THE DELIVERY AND SUPERVISION OF OUTREACH SERVICES Project SAFE Illinois Department of Human Services Office of Alcoholism and Substance Abuse 100 West Randolph Street, Suite 5-600 Chicago, Illinois 60601 Nick Gantes, Associate Director DHS Project Coordinator: Maya Hennessey Authors: Part I: William L. White Part II: William L. White Pamela Woll Susan Godley Content Consultant: Jan Motsinger Lighthouse Institute Project Coordinator: Randall Webber This manual was developed by Chestnut Health Systems/Lighthouse Institute through funding provided by The Illinois Department of Human Services, Office of Alcoholism and Substance Abuse. 2 Voices of Hope Project SAFE THE DELIVERY AND SUPERVISON OF OUTREACH SERVICES Part I: Voices of Hope: An Orientation Manual for Outreach Workers Project SAFE Voices of Hope 3 4 Voices of Hope Project SAFE You were always there for me, the tender wind that carried me. A light in the dark, shining your love into my life. You=ve been my inspiration, through the lies you were the truth. My world is a better place because of you. You were my strength when I was weak, You were my voice when I couldn=t speak. You were my eyes when I couldn=t see, you saw the best there was in me, lifted me up when I couldn=t reach. You gave me faith, >cause you believed. I=m everything I am because you loved me. From ABecause You Loved Me@ Words and Music by Diane Warren Performed by Celine Dion 8 1996 Realsongs (ASCAP) Warner Bros. Publications Project SAFE Voices of Hope 5 6 Voices of Hope Project SAFE Voices of Hope An Orientation Manual for Outreach Workers Introduction .....................................................................................................................................9 Acknowledgments..........................................................................................................................10 1.0 Our Clients .......................................................................................................................11 1.1 Addicted Women and Their Children....................................................................13 1.2 Multiple-Problem Clients and Families.................................................................21 1.3 The Dependency Cluster........................................................................................27 1.4 Learned Helplessness: Implications for Outreach .................................................29 2.0 Becoming an Outreach Worker......................................................................................37 2.1 What Does an Outreach Worker Do? ....................................................................39 2.2 Outreach: What Does it Take? ..............................................................................47 2.3 Early Fears ............................................................................................................57 2.4 Personal Style........................................................................................................65 2.5 Learning about Addiction and Recovery...............................................................71 2.6 Realistic Expectations ...........................................................................................79 3.0 Outreach Worker Functions...........................................................................................87 3.1 Client Engagement ................................................................................................89 3.2 Problem Solving Around Obstacles to Recovery ..................................................95 3.3 Home Visits ..........................................................................................................99 3.4 Monitoring Abuse and Neglect Issues ................................................................103 3.5 Providing Transportation for Addicted Women in Treatment.............................107 3.6 Linkage to Support Groups .................................................................................113 3.7 Parenting Support ...............................................................................................121 3.8 Crisis Management ..............................................................................................125 4.0 Issues in Service Delivery..............................................................................................127 4.1 Providing Outreach Services to Women of Color ..............................................129 4.2 Empowering Versus Enabling ............................................................................139 4.3 Minimizing Manipulation ...................................................................................145 4.4 Domestic Violence...............................................................................................151 4.5 Safety Tips for Outreach Workers ......................................................................157 4.6 Ethical Issues in Providing Outreach Services to Women .................................165 5.0 Professional Development Issues..................................................................................173 Project SAFE Voices of Hope 7 5.1 Time Management ...............................................................................................175 5.2 Stress, Strain, and Strategies of Self-Care ...........................................................183 5.3 Career Mobility....................................................................................................191 Appendices..................................................................................................................................195 A Developmental Model of Recovery .........................................................................................197 The Management of Resistance in the Treatment of Addicted Woman with Histories of Child Neglect or Abuse ......................................................................211 Sexual Trauma and Substance Abuse Developmental Trajectory and Implications for Treatment....................................................................................................215 The Delivery and Supervision of Outreach Services Supervision of Outreach Services 1.0 Recruitment and Selection of Outreach Workers ............................................................225 2.0 Orientation, Training, and Professional Development ....................................................235 3.0 The Supervision of Outreach Workers ............................................................................243 4.0 Enhancing the Safety of Outreach Workers.....................................................................251 5.0 Managing the Stress of Outreach Work: Supervisory Strategies ....................................261 6.0 A Final Note.....................................................................................................................267 8 Voices of Hope Project SAFE Introduction During the past ten years, Illinois has pioneered an innovative approach toward addressing the collision of maternal substance abuse and child maltreatment within the state. This initiative began with a Department of Health and Human Services demonstration grant that brought together the resources of the Illinois Department of Alcoholism and Substance Abuse (DASA) and the Illinois Department of Children and Family Services (DCFS), as well as local community resources, to provide substance abuse treatment to women with histories of abuse or neglect of their children. Between 1986 and 1996 this initiative, which came to be known as Project SAFE, spread to nineteen Illinois communities and treated more than 5,000 women and their families. One of the most innovative aspects of Project SAFE is a style of outreach work that has eliminated many of the obstacles that have kept significant numbers of women from entering or successfully completing substance abuse treatment. The outreach services have been such an important part of the success of Project Safe that these services have been emulated in additional Illinois projects that involve collaborative efforts between DASA and DCFS. While our knowledge of how to deliver these outreach services has grown, it has existed primarily as a body of oral folklore passed from worker to worker. While this body of folklore is a rich one, much knowledge has been lost as outreach workers and their supervisors have changed positions within the field or left the field for new endeavors. This manual is an effort to stem this loss of knowledge. The Outreach Worker Orientation Manual is designed to provide support to local agencies in their efforts to recruit, train, and supervise outreach workers who are working with addicted women and their families. The Manual has been designed for the widest possible utility. It may be read by a new outreach worker. It can serve as a framework of orientation used by an agency supervisor to acclimate a newly hired person to the role of outreach worker. It is also designed to be used as a training manual for regional or statewide orientation sessions for new outreach workers. A companion manual that also includes training tips and discussion guidelines for use with this manual has been developed for supervisors of outreach workers. The information in this manual is drawn from the following sources: 1) a review of the professional and folk literature on the treatment of addicted women and their children, 2) information drawn from reports