surviving and thriving through walk-in counselling · in the first sessions (slive, 2008) •45-50%...

Surviving and Thriving through Walk-in Counselling:

Challenges & Lessons Learned

AMHO Conference: May 28th, 2018

Presented By Irina Sytcheva, Jamie Lemen and Kulsum Khan

WoodGreen Community Services


Introductions

• What do you need to have happen for you to know that this was helpful?

• Any topics you want us to cover?

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Special Thanks

We wish to give special thanks to Sharna Cohen, Karen Young, Michael Worb & Family for their contributions to launching, building and growing WoodGreen’s Walk-in

Counselling Service.

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Agenda1. Introductions

2. Practicing Curiosity

3. Overview of Our Walk-in Counselling

4. Values & Principles

5. About Single-Session Counseling

6. Community Volunteer Therapist Program

7. Our Impact

8. Our Challenges

9. What We Learned

10. What’s Next

11. Wrap-up and Questions

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Practicing Curiosity



Thin Thick Interactive Experience• One interviewee, One interviewer, One or more

documenter/scribe/coach

• Interviewee: Start the conversation with stating a positive identity description about yourself. Must be one liked by you. Examples are: I am resilient, or courageous, or determined

• Documenter/scribe/coach: you can give feedback and helpful, but not to take over

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Thin Thick Interactive Experience• Interviewer: Be curious. Get a thick story.

– Find out everything you can about the identity description. Examples for “determined”?

– How does determination show up in your life?

– What stories can you tell me about determination?

– What events or people in your life have contributed to you seeing yourself this way?

– What values, principles, commitments do you draw on to sustain determination?

– Who in your life shares these values?

– What events or persons have inspired determination?

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Thin Thick subordinate stories• Thin stories lack detail

• A think story is inscribed with meanings and finds linkages between the stories of people’s lives and their cherished values, beliefs, purposed, desires and commitments…

• When people engage in a different telling, different language, new meaning, new ideas, new possibilities can emerge

• We can facilitate “A-ha” or pivotal moments

Developed by Karen Young, MSW/RSW.

Used with permission.

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So, What Is Walk-in Counselling

Play Video


Our Values & Principles



Values & Principles• People know when they need help

• It’s best to offer help when people ask for it

• Often single session can be enough

• People will use the service as they see fit and may return for subsequent sessions

• Some people may need a referral for more services

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Values & Principles• People are multi-storied, there are many parts of a

person’s story

• The “truth” about who people are (their identity) is shaped by societal, cultural, historical contexts in which they live (discourses). Identity is fluid, relational; it changes over time and between contexts.

• People can solve their problems and have knowledge, abilities, skills and resources that can be directed toward new possibilities

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Values & Principles• People exist outside of the problem. The problem is the

problem, not the person

• The purpose of the session is not to fix everything. Hope may be the only outcome, and we (as counselors) need to be okay with that

• The job of the counselor is to facilitate conversations in such a way that resources can be utilized and mutually discovered

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What is Single-Session Counseling and Why Does It

Work?



Single Session therapy or Walk-in Counselling is “not about providing traditional services faster; we need to significantly shift the way we think about change and the way we view the people who come to us for help.”

- Karen Young, RSW, Windz Institute

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Single-Session Structure• Each session is approached as a distinct therapeutic encounter –

building a therapeutic alliance, negotiating focus for the session, developing an understanding of the problem, identifying resources (internal and external), formulating an “intervention” and processing feedback all occur in one session

• The focus of the session is in the present and future – there is little prior information, discussion focusses on the problem in the present and how it effects the person now, and highlights preferences for the future

• Not: formal assessment, diagnosis, ongoing therapeutic relationship

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But Does It Work?

• In multiple session models much of the change occurs in the first sessions (Slive, 2008)

• 45-50% of clients attending walk-in do not ask for or require further services (Young, Dick, Herring, & Lee, 2008)

• Can provide interim support for those on waiting lists; can prevent people from going on waiting lists (Young, et al, 2008)

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But Does It Work?

• Successful outcomes are reported for the single session model in terms of client satisfaction and the development of an action plan (Miller, 2008; Slive, 2008; Bhanot-Malhotra, Livingstone, & Stalker, 2010)

• In a 2016 study of Walk-in participants identified ease and accessibility as most valued experience (Cait, 2016)

• Some studies suggest that Walk-in attracts more men and youth than traditional models (Stalker, 2012)

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Our Lifeline - Community Volunteer Therapist Program



What we’re looking for• Experience with mental health/addictions/family/etc.

• Theoretical knowledge and well-developed counselling skills

• Registration with Regulatory College is required

• The commitment is a minimum of one shift (ideally 4:15 - 9:00 p.m., latest acceptable arrival 5:30) per month, for 12 months. More frequent participation is recommended

• Can utilize variety of therapeutic models and approaches – based on own comfort and style and what’s most useful for the client

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What we offer• An opportunity to network with other WoodGreen staff

and volunteers

• Develop your clinical skills and receive clinical supervision/consultation

• Opportunity to provide 1-1 counselling with a diverse population

• Learn about resources and other programs offered in the community

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What we offer• Receive training in Single-session counselling models,

and booster trainings on a variety of topics throughout the year

• Provide letters of recommendation and confirmation of counselling hours to support professional development

• Formal recognition through Walk-in appreciation events

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Training and Supervision• Application & Interview process

• Orientation Training

• Shadowing (observing other counselors) 1-3 nights

• Co-counselling (observed by other counselors) 1-3 nights

• Peer & Self Evaluation

• Booster Sessions

• Support, clinical supervision, guidance, resources offered along the way

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Our Impact(Or Why We Are Awesome)



• Strengthen Skills

• Resource Sharing

• Networking

• Consultation Process

• Utilize skills within their home agencies

• Community of Practice

• Capacity Building

• Consultation

• Knowledge Sharing

• Receive counselling, resources

• (Re)gain skills, insights, knowledge

• Utilize skills within their own communities

• Non-traditional hours

• Free, no restrictions, no referrals or waitlist

• Reduce burden on Caregivers

• Diversion from more costly services, e.g hospital, crisis services

• Fills a gap in service, e.g. court diversion, child protective services

• Diverts from waitlist

• Fills the gap while on the waitlist

Larger Systems

Clients & Community Members

CounselorsCommunity Agencies &

Partners

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* Based on data from

April 2017 to March

2018. Discrepancy

between individuals

and sessions is a

result of individuals

receiving service

together

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*Other includes:

Crisis Line; Flyer;

School; 311; Walk-in’s;

EAP

Referral Source

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Presenting Concerns

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Mental Health Concerns

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Interpersonal Concerns

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If the Walk-in wasn't available what would you do?

* Other includes:

Use substances;

take a walk; stay up

all night; gamble;

meditate; church

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Interventions

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Our Challenges



Challenges Exercise

• What is one challenge you face in your work?

• Can be an individual, organization or system-level challenge

• Write down 1-2 challenges on the post-it notes and then stick them up on the flipchart

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Challenges Faced at the Walk-in

• High demand for service, e.g. wait-times

• Accessibility, e.g. language, childcare

• Volunteer management and retention, e.g. scheduling

• Volunteers’ balancing their work life and the Walk-in

• No direct funding

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Challenges Faced at the Walk-in

• Limitations of the Walk-in model, e.g. challenge to work

with complex and developmental trauma; people who

would benefit from working with one counselor

• Working with “Mandated” clients

• Every night is different (not knowing what to expect on

any given night)

• Re-occurring vs. new clients

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• Volunteer to share 1 of the challenges faced in your work

• Consult with the “team”

• What resources, supports, ideas, feedback, strategies can

you share with the counselor?

Challenges Exercise

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What We Learned



Lessons Learned

• Organizational commitment is key e.g. offering office space as counselling rooms, staff counselors

• Importance of the Intake/Program Assistant/Greeter

• Counselors come and go – word of mouth has been the best form of marketing

• Importance of taking care of volunteers, e.g. food, training

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Lessons Learned

• People use the Walk-in service as they need it

• Value of the mid-session consultation

• On-the-spot client feedback

• Resource sharing among counselors/On-hand resources

• Safety and comfort – for clients and counselors

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What’s Next



Where We’re Going…• Expansion

– Hub model of service– Different ways of accessing counselling– Increased days/hours

• Capacity Building – Consultation– Templates– Sharing of the model– Training

• Community of Practice– Share best practices, lessons learned– Peer support, networking

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Debrief and Q&A

• Questions

• Observations

• Where are you now that you weren’t at the beginning?

• Did you get everything you need?

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Let’s Stay In TouchIrina Sytcheva, Senior Manager – Counselling, Case Management and Support Services.

[email protected] ext. 2525

Jamie Lemen, Supervisor – Walk-in [email protected] ext. 1266

WoodGreen: Community Care Central [email protected]

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mailto:[email protected]




Works CitedBhanot-Malhotra, S., Livingstone, S., & Stalker, C. (2010). An inventory of walk-in counselling

clinics in Ontario. Children’s Centre. Retrieved from: http://www.childrenscentre.ca/Resources/Research%20and%20Evaluation/Research%20Reports/Walk%20In%20Inventory-20June%206%20final_3.pdf

Cait, C.A., Skop, M., Booton, J., Stalker, C.A., Horton, S. & Riemer, M. (2016). Practice-based qualitative research: Participant experiences of walk-in counselling and traditional counselling. Qualitative Social Work. 1473325016637910.

Miller, J. K. (2008). Walk-in single session team therapy: A study of client satisfaction. Journal of Systemic Therapies, 27(3), 78-94.

Slive, A. (2008). Special Section: Walk-in single session therapy. Journal of Systemic Therapies, 27(4), 1-4.

Stalker, C.A., Horton, S. & Cait, C.A. (2012). Single-Session Therapy in a Walk-in Counselling Clinic: A Pilot Study. Journal of Systemic Therapies. 31(1), 38-52

Young, K., Dick, M., Herring, K., & Lee, J. (2008). From waiting lists to walk-in: Stories from a walk-in therapy clinic. Journal of Systemic Therapies, 27(4), 23-39.

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http://www.childrenscentre.ca/Resources/Research and Evaluation/Research Reports/Walk In Inventory-20June 6 final_3.pdf

surviving and thriving through walk-in counselling · in the first sessions (slive, 2008) •45-50%...

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