Surviving and Thriving through Walk-in Counselling: Challenges & Lessons Learned - AMHO Conference: May 28th, 2018 - Addictions ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
WoodGreen Community Services
Surviving and Thriving
through Walk-in Counselling:
Challenges & Lessons Learned
AMHO Conference: May 28th, 2018
Presented By Irina Sytcheva, Jamie Lemen and Kulsum KhanWoodGreen 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?
2WoodGreen 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.
3WoodGreen Community Services
Agenda
1. 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
4WoodGreen Community Services
Practicing CuriosityWoodGreen 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
6WoodGreen 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?
7WoodGreen 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.
8WoodGreen Community Services
So, What Is Walk-in
Counselling
Play VideoWoodGreen Community Services
Our Values &
PrinciplesWoodGreen 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
12WoodGreen 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
13WoodGreen 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
14WoodGreen Community Services
What is Single-Session
Counseling and Why Does It
Work?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
16WoodGreen 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
17WoodGreen 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)
18WoodGreen 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)
19WoodGreen Community Services
Our Lifeline - Community
Volunteer Therapist ProgramWoodGreen 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
21WoodGreen 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
22WoodGreen 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
23WoodGreen 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
24WoodGreen Community Services
Our Impact
(Or Why We Are Awesome)WoodGreen Community Services
• Diversion from more costly • Receive counselling,
services, e.g hospital, crisis resources
services • (Re)gain skills, insights,
• Fills a gap in service, e.g. knowledge
court diversion, child • Utilize skills within their own
protective services communities
• Diverts from waitlist • Non-traditional hours
• Fills the gap while on the • Free, no restrictions, no
waitlist Clients & referrals or waitlist
Larger • Reduce burden on
Community
Systems Caregivers
Members
Community
Agencies & Counselors
• Community of Practice Partners • Strengthen Skills
• Capacity Building • Resource Sharing
• Consultation • Networking
• Knowledge Sharing • Consultation Process
• Utilize skills within their
home agencies
26WoodGreen Community Services
* Based on data from
April 2017 to March
2018. Discrepancy
between individuals
and sessions is a
result of individuals
receiving service
together
27WoodGreen Community Services
Referral Source
*Other includes:
Crisis Line; Flyer;
School; 311; Walk-in’s;
EAP
28WoodGreen Community Services
Presenting Concerns
29WoodGreen Community Services
Mental Health Concerns
30WoodGreen Community Services
Interpersonal Concerns
31WoodGreen 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
32WoodGreen Community Services 33
WoodGreen Community Services 34
WoodGreen Community Services
Interventions
35WoodGreen Community Services
Our ChallengesWoodGreen 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
37WoodGreen 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
38WoodGreen 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
39WoodGreen Community Services
Challenges Exercise
• 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?
40WoodGreen Community Services
What We LearnedWoodGreen 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
42WoodGreen 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
43WoodGreen Community Services
What’s NextWoodGreen 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
45WoodGreen 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?
46WoodGreen Community Services
Let’s Stay In Touch
Irina Sytcheva, Senior Manager – Counselling, Case
Management and Support Services.
isytcheva@woodgreen.org
416-645-6000 ext. 2525
Jamie Lemen, Supervisor – Walk-in Counselling
jlemen@woodgreen.org
416-645-6000 ext. 1266
WoodGreen: Community Care Central Intake
cccentralintake@woodgreen.org
416-572-3575
47WoodGreen Community Services
Works Cited
Bhanot-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%20Repo
rts/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.
48You can also read
