A1 ocasi retention and solution focus

Bell, Browne, Molnar & Delicate Consulting 1

Retention and Solution Focus

...A Lifecycle Approach

BBMD Consulting Inc.2011

Bell, Browne, Molnar & Delicate Consulting

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.

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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)

3


CM GAME PLAN

RETENTION


Research in Psychotherapy5

15%

15%

40%

30%

4. Counsellor

Technique:

15%

3. Client Expectancy:

15%

2. Relationship:

30%

1. Extra-Theraputic

Factors:

40%

With permission from Richard

Hamilton, “Disorient your Client –

SFBT”, 2011


BEFORE WE BEGIN...HOW ARE WE IMPACTING RETENTION BEFORE WE EVEN SAY A WORD?

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Expectation ManagementHow do we presently “sell” our service?

How COULD/SHOULD we “sell” our service?

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The “there’s no way this person is going to be able to (outcome)...’ niggle.

What triggers this ‘niggle’ for you?

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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...

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What are you bringing to the table? What ‘colours’ each exchange you have with clients?


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.html

• Google search (many free, some have costs):

– Self-esteem index

– Acceptance of others scale

– Assertiveness scales

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https://implicit.harvard.edu/implicit/demo/selectatest.html

https://implicit.harvard.edu/implicit/demo/selectatest.html


1. CLIENT IDENTIFICATION, ELIGIBILITY AND SUITABILITY

The role of the GATE KEEPER in RETENTION


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)

How could/does our ‘tone’ impact our service and our success??

Blink (2005), Malcolm Gladwell, pg 42

Initial phone inquiry

Initial centre visit Assessment Service Supports Monitoring Follow up


Data Collection

Too early, KILLS Expectancy and

Relationship

Why clients withdraw from service: MAIN factor identified in study by Richmond

(1992): counsellor’s focus on data gathering rather than rapport building


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 10


Impacts of ‘Priming’• Psychologist Claude Steele and

Joshua Aronson

– Black college students and twenty questions from the Graduate Record Examination

– ½ of the students asked to identify their race on a pre-test questionnaire... Enough to ‘prime’ them with all of the negative stereotypes associated with African Americans and academic achievement – the number of items they got right was cut in half.

• Two Dutch researchers

– Group of students, 42 fairly demanding questions from Trivial Pursuit

– Half asked to think about what it would mean to be a professor and write down everything that came to mind – got 55.6% correct

– Other half – think about soccer hooligans – 42.6% right

– Not smarter or more focused, just ‘smart’ frame of mind

Blink (2005), Malcolm Gladwell, pg 56


What do we do in our service that ‘primes’?

Negatively: Positively:


More than 2 days?

1) Task

2) Engage

3) Give

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If you have to send them away...

1. task them,

2. engage them,

3. give them something valuable IMMEDIATELY

What is your present ‘no-show’ rate?


2. NEEDS ASSESSMENTHow much service will this client need for retention?


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??



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:

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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.


2. Needs Assessmentb) 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?


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?


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.


Solution Focused Exploration Tools

Stephanie Johnson, www.solutionfocusedcounselling.com

How confident are

you in these skills?

1 2 3 4 5

NORMALIZATION is normalizing a situation or an event without trivializing the client’s complaint.

“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.

1 2 3 4 5

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

feeling useless didn’t get the better of you?” Looking for a time when the problem didn’t

dominate 24/7.

1 2 3 4 5

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

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.

1 2 3 4 5

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

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.

http://www.solutionfocusedcounselling.com/


Solution Focused Exploration Tools

Stephanie Johnson, www.solutionfocusedcounselling.com

How confident are

you in these skills?

1 2 3 4 5

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 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.

1 2 3 4 5COMPLIMENTS are a technique that we used at the end of the session to encourage the client and give a message of hope. Compliments need to be genuine, appropriate and not over the top.

1 2 3 4 5

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 carry them out and own them. Tasks need to be relevant and achievable. Never set up a client for failure.

http://www.solutionfocusedcounselling.com/


What do you

current ‘assess’

Type here


Indicators of client service need (MTCU 2010)

DO YOU FORMALLY CONSIDER:

• Demographics This includes basic information about the client’s gender, age, and education.

• *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 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.

• 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.

• *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 difficulties in maintaining positive relationships with employers and/or work peers.

• 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.

• 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.

• *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.

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Y N

Y N

Y N

Y N

Y N

Y N

Y N

Y N

Y N


Fishing for StrengthsPersonal

• Interests/ hobbies. What does this say about the person?

• What is something she is most proud of?

• Who passed on values to him

• When was a time in his life when he had to succeed against a problem like this?

Vocational

• When was the last time he was employed?

• How did she find that job?

• How long employed?

• How did he retain the job?


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 outcome


3. PLANNINGYour living service plan... INCLUDES RETENTION!


Core Components of a Service Plan1. 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!!


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.htm

http://www.kent.ac.uk/careers/sk/decisionmaking.htm


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-Crisis


4. IMPLEMENTATION / MONITORING

Moving the client to ACTION


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?


5. EVALUATION

Working, Not Working, Course Correction


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 benefit


6. FOLLOW-UP / TRANSITIONING / DISENGAGEMENT


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?


Transitioning/DisengagementRedefinition 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 disengagement


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 + HST

https://student.gototraining.com/802bj/register/8406236220169961984


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 + HST





Let us bring our training to your office

(613) 562-3468

[email protected]

www.bbmd.ca

mailto:[email protected]

http://www.bbmd.ca/

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A1 ocasi retention and solution focus