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Building Motivation with Rapid Rehousing Participants. Introduction. Most homeless families and individuals are offered Rapid Re-housing as a means to stabilize in the community Sometimes peoples experiences limit their thinking on how this could look or what they would have to trade for it
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Introduction • Most homeless families and individuals are offered Rapid Re-housing as a means to stabilize in the community • Sometimes peoples experiences limit their thinking on how this could look or what they would have to trade for it • Sometimes people thought processes interfere with being able to accept or hear what is offered. • In order to change behavior we have to look at the way people are thinking, what they are feeling and what they are doing • Help them to try different options and let their own experience be their guide. • This often starts with the relationship with the helping person • Housing is the base of moving forward in ones life
Agenda • Introduction • Building the Relationship • Assessment and Motivation • Negotiating Change and Harm Reduction • Setting Smart Goals • Shared Decision Making • Support for the Practice • Evaluations
Relationship • The relationship is developed through the interactions between the workers and individuals served • Each person brings something to the table • The ultimate decision is the person’s and based on their values and abilities • Each worker has the responsibility to continue to offer services and resources • Workers knowledge of the process and criteria for resources is shared • Negotiating the match between the resources and the needs and preferences is the goal
The Relationship • Peoples relationship with helping professionals can vary • Directive: the worker tells them what to do and the goods and services they want are contingent on compliance • Limited: Options are the same for everyone and does not necessarily reflect needs or preferences • Doesn’t Come Through: this will never happen • Quid Pro Quo: Everyone expects a trade for the services they deliver • Social Control: Their job is to really to get me to take medication or stop using • Magic: They have lots of vouchers and they give them to the people they like the best
Techniques • Look at the Person: • What did they commit to when they entered the program? • What did they work on before entering the program? • How do they live? • What is their role? • What do they do all day? • What do they want? • What is bothering them? • Introduce your Role: • Talk about what your role Is • Does each person understand how the program works? • Helping everyone take on tenant role • How does housing connect with their life goals? • Let each person know when you will be there and how they can reach you • Identifying different options and resources to meet their goals
Techniques • Persistent and Consistent: establish the worker is someone to be counted on. Negotiate simple tasks and follow up. Show kindness and recognition of the person. • Define paths to maintain housing when the program ends: Educate on rights and responsibilities of tenancy, define the process of getting needs met and lease parameters, be clear what the person has to do to increase income and maintain housing without the subsidy.
Techniques • Recognize Competence: Identifying skills that will help people access and maintain housing is important. IE You are clear about what might work for you, that will help to identify options or you got settled in quickly, you are good at getting things organized. • Find Common Ground: find things you can work on together to establish trust. For instance increasing money or establishing a child in school or daycare may help to establish a pattern of working together. • Reflect information to affirm it is heard: confirm information to ensure that each person knows they are heard. This may be the start of the conversation. The plan to increase income seems not to be working for you. Do you want to discuss other options? • Support Choice: acknowledge choice and always try to explore more than one option.
Focus on What is Important to Each Person • Establishing priorities with each person is an important part of the practice. • Getting people to rate their requests and priorities is a part of the MI practice • This can also establish a place to begin:
Focus on What is Important to Each Person • Having money to live on – 10 • Having my own apartment - 10 • Going to the Job Center – 4 • Seeing my family - 8 • Getting my children in daycare– 10 • Being able to relax with friends – 10 How can you work with this? Where are the discrepancies? How would this relate to the Stages of Change?
Julie • Julie did well in the shelter. She took good care of her two daughters, helped the staff and was willing to help other residents. She took her children to her Moms house on Wednesday and was able to go out and get some things done. • It is different in housing. She is lonely, the kids are lonely. They go to school but she doesn’t want them playing with the neighborhood kids. Her Mom is now taking care of her grandmother and can not help much. • It is all she can do to clean up and get her kids to school. How is she supposed to get a job. She misses the shelter but is ashamed to go back. She feels trapped. Things were supposed to get better. They didn’t it got worse.
Susie • Susie entered RRH from the shelter. She was happy to talk about going back to work and having her own place. Susie went to the job center and tried a couple of interviews. She is in her 50s and hasn’t had a job in 20 years. She hasn’t worked on computers only typewriters. • She did get a job boxing up shipments for the holidays but lost it. She was late and then didn’t show. She complains about the buses. She also moved her boyfriend in. she likes the company. He had been living outside; in this weather it seemed only right. They stay at home. She says she is not going for another job. She needs SSI or something. She wants you to get it for her.
Discussions • Identify three of the most common personal GOALS of the Tenants participating in your programs and three of the most common BARRIERS to following the lease and achieving • housing stability.
Motivating Change Keep focus moving forward Recognize success Common Understanding Several possible directions What are the costs/benefits?
Addressing Barriers • Issues such as: • Lease Violations • Symptoms of mental illness • Behaviors related to substance use • Medical Issues • Reluctance to take on employment or benefits • People see barriers when they get in the way of their goals and aspirations
Competencies • Beginning with what is most important establish a skill base • Motivational interviewing teaches us that when people feel competent they are more likely to pursue goals. They are also most likely to work on issues that are most important • Having your own home is important to you: You worked hard to get in, you always came to appointments and gathered all the documents. • What is your plan to maintain your housing? • Making progress on small goals can identify competency. When people can see progress other goals become possible
Evaluating PrioritiesCritical Thinking + Paying Rent - Paying Rent No money to do things Buy beer and relax Give money to family Have a normal life Program has vouchers and I deserve one I wont be able to keep job I am tired • Able to keep housing • Safe place to sleep • Can cook what I want • Drink in peace • Can keep my stuff • My kids are not in shelter • Might be able to get a different place
Activity • Meet people where they are, but don’t leave them where they are. • Using the template provided, develop a Harm Reduction plan for a current participant. • Identify risk/barrier to stable housing and options to mitigate/ eliminate the risk Handout: Harm Reduction Plan
Defining Limits • Define with your team what is negotiable and what is a not • Behaviors that present an active danger to themselves or others are not negotiable – action must be taken however the follow up is negotiable • The lease is not negotiable but a plan may be made to assist • Rent is not negotiable but often the amount can be changed by a different option (living with family, shared housing) or a payee can be arranged • Maintaining the apartment: adding the services of a homemaker or help from a worker may lessen the burden or add to it • Disturbing Neighbors is not negotiable but often a plan may be made to address the issues most important to the person while meeting the expectation
Clarify What You Can Offer • Role of the worker • Housing Options and Expectations of Each • Rights in housing • Expectations of tenancy • Rent payment when and how much • Quiet enjoyment • Maintaining apartment • Financial Realities of RRH • Process and timelines
SMART Goals • Specific • Measurable • Achievable • Realistic • Time-bound • Who • What • Where • How • When
Goal Setting Case Studies • Using the SMART goal format develop a goal for the following people: • Take a family or individual you are working with. Develop a smart goal plan for paying rent • Divide in groups by phase
Planning Cooperatively Planning reflects the conversations with each person and services offered Maintaining housing is always part of the goal • This would include someone in housing that is pursuing another option • Recovery goals are directed to a full life in the community Planning lays out the steps by which to reach the goals and who is responsible. Timelines are included
Support • The people we work with in the streets, in shelter, and in housing present the most complicated clinical challenges • The transition from homelessness to being stably housed is difficult for both the person and the worker. • Having access to specialty clinical expertise through consultation and/or supervision is key. If there is a setback, plans are not being followed or the person is not responding should trigger getting help. • Getting resources to respond is also a common frustration which can affect motivation. Support on a system level is crucial.
Discussion Contact info: Andrea Whiteawhite@housinginnovations.us
