so greatly increased that the time has come for the ABLE staff to redirect significant energies toward becoming a health-promotion demonstration model in addition to a clinical health service. By modeling to health-care providers the value of using inter-agency partnering and resilience building in families, hope and support within those families can be significantly enhanced.
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This model becomes a forum for exchanging diverse ideas around school-family
relations, multi-cultural competence, and medical home in relation
to children with chronic health and developmental conditions. The
model experience has the strong potential of planting seeds for
the birth of fruits for other stakeholders needing the strength
of similar partnering.