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Access

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Title: Access


1
Access Referral to Health
Human Services?
  • Developed by
  • The Area Agency on Aging of North Central Texas
  • with the assistance of
  • First Call of
  • the United Way of Metropolitan Tarrant County
  • the Community Council of Greater Dallas

2
Table of Contents
  • Module 1 Overview Background
  • Module 2 2-1-1
  • Module 3 Communication Skills
  • Module 4 Communication for Special Needs
  • Module 5 Information Referral Systems
  • Module 6 Chronic Clients Difficult
    Behavior
  • Module 7 Advocacy Professionalism
  • Module 8 Train the Trainer

3
Overview Background
  • Module 1

4
Module Objectives
  • Identify the purpose, target audience, learning
    objectives, and common language used in this
    training program
  • Describe the use and format of the training
    program
  • Discuss the demographics of the region and the
    impact on health human services
  • Identify the basic components of Information
    Referral Systems

5
Purpose Target Audience
Who is this training for?
  • The purpose of this training program is to assist
    health and human service workers in the North
    Central Texas area to more effectively assess
    needs and make referrals for people in their
    communities who need services

6
Learning Objectives
What you will learn
  • This training program assumes a wide range of
    skills, knowledge and experience
  • Many of you may be new to your jobs, to health
    and human services or to a geographic area
  • Many of you may have extensive experience in your
    career or geographic area
  • When the learning objectives of this training
    program state learn to it means that the goal
    is to refresh existing skills, learn a higher
    level of current skills, or learn additional
    tools and information

7
Learning Objectives
Learn how to more effectively
  • Communicate and interview to assess needs
  • Research resources
  • Refer and connect people to the right services
  • Follow-up to ensure that needs are met and
    improve overall information and referral services

8
Language Terminology
I know you think you heard what I said but I
dont think you realize that what you heard is
not what I meant.
Lets Agree to Some Common Language
  • Client an individual in need of services
  • Alliance of Information and Referrals Systems
    (AIRS) is the professional organization that sets
    the standards and practices for information and
    referral. TAIRS in Texas
  • I R centers (Information Referral)
    Official sources for health human service
    information and referral such as the United Way
    First Call and the Greater Dallas Community
    Council
  • Agency Service organizations that provide
    health and human services such as the United Way,
    Area Agency on Aging, Alzheimers Association,
    MHMR, Meals on Wheels
  • Advocacy groups organizations that do not
    provide direct services but provide information
    and advocacy for people with special needs such
    as the ARC, Autism Society and others

9
Using This Training Program
  • This training program contains learning modules
    that can be used separately or together, as
    needed, in a variety of ways
  • Computer-assisted training
  • Self-paced training
  • Staff training
  • For people needing information and resources
  • Customized for a specific audience or need

10
Introduction
  • The diversity of our communities presents many
    challenges
  • Access to services when people dont know where
    to find them
  • Distance from needed services with thousands of
    people living in rural communities
  • Lack of transportation to needed services
  • Caregivers who may live long distances from care
    recipients and work full time
  • Conflicting priorities for state and federal
    legislation and funding

11
Introduction
  • You cannot control many of these challenges
  • Our goal is for this learning experience to help
    you
  • Refresh your skills
  • Learn new techniques
  • Identify new information
  • Improve your overall ability to communicate with
    people in need of services.

12
Access Assistance
  • Comprehensive training
  • Resource development
  • Intensive promotion
  • Local control
  • Quality assurance
  • Systems design
  • Use of the internet and phone
  • Efforts to remove barriers
  • Use of technologies
  • Use of compatible resources
  • This training program is based on the Regional
    Access Assistance Plan of of the North
    Central Texas Council of Governments. This
    plan emphasizes improving the access to and
    integration of health and human services
    throughout the region
  • February, 2000

13
Demographics
Definition characteristics and statistics of
human population such as  size, growth density
  • Why do we need to know about the demographics of
    the North Central Texas area?
  • North Central Texas is changing dramatically
  • The region is rural and urban
  • People live in rural areas and commute to urban
    areas for jobs, recreation and health and human
    services

14
Demographics
  • The region is diverse with increasing numbers of
    people who are bilingual
  • One out of every five people in America has a
    recognized disability or special need

15
Aging Statistics
  • Older Americans are the fastest-growing
    population group
  • The most rapid population growth is among persons
    85
  • By the year 2005, ¼ of the U.S. workforce will be
    50 or older
  • By 2030, one of every five Americans will be 65
  • Someone in the U.S. turns 50 every 75 seconds
  • People over 50 control 70 percent of the total
    wealth in the U.S.
  • Over half of all Americans age 65 have one or
    more disabilities
  • Over one third of all Americans age 65 have
    severe disabilities

16
Regional Population
  • 5,429,366 people in the 14 county North Central
    Texas region
  • 160,000 annualized growth
  • 1,317,616 total growth since 1990
  • North Central Texas Council of Governments
    January 1, 2001 population estimates

17
Basic Tools
  • Assessment
  • Resources
  • Information referral
  • Follow-up
  • Advocacy
  • Professionalism

18
Getting Help
  • Think about a time when you were trying to get
    help or obtain a service
  • What happened?
  • What was not useful about what the person did or
    said?
  • What did the person do to help you?
  • What was the outcome?

19
What are Barriers
to accessing services?
  • Clients
  • Professionals
  • How would you answer?

20
What are Barriers
to accessing services?
  • Clients
  • Afraid to ask
  • Dont know what to ask
  • Dont want to feel stupid
  • Dont want to ask for help
  • Professionals
  • Lack time
  • Lack knowledge about how to find information
  • Information is not up to date
  • Not enough copies of printed information
  • Lack confidence in using the Internet
  • Limited ability to use the internet to find
    resources

How much of your list agrees with this one?

21
When do people look
for services?
  • People look for services
    when there is a need
  • Sometimes that need has
    become a crisis
  • When there is a need it is
    usually one that needs quick
    and easy solutions

22
Crisis
an opportunity riding a dangerous wind Confucius
  • Todays world is full of rapid and complex
    changes
  • Changes in health, changes in lifestyle, and
    changes in personal finances can create crises
  • Our challenge is to prevent a problem from
    becoming a crisis by
  • providing information and resources
  • connecting people with resources

23
Empowerment
How can we help people tap into their own ability
to find use resources?
  • Replace quick-fix Band-Aids? with long-term
    problem solving tools resources
  • Encourage people to use their coping skills and
    problem- solving abilities
  • Respect individual preferences make plans with
    people rather than for them
  • Listen allow others to express themselves
  • If I give you a fish today you will eat today
    if I teach to you fish, you will eat for a
    lifetime.

24
2-1-1 Area Information Centers
  • Module 2

25
Module Objectives
  • Describe the 2-1-1 system
  • Discuss the history of the 2-1-1 system
  • Identify the role of United Way of Greater
    Tarrant County First Call and the Community
    Council of Greater Dallas
  • Identify the benefits of the 2-1-1 system
  • Identify the current status of 2-1-1

26
Example of Regional Call Center
United Ways First Call
Tarrant Countys Information Referral Center
  • Telephone Information and Referral since 1973
  • Publish Blue Book directory since 1973
    disk version since 1996
  • Handled 38,000 calls in 2000

27
Benefits to the Community
  • Training
  • Information Referral
  • Community Resources
  • Blue Book (directory of community resources)
  • Blue Book on disk (computerized database)
  • Specialized reports
  • Multilingual capabilities
  • Staff
  • Language Line Services

28
This history of 2-1-1
29
What is 2-1-1?
  • July 2000 FCC designated 2-1-1
  • March 2001 Texas Public Utilities Commission
    approved new rules
  • July 2001 Texas Legislature awarded 4.7 million
    from TIF Board and the tobacco settlement to fund
    2-1-1 implementation
  • United Way of Metropolitan Tarrant Countys
    First Call will be the regional Area
    Information Center information on community
    services in Tarrant, Erath, Hood, Johnson, Palo
    Pinto, Parker, Somervell, Tarrant, and Wise
    Counties
  • The Community Council of Greater Dallas with be
    the regional Area Information Center for
    information on community services for Dallas,

30
What Changes?
How Will Current Systems Change?
  • Expanded hours of operation
  • More calls (up to 40 increase)
  • Expanded database
  • Additional staff resources
  • Improved geographic coordination
  • Larger budget
  • Better technology

31
Preparing for 2-1-1
The Tasks Ahead
  • Develop 2-1-1 business plan
  • Continue to build and strengthen partnerships
    with service providers, especially those in
    expanded service area
  • Collect, enter and maintain expanded data in
    database
  • Complete national accreditation

32
Schedule for 2-1-1
The Tasks Ahead
  • Texas Information Referral network (TAIRS) will
    develop the telecommunication infrastructure
    needed to implement 2-1-1 statewide
  • 12 Area Information Centers state-wide will
    receive funding in June 2002 to begin
    implementation in their specific region
  • Hire new staff
  • Upgrade technology
  • Develop marketing strategies

33
2-1-1 Benefits
  • New level of accessibility
  • Local IR centers already in place and supported
    by local private funds
  • Streamlined access to existing services
  • Expanded database

34
Area Information Referral Lines
  • 817.258.8100
  • Serving Tarrant,
  • Johnson, Parker,
  • Wise, Palo pinto,
  • Hood, Erath,
  • Somervell counties
  • 214.379.4357
  • Serving Dallas,
  • Denton, Collin,
  • Hunt, Rockwall,
  • Ellis, Kaufman,
  • Navarro counties

35
Communication Skills
  • Module 3

36
Module Objectives
  • Identify basic techniques of effective
    communication
  • Review and use active listening skills
  • Identify effective telephone techniques

37
Communication
  • The difference between the right word the
    almost right word is the difference between
    lightning the lightning bug.
  • -Mark Twain

38
Back to Basics
Practicing good communication
  • Your ability to listen is perhaps your greatest
    skill
  • You are building a partnership listening,
    gathering information and problem solving
  • Keep sentences short and simple
  • Keep the topic of the conversation clear
  • Allow enough time for the client to respond
  • Eliminate distractions
  • Use active listening techniques to make sure
    you understand
  • Allow time for the individual to respond
  • Provide choices, whenever possible
  • Practice patience, patience, patience!

39
Eliminate Jargon Buzzwords
  • What is in the alphabet soup in your
    organization?
  • AAA
  • I R
  • QMB/SLMB

WYSIWYG
40
Active listening
  • We were given two ears and one mouth for a
    reason.
  • -
  • Benefits
  • Clarifies what the client is telling you.
  • Helps to pace a conversation
  • Helps to keep a conversation focused
  • Cornerstones of active listening
  • Listening to feelings
  • Giving feedback
  • Being non-judgmental
  • Developing empathy

41
Techniques
  • Emotion labeling
  • Reflecting
  • Paraphrasing
  • Effective pause
  • Minimal encourager
  • Open-ended questions
  • I-messages
  • Consensual validation

42
Telephone Techniques
  • What is different about working with someone on
    the phone instead of in person?

43
Telephone Techniques
  • Verify numbers, dates, and names
  • Listen
  • Give your undivided attention
  • Signal that you are listening
  • Use active listening
  • Smile when you answer
  • Identify yourself
  • Use effective openings
  • Be prepared
  • Keep forms and reference materials handy

44
Telephone Techniques
Beyond just what you say
  • Eliminate background noise
  • Follow up when you say you will
  • Give progress reports
  • Ask, dont demand, to put callers on hold
  • Ask if callers prefer a call-back if you need the
    time to research information or verify something
  • Take complete information or messages
  • Use a temporary greeting when you are away from
    your office for an extended time

45
Closing a Conversation
  • I wont take up any more of your time.
  • Well, I hope it works out for you
  • Im glad you called and I hope its helped you
  • Call back if you need to.
  • I am glad we have been able to help your
    immediate problem.

46
Communicating with People Who Have Special Needs
  • Module 4

47
Module Objectives
  • Learn to modify communication
  • Identify ways to modify
  • Written materials for people who have visual
    impairments
  • Conversations with people who have hearing
    impairments
  • Communication with people who have cognitive
    impairments

48
Special Needs
  • Sensory
  • Emotional
  • Physical disabilities

Walk a mile in my shoes.
49
Communicating
with people who have special needs
  • Is there a special need? How will you know?
  • Ask the client if he/she understands you
  • Own the problem yourself

50
Written Materials
  • Written materials must be printed clearly
  • If your possible readers may be over age 50, use
    at least a 12 point font size
  • Use bright colors red, yellow, orange
  • Encourage the reader to increase the lighting if
    necessary

51
With Hearing Impairment
  • Reduce background noise
  • Speak slowly and clearly
  • Speak slightly louder than normal
  • Speak at a normal volume if the client wears a
    hearing aid
  • Speak at a steady, normal pace
  • Lower the tone (pitch) of your voice
  • Face the individual if possible

52
With Hearing Impairment
  • Cup your hand around the mouthpiece if you are
    talking on the phone
  • Keep sentences simple and short
  • Keep the topic of the conversation clear
  • Avoid chewing, eating or covering your mouth
  • Verify that you and the client are understanding
    one another
  • Try saying the same thing in different words
  • Give instructions slowly, asking the client to
    repeat them back

53
With Visual Impairment
  • Use font size of at least 12 point
  • Lighting
  • Provide adequate lighting
  • Encourage callers to go to good lighting

Let me know if you have trouble reading this. I
find these forms are hard to read.
54
With Older Adults
Dementia Alzheimers
  • Identify yourself and call the client by name
  • Use active listening
  • Keep sentences short simple
  • Use repetition
  • Speak clearly
  • Keep terminology simple
  • Use nouns instead of pronouns

55
With Older Adults
Dementia Alzheimers
  • Use concrete statements
  • Speak in a clear, even, normal tone
  • Wait for responses to questions
  • Dont attempt to finish the clients sentences
    for him or her
  • Use humor when appropriate

56
With Older Adults
Aphasia
  • Interference in the use or understanding of
    language
  • Responses
  • Be patient
  • Allow the client time to understand and respond
  • Use visual cues and gestures
  • Use short , clear words
  • Use visual aids
  • Nod when understanding
  • Allow client to write instead of speak
  • Characteristics
  • Highly sensitive
  • to the attitudes of others
  • may exhibit frustration
  • lack of self-confidence due to inability to speak

57
With Older Adults
Fatigue
  • Plan for and interview at the best time of the
    day for that individual
  • Allow time for interview and short break, if
    needed

58
With Older Adults
Impaired Mental Status
  • Remain patient and do not pressure the individual
    for information
  • Phrase questions in a clear simply fashion
  • Assist the person with orientation by giving them
    some indication of time, place, etc
  • Make every effort to obtain the fullest response
    from the older person before relying solely on
    information from others.

59
Grandparents Raising
Grandchildren Census 2000 Data
  • 4.5 million children are living with
    grandparents as primary caregivers
  • 2,350,477 grandparents are raising
    children under the age of 18
  • 889,415 or 38 are being raised by grandfathers
  • 30 increase since 1990
  • Grandparents are 60 more likely to be living in
    poverty
  • 27 of children in these homes are living in
    poverty
  • Grandparent head of households have grown 105
    since 1970

60
A Word About Caregivers
Engaging a Family or Community System
  • Engage the caregivers of people who have special
    needs in problem solving
  • Recognize stressors and limitation of caregivers
  • Encourage clients to identify and communicate
    with caregivers and other community supports

61
Information Referral Techniques
  • Module 5

62
Module Objectives
  • Know and apply standards the Alliance for
    Information Referral Systems (AIRS)
  • Identify key steps for successful information and
    referral
  • Identify use key assessment techniques
  • Discuss methods to research identify specific
    resources in the North Central Texas area
  • Discuss strategies for follow-up

63
Activities of Effective Assessment Referral
Assessment
  • Determine needs
  • Identify resources
  • Provide referral information
  • Follow-up

Research
Referral
Assessment
Follow-up
A combination of related activities
64
Build Partnerships
  • Establish an foundation built on communication,
    respect, trust
  • Engage people in a problem solving partnership
  • Partner to identify needs and make plans with the
    person not for the person

65
Key Basic Skills
  • Communicating with respect
  • Listening
  • Identifying assets and supports
  • Identifying functional abilities
  • Resolving problems
  • Identifying choices
  • Respecting confidentiality
  • Being patient

66
Assessment
67
Assessment Elements
  • Establish rapport
  • Identify client profile
  • Identify service needs
  • Gather pertinent data
  • Summarize needs

68
Assessment
Aspects of Social Functioning
  • Social relationships
  • Social activities
  • Social resources
  • Social supports Assets
  • Caregiver role
  • Quality of life

69
Gather information
  • What help is needed?
  • Are there unstated problems?
  • How does the person feel about the problem?
  • What has already been done?
  • Is the person being helped by another agency?
  • What resources does the client have?
  • Where does the person live?
  • Does the person have a religious/cultural
    preference?
  • Do you know enough?

70
What do you need?
  • Asking this question is one of the most helpful
    you can ask
  • Help the person prioritize the needs
  • Explore options consequences of choices on
    other needs

71
Assessment Skills
  • Active listening
  • Asking
  • Clarifying
  • Verifying

72
Interviewing
Foundation of Assessment
  • Observation
  • Listening
  • Reassuring

73
Interviewing Older Adults
Observe Respond
  • The environment
  • The language the person uses
  • Hearing or visual problems
  • Written materials used
  • Possible slower response time
  • The physical environment including the lighting
    and noise level

74
Assessment Steps
Alliance for Information Referral Systems
(AIRS) Model
  • Contact focus on feelings
  • Clarification focus on the problem
  • Closure focus on action

75
Contact
  • Focus on feelings
  • Avoid long silences
  • Be supportive
  • Reassure that feelings are okay
  • Be warm
  • Keep it personal
  • Use active listening

76
Clarification
  • Restate
  • Rephrase questions as statements
  • Prioritize
  • Acknowledge inconsistencies
  • Probe beyond the presenting problem

77
Closure
  • Verify understanding
  • Focus on action
  • Dont overload the client with information
  • Plan follow-up

78
Assessing for crisis
  • Is there a real or threatened loss?
  • What is the meaning of the problem or event?
  • Is support available?
  • Does the person have well-developed coping
    skills?

79
Resources
80
Research Resources
  • Clearly assess and prioritize the needs
  • Consider creative approaches outside the usual
    channels of assistance step outside the box
  • Identify research resources

81
Research
  • What are the available resources in my community?
  • How can I find those resources?
  • What are my agencys limitations?
  • What are my own limitations?

82
Research
Available Resources
  • Data bases
  • 2-1-1 when fully implemented
  • Special directories
  • The internet
  • Telephone directories
  • Libraries

83
Resources
  • Area Agencies on Aging
  • I R area information centers
  • Community Council of Greater Dallas
  • First Call, United Way of Metropolitan Tarrant
    County
  • United Way agencies
  • Department of Health Human Services
  • Disability specific organizations
  • MHMR, TRC
  • Service/advocacy
  • Arthritis Foundation, Alzheimers Association,
    American Heart association

84
Grandparents
Raising Grandchildren Resources
  • AARPs Grandparent Information Center,
    800-424-3410
  • www.aarp.org/grandparents/searchsupport AARPs
    national database of grandparent support groups
  • www.gu.org Generations Unlimited
  • www.grandsplace.com GrandsPlace

85
Problem Solve
  • Help create a win-win situation
  • Identify confirm the next step to take
  • Ask what the client needs from you?
  • Offer information names, phone numbers,
    resources, faxes, websites

86
Referral
87
Choices
Mutually Choose the Best Referral
  • Simple referrals do not require intervention
  • Complex referrals require intervention

88
How to Say No
  • When someone asks for the impossible, define your
    role
  • When someone wont take no for an answer repeat
    the information

89
Making the Referral
  • Select 2-3 possible referrals
  • Understand agency function and reason for giving
    as a referral
  • Record referral
  • Call Transfer feature

90
Referral Giving
  • Establish rapport
  • Restate the need
  • Give information
  • Ensure appropriateness of information
  • Obtain permission to follow up

91
Follow-up
92
Follow Up
  • Establish rapport
  • Restate the need
  • Restate referrals
  • Decide if referral was
  • Effective case closed
  • Ineffective identify and improve

93
Plan Isnt Working
What Questions Should You Ask?
  • What are the barriers?
  • Is the situation too complex need to be broken
    down to smaller steps?
  • Whose plan is it? (the clients or something they
    agreed to do for someone else?)

94
Types of Services
The Goal is to Link People with Services

A spectrum of services based on needs
  • Access
  • Community
  • Institutional
  • In-home

95
Chronic Clients Difficult Behavior
  • Module 6

96
Module Objectives
  • Define describe the behavior of chronic clients
  • Discuss use techniques with difficult behavior
  • Manipulative
  • Angry abusive
  • Identify effective techniques for early
    intervention

97
One More Time
Do You Have Clients Who Do Any of the Following?
  • Call repeatedly with the same same problem or
    request?
  • Are never satisfied?
  • Complain constantly?
  • Seem to use the system
    for a social outlet?
  • Ask for but dont accept help?
  • Dont follow up?
  • Dont want to be accountable?

98
How Do I Deal With It?
  • Consider the likely outcome if you choose to
    talk, or not to talk, with a chronic consumer
  • Be consistent
  • Set limits
  • Remain courteous and professional
  • Maintain communication within organization and
    with other referral organizations
  • Staff debriefing

99
Someone Abusive or Angry
Ending Calls
  • You are welcome to call back when you are ready
    to talk, but you dont seem ready now so Im
    going to hang up.
  • Its difficult to talk when youre so angry.
    Call back when you feel ready to discuss this
    your situation and needs.

100
Someone Manipulative
  • Be Supportive
  • Help person help him/herself
  • Try a genuine compliment
  • Make I statements
  • Follow up when necessary
  • Address feelings of fear or helplessness
  • Explain the rationale behind your decision
  • Define your role

101
Ending Calls Manipulative
  • With someone who is manipulative
  • We dont seem to be getting anywhere, so I think
    we should end this conversation.
  • We seem to be going in circles. Perhaps this is
    enough for today, so I m going to say good-bye
    now.

102
Cooperation
Change the Dynamics for Successful Outcomes
  • Set a positive tone from the beginning
  • Be supportive
  • Make contact
  • Use active listening
  • Repeat an important thought or phrase you heard

103
Cooperation
Change the Dynamics for Successful Outcomes
  • Silence
  • Allow the person time to think or collect their
    thoughts or emotions
  • Avoid long silences or you can lose the contact
    the person Assure the person that you are still
    there for them
  • Demonstrate warmth and acceptance
  • Use your voice, eye contact, body language
  • Remain non-judgmental
  • Dont assume

104
Patience
Skills and Practice
  • Pace yourself
  • Listen
  • Use active listening techniques
  • Take time outs if you need to.
  • Recognize that change is possible
  • Remember that some people do not have problem
    solving skills

105
I was scared
Have You Been in a Situation When You Were Afraid?
  • What were you feeling?
  • What were you thinking?
  • What do you think the person creating the
    situation was thinking or feeling?
  • What do you think caused the problem?
  • What worked about how you handled it?
  • What did not work?
  • What did you learn?

106
Triggers
What Causes People to Act Out?
  • Fear
  • Anxiety
  • Anger
  • Frustration
  • Substance abuse
  • Desperation
  • Acute, uncontrolled phase of a mental illness
  • Loneliness

107
Recognizing feelings
  • Be careful in identifying what you think someone
    is feeling people respond in different ways
  • Silence
  • Allow the person time to think or collect their
    thoughts or emotions
  • Avoid long silences the person may become
    agitated again
  • Assure the person that you are still there for
    them
  • Remain non-judgmental
  • Dont judge
  • Dont assume

108
Signs of Escalation
Toward Potential Crisis
  • Change from usual behavior
  • Physical signs uneven breathing, pacing, pick
    something up and put it down
  • Verbal signs voice cracks, talks fast or not at
    all

Different for everyone
109
Levels
Of Escalating Violence Potential
  • Anxiety
  • Defensive
  • Acting-out behavior
  • Reduction in tension

110
Signs of Escalation
Toward Crisis
  • Change from usual behavior
  • Physical signs uneven breathing, pacing, pick
    something up and put it down
  • Verbal signs voice cracks, talks fast or not at
    all

Different for everyone
111
Defusing a Crisis
What to Do
  • Respond dont react
  • Stay calm breathe!
  • Invite the person to sit down or to get
    comfortable
  • Give the person space
  • physical space in person
  • silence if over the phone
  • Be supportive
  • Avoid touching the person - why?

112
Defusing a Crisis
What to Say
  • Make contact
  • Assure the person I know it can be frustrating
    when you cant get the answers you want
  • Listen to the complaint or problem
  • Ask questions to clarify what need is not being
    met
  • Recognize frustration
  • Validate feelings It sounds like youve had a
    lot of things happen to you.
  • Explore options prioritize
  • What would be the most helpful to you right now?

113
Successful Intervention
  • Prevention
  • Intervene early make contact
  • Recognize and remove stressors that may be
    triggering the behavior create safety
  • Set limits confront supportively
  • Explain why the behavior is unacceptable
  • Set simple limits in a positive way
  • Explain consequences
  • Help problem solve
  • End on a positive note with follow-up if
    necessary

114
Suicide Risk Assessment
  • Have they already taken the 1st steps?
  • What are those steps?
  • Is there a plan?
  • Are the means readily available?

115
Apologize
If You Need to Do So
  • When you or someone else in your organization did
    something that led up to the crisis
  • They had to wait a long time with no
    communication about when to expect assistance
  • I am sorry that you had to wait.
  • Been given the wrong information
  • I am sorry that you got the wrong information.
    It is difficult to keep information updated.

116
Ignore It or Deal With It?
What Happens If a Situation Is Ignored or Not
Resolved?
  • The longer the stress related to the situation
    goes unchecked the more likely the situation will
    escalate
  • The earlier the intervention the less risk and
    the less energy is required

117
Advocacy Professionalism
  • Module 7

118
Module Objectives
  • Define professionalism
  • Identify professional responsibilities of health
    human service professionals
  • Define advocacy
  • Identify specific actions and processes for
    effective advocacy

119
Professionalism
  • Embrace client self-determination self advocacy
  • Practice flexibility and teamwork
  • Maintain confidentiality
  • Develop own skills as a professional
  • Confront bias abuse

120
Professionalism
  • Value your strengths
  • Identify your limitations
  • Identify ways to learn more about services in
    the organization, community, region
  • Plan for individual community initiatives to
    increase awareness access
  • State at least 3 personal actions to increase
    access to information and services in own
    community

121
Customer Service Mindset
Connect with people Don't process them
  • A customer, by definition, is anyone who receives
    services
  • Are your clients your customers?
  • How do they differ from a customer in a retail
    store?
  • How are they the same?
  • Walk a mile in someone elses shoes

122
Stress Management
  • What are you doing to manage your stress?
  • Breathe
  • Take time Out
  • Go outside
  • Walk
  • Watch the caffeine and nicotine

123
Advocacy
  • Empowering clients
  • Supporting client choice
  • Working toward system change
  • Confront people who belittle those with problems
    or disabilities
  • Be sensitive to indications of exploitation or
    abuse
  • Engage the client in the process every step of
    the way

124
Whats Different?
  • What does this symbol mean other than a triangle?

Delta
125
In Summary
  • What is the one most important thing that you
    learned or learned in a different way today?

126
To Work Toward More Positive Outcomes I Can
  • When they (do)(say) I can (do)(say)

127
End
128
Train the Trainer
  • Module 8

129
The purpose of this module is to
provide tips and suggestions to
help you train other people to use
the information in these training
materials
Purpose
130
Module Objectives
  • Identify uses formats for this training program
  • Discuss the use of electronic media for training
    delivery
  • Explain how to customize materials to the
    audience
  • Discuss effective instruction techniques
  • Practice presentation skills

131
Presentation Options
For Using the Program
  • PowerPoint software viewed with video projector
  • Go to a PowerPoint tutorial at http//www.fgcu.edu
    /onlinedesign/manage.html for hints on revisions
    to the basic program
  • Viewed as transparencies on an overhead projector
  • Shown on a PC and viewed by an individual or a
    small group gathered around a work space

132
E-learning Definitions
  • Electronic learning
  • CAI - Computer Assisted Instruction
  • WBT - Web Based Training
  • Blended Learning combination of methods
  • CAI
  • Teleconference
  • Virtual meetings
  • Discussion boards

133
Web Tools Terms
  • Web user guide
  • http//www.fgcu.edu/support/newuser.html
  • Web terms glossary
  • http//www.dc.peachnet.edu/drobinso/webcourseintr
    o/www_glossary.html

134
E-Learning
Choose wisely It may not be the answer
  • Benefits
  • Large audience
  • Distance learning option
  • Use public access computers such as libraries
  • Can be posted as web site links for easy viewing
  • Use on own schedule
  • Limitations Risks
  • Technology limitations
  • Computer access
  • Knowledge
  • Comfort intimidation factors
  • Transportation limitations
  • Isolates learner
  • Limits interaction
  • Takes discipline to schedule use
  • Increased material preparation time

135
Presentation Options
Low Tech.Just Talk Interact.
  • If an overhead or video projector is not
    available, use a copy of the slides as talking
    points for a presentation
  • Provide participants with a copy of the slides

136
To Print from PowerPoint

Photocopies or Transparencies
  • Hold down Ctrl P
  • The print window will pop up
  • All slides will be printed unless you choose
    certain pages in the print range window
  • At the print what window, scroll choose
    slides, handouts, or notes
  • If you are printing a handout choose how many
    slides you want
  • Hint the more slides printed on the page the
    smaller the letters. If your audience has
    limited vision, print no more that two slides per
    page
  • Click on the windows for black and white or
    grayscale

137
Consider the Audience
  • What is the size of your audience?
  • What are their needs?
  • What equipment is available?
  • What would be the best use of their time?
  • What documents should be revised or updated
    before your presentation?

138
Customizing Materials
Revising the Master PowerPoint Presentation
  • Customize to your audience
  • Revise to fit a schedule
  • Focus on a specific area
  • Do not revise the master work from a copy
  • Periodically save the document
  • Hint Email a saved copy to yourself

139
Scheduling/Promotion
  • Locate and schedule a room provide tables to
    write on, if possible
  • Due to peoples busy lives and conflicting
    priorities, schedule a site at least two weeks
    before a presentation
  • Create a simple flyer mail, email or fax

140
Checklist
  • Room set up
  • Enough chairs for each participant
  • Tables, if available
  • Set up in conference table or U shape when
    possible
  • Equipment
  • Power strip with several outlets, if available
  • Sufficient outlets for equipment
  • Sign-in, registration sheet, or roster to
    document participation in your training sessions
  • What information do you want to keep about your
    participants?
  • For what purpose? (mailing lists, email address
    lists?)
  • Paper
  • Pencils

141
Training Facilitation Techniques
142
Ground Rules
  • Start end on time
  • Return promptly from breaks/lunch
  • Turn pagers to vibrate cell phones off
  • Show respect and courtesy

143
Effective Instruction
  • State the goal of instruction
  • Introduce the skill(s) and why important
  • Tell them what you are going to tell them
  • Learning Objectives
  • Content/Discussion
  • Tell them what you told them Review/Summarize

144
Dos Donts
Effective Training Techniques
  • Dont
  • Cross your arms
  • Frown or scowl
  • Look away or stare
  • Point with one finger
  • Slouch
  • Appear tense/anxious
  • Clench fists
  • Hands in pockets
  • Hand hidden
  • Chew a pencil
  • Do
  • Open posture
  • Smile
  • Eye Contact
  • Sit forward, if seated
  • Relaxed appearance
  • Open palms
  • Hands at your sides
  • Arms outspread with open palms
  • Legs uncrossed

145
Summarize/Review
  • Review what they have learned by asking them
  • What one thing did you learn?

146
Evaluation
  • What do you want to evaluate?
  • Achievement of learning objectives
  • What format to use?
  • Questions What was the most useful thing about
    this training? What was the least useful?
  • Checklist such as Met goals objectives,
    information was was organized, and other areas
  • What type of scale to use?
  • Rate using standard Likert Scale of 1-5
  • 1-4
  • 1-10

147
Training Theory
  • Your goal is to not provide good training. it
    is to provide others an opportunity to learn!

148
Training Learning
  • Training
  • To coach in or accustom to a mode of behavior or
    thoughts
  • To make or become proficient with specialized
    instruction and practice
  • Learning
  • Acquire knowledge or skill
  • To gain comprehension or mastery of through
    experience and practice

149
What Do People Want?
  • Practical and relevant content to what they do
  • Bottom line What do I really need to know
  • To be entertained Adults are just kids in big
    bodies - Bob Pike
  • People stay tuned to WIFM - Whats in it for Me?

150
How Do Adults Learn?
  • Dont all learn the same so training must
    flexible enough to adjust to different learning
    styles
  • Need repetition
  • Need concrete examples
  • Need a variety of methods to experience knowledge
    skills
  • Hands on practice
  • Visual observation practice
  • Job Aids checklists handouts manuals
  • Given these factors, typical classroom training
    is not always the answer

151
Adult Learning Principles
  • Focus on how the learning can by applied in the
    real world
  • Relate the learning to learners expectations
  • Relate the information to real situations and
    experiences
  • Allow discussion and difference of opinion
  • Listen to and respect the opinions of others
  • Encourage people to be resources to each other
  • Treat people like adults

152
Learning Styles
  • Everyone has a unique learning style that affects
    how they learn and perform
  • What is Your Learning Style?

153
Listening Reading
  • Learn by researching listening to those who
    know how to perform the skill (Subject Matter
    Experts SMEs)
  • Traditional classroom settings where students
    read, take notes, work problems take pencil and
    paper tests
  • Example Learn computer skills by reading the
    manual and following demonstrations

154
Observing Imitating
  • Learn by watching someone else and then
    imitates/duplicates what they observe
  • Example Learn computer skills by sitting by
    someone and duplicating what they see
  • What are some of the problems with imitating
    someone else?

155
Doing
  • Learn primarily by trial and error
  • Try new things and then modify what they do as
    they go along
  • Example Sailing - continuously setting and
    adjusting the sails to stay on course

156
Receiving Feedback
  • Learn by having someone who has observed their
    behavior give them feedback or advice on what to
    change
  • Example Learn computer skills by having others
    observe what they do and coach them
  • Will this learner always take the initiative to
    ask about how to learn something?

157
Processing Information Impact on
learning
  • Visual
  • Auditory
  • Kinesthetic

158
Learners as Trainers
  • What learning style will someone training others
    most likely use?
  • How can that style impact the learner(s)?
  • What are the implications about training others?

?
159
Training Techniques Tools
160
Accelerated Learning
Research shows that adults learn the most
effectively when all of their senses are
involved, especially what they see. They also
learn more effectively when they are relaxed.
Weave humor and use creativity into your
presentations to create an environment that
encourages people to learn
  • During breaks play music
  • humor
  • Use humor
  • When people answer questions throw candy

161
Games Ice Breakers
  • Effective Training Techniques

162
Introductions toys
  • Gather several toys raiding the bottom of a
    childs toy box, yard sales, dollar stores - most
    lt 1.00
  • clay, legos, blocks, keyrings, deck of cards,
    clocks, slinkies, spark plugs, fake money
  • Place toys on tables at the training site
  • Post a flip chart with these instructions
  • Choose a toy from those you see that represents
    what it is like
  • finding information for someone who needs it
  • living in a community
  • being part of a team
  • Be prepared to tell the group what you chose and
    why
  • (Can add other parts to this such as My name is
    What I expect today is)

163
Introductions
  • Pair off with someone you do not know, dont know
    very well, and/or dont work with
  • Ask your partner any of these questions and be
    prepared to introduce them and what they said
  • What do most people not know about you?
  • What one place do you hope to visit?
  • Remembering a time when someone taught you how to
    do something, what did that individual do that
    helped you learn?

164
Introductions
  • Pair up
  • Think about the last time that you could not do
    something or do it well (hobby, game, sports)
  • Talk with your partner how did that make you
    feel?
  • Identify your expectations for this workshop

165
Expectations
Always start a class asking participants what
they expect
  • Ask participants what they expect from the class
  • Write these expectations on a flip chart
  • Cross off those that are not part of this
    training class and refer to other classes where
    the skills will be learned
  • Post the expectations
  • At the end of the class review the list
  • Decide how the expectations can be met that were
    not

166
Getting to Know You
  • Have each person fill out a short questionnaire
    about the person on the left
  • favorite color
  • car driven before their present car
  • does the person like broccoli
  • where was this person born
  • does this person like to fly, etc.
  • Tell the group to pass the questionnaires to the
    person on the left to see how many answers were
    correct.

167
Three Truths A Lie
  • Ask participants to think of three "facts" about
    themselves but two were true and one is a lie
  • Go around the group and each person will tell
    their three facts
  • The group will try to guess which is the lie
  • You can have people write down what they think is
    the lie and then give a prize to the person who
    gets identified the most lies
  • Good ice-breaker and opens up dialogue about
    making assumptions and stereotyping other people

168
Cartoons
  • Watch for appropriate cartoons in daily and
    weekend newspapers
  • Ask colleagues and peers to be on the lookout for
    them
  • Make transparencies from photocopies or scan into
    your computer and cut and paste into into Power
    Point and other presentations

169
Experiential Learning
  • Everyone stands in a circle
  • Give instructions
  • I will throw in this ball of yarn
  • Once you receive it throw the ball to the next
    person in the circle who you provide services or
    information to or you get services or information
    in order to do your job
  • Continue throwing the yarn until you have thrown
    the yarn to everyone who either supplies you with
    services or information or you provide to them
  • Once group is finished, ask Lets look at this
    activity and see what it has to do with helping
    people find resources?
  • Identified gaps
  • Interdependence

170
Experiential Learning
  • Collect several items
  • balls
  • toys
  • Give Instructions
  • I will throw in an item
  • Toss it to someone else
  • The object of this activity is to keep the item
    moving without dropping it
  • Once the one item is being tossed throw in
    additional items
  • Debrief to include statements and observations
    about
  • Importance of communication including non verbal
  • Interdependence
  • Multi-tasking and complexity
  • Teamwork

171
Drawing Metaphors
  • Ask group to draw a map or mural
  • Vision of the future
  • How they feel about a new change of some kind or
    it could be capturing a "career journey" or
    learning journey of some sort where you represent
    past, present, future
  • Encourage people to use symbols and metaphors and
    colors to communicate their message--not just
    words.
  • Use a weather analogy or sports analogy to get
    the group going--then leave it to their
    imagination
  • Create a motto or coat of arms
  • Use crayons or scented markers with colored paper
    or flip charts
  • Allow 15-20 minutes for discussion and drawing
  • Ask group to post and have a spokesperson share
    their picture

172
Group Activities
  • A group cheer!
  • Create team names
  • Making up parody skits of what "not to do" not
    to say
  • Play Jeopardy, Family Feud or Wheel of Fortune

173
Difficult Participants
  • KNOW-IT-ALL
  • KARATE EXPERT
  • ANGRY PARTICIPANTS
  • Stay calm and relaxed
  • Listen carefully, let him/her know you heard them
  • Use challenge as a learning opportunity
  • Ask the person to discuss it privately after
    class or during break

Yada Yada
174
Difficult Participants
  • SHY
  • EMBARRASSED
  • UNEASY PARTICIPANTS
  • Call on him/her by name cautiously
  • Use humor (tell an experience of your own where
    you were embarrassed, etc)
  • Ask for a show of hands

175
Difficult Participants
  • OVERLY EXCITED
  • TALKATIVE
  • DOMINANT PARTICIPANTS
  • Ask closed-ended questions
  • After his/her comment, ask what the rest of the
    group thinks
  • Ask him/her to link the comment with the subject
    - Columbo
  • Summarize the subject and move on

176
Advantages Drawbacks
of Training Methods
  • Case Study
  • Demonstration
  • Group Discussion
  • Role Play
  • Structured Exercise
  • Trainer Presentation

177
Practice Feedback
  • Now it is your turn to practice
    your presentation skills
  • 30 minutes to prepare
  • 5 minute presentation
  • What worked?
  • What improvements?

178
Improving Performance
  • Based on self assessment and the feedback you
    received from others, how will you improve your
    ability as a trainer and facilitator?
  • 1
  • 2
  • 3

179
Sources
Materials adapted from the following sources
  • The ABCs of I R, Alliance for Information and
    Referral Systems, Seattle, Washington.
  • Overview of 2-1-1, United Way of Metropolitan
    Tarrant County First Call, 2001.
  • Extraordinary Information Referral, Community
    Council of Greater Dallas, 2001.
  • People First training program, 2001, Zanda
    Hilger, M. Ed., LPC for the Area Agency on
    Aging of North Central Texas.
  • Train the Trainer materials developed by Zanda
    Hilger.

180
End Train the Trainer Module
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