Implementing Child First Meets HHS Criteria

Implementation last updated: 2020

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Training to support implementation

Requirements for program certification

Child First affiliate agencies must participate in accreditation from the NPO. The accreditation process includes a review of model implementation benchmarks, assessment outcomes, model fidelity, clinical fidelity, clinical charts (such as treatment plans), videos of home visits, reflective supervision practices, training participation, meetings of the Child First Community Advisory Board, and agency compliance with other requirements. Sites receive full accreditation, provisional accreditation, or probation based on satisfying the Child First model requirements. Affiliate agencies that receive full accreditation are re-evaluated within three years, as long as their sites meet annual benchmarks and their assessment outcomes remain strong. Any site that receives provisional accreditation or probation must participate in a quality enhancement plan and meet timelines for improvements. The Child First NPO provides technical assistance to sites that receive provisional accreditation until full accreditation is achieved.

Accreditation requires completion of the Child First training, which includes both pre-service and in-service training, as described below.

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Pre-service staff training

The Child First NPO provides all new clinical directors/supervisors with an intensive four-day training on the Child First model, emphasizing supervision.

All staff participate in distance learning modules, which explain the fundamentals of the Child First model through webinars, videos, teleconferencing, discussion questions, and activities. The modules are accompanied by prescribed reading and community-based child observations. Staff participate in selected distance learning modules before serving families; other modules are interspersed throughout the service delivery process. The distance learning modules are hosted on the Absorb platform.

All new Child First affiliates within a state participate in an in-person, on-site Child First Learning Collaborative based on the Learning Collaborative methodology, developed by the Institute for Healthcare Improvement. Staff learn and practice in a highly interactive manner the essential components of the Child First model and how to complete the CFCR. The collaborative lasts about eight months and is divided into four learning sessions of two to three days each that extend from pre-service through in-service training. Learning Sessions 1 and 2 occur before staff begin working with families and last about five to six weeks.

The state clinical director begins providing weekly Child First reflective clinical consultation with new affiliates for three hours per week (one hour individually with the affiliate site clinical director/supervisor and two hours with all teams) to enhance learning and respond to questions about clinical work and the implementation process.

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In-service staff training

After beginning to work with families, staff participate in two more Child First Learning Collaborative learning sessions over about six months. Each learning session is two to three days long. Staff continue to participate in distance learning modules between each learning session. In addition, clinical staff attend the Diagnostic Classification: 0–5 training, and all staff participate in the Circle of Security training. Specialty conferences are provided based on identified training needs for the population served.

An accelerated version of the Child First Learning Collaborative, Staff Accelerated Training (STAT), is available for new staff joining existing affiliates across the national network. STAT is a four-part training conducted one to two days per month either in person or through videoconferencing. If more than one location will be participating, the training is structured to support the simultaneous participation of up to four locations around the country. At each location, the state clinical director leads a small group of new staff in activities and discussions. Locations are connected to each other and the NPO through videoconferencing, where interactive discussions occur. There are three cycles each year.

The state clinical director continues to provide the affiliates with on-site reflective clinical consultation for three hours weekly for six months, and then three hours biweekly for six months. Each session includes two hours of group consultation with all clinical teams and one hour of individual consultation with the affiliate site clinical director/supervisor. After 12 months, the state clinical director provides the affiliate site clinical director/supervisor with individual consultation biweekly. The consultation provides sites with the opportunity to discuss their experiences in working with families, review videos, solicit responses to implementation questions, and review data. The state clinical director is available for consultation with affiliate site clinical directors/supervisors as needed at any time.

Staff also participate in a CPP learning collaborative conducted by CPP national trainers; it consists of three learning sessions over 12 months and 18 months of biweekly consultation calls.

The affiliate site clinical directors participate in Child First Clinical Director Network Meetings, which occur monthly for two hours. The meetings include case presentations, clinical discussion, and administrative and management updates and problem solving.

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Training materials

Training materials consist of the Child First Training Manual and Child First Toolkit (which includes all assessments and procedures), the Clinical Directors’ Manual, the Child First Comprehensive Clinical Record User Guide, and all distance learning materials. The training materials are available electronically on the Absorb platform. Staff also receive a training manual for each Child First Learning Collaborative session, which includes an agenda; the curriculum; and all associated handouts, readings, and PowerPoint presentations. Clinicians receive a CPP manual; care coordinators receive Abecedarian training materials.

All affiliate agencies receive access to online early childhood, trauma, and mental health articles and a library of selected books for their offices. In addition, all affiliate sites receive an assessment notebook (with samples of each assessment used in the Child First Assessment Protocol) and copies of each assessment as a start-up kit.

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Qualified trainers

The NPO Clinical and Training Department conducts the Child First Learning Collaborative, distance learning, STAT, and network meetings. Additional trainers may include senior staff from experienced affiliate sites and experts in the field. Trainers have expertise in areas relevant to implementing the model in a new region, such as the child welfare or court systems.

Certified national trainers facilitate the CPP Learning Collaborative and Diagnostic Classification: 0–5 and Circle of Security trainings.

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Technical assistance

The state clinical director, a member of the NPO Clinical Department, provides ongoing clinical consultation to all affiliate site clinical directors/supervisors on a biweekly basis. The NPO Data Department provides ongoing technical assistance on database use and a call line for any database difficulties. Affiliate agencies can request technical assistance from the NPO for any reason at any time. Child First NPO leadership conducts quarterly group meetings and/or conference calls with Child First network senior leaders in each state or region.

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Implementation notes

The information contained on this page was last updated in June 2020. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Child First CEO on February 21, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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