Core Element: Care Coordination and Collaboration
Care Coordination and Collaboration engages family members, treatment providers, community resources, and natural supports as a cohesive group with shared goals for working with a youth and family. Care coordination includes forming and meeting face-to-face with a treatment team, developing teamwork among participants, sharing relevant information on a regular basis, planning together, measuring treatment progress together, and working collaboratively to add, change, or end services. Care coordination and collaboration follows the same process whether IHT is the hub or the youth also has Intensive Care Coordination; in the former case, the IHT team takes the lead role for care coordination; in the latter, the ICC team leads the process with IHT as an active participant.
CONTRIBUTION TO THE OUTCOME: The foundation for child-centered, family-driven treatment is a team that always includes family. Collaborative care strives to join all stakeholders in a youth’s life to ensure effective work across domains. Different perspectives on a team create opportunities to find and use strengths. Consistent collaboration between the IHT team and the range of natural supports and service providers working with the family results in cohesive efforts to achieve desired outcomes, foster the family’s community connectedness, and promote sustainability of treatment gains. Ideal communication takes a variety of forms that are organized, timely, culturally responsive, and inclusive