Outreach and Engagement

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Outreach and Engagement
Rev. Dr. Craig Rennebohm Mental Health Chaplaincy
Seattle, WA. Michael OConnor RN Boston Health
Care for the Homeless HIV Team Boston, MA.
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Outreach

• Michael OConnor RN
• Boston Health Care for the Homeless
• HIV Team

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Basic principles (for not getting lost)

• 1) Outreach is from something
• a service or an agency, the outreach worker is an
  agent.
• 2) Interacting with clients
• the clients are interested in the possible
  benefit being offered them, and
• should be approached in a specific manner
  designed to engage.
• 3) There is a plan
• There is an end in mind
• this directs the plan for engaging, connecting
  and follow up.

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Outreach from

• place
• hospital or a drop in center
• philosophy
• Church of Latter Day Saints or Republican party
• Activity
• job fair or blood pressure screening
• any or all of the above, whole lifestyle change,
• Army recruiter or commune advocate

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Philosophy of parent organization

• potential for conflict or confluence between the
  organization and agent
• conflict may make the outreach worker
  uncomfortable and resentful, leads to burnout
• outreach worker should share the values of the
  organization from which outreaching.

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Interacting With Clients

• Identifying clients
• Client should be interested, at least
  potentially benefit.
• Approach with respect.
• intuition or art to subtly approach a potential
  client.

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Engagement

• The style of engaging depends on the mission and
  nature of the program
• homeless outreach
• nighttime outreach, pts bedroom
• Approach from a distance, wait for signal that it
  is OK to come closer
• Safety.

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Respect and Privacy

• appearance of stigma
• personally, or public, to the social milieu.
• uncomfortable and even humiliating singling-out.
• low income students in a school for a meal
  benefit
• illiterate population in a prison
• identifying HIV positive clients among a group of
  homeless men

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Dignity

• Nonjudgemental.
• Respectful of choice, even if not our choice.
  e.g.to stay out, to not take meds, to not go to
  detox etc. (harm reduction).
• Principles of motivational interviewing, avoiding
  You should or you have a problem defenses.

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Plan

• Connecting back to program
• Homeless health care,
• There exist excellent and nontraditional clinics
  and clinicians
• specialize in reducing the barriers to health
  care experienced by the disenfranchised,
  disorganized and disconnected homeless persons

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Homeless health care outreach

• Curbside medical care is great to engage and
  care for client, but have the client to connect
  with health care setting, if possible.
• homeless clinic in Boston Medical Center - nurses
  and case-managers sometimes do outreach to the
  hospital!
• clients in hospital beds who are not well
  connected
• clients roaming through the lobby either lost or
  forgotten who agree to meet with a nurse or
  attend a group etc.

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Follow up

• Consistency is a hallmark of good outreach
• On the most general level it serves as a model
  for caring that perhaps has not been experienced
  by the homeless person
• serves to strengthen the therapeutic relationship
  by increasing the level of trust.

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Follow up

• Follow up can occur on any level, from checking
  in on someone in a routine pattern, e.g. weekly,
  to reminders of appointments and accompanying to
  visits.

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Summation

• Dont just do something, sit there!.
• the most simple and the most difficult skill to
  put into practice is to listen
• working with difficult populations is just that,
  difficult, but it can and should be a rewarding
  experience to both outreach agent and client
  alike.

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Relational Outreach and Engagement

• Rev. Dr. Craig Rennebohm
• Mental Health Chaplaincy
• Seattle, WA.

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Relational Outreach and Engagement

• A Response to Suffering
• A Shared Journey
• Supportive of Healing
• Moving Toward Mutuality

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The Human Milieu

• Street
• Drop-in Center, Meal Program, Shelter
• Clinic and Hospital
• Housing and Neighborhood

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Suffering

• Personal
• Relational
• Social

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Relational Suffering

• Trauma and Abuse
• Insecure Attachment

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Social Suffering

• War
• Poverty (class)
• Homelessness
• Injustice and Exclusion

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Social Isolation

• 90 incidence of trauma and abuse
• 80 no social contact

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Deep Woundedness

• A function of
• early insecure attachments.
• trauma and abuse,
• poverty and class discrimination,
• the injustice and exclusion of homelessness,
• general medical conditions,
• personality developments
• neuro, biochemical brain disorder

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The Beloved Stranger

• hurt, alone, wary, protective,
• fragile selfhood
• multiple and complex needs
• difficult to serve vs non-compliant

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Four Movements of Outreach and Engagement

• Approach
• Offering Companionship
• Partnerships, Building a Circle of Care
• Mutuality

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Approach

• Sensitivity
• Sympathy, Empathy and Compassion
• Concern
• Introduction

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Introduction

• Observation
• Reflection
• Roles
• Personal
• Professional
• Neighbor
• Human Being

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Companionship

• Hospitality
• Side by Side
• Listening
• Accompaniment

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Listening

• Story
• present
• / \
• past future

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Seven Comments on Listening

• It is a gift to listen
• Listen for feelings and themes
• Take care with responses
• Listen to yourself
• Listen in community and over time
• Listen for the words of faith, hope, possibility
• Listen for the story of wholeness

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Healing and Wholeness

• Cure
• Healing
• Wholeness

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Healing

• symptom recognition
• explanatory models
• treatment
• convalescence, recovery and wellness

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Wholeness

• more than cure
• restoration of maximum functioning
• growth and integration of selfhood

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Partnerships, Building Circles of Care

• Referral
• Collaboration
• Debriefing

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Trust Issues

• Abandonment
• Two, Three, Four against One
• Fear of the Unknown
• The Nature of Bureaucracies

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Mutuality

• Terminating with Authenticity
• Recognizing Personal and Social Responsibility
• Continuing roles as Neighbors and Fellow Citizens
• Capacity for Interdependence, Inclusion,
  Belonging and Community- Markers of Mutuality