Slide 1

Engaging Families & Children: Practical Tips

Training Dates: March 18 & April 1 2015

Presenter: Melissa Cole, MSW, LCSW-C

Why do we choose to do this work?

What makes this type of work important to us?

Personal Values

Personally Affected

Desire to Help Others

Need to Contribute to the CommunitySpiritual Calling

Professional Career

Personal or Professional Development

Additional Income

Other

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Why do families choose to work with us?

The Working Relationship.

Regardless of:How the families reach us

Their unique presenting problems

The length or type of services

The number of workers involved

The team members

Other..

It is ALL about:How meaningful services are to the family

What the family gains from services

How easy service participation is for the family

RELATIONSHIP consists of:

Commitment +Relating +Knowledge +Skills+ = Engagement

Engagement leads to positive outcomes!

Fortunate to receive referrals based on positive referencesCommunity collaboration strong relationshipsFamilies often go with a default provider out of necessity: location, coverage, crisis, referral, impaired advocacy skills, etcOnce connected, even if voluntary, if families dont like the services they can withdraw by passive resistance aka non-compliance3

What Brings BSF Staff & Families Together?Core Principles of BSF Programs

Establishing TrustActive listeningAssessingCommunicating Assisting / MentoringCrisis InterventionCoaching / ModelingAdvocatingEducatingMaintaining SafetyFocusing on Strengths

Core Elements of Effective Helping Relationships

Availability Knowledge Flexibility Communication Time Trust Responsibilities Positive attitude Humor Respect Strengths

HopeForgivenessBoundariesDefined RolesReciprocityReliabilityHonestyEmpathyConsistencyAuthenticityHumilitySafetyOther..

What Do We Often Take for Granted?

Some common sense things we often overlook:

Remember: we are guests in their lives their participation in services is a gift not aguarantee

Courtesy goes a long way: confirm each appointment day/time; be flexible

Use preparatory empathy:put ourselves in their shoes

Select our words carefullyinteractions shape the relationship

Follow our purpose / we must stay on taskwe are more than friendly visitors!Do NOT make assumptionswe have the responsibility to seek clarification & to set the tone for authentic interactions

More Items We Often Take For Granted.Maximize teachable moments & apply them to the IRPUsing here and now examples makes the treatment plan real

Be open minded / look for creative solutionsSolution focused & strength based interventions

Think like we are a member of a teambecause we are!Be mindful of other providers working with the family & make sure we are collaborating

Utilize anticipatory guidance / review next steps together For example: changes in service delivery or plans for discharge

Alert the supervisor to ANY safety concerns Be familiar with agency protocols regarding safety issuesDiscuss observations, disclosures, questions we have on this topic

Normalize taboo topicsWe have a responsibility to help families talk about tough topics in constructive and productive ways (ie: sex, disabilities, violence, discipline, etc)

How Do We Make the Most of Our Interactions?

What we sayWe must be purposeful in our communication

How we say itVerbalNon-verbal

Active Listening: WordsBehaviorsFeelings

Role Modeling / ActionTake time to teachCelebrate accomplishments Lead by example

What is Active Listening?EMPATHY: identification with and understanding of anothers situation, feelings and motives.

Perspective and Engagement

Perspective = Connection

Once connected, rapport begins

Rapport provides opportunities for effective communication

Once communicating, engagement is built through the development of trust, respect & reliability

We must recognize differences & while also finding common ground

How Can We Use Our Perspective?

Key questions to consider as we build & maintain relationships:

What is the purpose of my contact?Have I communicated my purpose clearly?Do we share the same agenda?Do we have the same priorities?Do we share the same definitions for common concepts, words & goals?Are our roles well defined? Am I demonstrating my role, my purpose & my professional boundaries through my words and actions?Is the treatment plan on target or in need of adjustment?How well does the family understand, apply & buy in to the treatment plan?Whats working/successful in the working relationship? Has the success been discussed/acknowledged? Have mistakes been addressed?What obstacles are blocking progress in the working relationship?What new information has come to my attention that needs to be addressed?What risk factors/safety concerns do I need to consider for each relationship?

What Differentiates Us?Cultural/Racial/Ethnic IdentityTribal AffinityNationalityAcculturation/AssimilationSocioeconomic Status / ClassLanguageEducationLiteracyFamily constellationSocial historyPerception of TimeHealth Beliefs

Health / Mental HealthBeliefs about Health/Mental HealthValuesAge CyclesLife CyclesGender & Gender IdentitySexual Orientation / IdentityReligion & Spiritual ViewsSpatial & Regional PatternsPolitical Orientation &Affiliation

Engagement and Boundaries

Why are boundaries so important?

They set the framework for us to talk about:

Our roles & responsibilitiesThe services being deliveredOur expectations for the working relationshipLimits of confidentiality , privacy & safety issues

They help us focus on our responsibilities to the client

The treatment plan is central to all communications

They reduce compassion fatigue

We dont get overwhelmed as easily when were attentive to our limits

They establish parameters for legal & ethical behavior

When in question, consult the regulations / agency protocol / supervisor

They support regulatory & reporting requirements

Our timelines for home visits, reports & other services

Key Components of Boundaries

What we say How we say it The meaning behind our communications

Limits of Confidentiality

Privacy

Informed Consent

Clients right to self-determination

Competence (including cultural competence)

Conflicts of interest

Dual relationships

Record keeping & treatment planning

Personal values

Desire to rescue to be friends or to be liked by the family

Roadblocks to Successful Engagement

Making assumptionsGiving adviceJudgingMaking the work about usPlacing blamePicking favoritesDoing favorsBreaking confidentiality ArguingSaying: I told you so

Avoiding tough topicsLack of preparationBecoming friends Blurring boundariesPrideEmbarrassmentStressOne sided thinkingFrustration / ImpatienceIgnoring taboo topics

Active CharacteristicsPassive Characteristics

Unique Factors Influencing Engagement

Involvement of Multiple Systems

Medical / HealthAcademic / VocationalMental Health / Psychiatric

Cultural DifferencesUnique relationships with families

Parental FunctioningHistory or current stressors from:SubstancesVictimization / PerpetrationMental Illness

How do the Unique Factors Play a Role?

Families are often in crisisPrevious coping skills are not effectiveSense of urgency to resolve problemsConfusion / fear / intense emotionsSometimes socially isolated & vulnerable

Psychiatric conditions are impactfulUntreated conditions complicate engagementTreated conditions require special consideration

Workers may represent unresolved issuesWe are symbols of prior working relationships

Life is dynamicEngagement, assessment, intervention & outcomes are processes

Parent/Guardian Functioning Up Close

Substances

Victimization / perpetration / trauma

Mental illness

Involvement of other services

Other

Stress managementCan be easily overwhelmedJudgment Often impaired or limited due to stressFrustration toleranceMany times low tolerance for stressEmpathyOften self-absorbed due to unmet needsPersonal boundariesConcept of privacy or intimacy is often blurredRational thinkingEmotional flooding or cognitive distortions Social stabilityMultiple relocations, losses & abrupt transitionsIntimate relationshipsAnxiety often drives behavior

Impact Issues = effects on coping

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What Issues Require Immediate Attention? Important Topics:

Limits of ConfidentialityPrivacyPersonal SafetyPublic SafetyBoundariesDual RelationshipsMisinformation MisunderstandingsDifferent ExpectationsThings to Consider/Steps to Take:

Gather InformationDocument what is seenContact the SupervisorFollow State RegulationsFollow Agency ProtocolProblem Solve the SituationImplement Crisis InterventionTake care of self

Some Engagement & Boundary Questions to Consider

When Im asking questions about the familys life & routines, how do I remain respectful of the familys right to privacy & determination about what information to share? What information do I have the right to know?

When is it OK for me to disclose something personal with the family?

What if the family invites me to dinner or to a family event? Is it ever OK to support a family by forming a friendship with them?

What if I dont feel comfortable with something the family is doing in their home. Should I say something? How would I bring it up politely/respectfully?

When is it OK to give a hug or to put my arm around a client?

What if I suspect child maltreatment or a safety concern in the home? How do I bring up the limits of confidentiality in a way that supports the family and follows the law?

What if I feel like a co-worker is crossing a boundary?

When is it OK for me to give advice to a family?

Is it ever OK to give a family money or personal gifts?

Helpful Websites

National Association of Social Workers http://www.socialworkers.org/pubs/code/code.asp

National Association for the Education of Young Children http://www.naeyc.org/about/mission.asp

National Early Childhood Technical Assistance Center http://www.nectac.org/~pdfs/pubs/assuring.pdf

Division for Early Childhood Code of Ethics http://www.campbellsville.edu/Websites/cu/Images/Academics/Education/Documents/ECE/Cod e%20of%20Ethics_updated_Aug2009.pdf

American Counseling Associationhttp://www.counseling.org/resources/aca-code-of-ethics.pdf

ASHA Code of Ethics http://www.asha.org/docs/html/ET2010-00309.html

Select ReferencesAllen S.F., Tracy E.M. (2008). Developing Student Knowledge and Skills for Home-Based Social Work Practice. Journal of Social Work Education, Vol. 44 No. 1 p. 125-143. Boland-Prom K., Anderson S.C. (2005). Teaching Ethical Decision Making Using Dual Relationship Principles as a Case Example. Journal of Social Work Education, Vol. 41 No. 3 p.495-510.

Jacobson, G.A. (2002). Maintaining Professional Boundaries: Preparing Nursing Students for the Challenge. Journal of Nursing Education, Vol. 41, No. 6 p. 279-281.

Joanne Bardnt- ACSW LCSW (2008). Clinical Associate Professor Emerita Social Work Field Program, University of Wisconsin- Milwaukee.

Gray, M. Gibbons, J. (2007). There are no Answers, Only Choices: Teaching Ethical Decision Making in Social Work. Australian Social Work, Vol. 60,. No.2 p. 222-238.

Kagle, J.D., Giebelhausen, P.N. (1994). Dual Relationships and Professional Boundaries. Social Work, Vol. 39 No. 2 p. 213-220

Lea, D. (2006). You Dont Know Me Like That: Patterns of Disconnect Between Adolescent Mothers of Children with Disabilities and Their Early Interventionists. Journal of Early Childhood, Vol. 28 No. 4 p.264-282.

Reamer, F.G. (2003). Boundary Issues In Social Work: Managing Dual Relationships. Social Work, Vol. 48, No. 1 p. 121-133.

Rosin, P., Whitehead, A., Tuchman, L., Jesien, G., Begun, A. (1993). Strategies for Dealing with Unexpected Immediate Needs or Crisis. Partnerships in Early Intervention: A Training Guide of Family-Centered Care, Team Building, and Service Coordination.

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