What is collaboration?

Collaboration involves altering relationships, such as agency staff working together to plan and schedule activities.  Collaboration requires more sophisticated interagency relationships – uniting organizations and people for the purpose of achieving common goals that could not be accomplished by any single individual or organization acting alone.  Collaboration involves four key elements:

  • Agreed-upon and institutionalized mutuality and common goals
  • Jointly developed structure and shared responsibility
  • Mutual authority and accountability for results
  • Shared resources and rewards.

Family-Driven Collaboration is Key to Success

Family-driven collaboration is fundamental to eliminating seven interdependent barriers to the transformation of fragmented services into a true system of care:

  • Professional socialization, structure, and culture
  • Agency structure, routine, and culture
  • Categorical legislative mandates
  • Professional and agency self-interest
  • Inadequate understanding of the strengths and needs of youth, families and communities
  • Inadequate youth and family understanding of the needs and skills of service providers and how to work with them
  • Youth and family resistance to services.

Building family-driven collaboration is a developmental process that involves time and resources as well as attitudinal, behavioral and policy changes in four areas:

  • Policymaking (laws and regulations)
  • Agency activity (such as a school or mental health agency)
  • Program activity (such as a special education class or day treatment program)
  • Practice (such as individual counseling, respite care, and tutoring)

Collaboration in Action

A review of collaboration with families in the Casey Mental Health for Urban Children initiative, a project of the Federation of Families for Children’s Mental Health sponsored by the Annie E. Casey Foundation, identifies key steps to the collaboration process.

  • Getting to the same page (vision, knowledge, commitment)
  • Working through rough spots (racial, linguistic, cultural, class barriers; “authentic” vs. “expert” voices)
  • Involving the local community (familiar with community needs and skilled in addressing those needs)
  • Building collaborative relationships (raising family status to government and provider agency status):
    • Bring a pen and paper to the meeting and write down what happened.
    • Take down the date, who was there, the topics discussed, commitments made, and deadlines.
    • Type up notes and mail them to the other participants with a cover letter to explain any problems with meeting deadlines up front.
    • Follow through.  If someone drops the ball, check your notes.  A phone call and a note can avoid hard feelings and add accountability.
  • Working together to review, monitor, evaluate and change system(s) and services.

Tips for Building a Collaborative Partnership

From the agency perspective, it’s important to:

  • Make it a usual practice to include families as equal partners in the design of all programs.
  • Encourage families to share their perspectives when new ideas for programs and services are being presented.
  • Use parent advocates to assist families in participating.
  • Model and promote the belief that families must be involved in all decisions about services and programs.
  • Hire contractors who embody the belief of family involvement.
  • Show resistant staff how families can participate.
  • Encourage staff to ask family members what they think.
  • Allow sufficient time and support to help staff learn to collaborate.
  • Be honest and share concerns/fears with family members.
  • Help reduce barriers that interfere with family members’ ability to attend meetings by providing supports (child care, transportation)
  • Begin collaborating with people who share your beliefs.
  • Offer to contribute your skills in addressing the issues
  • Follow through with commitments.
  • Participate in professional development opportunities that teach team building skills, negotiation skills, and group decision making skills.
  • Work through your own frustrations about services and channel your energies into becoming an advocate.
  • Educate providers as to what you need and why.  Write out your stories and those of others and share them with appropriate policymakers.
  • Learn everything you can about the system(s) of care.
  • Make allies at the state level.
  • Support your co-collaborators.
From the family perspective, it’s important to:

Lisa Conlin, RI Parent Information Network

Kathy Nicodemus, Children’s Behavioral Health, Department of Children, Youth and Families, Rhode Island

Other Lessons Learned

Other lessons learned at the Casey sites include:

  • Never leave the table.  It can be hard to listen to families’ pain and frustrating for families to decipher acronyms and bureaucratic jargon, but all parties need to have patience.
  • Recognize that people may use language differently.  Ask people what they mean and tell then when you don’t understand.
  • Develop a support system for yourself.  Collaboration is difficult work, and it demands that you cross certain barriers in order to succeed.  Find people inside your world who understand and will back you up.

“Collaboration is not a simple process – every step, from developing a shared vision to overcoming language and organizational gaps, is a series of give-and-take adjustments to normal operating procedure. Collaboration is not just plugging old skills into a new arena, it is an innovation and a life-changing process, simultaneously exciting and threatening, which makes personal and professional support essential.” 

Valerie Muhammad, Parent Resource Network (Virginia)

Adapted from Family-Agency Collaboration (Barbara Huff); Effective Collaboration: Key to Improving Outcomes for Children and Youth (David Osher); Collaboration at the Casey Sites and Update on Federation Chapter Activities: Family/Professional Collaboration (Stephanie Snow), from the Summer 1999 Special Theme Issue on Family-Agency CollaborationClaiming Children, Newsletter of the Federation of Families for Children’s Mental Health


Families are in an ideal position to take on the task of promoting cultural competency within the systems in which they work.  The elements of cultural competence include an understanding and acceptance of one’s own culture, an acceptance of other cultures, and an understanding of the dynamics of difference.

Strengthening the Link Between Families and Culture

Each family is a member of a culture and carries that culture into the system of care.  Therefore, it is vital to understand the culture of each family, as  well as how each family relates to its culture of origin and responds to cross-cultural interactions.  It is only through this cultural context that systems of care can begin to craft appropriate responses to each family’s unique needs.  There are several ways in which this can be accomplished.

  • Provide families with information on cultural competency.  Families who have a clearer understanding of cultural competency principles are in a better position to assess their providers’ services and to define what constitutes culturally appropriate services in their community.
  • Cross-train providers and family members on cultural competency.  Shared learning provides participants time to develop a shared understanding of their roles and views within the system of care.  Cross-training also helps develop a system that is responsive to the specific values and needs of families in the local service area.
  • Incorporate family members into the training of providers.  Local family organizations have demonstrated the capacity to develop training modules tailored not only to families, but also to providers of services. Training and then using family members as trainers on issues of cultural competence provides yet another avenue for families to influence the development of systems of care.
  • Employ family members as direct service providers.  Culturally similar families represent a valuable storehouse of knowledge for systems of care.  Employing family members of a similar culture creates the possibility for providing more culturally relevant services.  More importantly, it sets the stage for cross-cultural learning within the provider network of the system.
  • Understand and address cultural diversity from within.  Family support organizations must even more aggressively acknowledge and address the cultural diversity of the families they seek to support and serve. These groups must pursue a clear understanding of the diverse populations they represent, and ensure that those populations are incorporated into the organizational structure of the family movement at both the local and national levels.  All family support organizations should conduct a cultural self-assessment, engage in competency training, and establish ongoing processes for incorporating cultural competency.

Meeting the Challenges of Collaboration and Cultural Competence

According to the National Agenda for Achieving Better Results for Children and Youth with Severe Emotional Disturbance, collaboration with families should be marked by:

  • A demonstration of respect and compassion for family members.
  • An understanding and accommodation of different styles of social interaction.
  • The use of straightforward language.
  • Creative outreach efforts.
  • Respect for families’ cultures and experiences.
  • The provision of crucial information and viable options to families.
  • The scheduling of meetings at convenient times and places for families, care givers, and surrogates.

“It is impossible for a system to be culturally competent without addressing the role of families, and it is equally impossible to be family centered without addressing the racial and ethnic cultures of the families involved.”

Adapted from The Role of Families in Promoting Cultural Competency (Raymond Crowel & Angela Vaughn, Baltimore, Md.), in the Summer 1999 Special Theme Issue on Family-Agency CollaborationClaiming Children, Newsletter of the Federation of Families for Children’s Mental Health