1. Engagement Strategies: Service Delivery in Supportive Housing
Joyce Grangent
Senior Program Manager
Corporation for Supportive Housing

2. Long-term homelessness Development disabilities Histories of trauma
Every tenant brings a history, a culture, a set of expectations and behavior that can be shaped by such things as:
Criminal histories
Long-term homelessness
Development disabilities
Histories of trauma
Issues specific to women with children
Much more!
Cultural, ethnic, and racial differences
Gender and sexuality issues
Mental Health History
HIV/AIDS
Other medical issues
Domestic violence

3. What else tenants bring
Housing history
Family history
Spiritual life
Survival skills
Social networks and support systems
Tolerance level for structures and rules
Behavioral history
Expectations and Preferences

4. The Professional Support Person The Homeless Person
A Clash of Agendas
The Professional Support Person
Duties and responsibilities
Product oriented
Caring (We hope!)
The Homeless Person
Multitude of losses
Depth of mostly negative feelings
Unique and uniquely acquired strengths
This and the next slides are designed to help folks understand why there
may initially be a chasm between "us" the professional care giver types,
including job placement folks, and "them" homeless or formerly homeless
persons, who come to the table with a lot of baggage that doesn't disappear
just because they have housing, We have used this concept successfully in a
Sensitivity Training for hospital or shelter workers.

5. Resolving the Clash Don’t create more losses Understand the feelings
Uncover and build on strengths
Using strategies and techniques
Harm Reduction
Stages of Change
Motivational Interviewing
Reflective Listening
Large group discussion-Take time at this point to discuss how people feel about what we have covered so far and their feelings about harm reduction.
1. Ask participants to give their personal definitions of HR and record the responses on a flip chart.

6. Engagement Strategies
Engagement sets the stage for formal case management and treatment sessions where in-depth assessments, counseling, and referrals can occur on an individualized basis.

7. Goals of Engagement
Care for immediate needs
Develop a trusting relationship
Provide services and resources
Connect to mainstream services and social networks to maximize independence
Helping people stay housed

8. Effective Engagement Create the proper physical environment
Respect, accept and support people
Develop active listening skills
Let the tenant’s goals drive the services offered
Help people make informed choices
Be consistent with repeated, predictable patterns of interaction
Engagement should be non-threatening

9. Effective Engagement
Effective engagement for people with mental health issues
Effective engagement for people with substance use issues

10. Engagement is a Process
Where we introduce tenant to services relationship
Explain our role
Find common ground to build on
Engagement is not an event
Does not happen overnight
Varies from tenant to tenant

11. Creative Engagement Strategies
For Open:
Friendly
Listen
Maintain eye contact
Keep conversation light
Respond to humor

12. For Closed: Creative Engagement Intrusive Talk to much Too opinionated
Lecture
Analytical
Demanding

13. Engagement for People With Mental Illness
Enhanced When:
Worker develops shared reality with tenant
Interaction is consistent
Worker allows tenant to exercise control in the interaction
Worker communicates his/her role clearly

14. Provide coordination among service providers Develop buddy systems
Whose Goal Is It
Orient new tenants
Provide coordination among service providers
Develop buddy systems
Provide individual case management

15. Opportunities to Achieve Goals
Develop case management plan
Help with skill building
Coordination of mental, physical and substance abuse services
Assistance with medications and/or doctor appointments

16. Developing Trusting Relationships
Professional Relations
Goal is maintain housing
Information is confidential
We must set limits

17. In a Personal Relationship
Different goals with different people
We can gossip to friends
We don’t have to set limits

18. Enhancing Motivation for Change

19. Building Motivation for Change
Build Trust: Be consistent, trustworthy and honest
Get to know the person
Learn to recognize and Identify Emotions/Physical sensations of anxiety
Define the helping relationship

20. Working With Ambivalence and Resistance
Reactance Theory –helps to predict how people respond to the perceived loss of valued freedom
Reactance Theory states that it is natural for people to try to maximize control and choice

21. Why Tenants May Be Resistant
Afraid staff will tell them what to do
Don’t want to be controlled or lose the right to make choices
We view resistance as negative and part of tenants illness
Tenant is trying to maintain their independence/freedom

22. When Working with tenants Who Is Resistant
Avoid telling tenant what to do, instead present options
Explore both sides of an issue, one-sided focus increases reactance
Address one problem at a time-partner with tenant to set priorities and timelines for addressing them
Work with tenant where they are along spectrum of change

23. What if this is not working?
Steps to consider before terminating your clients
Discuss with Colleagues and Supervisor
Talk to clients about consequences/alternatives
Is there a way to negotiate the dispute?
Remember this is the only way for our folks to get
permanent housing

24. Roadblocks to Listening
Directing- Do it this way
Warning- Creates fear or submission
Making suggestions-Tenant is not competent or judgment is not trusted
Persuade with logic- you need to stop drinking, or you may damage your liver
Shaming-Do you really want others to see you like this

25. Motivational Interviewing
Motivational Interviewing - is a way to get tenants to recognize and do something about problems
Useful with tenants who - are reluctant to change and ambivalent about ability to change
Intended to help resolve ambivalence and get tenant moving on path to change
Staff acts as change agent

26. Five Basic Principals To Motivational Interviewing

27. Accurate Empathy Express Empathy
Not identifying with tenant instead seeks to understand what the tenant is saying without being judgmental, criticizing or blaming .
Acceptance lowers defenses and make tenant more open
Trying to “make” tenant change creates resistance and refusal

28. Develop Discrepancy
Listening patiently can help tenant see the discrepancy between their present behavior and goals
Gaining insight into discrepancy can help gain motivation to change (must remember what is said)
It should be the tenant who begins to fell safe enough to voice concern

29. Arguing leads to negativity Destroys alliance Increases defensiveness.
Avoid Argumentation
Avoid expert trap
Arguing leads to negativity
Destroys alliance
Increases defensiveness.

30. It’s normal and we should expect it
Roll With Resistance
Resistance is not bad.
It’s normal and we should expect it
Go with it and don’t get into power struggle
It gives insight to guide our work

31. Support Self-Efficacy
Hope, optimism and self esteem are needed for change
Plant seed of believability
Reframe failures
Let’s figure out what didn’t work

32. “Life takes on meaning when you become motivated, set goals, and charge after them in an unstoppable manner.”
–Les Brown

33. CSH Tools and Resources

34. CSH website: www.csh.org Institute website: www.csh.org/IL/institute
CSH Resources
CSH website:
Institute website:
CSH Publications:
Not a Solo Act
Developing the Support in Supportive Hsg
Toolkit for Developing and Operating Supportive Housing