Engaging Families to Identify Their Children

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Engaging Families to Identify Their Childrens
Underlying Needs for SCSWs
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• Welcome
• and
• Introductions

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Supervisors are the Heart of Everything

• Social Work supervision is a basic and integral
  part of the professions approach to education
  and practice. It is based on the principle that
  those with more knowledge, skills and experience,
  guide the development and practices of others.
  
• -NASW

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Research Supports Engagement

• Research Demonstrates a direct correlation
  between family engagement and child safety and
  re-occurrence of maltreatment
• Engagement is key to conducting comprehensive
  assessments, enhancing decision making and making
  individualized plans that fit families
• Approach matters when helping children and
  families
• The Social Worker matters and is related to
  client success
• (Lambert and Barley, 2002)

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Approach Matters

• Small things such as the way that workers
  introduce themselves, the way that workers
  describe the allegation and the tone of voice
  impact the willingness of the family to allow us
  in the front door, and into their lives.
• Lorrie Lutz, Operationalizing the DCFS
  Practice Model

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Strength-Needs Practice

• Requires appreciating the needs of the parents
  child and finding common ground about their
  worries
• Requires engaging the parent through the NEEDS of
  the child
• Requires focusing on needs throughout the life of
  the case (assessment and planning are ongoing)

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Strength-Needs PracticeRequires Effective
Working Relationships

• Core Conditions
• Respect
• Empathy
• Genuine
• Competency

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Rapport First Step of Engagement

• Rapport is the Building Block to Engagement
• Engagement requires Rapport
• Rapport does not equate to Engagement

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Engagement Moves Beyond Rapport

• Effective working relationships with shared tasks
  and goals
• Mutual accountability
• Active listening that supports family empowerment
• Honest, open dialogue about concerns and success
• Flexibility in response
• Ability to solicit feedback from children
  families

Adapted from Vincent, 2008
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Rapport vs. Engagement

• Rapport
• Empathy
• Kind/Respectful
• Mutual understanding
• Comfort
• Trust

• Engagement
• Active listening
• Real dialogue
• Mutual feedback
• Flexibility
• Solution/Goal Focus

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Rapport vs. Engagement

• Large Group Exercise

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Engagement and the Use of Authority

• Seek to avoid, to the extent possible, actions
  that
• minimize/undermine parents power
• It is important to remember that invoking
  authority is easier and requires less skill than
  engaging families
• People are more disclosing, open, and cooperative
  if they dont feel threatened and judged
• 
  
• Lorrie Lutz

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Moving From Rapport to Engagement

• Small Group Discussion
• Share examples of when your observed too much or
  too little use of authority?
• How would you assess yourself? (Do I find myself
  being too uncomfortable with using authority or
  being directive?)
• What are some engagement strategies that I use
  even when I need to use protective authority?
• 
  

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Shifting the Focus of Engagement - Talking About
Needs Instead of Behaviors

• Behaviors are important but may unintentionally
  distract us from a clients real need
• Needs are not services but are what drives the
  behavior
• Addressing needs is key to sustaining meaningful
  change
• Connecting needs to behaviors can strengthen a
  familys willingness to work together with DCFS
  and partners
• (How can you do this?)
• Needs reflect the unique experience of the child
  within the context of their culture

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Systemic Challenges to Engagement(no wonder the
work can sometimes feel overwhelming)

• Child/Youth/Familys Needs
• Resistance
• Workers Needs
• Case Load/Work Load
• Competing Priorities
• Limited Resources
• Court
• Service Providers
• Training

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Challenges to Engagement Reflect Workers Needs

• Lets Discuss
• What are some of the needs you see related to
  workers better engaging children families?
• What are some of the strengths you see related to
  how workers engage
• children families?

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Hunches About Workers Needs

• Support
• Time
• Safety/Respect
• Accountability
• Core Values
• Professional Development
• Coaching and Mentoring
• Other_______
• 
  

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Parallel Process How our own experience helps
us to effectively engage with others

• Small Group Activity
• Write down differences and/or similarities we
  (and our workers)
• have with our clients feelings, experiences,
  and/or needs?
• Discuss How does this awareness of
  differences/similarities
• contribute to effectively working with
  clients?
• Discuss How does the way we manage our own
  experiences or
• feelings impact the quality of the work we do
  with our families?

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3 Engagement SkillsTo help children and
families identify and address
their needs

• Exploring
• Focusing
• Guiding
• - Paul Vincent

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1) Exploring Skills Active listening and
hearing what people want to say before addressing
the problem

• Attentive and Interested
• (Physically and Psychologically)
• Recognizing Strengths and Needs
• Encouraging Expressions of Feelings
• (Ventilation, Validation, Conciliatory Gestures)
  
• Normalization and Objectivity
• Reflection (Convey Understanding)

Adapted from Vincent, 2008
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2) Focusing Skills Centering discussion
on the needs that are most important

• Questions (Open, Closed, Indirect)
• Summarization (concise review)
• Clarification (together, define words used)
• Concreteness (no DCFS/social work jargon)
• Reframing (look for positives)
• Solution-Focused

Vincent, 2008
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3) Guiding Skills Collaboratively
identifying solutions and creating a plan
to carry out ideas

• Formulating options with family input
• Partialization
• Information/Suggestions
• Strengths/Needs based Feedback
• Positive Feedback What is working well?
• Constructive feedback What can be
  working better?

Vincent,
2008
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BREAK
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Keys to Engagement

• Using Activity 3C, Observe Demonstration
• In small groups, utilize keys provided and engage
  clients regarding assigned tasks provided at each
  table

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Lets Discuss

• How did the utilization of keys
• Invite discussion and disclosure
• Identify and mobilize strengths
• Discuss hunches around needs
• Focus on solutions
• Offer hope
• strengthen the working
  relationship?

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Understanding and Normalizing Resistance

• (When helpful intent sometimes collides with
  a lack of trust)
• Lets Discuss
• Resistant Behaviors/Situations you observe
• If you have worked with youth who need to
  develop
• self-sufficiency skills, does resistance arise
• in a different way?

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Common Signs of Resistance
Avoidance Passivity Anger/Hostility
Physical Flooding with details False compliance Flight to health Pressing for solutions Silences Excuses Denial Rationalization Threats Aggressive posturing Blaming
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Good Practice Recognizes

• RESISTANCE IS A PREDICTABLE AND NATURAL
  EMOTIONAL REACTION TO FEELING FORCED TO CHANGE OR
  WHEN FACING DIFFICULT ISSUES.
• RESISTANCE OCCURS AS A RESPONSE TO FEELING
  VULNERABLE, OUT-OF-CONTROL AND THREATENED BY
  CHANGE.
• 
  
• Adapted from Vincent 2008

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Good Practice Recognizes

• Resistance Reflects Needs
• Lets Discuss
• What Needs may be underlying the resistance?
• What Practice Skills are required to address
  those needs?

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Strategies That Help Clients Move From Resistant
to Ready

• Resistance is important information not to be
  judged
• Prepare for resistance its part of the change
  process
• Actively listen, validate feeling and reflect
  what is happening
• Remain respectful
• Focus on the needs of the child as a place to
  join together
• Focus on solutions or desired results
• Reflect when we do react, and remain available to
  help

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• WHEN I REACT
• ITS TIME TO REFLECT

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Self Reflection Promotes Engagement!

• In Small Groups
• Write down some reactions that I observe in
  myself or others that may be nonproductive?
• What might be going on with me or a worker when I
  
• react in non- productive ways?
• How do reactions sometimes get in the way of
  forming effective working relationships with
  children and families?
• What is one strategy that I will try and apply to
  my work to help move clients from resistant to
  ready?

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What is Mental Health?

• For Adults The capacity to love well and
• work well
  -Sigmund Freud
• For Children The capacity to grow and to
• love well
  -Alicia Lieberman, PhD

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Mental Health Needs of Children

• TRAUMA-BASED NEEDS
• 30 to 85 of youngsters in foster care have
  significant emotional disturbances
• Adolescents living with foster parents or in
  group homes have about four times the rate of
  serious psychiatric disorders as those living
  with their own families

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Lets Discuss Mental Health Symptoms of Children
and Youth

• ?List symptoms youve observed
• ?How do these children typically get labeled?
• ?What might be some of their underlying needs?

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Besse Van Der Kolk, MD Developmental
Trauma Disorder

• Unless caregivers and professionals understand
  the nature of trauma reenactments, they are
  likely to label the child as oppositional,
  rebellious, unmotivated, or anti-social.

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Remember, in Trauma-Informed Practice

• Behaviors, Symptoms and Deficits reflect
• NEEDS!

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POSSIBLE BARRIERS TO ADDRESSING MENTAL HEALTH
NEEDS

• Delayed engagement/assessment
• Overwhelmed by multiple, urgent needs
• Delayed linkage to services, limited resources
• Denial or ambivalence regarding treatment
• Bias or stigmas held by helpers families
• Other __________

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Mental Health Stigmas

• Stigmas negative biases, which focus on
  behaviors and distract us from the unmet needs
• Stigmas may contribute to negative feelings that
  may deter us from seeking help
• Stigmas may contribute to negative feelings that
  may deter us from providing help

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Overcoming Stigmas About Mental Health Services

• Be sensitive to the idea that children, families
  and community partners (foster parents) may have
  biases about mental health diagnoses and services
• Be willing to look at our own bias

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Engagement Requires Looking at Our
Potential Biases

• Clicker Activity regarding stigmas
• Please respond to the following statements

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Los Angeles DCFS is the largest child welfare
system in the country

1. Strongly Agree
2. Agree
3. Neutral
4. Disagree
5. Strongly Disagree

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Individuals who have a mental illness have a
disease

1. Strongly Agree
2. Agree
3. Neutral
4. Disagree
5. Strongly Disagree

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Individuals who are homeless have mental illness

1. Strongly Agree
2. Agree
3. Neutral
4. Disagree
5. Strongly Disagree

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Individuals who have mental illness can
adequately care for children

1. Strongly Agree
2. Agree
3. Neutral
4. Disagree
5. Strongly Disagree

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Individuals with substance abuse or addiction
have mental illness

1. Strongly Agree
2. Agree
3. Neutral
4. Disagree
5. Strongly Disagree

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Encouraging Participation in Mental Health
Services

• Explain the purpose/goals of mental health
  treatment
• Address any issues or fears of stigmatization
• Provide space for healthy ventilation and
  validate feelings
• Together, discuss informal and formal supports
  that fits the
• the familys needs
• Have a discussion about the pros and cons of
  treatment
• Provide options and agree to a plan with the
  family
• Regularly assess how their plan is working and
  adapt as needed

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Addressing Needs Through Community Partnerships
Teaming Training to Follow

• Requires engaging community partners
• Best outcomes arise when there are strong
  working relationships between a family and its
  helper
• Requires helping children and families engage
  with
• their community
• Best outcomes are sustained when families
  feel connected to and supported by their
  communities

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Stages of ChangePrimary Tasks

1. Precontemplation

Definition
Not yet considering change or is
unwilling or unable to change
Primary Task Raising awareness
2. Contemplation
6. Recurrence
Definition
Definition Experienced a recurrence
of the problems
Sees the possibility of change but is
ambivalent and uncertain
Primary Task
Primary Task Cope with consequences
and Determine what to do next
Resolving ambivalence, Helping to choose change
5. Maintenance
3. Determination
Definition Has achieved the goals and
is working to maintain change
Definition Committed to
changing but still considering what
to do
4. Action
Primary Task Develop new skills for maintaining
recovery
Primary Task Help identify
appropriate change strategies
Definition Taking steps toward
change but hasnt stabilized in the change
process
Primary Task Help implement change
strategies and learn to eliminate potential
relapses
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BREAK
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Key Points to Remember

• Recognize Stage and focus on the Primary Task
• Remember not to move too quickly (one stage at a
  time)
• People may repeat stages of change or move back
  and forth along the stages of change (i.e.
  relapse)
• Most people cannot move through stages alone
• (your encouragement matters)
• Build on strengths and recognize success

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Motivational InterviewingCreating Conditions
for Change

• Five Basic Principles
• Express Empathy
• Avoid Argument
• Support Strengths
• Roll with Resistance
• Discuss Discrepancy
• (Changing Behavior Using Motivational
  Interviewing Techniques Bundy2004)

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EMPATHY

• It is not so much identifying with a persons
  experience or expressing sympathy or just being
  kind to people.
• It is
• Conveying a real, informed, understanding of a
  persons predicament and what maintains the
  ambivalence
• Requires active listening and reflection
• Provide concise statements that encapsulate what
  person is trying to communicate

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In Small Groups

• Read the following scenarios (see hand-out) and
  make empathetic statements
• Remember to attempt to genuinely express
• the persons predicament and the challenges
  to change

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Avoid Argument Arguments are Counterproductive

• Be proactive and prepare self before the
  conversation
• (remain calm at all times)
• Encourage clients to state what they want to
  change
• Listen and offer available choices
• 
  

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Support Self Efficacy

• Genuinely promote the belief that people can
  change!
• When the individual makes any type of statement
  about their belief that they can changeor that
  they intend to do something, validate the
  statement.
• Support and highlight success
  
  

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Roll with Resistance

• Use thoughtful questioning, clarification and/or
  reflection to gently challenge thoughts that
  become barriers to change
• Help the person see incongruency between their
  beliefs and their actions
• Discuss the concept of ambivalence (change is
  hard)
• Offer new perspectives without imposing them
• Remain solution-focused (How will this be
  beneficial?)

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Resistance I May Encounter

• Why should I go to counseling?Talking
  doesnt helpI dont need to talk to anyone
• In Small Groups
• Discuss what I could say to a roll with this
  resistance (what are the benefits to
  counseling?)

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Discuss Discrepancy

• Identify together, realistic goals which address
  needs
• Discuss discrepancies between stated goals and
  current behavior
• Regularly discuss progress towards those goals
• Respectfully point out consequences for
  behavior/choices and how those choices impact
  others (i.e., children)
• Encourage change but dont insist Inspire hope
• 
  
• 
  -adapted
  from Bundy, 2004

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How does MI fit with my work?

• Developing tools to help motivate others to make
  needed changes
• Each contact with the child and family is an
  opportunity to engage and inspire hope
• Motivating others to get connected to their
  community supports to support long lasting change

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Effective Case Management
Reasonable Efforts Involves Engagement

• Call potential resources prior to providing
  referrals and find
• out about the resource to facilitate
  success
• Ask if assistance is needed with contacting
  community supports
• (if so, model how it is done)
• Regularly discuss how each resource is working
• (What are you learning? Any challenges?)
• Regularly discuss the value and benefits of
  participating in
• services
• (What changes are you making? How is this
  meeting your needs?)
• Document these conversations in your contacts and
  Court reports

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Talking with Clients about the Value of Court
Ordered Services

• In Small Groups
• Identify a youth or parent who has been ordered
  to counseling, parenting, drug treatment, etc.
• Discuss what you could say to ENGAGE and
  MOTIVATE
• participation in counseling
• participation in parenting program
• participation in a substance abuse treatment
• a youth to remain in a good placement
• a youth to take psychotropic medication
• a youth to consider transitional housing

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Lets Practice

• SMALL GROUP EXERCISES

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Effective Engagement Requires

• Self Appraisal
• Review Self Appraisal Check List
• 
  

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Effective Engagement Requires

• Support!
• Office Based Lead Coaches are being trained
  to Coach and Mentor SCSWs
• 
  

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Effective Engagement Requires

• Self Care!
• Review Self Care hand-out and make a plan to
  take good care of yourself
• 
  

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You Make A Difference !!

• Your continued commitment to providing quality
  Social Work supervision positively impacts the
  lives of children and families.
• For all your dedication and hard
• work with children and families!