Title: Engagement Strategies: Service Delivery in Supportive Housing
1Engagement StrategiesService Delivery in
Supportive Housing
- Joyce Grangent
- Senior Program Manager
- Corporation for Supportive Housing www.csh.org
2Every tenant brings a history, a culture, a set
of expectations and behavior that can be shaped
by such things as
- Criminal histories
- Long-term homelessness
- Development disabilities
- Histories of trauma
- Issues specific to women with children
- Much more!
- Cultural, ethnic, and racial differences
- Gender and sexuality issues
- Mental Health History
- HIV/AIDS
- Other medical issues
- Domestic violence
3What else tenants bring
- Housing history
- Family history
- Spiritual life
- Survival skills
- Social networks and support systems
- Tolerance level for structures and rules
- Behavioral history
- Expectations and Preferences
4A Clash of Agendas
- The Professional Support Person
- Duties and responsibilities
- Product oriented
- Caring (We hope!)
- The Homeless Person
- Multitude of losses
- Depth of mostly negative feelings
- Unique and uniquely acquired strengths
5Resolving the Clash
- Dont create more losses
- Understand the feelings
- Uncover and build on strengths
- Using strategies and techniques
- Harm Reduction
- Stages of Change
- Motivational Interviewing
- Reflective Listening
6Engagement Strategies
- Engagement sets the stage for formal case
management and treatment sessions where in-depth
assessments, counseling, and referrals can occur
on an individualized basis.
7Goals of Engagement
- Care for immediate needs
- Develop a trusting relationship
- Provide services and resources
- Connect to mainstream services and social
networks to maximize independence - Helping people stay housed
8Effective Engagement
- Create the proper physical environment
- Respect, accept and support people
- Develop active listening skills
- Let the tenants goals drive the services offered
- Help people make informed choices
- Be consistent with repeated, predictable patterns
of interaction - Engagement should be non-threatening
9Effective Engagement
- Effective engagement for people with mental
health issues - Effective engagement for people with substance
use issues
10Engagement is a Process
- Where we introduce tenant to services
relationship - Explain our role
- Find common ground to build on
- Engagement is not an event
- Does not happen overnight
- Varies from tenant to tenant
11Creative Engagement Strategies
- For Open
- Friendly
- Listen
- Maintain eye contact
- Keep conversation light
- Respond to humor
12Creative Engagement
- For Closed
- Intrusive
- Talk to much
- Too opinionated
- Lecture
- Analytical
- Demanding
13Engagement for People With Mental Illness
- Enhanced When
- Worker develops shared reality with tenant
- Interaction is consistent
- Worker allows tenant to exercise control in the
interaction - Worker communicates his/her role clearly
14Whose Goal Is It
- Orient new tenants
- Provide coordination among service providers
- Develop buddy systems
- Provide individual case management
15Opportunities to Achieve Goals
- Develop case management plan
- Help with skill building
- Coordination of mental, physical and substance
abuse services - Assistance with medications and/or doctor
appointments
16Developing Trusting Relationships
- Professional Relations
- Goal is maintain housing
- Information is confidential
- We must set limits
17In a Personal Relationship
- Different goals with different people
- We can gossip to friends
- We dont have to set limits
18Enhancing Motivation for Change
19Building Motivation for Change
- Build Trust Be consistent, trustworthy and
honest - Get to know the person
- Learn to recognize and Identify Emotions/Physical
sensations of anxiety - Define the helping relationship
20Working With Ambivalence and Resistance
- Reactance Theory helps to predict how people
respond to the perceived loss of valued freedom - Reactance Theory states that it is natural for
people to try to maximize control and choice
21Why Tenants May Be Resistant
- Afraid staff will tell them what to do
- Dont want to be controlled or lose the right to
make choices - We view resistance as negative and part of
tenants illness - Tenant is trying to maintain their
independence/freedom
22When Working with tenants Who Is Resistant
- Avoid telling tenant what to do, instead present
options - Explore both sides of an issue, one-sided focus
increases reactance - Address one problem at a time-partner with tenant
to set priorities and timelines for addressing
them - Work with tenant where they are along spectrum of
change
23What if this is not working?
- Steps to consider before terminating your clients
- Discuss with Colleagues and Supervisor
- Talk to clients about consequences/alternatives
- Is there a way to negotiate the dispute?
- Remember this is the only way for our folks to
get - permanent housing
24Roadblocks to Listening
- Directing- Do it this way
- Warning- Creates fear or submission
- Making suggestions-Tenant is not competent or
judgment is not trusted - Persuade with logic- you need to stop drinking,
or you may damage your liver - Shaming-Do you really want others to see you like
this
25Motivational Interviewing
- Motivational Interviewing - is a way to get
tenants to recognize and do something about
problems - Useful with tenants who - are reluctant to change
and ambivalent about ability to change - Intended to help resolve ambivalence and get
tenant moving on path to change - Staff acts as change agent
26Five Basic Principals To Motivational Interviewing
27Express Empathy
- Accurate Empathy
- Not identifying with tenant instead seeks to
understand what the tenant is saying without
being judgmental, criticizing or blaming . - Acceptance lowers defenses and make tenant more
open - Trying to make tenant change creates resistance
and refusal
28Develop Discrepancy
- Listening patiently can help tenant see the
discrepancy between their present behavior and
goals - Gaining insight into discrepancy can help gain
motivation to change (must remember what is said) - It should be the tenant who begins to fell safe
enough to voice concern
29Avoid Argumentation
- Avoid expert trap
- Arguing leads to negativity
- Destroys alliance
- Increases defensiveness.
30Roll With Resistance
- Resistance is not bad.
- Its normal and we should expect it
- Go with it and dont get into power struggle
- It gives insight to guide our work
31Support Self-Efficacy
- Hope, optimism and self esteem are needed for
change - Plant seed of believability
- Reframe failures
- Lets figure out what didnt work
32Life takes on meaning when you become motivated,
set goals, and charge after them in an
unstoppable manner.
33CSH Tools and Resources
34CSH Resources
- CSH website www.csh.org
- Institute website www.csh.org/IL/institute
- CSH Publications www.csh.org/publications
- Not a Solo Act
- Developing the Support in Supportive Hsg
- Toolkit for Developing and Operating Supportive
Housing www.csh.org/toolkit2