Skip to main content

9: Professional Development

Professional Development Across Three Types of Training

One-time training is not optimal for any profession and can negatively impact case outcomes and team effectiveness. Build into the MDT protocols periodic and ongoing training, both formal and informal, particularly as new members join the team and protocols and policies change. There are three types of training reviewed in this chapter:

  • Professional Training
  • MDT Training
  • Cross Training

Over time, belonging to a group changes the ways its members view the world (Levi, 2014).

Elder Abuse Training for Respective Professions

All MDT members should maintain their profession’s standards of training (e.g., continuing education training). In addition, given the varying levels of familiarity with elder abuse, all MDT members should attend elder abuse training, regardless of their level of expertise, to ensure that all MDT members have the same exposure to information on elder abuse. 

In addition, the MDT Coordinator will want to identify weaknesses in the MDT’s knowledge base and arrange for training (e.g., financial exploitation; abuse of a power of attorney) where weaknesses exist. Your MDT may want to offer paying for training for MDT members whose training budgets are unable to cover the costs of training.

MDT Training

Not everyone instinctively knows how to collaborate and be a member of an MDT. Therefore, your MDT will benefit from MDT training. MDT training can overcome the tension between different organizational cultures and also produce morale and cohesion among team members. If professional training is unavailable in your community, consider requesting the MDT TAC’s virtual MDT Training or attending MDT training offered in other disciplines. Alternatively, host group exercises designed to strengthen relationships, using active learning styles such as role playing and small group discussions. 

Cross Training

An important component that must be built into your MDT is cross training. As it stands, most systems are unfamiliar with other system’s mandates and jargon and the contribution each system makes to the team. 

…simply putting people together in groups, representing many disciplines, does not necessarily guarantee the development of a shared understanding. …The extra ingredient that turns a group of professionals from different disciplines into an effective working team…[is] the creation of a new way of working…[which] can only emerge and develop through intense interactions (Ratcheva, 2009).

Cross training provides an opportunity to ensure that all members of the MDT know each other, trust each other, and share a common vision for the MDT. These are critically important qualities. If an MDT member knows he needs help with some aspect of a case, but does not know which MDT member to contact, the MDT is not functioning effectively for that team member.  

In addition to formal cross training (or where formal training is unavailable), informal cross training can be beneficial as well. Examples might include:

  • Visiting another organization.
  • Listening in on elder abuse intake calls.
  • Inviting MDT members to in-service trainings.
  • Asking a member to make a brief educational presentation to the team on matters in which they have expertise that would be of benefit to the MDT, either in a structured manner, such as once a month, or on an ad hoc basis.
  • Consider visiting or observing other team discussions.
  • Creating your own training. Toolkit item: Issues to Discuss for Cross Training, provides an extensive list of topics for cross training purposes that the MDT may choose to discuss. Look for commonalities as well as differences across these topics. Once those differences have been identified and discussed, the MDT will need to decide how to address these differences and memorialize them in protocols so they are no longer barriers. Discuss these issues in the context of the case example below.

Case Example

An older domestic violence survivor, Mrs. M., lives in senior housing but her three sons live with the couple and sleep on the floor. She could lose her housing if the housing authority learns they live there. The MDT wondered whether these sons were protective – whether her husband doesn’t beat her when the boys are home – or whether they are also abusing her. The APS caseworker is unsure. The team agreed not to notify the housing authorities until it was learned what role the sons play. In the meantime, a mental health provider is still seeing her to ensure the older woman has contact with someone outside her family, but is not telling Mrs. M. that she is a mental health provider. The team noted that Mrs. M. either has an eating disorder or does not eat when she feels anxious.

  • Consider drafting a case flow chart, and where each MDT member fits in the flow chart (see below). The flow chart should begin with the referral protocol to ensure everyone knows their role and the procedures to follow from the beginning of the case through to completion. Two examples are below. 

Santa Clara County Flow Chart

 

Santa Clara Flow Chart

The image above depicts the Santa Clara County FAST Flow Chart.

Referrals can come from the District Attorney, the public (for example friends, relatives, neighbors, or mandated reporters), or from the Public Administrator/Guardian/Conservator.

These referrals flow into Adult Protective Services, also known as APS (phone number 1-800-414-2002).

APS receives reports of suspected abuse, screens for eligibility, and conducts a risk assessment.

Then APS refers these cases to one of two places: The Financial Abuse Specialist Team Rapid Response (also known as FAST) or to a 10 Day APS response category.

FAST Meetings are held bi-monthly.

If the case is referred to FAST, the following immediate interventions are available:

  • 911 / Medical Provider Contact
  • Call for Law Enforcement Assistance
  • FAST Investigation
  • Use Probate Code 2901 to Freeze Assets
  • Referral for Probate Conservatorship

If the case is referred to the 10 Day APS response category, the following interventions are available:

  • Referrals for Services
  • Advocacy
  • Family Support
  • APS Case Management
  • Public Guardian investigation/ Evaluation
  • Conservatorship

These additional resources are available to both groups of referrals:

  • Private Attorney
  • Community Legal Services
  • District Attorney
  • County Counsel

 

Houston Sample Flow Chart

Houston Sample Flow Chart

 

The chart above shows how a case flows from Adult Protective Services (APS) to the Texas Elder Abuse and Mistreatment Institute, also known as TEAM Institute or TEAM.

APS refers to TEAM intakes triage. From here, the case can flow in one of two directions:

  1. Capacity assessment only, in which case the psychiatry team in engaged, the case is referred for IDT, and then a court document is produced, or
  2. Medical assessment with or without a capability assessment, in which case it flows to the geriatrics team, IDT, and assessment report with or without court document, TEAM submits reports to APS, and APS and TEAM complete billing.