SERVICE PROVISION TRAINING PLATFORM

AUTHENTIC & SUCCESSFUL ENGAGEMENT

CRISIS RESPONSE & MANAGEMENT

SOCIAL JUSTICE & POSITIONALITY

This platform is intended for people who are interested in volunteering with a service provider, currently volunteering, or looking to engage more thoughtfully with unstably housed youth. These online training modules will help to frame your experience and engagement with social services. It will introduce you to successful, authentic engagement, crisis response, and ask you to reflect on your positionality in relation to your work.

Please treat this online platform as a resource throughout your work, but bear in mind that it is not intended to be a comprehensive training. This platform cannot address all of the nuances of your organization or clients, but it can provide you with basic frameworks from which you can shape your interactions.

AUTHENTIC & SUCCESSFUL ENGAGEMENT

When building relationships, allow yourself to engage authentically and empathetically. When building caring relationships with folks experiencing homelessness, it is important to acknowledge both the daily trauma of homelessness and the history of trauma folks are likely to have experienced. This module will introduce you to a trauma-informed framework for engagement and provide strategies for building trust, maintaining boundaries, and building relationships.

  • TRAUMA-INFORMED CARE: We recognize that most of our clients have internalized trauma from their lived experiences. Trauma impacts the way that people engage in the world, and thus must be part of how providers engage with clients. A trauma-informed framework emphasizes the physical, psychological, and emotional safety of clients and providers. It requires that we acknowledge trauma and its impact on behaviors in our clients, as trauma overwhelms one's ability to cope. It is “an organizational change process centered on principles intended to promote healing and reduce risk of re-traumatization for vulnerable individuals,” but it relies heavily on interpersonal interactions in acknowledging trauma and its impact on behavior (Bowen & Murshid, 2016).

    • Core Principles of Trauma-Informed Care:

      • Safety – ensuring physical and emotional safety is extremely important because trauma can overwhelm an individual’s ability to cope with even minor triggers, resulting in difficult behaviors

      • Trustworthiness – maintaining appropriate boundaries, making expectations clear, and following through on commitments.

      • Choice – prioritizing client choice and autonomy, especially when coping

      • Collaboration – maximizing collaboration between clients and providers; “nothing about me without me”

      • Empowerment – prioritizing client empowerment and skill-building

    • Trauma & Homelessness: Trauma is both a cause and a consequence of homelessness. Approaching this trauma and its effects on clients may fall outside of your area of expertise, and we ask that you avoid attempting any treatment, but offering and connecting to resources may be something that is vital in your practice.

    • Resources:

  • TOOLS FOR ENGAGEMENT: In many social services, connections with clients are of the utmost importance. These connections can help our clients develop positive relationships with people they can trust, can help them to connect to and build community, can provide an empathetic ear, and can help providers gauge behavior and assess when something might be wrong. In building relationships, it is important to be mindful of the professional nature of the provider-client relationship.

    • Building Trust:

      • Introduce yourself & learn names! Being addressed by your preferred name can bring a sense of familiarity even into unfamiliar spaces.

      • Keep it light! Attempt to get to know the person, their interests, their hobbies, their favorite joke, etc; but not the person’s traumas, when first meeting them. Do not ask questions that will not directly contribute to their care! Vulnerable conversations should be initiated by the client and should be responded to with the utmost respect.

      • Be honest & authentic! When someone is being inauthentic or dishonest with us, we can quickly sense it and immediately become distrustful. The same holds true for our clients. In many social services, our connections with clients are very important. Authenticity ensures successful, honest relationships.

      • Be humble! If you make a mistake, even a minor one, acknowledge it, apologize for it, and move on! No one knows everything but together we know a lot!

      • Be yourself! The more comfortable you are, the more comfortable you make other people feel! Don’t feel as though you need to change or adjust your personality to interact with clients--just be yourself!

    • Maintaining Boundaries: Maintaining consistent, clear, and equitable boundaries with clients is extremely important to building relationships and trust. Remember that there are inherent power dynamics in the relationship between a service provider and a client, that clients can sense when they are treated inequitably (as we all can perceive), and that honesty is essential in building trust. This honesty includes only making promises you can keep and being okay with saying you don’t know the answer. (When in doubt, err on the side of “I’m sorry, I’m not sure, let me see if I can find out for you”.)

    • Building Relationships: Building rapport with clients is not unlike building relationships in our personal lives. Regardless, we could all use some refreshers on how to be a human:

      • Listen to understand, not to respond.

      • Lean into Discomfort. Don’t overshare out of a desire to fill space or time. Be conscientious about the space you are taking in the conversation.

      • Reflective questioning & mirroring. Ask clarifying questions, repeat what you have understood from the conversation to ensure that you understand and to show that you are listening.

      • Notice & reflect body language. Most (nearly 90%) of communication is nonverbal, so be aware of body cues.

      • Remember Small Details.

      • Be Consistent & Stable.

      • Be Open (Within Reason).

      • Be Genuine & Honest.

    • Respecting Space & Genuine Engagement: As much as services might want you to intentionally foster community with their clients, it is also important to acknowledge and respect when someone wants space. If they want to genuinely engage with you, they will! If they don’t, do not take it personally. It is rarely, if ever, about you!

    • Words from Young People Experiencing Homelessness:

    • Resources:

  • EMPATHETIC INTERACTIONS: As we build relationships with people, it is important to approach conversation, conflict, and trauma from a place of empathy. Empathy, as opposed to sympathy, drives connection. Empathy, at all of its levels, encourages us to attempt to cognitively understand how a person might feel, to emotionally connect to something within them, and to be driven to action on their behalf.

    • Justin Bariso divides empathy into three categories, each of which can be practiced in turn:

      • Cognitive Empathy: understanding how a person might feel and what they may be thinking while communicating.

      • Emotional Empathy: ability to share the pain of another person, reaching emotional connection

      • Compassionate Empathy: ability to take action on behalf of others… this means that you are driven to action.

    • Remind yourself:

      • You don’t have the whole picture. At any given time, a person is dealing with far more than you can be aware of...

      • The way you think and feel about situations is influenced by many different elements; so is theirs

  • Resources:

CRISIS Response & MANAGEMENT

Homelessness is in itself a crisis and can contribute to other crises. Our clients often live in a state of crisis, trauma, and emergency. As such, there may be times when crisis (conflict and mental health emergencies) arises. When this happens, we need to be effective responders. Your team is most effective if you react methodologically by separating into primary, secondary, and tertiary responders to maintain the safety of the clients and the space:

  • RESPONSE:

    • Primary Responder(s): Addresses the parties in crisis (conflict, mental health emergency, etc), attempting to de-escalate the client and move them to a more calm, secluded area. There should be one primary responder per client in crisis, to devote attention and energy to their de-escalation. This is typically staff and experienced volunteers, so please defer to your agency’s protocol here.

    • Secondary Responder(s): Supports the primary responder by ensuring emergency response is initiated, materials are provided, and all positions are covered. This might include: getting other staff, clearing a path to exits, gathering resources, delegating other tasks, or calling the police* as staff dictate.

      • *Calling Police is not a decision that is made lightly given the criminalization of homelessness, violence against people of color and other marginalized populations, etc. This decision should come from directors, program managers, and preceptors. Your staff might request that police be called if assault occurs or a weapon is brandished. The call can always be canceled.

    • Tertiary Responder(s): Engages with people in the surrounding space to ensure that other parties remain disengaged from the conflict and don’t get pulled into an escalation. This is vital to maintaining the safety of the entire space during a crisis. These folks should also continue with their typical tasks, working to maintain a typical flow of the space.

  • CONFLICT RESPONSE. In such a high trauma, high intensity environment, posturing and the threat of violence are often used to resolve conflict. Understanding that conflict does not arise out of nowhere, but follows a cycle of conflict, can help us to understand how and when to intervene. Understanding how to respond verbally and physically can help us become effective de-escalators.

    • Cycle of Conflict: Conflict often follows a cycle of instability, emergence, escalation, manifestation, and de-escalation. The severity and behavior at each stage varies, but generally follows this cycle:

      • Latent Conflict & Unstable Peace: Differential power, resources, interests, and values all have the potential to spark conflict if and when a triggering event occurs.

      • Conflict Emergence: Some triggering event marks the emergence of conflict.

      • Conflict Escalation: The conflict becomes more dangerous as people become more upset, but the conflict has not manifest yet.

      • Conflict Manifest: The conflict is realized in some type of harmful behavior or interaction between the parties.

      • Conflict Aftermath: The manifestation concludes, the parties separate, and the resolution begins.

    • Responses to Conflict: We have the capacity to intervene at each point in the cycle of conflict. When responding, we must be aware of our physical responses to conflict, our body language, our position in the space, and our verbal responses to behavior.

      • Physiological Responses & Survival Mode: When we observe or participate in conflict, it is natural for our bodies to enter survival mode  faster than our rational minds can react. This alters the way that we approach and respond to situations. Understanding and being aware of possible responses helps us notice them in ourselves and our clients:

        • Survival Mode (Fight, Flight, Freeze, Flinch, Faint): when we are under stress or a perceived threat, our bodies quickly enter survival mode (fight, flight, freeze, flinch, faint), where physical functioning is heightened and cognitive function is simplified.

          • Physically: increased heart rate, decreased digestion relate as blood is devoted to major muscles, tension builds in major muscle groups

            • Fight: The immediate instinct is to fight whatever the perceived threat is. It is difficult to resist the urge to become more aggressive or to disengage.

            • Flight: The immediate instinct is to remove yourself from the situation, rather than engage. It is difficult and uncomfortable to engage.

            • Freeze: The immediate response is to freeze completely, reducing capacity to respond dynamically.

            • Flinch: The immediate response is a physical flinching, often reactive and impulsive. It is difficult for others to read this body language.

            • Faint: The immediate response is feeling faint or dizzy, which is difficult to navigate in the intense situation.

          • Cognitively: tunnel vision, reduced facial recognition capacity, dizziness and lightheadedness… This switch from rational to survival thinking can make our reactions more impulsive, more aggressive, and less thorough. It is important to resist this when de-escalating conflict.

    • VERBAL RESPONSE.

      • Non-Verbal Communication: present the type of calm body positioning you want to see reflected, engage on an equal level, and maintain soothing, calm movements.

      • Verbal communication (Empathetic & Calming):

        • Lead with Compassion. Conflict ultimately stems from some place of hurt or triggering. Leading with compassion can make people reflect your calm.

        • Validate & Recognize Emotions (without validating behavior): when someone is extremely upset, validate their emotions (I see you feel angry, but I can’t understand you when you’re yelling) until they feel validated… This does not include validating the behaviors.

        • Present Options: once we have validated this person, explore options for removing them from the triggering situation (moving to a different space, presenting consequences for behavior, providing other options for resolution)

        • Allow for Choice: recognize that they have choice within this situation, but the consequences are on them (You can either come talk to me now or you can go outside)

    • Other Resources:

  • MENTAL HEALTH EMERGENCIES. The methods used for responding to folks who are battling complex traumas, mental health crises, or severe drug use differ from those used for people who are simply engaging in conflict (although these sometimes intersect). Responses involve heightened levels of empathetic listening and validating safety… Unless you are a mental health professional, you are likely not adequately trained to walk people through this, so the following pertain to immediate responses, rather than ongoing support procedures.

    • Responding to Mental Health Crisis: The legal language of “imminent danger to oneself or others” is used to determine whether someone should be involuntarily committed. Many of the situations you might encounter may not be dangerous in this way, but will include intense feelings, behaviors, or anxieties. The following are guidelines for responding:

      • Ensure & Establish Safety

        • Respect Personal Space

        • Approach calmly, immediately ensure that the person feels as safe as possible

        • Remove triggers or respond creatively to their needs

        • Minimize potentially harmful interventions whenever possible

      • Engage Verbally & Intervene Empathetically

        • Be concise (repeat your simple message until it is heard)

        • Identify wants & feelings (approach from a person-centered, trauma informed standpoint, attempting to understand the person and the situation).

          • “I really want to know what you’re upset about, even if I can’t provide what you need, so that we can work on it together”

        • Agree wherever possible (truth, principle, odds, or agree to disagree)

      • Provide Options & Control

        • Establish limits and boundaries

        • Present options and include the person in decision making

    • Specifics: If you wish to learn how to specifically respond to folks in different states of crisis, please use the following resources:

    • Harm Reduction & Drug Use: Some folks experiencing homelessness might be using substances to cope with various traumas. Harm reduction is the practice of acknowledging that drug use will happen and attempts to prevent harms associated with drug use. This harm reduction can result in many practices, including safe consumption spaces, permitting folks to access services regardless of drug use, and providing support despite drug use. People who are using may present in similar ways to that of a mental health crisis.

    • More Resources:

  • SECONDARY TRAUMA & SELF CARE: Working in high intensity settings can expose you to secondary trauma, the emotional duress from hearing others speak of or walking others through their first hand trauma. It is often accompanied by various emotional, physical, and mental symptoms that can result in burnout, compassion fatigue, or worsening mental health if not addressed. Self care (intentionally taking time for yourself and setting boundaries around your work) can help to mitigate the effects of secondary trauma.

SOCIAL JUSTICE & POSITIONALITY

Often times, as volunteers or staff in social services, we choose to be in the space or to engage with people. This is a privilege that not many of our clients hold. We need to be aware of and responsive to the privileges that we may carry that our clients may not. This includes not only being aware of how oppression and privilege may manifest on structural and cultural levels, but also in how these manifest on interpersonal levels.

  • Oppression & Privilege:

    • Oppression: Sociology defines oppression as the systematic mistreatment, exploitation, and abuse of a group (or groups) of people by another group (or groups). It occurs whenever one group holds power over another in society through the control of social institutions, along with society's laws, customs, and norms.

      • Intersectionality of Identity: Every person holds many identities, some more salient than others. When many of these identities are disadvantaged or marginalized, people experience intersectionality of oppression.

        • Age, Disability, Religion, Race & Ethnicity, Sexuality, Class, Gender

      • Multidimensionality: oppression operates on multiple levels (dimensions) from structural, to cultural, to personal. These levels also vary on whether the impact was intended or unintended. This has been referred to as the iceberg of oppression.

    • Privilege: can be considered to be the unearned, not necessarily undeserved, opportunities that people have due to the identities that they carry, not the merits they have earned; “the things that you have without having to think about having them.”

      • Positionality: In thinking about privilege, it is important to consider the ways that you carry privilege and oppression and how that might impact the space that you take up and the understandings you walk in with.

        • As you prepare to volunteer your time and energy, consider the following questions:

          • How does my background/upbringing affect the way I see the world (or the situation I’m about to enter?)

          • Do I have biases or assumptions based on anything discussed here that I need to be aware of and try to mitigate?

          • Do I have an internalized understandings of superiority and inferiority that affect my interactions?

        • During your volunteer time, pay attention to how you feel, what you’re thinking, and focus on staying authentically engaged even if you’re processing discomfort, surprise, or confusion.

        • It may be helpful to reflect afterwards:

          • Did I have assumptions coming into this experience, and were they contradicted?

          • How does this change the way I see the world, especially this marginalized population?

          • What did I learn, personally?

  • Interpersonal Oppression & Stereotypes: Privilege and Oppression are often entangled with the stereotypes and judgments that are placed upon people. Our clients live with stereotypes like “dirty,” “lazy,” “addicted,” “crazy,” and “criminal.” When unpacked, each stereotype can be either proven false or a product of an unjust system.

    • Dirty: Many folks engage in frequent bathing & laundering, but reduced availability of public toilets, showers and laundry facilities negatively impacts the hygiene of folks experiencing homelessness.

    • Lazy: Many folks experiencing homelessness are working formal jobs (45%). This would be a higher percentage if “under the table” work was included as folks adopt ingenious ways to subsist.

    • Addict: Substance abuse is often a result of homelessness rather than a cause as folks use as a means to cope. Many folks who are addicted never become homeless, whereas poor folks struggling with addiction are more likely to experience homelessness.

    • Crazy: People with severe mental illnesses (major depression, bipolar disorder, and schizophrenia) are in the minority of homeless folks  (13-15%). Still, these folks are among the most visible due to the extreme lack of mental health services for people with severe mental illnesses.

    • Criminal: Folks on the street are more likely to be victims of crimes rather than perpetrators. Attacks against homeless people have resulted in hate crime legislation in some states. Even for folks who have committed crimes (~20%), these crimes are often survival crimes (prostitution, shoplifting, trespassing). Homelessness in itself is criminalized in many ways (through various laws, hostile architecture, and banishment from public spaces).

      • Media & Homelessness. The media often depicts the most troubling aspects of homelessness and often relies on stereotypes to do so. Be mindful of how this might come up in the media that you consume and how critical you are of it.

  • Structural Oppression & Causes of Homelessness: Homelessness is the manifestation of poverty and inequality. It is one of the most visible reminders of structural inadequacies and inequalities. This is especially true across various axes of oppression, where classism, homophobia/transphobia and racism result in immense disproportionalities across populations.

    • Contextualizing Demographics:

      • Racism: People of Color are 3-7 times more likely to experience homelessness as compared to white people.

      • Classism: Poverty is inextricably linked to Homelessness.  

      • Homophobia/Transphobia: especially for youth and young adults, homelessness is linked to LGBTQ status (~20-40% of young adults experiencing homelessness are part of the LGBTQ community).

INTERPROFESSIONAL COLLABORATION

As health care in the United States becomes more complex, there is a growing emphasis on prevention, primary care, and the importance of addressing issues such as the social determinants of health.  This expanded and more holistic view of how to achieve health is driving commitment to the ideals of interprofessional collaborative practice. Becoming a good collaborator requires explicit honing of teamwork skills over time, often beginning in the earliest days of professional training/socialization.

Acknowledgments: This list of resources and frameworks was compiled by Samantha Fredman. Samantha works as a Program Manager and Training Facilitator at ROOTS Young Adult Shelter. Any questions, comments, or concerns can be fielded to her (samf@rootsinfo.org)

An amazing team edited and suggested content for this project, including Anna Humphreys, Heather Wilcox, Rachel Lazzar, Tracy Brazg, Fredrik Mansfield, and Jordan Beaudry in Winter 2019.