Surviving and Thriving through Walk-in Counselling · in the first sessions (Slive, 2008) •45-50%...
Transcript of Surviving and Thriving through Walk-in Counselling · in the first sessions (Slive, 2008) •45-50%...
Surviving and Thriving through Walk-in Counselling:
Challenges & Lessons Learned
AMHO Conference: May 28th, 2018
Presented By Irina Sytcheva, Jamie Lemen and Kulsum Khan
WoodGreen Community Services
WoodGreen Community Services
Introductions
• What do you need to have happen for you to know that this was helpful?
• Any topics you want us to cover?
2
WoodGreen Community Services
Special Thanks
We wish to give special thanks to Sharna Cohen, Karen Young, Michael Worb & Family for their contributions to launching, building and growing WoodGreen’s Walk-in
Counselling Service.
3
WoodGreen Community Services
Agenda1. Introductions
2. Practicing Curiosity
3. Overview of Our Walk-in Counselling
4. Values & Principles
5. About Single-Session Counseling
6. Community Volunteer Therapist Program
7. Our Impact
8. Our Challenges
9. What We Learned
10. What’s Next
11. Wrap-up and Questions
4
Practicing Curiosity
WoodGreen Community Services
WoodGreen Community Services
Thin Thick Interactive Experience• One interviewee, One interviewer, One or more
documenter/scribe/coach
• Interviewee: Start the conversation with stating a positive identity description about yourself. Must be one liked by you. Examples are: I am resilient, or courageous, or determined
• Documenter/scribe/coach: you can give feedback and helpful, but not to take over
6
WoodGreen Community Services
Thin Thick Interactive Experience• Interviewer: Be curious. Get a thick story.
– Find out everything you can about the identity description. Examples for “determined”?
– How does determination show up in your life?
– What stories can you tell me about determination?
– What events or people in your life have contributed to you seeing yourself this way?
– What values, principles, commitments do you draw on to sustain determination?
– Who in your life shares these values?
– What events or persons have inspired determination?
7
WoodGreen Community Services
Thin Thick subordinate stories• Thin stories lack detail
• A think story is inscribed with meanings and finds linkages between the stories of people’s lives and their cherished values, beliefs, purposed, desires and commitments…
• When people engage in a different telling, different language, new meaning, new ideas, new possibilities can emerge
• We can facilitate “A-ha” or pivotal moments
Developed by Karen Young, MSW/RSW.
Used with permission.
8
So, What Is Walk-in Counselling
Play Video
WoodGreen Community Services
Our Values & Principles
WoodGreen Community Services
WoodGreen Community Services
Values & Principles• People know when they need help
• It’s best to offer help when people ask for it
• Often single session can be enough
• People will use the service as they see fit and may return for subsequent sessions
• Some people may need a referral for more services
12
WoodGreen Community Services
Values & Principles• People are multi-storied, there are many parts of a
person’s story
• The “truth” about who people are (their identity) is shaped by societal, cultural, historical contexts in which they live (discourses). Identity is fluid, relational; it changes over time and between contexts.
• People can solve their problems and have knowledge, abilities, skills and resources that can be directed toward new possibilities
13
WoodGreen Community Services
Values & Principles• People exist outside of the problem. The problem is the
problem, not the person
• The purpose of the session is not to fix everything. Hope may be the only outcome, and we (as counselors) need to be okay with that
• The job of the counselor is to facilitate conversations in such a way that resources can be utilized and mutually discovered
14
What is Single-Session Counseling and Why Does It
Work?
WoodGreen Community Services
WoodGreen Community Services
Single Session therapy or Walk-in Counselling is “not about providing traditional services faster; we need to significantly shift the way we think about change and the way we view the people who come to us for help.”
- Karen Young, RSW, Windz Institute
16
WoodGreen Community Services
Single-Session Structure• Each session is approached as a distinct therapeutic encounter –
building a therapeutic alliance, negotiating focus for the session, developing an understanding of the problem, identifying resources (internal and external), formulating an “intervention” and processing feedback all occur in one session
• The focus of the session is in the present and future – there is little prior information, discussion focusses on the problem in the present and how it effects the person now, and highlights preferences for the future
• Not: formal assessment, diagnosis, ongoing therapeutic relationship
17
WoodGreen Community Services
But Does It Work?
• In multiple session models much of the change occurs in the first sessions (Slive, 2008)
• 45-50% of clients attending walk-in do not ask for or require further services (Young, Dick, Herring, & Lee, 2008)
• Can provide interim support for those on waiting lists; can prevent people from going on waiting lists (Young, et al, 2008)
18
WoodGreen Community Services
But Does It Work?
• Successful outcomes are reported for the single session model in terms of client satisfaction and the development of an action plan (Miller, 2008; Slive, 2008; Bhanot-Malhotra, Livingstone, & Stalker, 2010)
• In a 2016 study of Walk-in participants identified ease and accessibility as most valued experience (Cait, 2016)
• Some studies suggest that Walk-in attracts more men and youth than traditional models (Stalker, 2012)
19
Our Lifeline - Community Volunteer Therapist Program
WoodGreen Community Services
WoodGreen Community Services
What we’re looking for• Experience with mental health/addictions/family/etc.
• Theoretical knowledge and well-developed counselling skills
• Registration with Regulatory College is required
• The commitment is a minimum of one shift (ideally 4:15 - 9:00 p.m., latest acceptable arrival 5:30) per month, for 12 months. More frequent participation is recommended
• Can utilize variety of therapeutic models and approaches – based on own comfort and style and what’s most useful for the client
21
WoodGreen Community Services
What we offer• An opportunity to network with other WoodGreen staff
and volunteers
• Develop your clinical skills and receive clinical supervision/consultation
• Opportunity to provide 1-1 counselling with a diverse population
• Learn about resources and other programs offered in the community
22
WoodGreen Community Services
What we offer• Receive training in Single-session counselling models,
and booster trainings on a variety of topics throughout the year
• Provide letters of recommendation and confirmation of counselling hours to support professional development
• Formal recognition through Walk-in appreciation events
23
WoodGreen Community Services
Training and Supervision• Application & Interview process
• Orientation Training
• Shadowing (observing other counselors) 1-3 nights
• Co-counselling (observed by other counselors) 1-3 nights
• Peer & Self Evaluation
• Booster Sessions
• Support, clinical supervision, guidance, resources offered along the way
24
Our Impact(Or Why We Are Awesome)
WoodGreen Community Services
WoodGreen Community Services
• Strengthen Skills
• Resource Sharing
• Networking
• Consultation Process
• Utilize skills within their home agencies
• Community of Practice
• Capacity Building
• Consultation
• Knowledge Sharing
• Receive counselling, resources
• (Re)gain skills, insights, knowledge
• Utilize skills within their own communities
• Non-traditional hours
• Free, no restrictions, no referrals or waitlist
• Reduce burden on Caregivers
• Diversion from more costly services, e.g hospital, crisis services
• Fills a gap in service, e.g. court diversion, child protective services
• Diverts from waitlist
• Fills the gap while on the waitlist
Larger Systems
Clients & Community Members
CounselorsCommunity Agencies &
Partners
26
WoodGreen Community Services
* Based on data from
April 2017 to March
2018. Discrepancy
between individuals
and sessions is a
result of individuals
receiving service
together
27
WoodGreen Community Services
*Other includes:
Crisis Line; Flyer;
School; 311; Walk-in’s;
EAP
Referral Source
28
WoodGreen Community Services
Presenting Concerns
29
WoodGreen Community Services
Mental Health Concerns
30
WoodGreen Community Services
Interpersonal Concerns
31
WoodGreen Community Services
If the Walk-in wasn't available what would you do?
* Other includes:
Use substances;
take a walk; stay up
all night; gamble;
meditate; church
32
WoodGreen Community Services
33
WoodGreen Community Services
34
WoodGreen Community Services
Interventions
35
Our Challenges
WoodGreen Community Services
WoodGreen Community Services
Challenges Exercise
• What is one challenge you face in your work?
• Can be an individual, organization or system-level challenge
• Write down 1-2 challenges on the post-it notes and then stick them up on the flipchart
37
WoodGreen Community Services
Challenges Faced at the Walk-in
• High demand for service, e.g. wait-times
• Accessibility, e.g. language, childcare
• Volunteer management and retention, e.g. scheduling
• Volunteers’ balancing their work life and the Walk-in
• No direct funding
38
WoodGreen Community Services
Challenges Faced at the Walk-in
• Limitations of the Walk-in model, e.g. challenge to work
with complex and developmental trauma; people who
would benefit from working with one counselor
• Working with “Mandated” clients
• Every night is different (not knowing what to expect on
any given night)
• Re-occurring vs. new clients
39
WoodGreen Community Services
• Volunteer to share 1 of the challenges faced in your work
• Consult with the “team”
• What resources, supports, ideas, feedback, strategies can
you share with the counselor?
Challenges Exercise
40
What We Learned
WoodGreen Community Services
WoodGreen Community Services
Lessons Learned
• Organizational commitment is key e.g. offering office space as counselling rooms, staff counselors
• Importance of the Intake/Program Assistant/Greeter
• Counselors come and go – word of mouth has been the best form of marketing
• Importance of taking care of volunteers, e.g. food, training
42
WoodGreen Community Services
Lessons Learned
• People use the Walk-in service as they need it
• Value of the mid-session consultation
• On-the-spot client feedback
• Resource sharing among counselors/On-hand resources
• Safety and comfort – for clients and counselors
43
What’s Next
WoodGreen Community Services
WoodGreen Community Services
Where We’re Going…• Expansion
– Hub model of service– Different ways of accessing counselling– Increased days/hours
• Capacity Building – Consultation– Templates– Sharing of the model– Training
• Community of Practice– Share best practices, lessons learned– Peer support, networking
45
WoodGreen Community Services
Debrief and Q&A
• Questions
• Observations
• Where are you now that you weren’t at the beginning?
• Did you get everything you need?
46
WoodGreen Community Services
Let’s Stay In TouchIrina Sytcheva, Senior Manager – Counselling, Case Management and Support Services.
[email protected] ext. 2525
Jamie Lemen, Supervisor – Walk-in [email protected] ext. 1266
WoodGreen: Community Care Central [email protected]
47
WoodGreen Community Services
Works CitedBhanot-Malhotra, S., Livingstone, S., & Stalker, C. (2010). An inventory of walk-in counselling
clinics in Ontario. Children’s Centre. Retrieved from: http://www.childrenscentre.ca/Resources/Research%20and%20Evaluation/Research%20Reports/Walk%20In%20Inventory-20June%206%20final_3.pdf
Cait, C.A., Skop, M., Booton, J., Stalker, C.A., Horton, S. & Riemer, M. (2016). Practice-based qualitative research: Participant experiences of walk-in counselling and traditional counselling. Qualitative Social Work. 1473325016637910.
Miller, J. K. (2008). Walk-in single session team therapy: A study of client satisfaction. Journal of Systemic Therapies, 27(3), 78-94.
Slive, A. (2008). Special Section: Walk-in single session therapy. Journal of Systemic Therapies, 27(4), 1-4.
Stalker, C.A., Horton, S. & Cait, C.A. (2012). Single-Session Therapy in a Walk-in Counselling Clinic: A Pilot Study. Journal of Systemic Therapies. 31(1), 38-52
Young, K., Dick, M., Herring, K., & Lee, J. (2008). From waiting lists to walk-in: Stories from a walk-in therapy clinic. Journal of Systemic Therapies, 27(4), 23-39.
48