trauma informed casework for refugees international counseling and community services, a program of
TRANSCRIPT
Trauma Informed Casework for Refugees
International Counseling and Community Services, a program of
Stages of Refugee Migration
Fleeing Encampment or Exile
Resettlement
Results
Poor sleep Fatigue Hyperarousal/Irritability Poor memory/Difficulty focusing Lack of Trust/Suspicion Poor Physical Health Difficulty making decisions Lack of ‘agency’ Flooding Disappointment
Trauma and Migration Impact on Casework
Feeling overwhelmed/difficulty setting goals Poor memory Difficulty focusing Unrealistic goals Unrealistic timeframes Lack of agency Complex external barriers Competing resettlement commitments Frustration/Anger Hopelessness/Feelings of Defeat
Trauma Informed Casework
Understands the client’s current context
Recognizes that certain casework activities can be triggering
Knows the many different ways stress and being overwhelmed can present itself
Trauma Informed Casework
Adheres to strict privacy rulesConveys confidentiality to the clientIs strengths-basedEmpowers the clientHelps mitigate anxiety by be
consistent and transparentIs open-minded about client concerns
and has a process for evaluating them
Trauma Informed Casework
Has private room to meet with clientUses professional interpretersKeeps all client information locked
and secureUses Releases of Information for all
entitiesIs able to ask for help from
colleagues and supervisors
What is Casework?
Case work is a collaborative processwith a individual to reach a goal.
Both people – the case worker and the client – work to make the goal happen. The case worker generally offers their
expertise, resources, and guidance while the client offers their energy and
initiative.
Basic Casework
Step 1: ASSESSMENTWhat is the client hoping will happen?
Does it differ from what you think should happen? Is it realistic?
Basic Casework
Step 2: PLANSet measurable goals. If goals are too big break them into smaller pieces.Example: Non-measurable – Client will improve English. Measurable – Client will move from Level 1 to Level 2 within 3 to 6 months.
Basic Casework
Step 3: IDENTIFY BARRIERSLanguagePhone MinutesTransportationResponsibilities at home
Basic Casework
Step 4: IMPLEMENTATIONWhat does it take to get it accomplished?
Is everyone clear on the next steps? Do you have a timeline?
Basic Casework
Step 5: MONITORSet regular check-insAssess “why” if goals are not met
Basic Casework
Step 6: Reconfigure goals or move towards terminationCreate new or modified goals if necessaryIf case is completed let client know
Intake ‘Flow; or Process
The way you structure the intakeso that you can help determine
goals, set an action plan, and collect needed information for billing and
reporting
Intake Flow
• Introduction• Discuss confidentiality (with specifics)• Collect demographics• Identify goals (client voice and choice)• Assess other areas of need• Set goals• Allocate tasks• Establish timeframes• Ask if anything is missing• Establish next check-in time
Case Example - Dorcas
Dorcas is a 37-year old woman from the DRC. She is married and has two elementary school age children. She has been in the U.S. for five months. Her husband found work at Sky Chef but recently lost his job. She is coming to you for housing assistance because they family is having great difficulty paying rent.
Initial thoughts about goals and barriers?
Case Example - Dorcas
In talking to Dorcas you discover that her 10-year old daughter has been in and out of Children’s Hospital with what may be a serious cardiac problem.
Second thoughts about goals and barriers?
Case Example - Dorcas
You also find out that her husband lost work because he has been taking the child and mother to Children’s Hospital and had to miss work several times because of conflicting appointments.
Final thoughts about goals and barriers?
Assessment
What are the client’s need(s)? 1. Housing Assistance2. Transportation3. Exploration of SSI4. Medical Case Management5. Employment Services for spouse6. 7.
Assessment
What barriers does the client have to self-sufficiency?1. Lack of English Skills2. Medically Needy Child3. Insecure Housing4. 5.
Assessment
What local resources are available to address the client’s needs and/or barriers?1. Refugee Health Promotion Project2. HopeLink3. Rental Assistance4. Employment Programs5. 6.
Assessment
What PRIME Program service(s) will the agency provide to address the client’s needs and/or remove barriers to Self-Sufficiency?1. Refer to RHPP2. Ask Children’s Hospital about HopeLink3. Apply for rent assistance4. Connect spouse to employment5.
Things You Might Need
• Private Room• Way to Keep Confidential
Information• Releases (in addition to DSHS)• Establish times for checking
progress• Ways to track outcomes
Progress Notes
A Progress Note is a written detail of what the caseworker and the client did together to achieve the goal. It provides: A way to review progress madeA way to review what has been tried and re-establish goals and interventions as neededAccountability to all involvedA guide for future caseworkers
Progress Notes
Should always be:ClearConciseRelevantUseful
Progress Notes
Should always have:Goals worked onInterventionsOutcomesAny referrals and next stepsName and contact information for anyone contacted
Progress Notes
Should never have:Private sensitive informationNon-relevant informationJudgement and Conclusions
Examples
INCORRECT:Spoke with client who said she is really worried about her daughter and that she is throwing up all the time. She also said husband has started drinking. Spoke with lady at Children’s Hospital who said child is really sick but she doesn’t know if she will die. Told them that client needs HopeLink.
Examples
CORRECT:Spoke with Mary Lewis at Children’s Hospital (206-555-1212) regarding establishing HopeLink transportation for client’s child. Mary said she felt child would be eligible and would have the clinic fill out the forms by the end of the week. Agreed to contact Mary next Monday, 11-14-15, to check in on status. Called client to convey status of transportation forms.
Examples
CORRECT:Spoke with Mary Lewis at Children’s Hospital (206-555-1212) to check status of HopeLink application. She confirmed she sent it to HopeLink. Called client and updated her on transportation issue and made appointment for her to come into office tomorrow (11-15-15) with list of child’s appointments so I could teach her how to use HopeLink.
Helpful Hints
Affirm – “This IS a difficult process” Normalize – “Almost everyone has a difficult time and it is common to
feel overwhelmed, sad, or even angry” Connect to client’s larger life goals – “Learning ESL is really going to
help you parent your children as they go to school and adjust to the United States.”
Praise/Encourage – “I admire that. That tells me a lot about you as a mother.”
QUESTIONS?
Further questions…
Beth Farmer, LICSWLutheran Community Services NorthwestInternational Counseling and Community Services