A1 ocasi retention and solution focus

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A1 ocasi retention and solution focus

  1. 1. Retention and Solution Focus ...A Lifecycle Approach BBMD Consulting Inc. 2011Bell, Browne, Molnar & Delicate Consulting 1
  2. 2. Retention and the Solution Focused Approach High no-show and/or lost contact rates. Client disengagement, low motivation, lack of follow through. Results that don’t ‘stick’. How are we contributing to these issues? In examining our service ‘life cycle’, this workshop explores how our existing policies and practices may be getting in the way of success, while focusing our attention on a few key solution-focused strategies that can have a big impact. Relevant for all staff and program management. Lecture, discussion, and role play. 2Bell, Browne, Molnar & Delicate Consulting
  3. 3. Session Objectives 1. To take a few GIANT steps back, and look at ourselves 2. To look at how we handle retention issues throughout our entire case management service lifecycle – (both in service retention and outcome retention i.e. employment) 3Bell, Browne, Molnar & Delicate Consulting
  4. 4. CM GAME PLAN RETENTIONBell, Browne, Molnar & Delicate Consulting
  5. 5. 4. Counsellor 15% Technique: 15% 15% 3. Client Expectancy: 15% 2. Relationship: 40% 30% 30% 1. Extra-Theraputic Factors: 40% With permission from Richard Hamilton, “Disorient your Client – SFBT”, 2011 Research in Psychotherapy 5Bell, Browne, Molnar & Delicate Consulting
  6. 6. HOW ARE WE IMPACTING RETENTION BEFORE WE EVEN SAY A WORD? BEFORE WE BEGIN...Bell, Browne, Molnar & Delicate Consulting 6
  7. 7. Expectation Management How do we presently “sell” How COULD/SHOULD we our service? “sell” our service?Bell, Browne, Molnar & Delicate Consulting 7
  8. 8. The “there’s no way this person is going to be able to (outcome)...’ niggle.What triggers this ‘niggle’ for you? Bell, Browne, Molnar & Delicate Consulting 8
  9. 9. Understanding ‘Self- awareness and understanding’ • Employment Counselling is the conscious and deliberate use of ‘self’ • Self is the medium through which your knowledge, attitudes and skills are conveyed • Well-developed and developing self-awareness and self-understanding is critical... What are you bringing to the table? What ‘colours’ each exchange you have with clients? 9Bell, Browne, Molnar & Delicate Consulting
  10. 10. Self-assessment tools • Implicit Association Test – Race, Disability, Gender-Career, Gender-Science, Asian, Weight, Sexuality, Native, Age, etc. – measures biases – https://implicit.harvard.edu/implicit/demo/selectatest.ht ml • Google search (many free, some have costs): – Self-esteem index – Acceptance of others scale – Assertiveness scales 10Bell, Browne, Molnar & Delicate Consulting
  11. 11. The role of the GATE KEEPER in RETENTION 1. CLIENT IDENTIFICATION, ELIGIBILITY AND SUITABILITYBell, Browne, Molnar & Delicate Consulting 11
  12. 12. How you deliver... • Research has shown that a Doctor’s risk of being sued for malpractice in the USA has very little to do with how many mistakes a doctor makes – Instead, has everything to do with HOW the patient felt they were treated, on a personal level, by their doctor. • Could predict which doctors were sued based on 40 seconds interaction clips of just the doctor’s tone of voice (stripped out words, just tone) • Surgeons who had never been sued spent more than 3 minutes longer with each patient than those you had been sued (18.3 min vs. 15 minutes) Blink (2005), Malcolm Gladwell, pg 42 How could/does our ‘tone’ impact our service and our success?? Initial phone Initial centre visit Assessment Service Supports Monitoring Follow up inquiryBell, Browne, Molnar & Delicate Consulting 12
  13. 13. Data Collection Why clients withdraw from service: MAIN factor identified in study by Richmond (1992): counsellor’s focus on data gathering rather than rapport building Too early, KILLS Expectancy and RelationshipBell, Browne, Molnar & Delicate Consulting 13
  14. 14. Talking and listening skills I consider myself to be highly skilled in: Talking (using voice, speech, and body language) 1 2 3 4 5 6 7 8 9 10 Listening (hearing, observing, remembering) 1 2 3 4 5 6 7 8 9 10 Active listening (Listening & understanding, Empathizing, Asking & Encouraging, Paraphrasing / Summarizing) 1 2 3 4 5 6 7 8 9 10Bell, Browne, Molnar & Delicate Consulting 14
  15. 15. Impacts of ‘Priming’ • Psychologist Claude Steele and • Two Dutch researchers Joshua Aronson – Group of students, 42 fairly – Black college students and demanding questions from Trivial twenty questions from the Pursuit Graduate Record Examination – Half asked to think about what it – ½ of the students asked to would mean to be a professor identify their race on a pre-test and write down everything that questionnaire... Enough to came to mind – got 55.6% ‘prime’ them with all of the correct negative stereotypes associated – Other half – think about soccer with African Americans and hooligans – 42.6% right academic achievement – the – Not smarter or more focused, number of items they got right just ‘smart’ frame of mind was cut in half. Blink (2005), Malcolm Gladwell, pg 56Bell, Browne, Molnar & Delicate Consulting 15
  16. 16. What do we do in our service that ‘primes’? Negatively: Positively:Bell, Browne, Molnar & Delicate Consulting 16
  17. 17. More than 2 days? If you have to send them away... 1) Task 1. task them, 2. engage them, 3. give them something valuable 2) Engage IMMEDIATELY What is your present ‘no- show’ rate? 3) Give 17Bell, Browne, Molnar & Delicate Consulting
  18. 18. How much service will this client need for retention? 2. NEEDS ASSESSMENTBell, Browne, Molnar & Delicate Consulting 18
  19. 19. Assessments • All assessments aim to organize descriptive information in a sensible structure to facilitate planning, efficient retrieval and examination – Attempting to understand how the person and situation influence the problem, and vice versa – Provides direction on how to proceed – Represents the foundation on which a contract for work is negotiated – Assessments are not undertaken in exactly the same way with all clients – Should ensure differentiation between fact and opinion • Focused on the goal statement: – NOT JUST “What are all the things that you think need to be in place to get a _____ job?” BUT “what are all the things that you think need to be in place to KEEP A ______ JOB? – Retention skills MUST BE DISCUSSED AND ASSESSED NOW – it’s too late to engage once they have secured the job. Your challenge... What will be your “sensible structure” for assessing RETENTION service needs??Bell, Browne, Molnar & Delicate Consulting 19
  20. 20. Bell, Browne, Molnar & Delicate Consulting 20
  21. 21. 2. Needs Assessmenta) Preparing for your meeting – First meetings significantly influence the general direction and tone of subsequent interactions, and often determines whether a prospective client decides to attend future meetings or follow through on action plans (impact on retention/lost contact!) – Preparation enables the worker to be personally and professionally ready to perform competently from the very first moment of contact – Part of your professional responsibilities: I do this!  Preparatory review of all pre-existing information (let’s hope for good documentation!)  Preparatory exploring if referred from another source (OW, etc). Apply filters!  Preparatory consulting if required (additional expertise)  Preparatory arranging if required (disability, time adjustments, etc.)  Preparatory empathy – ‘priming’ yourself, get into their shoes – how might you be feeling?  Preliminary planning – am I clear about the purpose of this meeting?  Preparatory self-exploration – introspective in relation to the person, presenting problems, and situations. What personal reactions might I anticipate from myself? Biases? Emotional tender spots, behavioural patterns?  Centering – temporarily managing personal thoughts, feelings, and physical sensations so that they do not interfere with your professional obligations and activities. Bell, Browne, Molnar & Delicate Consulting 21
  22. 22. 2. Needs Assessment b) Beginning 1. Facilitate exchange of introductions (good idea to provide business card – establish methods of contact) 2. Establish a tentative direction or purpose for the meeting – • “when you called the other day, you indicated that you thought [your skills were out of date]... Is that correct?” • “What has to happen here today for you to later think that coming in was worth it?” • “How can we be most helpful to you?” • “What would you like to accomplish as a result of coming here, so that one day you can look back and say, ‘Going to that agency was the best thing I every did’?” How do you presently establish direction / purpose for the meeting?Bell, Browne, Molnar & Delicate Consulting 22
  23. 23. b) Beginning - Continued 3. Outline the general expectations of the client (client role) – client has considerable uncertainly and anxiety about what is expected of them – help them with a clear but friendly outline – “you can best help in this by sharing your thoughts and feelings as freely and fully as possible, asking questions when you do not understand, and by giving me honest feedback concerning what is helpful and what is not...” 4. Outline what the client can expect from you (worker role) – WHOLE PICTURE – from assessment through to follow up and retention. 5. Outline what the client can expect from the service. Describe policies and ethical principles that might apply during this and future encounters with the client, and ensure that the prospective client understands the conditions of the relationship (legal and ethical obligations related to informed consent) 6. Seeking feedback - Encourage the client to react to and comment about what you have just communicated, “checking out” to determine whether it has been accurately heard and understood. Sends the message that this process has mutuality – you’re interested in what they have to say - “how does that sound to you? What do you think about what I’ve said thus far? What questions or comments do you have?Bell, Browne, Molnar & Delicate Consulting 23
  24. 24. 2. Needs Assessment c) Exploring/probing – To derive a more complete and realistic perspective towards the desired outcome – what is the desired outcome? Identify clear goals from the start. What will success look like? – Solution focused - highlights people’s strengths and competences instead of their perceived deficits, weaknesses and limitations Caution! Too often, Needs Assessments focus wholly on the negative. Remember what we discussed about priming! Look for ways to frame in the positive.Bell, Browne, Molnar & Delicate Consulting 24
  25. 25. Solution Focused Exploration Tools How confident are you in these skills? Stephanie Johnson, www.solutionfocusedcounselling.com NORMALIZATION is normalizing a situation or an event without trivializing the client’s complaint. 1 2 3 4 5 “Lots of men in their late 50s are facing unemployment for the first time. However, it must feel like you are the only one... “ still acknowledging feelings while normalizing the situation. An EXCEPTION is when the problem is not around all the time, when the client did something different. For example the client is feeling very depressed and ‘useless’, “tell me a time when 1 2 3 4 5 feeling useless didn’t get the better of you?” Looking for a time when the problem didn’t dominate 24/7. REFRAMING is changing a negative label or negative view for a positive view or positive lens. For example, a client comes to see you and is upset because her employer has told her that she is 1 2 3 4 5 loud and demanding. We could reframe this as “sounds like you are assertive and motivated”. Changing the negative view of the behaviour to a positive view, like changing the TV channel over. Sometimes the problem is how we view the problem. SCALING is asking a client to scale a problem or situation or feeling from 1-10. For example “ on a scale of 1-10, where 10 being you are on top of the problem and 1 being the problem is on top of 1 2 3 4 5 you, where are you today?”. Scaling is a quick and powerful tool, it gives you both a clear snapshot of the level of the problem. Use a whiteboard or your hands to visualize the scale.Bell, Browne, Molnar & Delicate Consulting 25
  26. 26. Solution Focused Exploration Tools How confident are you in these skills? Stephanie Johnson, www.solutionfocusedcounselling.com MIRACLE QUESTION is a technique devised by Insoo Kim Berg; it is a technique which encourages the client to start to envisage what their life would look like without the problem. Prefix the miracle question by saying,” this may sounds a little weird but go with me on this… Imagine that you go to bed tonight and while you are sleeping a miracle occurs. When you wake up in the 1 2 3 4 5 morning, all your problems are solved/you got your dream job, how would you know? What would you be feeling, thinking? how would you know that your problem was solved? What would you be doing differently?” Change the problem talk into solution talk and start the visual process of imagining life without the problem. COMPLIMENTS are a technique that we used at the end of the session to encourage the client 1 2 3 4 5 and give a message of hope. Compliments need to be genuine, appropriate and not over the top. TASKS are homework for the client to do out of session; it may be a noticing task or a pretending task just to name a few. When clients come up with their own tasks, as they are more likely to 1 2 3 4 5 carry them out and own them. Tasks need to be relevant and achievable. Never set up a client for failure.Bell, Browne, Molnar & Delicate Consulting 26
  27. 27. What do Type here you current ‘assess’Bell, Browne, Molnar & Delicate Consulting 27
  28. 28. Indicators of client service need (MTCU 2010) DO YOU FORMALLY CONSIDER: Y • N Demographics This includes basic information about the client’s gender, age, and education. Y • N *Performance Indicators The Performance Indicators dimension focuses on characteristics of candidates which will prevent them from performing as required on-the-job. Job developers work with employers to redefine job requirements in order to place candidates with performance indicator problems. • Market Perceptions The Market Perceptions dimension refers to characteristics of job candidates which lead Y N potential employers to form negative biases or perceptions about the desirability of the candidate and their ability to perform on the job. Such characteristics block the access of clients to the competitive market even though the characteristics may not impede their potential to perform on-the-job. Y • N Motivation The Motivation dimension refers to attitudes which prevent clients from initiating the job search or participating fully in the activities required to secure and maintain employment. Y • N *Work Habits The Work Habits dimension refers to on-the-job behaviours and attitudes which employers desire in prospective candidates. • *Interpersonal Skills The Interpersonal Skills dimension refers to the lack of skills associated with clients who have Y N difficulties in maintaining positive relationships with employers and/or work peers. Y • N Employment Expectations The Employment Expectations dimension refers to the need for assistance in clarifying the candidates’ job preferences or understanding how their skills meet opportunities in the job market. Y • N Self-Marketing The Self Marketing dimension refers to the ability of clients to successfully present themselves to employers in the competitive or hidden job markets. Y • N *Stability Issues The Stability Issues dimension refers to lifestyle patterns, personal situations, or self-management issues that may impede the ability of the candidate to initiate a successful job search and remain employed. 28Bell, Browne, Molnar & Delicate Consulting
  29. 29. Fishing for Strengths Personal Vocational • Interests/ hobbies. • When was the What does this say last time he was about the person? employed? • What is something she • How did she find is most proud of? that job? • Who passed on values to him • How long • When was a time in his employed? life when he had to • How did he retain succeed against a the job? problem like this?Bell, Browne, Molnar & Delicate Consulting
  30. 30. Build expectations of success • Pre-suppositional language – “when you are successful in [FILL IN BLANKS] what difference will it make to you?” • Communicate that this is a start towards a successful outcomeBell, Browne, Molnar & Delicate Consulting
  31. 31. Your living service plan... INCLUDES RETENTION! 3. PLANNINGBell, Browne, Molnar & Delicate Consulting 31
  32. 32. Core Components of a Service Plan 1. Have a clearly defined objective(s). (‘‘Where do I want to be?’’). To be motivating a goal needs to be challenging enough to stimulate, but not difficult enough to be demoralizing. It should be just outside their comfort zone: stretching but not highly stressful. NEEDS TO BE SPECIFIC, MEASURABLE, ACCOUNTABLE, REALISTIC, TIMEBOUND (SMART) 2. Have them list the benefits they will gain by achieving the goal. Again, keep the focus on the positive. Positive imaging has a very positive ‘priming’ effect. 3. Define clearly the steps the client and the Case Manager will take. ("How do I get there?’’) Think of all the possible things that need to be done, no matter how small. Break down any large steps into smaller components, so it doesn’t seem so difficult to achieve. What is the biggest obstacle? What could go wrong? If it is too vague - “cold call employers”, it will not get done. Should be able to hand off to ANYONE, and they would know exactly what to do. 4. Arrange the steps in a logical, chronological order and put a date by which each step will start. Try to set weekly goals: what research you will do into jobs, what skills you will concentrate on learning etc. It’s also a good idea to get clients into the habit of planning a timetable each evening, listing tasks for the next day or two. Action generates the impetus for further action: if you want something done quickly, give it to a busy person!!Bell, Browne, Molnar & Delicate Consulting 32
  33. 33. Core Components of a Service Plan 5. Satisfaction is greatest for those involved in short term goals which are enjoyable, not too difficult; and done in cooperation with others. Focus on one objective at a time and always have the next goal in mind. 6. Think about the type of problems they might encounter at each step. What are the barriers in the way of achieving the goal? What might they do to overcome these problems? Concentrate 10% on the problem and 90% on the solution. Try to turn every problem into a challenge and every challenge into an opportunity. 7. Review progress. Encourage your clients to keep a diary or blog of their daily activities and record progress as things happen. Provide them with tools to do this. This keeps their plan as concrete as possible. WHEN TO REVIEW DEPENDS ON THE CLIENT. Review how far they have got towards their objective, identify any mistakes made and what they can learn from them, look at any new ideas or opportunities that may have presented themselves and then revise the plan to incorporate these. 8. Encourage your clients to mix with positive people who will encourage them to keep going! Encourage them to tell their friends or relatives about their goals – give them extra copies to share with people. They will provide support when the going gets tough and will also give them an incentive to keep going (hard to tell people you have given up!) Adapted from: http://www.kent.ac.uk/careers/sk/decisionmaking.htmBell, Browne, Molnar & Delicate Consulting 33
  34. 34. YOUR PLANNING TOOL KIT • Enable consistent, equitable and defendable service decisions • Make sure the tool kit is FULL, and that everyone has access • Helps with staff orientation and training • MAKE SURE YOU PLAN FOR MONITORING AND FOLLOW UP SUPPORT! Retention Indicators E.g.: Interpersonal Skills    Thriving Stable Safe At-Risk In-CrisisBell, Browne, Molnar & Delicate Consulting 34
  35. 35. Moving the client to ACTION 4. IMPLEMENTATION / MONITORINGBell, Browne, Molnar & Delicate Consulting 35
  36. 36. Examples of External Structures 1. E-mail reminders of upcoming action items – set up automated task reminders 2. Twitter/Facebook contacts to ‘touch base’ on plan 3. SCHEDULED follow ups based on timelines 4. On-line ‘communities’ to share successes and challenges 5. Have client arrange for a ‘coach’ to help hold up their plan for them from their support circles (spouse, adult child, friend) 6. Others?Bell, Browne, Molnar & Delicate Consulting 36
  37. 37. Working, Not Working, Course Correction 5. EVALUATIONBell, Browne, Molnar & Delicate Consulting 37
  38. 38. 5. Evaluation (looking backwards and forwards) • Determine intensity and frequency of reassessments on an individual client basis – SCHEDULE AS PART OF THE ACTION PLAN - NO SURPRISES! However, sometimes you will need to be ‘just in time’ • Measure and document the effectiveness and efficiency of the interventions • Informs next steps with client, recognizing that needs change over times, as well as the policies and availabilities of interventions. • Evaluation conditions such as: – Goals in action plan are current – Effective and efficient movement towards those goals exists within a reasonable timeframe – Client stability issues have not changed • Identify gaps in services or support structures - plan • Attempt to remove or resolve service and support gaps to the clients benefitBell, Browne, Molnar & Delicate Consulting 38
  39. 39. 6. FOLLOW-UP / TRANSITIONING / DISENGAGEMENTBell, Browne, Molnar & Delicate Consulting 39
  40. 40. CONGRATULATIONS! YOU [fill in the blank]! Follow-up support (e.g.: retention support!) – Frequency and intensity based on individual client need – scheduled in advance, determined early in the relationship. No surprises! • NOT determined by compliance requirements... 3-6-12 IS NOT CLIENT FOCUSED, but a minimum standards • Conversations are driven by the strengths and weaknesses outlined in the needs assessment, using probing/scaling questions, NOT DATA COLLECTION REQUIREMENTS e.g.: you identified earlier that you sometimes have a hard time ‘fitting in’ – on a scale of 1-10, how do you feel you are ‘fitting in’? Why so high/low? What needs to happen to move that to a #? – On-going interventions and supports must align to needs determined in the needs assessment – • What are the threats? • What strategies are in place to support success? • What are the retention ‘911’ options available to the client? (YOU? SUPPORT CIRCLES? MENTOR?) – Formal action plan kicks in for retention support. Developed upfront – establishes go- forward interventions, expectations, and relationships. – JOB DEVELOPMENT – what are the retention interventions and supports that you are providing to the EMPLOYER?Bell, Browne, Molnar & Delicate Consulting 40
  41. 41. Transitioning/Disengagement Redefinition of the relationship between the client and the case manager – May be triggers with the achievement of agreed-upon goals, or some other valid rationale – Must ensure that disengagement and the criteria for disengaging case management services are understood early in the relationship – Provide clients with information or links to alternative community resources – Support the client in their effort to secure other appropriate or alternate resources, if desired – Ensure the transfer of timely and accurate information across settings / documentation into CAMS – Provide contact information about re-accessing services or support – Address concerns about disengagement before finalizing the disengagementBell, Browne, Molnar & Delicate Consulting 41
  42. 42. Disorient your Client - Solution Focused Brief Counselling Clients come into settlement service expecting to be judged, to not have their ideas listened to, and to be told what to do. A negative first experience results in a high no-return rate and poor outcomes. Disorient your client by learning how to tap into their strengths, build on their experiences, and uncover their unique strategies and goals. This 4-part webinar will give you the research, the SFBT counselling techniques, demonstrations and experience to be an effective solution focused counsellor. $399.00 + HST per participant Fall Series Registration (Sept 9, 16, 23, 30) ‘Whole agency rate of $1350.00 + HSTBell, Browne, Molnar & Delicate Consulting 42
  43. 43. Disorient your Client - Solution Focused Brief Counselling Clients come into settlement service expecting to be judged, to not have their ideas listened to, and to be told what to do. A negative first experience results in a high no-return rate and poor outcomes. Disorient your client by learning how to tap into their strengths, build on their experiences, and uncover their unique strategies and goals. This 4-part webinar will give you the research, the SFBT counselling techniques, demonstrations and experience to be an effective solution focused counsellor. Fall Series Registration (Sept 9, 16, 23, 30) $399.00 + HST per participant ‘Whole agency rate of $1350.00 + HSTBell, Browne, Molnar & Delicate Consulting 43
  44. 44. Let us bring our training to your office (613) 562-3468 Learning@bbmd.ca www.bbmd.ca Bell, Browne, Molnar & Delicate Consulting 44

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