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……

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 familyWhat the family gains from servicesHow ‘easy’ service participation is for the family

‘RELATIONSHIP’ consists of:

Commitment +Relating +Knowledge +Skills…………+ = Engagement

Engagement leads to positive outcomes!

What Brings BSF Staff & Families Together?

Core Principles of BSF Programs

Establishing TrustActive listening

AssessingCommunicating

Assisting / MentoringCrisis Intervention

Coaching / ModelingAdvocatingEducating

Maintaining 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 flexibleUse preparatory empathy:

put ourselves in ‘their shoes’Select our words carefully

interactions shape the relationshipFollow our purpose / we must stay on task

we are more than friendly visitors!Do NOT make assumptions

we 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 IRP

Using ‘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 team…because 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 topics’We 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 say• We must be purposeful in our

communication

How we say it• Verbal• Non-verbal

Active Listening: • Words• Behaviors• Feelings

Role Modeling / Action• Take time to teach• Celebrate accomplishments • Lead by example

What is Active Listening?

RelatingAttitude

Do thoughts & behaviors match?Type of communicatorInvestment in services

Planning & ReflectingPersonal & Family Values

Self ImageSelf-Esteem

DoingTreatment PlanningProcess of Change

Current Problems & Obstacles

Reacting / “Fight or Flight”

Identifying, Owning & Managing FeelingsTriggers for Feeling States

.

EMPATHY: identification with and understanding of another’s 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? What’s 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 Identity Tribal Affinity Nationality Acculturation/Assimilation Socioeconomic Status / Class Language Education Literacy Family constellation Social history Perception of Time Health Beliefs

• Health / Mental Health• Beliefs about Health/Mental

Health• Values• Age Cycles• Life Cycles• Gender & Gender Identity• Sexual Orientation / Identity• Religion & Spiritual Views• Spatial & Regional Patterns• Political Orientation

&Affiliation

Engagement and BoundariesWhy are boundaries so important?They set the framework for us to talk about:

Our roles & responsibilities The services being delivered Our expectations for the working relationship Limits 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 don’t get overwhelmed as easily when we’re 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 Client’s 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 assumptions Giving advice Judging Making the work about us Placing blame Picking favorites Doing favors Breaking confidentiality Arguing Saying: ‘I told you so’

Avoiding tough topics Lack of preparation Becoming friends Blurring boundaries Pride Embarrassment Stress One sided thinking Frustration / Impatience Ignoring ‘taboo’ topics

Active Characteristics Passive Characteristics

Unique Factors Influencing Engagement

Involvement of Multiple Systems

• Medical / Health• Academic / Vocational• Mental Health / Psychiatric

Cultural Differences• Unique relationships with families

Parental Functioning• History or current stressors from:

Substances Victimization / Perpetration Mental Illness

How do the Unique Factors Play a Role?

Families are often in crisis Previous coping skills are not effective Sense of urgency to resolve problems Confusion / fear / intense emotions Sometimes socially isolated & vulnerable

Psychiatric conditions are impactful Untreated conditions complicate engagement Treated conditions require special

consideration

Workers may represent unresolved issues We are symbols of prior working relationships

Life is dynamic Engagement, assessment, intervention &

outcomes are processes

Parent/Guardian Functioning Up Close

Substances Victimization /

perpetration / trauma

Mental illness Involvement of

other services Other…

Stress management Can be easily overwhelmed

Judgment Often impaired or limited due to stress

Frustration tolerance Many times low tolerance for stress

Empathy Often self-absorbed due to unmet needs

Personal boundaries Concept of privacy or intimacy is often

blurred Rational thinking

Emotional flooding or cognitive distortions

Social stability Multiple relocations, losses & abrupt

transitions Intimate relationships

Anxiety often drives behavior

Impact Issues = effects on coping

What Issues Require Immediate Attention? Important Topics:

Limits of Confidentiality

Privacy Personal Safety Public Safety Boundaries Dual Relationships Misinformation Misunderstandings Different Expectations

Things to Consider/Steps to Take:

Gather Information Document what is seen Contact the Supervisor Follow State Regulations Follow Agency Protocol Problem Solve the

Situation Implement Crisis

Intervention Take care of self

Some Engagement & Boundary Questions to Consider

When I’m asking questions about the family’s life & routines, how do I remain respectful of the family’s 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 don’t 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

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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.

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