Home Visiting Families At-Risk

1. Home Visiting Families At-Risk OCDC 2009

2. “At-Risk” • For which stress factors are OCDC families at risk? • What do we need to do as Head Start Home Visitors? • How can we best perform our roles and keep ourselves safe & healthy? • How do we support the children and adults at-risk or in crisis? • What resources are available to give to families? With whom do we collaborate? • What support is available to staff? How do we access the support?

3. Active Listening Active listening • is a structured way of listening and responding to others. It focuses attention on the speaker. Suspending one’s own frame of reference and suspending judgment are important in order to fully attend to the speaker. How to Actively Listen: • Look at the person, and suspend other things you are doing. • Listen not merely to the words, but the feeling content. • Be sincerely interested in what the other person is talking about. • Restate what the person said. • Ask clarification questions once in a while. • Be aware of your own feelings and strong opinions. • If you have to state your views, say them only after you have listened.

4. Observations What do you see or hear? • Signs & Symptoms of at-risk circumstances • Family or Adults vs. Child • Behavioral & Verbal disclosures What do you sense or feel? • Instincts, suspicions, intuitions Subjectivity vs. Objectivity (bias vs. neutral)

5. Assessments Family Partnership Process • All home visitors Family & Child Strengths, Needs, & Resources • FA&PP = specific questions re: emotional (mental health), substance abuse and violence, and home safety • PEDS = specific questions re: social & emotional development • Knowing stages of change (Handout 3.3)

6. Inquiry & Empathy How to inquire beyond observations: • Specific Strengths Based Questions • Open Ended Questions • Questions that Encourage Problem Solving Expressing concern and developing rapport: • Empathy vs. Sympathy • Empathy Practice • Empathy Scale ACTIVITY: Identifying Domestic Violence (Handout 3.6) • Where is the family/adult in the change process?

7. Communicate & Collaborate • Discuss concerns with family & team • Who else supports child/family? • How do we discuss? • Seek Supervision • Mutual Holding Environments & Reflective Supervision • Seek Consultation • Find out who knows what you don’t know! • Peers • Mental Health Consultant • Community Professionals • Facilitate accessing of resources with family & community agencies

8. Document • Rules of good documentation: • Objective, clear, concise, and respectful • Stick to the facts! • OCDC Forms • Progress Notes • Home Visit Forms • Family Assessment & Partnership Plans • Case Management Team Meeting Forms • Remember documentation may be subpoenaed by the courts and may be subject to review by the family. • Avoid labeling or judging and avoid using terminology that may be stigmatizing or unprofessional. • Confidential records vs. family file

9. Personal Care & Safety • Dealing with Potentially Dangerous Situations • OCDC Safety Tailgate: Home Visit Precautions Self-Care Strategies: • Preventing Burnout • Suggestions for Thriving Amidst Trauma • Understanding & Preventing Compassion Fatigue • Supervision & Consultations • Employee Assistance Program (EAP)

10. How do we know when someone is in Crisis? Crisis: • a state of disorganization in which the person faces frustration and profound disruption of his/her life. • refers to the person’s feelings of fear, shock, and distress about the disruption, not the disruption itself. • occurs when the usual ways of coping do NOT work and there is a breakdown in functioning. • Crisis can be based on external factors, internal distress, or transitional states. Common Crisis Behaviors: • Difficulty thinking clearly • Dwell on meaningless activities • Express hostility or numbness • Act impulsively without thinking about consequences • Feel dependent on professionals or those in authority • Feel incompetent

11. Crisis Intervention • Purpose of Crisis Intervention is… • to ensure that everyone is safe, stabilize the situation, and connect the family to necessary resources. • Consult with others, work as part of a team • Call 911 for immediate dangers! • Use closed-ended questions to find out • What happened • What are the immediate needs • What needs to happen next

12. Crisis Intervention Strategies • Assess the lethality of the situation and whether others are at risk • Gather information on what the client sees as the problem • Assess their access to help from friends or family • Discuss various options for action- keep it short term & involve support of family • Make a clear and acceptable plan to get through crisis • Remain calm and take charge; be straightforward and direct • Encourage slow, deep breathing to avoid hyperventilation • Keep the focus on the present • Don’t give false assurances that everything will be fine • Work to help the client identify and regain past coping strategies to help with this situation • Keep confrontation to a minimum, don’t take sides, assign blame, or argue with person • Let the person know you care

13. Children in Families At-Risk Resiliency • The ability to recover readily or “bounce back” from adversity and stressful events. Protective Factors • Characteristics that protect children from the damaging effects of negative life circumstances and events and build resiliency. • Characteristics: Child, Family, and Community Risk Factors • Characteristics and experiences that make it more challenging for a child to grow and develop skills that lead to success in life.

15. Children & Domestic Violence • For Children Living with Domestic Violence • Statistics • Signs • Impact/Effects on Development • Outcomes • Effects of Domestic Violence on Parenting Reminder: Mandatory Reporting Obligations • Children witnessing or being exposed to Domestic Violence can be Threat of Harm • Children being exposed to illegal activities (e.g. drug sales, theft, drug abuse, etc.) is considered Neglect

16. Helping Children At-Risk • Helping Children During a Crisis • Talking & Interacting with Children who have experienced: • Death, Grief & Loss • Disaster • Domestic Violence • Suggestions for Mothers to help children recover • Interrupting Child Abuse or Potentially Abusive Situations

17. Head Start Role re: D.V. • Through our work with families, we can listen openly to people who talk about abusive relationships, validate their feelings, and let them know that they do not deserve the abuse. Through the family partnership process, staff can: • Let families know that they can talk about relationship issues and that Head Start has resources for families experiencing domestic violence. • Identify families at risk. • Assess the presence, scope, and impact of domestic violence. • Validate the victim’s experiences. • Build on the victim’s strengths. • Connect the family to information and resources. • Provide crisis intervention and concrete services. • Help the victim regain control over her life. • Reflection Activity on DV & Partnership Process (Handout 3.5)

18. Head Start Home Visitor Responsibilities • Build Rapport & Relationships • Assess Child & Family Development • Promote Child & Family Growth • Provide Effective Resources/Referrals • Follow-up Support • Maintain Relationships • Support Transitions in Children & Families

19. References: • Marsh, Elizabeth, Safe Futures: Supporting Children and Families Impacted By Domestic Violence, (2005). • Oregon Department of Human Services, What you can do about child abuse, (2009). • http://www.merriam-webster.com/dictionary/sympathy • http://en.wikipedia.org/wiki/ • http://dictionary.reference.com/browse/sympathy