Engagement Strategies:
Service Delivery in Supportive Housing
Joyce Grangent
Senior Program Manager
Corporation for Supportive Housing www.csh.org
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Every tenant brings a history, a culture, a set of expectations and behavior that can be shaped by such things as:
Cultural, ethnic, and racial differences
Gender and sexuality issues
Mental Health History HIV/AIDS Other medical issues Domestic violence
Criminal histories Long-term
homelessness Development
disabilities Histories of trauma Issues specific to
women with children Much more!
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What 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
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A 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
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Resolving the Clash
Don’t create more losses Understand the feelings Uncover and build on
strengths Using strategies and
techniques– Harm Reduction– Stages of Change– Motivational
Interviewing– Reflective Listening
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Engagement 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.
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Goals 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
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Effective Engagement
Create the proper physical environment Respect, accept and support people Develop active listening skills Let the tenant’s goals drive the services
offered Help people make informed choices Be consistent with repeated, predictable
patterns of interaction Engagement should be non-threatening
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Effective Engagement
Effective engagement for people with mental health issues
Effective engagement for people with substance use issues
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Engagement 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
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Creative Engagement Strategies
For Open: Friendly Listen Maintain eye contact Keep conversation light Respond to humor
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Creative Engagement
For Closed: Intrusive Talk to much Too opinionated Lecture Analytical Demanding
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Engagement 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
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Whose Goal Is It
Orient new tenants Provide coordination among service
providers Develop buddy systems Provide individual case management
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Opportunities 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
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Developing Trusting Relationships
Professional Relations Goal is maintain housing Information is confidential We must set limits
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In a Personal Relationship
Different goals with different people We can gossip to friends We don’t have to set limits
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Building 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
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Working 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
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Why Tenants May Be Resistant
Afraid staff will tell them what to do Don’t 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
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When 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
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What 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
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Roadblocks 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
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Motivational 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
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Express 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
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Develop 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
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Avoid Argumentation
Avoid expert trap Arguing leads to negativity Destroys alliance Increases defensiveness.
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Roll With Resistance
Resistance is not bad. It’s normal and we should expect it Go with it and don’t get into power struggle It gives insight to guide our work
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Support Self-Efficacy
Hope, optimism and self esteem are needed for change
Plant seed of believability Reframe failures Let’s figure out what didn’t work
“Life takes on meaning when you become
motivated, set goals, and charge after them in an unstoppable manner.”
–Les Brown
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