Family-Driven and Youth-Guided Systems

Family-driven, as defined by the Federation of Families for Children's Mental Health, means families have a primary decision-making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation.

Youth guided as defined by SAMHSA's Systems of Care, means that young people have the right to be empowered, educated, and given a decision-making role in the care of their own lives as well as the policies and procedures governing the care of all youth in the community, state, and nation.

Working definitions of family-driven and youth guided can be found at both the Federation of Families for Children's Mental Health and SAMHSA's Systems of Care websites. These definitions include ideas or guidelines that call for families and youth to be given complete information and included in all decision-making about their care.

TIPS to ensure that the services you receive are family-driven and youth guided:

  • Know what you want to achieve. Know what outcomes you want.
  • Keep your provider focused on the outcomes you want.
  • Share stories about your child's healthy state of being, as well as his or her problems, to give the provider a full picture of your child. Youth, tell your provider what you are like when you feel your best (i.e., when you are not depressed.)
  • Know what is included in the Evidence-Based Practice you and/or your child is/are receiving and what is supposed to change as a result. Visit the section on Learning about Interventions to learn more.

    • EBPs should be delivered exactly as designed and tested. But when adaptations are needed, ongoing evaluation is essential.

  • Know what adaptations can be made within that EBP and ask for them if you need them.
  • Keep a written record of what services you or your child is/are receiving. That is, make sure you are receiving the treatment or service you are supposed to be receiving. This refers to an important concept known as fidelity to the model (the service is delivered according to its proven design.)
  • Keep a written record of how your or your child's symptoms or behaviors improve, get worse, or stay the same.
  • Seek support and advocacy when you need it. To learn more, visit the Families and Youth Advocacy section of this Resource Guide.

TIPS for helping your community develop an Evidence-Based Culture

  • Promote and practice family-driven and youth guided principles.
  • Educate yourself and ask for information when you need it. Speak up when you have questions.
  • Stay open to learning new things and supporting others to do the same.
  • Ask for and participate in evaluation skills training. The Federation of Families for Children's Mental Health provides helpful information on Family Leadership in Systems Evaluation.
  • Learn to use data (information gathered in a scientific way) when making decisions. (For example, instead of saying you are never able to sleep at night, keep a journal and count the actual number of nights you were not able to sleep more than 6 hours over the past month.)
  • When meeting with program administrators and policy makers, insist they use data to guide their decisions. (For example, rather than deciding that our county cannot afford to provide a certain service, document the cost of not providing the service and/or ask for evidence of the real cost to a neighboring county for comparison.)
  • When considering an EBP, ask questions to ensure:
    • The children and youth involved in proving this practice works were like the children or youth it is being recommended for in your community. (e.g., race, age, ethnicity, socioeconomic backgrounds, single or multiple diagnoses)
    • The providers involved in proving this practice works were like the providers intending to use it in your community. (e.g., race and ethnicity, educational backgrounds, training, years of experience)
    • The conditions under which this practice was proven to work are similar to the conditions of your community (e.g., urban or rural; school, clinical or home based, etc.)
  • When there are differences between children and youth, providers, or practice delivery conditions than in those where the EBP was proven originally, participate in decisions about adaptations to the EBP and how those adaptations will be continuously evaluated to ensure they continue to work.
  • Promote and engage in Continuous Quality Improvement (CQI). (e.g., ask advisory councils to report on the quality improvement data and resulting changes to improve services and supports.) The section on Families and Youth as Providers and Evaluators provides helpful information in this area.