Information and referral program training manual june 2013 by 211 Central East Ontario

Information and Referral Program Employee Training Manual Updated: May 2013

Community Connection - Information and Referral Program Employee Training Manual Table of Contents Goal of Training Program ___________________________________________________________ 41 Community Connection Overview ____________________________________________________ 42 Information and Referral ___________________________________________________________ 45 What is I&R? ___________________________________________________________________________ 7 Tenets of Information and Referral - Information and Referral Bill of Rights ________________________ 8 Philosophy of Information and Referral ______________________________________________________ 8

Communication Skills ______________________________________________________________ 10 Needs Assessment_________________________________________________________________ 15 Follow-Up, Advocacy, Confidentiality _________________________________________________ 56 Attitudes and Work-Related Behaviours _______________________________________________ 60 Quality Assurance ________________________________________________________________ _62 Human Service System- Title Page ____________________________________________________ 26 Employment _____________________________________________________________________ 27 Financial Assistance________________________________________________________________ 64 Food Assistance ___________________________________________________________________ 74 Government______________________________________________________________________ 38 Health Benefits and Services ________________________________________________________ 75 Housing _________________________________________________________________________ 79 Legal ____________________________________________________________________________ 43 Transportation ____________________________________________________________________ 81 Accessing Human Services Information: Resource Database and Internet ____________________ 46 Specialized Inquirer Populations _____________________________________________________ 85 Addicts & Addictions: Alcohol, Drugs, Substance, Gambling, Sex ___________________________ 87 Adolescents ______________________________________________________________________ 53 People with Disabilities____________________________________________________________ 91 Deaf, Deafened or Hard of Hearing ___________________________________________________ 59 Ethnic and Cultural Differences ______________________________________________________ 65 Mental Health ____________________________________________________________________ 69 Seniors __________________________________________________________________________ 72

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Table of Contents - Continued

Sexual Diversity ___________________________________________________________________ 76 Difficult/Challenging Inquirers _______________________________________________________ 87 People in Crisis ___________________________________________________________________ 88 Emergency Suicide In-Progress _______________________________________________________ 92 Information and Referral in Times of a Disaster ________________________________________ 133 Abuse/ Assault/ Violence ___________________________________________________________ 97 Child Abuse and Neglect _________________________________________________________________ 97 Elder Abuse __________________________________________________________________________ 100 Spousal Abuse ________________________________________________________________________ 101

Violence ________________________________________________________________________ 109 Time Management _______________________________________________________________ 111 Stress Management ______________________________________________________________ 115

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Goal of Training Program This training guide provides orientation and training in the combination of skills and knowledge that comprise effective Information and Referral. The content is appropriate both for those who are formally designated as information providers in their job descriptions, and those who are informally called upon to act as information providers due to the frequency and nature of their contact with the public. We would like to thank and acknowledge Findhelp in Toronto for many items from which we have been able to borrow inspiration and content. Specific objectives of Community Connection’s Training Program are: •

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To provide an introduction to Community Connection as a community information centre, to information and referral services, and to the roles of I&R Specialists (including the Information and referral Bill of Rights and the Philosophy of Information & Referral To identify the steps involved, and the skills and competencies required in conducting an effective needs assessment To identify and practice effective communication and listening skills as they relate to the information and referral process To provide basic information and strategies on how to assist challenging inquirers, specialized populations, and inquirers in crisis To provide a basic introduction to, or review of, sources of information on our complex human service system and examine their use

Staff Will Review the Following Operational Policies and Procedures Please consult the Policies and Procedures Manual for items including: • ACD and phone systems • case studies • certification requirements • contact tracking • hours • job descriptions • other operating issues • performance reviews • special intake projects (eg: Winter Warmth, LEAP, etc) • Memorandum of Understanding with partner agencies (eg: Crisis, Military.etc) • policies on advocacy, confidentiality and follow-up • quality assurance • schedules • supervisory observation • testimonials • training log • TTY, best practices and procedures with Deaf Access

Information and Referral Program – Training Manual

Community Connection Overview Community Connection - History The original notion of Community Information Centres can be traced to situations where people were disoriented, displaced or requiring special assistance in coping with daily living. In the 1940’s “Citizen’s Advice Bureaux” was established in Britain to help people cope with the aftermath of WWII. The United States “War on Poverty” programs of the 1960’s lead to neighbourhood Information Centres, many of which became information and referral agencies. The first Canadian information and advice service was founded by the Social Planning council of Toronto in the early 1950’s. Since then over 75 Community information Centres have opened their doors in Ontario. All provide personalized assistance to people by explaining the services and procedures of human service agencies in their communities. Locally the Collingwood and District Information Centre had its humble beginnings in the Stayner Town Hall as a Crisis Intervention program, staffed by community volunteers and directed by Reverend Douglas Stokesbury. In 1969, the centre moved to the former Connaught Public School. This move was the first step in offering and information and referral service. In 1971 our first provincial funding was received through the Ministry of Culture and Recreation. In 1987, we moved to the ground floor accessible store front accommodations at Cameron Street. In December 1993, the Centre went on the move for a more reasonable rent with the intention to maintain our current tenants. We then moved to 50 Hurontario Street in downtown Collingwood. Again we outgrew our quarters and found new accommodation at 275 First Street with lots of room for expansion. The expansion continues. At the end of June 1979, Community Connection became a registered charity. The Community Connection charitable number is 05-94424-09. In May 1990, Community Connection was the first to become automated using the On-line Ontario System. Major Characteristics of Community Information Centres (CICs) •

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Deals with the “whole person”, rather than focussing on one aspect of human need such as financial or health problems. They are generalists in the sense that they provide Information and Referral about the whole range of human services in the community Maintains extensive resource files or databases on the services of community organizations, government agencies and departments serving their communities Universal services available to anyone within their geographic boundaries Common philosophy of “taking the time to listen” and of encouraging the independence of customers whenever appropriate. They believe everyone has the right to information about human services in their community Provide a confidential service Most CICs are charitable non-profit organizations with voluntary boards of directors or management committees that are drawn from, and accountable to, their communities. Community Information Centres play a role in identifying gaps in services and trends in their communities

Information and Referral Program – Training Manual

Community Connection - Today Vision: Our Vision is healthy communities in which everyone has access to the services they need. Mission: Our Mission is to be the most effective gateway to the community’s health, social and disaster service networks. Principles: We believe in the strength of community and creating alliances with people and organizations to affect positive change. Community Connection is a community-based non-profit agency, providing an easier way to find answers to life’s toughest questions. 211 Community Connection delivers 211, an information and referral service providing information on the full range of human services from all levels of government, the non-profit sector, the private voluntary sector, by individuals in the community as well as from the business sector. Individualized information is free, confidential and available to everyone. Services are provided by telephone, chat, TTY, in person or through the email & the internet. Users include the general public, often people who have trouble accessing services because of language, age, culture, poverty, lack of education, illiteracy, fear of violence or unemployment. Human service providers such as social and constituency workers, health care professionals, business people, government officials and students are also major users. • • •

•

We staff the 211 service from 7:30 am to 8:30 pm week days, and from 8 am to 8:30 pm on weekends and holidays. Toronto’s Findhelp Service staffs the 211 service overnight starting at 8:30 pm. Our staff responds to thousands of requests for information each year. Our agency is staffed by certified information & referral specialists, who assess problems and provide information that directs callers to the appropriate and relevant community, social, health or government organization. We maintain various websites containing records created by 211 data partners and Community Connection staff. 211 Central East Expansion History Community Connection serves 11 counties and districts in central Ontario. 211 was launched into counties over time. County Launch Date Simcoe County Muskoka District Grey County Bruce County Northumberland County Peterborough County City of Kawartha Lakes Haliburton County Perth County Huron County

November 2005 November 2008 July 2009 May 2009 May 2009 June 2009 September 2009 September 2009 June 2010 June 2010

Parry Sound District

November 2011

Information and Referral Program – Training Manual

Information and Referral (For AIRS Standards and Competencies please see HR Policy & Procedures Manual) What is I&R? – Information vs Referral Information and Referral (I&R) is a complex and dynamic process which involves working thoughtfully with people, properly assessing the inquirer’s requirements, listening to and understanding their needs and problems, and then carefully directing them through the maze of community, government and social services. In addition there are complex eligibility requirements and application procedures to communicate to the inquirer. Effective I&R provides the critical function of helping individuals to access services that best address their needs. Information Information provision is the process of researching and giving information in a response to a direct request for information from the inquirer. Information can range from a limited response (such as an organization's name, telephone number, and address) to detailed data about community service systems (such as explaining how a group intake system works for a particular agency), agency policies, and procedures for application. Example of an information request: “Who is my Member of Parliament?” This does not involve any assessment of need. The inquirer appears clear on what information he or she wants and needs. In information provision, the inquirer is directing the information provider. Referral Referral provision involves the application of a wide range of skills and competencies. It involves gathering information, assessing the inquirer's need, identifying appropriate resources, assessing response modes and indicating organizations capable of meeting those needs. It further includes providing enough information about each organization to help inquirers make an informed choice, helping inquirers for whom services are unavailable by locating alternative resources, and, when necessary, actively participating in linking the inquirer to needed services. Inquirers do not necessarily know what their needs are or they may encounter difficulty articulating them. In referral provision, the information provider is directing the inquirer. History of Information and Referral I&R came as a result of World War II in Britain and the United States. The Americans developed ‘Veteran Information Centres’ (VICs). By 1946, there were 3,000 in operation. The primary purpose of the VICs was to provide information to bets on all governmental benefits and community services and make referrals to other agencies for additional help The VIC model became a significant model for early Information and Referral Centres in the USA. These early centres were organized and coordinated by the Red Cross and the United Way after World War II. The Alliance of Information and Referral Systems (AIRS) was incorporated in 1973 to improve access to services for all people through information and referral.

Information and Referral Program – Training Manual

AIRS is … • the international voice of Information and Referral (I&R). • a professional membership association of over 1,000 organizations, supporting over 30 state and regional affiliates, bringing people and services together. • in partnership with the United Way, the premier leader in the development of the 2-1-1 movement that has transformed access for human services. • the driving force behind the development of clear and consistent professional Standards that benchmark every aspect of quality I&R. • the administrator of an accreditation program that measures an organization’s ability to meet the AIRS Standards, and a certification program that evaluates the competence of I&R practitioners. • a provider of training, support and technical assistance that culminates in an annual international conference that attracts over 700 delegates to participate in nearly 100 workshops. • a national leader in human services that participates in critical partnerships with the United Way of America, the National Association of State Units on Aging, the National Emergency Number Association, the American Association of Suicidology and InformCanada. • a non-profit organization as determined under section 501(c)(3) of the Internal Revenue Code. • a membership organization committed to serving our members at the same level that they serve their clients. • The web site is http://www.airs.org. Tenets of Information and Referral - Information and Referral Bill of Rights The Alliance of Information & Referral Systems (AIRS) supports practices that respect everyone’s right to: 1. Anonymous and/or confidential access to information. 2. Be empowered to the extent possible. 3. Assistance based on the inquirer's personal value system. 4. Treatment based on respect and sensitivity to cultural, generational and age/disability related differences. 5. Self-determination and the opportunity to access the most appropriate I&R service available in the system. 6. Accurate and comprehensive information about services. 7. An appropriate level of support in obtaining services. 8. A grievance procedure if they feel they have not received satisfactory service from the I&R specialist. Philosophy of Information and Referral Information and referral specialists are unique in their understanding of and sensitivity to the needs of people seeking help and information. I&R specialists shall: 1. Attempt to understand each inquirer’s situation including the origins of the difficulty, the feelings inquirers have about their circumstances, the personal resources inquirers may bring to bear on the issue, and the barriers to resolution of the problem. 2. Offer immediate and appropriate response when the individual is experiencing a crisis or other emergency situation. 3. Be available, not to solve inquirers’ problems for them, but to empower inquirers to understand and solve their own problems. 4. Help inquirers prioritize their needs and build an action plan. 5. Help inquirers identify resources that can meet their needs. 6. Be careful not to overwhelm inquirers with a myriad of options or provide them with too few to allow them an informed choice. 7. Advocate on behalf of inquirers who require extra support to access necessary services either because they don’t have the appropriate skills or because the service is difficult for the person to access. 8. Follow up on all cases involving endangerment and situations in which the specialist believes that the inquirer does not have the necessary capacity to follow through and resolve his or her problem. Information and Referral Program – Training Manual

Principles of an Information and Referral Service Information on community services increases an individualâ&#x20AC;&#x2122;s independence, ability to solve problems and to participate fully in the life of the community. The underlying assumptions or principles to which a community information service must conform within the limits of available resources are: 1. Everyone has the right to free information on community services 2. The confidentiality of the customer must be ensured 3. Information on community services must be integrated, presenting programs provided by governments, voluntary and other organizations 4. Information must be accurate, unbiased and present the full range of available options 5. Information must be presented in a simple, non-threatening, non-patronizing manner directed to people and their needs 6. The individualized problem-solving component must be part of any Information and Referral service 7. Information must be presented in a manner that assists users to become knowledgeable consumers of community services 8. The service is responsible to assist the individual to receive a service to which she or he is entitled 9. Information must be relevant and adaptable to the changing needs of users 10. Information should be provided in languages other than English and/or French where numbers warrant 11. The structure of the database must allow for frequent updating and expansion in order to accommodate the rapid rate of change in information on human services 12. Organization and presentation of the information must facilitate its use 13. The service must be provided in a cost-effective manner 14. An Information and Referral service must be supportive of a multiple access system and thereby encourage the sharing of databases with other information providers 15. An Information and Referral service must be highly visible, accessible and responsive to the changing information needs of the community 16. A service must have a social reporting function through which it identifies gaps and trends in services and reports these to the appropriate bodies 17. Develop and maintain a comprehensive resource database of information about organizations that provide human services for the community. 18. Follow up with inquirers and/or service providers to determine whether the needed service was obtained and whether it adequately met the need. 19. Develop cooperative relationships to build a coordinated information and referral system that maximizes the utilization of existing comprehensive and specialized I&R providers. 20. Develop collaborative working relationships with local service providers to build an integrated services delivery system that ensures broad access to community services. 21. Participate in community education activities regarding available services, providers and the service delivery system. Services for Individuals Information and referral programs are the traditional points of contact for people in the community who require information about or linkage with human service providers. I&R programs provide early intervention and resource support for people in times of personal and family crisis. They simplify access through the maze of social service programs and help people find the strength to cope even in the most difficult situations. The I&R process reinforces the individual's capacity for self-reliance and selfdetermination through education, affirmation, advocacy, collaborative planning and problem solving.

Services for Communities Information and referral resource databases support referral efforts and also provide an inventory of human services for the community. I&R Internet sites, resource lists, directories, electronic databases and other resource database products provide information alternatives for people who do not need the professional assistance of an I&R specialist. I&R statistics reveal gaps in service and help to establish Information and Referral Program â&#x20AC;&#x201C; Training Manual

priorities for funding. Information and referral is a profession with a comprehensive understanding of the human services delivery system and a holistic view of people's wants and needs. I&R programs are uniquely positioned to meet the information needs of individuals and families, as well as agencies, community planners and funding organizations. Information and Referral is NOT: • • • • • • •

Counselling or Psychotherapy Telling people what to do Diagnosing Threatening Blaming Labelling Converting

Communication Skills Effective communication is the process of understanding and being understood “A Variety of Factors can affect the Communication Process” They can be grouped under 5 areas: 1. Attitudes • Negative attitude • Personal attitude • Prejudices/biases 2. Listening • Not listening • Missing important information • Not focusing on what is being said 3. Language • Use of jargon • Inability to communicate with a customer who is not comfortable speaking English • Use of technical terms 4. Organization of the communication • Is it clearly thought out by the customer or counsellor? Did they say what they mean or ask for what they needed? • Has the counsellor or customer processed the information that they are going to communicate? Did they think before they spoke? 5. Methods of communication • Verbal • Written • Body language • Voice tone • Cultural differences • Technological, i.e. voice mail, auto-attendant, e-mail, faxing, TTY

Information and Referral Program – Training Manual

Effective Listening Skills Positive Listening Habits Besides ridding themselves of bad listening habits, people can acquire positive listening habits. Listed below are a few descriptions of behaviours that can lead to effective listening. Paying attention: If people really want to be good listeners, they must force themselves to pay attention. When speakers are dull conversationalists, a listener must sometimes make an effort to keep from being distracted by other things. It is important not only to focus on the speakers, but also to use nonverbal cues / minimal encouragers (see next item below) to let them know they are being heard — such as eye contact, nods, smiles, or (in telephone interviews) minimal encouragers like “uh huh” and “really”. Minimal Encouragers: One of the simplest ways to show that you are listening is through minimal encouragers. These are little conversational fragments such as, “ah ha”, “mm mm”, “I see” that keep a conversation flowing. They are useful tools to use when you do not want to interrupt but want to let your caller know you are interested in what they are saying. Listening for the whole message: This includes assessing meaning and consistency in both the verbal and nonverbal messages, and listening for ideas, feelings and intentions as well as facts. It also includes hearing things that are unpleasant or unwelcome. Hearing before evaluating: Not drawing premature conclusions is a valuable aid to listening. By questioning the speaker in a non-accusing manner, a listener can often discover exactly what the speaker has in mind – which many times is quite different from what the listener assumed they were hearing. Pauses: Avoid long pauses in the early stage of the call/interview. Effective pauses are to be encouraged – when you want information to sink in and for the inquirer to think through whatever has been discussed. When you are waiting for the inquirer to gather/ calm themselves or remember something. Be patient, don’t push, don’t go too fast. Let the Inquirer Talk: Make sure that you are not doing all the talking yourself. Questions as Statements: Phrase some questions as statements to avoid interrogating the inquirer. Non Verbal Cues: Be aware of body language, pauses, hesitations, fidgeting, taping pens, sighs, looking at watch, etc. Sometimes we say one thing with words and another with our body. Be careful your posture does not reflect boredom, distraction, disinterest, distrust etc. Keep your facial expressions appropriate and your tone of voice warm and friendly. Remove environmental distractions if possible. Observation: Observation involves being aware of the total person. • In face-to-face interviews, the interviewer should be aware of what is being said non-verbally as well as verbally. • In telephone interviews, the interviewer should be aware of tone of voice, hesitations or pauses, and other clues that add to understanding of what is being said verbally and also to what is being left unsaid. Language / Voice: The I&R Specialist should: • use articulate, clear, precise language; • match his/her choice of words and syntax to the inquirer’s needs and level of sophistication (e.g., avoids professional jargon, street slang when inappropriate); Information and Referral Program – Training Manual

• • •

use a well-modulated tone of voice (avoids speaking too softly or loudly); have an adequate grasp of English or other language in which s/he has been assigned to take calls; allow the inquirer to communicate in his or her own style. Poor Listening Habits: What to Avoid

Most people spend more time listening than on any other communication activity, yet a large percentage of people never learn to listen well. One reason is that they develop poor listening habits early on that continue with them throughout their lives. The following list contains some of the most common poor listening habits. One way people can improve their listening is to identify their own poor listening habits and make an effort to change them. Not paying attention: Listeners may allow themselves the distraction of thinking of something else. Not wanting to listen often contributes to lack of attention. Pseudo-listening: Often people who are thinking about something else deliberately try to appear as though they are listening. Such pretence may leave the speaker with the impression that the listener has heard some crucial information or instructions. Listening but not hearing: Sometimes a person listens only to the facts or details, or to the way they were presented, and misses the real meaning. Rehearsing: Some people only listen until they want to say something; then they quit listening, start rehearsing what they will say, and wait for an opportunity to respond. Interrupting: The listener does not wait until the complete meaning can be determined, but interrupts so forcefully that the speaker stops in mid-sentence. Hearing what is expected: People frequently think that they actually hear speakers say what they expect them to say. Alternatively, they refuse to hear what they do not want to hear. Or they finish someone’s sentence for them. Feeling Defensive: The listener assumes that they know why something was said, or expects to be verbally attacked. Listening for a point of disagreement: Some listeners seem to wait for the chance to attack someone. They listen intently for points with which they can disagree. Empathy busters: words and actions that make people feel put down, ignored, not understood, or not cared for. Belittle: Put down the other person and his/her concerns. “How can you let a little a little thing like that bother you? Dismiss: Brush off the other person’s concerns. “Oh don’t worry. It’s fine.” Ignore: Change the subject or talk about yourself.

Information and Referral Program – Training Manual

Active Listening Techniques These techniques should help the inquirer feel more confident about discussing their situation. TECHNIQUE

PURPOSE

METHOD

EXAMPLE

To help you understand what the speaker is saying. To learn more about the inquirer’s situation To show you are listening and understanding what is being said To check your interpretation of what you have heard to make sure you understand correctly To show that you understand how the speaker feels To help the speaker evaluate her own feelings after hearing them expressed by someone else

Ask open-ended questions, that cannot be answered with only a "YES" or "NO"

“If you don’t finish, what will happen?” "When did you first notice this?” "Can you help me picture this situation?” "So you think that the organization refused you a promotion because you are an immigrant. Am I right?"

Validating

To acknowledge the worthiness of the speaker To show respect without necessarily agreeing with what the speaker says

Show appreciation for the speaker's positive intentions, values and efforts Recognize the value to the speaker of his issues and feelings

Empathy

Acknowledge and support the inquirer’s feelings utilizing empathy rather than sympathy. You do not know exactly how they feel or what they are going through. But you understand that they are going through something difficult

Demonstrate that you care about the inquirer and believe you have some understanding of their unhappiness or displeasure. Empathy might also manifest itself with clarifying, reflecting, and validating

Clarifying

Restating / Paraphrasing

Reflecting

Information and Referral Program – Training Manual

Using your own words, state briefly what the other person has said Encourage the speaker to correct you if you are wrong

Identify the speaker's emotions. Encourage the speaker to correct you if you are wrong

"It sounds as if you felt humiliated when you were criticized in front of your co-workers. Is that right?" "You were devastated when your dog was killed because she was your best friend." "I know that it has taken a lot of courage for you to speak to me about this". (Positive effort) "The respect of your colleagues is very important to you". (Positive value) “I’m really sorry you’re having such a hard time”.

TECHNIQUE

PURPOSE

METHOD

EXAMPLE

Offer your expertise, skills, ear, database etc. for their ‘use’ but don’t tell people what to do

“Is there anything I can do to help? NOT “You should go right up and tell her off.”

They are questions that cannot be answered with a “Yes” or “No

They are questions that begin with “Tell me …”, “How …”, “Where …”, “Why …” or “What …”.

These are questions that only require a “Yes” or “No” answer.

“Have you applied for Employment Insurance?”

If your inquirer is telling you about the difficulties the family is having with a teenage son and then starts talking about the weather, you use verbal tracking to bring them back Be aware of your inquirer’s feelings, really listen to what they are saying and “mirror” and or reflect their emotions back to them. “Summarize” the important details and double check with the inquirer to ensure you haven’t missed anything.

So I understand that when your son does …”

for them. Offer help, don’t instruct/ dictate

Open and Closed Questions (see also Questions section under Needs Assessment)

Closed questions (see also Questions section under Needs Assessment)

Verbal Tracking

Don’t put the inquirer’s back up, don’t take away their ability to make decisions for themselves Open-ended questions are used when we want more information or details about a situation. Closed questions are used when you simply need specific information without details. Verbal Tracking helps to keep inquirers focussed.

Mirroring/Reflecting

Mirroring reflects emotions and empathy.

Summarizing

Summarizing is critical in making the appropriate referral. It lets the inquirer know that you are listening

Information and Referral Program – Training Manual

Many mothers do it naturally, i.e. a child skins his knee, runs to mom and she say, “Oh that must hurt, I’ll get a band aid”, and the child feels better already. “So the most important thing for you to find at the moment is ‘x’ and once that is organized, you’ll call us back to find information regarding ‘y’. Is that your understanding at the moment?

Needs Assessment High quality I&R service delivery takes time and patience. • Following a series of steps in the information, referral and assessment process is helpful when assisting inquirers. This process involves asking relevant questions, gathering information and assessing urgency. • If I&R providers neglect to ask important questions to clarify situations, they run the risk of making assumptions about what the inquirer has to say. • All I&R Specialists must read and understand the section on ‘Attitudes and Work Related Behaviours’ for important information on guiding the behaviour of the Specialist in carrying out the I&R work. • The assessment conducted will determine whether the inquirer is referred to a direct service provider or to another source of information. • Generally there are two types of referrals: o To an organization where the inquirer can receive a direct service – e.g. a food bank or translation service. o To a source of information – e.g. a community legal clinic or a community or government information centre. • Assessment = The caller's understanding of his/her need + the information obtained from your interview + your observations (caller's mood, language, behaviour, background noise) + your understanding of available resources Steps in the Needs Assessment Process Needs Assessment Activity ACD Directs Call

Description Depending on who is signed in, for how long since last call, and the I&R Specialist’s priority level, the ACD (automatic call distribution) system will direct the call to an I&R Specialist

Prompt Answer

Try to answer the call as quickly as possible

Greeting

Offer a proper introduction or greeting e.g. “Hello, Bonjour, 211, This is [name], how may I help you?” [Professional and courteous, not too formal or informal, warm, friendly tone, not bubbly]

Establish Rapport with Inquirer

• Use active listening techniques (see Communications section); Phrase some questions as statements (to avoid interrogating the inquirer) • Avoid long pauses in the early stage of the call/interview • Explain the need to ask questions and why the requested information is necessary • Acknowledge and support the inquirer’s feelings utilizing empathy rather than sympathy • Allow the inquirer to communicate in his or her own style. (see the Attitude/ Behavior section)

Recording

•

• •

Understanding

Taking brief, relevant notes during an interview has many benefits. It can help the interviewer to focus and provide direction to the interview, as well as highlighting and remembering pertinent facts. In face-to-face interviews, request the inquirer’s permission to take notes during the interview. Always tell someone when you are going to put him or her on hold and explain why you are doing so.

Fully understand the question before you find the answer

Information and Referral Program – Training Manual

Needs Assessment Activity

Questions

Restate/Paraphrase

Description Ask questions, listen (see separate section on communication / listening). See also probing/ leading below and section on questions below the table. Ask relevant questions and obtain the information necessary to make a referral. Probe. Explain why you're asking- you need to understand so you can find the right referrals for the caller Do you sense an underlying question, which you can help the inquirer to express? If they mention one issue, could suggest alternative services/ programs. e.g. no food, they might need other services e.g. employment or financial assistance. E.g. “do you think I could help you find any other services or programs …” If the inquirer was asking for food banks ask if they’d be interested in knowing about… Good Food Box, for example. Check your understanding of the situation with the inquirer by restating the question. Do you know what the inquirer wants you to do?

Inquirer in Crisis?

Help him/her remain calm. It is important to help the inquirer talk about and work through his/her feelings as part of the assessment and problem solving stages of the interview. If necessary transfer caller to a crisis line. (see also separate section on Inquirers in Crisis)

Inquirer is Being Difficult? (angry, abusive, under the influence of a substance)

•

Inform Inquirer – What is happening

• •

•

Set your parameters, de-escalate and stabilize the inquirer and help him/her remain calm. Make sure you are in a physical place where you can signal or call for help. Terminate interview, tell the inquirer your conditions under which you will be pleased to help another time (e.g. no swearing, threatening, yelling) Tell inquirers what you are doing when there is dead air – i.e. that you are searching the database or reading through the items that came up, searching the internet etc. Don’t talk to colleagues without putting inquirer on hold – and tell them what you are doing.

What has been done before?

Find out if the inquirer has already tried any solutions and the results were.

Prioritize

If there are several problems, help the inquirer to determine which is the most urgent or important in order to decide which course of action to pursue. Do you know if or how the problems affect each other?

Factors affect Eligibility

Take into account such factors / special needs as geographic, physical accessibility, cultural preferences, the inquirer’s ability to pay, language, disability, age, transportation. These factors may also influence your ‘communications’ style/ approach (see sections on specialized populations)

Necessary knowledge/ authority?

•

Do you have the necessary knowledge, skills and authority to help the inquirer? Have you decided what step(s) you are going to take next? You may need to consult or refer to a colleague or external expert.

•

Our database may not contain the information required, or we may be aware that our information is incomplete or out-of-date.

•

The inquirer may need a more in-depth assessment of his problem which

Information and Referral Program – Training Manual

Needs Assessment Activity

Description may be provided, for example, by a doctor, public health nurse, social worker or lawyer. •

The inquirer may need someone who is in a position that allows him to act on his behalf (someone with power of attorney or other credential or special knowledge).

•

We may have to call the government information centre or another resource and get back to the person with the information.

•

Our role at this point is to help the inquirer make the proper connection with another source of information or assistance.

Provide best resources

Locate resources relevant to the inquirer’s needs. • Resource database, then if not in the database then try… • Internet web site • colleague • someone in the social service system

Provide alternatives

Make suggestions to the inquirer on the possible alternatives and review the options with the inquirer including the inquirer’s own resources and those that may partially meet his/her needs. Pursue the problem until both the inquirer and the specialist are assured that all appropriate options have been exhausted.

Be Creative if there’s a gap

Be creative in suggesting reasonable alternatives when an apparent service gap exists but don’t mislead the caller if there truly is no program.

Give the right amount of Information

Where possible and desirable, provide at least three referrals to give the inquirer a choice (and to protect the I&R service from being perceived as making a “recommendation”); • Provide only as many referrals as the inquirer can reasonably use i.e., avoid overwhelming the inquirer with an unwieldy list of options - We will always invite them to call back if they are ready for more information

Inquirer’s understanding / Right to self determination

• •

Check the inquirer’s understanding of the information. Does she know what to do next or what is being done on her behalf? Accept the inquirer’s right to self-determination in choosing a course of action

Information and Referral Program – Training Manual

Needs Assessment Activity Provide realistic picture, Never say “I don’t know”

Need to do more research?

Advocacy

Description • If you cannot answer the question, tell the inquirer why you cannot help him/her. Never say “I don’t know” and hang up. • You may find that the inquirer isn’t eligible for a service or that a service does not exist to meet their exact need, or that there is a fee to pay that the inquirer can’t afford or a waiting list that the inquirer can’t wait for. • In these circumstances, it is always best to be honest with inquirers. • When you need to give bad news, try to avoid saying “you or your” which can sound like you are placing blame. For example, do not say: “Well, everybody is out of money so I can’t help you. ”Do say: “At the end of the month it may be difficult to find a source of financial assistance but I will try to help you with some other options.” • Do not provide numbers for programs that you know will not help them, just to get rid of them, and force another agency to tell them the truth about their lack of eligibility or the restrictions of a program. • Provide a realistic picture of expected outcome. For example, if the referral is for a subsidized housing, the likelihood of immediate service is low, and there is a long waitlist. • If at all possible, provide the inquirer with information on another resource or an alternative strategy to follow, someone they can call for assistance. If there is no service/ program in our area, make sure this is documented as a ‘gap’ on our contact tracking system.

• •

You may feel you need to do some more research and get back to them. Tell the inquirer what you are going to do. Arrange to call inquirer back if appropriate or have them call you.

•

Is the inquirer capable and willing to act further on his/her own behalf? If you feel the need to act on the inquirer’s behalf; if appropriate, advocate on behalf of the inquirer.

Ask for, and document, if you have permission to do so. (see section on Advocacy) You may find it necessary to help the inquirer by transferring them to a 3rd party, and possibly staying on the line either to listen and check that all is OK, or, speak on behalf of the inquirer – with the inquirer still on the line. •

3rd party transfer/ conference

Follow-up – inquirer requires assistance

Encourage Call back /End the inquiry

Record the inquiry

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Do you believe the inquirer to be in an endangerment situation or that the inquirer does not have the necessary capacity to follow through and resolve their problems?

•

If so, use the follow up permission form.(see Follow Up section)

Thank the caller for accessing the 211 service. Encourage the inquirer to contact the I&R service again if additional referrals are required and say goodbye

Use the contact tracking tool on Survey Monkey

Information and Referral Program – Training Manual

Needs Assessment Activity

Description

Follow-up/ research/ advocate as appropriate.

Depending on what happened during the interview, you may have to follow-up, advocate or research more options for the inquirer.

Follow-Up and Advocacy Follow-up is the process of contacting inquirers who have been referred to a service to determine if he/she has been linked successfully to the service (s). Implicit to the follow-up is the desire to know how the person is doing, if the agency did or could provide the requested services, and if Community Connection has fulfilled its mission. The follow-up call usually takes place 1 to 4 days after the initial call, depending on the urgency of the situation. Follow-up also provides an opportunity to help the person again if the first effort failed, or if new needs arise. Regardless of the type of call, the invitation to make a follow-up call should be initiated by the I&R specialist answering the phone call. I&R specialists will request permission to follow-up with every caller presenting the following situations: - Community Connection has already acted in an advocacy role - The caller is determined to be (or due to lack of resources may become) in an at-risk situation. At risk is considered a serious threat to health or safety - for example: illness, abuse, no available heat or power, etc. - The I&R specialists determines the caller may not have the necessary capacity to follow through and resolve their problems and may benefit from extended assistance - for example: language, isolation, health, etc. The I&R specialist will fill out the Follow-Up form with caller contact information and details about the original call and secondary calls. Advocacy can be used as means of ensuring the inquirer gets the assistance he or she needs. The information provider can be the link or bridge that enables inquirers and their families to access desired programs and services. Community Connection will advocate on behalf of the inquirer to assist in the obtaining of needed human services when the following conditions present themselves: • The I&R specialist deems the inquirer unable to act on his/her own behalf. • The inquirer has contacted the service provider and has been denied benefits or services to which they are entitled and the I&R specialist is not immediately aware of the reason for denial, or has reason to believe the reason for denial is invalid. • The inquirer asks the I&R specialist to do so - when they need assistance to communicate their needs to a service provider or otherwise effectively represent themselves • When the inquirer faces barriers to accessing services (e.g. language, frailty, emotional condition) It is important to remember that individual advocacy must only be done with the permission of the inquirer System Advocacy: Community Connection will advocate for changes in the community provision of human services when documented evidence shows that such changes will improve or introduce the needed human services. Confidentiality Information about an inquirer must not be shared with others unless disclosure is required by law, explicit permission has been secured from the person to do so, or unless the person is in danger of harming him or herself or another.

Information and Referral Program – Training Manual

All aspects of the interaction with an inquirer are confidential and will be handled in such a way to ensure the individual's privacy and preserve his or her dignity. This includes the identity of inquirers, their personal contact information, their requests and the resources given to them. I & R Specialists should not discuss confidential information in any setting unless privacy can be ensured. The I&R Specialist must never discuss the inquirer with a member of the inquirer’s family. Sometimes violating confidentiality can even endanger an inquirer who is in an abusive situation. Private inquirer information including, but not limited to, paper records, shall be kept secure and confidential. No inquirer data should be recorded or stored in any electronic format. Conditions under which confidentiality is broken: 1. When disclosure is required by law, such as when a child is in need of protection; 2. When explicit verbal or written permission has been secured from the person to do so in situations where advocacy is required; or 3. When required to prevent clear or imminent danger to the inquirer or others. A form of this name, ‘Consent to Disclose Personal Information’ must be used to document consent.

Boundaries An understanding of personal and professional boundaries is vital to establishing a healthy working relationship with callers. Boundaries allow callers a full range of appropriate choices, and they can empower you to be consistent and honest with your callers. Boundaries also protect you from unclear expectations or misunderstandings. Having appropriate boundaries means you have a personal standard that applies to everyone. Appropriate boundaries insure that your own interests, needs and agendas do not infringe on the welfare of others. Below are some guidelines to help you respond to inquirer needs. •

• •

• • •

Different agencies provide different services, and no one organization can meet all of a inquirer’s needs. Beyond that, there are always needs that go unmet. Be clear to yourself about what we can and cannot offer and feel comfortable working within those limits. Prevent the intrusion of your personal needs into relationships with callers. If you find you are feeling “motherly” towards a inquirer, you are probably stepping over a boundary. All contacts with inquirers are made through the office. At no time is it appropriate to give your home telephone number, cell phone number, or personal address to inquirers. Nor should you go somewhere with them, away from the office, including their living quarters. It is never appropriate to initiate personal relationships with inquirers because of the risk that their welfare could be jeopardized by such a dual relationship. Protect your privacy without being rude or secretive. The knowledge that you, too, have pushed through difficulties may be helpful, but details may be inappropriate. Listen to yourself for the difference. Will telling help the inquirer? Be aware of your limitations. It’s OK to say, “I’m not sure,” or “Let me get back to you on this.” Clearly differentiate between the inquirer’s responsibilities and I&R service’s responsibilities and avoid creating a dependency that goes beyond the I&R service’s responsibilities. Skilfully deal with inappropriate questions such as requests for advice, questions that are overly personal, or requests for confidential information or information about another person;

(Adapted/ modified from The Skilled Helper, Model, Skills, and Methods for Effective Helping, Second Edition, by Gerard Egan, Brooks/Cole Publishing Company, 1982)

Information and Referral Program – Training Manual

Personal Questions about I&R Specialist On occasion, an inquirer may ask the information provider personal questions. This may be to establish a closer relationship, to test the information provider or to avoid discussing their own situation. Judgment must be used, but generally a brief, honest answer is appropriate, unless it involves giving personal advice or expressing personal biases. Effective Questioning Skills The purposes of questioning in an I&R interview are to: • Help focus/direct the conversation so that the situation/problem can be assessed. • Get feedback to ensure that the process of understanding, and being understood, is taking place effectively. • Obtain specific information. • To understand the impact of appropriate vs. inappropriate questions. Appropriate questions may help the inquirer to relax and to trust the information provider. Inappropriate questions will impede this process. It may help if you explain why you are asking certain questions. • Adjust the pace of questioning to that of the inquirer. It’s important you use questioning skills to help you completely understand the inquirer’s situation. Otherwise, you could be responding to what you guess the inquirer means, which may or may not be correct. Questioning goes beyond listening. Effective questioning is a real compliment to your skills. It shows that you have the ability to get real needs. It shows you’re looking for meaning that’s deeper than the spoken message. Effective questioning is a powerful, learned skill. It says to the inquirer...I’m interested in determining your needs. Questioning can be put into two divisions: • Open-ended Questions • Closed-ended Questions Open-ended questions are questions without a fixed limit. They encourage inquirers to describe or explain how they feel or think about the situation.. Plus, they often give insight into the other person’s feelings. Openended questions draw out more information. When you want the inquirer to open up, use open-ended questions that start with WHO, WHAT, WHERE, WHY, WHEN and HOW. A few examples are: "What are some of the things you look for in a hotel?" "How do you feel government could be more responsive to your needs?" "What are your concerns about this new program?" Closed-ended questions have a fixed limit. They’re often answered with a yes or no, or with a simple statement of fact. Closed-ended questions are used to direct the conversation. They usually get brief specific information, or are used to confirm facts. Here are some examples.

"Do you have health insurance?" "Do you want the new brochure?" "Would you be interested in that?" We use the open-ended questions to get more information, and the closed-ended questions to focus in on one area. Additionally, there are several other type of questioning techniques. A few are:

Information and Referral Program – Training Manual

Probing Questions Sometimes you ask an open-ended question to get more information and you only get part of what you need. A probing question is another open-ended question, but it’s narrower. The I&R Specialist may need to probe beyond the presenting problem when indicated, for example, if they think • There might be possible endangerment situations and need to probe further; • They need to identify problems which require a longer term solution than that which the inquirer is requesting; The I&R Specialist should: • probe with sensitivity and awareness of the inquirer’s feelings avoiding extraneous or intrusive questions or questions to satisfy his/her own curiosity; • avoid over-counselling or confusing probing with exploring psychological motivations for the inquirer’s actions. The Echo Question Here’s a good technique for getting more information. You can use this like a probing question. The idea is to use the last part of a phrase the inquirer said. Slightly raise the tone of your voice at the end of the phrase to convert it to a question. Then pause and use silence - like this: ......................The bill you received? An echo question repeats part of the phrase that the inquirer used, with voice inflection, converting it to a question. Some people call it mirroring. Some - reflecting. Others call it parroting. We call it echoing. Leading Questions Leading questions can be good or bad. Leading questions, if used improperly, can be manipulative because you’re leading the person to give the answer you want. But when used properly, you’re helping that person. Some examples of proper leading questions are: "You understand what I’m saying, don’t you?" "You’ll want to know about our same day delivery service, right?" "You’ll want to go ahead with this, wont you?" Leading questions often end with suggestive nudges toward the desired answer. Some ending phrases would be, "Don’t you?" "Shouldn’t you?" "Won’t you?" "Haven’t you?" "Right?" So where are leading questions useful? Well, they’re useful in helping someone who’s undecided make the right decision. A decision that’ll benefit them. You use a leading question ethically, when you help someone do the right thing. Some folks call this technique the "TIE DOWN" technique due to the fact that you’re actually trying to tie down the inquirers needs. Bottom line: Practice using a variety of questioning techniques. It’ll help you help your inquirers better. (Adopted From AIRS, By Nancy Friedman, with additions/ modifications)

Information and Referral Program – Training Manual

Attitudes and Work-Related Behaviours Behaviour / Attitude

Description / Explanation

Accessibility

Inquirers should be able to access the service at reasonable hours, and it should be clear when they can reach the service. Live answer rather than an automated response to phone calls is helpful, particularly for inquirers who face barriers to access. Accessibility refers to being able to provide service without physical, cultural, financial or psychological barriers.

Accountability

Responsibility to inquirers for the services provided.

Awareness of Personal Stress Triggers

I&R Specialists must always be aware of their personal triggers - the inquiries and inquirers that stress them out of all proportion to the situation. I&R specialists must develop an awareness of their own personal attitudes and values and realize that their own orientation may condition their expectations of and response to others (inquirers, co-workers, staff from other agencies, people in the community).

Breadth of Scope

Confidentiality

Service includes information about the broad range of services covering the full range of human needs.

Information about a inquirer must not be shared with others unless disclosure is required by law and explicit permission has been secured from the person to do so, or, unless the person is in danger of harming him or herself or another. The identities or problems of our inquirers should not go beyond the confines of this office.

Efficiency

An adequate number of well-trained staff, who provide appropriate information and referrals in a timely manner.

Flexibility

Each inquiry treated individually, with all of the options considered, not "pigeonholing" problems or requests.

Friendliness

A demonstrated open and positive attitude to make inquirers feel comfortable about using the service.

Honour the inquirerâ&#x20AC;&#x2122;s right to confidentiality.

Remember you signed declaration of confidentiality. This confidence must also be maintained when advocating on behalf of the inquirer with other organizations. You must have the inquirerâ&#x20AC;&#x2122;s consent to act on their behalf.

Objective, nonjudgmental, unbiased

I&R specialists must have attitudes that are appropriate to their role as professionals. They must be objective, non-judgmental and avoid making assumptions about inquirers or their needs based on their cultural or ethnic background, income level, disability, marital status, place of residence or other stereotypic identification.

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Behaviour / Attitude

Neutrality

Description / Explanation Non-partisan and non-sectarian

Non-Stigmatization

This refers to the process of never making people feel ashamed. It involves not labelling, prejudging or stereotyping inquirers due to their circumstances. Needing help is universal.

Patience

Exhibits patience and defuses his/her own frustration without affecting the inquirer or the interview.

Reliability

Accurate information is essential to inquirer confidence in the I&R service.

Respect Differences in Others

I&R specialists must recognize that inquirers may have different perceptions of their needs and different views regarding obtaining services. I&R specialists must demonstrate the ability to hear and support differing perspectives from inquirers as well as others in their environment (co-workers, staff in other agencies, people in the community).

Respect Differences in Others

I&R specialists must demonstrate respect for the traditions, values and/or lifestyles of different ethnic or cultural groups and accept the choices made by inquirers representative of these groups.

Respect Differences in Others

I&R specialists must be open and flexible and demonstrate respect in their communication with people with disabilities, older adults, sexual minorities and other special populations.

Respect Differences in Others

Sensitivity

The ability to provide assistance in ways that are helpful, effective and strengthening to those served, through understanding of and respect for individual differences.

Stress Management

I&R specialists must understand the basic principles of stress management and develop an effective strategy for coping with personal stress in the workplace.

Teamwork

I&R specialists must have good teamwork skills and the willingness to work collaboratively with co-workers and other providers I in the community

Time Management

I&R specialists must understand the basic principles of time management and manage their work in an efficient way.

Understand the complexity of the human service system

It is no longer possible for any one individual, no matter what her position or experience, to know all the details of our complex, rapidly changing service system. However, it is essential to be aware of the size and complexity of this system. We must understand that services provided by the government, voluntary and commercial sectors are customized to meet various human

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Behaviour / Attitude

Description / Explanation needs and change rapidly in response to changes in these needs. This awareness is necessary in to avoid giving incomplete or inaccurate information, such as eligibility criteria and/or application procedures.

Limits of I&R Service: • •

•

I&R Specialists must accept that there is not an ‘ideal’ solution for every problem and that it is not their fault if an ‘ideal’ solution cannot be found for an inquirer There is often a feeling of helplessness around certain types of calls that seem to occur over and over and over again, together with a sinking feeling that there is never going to be a long-term solution for certain inquirers. And that whatever you do, it is not going to be enough and that the inquirer is never going to feel it is enough. There is a responsibility to provide an empathetic assessment and appropriate referrals but there is no control over whether or not an inquirer follows through or even, having taken action, whether they eventually receive the help they need An I&R service does not turn people’s lives around – although it may be the first step in doing so. An I&R service listens to people, sometimes for the first time, and directs them to agencies that can turn their lives around. An I&R program is a critical part of a system of services – but it is not the entire human services system.

Celebrate I&R Service: Every day in every I&R, there are numerous inquiries to feel very good about. With the help of the I&R team, people are being helped … and that is the feeling in which to frame the memory of every day! Quality Assurance – I&R Service and I&R Staff Community Connection has established several quality assurance programs in an attempt to provide continuous quality service to I&R inquirers. On a staffing level, I&R will undertake a monthly report card, and periodically have calls monitored and graded by a supervisor. Community Connection and 211 Ontario have set in place a process to have 211 callers participate in a survey to garner feedback on the 211 service, the I&R staff who handled the call, and the outcome of the referral given to the caller. In general, surveys are requested from callers every day. The results are fed back to Community Connection management, and I&R staff.

Information and Referral Program – Training Manual

Human Service System

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Employment Questions to ask: Is the person looking for job training or job placement (or both)? What is the age group of the caller? (Some agencies have age group specific services) Is the person eligible for employment benefits or Worker’s Compensation? Is the person looking for temporary work or a permanent position? What has already been done to try and find employment? What are your skills, background and experience? Where do you want to work? Things to Consider: Be sure to read eligibility for services A person may be eligible for Ontario Works while unemployed, or employed and receiving low wages. Ontario Ministry of Labour This website contains information on employment standards, health and safety and labour relations. Career Centres, Employment Resource Centre, Offer employment counselling, adjustment services, workshops, coaching. Programs include the Employment Support Program and the Job Search Workshop. Job banks, Some will help with resumes, and allow use of computers, fax, copiers. “Temp” Agencies

Employment agencies that place people looking for work in temporary, permanent, and contract work, usually in the areas of factory workers, labourers, clerical work, accounting, executive assistants, customer service. You can suggest career centres and/or temp agencies to people who say they are looking for work, can’t find work, have been denied social assistance, etc. They may not know about the services offered by these agencies or that they exist in their communities.

Financial Assistance – Income Programs Ontario Works Ontario Works, (formerly “welfare”) provides employment and income assistance to eligible participants. Income support assistance is provided to persons in need to cover the costs of food, shelter, and basic needs. Dependent children are eligible for mandatory dental and vision care benefits. Adult participants may also be eligible for assistance for such items as optical services, dental services, and prosthetics. Ontario Works legislation requires that those receiving social assistance actively participate in a plan of increased employment activity to support their eligibility for benefits. People receiving social assistance, who are not disabled or elderly, or who are not sole support parents (with dependents under school age) must be willing to contribute service to their communities at the same time that they make efforts to find paid employment. People who are temporarily ill, incapacitated, or care for a disabled or elderly family member may be temporarily exempt from these requirements. Information and Referral Program – Training Manual

Key Principles of Ontario Works Program •

Welfare is to be temporary. Welfare is a program of last resort. It provides short-term financial assistance to those most in need while they participate in activities leading to paid employment.

•

In order to receive financial assistance, people on welfare must, learn, train, find work, or contribute to their communities. Participation is mandatory for all able-bodied people, including sole-support parents with school-aged children.

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Eligibility to receive welfare is based on an assessment of financial need.

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A participation agreement is a negotiated agreement between a participant and a worker, and includes employment assistance activities that move the participant to paid employment. The agreement is updated as activities are completed or new activities are added.

Basic financial assistance provided under Ontario Works includes: •

income assistance for basic needs and shelter.

•

benefits for specific needs including prescription drugs, basic dental and vision care, moving costs, funerals and burials, community and employment start-up expenses

Mandatory Benefits of Financial Assistance Back to School Allowance Paid each year for eligible dependent children to help with costs of starting or returning to school. Winter Clothing Allowance Paid in November or December each year for eligible dependent children to help with winter clothing needs. Community Start-Up and Maintenance Benefit Community Start Up and Maintenance Benefit is a mandatory benefit under Ontario Works legislation and is granted to a participant to meet special expenses relating to establishing or maintaining a residence in the community.

• •

where he or she is establishing a new principal residence within or outside the geographic area or will be remaining in his or her current residence; and the administrator is satisfied that he or she will need financial assistance to establish the new principal residence or to remain in the existing residence.

Community Start Up is issued in the following situations: • • • •

client is being discharged from an approved institution or facility, client is leaving a situation that is harmful to the client's health and welfare, client has been evicted, client is facing eviction at the current address and payment of arrears would prevent eviction,

Information and Referral Program – Training Manual

• • •

client is facing disconnection of energy-related services at the current address and payment of arrears would stop disconnection, client has had energy-related services disconnected at current address and payment of arrears would have services resume, client is moving to a significantly improved situation.

Community Start Up is available only in a 24 month period. Employment Start Up Benefit Clients starting employment may be eligible for this allowance to assist with costs associated with paid employment or an employment assistance activity. Child Care Start Up Costs Clients starting employment may be eligible for this allowance to assist with child care costs associated with paid employment or employment assistance activity. Health Benefits Assistance with special diets, allowance for pre/postnatal care, costs associated with diabetic and surgical supplies, medical transportation, drug costs in the form of a monthly drug benefit card, vision services and dental for dependent children.

Ontario Disability Support Program ODSP is a program of the Ministry of Community and Social Services that provides financial support to individuals with a proven disability who are in financial need .Its goal is to allow such individuals to live independently in the community. To meet the requirements, you must: •

be 18 years of age or older

•

qualify financially, and

•

have a substantial physical or mental impairment that is continuous or recurrent and is expected to last one year or more.

Application Procedures The application process for ODSP can be a long and difficult. The first step in applying for ODSP involves setting up an appointment at your local ODSP office, where the applicant will be provided with a list of documents needed to bring to that appointment, such as: Social Insurance Number, OHIP Number, proof of birth date and immigration status, records of bank statements, assets and income, proof of expenses (e.g. rent receipts), school and employment activities. The application process involves two steps. The first step is to determine if you qualify financially; the second step is to determine if you qualify as a “person with a disability”. If you qualify financially, you will be given a Disability Determination Package (DDP) to fill out. The forms in this package include:

Information and Referral Program – Training Manual

Health Status Report and Activities of Daily Living Index • A Medical Consent Form The applicant must sign this form so that the doctor or medical professional has your permission to release medical information to ODSP. •

A Self Report

What you can do if you are turned down for ODSP? If you are turned down for ODSP you have the right to ask for an Internal Review. You must request this in writing within 10 days of receiving the decision. You may provide additional medical information with your Internal Review. If you do not agree with the decision of the Internal Review, you have 30 days in which you may appeal this decision to the Social Benefits Tribunal. If you do not agree with the decision of the Social Benefits Tribunal you may request a Reconsideration of the Decision with a further appeal to the Divisional Court of Ontario. It is advisable for clients who have been turned down to connect with their local Community Legal Clinic for assistance. What benefits are available from ODSP? The ODSP benefits include: •

Monthly financial income

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An Ontario Drug Benefits Card, which covers medications listed in the Ontario Drug Benefits formulary

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Basic dental care

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Vision care and hearing aids

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Back-to-school and winter clothing allowance for dependent children

Employment Insurance (EI) Benefits Employment insurance Benefits are administered through Service Canada, a federal government program. There are different types of EI benefits. Regular Benefits You can receive regular benefits if you lost your job through no fault of your own, for example, due to shortage of work, seasonal or mass lay-offs and you are available for and able to work but you can’t find a job. To be eligible for regular benefits you must show that: •

you have been without work and without pay for at least 7 consecutive days;

•

in the last 52 weeks you have worked for the required number of insurable hours. The hours are based on where you live and the unemployment rate in your region at the time of filing your claim for benefits. Currently in Ontario, claimants must have worked a set amount of hours of insured employment in the year prior to application.

Application Procedures Information and Referral Program – Training Manual

To see if you can receive EI benefits, you must apply for EI, either online or in person, at a local Service Canada office. You must request your Record of Employment (ROE) from your previous employer. If the employer does not give you the ROE, the local Service Canada office can help you. You will have to fill out a form explaining how you tried to get it. You will also have to give other proof of employment, such as pay stubs, cancelled pay cheques, T4 slips, or work schedules. If you worked for any other employers in the previous 52 weeks, you also need an ROE from each of them. But if you can’t get all of them, still apply. In addition to the ROE, you will be asked to provide the following information: •

Your social insurance number – if your SIN starts with a 9, you have to give proof of your immigration status and a work permit

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For direct deposit of EI funds, supply bank information from a cheque or bank statement.

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Your detailed version of facts – if you quit or were fired from any job in the last 52 weeks.

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Details of your most recent job, including your gross salary (total earnings before deductions including tips and commissions) for your last week of work (from Sunday to your last day worked). As well, include any other money you received or will receive, such as vacation pay, severance pay, pension, and pay instead of notice or lay off (these must also be the gross amounts).

•

If you apply in person, personal identification such as a driver’s license, birth certificate or passport.

Waiting Period No benefits are paid in the first 2 weeks of your claim, called the waiting period. Any income you earn then is deducted from your benefits and delays your claim. Income includes vacation pay, severance pay, retirement pay and leave credits, and most bonuses and gratuities. If EI has all the required information and if you qualify for benefits, your payment will be issued usually within 28 days from the date of filing your claim You can receive EI from 14 weeks up to a maximum of 45 weeks depending on the amount of insurable hours you have accumulated in the last 52 weeks How much will I receive? The basic benefit rate is 55% of your average insured earnings up to a maximum payment of $468 per week (Jan 1, 2011 figures). Your EI payment is a taxable income, meaning federal and provincial or territorial (if it applies) taxes will be deducted. What are my responsibilities while on EI? EIrequires you to do the following things while you get benefits • • • • • • •

File a report every two weeks with EI over the internet, phone or mail. Be willing and able to work. Look for work and keep a written record of employers you contact and when you contacted them. Tell EI when you are not available for work. Accurately report and keep records of all money you earn or receive and all work you do – whether you work for yourself or someone else. If you work while collecting benefits, tell EI if the job ends, and if so, why. Tell EI if you leave the area where you live or if you leave Canada.

Information and Referral Program – Training Manual

Parental Benefits Parental benefits are payable either to the biological or adoptive parents while they are caring for a new-born or an adopted child, up to a maximum of 35 weeks. To receive parental benefits you are required to have worked for a certain amount of hours in a certain time frame. The requirements change periodically. Parental benefits can be claimed by one parent or shared between the two partners but will not exceed a combined maximum of 35 weeks. Claimants making application for parental benefits must provide the name and Social Insurance Number (SIN) of the other parent for cross-reference purposes. Parental benefits for biological parents and their partners are payable from the child's birth date and for adoptive parents and their partners from the date the child is placed with you. Maternity Benefits Maternity benefits are payable to the birth mother or surrogate mother for a maximum of 15 weeks. To receive maternity benefits you are required to have worked for 600 hours in the last 52 weeks or since your last claim. You need to prove your pregnancy by signing a statement declaring the expected due or actual date of birth. The mother can start collecting maternity benefits either up to 8 weeks before she is expected to give birth or at the week she gives birth. Maternity benefits can be collected within 17 weeks of the actual or expected week of birth. Sick or Illness Benefits To be eligible for Employment Insurance sickness benefits, you must be medically unable to work but also be able to demonstrate that you would be otherwise available for work. Your doctor will need to indicate your medical limitations to perform your job. Sickness benefits may be paid up to 15 weeks to a person who is unable to work because of sickness, injury or quarantine. To receive sickness benefits you are required to have worked for 600 hours in the last 52 weeks. There is a two-week waiting period for which no benefits are paid. Compassionate Care Benefits Compassionate care benefits are paid to persons who have to be away from work temporarily to provide care or support to a family member who is gravely ill with a significant risk of death. EI defines a family member as: •

your child or the child of your spouse or common-law partner

•

your wife/husband or common-law partner

•

your father/mother

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your father’s wife/mother’s husband

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the common-law partner of your father/mother

When requesting compassionate care benefits you must provide a medical certificate as proof that the ill family member needs care or support is at risk of dying within 26 weeks. Information and Referral Program – Training Manual

Child Tax Benefit The Child Tax Benefit (“baby bonus”) is administered through the Canada Revenue Agency and provides eligible families with a tax free monthly payment to assist them with the cost of raising children. To be eligible for the Child Tax Benefit you must meet the following eligibility criteria: •

you must live with the child, and the child must be under the age of 18

•

you must be the person who is primarily responsible for the care and upbringing of the child

•

you must be a resident of Canada

•

you or your spouse or common-law partner must be a Canadian citizen, a permanent resident, a protected person, or a temporary resident who has lived in Canada for the previous 18 months • The benefit amount is based on total household income, the higher a household income, the lower the benefit amount is.

National Child Benefit Supplement The National Child Benefit Supplement (Child Tax Benefit) provides a monthly benefit for low income families with children based on net family income. The amount is reduced by a percentage amount (depending on number of children) if income is more than the base amount. Child Disability Benefit The Child Disability Benefit is tax free benefit for low to moderate income families who care for a child under 18 years with a severe or prolonged mental or physical impairment. This is paid as a monthly supplement to the Canada Child Tax Benefit. Universal Child Care Supplement The Universal Child Care Benefit is a new initiative designed to assist Canadian families, as they seek to balance work and family life, by supporting their child care choices through direct financial support. Parents receive $100 a month for each child under six. If you are already receiving the Canada Child Tax Benefit, you do not need to apply for the Universal Child Care Benefit. You will receive it automatically. If you do not currently receive the Canada Child Tax Benefit, you will need to apply. Applying for the Child Tax Benefit and Other Child Tax Programs Application forms are available at your local Canada Revenue Agency office or Service Canada. Alternately, forms can be obtained by calling Service Canada or downloadable at the Service Canada website.

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Financial Assistance for Seniors Veterans If you are a veteran (including a veteran of the Commonwealth or Allied Forces), a former prisoner of war, a civilian who served in close support of the Canadian Armed Forces during wartime, or a veteran's survivor or dependent, you may be entitled to a variety of assistance programs from Veterans Affairs Canada. The level of assistance depends upon length of war service, age or incapacity, residence and income. For information, contact: Veterans Affairs Canada You can also apply though Veterans Affairs for assistance from programs such as the Army Benevolent Fund and the Soldiers Aid Commission of Ontario. Home Adaptation for Seniors Independence (HASI) If you require financial assistance for minor home adaptations such as the installation of handrails or bathtub grab bars, you may be eligible for some assistance from this program. For information, contact: Subsidies for Long Term Care All applications for long term care facilities are coordinated through one of the Community Care Access Centres (CCAC) in the Province of Ontario. There are different types of accommodation available in long term care facilities: standard ward accommodation which consists of 3-4 to a room, semi-private and private. If you live in a long term care facility (a home for the aged or a nursing home) and have a limited income, you may be eligible for a subsidy for your room and board. Generally, a subsidy is only available for standard ward accommodation. Rates are standardized through the Ontario Ministry of Health. For information, contact: Community Care Access Centre Tax Credits for Seniors An annual provincial tax credit is available to seniors 65 years or over with low to moderate incomes, who own or rent their home. The amount of the credit depends on occupancy cost and income. In a marriage or common-law relationship, the incomes of both spouses must be included. Applications for these credits are included in the general income tax kit.

Old Age Security Basic Pension (OAS) The OAS basic pension is a monthly benefit available, if applied for, to anyone 65 years of age or over. OAS residence requirements must also be met. An applicant’s employment history is not a factor in determining eligibility, nor does the applicant need to be retired. OAS pensions are taxable, both Federally and Provincially. Eligibility Conditions: To qualify for an OAS pension, a person must be 65 years of age or over, must be a Canadian citizen or a legal resident of Canada on the day preceding the application’s approval or, if no longer living in Canada, must have been a Canadian citizen or a legal resident of Canada on the day preceding the day he or she stopped living in Canada. A minimum of 10 years of residence in Canada after reaching age 18 is required to receive a pension in Canada. Amount of Benefits: The amount of a person’s pension is determined by how long he or she has lived in Canada. Old Age Security Program. Guaranteed Income Supplement (GIS) The Guaranteed Income Supplement is a monthly benefit paid to residents of Canada who receive a basic, full or partial OAS pension and who have little or no other income. GIS payments may begin in the same month as OAS pension payments. Recipients must renew their GIS benefit annually. Thus, the monthly payments may increase or decrease according to reported changes in a recipient’s yearly income. Unlike the basic OAS Information and Referral Program – Training Manual

pension, the GIS is not subject to income tax. The GIS is not payable outside Canada beyond six months, regardless of how long the person lived in Canada. Eligibility Conditions: To receive the GIS benefit, a person must be receiving an OAS pension. The yearly income of the applicant or, in the case of a couple, the combined income of the applicant and spouse/common law partner, cannot exceed certain limits. Amount of Benefits: The amount of the GIS to which a person is entitled depends on his or her marital status and income. Old Age Security Program. The Allowance/Allowance for the Survivor The Allowance is paid monthly. It is designed to recognize the difficult circumstances faced by many survivors and by couples living on a single pension. Recipients must re-apply annually. Benefits are not considered as income for income tax purposes. The Allowance is not payable outside Canada beyond a period of six months, regardless of how long the person lived in Canada. Eligibility Conditions: The Allowance may be paid to the spouse/common-law partner of an OAS pensioner, or to the survivor. To qualify, an applicant must be between the ages of 60 and 64 and must have lived in Canada for at least 10 years after turning 18. An applicant must also have been a Canadian citizen or legal resident of Canada on the day preceding the application’s approval. To qualify, the combined yearly income of the surviving spouse/common law partner, cannot exceed certain limits. OAS and GIS benefits are not included in the calculation of a couple’s combined yearly income. The Allowance stops when the recipient becomes eligible for an OAS pension at age 65, or when the beneficiary leaves Canada for more than six months or dies. In addition, the Allowance for the Survivor stops if a survivor remarries or enters into a common-law relationship. Canada Pension Plan (CPP) The Canada Pension is a monthly retirement pension for those people who have contributed to the Plan. To be eligible to receive the Canada Pension Plan, individuals must have made a least one valid contribution and be between the ages of 60 to 64 years of age or at least 65 years of age. The retirement pension is not started automatically and eligible candidates must apply for it. To receive the maximum possible, an individual must wait until they are 65. Eligibility Conditions: Any person who has made at least one valid contribution to CPP is eligible to receive a monthly retirement pension after his or her 60th birthday. Amount of Benefits: A monthly benefit equal to 25 percent of a contributor’s average monthly pensionable earnings during that person’s contributory period. Canada Pension Disability Benefit A contributor is considered to be disabled under CPP if he or she has a physical or mental disability which is both severe and prolonged. “Severe” means that the person’s condition prevents him/her from working regularly at any job. “Prolonged” means that the condition is long term or may result in death. Eligibility Conditions: To receive a disability benefit, a contributor must have made sufficient contributions to the plan, must be disabled according to the terms of the CPP legislation, must be under 65 and not in receipt of a retirement pension, and must apply in writing. Amount of Benefits: A disability benefit is a monthly benefit which begins in the fourth month after the month a person is considered disabled by CPP. It is payable until the beneficiary either recovers from the disability, receives a CPP early retirement pension, turns 65 or dies. When the recipient reaches 65, the benefit is automatically converted to a retirement pension. Information and Referral Program – Training Manual

Canada Pension Plan. Survivors Benefit The survivor pension is a monthly pension paid to the survivor (married or common-law) of a deceased contributor. Eligibility Conditions: A spouse or common-law partner of a deceased contributor may be eligible for a survivorâ&#x20AC;&#x2122;s benefit if the deceased has contributed to CPP during at least one third of their contributory period, for a minimum of three years to a maximum of ten years. Amount of Benefits: The benefit payable to a survivor aged 65 or over is equal to 60 percent of the retirement pension which the deceased contributor could have received at age 65. If the contributor died before turning 65, a retirement pension is calculated as if the contributor had become 65 in the month of death. Canada Pension Plan. Orphans Benefit The orphan benefit is a monthly pension paid to the children of a deceased contributor. Eligibility Conditions: A benefit may be paid for the child of a deceased contributor if the application is made in writing and if contributions have been made for the minimum qualifying period, (similar to that of the survivorâ&#x20AC;&#x2122;s benefit) and the child is under 18 years of age, or between the ages of 18 and 25 and in full-time attendance at a recognized educational institution. Benefits are suspended if the child is no longer attending school full-time, but may reinstated if schooling is resumed. Canada Pension Plan. Death Benefit The death benefit is a one time payment to, or on behalf of, the estate of a deceased Canada Pension Plan contributor. Eligibility: A death benefit may be paid to the estate of a deceased contributor if contributions to the CPP were made for the minimum qualifying period. This minimum period is the same as for a survivors benefit. When there is no will or estate, the death benefit is paid to the person responsible for funeral expenses, the survivor, or the next of kin, in that order. Amount of Benefit: The death benefit is a lump-sum payment equal to six times the monthly retirement pension of the deceased contributor up to a maximum of $2,500. Guaranteed Annual Income System (GAINS) The Guaranteed Annual Income System (GAINS) program helps to ensure a guaranteed minimum income for Ontario senior citizens aged 65 and over, by providing monthly payments to eligible seniors whose income from other sources falls below the level guaranteed by the province. Eligibility: You are 65 or older, and receive the full or partial Federal Old Age Security (OAS) and the federal Guaranteed Income Supplement (GIS). You are and have been a permanent resident of Ontario for the past 12 months, or you previously lived in Ontario for a total of 20 years after the age of 18; and your total income from all sources is below the level guaranteed by the province. Amount of Benefit: The specific amount of GAINS benefit is directly linked to the amount of your GIS monthly payments.

Food Assistance Food Banks: Individuals needing assistance with food can access local food banks. Common food bank organizations are The Salvation Army, and Society of St. Vincent de Paul. In some small towns, local churches might have a food bank or food cupboard. Some larger areas such as Barrie might have several options regarding food assistance, for example in 2011 Barrie had the main food bank, 2 different St. Vincent de Paul Information and Referral Program â&#x20AC;&#x201C; Training Manual

societies, a Grocery Assistance Program run by Elizabeth Fry Society, and also an individual that helped the community from her house. In contrast a small rural town might not have a food bank and residents might be served by another town. In some cases it is difficult to get fresh food from a food bank such as meat, milk, eggs, fruit and vegetables. Some food assistance programs will offer vouchers that can be used at grocery stores. Application process: Many food banks require applicants to provide proof of residency; assessment of need; proof of income, and identification for family members such as Social Insurance Number for adults; Birth Certificates for children or dependents. Food bank hours vary, some are every day of the week, some are limited to one or two days a week, some are only open a couple times a month. Some food banks have rules that applicants can only use the food bank a certain amount of days per month, some only allow clients to use it once per month. Some food banks require an appointment , some allow just â&#x20AC;&#x153;walk-inâ&#x20AC;? with no appointment. Other food assistance programs: Many communities have a fresh fruit and vegetable program, commonly known as Good Food Box program. Good Food Boxes include an assortment of fresh fruits and vegetables and are available to anyone in the community. There is a cost, usually around $10 depending on the size of box, but it is still cheaper than buying the items at the grocery store. Some programs will donate a box to needy individuals if asked. In most cases these boxes given out once a month. Many communities have food assistance programs for mothers, which will provide baby formula, baby food, and some items such as diapers and baby wipes. Some will cater to pregnant mothers or mothers of newborns by providing vitamins, milk coupons, etc. Some programs offer drop in social groups for mothers with nutritional snacks. These programs go by common names such as Mothercare, Baby Needs Depot, and are often run by Ontario Early Years Centres or community health centres. Christmas Hamper programs are available during the Christmas season. They usually provide a full turkey dinner, some will have extra food such as breakfast, lunch for days after Christmas. Some will provide toys or gift cards for teens. Application dates can start as early as November. Like food banks, some hamper programs require id and documentation to qualify. Soup Kitchens and Community Dinners are available in some towns. Some soup kitchens are daily, some are only for lunch, some are only for supper. Community dinners are often held once a month at each location and are often free. Some communities might have several community dinners in a month which are hosted at different locations such as churches.

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Government Programs Province of Ontario Access to Ontario government agencies, programs and Ministries, provincial legislative assembly, laws, employment standards, health coverage including OHIP cards, long term care, financial assistance, roads, Ministers of Parliament (MPP) and lotteries. In 2011, some common provincial programs became available at one convenient location. Ministry of Transportation Driver’s Licence offices added health card (OHIP) services, and some also have the Land Registry office as well. These locations are now called “Service Ontario” stores. Federal Government Federal government programs such as employment, taxes and tax benefits, financial benefits, immigration, ID cards, passports, health, environment, the economy, veterans, travel and leisure, seniors, business start-up, Minister of Parliament (MP), and financing. Canada Revenue Agency Issues regarding customs, income taxes and tax credits, child and family benefits, OAS/CPP/RRSP/GST/HST, register charitable organizations

Health Benefits and Services Ontario Health Insurance Plan (OHIP) The Ontario Health Insurance Plan covers a wide range of health and medical services for Ontario residents. OHIP covers all insured medically necessary services provided by physicians. OHIP may also cover the following: •

approved dental surgery in hospitals (You must pay the cost of regular dental services in a dentist's office.)

•

annual eye examinations by an optometrist for people under 20 years or 65 years and over. OHIP also covers a major eye exam once every 12 months for persons aged 20 - 64 who have medical conditions requiring regular eye examinations

•

covers standard ward services for hospital stay, many outpatient services, and medically prescribed physiotherapy in approved facilities

Eligibility Criteria You are eligible for the Ontario Health Insurance Plan (OHIP) if you are included under one of the following categories: •

you are a Canadian citizen, permanent resident or landed immigrant, convention refugee, or are registered as an Indian under the Indian Act

•

you have submitted an Application for Permanent Residence or an Application for Landing and have been confirmed by Citizenship and Immigration Canada as having satisfied the medical requirements for landing

Information and Referral Program – Training Manual

•

you are a foreign worker who holds a valid work permit or employment authorization which names a Canadian employer situated in Ontario and your prospective occupation, and is valid for at least six months.

•

and you make your permanent and principal home in Ontario

•

and you are in Ontario for at least 153 days of the first 183 days immediately following the date you establish residency in Ontario (you cannot be absent for more than 30 days during the first 6 months of residency)

•

and you are in Ontario for at least 153 days in any 12-month period

Tourists, transients and visitors not eligible for OHIP, and would have to pay for services on site.

Waiting Period for OHIP Coverage There is a waiting period for Ontario Health Insurance Plan (OHIP) coverage. It affects new applicants for coverage and former residents returning to Canada after living in other countries for long periods. OHIP Outside Ontario Most of your Ontario health coverage benefits can be used across Canada. The province or territory you are visiting will usually bill Ontario directly. If you have to pay for health services you receive in another part of Canada, you can submit your receipts to your local ministry office to be considered for reimbursement. Interim Federal Health Program The Interim Federal Health (IFH) program provides temporary medical coverage for certain immigrants (now almost exclusively limited Refugee claimants and Convention Refugees) in need of assistance during their settlement period in Canada, prior to their qualification for provincial health care coverage. Refugees resettled from overseas including those government-assisted or privately-sponsored are eligible for full benefits under the IFH program until coverage under their provincial health plan begins. The IFH Program is not designed to replace provincial health plans and does not necessarily provide the same extent of coverage allowed to permanent residents. The IFH Program provides the following: • • • •

only essential and emergency health services for the treatment and prevention of serious medical conditions and the treatment of emergency dental conditions contraception, prenatal and obstetrical care essential prescription medications costs related to the Immigration Medical Examination by a Designated Medical Practitioner

Assistive Devices Program (ADP) The Assistive Devices Program (ADP) is a program of the Ministry of Health and Long-Term Care to financially assist Ontario residents with long term physical disabilities to obtain basic, competitively priced, personalized

Information and Referral Program – Training Manual

assistive devices appropriate for the individual's needs and essential for independent living. ADP covers over 8,000 separate pieces of equipment or supplies. These include: •

custom made braces and splints

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manual and powered wheelchairs

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prosthetic devices including artificial limbs, eyes and breasts

•

low technology communication and vision aids

•

home oxygen and respiratory equipment

•

seating systems

Eligibility Requirements Applicants must have a valid OHIP card and have a long term physical disability for 6 months or longer. Initial access is often through a medical specialist or general practitioner who provides a diagnosis. Most devices must be authorized by a qualified health care professional registered with the program. Registered authorizers work in hospitals, home care agencies or private practice. The program will only help pay for equipment that is purchased from vendors registered with the Assistive Devices Program. Generally, the Assistive Devices Program will pay up to 75% of the cost of specified equipment. In most cases, the client pays a share of the cost at time of purchase and the vendor bills ADP the balance. There are other sources of funding that may help applicants pay for part of their assistive devices costs. These include: •

organizations such as Ontario March of Dimes, Easter Seal Society

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Service Clubs such as Kiwanis or the Lions Club

•

Veterans Affairs

Ontario Drug Benefit Program Through the Ministry of Health and Long-Term Care, the Ontario Drug Benefit Program covers most of the cost of prescription drug products listed in the Ontario Drug Benefit (ODB) Formulary. If you belong to one of the following groups of Ontario residents and you have valid OHIP card you may eligible for prescription drug coverage. •

Ontario Works Recipients

•

Ontario Disability Support Program (ODSP) Recipients

•

people 65 years of age and older;

Information and Referral Program – Training Manual

•

residents of long-term care facilities;

•

people receiving professional services under the Home Care program

The prescription must be prescribed by an authorized Ontario prescriber and must be filled in Ontario. There are approximately 3,000 quality-assured prescription drug products are covered under this program. ODB eligible people may be asked to pay some portion of their prescription drug product costs. Single seniors (people aged 65 or older) (2011 figures) who have an annual income of $16,018 or more and seniors in couples with a combined annual income of $24,175 or more pay a $100 deductible per senior before they are eligible for drug coverage. After these seniors pay the deductible, they then pay up to $6.11 toward the dispensing fee each time they fill a prescription for a covered drug product in Ontario in the benefit year. Recipients may be asked to pay up to a $2 co-payment for each prescription. Trillium Drug Program The Trillium Drug Program is a financial assistance program for persons who spend a large part of their income on prescription medications. The program covers drug and nutrition products, blood-glucose testing agents, and drugs on the Facilitated Access List HIV/AIDS in the Ontario Drug Benefit Formulary/Comparative Drug Index. Qualified Ontario residents pay a quarterly deductible based on income and family size. Starting on August 1 of each year, recipients pay drug costs up to the deductible level. Once the quarterly deductible level has been reached, recipients pay up to $2 towards each prescription. Ontario residents may apply for coverage under the Trillium Drug Program if they meet ALL of the following criteria: 1. They have a valid Ontario Health Insurance card. 2. They are not eligible for coverage under the Ontario Drug Benefit (ODB) Program. 3. Their private insurance plan does not cover 100% of their prescription medication expenses. Dental Services In general there is no assistance programs for adults or seniors for dental services. Some may have benefits through work that covers dental, but not all work places offer health benefits (also known as EAP). Dental services are not covered by OHIP unless the approved dental surgery takes place in a hospital. However, some health units offer programs and services designed specifically for school children (screening, referrals, and preventive services). Families unable to afford needed treatment for their children can get financial help through Children in Need of Treatment (CINOT) program and funds available to assist high school students (Extended CINOT) with urgent dental care needs. Those on Ontario Works or ODSP also have access to dental benefits. In a few cases, some county social service departments may have an assistance program for low income residents not on OW or ODSP. Other low-cost dental treatment service options are available from dental schools such as Georgian College of Applied Arts and Technology, Orillia Campus, Dental Clinic, or University of Toronto. There is still a fee for dental services, but lower than going to a local dentist.

Information and Referral Program – Training Manual

Public Health Units Public health units offers a wide range of health services focused on promoting and protecting health and preventing disease, illness and injury. Services provided through this office include Healthy Living, Family Health (including Healthy Babies, Healthy Children), Sexual Health Clinical Services, and Health Protection (including safe food and water programs) Services. People can call the Health Connection number for general inquiries about any Health Unit service. Ministry of Health and Long-Term Care Ontario Created by the Ontario Ministry of Health and Long-term Care- provides extensive access to health assessment tools, health and medical information, health care and services throughout Ontario-covers issues regarding children, men, women, seniors, conditions, drugs and services

College of Physicians and Surgeons of Ontario The body that regulates the practice of medicine to protect the public interest, has information by phone, or website of all physician in Ontario, including family doctors and specialists. Has a general phone number and a number to raise a complaint against a physician.

Housing Social Housing Social housing, also known as rent-geared-to-income, or subsidized housing, or public housing, provides affordable housing to seniors, families and individuals. Often, the program is run by the County or District government. Properties are owned by the county/district. Some units are completely accessible to those with physical disabilities. Abused women and children needing permanent subsidized housing may be eligible for special priority when referred by Crisis Centres. Also administers several Senior Citizen apartments. Seniors may apply to live in rent geared to income senior apartments or family housing apartments.

Housing Resource Centres Provides assistance for home seekers in obtaining and maintaining suitable and permanent rental accommodations; aids landlords in finding suitable tenants; provides guidance for individuals with housing concerns; acts as an advocate in addressing housing barriers; and maintains a computerized housing registry of rental units of all sizes. Some will assist with homelessness or those at risk of being homeless. Not all areas or counties have a housing resource centre/registry. In areas that do not have a housing registry, callers would have to find rental housing in the traditional methods such as newspapers, or if they have access to a computer, kijiji, or rental websites. Some housing resource centres will also run programs to assist with rent arrears and utility arrears.

Cooperative Housing Cooperative housing is member controlled housing. The members who live in a co-op are the ones responsible for running the co-op. Each member has a vote and every year members elect a Board of Directors from the membership. There are no landlords in cooperative housing. Members make decisions about how the buildings will be maintained and how the business of the co-op will be managed. Information and Referral Program â&#x20AC;&#x201C; Training Manual

The application procedures for cooperative housing vary according to the coop and whether a market-rate unit is required or a subsidized unit. Shelters Shelters offer anyone who needs a warm and safe place to sleep. Some shelters may have restrictions such as only men or women allowed, and some are strictly for families. Some even have restrictions such as only accepting women who are fleeing an abusive situation. There may also be restrictions on the length of stay, however this varies greatly from shelter to shelter, depending on the need. Some areas have limited options for shelters such as a shelter for youth, or a shelter that accepts families, or a shelter for women who are not fleeing an abusive situation. For example in Simcoe County (2012) there is only 1 youth shelter which is located in Barrie, which means clients would have to find transportation to get to Barrie. Accessing emergency housing: Obtaining immediate housing for the homeless could involve contacting the shelter, or in some cases housing is arranged by an agency such as the Salvation Army. For after hours (evenings and weekends) alternative contacts might be in place such as the local police service. Canada Mortgage and Housing Corporation Underwrites loans for home ownership, rental housing and non-profit housing-RRAP (Residential Rehabilitation Assistance Program for low income housing, rental units rooming houses and accommodation for the disabled)-HASI (Home Adaptation for Seniors Independence for low income seniors)-On Reserve Non-profit Housing-SEP (Shelter Enhancement Program financial assistance fort agencies dealing with family violence to build, repair and improve shelters) Landlord & Tenant Board The Tribunal is an independent body established to administer the Tenant Protection Act; to resolve disputes between landlords and tenants and to provide information about the Act. Provides information to residential landlords and tenants concerning their rights and obligations under the Act

Legal Questions to ask: What is the personâ&#x20AC;&#x2122;s legal situation? Do they need to be directed to Legal Aid or to the Community Legal Clinic? Would they qualify for Legal Aid? Has the person previously sought legal advice regarding this matter? Things to consider: Is this a Criminal or Family Law Matter â&#x20AC;&#x201C; refer to Legal Aid Community Legal Clinic will not assist individuals in Criminal or Family Law matters Legal Aid

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Legal services for low-income residents involved in some types of court matters, including family, criminal, mental health, and immigration litigation. If a qualified applicant is approved, Legal Aid may provide partial or complete payment of the legal services provided by a lawyer. Family violence clients may qualify for two hours of free legal advice through the Women's Shelters Community Legal Clinics A legal clinic funded by Legal Aid Ontario to encourage access to legal services and to provide direct legal services to low income clients. Provides free legal advice to the public. Advises them as to their legal rights and proceeds to court or tribunal if necessary. Offers advice on Income Maintenance Programs such as Workplace Safety and Insurance Board, Ontario Works, Ontario Disability Support Program, Employment Insurance Benefits, Canada Pension Plan Benefits. Also offers advice on Education, Residential Tenancies Act, Ontario Housing, Human Rights as it applies to Employment, Housing, Government Service, Income Maintenance, General and Administrative Law. Does not do family law or criminal law. Services offered over the telephone and by appointment. Community Legal Education Ontario CLEO is a community legal clinic that produces clear language publications and resources on variety of topics. Main topics include social assistance, landlord and tenant law, refugee and immigration law, workers' compensation, women's issues, family law, employment insurance and human rights. Upper Canada Law Society Lawyer Referral Service

The free call to the The Lawyer Referral Service will provide the name of a lawyer who will provide a free consultation of up to 30 minutes to help you determine your rights and options who practices in the area of law that meets your needs. The service can also help you find a lawyer who meets specific requirements such as speaking a certain language or accepting Legal Aid certificates. Lawyers participating in the Service will offer you up to a half-hour free consultation. This consultation may be over the phone, or in person (the choice is up to the lawyer). During this time, you can ask: * How the law applies to your situation * How to use the law to solve your legal problem * How long the legal work may take * How much the lawyer will charge After the consultation, you can decide if you want to hire the lawyer to work for you.

Transportation Transportation can be a challenge for residents in rural communities. Local resources are often limited as far as medical, social and government resources which require residents to travel outside their communities. Unless they have can drive themselves or have family to drive them, callers are left to obtain transportation on their own, which can be costly. Quite often, people are required to travel as far as Toronto for medical services. Public Transportation Larger towns and cities will have a bus service run by the municipality, providing transportation for a fee for residents. Information and Referral Program â&#x20AC;&#x201C; Training Manual

Transportation Options

Often, callers will be seeking free or volunteer transportation services either to get around town or to travel to another community. Very few communities have a volunteer ride program. This is true even for the disabled and seniors trying to get to medical appointments. Some agencies such as the Cancer Society will provide free transportation to medical appointments related to cancer treatment. Recipients of Ontario Works or ODSP can talk to their worker about getting transportation for medical appointments paid for. In general, most transportation options are a fee for service program. Rates could be charged by time (by the hour), or mileage or sometimes both. There are multiple agencies that will provide transportation but for a fee. Options for long distance travel, such as to Toronto are limited and expensive. The service provided by programs such as those for seniors varies as well. Some will pick up at the doorstep, stay with the client during the appointment and drive them back home again, some will pick up drop off at the location, then pick them up again later to take them back home. Some programs require a lot of advance notice to book a ride, in some cases this can be 7 days. When making a referral for transportation, determine if the caller requires accessible transportation. Not all programs use accessible vehicles. In some cases the driver is using their own car. For some programs, they only serve individuals with a disability. .

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Accessing Human Services using the Resource Data Base A resource database is a computerized collection of information about community resources maintained by the I&R service. The database is the key tool for the delivery of information and referral, helping bring people and services together. When a client calls 211, walks in to see and I&R specialist, or searches the online database, the database is used to find the correct information. Community Connection has created a comprehensive database with thousands of individual records for agencies, services and programs in 211 Central East catchment area. Community Connection’s data resources department combined with I&R specialists ensure that the information in each record is accurate and up to date. For each record, the database will describe, what the agency does, who does it serve, contact information, fees if any, eligibility requirements, what type of agency it is, and other useful information needed to provide information and referral.

Accessing Human Services Information on the Internet In some cases, the internet might have to be used if the information cannot be found in the I&R resource database. This is often the case if someone with a disability, such as being visually impaired is requesting information on a service not normally found in the database, such as a business. The following information is designed to provide I&R practitioners with helpful hints and instructions when using the Internet to locate information when cannot find the information on the 211 data base. 1. Know What You’re Looking For This is where the assessment process plays a critical role. If we don’t know what we are looking for, how do we know when we have found it? Before even using the Internet, determine the focus of your search. 2. Find the Information You Want To find information on the Internet, I&R providers need to know: a) How to use the Internet; b) What search tools are needed; and c) How to access them. Most of us are familiar with search engines, but there are also other search tools, including directories, subject guides, libraries and bibliographies. Search Engines Search engines, such as Google, are Internet pages dedicated to locating other pages. To use a search engine, a key word (or words) is entered and the search engine scans the Internet for resources related to the key word(s). The result is a list of links to different Internet pages that can be immediately accessed. The more detailed the key word(s), the more exact the results. As in any library search, the parameters of a search may have to be adjusted to locate the desired information. This is done by typing in new key words, or new combinations of words. Not all search engines are the same. If you want to find out how to best use a particular search engine, read the tips, Frequently Asked Questions (FAQs), or Help sections on the site to learn how best to find the results you need.

Information and Referral Program – Training Manual

Directories Resources such as Yahoo! organize information into categories. You can type in key words or click on the various categories in a subject area. To have their site appear in a search, Internet site owners must register their site with the directory. This is why some organizations with Internet sites do not always appear, even in the most detailed search. Subject Guides Subject Guides are similar to directories, but content is developed by editors to ensure effective search results. www.211SimcoeCounty.ca is an example of a subject guide made up of organization and program information. 3. Get the Information in a Format You Can Use

The Internet allows users to actually take files (MS Word, PDF, Excel, etc.) and even pieces of software from an Internet site and save them to a computer. Downloading something from the Internet means copying a file from one computer to another. Two main steps are involved: downloading the file opening or reading the file. An anti-virus program is critically important when you will be downloading information to a computer. These programs scan the document for viruses that can harm a computer or the information stored in a computer. Internet browsers like Internet Explorer and Netscape Navigator allow users to save Internet pages on the desktop of a computer if the information is not available to be downloaded, and exists only as an Internet page. You can get the information in two ways: Copy and Paste: to save pieces of information from an Internet page, highlight/select the text that you want to save, copy it and then paste it into your open word processor or text editor program. Save As: to save the entire text on a page, click on the pull-down menu “File” and select “Save As ”. Make sure that you select “plain text” and that the file name you chose ends in “.txt”. You’ll be saving the file to your computer as a plain text file, without any of the funky formatting on the screen and without the graphics, but the text will be saved. 4. Evaluating the Information Assessing and evaluating the information to ensure it is accurate, reliable, appropriate and up-to-date is the next important step. Don’t assume that just because the information is on the Internet it is reliable. There are five basic criteria for evaluating Internet pages. 1. Accuracy 2. Authority 3. Objectivity 4. Currency 5. Depth of coverage 5. Use the information Downloaded or saved information from the Internet can be printed, or incorporated into reports or other print materials (citing Internet site addresses and other sourcing information as required). It can also be e-mailed or sent to someone else. Information and Referral Program – Training Manual

Specialized Inquirer Populations Awareness and Tolerance So much of the way we interact with people has to do with who we are. Self-awareness is one of the keys toward positive interaction with people who are different. People who are secure in their own ethnic identities can act with freedom, flexibility and openness to persons of different ethnic backgrounds. Stereotyping, prejudice and discrimination limit our ability to assist callers. Stereotypes are irrational beliefs associated with a category, such as a group of people. Although stereotypes are not identical to prejudice, rigid stereotypes about people lead to prejudice. Prejudice is a way of viewing people who are different as somehow deficient. It means prejudging a person based on a stereotype without taking an opportunity to know the person. Discrimination refers to actions towards or practices regarding members of a less powerful group that result in there being treated differently in ways that disadvantage them Effective I&R Specialists demonstrate the ability to work with multicultural/ethnic inquirers, older adults/ seniors, people with disabilities (including hearing and vision), sexual minorities and other special populations. Learning Objectives: Many different people will be calling you for assistance. You should always be mindful of the special needs of some of your callers. As professionals, we must always be aware of how our own values and biases can impact the way we respond to callers. Over the phone we have extremely limited information regarding who the caller really is as an individual. This is why we must always strive to expand our knowledge regarding how to communicate and assist people of different backgrounds, educational levels, abilities and language capabilities. When assisting callers, it is important to be patient and understanding. Callers deserve support in getting a positive solution to their problem despite any difficulties they have in communicating their situation. Prejudging and Making Assumptions about People When speaking to callers there are prejudgments that should not be made. For instance, some prejudgments have to do with language, accents, and speech. If someone does not speak English well, stutters, speaks slowly, or has a speech impediment, it does not necessarily mean they do not understand what you are saying. Some prejudgments are made based on economics. If someone is experiencing a financial crisis, it does not necessarily mean they need help with money management or have always been poor. Their tight financial situation may have come about suddenly or may be temporary. Some prejudgments are based on age. There is a tendency to equate some ages with limited mental capabilities. If someone is “too young,” “ too old,” hard of hearing, uses very simple words, or asks a lot of questions, we sometimes assume that they cannot comprehend complex ideas. For each of us our perception is reality. What we see or hear is real to us. We need to be aware of our attitudes, the potential for being judgmental, and the resulting impact it can have when we interact with clients.

Information and Referral Program – Training Manual

Things to Remember... Don’t make assumptions based on: ♦Accents ♦Tone of voice ♦Speech impediment

♦Stuttering ♦Slow or fast speech ♦Difficulty speaking English

I&R specialists must strive to: • View each inquirer as an individual and each inquirer’s needs as unique and worthwhile. • Recognize and respects differences, and when uncomfortable, looks to his or her own values as the source of the difficulty rather than reacting negatively or making judgments about the inquirer; • Use language that is respectful and acceptable within the group: • Avoid words that are offensive such as “senile” or “crippled”; • Avoid labelling people (e.g., substitutes “people with disabilities” for “disabled people”, “people who use wheelchairs” for “wheelchair-bound”); • Avoid language that is sexist. • Avoid making assumptions or generalizations about a particular ethnic/cultural group or other special population (e.g., that all members of a particular group are alike, that all have the same values, that all are unable to speak/understand English, that all are able to speak what is assumed to be their native language); • Recognizes when the inquirer is struggling with communication in English and follows the agency’s language protocol to identify and access interpretation assistance; • Learn cultural differences, which may affect communication (e.g., differences in body language, eye contact conventions, forms of address, methods of conveying respect) and avoids negative reactions or value judgments when differences arise; • Learn cultural differences, which may have an impact on service delivery and usage (e.g., feelings about being ill or asking for financial assistance) and takes appropriate steps to ensure that the individual receives the assistance he or she needs. The Illiterate Caller The caller who can’t read or write well enough to write down the resources available to him presents a special situation. Often these callers will let the I&R Specialist know at the beginning of the call and ask for additional assistance. However, because of embarrassment, more often than not the caller will ask for the information to be repeated in order to memorize it or they will ask the I&R Specialist to spell each word. The specialist needs to keep in mind that patience helps to put the caller at ease and it is more likely that the caller will be able to use the information more effectively. Assisting Illiterate Callers 1. These callers usually ask you to repeat things over and over. 2. They may be embarrassed to let you know that they are illiterate and are trying to memorize the information. 3. Do not become angry or upset. 4. Your patience and support are very important to these types of callers. 5. When appropriate, you may want to offer to spell the word. Callers on Government Assistance Callers on government assistance have their own set of difficulties when calling for assistance. Many times these callers are in a crisis, in a state of dysfunction, or illiterate and they are unable to manage without assistance. They may also be unable to cope with government programs and unable to access needed resources or assistance. More often, these callers are frustrated because of lack of resources, and fearful of not being able to provide for their families. The caller could also be afraid of government authorities and this frequently prevents the I&R Specialist from assisting the caller with resources. An I&R Specialist will need to reassure the caller that there are solutions. Information and Referral Program – Training Manual

The New Poor Economically, Canadians are suffering more and more due to changes in government programs and this means that families are faced with a growing lack of resources. There is a new segment of the population, the new poor or newly disenfranchised. These callers have been recently laid off, fired or injured, and unable to work. Unable to cope with the lack of resources, the caller could be very angry. Having worked all of their adult life, many times at the same job for many years, they don't have the same survival skills of people who have been poor. They feel lost and at odds with the world. They may feel ashamed of being without means and having to ask for help. It is with these callers that the Specialist must utilize all of their active listening skills. Listening is the most important part of the call and it makes the caller receptive to solutions.

Addictions: Alcohol, Drugs, Substance, Gambling, Sex Alcohol Is alcohol really a drug? Yes, in every sense of the word. Alcohol can produce all the classic signs of addiction: changes in tolerance (the need of more and more alcohol to achieve the same effect), cellular adaptation or tissue change, and withdrawal. For simplicity’s sake, the following definition applies to both alcoholism and other drug addiction. Alcoholism/drug addiction: a chronic, primary disorder characterized by some loss of control over the substance, with either psychological or physiological dependence/need, or causing interference in any major life function (e.g., health, job, family, friends, legal, or spiritual). Drugs A drug is a chemical substance, which when taken into the body, produces some mind/mood/physical change in the normal state of the person. Drugs are classified into three general categories: depressants, stimulants, and hallucinogens. Relief – If bored, lonely, unhappy, scared, angry, or feeling pressured, some people try a drug or drink alcohol for quick relief. Increased use – To feel the same relief, the person must take more of the drug or alcohol more often. Preoccupation – The person frequently thinks about taking the drug and/or about its effects. Daily use becomes the norm. Problems can increase with parents, relationships, work, or school. Dependency – More of the drug or alcohol is needed to feel okay. Physical signs such as coughing, sore throat, runny nose, weight loss, and fatigue are common. Blackouts and overdosing may occur. Withdrawal – If users cannot get the drug, most experience withdrawal symptoms: itching, chills, feeling tense, nausea, sweating, and stomach pain. Gambling

Problem gambling affects people from all walks of life. Gambling can take on forms of betting on sports, buying lottery tickets or scratch cards, playing roulette, poker, or slots, in a casino or online games. Gambling can strain your relationships, interfere with home and work, and lead to financial hardship. Gambling may lead individuals to do things they never thought possible, like stealing money to gamble, taking money meant for your children, using money meant for household bills. Gambling addiction, is also known as compulsive gambling. Gamblers can’t control the impulse to gamble, even when they know their gambling is harmful to themselves or their family. Gambling is all Information and Referral Program – Training Manual

they can think about and all they want to do, no matter the consequences. Compulsive gamblers keep gambling whether they’re winning or losing, broke, happy or depressed. Even when they know the odds are against them, even when they can’t afford to lose, people with a gambling addiction continue to gamble.

Helping a gamble out financially might sound helpful, but, quick fix solutions may appear to be the right thing to do. However, bailing the gambler out of debt may actually make matters worse by enabling gambling problems to continue. Gambling addiction is sometimes referred to as the "hidden illness" because there are no obvious physical signs or symptoms like there are in drug or alcohol addiction.

Sexual Addiction Studies show that sexual addicts use sex in the same way that drug addicts and alcoholics use drugs or alcohol: to alter their moods and temporarily relieve psychological states of discomfort, such as anxiety or depression. Most sexual addicts feel ashamed and worthless. Some behaviours associated with sex addiction are, multiple affairs, anonymous partners, consistent use of pornography, obsessive dating. In addition to damaging the

addict's relationships and interfering with work and social life, a sexual addiction also puts the person at risk for emotional and physical injury. Resources for sexual addicts are limited. Be sure to be creative and offer generalized counselling also. Substance Abuse If you’re working with a substance abuser, be prepared to deal with ambivalence, denial, and manipulation. The denial is easy to understand — “If I can convince myself and everyone else I don’t have a problem, I don’t have to deny myself what I want so badly. I can continue using my drink or drug of choice. The trouble is, perhaps my habit is causing me problems”. That’s when ambivalence comes about. Change of mind when someone is considering seeking treatment, is not uncommon. Then there’s manipulation. How do you help someone with a substance abuse concern? First, you prioritize for safety. “Prioritizing for Safety” • Is the person showing any of these symptoms: • Is he unconscious? • Is his breathing shallow? • Does he have a frozen or unnatural appearance? • You should also treat suicide threats from a person who has been using alcohol or drugs with extreme seriousness. Substance abuse significantly increases the risk of suicide. • Someone who isn’t experiencing dangerous symptoms. Case Example:

Joe calls or comes to see you with some presenting problem which may have nothing to do with alcohol or drug use. But as you listen to the circumstances of his life you will realize there is a problem beyond the presenting one. Frequently you’ll hear, “I got fired for missing too much work.” “My family Information and Referral Program – Training Manual

won’t help me, they’re so cold.” “None of my friends will help me.” “ My sister took my children from me,” or maybe, “My sister lied about me and Children’s Aid took my children away.” And as you get into the circumstances you’ll begin to realize who you are talking to. “The judge says I have to attend a treatment program before I can get my children back.”

How to deal with this call: The first words out of your mouth should not be, “Aha! You are an alcoholic!” or “You are a drug addict!” That kind of intervention won’t work until there’s some level of trust and some level of caring established. Labelling isn’t important at this stage. It’s not a question of getting someone to agree with you that she’s an alcoholic so much as helping her to be willing to deal with the problems alcohol has caused in her life. This is, however, a good time for a supportive confrontation. Remember that a supportive confrontation is never hostile, but is a sort of clarification. “You feel like you don’t have a problem, but the judge says you have to get into treatment before your kids can come home. Is this something you’re willing to do to get your kids back?” Substance abusers come from all walks of life, and some are very successful and wealthy. If they have enough money, all they have to do is turn on the TV and they will see commercials telling them where they can go for help. They are usually not the people who ask us for help. The Information & Referral Specialist will more likely be dealing with people who not only can’t afford to pay for treatment, but who may not be able to meet even their basic needs for food and shelter. Those basic needs have to be addressed, and they have to be addressed first. It’s just not feasible to expect someone to get sober if he’s on the street. Treatment Suppose someone really does want to enter a treatment program. If you want to refer her to a source of help, where do you start? Consider starting with the least intensive treatment that may work, because those are the easiest to access. Anybody can attend a 12 Step meeting, but residential programs are tougher to get into. Often there are waiting lists. If somebody lives in a fairly supportive environment, he may be able to get clean just by going to 12 Step meetings. On the other hand, if he’s surrounded by substance abusers, he probably needs to get away from that environment, and that means a residential program. Some people need to first get the alcohol or drugs out of their system, which means they need to detox. Most people with alcohol problems can go to a social model detox. This is a supportive environment without medical supervision. A few can’t. These include people who get seizures when they stop drinking, or who are in the final stages of alcoholism and are hemorrhaging from the lungs. They may need medical model detox which is medically supervised. While it’s relatively easy to get people into a social model detox, even if they don’t have much money, medical model is another story. Many medical model programs are very expensive, or if they are funded through government health care, the waiting lists are very long. You really don’t have to make the determination about which is most appropriate. Usually you can refer to a social model (service) program first and let the program do the screening. If someone isn’t appropriate for them, they can sometimes help them get into a medical model.

Information and Referral Program – Training Manual

Family and Friends If the abuser is in treatment, family support is readily available. But what if the abuser refuses treatment? Family and friends need help to cope, and to make some decisions. There are programs for families of addicts such as Alanon. Other programs may also be available in the community.

Addictions Resources: Ontario Drug and Alcohol Registry of Treatment (DART)

This program provides information of drug and alcohol treatment agencies and programs throughout Ontario. Because this is a province wide agency, this is a helpful resource to suggest when there are no (or limited) treatment options it the caller’s area. For example, DART can let the caller know about residential programs that are outside of the Central East 211 catchment area, but that the caller can still access.

Adolescents Challenges of Adolescents Adolescents can be a difficult target population. Youth may have different expectations and approaches to services than other callers.

Young people often focus on the present. They find it hard to make long-range plans or to prepare for the distant future. Young people often find it hard to understand the idea of risk or risky behaviour. Adolescents are characterized by black and white thinking. When problems occur, adolescents may go to extreme thinking and automatically assume that this is the worst problem ever. Listen instead of judging. Many times when teenagers seek assistiance we immediately feel as though we have words of wisdom that we need to impart. Instead of being quick to share, make sure you are listening. Adolescents may not be interested in services, although there parents may be calling for help. Show respect, as you do for other clients. Do not talk down to young clients. Be understanding. Recall how you felt when you were young. Avoid judgments.

Resources for Adolescents: Care must be taken when finding referrals for youth. Some things to keep in mind the when making researching referrals: youth’s age, location, financial situation, access to transportation, are they Information and Referral Program – Training Manual

attending school, family & friend’s support. Remember to check a program’s eligibility before giving out a referral. Quite often, resources for youth are scare or non-existent. Counselling: Some agencies are directed only towards children and adolescents. Some programs only serve 18+, some only serve 16+, some are only for preschoolers. Check age eligibility for the program before giving out the referral. Some terms to consider for adolescent counselling: behaviour, aggression, bullying. Services for ADD, ADHD, Autism etc, might be limited for some areas. Crisis:

Some areas will have a separate crisis line for adolescents. Sometimes crisis services will be “mobile”, meaning a crisis worker will meet youth/parents at a location (home, hospital, school, etc). Shelters: Shelters just for youth can be scarce. Some counties do not even have a youth shelter. In some counties, there is only 1 youth shelter. Some adult shelters will accept anyone 16 and older, but then the youth would be sharing space with adults. Try to review options for homeless youth, such as staying with friends, or family, even if for a temporary basis. If youth do not plan on returning home, they will need a referral for permanent housing through their local housing resource centre (if there is one), and may also require a referral to Ontario Works for income assistance. Drop-in Centre: Youth drop-in centres offer a safe place for youth to hang out with activities such as recreation, computer usage, homework assistance among others. The centres can be open to all interested or at risk youth. Provincial Wide Resources:

Children's Mental Health Ontario, an association of over 85 Children's Mental Health Member Agencies that maintains a database and website of resources and links to assist the public in understanding mental health issues in children and youth.

Kids Help Phone: toll-free, 24-hour, bilingual, confidential and anonymous phone and web counselling, referral and information service for children and youth aged 5-20. Provides immediate, caring support to young people in urban and rural communities across the country.

People with Disabilities Historically, people with disabilities have been marginalized, treated as "other" or "less than" by society. People with disabilities were seen as burdens to society, since it was assumed they couldn't work to contribute to the greater good or to support themselves economically. When children with severe disabilities died, friends and neighbors called it a "blessing." Even very recently, doctors and human service workers counseled families Information and Referral Program – Training Manual

to send their newborns with disabilities to institutions, often suggesting they forget them, have more children, and move on with their lives. Unfortunately, current media portrayal of people with disabilities leaves us with images and language that are directly in line with that historical mindset. Just as damaging are writers and newscasters who describe people with disabilities as "heroic" when then accomplish a task that nondisabled people routinely perform. They talk about people "fighting to overcome their handicaps", describe people as "victims of polio struggling to be normal again." Examples of this abound, like recent stories of a blind couple who are successful parents “despite their blindness,” or a little girl with a prosthetic leg participating in track and field events "against all odds". We ourselves may have even felt admiration for the people in these stories. However, these stories send strong negative messages: • Having a disability is bad, awful, and abnormal and that you should be glad it hasn't happened to you. • That while there are people with disabilities who are to be admired for achieving what non-disabled people do, they are probably exceptions rather than the rule and that we should feel sorry for the rest. Civil Rights for People with Disabilities: In the early 1970s, Americans with disabilities began a civil rights movement of their own modeled much after the earlier efforts of African Americans and women: • People with disabilities fought against institutionalization of people with developmental disabilities and mental illness and against warehousing people with severe physical disabilities in nursing homes. • They fought against the medical model of treatment by Tips for Improving Communication human service agencies when dealing with the large part of their lives that wasn’t related to their medical condition. • They fought for access to public buildings and public transit, chaining themselves to buses in protest. • They fought against discrimination in employment and hiring practices, in housing and access to recreational activities. Leaders of this movement recognized that many of the barriers they faced came from society and were not intrinsic to their disabilities. They worked to bring that same realization to people without disabilities, especially those in positions of government and power. The signing of the disabilities acts and legislation increased public awareness of the barriers that people with disabilities face in everyday situations. The but while the legislation changed the law, it didn’t necessarily change public stereotypes of people with disabilities. Much work still needs to be done on that front, and some of that work needs to be done by people without disabilities who are in positions of power and influence in our communities. In other words, some of the responsibility lies with us as I&R providers. The Role Of I&R Providers in Changing Stereotypes: People First Language: The human service community is just beginning to recognize the need to become more educated and sensitive in interacting with clients who have disabilities. I&R providers can take the lead in this area by modeling new ways of thinking about and interacting with people with disabilities. We can also model empowering language and values to people with disabilities themselves, many of whom have internalized society’s less-than-positive assumptions and expectations. As I&R providers, we know that the meta-message we send to callers can be more powerful than the informational content of the message itself. The words that we choose (consciously or unconsciously) when talking to or about people with disabilities can either reinforce stereotypes and continue to oppress or it can start changing paradigms. It is vital that we make a conscious choice of using neutral rather than prejudicial language. Consider the images that get conjured up by two sentences: • My husband can’t walk • My husband uses a wheelchair. Information and Referral Program – Training Manual

By focusing on what the subject can’t do, the first sentence suggests someone to be pitied. The second portrays someone who gets around. Prejudicial language is so pervasive that people with disabilities may inadvertently use it themselves. That’s hardly surprising, since they grew up with the same role models as the rest of society. One way to confront and redirect caller’s prejudicial language without being confrontational or embarrassing them is to paraphrase what they have said back to them using appropriate, empowering language. If a caller says someone is confined to a wheelchair, you can say that the person uses a wheelchair. If the caller says someone is suffering from polio, you can refer to the person as having polio. Similarly, avoid making seemingly sympathetic comments that reinforce stereotypes. When talking about a person who is blind, don’t say things like It must be so hard for her to get around, she must be deprived of a lot of things. If someone uses a wheelchair, don’t say He’s such a nice looking man, it’s too bad he’s in a wheelchair. If you find yourself wanting to make those kinds of statements, it is an opportunity for you to struggle with your own internalized assumptions and expectations of persons with disabilities. As I&R providers, we are in a unique position to serve as NEW role models to the community at large and to people with disabilities who have internalized the attitudes society has of them. Communicating with People with Disabilities Who Call for I&R Services: For the most part, communicating with people with disabilities is not unlike communicating with any other individual calling for I&R services. However, there are general communication guidelines and specific word choices that will let a caller with a disability know that the I&R provider views them as having inherent worth and dignity. This positive rapport facilitates effective service and helps to ensure that callers not only get the assistance they need during that phone conversation but also feel good about calling back for additional assistance should they need to. Along with the factors that also apply to non-disabled people (tone of voice, pace, empathy skills, etc), the words we choose to describe people with disabilities and their situations are important. Few of us have been schooled in disability etiquette, so we’re often unsure of what to say to someone with a disability or how to say it because we don’t want to risk offending anyone. We consequently take our cues from the media and the culture around us, and therein lies the potential for problems. Don’t Generalize: Just as we cannot make generalizations about women callers or Hispanic callers, it’s dangerous to make them about callers with disabilities. Disabilities cut across ethnic, gender, socioeconomic, cultural, and age lines. When you’re dealing with a person with a disability, focus on the person rather than the disability he or she happens to have. Don’t assume that people with disabilities know each other. There isn’t a natural wheelchair community or a stroke community, and assuming there is shows a segregationist mindset. Don’t assume that all people with similar disability labels are impacted by that disability in the same way. Chronic Fatigue Syndrome and MS are good examples of conditions that may be more disabling to one individual than another, and the intensity of the symptoms may vary from one day to the next within each individual. Just because you know one person with MS who used a motorized cart, don’t assume that the next caller who has MS also needs a cart. • •

• •

Furthermore, don’t assume that all persons with disabilities are activists. Just as not all women are actively involved in the women’s rights movement, not all persons with disabilities are part of the disability rights movement. One exception to this may be the Deaf community, who historically have formed their own community, based primarily on a shared language and culture. People First Language: Information and Referral Program – Training Manual

One way of displaying sensitivity is by referring to a person with a disability as a person before referring to their medical condition or diagnosis. In her article, “People First Language,” Kathie Snow says that, “When we misuse words, we reinforce the barriers created by negative and stereotypical attitudes. When we refer to people with disabilities by medical diagnoses, we devalue and disrespect them as members of the human race.” Consider the following examples: People First Language: People with epilepsy People who had polio People with disabilities

Prejudicial Language: Epileptics Polio victims The disabled

Neutral Language Much of the language customarily used to describe persons with disabilities is blatantly prejudicial. By using these tired phrases, people unconsciously perpetuate negative images. Neutral Language: Prejudicial Language: He has a congenital disability He has a birth defect She has an emotional disability She’s emotionally disturbed He uses a wheelchair He’s confined to a wheelchair Accessible parking Handicapped parking Words like defect and disturbed are inherently negative terms, and the only persons in our society who are confined are prisoners. Neutral language applies when referring to ALL people, including those without disabilities. The term able-bodied is itself prejudicial and offensive and presents a narrow view of what a disability could be—many people with disabilities can be described as being able bodied. When referring to people who are not disabled, refer to them as people without disabilities or non-disabled people. Remember: people don’t overcome disability. They overcome social, economic, psychological, attitudinal, architectural, transportation, educational and employment barriers. Using Common Figures Of Speech: It’s acceptable to use common expressions and figures of speech, even if they seem to related to a person’s disability. We all say things like, See you later or Gotta run. People with disabilities use these phrases, too, even if they can’t see or run. Take a walk with a friend may be an appropriate suggestion to a caller, even if they use a wheelchair. Don’t be uncomfortable about using everyday English. One cautionary note: Words that are used as negative labels for persons with psychiatric disabilities are also part of daily speech. Some people feel that it’s OK to say That person is driving me nuts, while other people feel that this is an inappropriate statement. There is some amount of debate about this among people with psychiatric disabilities. In needing to choose sides on this issue as I&R providers, the best course of action may be to eliminate the use of words like crazy and nuts when describing people or situations. Asking Questions About A Person’s Disability: If a caller tells you they have a particular condition that you’re unfamiliar with and if the condition seems to be related to their reason for calling, tell them so and ask them to briefly describe how their medical condition or disability impacts on the reason they are calling for assistance. Honesty about your own lack of knowledge about their particular disability will enable you to gather important information to assist the caller. Questions that satisfy only your own curiosity about a particular condition or disability but do not directly impact the service you are providing should not be asked. For example, if a caller want to know if there is a local ski resort that rents skis for wheelchair users, it would be inappropriate to ask about how people in wheelchairs can ski. Specific Strategies for Enhancing Communication with People with Disabilities: When talking with most people with disabilities on the phone, there aren’t many communication considerations to keep in mind beyond what has already been discussed. However, there are a few disabilities Information and Referral Program – Training Manual

that may make communication more difficult than we are used to, usually due to our own individual lack of experience or comfort level. Talking with people with speech disabilities: Don’t make any assumption about the caller’s cognitive functioning level based solely on their speech pattern. A speech disability does not necessarily mean that the caller has a cognitive disability, even though speech disabilities can accompany disabilities that impair cognitive function. Listen for content or responses to complex questions to determine whether the caller has a cognitive disability. Resist the urge to finish sentences being spoken by people with speech disabilities. You may find yourself engaging in this practice without being aware of it. As soon as you become aware of it, apologize and then stop doing it. While it’s always useful to repeat back to any caller what you think he or she has said to see if you've gotten it right, the technique is crucial when the caller has a speech disability. Simply being heard is important to every caller. Don't be afraid to admit that you didn't understand what was said and to ask the caller to repeat the message (and perhaps to phrase it differently). Pretending to understand is never an option. By making repeated efforts to understand the caller, you’ve built trust and rapport, even if both of you experienced frustration during the interaction. Talking to people with physical/motor disabilities: If you’re not sure whether a place is accessible, don’t assume it is when you make a referral. Just because the city commission meetings should be held in an accessible facility doesn’t mean they are. Encourage callers who indicate they have a disability that impacts their mobility to call the venue and ask the specific questions that allow them to determine if the facility is accessible to them. What may be accessible for one person may not be for the next. Talking with people who are hard of hearing: Many people who are hard of hearing have learned to guess at what has been said in order to blend in and hide their disability. They may be embarrassed to admit they have a hearing loss. It is especially important to ask callers with this disability to repeat the information you gave them back to you. Talking with people with psychiatric disabilities: Some psychiatric disabilities manifest themselves as thought processing disorders, which means callers will present as if they have one of the cognitive disorders mentioned below. In that case, simply adhere to those guidelines. For callers who seem to lack a reality orientation or are in crisis, fall back on the skills and training you already possess for dealing with these situations. Talking with people with cognitive disabilities: Common cognitive disabilities include people with developmental disabilities (what used to be called mental retardation), brain injuries, and severe learning disabilities. One of the most important things to remember is to treat adults with cognitive disabilities as adults. The common tendency to describe adults with cognitive disabilities as being child-like or having the mental capacity of a 10 year old is not only patronizing, it encourages people to interact with them as though they are children. Don’t make this mistake. Use language that is concrete rather than abstract, and avoid common expressions and similes that have the potential to be confusing (like It sounds like you felt like a fish out of water). Information and Referral Program – Training Manual

Be specific when giving instructions and use short sentences. Be prepared to restate the same information multiple ways. People with brain injuries may have short term memory deficits and may repeat themselves and/or require information to be repeated multiple times. When giving directions or instructions, describe what needs to occur in the sequence in which it needs to occur. People with cognitive disabilities may have difficulty prioritizing the order of tasks. Again, all people are unique. These guidelines aren’t meant to imply that all people with a particular type of disability may have the same communication needs. Reasonable Accommodations When Providing I&R Service for People with Disabilities: Like all other human service agencies, I&R programs are required to provide reasonable accommodations to people with disabilities. These reasonable accommodations might be things like: Providing brief written summaries of referrals and recommendations via post, fax, or e-mail - Never assume that people can remember things or that they can physically jot them down. It's good practice to always ask callers to write down the information you're supplying (particularly phone numbers) and to have them read the phone numbers back to you, but remember that, for a variety of reasons (not all of which are related to disabilities), not all people can read or write. People may sometimes be reluctant to admit that they can’t write down the information you’re providing over the phone, but if you suspect that this is the case, offer to send written information to the caller. We sometimes give information that is more complex than just a phone number, so writing down instructions may be too cumbersome for something who has trouble with short term memory tasks. Even if the caller can write, it may be more expedient for the I&R provider to summarize what was discussed and send that to the caller. Sending information to blind/visually impaired persons in alternative formats - Remember to ask what format they would like their material in. Formats may include standard text (which friends or family members can read to the caller), Braille (which not all blind people can read), audiotape, or large print e-mail (which can be read aloud by special computer programs). * * *As we continue to move toward a society that believes in the inherent worth of every citizen, much of what is discussed here will simply become what we do. Each of us has a role to play in making that future a reality. I&R providers are in a unique position to disseminate not just information but more cultural constructs that can help change the way that people with and without disabilities communicate with each other. (Adapted from text written by Michele McGowen, Disability Resource Center (Kalamazoo, MI) for the Alliance of Information and Referral Systems)

Deaf, Deafened or Hard of Hearing Members of the hearing world often group deaf and hard of hearing persons into one category. The frequency with which the term "deaf and hard of hearing" appears in the media attests to this conglomeration. In reality, there are several groups included within the broad "deaf and hard of hearing" category, and the various groups have distinctly different characteristics.

Orally Deaf: Were born deaf or became deaf at a very young age, before the acquisition of language but who lives in the hearing world by reading lips and learning how to speak. They were typically fitted with hearing aids and encouraged to function as much as possible as a hearing person. They probably attended a mainstream school, rather than a Deaf school. Oral deaf persons typically do not learn ASL or participate in the Deaf community.

Information and Referral Program – Training Manual

Culturally Deaf: People who were born deaf or lost their hearing at a very young age. Communicate with ASL, immersed in Deaf Community, identify as a deaf person. Because culturally Deaf people never had

hearing, they don't miss it. Many, if offered a magic pill that would make them hearing, would not take it. Losing their Deafness is just as frightening to them as losing their hearing is to hearing people. This is a difficult thing for hearing people to understand. Note that when the word "Deaf" is capitalized, it refers to Deaf Culture or culturally Deaf people. The uncapitalized word refers to the medical condition of impaired hearing.

Hard of Hearing: The vast majority of people with hearing loss consider themselves hard of hearing.

Their hearing loss ranges from mild to profound, but they consider themselves to be hearing people who just don't hear well. Deafened or Late Deafened: Have become deaf later in life (seniors, accident victims, etc) Deaf-Blindness: 69,700 Canadians over age 7 are considered Deaf-Blind. Persons who provide support are called intervenors who communicate buy using special sign language touching the hands. - never touch a person who is deaf-blind without permission - don’t touch the service animals - never leave a deaf-blind person alone. If you must, ensure they know where they are and when you will return.

Inappropriate Labels: • deaf & dumb (meant mute) • deaf mute • handicapped • hearing impaired (because it labels a person by what they don’t have, negative), although some will identify themselves as “hearing impaired”. Appropriate: Deaf, hard of hearing, deafened

Misconceptions: Speech Reading (lip reading): • Assumed to be easy, not true, and those who can lip read must be getting most of the information • In fact, only 4% can fluently lip read and even those individuals can only read 60% of the information (40% of speech is with the tongue and vocal chords, so can’t be seen with mouth and lips) Sign Language (ASL): • Assumed just gestures, but really a unique language with its own grammar, inflections, etc • Sign language is NOT universal, for every written language there is a sign language as well • ASL is the 3rd most used language in Canada and the US Hearing Aids: • Not like glasses, doesn’t make hearing clear, only amplifies any hearing that already exists Literacy Skills: Information and Referral Program – Training Manual

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Many deaf people have poor literacy skills, nothing to do with intelligence, the system has not taught them adequately Focus for deaf is on vocational training rather than academics Also a teacher bias, not expecting the same level from deaf students as others

Communication Modes: Gestures/Home Signs: developed within a family, shorthand means of communication Auditory/Oral (AO) (speech reading): missed info, as discussed Total Communication: Sign, lip reading, writing all together (2 or more modes at the same time) Manually Coded English: Sign language that follows English grammatical structure American Sign Language: Majority use this form of communication Tips for Communication: Face the person when speaking and talk directly to them Get the person’s attention before you speak Don’t chew gum or cover your mouth with hand or object Use pen and paper when necessary Don’t shout, speak clearly, naturally and at a moderate pace Rephrase rather than repeat Best communication mode between hearing and deaf is an Interpreter Interpreting Services: • • • •

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Everyone’s right, for deaf AND hearing, for both it’s important Access to interpreters can be limited, some freelance (not always available) Generally lack of qualified interpreters all over Ontario (excluding Toronto) When communicating through an Interpreter, the Interpreter should have no identity in the communication, don’t speak to Interpreter or look at them when communicating. They are just there to facilitate communication and your focus should be on the deaf individual Ask the deaf person where they want the Interpreter to sit/stand A lot of training goes into becoming an interpreter. Communication must be through a trained interpreter. NEVER ASK A FRIEND OR FAMILY MEMBER TO DO THE INTERPRETING. (Privacy, confidentiality, ex: police or medical situations) Emergency/After Hours Services: Interpreter on-call for police situations or other emergencies If no Interpreter is available, better to reschedule the meeting

Who pays for Interpretation Services? • Just as a person with a disability doesn’t have to pay for ramps to access buildings, elevators, etc, deaf people shouldn’t have to pay for their interpreters • Average rate for services is $50-$60/hour • all agencies should have funds set aside for Interpreter services (access issue) Technology: Communication Technology: • Hearing aids • Cochlear Implants (surgery, implant in the cochlea) • FM systems- box worn around the waist, with an earphone, amplifies the sound Information and Referral Program – Training Manual

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TTY – (Text Telephone, Teletype Terminal, TeleTYpewriter - a device that lets people use the telephone to communicate by allowing them to type text messages. A TTY is required at both ends of the conversation. Video Phone: Box goes on the TV, uses Internet or phone line, can see person on TV screen (they have to have same box) Pagers: lots of deaf people use, like phone or Internet

Home Technology: • Alarm clocks (lights or vibrators) • Closed Caption (machine or Automatic, most TVs have closed caption now) • Alerting systems (for phone, door, fire alarm, etc. Lights flash differently for each) • Personal amplifiers (used by deafened, plugs into TV, looks like a stethoscope) • Hearing Dogs

The Assistive Devices Program (Ministry of Health) only provides a certain amount per year for deaf people and may not cover the entire costs of equipment (ex: a hearing aid can be $1000, just for one side) so most deaf people can’t afford the technology they need. On top of that, many deaf individuals have no income source, not working. Disability vs Culture (Definitions) Disability:

1) The condition of being disabled 2) Inability to persue an occupation because of physical or mental impairment

Culture:

1) The integrated pattern of human behaviour that includes thought, speech, action and artifacts and depends upon the human capacity for learning and transmitting knowledge to succeeding generations 2) The customary beliefs, social forms, and material traits of a racial, religious or social group

Some deaf people identify themselves as having a disability. They don’t identify with the Deaf culture, usually try to communicate with lip reading/speech and adapt to the hearing person’s mode of communication. May feel isolated, depressed, deny their deafness, just get by, etc. Deaf people who identify with the culture are proud of their differences, feel pride in their ability to sign and connected with the community. More likely to use sign language and expect hearing person to adapt to their mode of communication. May feel defensive about feelings of being patronized or pitied for their deafness.

Language ASL: Similar grammatical structure to French (root is French Sign Language). Some of ASL’s signs are totally unique to the language and not able to be translated to English. Rules of Behavior Slamming table or flicking lights to get attention very common between deaf people but may seem odd to hearing people Personal space likely to be smaller with Deaf people. Often hugs to say hi, even with people they’ve just met rather than handshakes. Tapping person to get attention common. Lots of physical contact. Values Deaf people highly value the language, history, community, traditions, schools for the deaf, customs, etc. Everything related to Deaf culture. Information and Referral Program – Training Manual

Traditions Very important. Developed in the community. Shared experiences through school, etc. History Very highly valued. Ex: how ASL began, Teachers, first Deaf MPP, technology (old TTYs, etc) Communication Modes Writing: Some people may write back and forth. Some may not be comfortable (due to low literacy). Never hold a meeting through writing. Good for short communication only (ex: at a restaurant, gas station) Gestures/Home signs: May be used informally Lip Reading (Auditory- Oral AO): Short communication Simultaneous/Total Communication: Combination of lip reading, gesturing, ASL, writing Manually Coded English/Pidgin Sign Language: English grammatical structure & some ASL signs Using a TTY Each side need a TTY device or through a Bell Relay TTY to regular phone through the Bell Interpreter Communication short forms: “GA” is Go Ahead. Used when one side has completed their end of the exchange (ex: How are you today? GA) “SK” is Stop Keying. Used at the end of the conversation (ex: “Good-bye SK.” The other side replies “Good-bye SK” and the first end finishes with “SK to SK”) Abbreviations often used (abt for about) Some type or write in ASL grammatical order (ex “Me store go” for “I am going to the store”) Literacy may come into play here as some don’t have great literacy training. Letters may be scrambled or the phone may be off the hook a bit where letters get missed. May have to guess at what the person is saying or ask them to rephrase or reiterate the question or statement. I&R Inquiries and the deaf: Deaf, Deafened or Hard of hearing- each may have different barriers Deaf: Have different needs, may be at the CRC for help finding a job, place to live Deafened: May be feeling frustrated with hearing loss, loss of communication -For anyone don’t assume that the issue they are dealing with has to do with deafness Information and Referral Program – Training Manual

Deaf community is small. Person in a domestic abuse situation may not feel comfortable telling about it. May be worried others in the community will find out. Only one shelter for Deaf people (in Toronto) so the woman may not go there because the abuser would know where she is. Communication: When a Deaf person is upset they may seem aggressive. They aren’t, just expressing themselves with bigger signs. Very important: In an emergency situation NEED an interpreter. How to identify the REAL problem: Go through the regular intake questions as you would with anyone else. Again, don’t assume Deafness is the problem. Respect: very important. Don’t pity the Deaf person or look down on them. Treat them as an equal and Be aware of your attitude and behaviour. In Case of an Emergency How to identify that the person in the emergency situation is Deaf: May see person signing May have a different voice (nasal, slurred, etc) May see a hearing aid, FM system, cochlear implant May have a bracelet or ID card How to approach the Deaf person: Ensure the person sees you. Never approach from behind. In a medical emergency, make eye contact first before touching. Unconscious victim: in CPR be sure to shake and shout (not just shouting to see if unconscious) Communication: May be frustrated, nervous or angry if unable to communicate in an emergency. It’s not that the person is rude, just frustrated. May try gesturing to communicate. Individual may want to write or lip read. Need to ensure individual is ok. It’s the hospital’s responsibility to provide a Sign Language Interpreter. There are After Hours Emergency Interpreter services available. In an emergency where the individual HAS to be admitted to the hospital, the Deaf person might have to wait until the next day for an Interpreter. Resources for Deaf/ Deafened/ Hard of Hearing: Canadian Hearing Society Deaf Access (in Simcoe and Muskoka) Communication: Bell Canada Relay Service, Bell Canada provides a relay service which enables hearing callers to contact hearing impaired TTY (Teletype) users, and vice versa. The caller provides the name and telephone number of the person to be called. The operator uses a computer, and appropriate software, to contact that person and relay the messages back and forth between the two people. There is no cost for local calls, and a 50% discount (for the deaf person only) for long distance calls in Canada. Ontario Interpreting Service. Provides ASL interpreting services across Ontario, on a pre-booked or emergency basis. Emergency after hours service 24/7, 365 days a year Information and Referral Program – Training Manual

Blind and Partially Sighted Over 836,000 Canadians have vision loss that cannot be corrected with ordinary lenses. Communicating: - always introduce yourself, a person may not recognize your voice - provide orientation to their surroundings, avoid using terms like “over there”. Be specific, use the hands of the clock method. - if you are needed to act as a guide, let them take your arm at the elbow. By voice, alert the person to any unexpected obstacles.

Ethnic and Cultural Differences Minority Groups and Other Cultures With the ever-growing population, many callers will have difficulty communicating their need in our complex society. These problems include an inability to speak English, not understanding laws and customs, and being afraid. When the caller doesn’t speak English, they are fearful of not being fully understood. When a caller is from another culture or a minority group, the I&R Specialist needs to keep in mind what these callers face when trying to access needed resources. Culture can be defined as the customary beliefs, social norms, and material traits of a racial, religious, or social group. The importance of culture is not always evident when the presenting problem is not characterized as a cultural issue, but many would argue that one’s experiences and perceptions are influenced by one’s culture. Therefore, one’s problems and, more importantly, one’s problem solving can be seen in the context of his/her culture. Some racial groups are more family oriented than others. Some religious sects dictate strict adherence to certain laws. Individuals with certain sexual preferences may use particular terms to refer to themselves. We are not expected to know everything about every culture, but we can be more effective with culturally different callers by attempting to “get into their world”. We can learn about the context of their problems by listening and asking questions, when necessary. We must be accepting of them. If we have any negative, preconceived notions about particular cultural groups, we may not be effective in listening, empathy, establishing an action plan, or simply helping the caller with her/his particular crisis issues. Educating ourselves on cultural differences, assessing our own beliefs and employing those accepting skills, will help us to look at problems from the callers perspective and be more effective in facilitating their growth. Native Canadians: First Nations, Inuit/ Metis (FNMI) The FNMI community represents a diverse range of cultures, languages, traditions, beliefs, history, perspectives, and political affiliations. The 2006 census reports 1,172,790 being aboriginal with one fifth living in Ontario. There are 633 First Nations reserves in Canada, with 52 distinct nations or cultural groups and more than 50 languages. Of the approximately 300 different Native American languages spoken in 1492, only about half still exist. Friendship Centres, Native Women’s groups, and Healing Lodges can enhance social interaction, and cultural based programs. But don’t assume that all FNMI want services from FNMI agencies. FNMI may identify their community of origin, spirit name, and clan if they know it. This is another important aspect of identity. A Health Council of Canada report displayed the disparities between FNMI and the Canadian population: Information and Referral Program – Training Manual

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3 to 5 times at risk of diabetes Life expectancy of 5-7 years less than non-FNMI a rate of tuberculosis at 31 times the national average 1 in 4 live in poverty, double the national average Suicide rate is 5-6 times higher than the national average 1 in 4 children in CAS care

Native Canadians may experience difficulty in developing rapport because of distrust that derives from a history of being exploited/discriminated against.

Asian Canadians Some examples of Asian Canadians include the Chinese, Filipinos, Japanese, Koreans, Vietnamese, and Laotians. Generally, traditional Asian values place great emphasis on appropriate behavior, the strict control of aggressive or assertive actions, and a self-conscious concern for what one does in the presence of others. Sibling rivalry is discouraged, and older children are socialized to set an example for younger siblings in politeness, gentleness, and unselfish sacrifices for another’s pleasure. Asian children experience the external sanctions of shame, or losing face – of bringing disgrace or dishonor to the family name. Within the family, open displays of emotion or affection are rare, except with infants and small children. Uniting the family is the important value of filial piety. Elders in the family, even those only slightly older, command respect and obedience; one never talks back to them. Traditional sex-role definitions require the men to provide for and protect women and the women to be subordinate to the men. Fathers and eldest sons are thus the most dominant family members. As with most immigrant groups, the Asian extended family is predominant. A cohesive structure exists, encouraged in part by the sense of duty and responsibility arising out of filial piety but also by values stressing ancestor worship and the importance of family name. Loneliness and isolation for the unmarried or aged seldom occur because the extended family embraces and absorbs them. Asians are often viewed as a homogenous group. Western & Middle Asians Some examples of Western and Middle Asian Canadians include Asian Indians, Syrian-Lebanese, Palestinians, Iranians, Iraqis, Turks, and Pakistanis. Of the post-1965 immigrants from India, the largest numbers have been Hindu speakers, followed by Gujaranti, Punjabi, and Bengali speakers. Asian Indian immigrants have also been arriving from East Africa and Latin America. African-Canadians / Blacks Historically, African Canadian family income has always been significantly lower than White family income. The following ethnic countries are associated with the Black race, though each has their own culture, language, and beliefs. Jamaica – English Haiti – French/Creole Trinidad – English Africa – variety (Nigeria, Ethiopia, South Africa) Information and Referral Program – Training Manual

Hispanics / Latinos Some examples of Hispanic and Latinos are from Mexico, Puerto Rico, Cuba, Dominican Republic, El Salvadore, Nicaragua, and Colombia. Spanish is the predominant language.

Cross-Cultural Communication Assisting a distressed person whose language and/or culture is different from our own presents a number of challenges. A general understanding of the concepts of cross-cultural communication is essential for working on the crisis line or 2-1-1. When reviewing this material it is important to remember that each language and culture has its own, unique style of communication and not all information will apply to all cultures or languages. Also, be aware that the purpose of 2-1-1 may be unclear to some callers. The concept of seeking help in this manner originated in the Western cultures and it may seem strange, confusing, and uncomfortable for some callers. In such cases, a basic explanation of what our services are for and what kinds of help we provide may be appropriate.

Rapport Building When speaking with someone who does not share your culture or linguistic assumptions, rapport building may take longer. In some cultures, it is important to establish a relationship with the person who you are dealing with prior to discussion of the “real issues.” Omitting at least the minimal social interactions may be considered rude. Remember to listen carefully, test your understanding of what has been said, and be patient.

Sentence Structure Different languages have different ways of structuring sentences, and in some cases the important part of the sentence is at the end. Description of the circumstances surrounding the main issue may be very important to the caller.

Acronyms, Technical Jargon, Abbreviations Use the full names. Alcoholics Anonymous is much clearer than AA and psychiatrist assessment unit is clearer than PAU or psych assessment. Be prepared to explain in simple terms the meaning and purpose of unfamiliar names, agencies or services.

Idiomatic Expression Some English idiomatic expressions are difficult even for those who are speaking in their first language. A phrase such as “throw in the towel” means little to someone who is learning English. Likewise, the description “graveyard shift” can take on an entirely unintended meaning for some.

If You are Not Understood, Repeat the Sentence Say the same thing only slower, and use fewer words. Keep your language specific and concrete. “Call the mental health team and check in with the intake worker” is less clear than “call the mental health office, ask for a worker, tell the worker your problem”.

Information and Referral Program – Training Manual

Avoid Raising Your Voice The problem is not one of hearing but one of understanding. Raising your voice can be insulting and intimidating.

Avoid Metaphors Metaphors can be confusing. Saying to a caller “sounds like you are between a rock and a hard place” could be meaningless. Rather “you have two choices and both are difficult” would be clearer.

Never make assumptions The meaning of “family” or “community” and “crisis” etc., may be different from your own. For example, for some family means mother, father, and children; for others family is the parents, children, grandparents, grandchildren, spouses, aunts, uncles, etc. Also, one person’s definition does not generalize to all others in their culture..

Perception of the role of the helper 2-1-1 specialists may be viewed as a source of advice and direct guidance and as a result the call may be more about facts and resources than about emotions coping. In some cultures, the “helper” is an elder or senior member of one’s extended family and seeking help from someone other than these individuals can be seen as disrespectful. As a result, calling 2-1-1 can be an extremely stressful event and reassurance about confidentiality may be necessary.

Providing resource and referral information Help, support, and counselling all mean different things to different cultures. Government or authority involvement with the helping process may be viewed as threatening by the caller. When assisting a caller with referral information, take care with the following: ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦

Does the caller clearly understand the name and purpose of the resource? Does the caller clearly understand why they are calling or visiting the resource? Does the caller know what to say when they call or visit? Is the caller fearful of government involvement? Is there a concern regarding the cost? Is the caller aware of our understanding of timekeeping and the need to call or visit punctually? Is the caller aware that most resources do not have childcare services available? Is an interpreter needed? Does the caller understand they may choose the resource best suited to their needs? Have you explored with the caller more familiar resources such as family, community, or religious leaders before exploring “outside” resources?

Information and Referral Program – Training Manual

Mental Health Difficulties Experienced by Persons with Mental Health Concerns • • • • • • • •

Inability to concentrate. Random perceptions and ideas often interrupt their train of thought. Distorted perceptions. They may not understand reality as others know it. Inability to cope with even non-threatening social situations. They may have to struggle to remember who people are and what their roles are. Inability to control their behaviour. They may become extremely agitated without quite understanding why. Extreme feelings of anxiety and fear that immobilizes them. Finding themselves saying things that do not quite make sense. Delusional thinking. They may believe they are important or famous persons. Suspicious or paranoid thinking. They perceive the world as full of threats directed against them.

Suggestions for Communicating with Persons with Mental Health Concerns • • • • • • • •

When possible, choose a quiet setting to hold a discussion. Noise and background activity can be confusing. Speak in clear, straightforward terms. Metaphors and jokes tend to confuse. Refrain from making jokes or acting as if the person is not present. Even if the person with mental health issues seems totally distracted and unaware, she may hear and remember what is said. People who are unduly suspicious (paranoid) require a businesslike, somewhat distant but direct approach. Avoid arguments about whether delusions are true or false.

Sometimes a consumer may call with a different request, and we recognize from the content of what she is saying that she has a mental health issue. For example, she may request emergency food because the Mafia is stealing her money. Too many times we dismiss her need because of her disability. In fact, she may have a real need. Try saying something like, “I can’t help you with the Mafia. You say you need food and I may be able to help with that.” Usually the consumer will accept this response, and we can then assist her with food just as we would anyone else.The other ill-advised response we sometimes make is to ignore the request for food and try to persuade the person to get psychiatric help. Is there an exception to the rule we have stated? When must you do everything you can to ensure that the consumer with a mental health issue receives the help she needs? Crisis & Involuntary Placement in a Psychiatric Facility For our purposes, persons whose symptoms are so severe that they can be compelled to seek treatment are considered to be experiencing a psychiatric emergency. Laws vary from province to province, but generally the person must be imminently dangerous to himself or others (suicidal or homicidal) due to a mental disorder. Some provinces also include the concept of “gravely disabled” as a criterion for involuntary treatment. An example of a gravely disabled person might be someone who has been refusing to eat or drink, and dehydration and starvation are a real danger. Information and Referral Program – Training Manual

Having stated what a psychiatric emergency is, it may be helpful to state what it is not. Persons who usually function well but are overwhelmed by a situational crisis do not usually fall under involuntary treatment guidelines. They may urgently need help, either from a professional who can deal with a variety of emotional problems or from a specialized source; for example, someone who just experienced a death of a family member. Resources for emotional problems differ from those for psychiatric emergencies, unless the person is so incapacitated that she is in imminent danger. An example might be a person who becomes so depressed that psychiatric intervention is required to keep her from committing suicide. Persons with mental health issues may suffer acute and chronic phases. During chronic phases, they may not be dangerous to themselves or anyone else and will not fall under guidelines for involuntary treatment. However, they may voluntarily seek medication and other treatment from the same resources; psychiatric hospitals, mental health clinics, community clinics, or other facilities which treat mental health problems. A person with mental health issues is clearly experiencing a psychiatric emergency if she is threatening to take her own life or someone else’s. A person with mental health issues may hear voices telling them to do something, or that someone they know would be better off dead. Frequently they are frightened by these bizarre thoughts and willing to get help. Do not argue about whether the voices are real. Instead, say something like, “it sounds like you need help to resist the voices.” Once you have identified a source of help, you need to talk to the person with mental health issues about arrangements, such as how they will get there. Crisis staff will assess the person’s condition and admit them if necessary, or stabilize their condition with medication and follow-up on an outpatient basis. If a dangerous person with mental health issues absolutely refuses to seek treatment, you will need to make arrangements to have her involuntarily committed for observation. Details vary, but provincial or local governments make some provision for involuntary hospitalization for a short period for observation, with certain mental health professionals authorized to write the necessary psychiatric hold order. If she requires longer treatment and is unwilling to get it voluntarily, she may, with due process, be committed for treatment for a longer period, usually following a hearing. Of course, if a person with a mental health issue is, at that moment, threatening harm to someone else or herself, call the police for immediate help. Assisting Inquirers with Mental Disabilities This population is the most challenging to assist for many reasons, but the most common reason is our own fear or discomfort. Below are some of the behaviours that may be exhibited by customers with mental disabilities: 1. Inability to concentrate. Random train of thought and speech. 2. Distorted perception of reality. They do not see things the same way we do. 3. Inability to remember why they called you. 4. Extremely agitated, anxious, inpatient, and fearful. 5. Delusional thinking. 6. Suspicious or paranoid thinking. Here are a few tips designed to help you assist these callers: 1. Reduce the noise and background activity in your area. 2. Provide clear and precise information. Use short and simple sentences. 3. Do not use metaphors or jokes. 4. Be very business-like and direct. Expressions of warmth may threaten suspicious or paranoid callers. 5. Do not argue with caller regarding their delusions or suspicions. 6. Bring the focus of the conversation back to the specific need and continue to assist them. Information and Referral Program – Training Manual

Mental Health Resources: Resources can vary in scope and accessibility. In general, treatment can be in the form of counselling (going to an office for a brief session) or residential (inpatient) treatment. Counselling can be in the form of individual, group, or family setting and usually involves going to an office for a brief session lasting an hour or so. Ongoing counselling can be arranged. Usually mental health centres focus on diagnosable mental health problems such as anxiety, depression, obsessive compulsive disorder, schizophrenia, bipolar depression, etc, they do not offer counselling for marital/family/parenting problems. Mental health counselling can be offered by a mental health clinic, a hospital, or by a private counselling. In some cases there can be a waitlist or waiting period for free counselling services. Private counselling usually involves paying an hourly fee, but clients can get services quickly. For services that require payment, some workplace health benefits cover counselling, also some agencies will have a “sliding scale” assistance program based on client’s income. Residential or inpatient treatment involves staying at a facility whether that is a wing of a general hospital or a mental health hospital. Admission usually occurs as the result of a crisis situation.

Learning Disabilities Up to 20% of Canadians have a learning disability, often not diagnosed. Learning disabilities have nothing to do with intelligence or mental health. The condition may be subtle or pronounced and may interfere with a person’s ability to receive, process, or express information. – concentration, sequencing, memory, personality, ability to read, write, follow directions, or sit in a noisy room. Communication: - ask how to accommodate the client’s specific needs - patience, optimism and a willingness to find creative solutions are the best tools. Speech or Language Disability Partial or total loss of the ability to speak. Can lead to difficulty communicating, expressing themselves, or understanding spoken or written language – includes problems with pronunciation, pitch and loudness, hoarseness and breathiness, stuttering or slurring. Communication: - speak directly to the person with a disability, not the person who may be accompanying them - do not assume that a person with a speech disability also has a developmental or intellectual disability - do not finish sentences for the person, give them whatever time they need to get their point across - ask them to repeat as necessary, or write their message - if you ask questions, try ones that can be answered with a “yes” or “no”

Information and Referral Program – Training Manual

Seniors Providing Information and Referral to seniors requires that service providers have an accurate understanding about older adults and are not influenced by negative myths and stereotypes that prevail in our society. Myth 1: People over 65 are old Myth 2: Most older people are in poor health Myth 3: Older minds are not as bright as younger minds Myth 4: Older people are unproductive Myth 5: Older people are unattractive and sexless Myth 6: All older people are pretty much the same The reality is that due to advances in medicine and the practice of positive lifestyles, people are living longer and maintaining their health. Service providers will interact with many vibrant seniors but also with individuals who experience limitations and impairments to healthy functioning. Regardless of their level of functioning, seniors will need continued access to appropriate services in order to maintain and achieve their optimal level of wellbeing. In order to be able to access formal services, seniors need information about: 1. Their right to use a needed service 2. The existence and availability of a service 3. How to access a service 4. Application procedures 5. Their eligibility for using a service 6. What the service can and cannot do for them Obstacles to Accessing Services – Seniors

(Many of these barriers are equally applicable to the general population) • • • • • • • •

• •

A service does not actually exist. Financial constraints – many seniors are on a fixed income and do not have extra funds for programs which can cost $20 and hour or mileage rates. There are gaps in providing needed services because of limited resources such as funding. Limitations in the continuum of available services result in some seniors using services that are inappropriate or insufficient for their needs; for example, home care. Waiting lists for services operating at or beyond capacity create frustrations for seniors; for example, subsidized housing. Often services are sought when a senior’s situation is near crisis. Due to timing, obstacles are particularly frustrating. Some seniors may not meet the eligibility criteria for a service, for example, services that have age, gender, financial, or specific geographical requirements. Seniors may also experience frustration from: • busy telephones/automation • long waiting lines • confusing and lengthy application forms • poorly trained staff • ageist attitudes of staff Seniors from diverse cultures may require services in languages other than English. Older adults with specialized or multiple needs may require access to more than one service. Coordinating services may be complicated and confusing. Seniors may need assistance to access multiple

Information and Referral Program – Training Manual

• • • •

services. Changes to Long Term Care, Placement Co-ordination Services, Multi Service Agencies, Community Care Access Centres. Seniors may become frustrated when they are required to provide the same information on each application form for every service they want to access. Seniors may have difficulty filling out forms because of language or lack of literacy abilities. Forms are unclear or print is too small. Seniors may perceive their privacy is intruded by government questions. The design of a service’s physical space can create barriers for those with physical limitations or disabilities. Some seniors may have mobility problems, which prevent them from leaving home to obtain services. For other older adults, there is not enough appropriate transportation services and in some rural areas, no transportation at all.

List of Financial Aid that seniors are eligible for (see the Income Security and Financial Assistance sections) Canada Pension Plan (CPP)” “Old Age Security (OAS)” “Guaranteed Income Supplement (GIS), Guaranteed Annual Income System (GAINS) and Spouse’s Allowance” “Widowed Spouse’s Allowance, Ontario Disability Support Program (ODSP) and Ontario Works (OW)” “Veterans, Assistive Devices Program (ADP) and Home Adaptation for Seniors Independence (HASI)” “Ontario Drug Benefit (ODB) Program, Subsidies for Long Term Care” “Tax Credits and Income Tax Help” Seniors Programs Retirement Residences

Retirement residences offer private pay accommodation and services for seniors. The accommodation is typically a private room with a 3 piece bathroom that is rented on a monthly basis. Services generally include 24 hour supervision, meal preparation, laundry/housekeeping, medication distribution, assistance with activities of daily living, social events and recreation. Assistance with daily living is usually limited at the retirement level. Private and non-profit organizations own and operate retirement residences. There is no centralized application process. Individuals present at and apply for the retirement home of their choice. Generally, there are no subsidies available unless they are offered directly through the retirement home or Veterans Affairs Canada. The starting cost for a room can be approximately $2500 a month for a basic room, which would include all services including 3 meals a day. Retirement homes are for more high functioning seniors who are expected for the most part to care for themselves, but might just need some supervision or reminders about daily matters such as taking medication, coming down for meals etc.. Long-Term Care Facilities

Long-term care facilities are nursing homes or homes for the aged and are specially designed for people who require 24-hour nursing care and supervision within a secure setting. They usually offer a higher level of personal support and care than retirement homes or supportive housing. LTC homes cater to those who may require assistance with bathing, toileting, feeding, getting out of bed, etc. Information and Referral Program – Training Manual

Applications for long-term care facilities are coordinated through the local Community Care Access Centre. The rates are set by the Ontario Ministry of Health and Long-Term Care and are standardized across the province. Subsidies may be available through the administrator of the long-term care facility. Subsidies are only available for basic accommodation. Community Care Access Centres (CCAC’S) Community Care Access Centres plan, coordinate and ensure delivery of a full range of in-home services to support clients and their caregivers. CCAC’s can help individuals and families to do the following: • • • • •

Identify health care needs Determine eligibility for government-funded services and settings Provide information about home, community support services and residential care in a specific area Arrange and apply for admission to a long-term care home To be eligible for the services of a CCAC, individuals must have a valid OHIP card and must live within the area serviced by the CCAC.

Home Support Services Home support services are designed to allow seniors or persons with disabilities maintain their independence in their home. Home support services help with everyday tasks of living. There is quite a range of home support services and these services can be provided by either non-profit corporations or private companies. Services include: • • • • • • •

Adult Day Care Caregiver Support Friendly Visiting and Security Checks Laundry, housekeeping, yard work, snow shoveling Meals on Wheels, frozen meal delivery Respite and Vacation Care Transportation

There may be fees associated with some of these services. Some services are free and others may calculate rates on a sliding scale according to income. It is important to recognize that most home support service organizations will only serve very specific boundaries or geographic areas. Often you will get a call from a senior who thinks these services are free or that there is a “volunteer” program that provides these services. In some cases they may become upset because they believe that they are entitled to these services for free after working hard their entire lives. You will have to explain that there is a charge for many of these services. Elder Abuse

Elder abuse is abuse against a senior, the abuse takes many different forms: * Physical abuse * Sexual abuse * Financial abuse * Psychological or emotional abuse Information and Referral Program – Training Manual

* Neglect * Systemic Abuse such as elder discrimination If the situation is an emergency and you believe that the person is at risk, call 911. If the situation is not an emergency or the caller wants to express/review concerns there is a province wide Elder Abuse Hotline. Some counties will have an elder abuse program themselves.

Province Wide Resources: Ontario Residential Care Association ORCA sets standards, inspects, and accredits retirement residences in Ontario. Not all retirement

residences are ORCA approved, only those that meet and maintain ORCA's standards for accreditation. ORCA operates a toll-free hotline that anyone in Ontario can call to get help resolving a complaint about any retirement residence or to get information about their care options. Ontario Long-Term Care Association

The association represents owners/operators of long term care facilities across Ontario; provides liaison services between owners/operators and the Ministry of Health and other professional groups; provides education and information to owners, administrators and department heads of long term care facilities. If someone has a concern about a long-term care (LTC) home (nursing home), or about a resident's rights within the LTC, follow the complaint process posted in each home. If not satisfied with the response, the client may call the Ministry's Long-Term Care ACTION to register your concern(s) about a LTC home. Office of the Public Guardian and Trustee If you believe someone is no longer mentally capable of understanding their situation, and you believe that they are being harmed because they do not have enough to eat, or because their money is disappearing, you may want to call the Office of the Public Guardian and Trustee. The Guardianship Investigations branch of that Office has legal authority to investigate and intervene in these kinds of situations.

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Sexual Diversity Sexuality and sexual orientation are often little understood components of people’s lives. While some people spend their entire lives as strictly homosexuals or strictly heterosexuals, some people do not fit neatly into either description. Many women who identify themselves as lesbians have had sexual relationships with men in their past, including marriage and children. The same is true for men who identify themselves as gay. People who identify themselves as homosexual today may in the future find that they are attracted to a person of the other sex and act on that attraction. The converse is true of people currently identifying themselves as heterosexual; many will have some passing interest or sexual encounter with someone of the same sex and may or may not continue to consider themselves as strictly heterosexual. Even people who use a specific label (e.g., “gay”, “lesbian”, “bi-sexual”, and “straight”) may behave in ways that would seem to make that label inappropriate. In short, self-identification does not always predict behavior and vice versa. As in any call to 2-1-1, the attitude and overall approach of the worker are as important as the skills and techniques used. Remember: compassion, respect and patience cross all cultural boundaries. Communication: • •

• • •

•

Allow the person to tell you how they identify rather than offering them your label. Avoid use of the word homosexual, sexual/gender preference or sexual/gender choice. Homosexual was a term coined by early psychiatric medicine and is not generally embraced by queer people. Many queer people feel that their sexuality/gender is a part of who they are as a person. Some queers if they had a “choice” or “preference” would prefer to live in the majority of the world rather than in an oppressed minority. “Outing” a person without their permission is a serious breach of confidence that may have serious complications for the person you have inadvertently “outed”. Start using gender-neutral language. Instead of saying he/she say they or the person. Notice your language and try using less gendered and heterosexist words. Many queer communities are embracing words about being LGBTT2IQ that were previously considered insults e.g.: dyke, queer, fag, etc. For the most part these words are best used within those communities. Trans people can refer to a spectrum of gender orientations including (but not limited to): • Transsexual people, including pre-op, post-op and non-op who are living in the opposite gender of their birth. • Transgendered people who are living in the world full or part of the time in the gender opposite to their birth or who occupy a more fluid gender expression. Some transsexual and transgendered people take medical measures to alter their appearance and some do not. • Intersex people are born with the hormonal or biological characteristics of both males and females, some intersex people identify as trans and some do not. It is important that we avoid assumptions, as the person’s gender orientation and way of identifying is unique to them. Passing is a huge issue for many trans people given the emphasis our society places on appearances. Check in with yourself about your biases regarding how a person “should” look. This is usually the major cause of offense to a trans person. (from text by Jody Raven, Co-Chair of the Diversity Newsletter Division, Diversity Advisory Committee, Spring 2006)

Province Wide Resources for Sexually Diverse Individuals: Lesbian Gay Bi Trans Youth Line, The Lesbian Gay Bi Trans Youth Line is a toll-free Ontario-wide peer-support phone line for lesbian, gay, bisexual, transgender, transsexual, 2-spirited, queer and questioning young people. PFLAG: Devoted to helping families of gay and lesbian persons come to a comprehensive understanding of homosexuality. In a warm and supportive atmosphere, they can share their concerns and feelings with others Information and Referral Program – Training Manual

experiencing similar situations and gain comfort and reassurance regarding their gay or lesbian loved ones. ( Parents and Friends of Lesbians and Gays)

Difficult/ Challenging Inquirers Learning Objectives 1. To identify and implement the skills needed to recognize and respond to challenging and difficult inquirers (including manipulative, angry, abusive, sex related, bullies) 2. Also, to provide the I&R specialist with an understanding of when and how to terminate abusive calls. Overview Service providers have to be prepared to handle a variety of situations, and periodically these may include inquirers demonstrating behaviours and emotions that require a special response. Inquirers may demonstrate behaviours and emotions that arise from stressful situations, urgent needs, confusion or frustration. I&R providers can assist by focusing on the problem-solving process. It may be necessary to acknowledge and validate a inquirer’s feelings before problem-solving begins. The goal of an I&R provider’s communication with inquirers who are demonstrating challenging behaviour is to assist the inquirer to move from an emotional state to a cognitive state. In a cognitive state, the inquirer is aware of the impact of their emotions and how they relate to the problem or situation. The following strategies are helpful when interacting with challenging inquirers. Steps To Defuse Anger And Hostility 1. Assess and Take control of the situation • Remember that it is not a win/lose situation. • Do not take the complaint personally. • Intervene early before the situation escalates. • Defuse yourself before defusing the inquirer - Do not get caught up in their anger. • They are angry at their present situation, not you. • You need to stay calm and rational. • Remain courteous and professional throughout the call/interview. • Define your Role - Be clear with the inquirer about the role and responsibilities of the I&R provider and the organization. Do not set unrealistic expectations about what can be done for the inquirer.

2. Establish Rapport • • • • • • • • •

It is important that the interaction with the inquirer begins well. This may include: personalizing the interaction by exchanging names, using appropriate voice tone, assuring the inquirer that the I&R provider’s role is to try and help. Apply active listening techniques Let the client set the pace, give them time to think Use body language and tone of voice that convey that the I&R Specialist is relaxed and open; Show concern Remain Non-judgmental - I&R providers should avoid using words that appear judgmental. Being nonjudgmental requires accepting the inquirer and being aware of one’s own biases.

3. Acknowledge and Validate Information and Referral Program – Training Manual

It is helpful to acknowledge and validate how the inquirer is feeling (frustration, anger etc.). This will help them finish venting their negative emotions surrounding the situation. It demonstrates an understanding of the person’s feelings and lets the inquirer know that they have been heard. The I&R provider does not necessarily have to agree with the inquirer in order to acknowledge and validate feelings. The I&R Specialist can normalize and depersonalize the situation, help the person save face and be re-assured that their reaction could be understandable. • Shame: “It is difficult to accept what has happened” • Guilt/ responsibility: “You may not feel this way right now, but it is /was not your fault…” • Discomfort: “It is uncomfortable talking about something so personal” • Anger/ rage: “Feelings of anger are normal reactions to things that are unfair” • Sadness: “Your sadness will gradually go away as you work through this…” • Despair/ Hopelessness: “You may not feel there is any hope, but by calling me today you have made the first step to get through it” • Weak/ unmanly: “You may feel weak but it is courageous of you to call me today” • Confused: “Your feelings of confusion and lack of control will gradually go away as you work through this” • Scared: “Your fear is justified because fear is a normal reaction in your situation…”

4. Listen to what triggers the inquirer. For example, if it is time pressure you might say “I understand that you are under a time restraint, however I will need to ask you a few questions to get this problem resolved as quickly as possible."

5. Disengage the inquirer Disengage the inquirer to give them and you some time to recover. For example you might say “Let me check to see who can help you with this.” 6. Engage in a problem solving process. • Focus on the problem. • Ask specific questions to fully understand the problem. • Ask open -ended questions • Review the choices and the consequences for each choice. • Help the individual stay focused on the main issue(s); • Foster empowerment - Help inquirers understand the steps to take to obtain needed services fosters independence, so the inquirer can advocate on their own behalf.

7. Set appropriate limits. •

• • • •

Be clear about what can and cannot be offered and work within those limits. An understanding of personal and professional boundaries is vital to establishing a healthy working relationship with inquirers. Clear boundaries enable consistent and honest communication with inquirers. Boundaries reduce unclear expectations or misunderstandings and ensure that a common standard applies to everyone. Appropriate boundaries ensure that personal interests, needs and agendas do not infringe on the welfare of others. By setting limits I&R providers indicate what attitudes and behaviours will be tolerated. Enlist appropriate assertiveness techniques. For example you might say, “I can hear that you are very angry and frustrated. I would like to help you however I will not tolerate your yelling, swearing and abusive behaviour. If you do not stop, I will terminate this call."

8. Recognize when you have done all that you can You may need to refer them to the supervisor if you are unable to help them. Share with the inquirer that you take the problem seriously and that you would like to direct this matter to the supervisor. Information and Referral Program – Training Manual

9. Once the situation has been resolved: Examine what happened. Use the supports of your peers and supervisor. Practice skills in a team situation. Debrief effective strategies for dealing with problem inquirers. Consider taking a break until you feel composed again. Practice stress reduction techniques Sample Scripts – Angry Inquirers “We can’t help you if you continue yelling. (Short pause) It sounds as if you may be too angry to discuss your problem now. Why don’t you take a moment to calm down and then call us back so we can discuss how to best assist you?” “Would you please explain your problem? We might be able to refer you to an agency that may be able to help you.” “I understand you are angry and frustrated. Now, we’d like to be able to help you.” “Often when people call about this issue…” (Normalize and depersonalize) “Many people feel the way you do. It is a normal reaction to…” To help diffuse an angry caller, you can put them on hold while you look up resources for them, this will give you time to calm down and focus on the issue the caller is inquiring about. Abusive Behaviour • •

•

• • • •

• • •

There is a difference between angry behaviour and abusive behaviour. Inquirers may be angry about a specific situation, for example, not being eligible for a certain service, or facing a long waiting list for that service. To develop the appropriate response, it is useful to understand where the inquirer’s anger is really being directed. Abusive behaviour from a inquirer is designed to engender a reaction from the service provider. Abusive behaviour includes: o Bullying o Belittling o Name calling o Verbal abuse Tolerating abusive behaviour reinforces it, which will disadvantage the inquirer in other settings. Inform the inquirer if and when you feel that further interaction with them is futile. Under what circumstances do you feel it is appropriate to terminate an interaction with a inquirer? The difficulty of dealing with an angry, hostile or abusive inquirer may trigger an I&R provider to react inappropriately. Regardless of where the anger is directed, an I&R provider needs to avoid taking inquirer anger personally and becoming defensive. Triggers are attitudes, behaviours or statements that affect a person. Self-awareness about personal triggers increases the ability to respond effectively. I&R providers need to be able to defuse themselves before they attempt to defuse others.

Here are some tips when dealing with abusive callers: 1. Inquirers may have legitimate reasons to be angry, but there are never legitimate reasons for them to be abusive to you. 2. Never use offensive language to express yourself. Do not join them in their abuse and anger. Information and Referral Program – Training Manual

3. By establishing clear boundaries of what constitutes acceptable behaviour, inquirers are informed that there will be consequences for abusive behaviour. 4. It is always OK to ask the supervisor to “listen in” on your call if you are having difficulties. 5. If you have no recourse except to terminate an abusive call, do so in a courteous and professional manner. Do not just hang up. Sample Scripts: “I am unable to help you when you are so angry. Would you please take a moment to calm down?” “You are being offensive, and it is interfering with my ability to assist you. If you cannot calm down, I will hang up and you may call back when you’re calmer.” “This call will be terminated if you do not stop using obscene language. You can call back later, once you have calmed down.”

Terminating Calls: Terminating a call is a last resort. This is when someone is being abusive, manipulative, and is refusing to cooperate in the conversation. Always give them an opportunity to call back. If you tell them you are going to hang up, always do so immediately. 1. Be sure you know when the appropriate time to terminate the call has arrived. 2. If a caller doesn’t calm down, ask him/her to call back when he/she is ready to discuss possible solutions. 3. If you say that you’re going to hang up -- DO IT! Some Helpful Phrases When Terminating a Call: For “normal” callers: “Why don’t you go ahead and try those numbers that I gave you?” “I won’t take up anymore of your time...” “Well, I hope it works out for you...” “I’m glad you called and I hope this information helps you...” “Call back if you need to. I think we’ve solved your immediate problem.” For Abusive or Angry Callers: “I have asked you to stop using offensive language and you have not. I am going to hang up now.” “It’s difficult to talk when you’re so angry, so I will hang up now. Call back when you feel ready to discuss your problems. Good-bye.” Exercise: What attitudes or behaviours are triggers for you?

Information and Referral Program – Training Manual

Attitudes that anger

Avoid

Adopt Ask yourself, “What is good about this situation?”

Arguing Rationalizing Defending Complaining Reacting Emotionalizing

Empathize

Judging Sneering Criticizing

Remain neutral

Technical terms Jargon Acronyms

Clear wording

A reminder: an angry inquirer finds it difficult to remain angry when given a calm response

Demanding Inquirers •

• • • •

Demanding inquirers are often very frustrated to hear that we do not provide direct services. Sometimes gently and carefully explaining what we do offer is enough to deal with these inquirers. “Let me explain what we do (or how I can help you). We are an Information and Referral Service and based on what your situation is, we provide referrals to places that may be able to help you.” It is important to remain neutral – don’t take this personally. Focus on the inquirer’s concern while remaining patient with the inquirer. Use Active Listening Skills - use your voice tone as a tool. Keep your voice tone firm, yet soothing and calm. Validate inquirer’s feelings. Be honest with your inquirer. As a last resort (or if the inquirer insists), offer the inquirer an opportunity to speak with the Coordinator or Manager. For some inquirers, nothing else will do, regardless of how you have handled the call. Don’t take it personally.

Bullies When faced with a bully • Give the bully time to run down’ • Interrupt if you need to • Try using his/her name • Don’t fight or argue • Don’t sound apologetic be matter of fact • Educate • Set limits

Information and Referral Program – Training Manual

Complaint Calls To ensure and maintain excellent rapport with the community the Call Center has established a customer service plan. Sometimes we receive complaints about a certain agency or about the 211Service or the Resource Centre. These issues should be handled as follows: • The I&R Specialist should kindly explain what we do at the Call Center. • The I&R Specialist should use active listening skills, and a pleasant voice tone. • The I&R Specialist should ask the inquirer, “Would you like to make a formal complaint?” • The I&R Specialist should complete the Complaint Form. • The I&R Specialist then routes the form to the Inquiry Services Manager. • The Inquiry Services Manager will follow up with the inquirer. • Another option would be to offer to transfer a caller to a manager.

Manipulative Inquirers These inquirers are the ones that “push your buttons.” They may try to make you feel guilty, sorry, or responsible for their current crisis. They try to manipulate you by tapping into your feelings of guilt and fear. They tell you that their children will go hungry and become homeless without your immediate assistance. Tips when Dealing with Manipulative Inquirers: 1. Do not allow yourself to be caught in their traps. You must remain objective in order to provide them with accurate and helpful choices. 2. If the inquirers perceive that they are “getting under your skin,” they will continue calling you. You have now become a lightning rod for all their negative energy. 3. Always be courteous and professional with manipulative customers. 4. If the conversation is making you feel uneasy or bad, tell the customer that you are putting him/her on hold for a minute. Take a few deep breaths and remind yourself that you are not responsible for their feelings or problems. Sample Scripts--Inquirer is Crying “Do you need some time to calm down? You can call us back in a few minutes.” “I can tell that you are very upset and I’d like to try to assist you. Would you mind answering questions?”

some

“We’re going to try to assist you in finding an agency that can possibly help you.” For Manipulative Callers: “We don’t 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, I’m going to say goodbye.” “Since there is no way I&R can help you, I’m going to terminate this call. Thank you for calling.” You cannot choose what type of call you receive. However, you can keep reminders near you to help avoid getting “hooked” by difficult inquirers.

Information and Referral Program – Training Manual

Sample Scripts--Inquirer Calls Repeatedly “I have the same information that you provided to you earlier. Were you able to follow up with the information we gave you?” “Unfortunately we don’t have the resources you need. May I suggest that you try calling _____.” “Unfortunately you have exhausted the resources of which we know. There is nothing further can do for you.”

Tips--After the Call ♦ Always take a break after answering a call from a difficult inquirer. ♦ Walk to the kitchen and get a drink of water. ♦ Take steps to diffuse your negative feelings before talking to the next inquirer. ♦ Talk to a co-worker or your supervisor who knows how to “un-push your buttons.”

Inquiries – for Personal Satisfaction These inquirers are persons who call repeatedly to meet personal needs other than information and referral. We will provide information and referral to all inquirers regardless of how often they call. However, will not provide any service beyond information and referral or advocacy to any inquirer, particularly if it impedes services to other inquirers or does not promote the inquirer’s self-empowerment. When faced with such a inquirer, the procedure is to first ask the inquirer if he or she has a request for services. If the inquirer does not intend to ask for information and referral services, give him or her one warning and then terminate the call. Sample Scripts “It sounds like you have a lot of things are your mind. I am not sure how I can help, so please let me know what kind of information or referrals you need. If you do not have a need for information or a referral, then I will let you go.” “What referral can I make for you today? If you do not need a referral to an agency, I will let you go so I may assist other inquirers.”

Inappropriate Sex Related Calls There are two types of sex inquirers. The first type of inquirer openly admits to wanting to masturbate or is already in the process of masturbating. He pleads with the I&R Specialist to stay on the line, talking with him until he has finished. The second type of sex inquirer tells a fantasy problem that is presented as real. It is usually, but not always, of an overt sexual nature. While discussing this “problem” with the I&R Specialist, he masturbates. Common Opening Lines: 1. I want to talk. 2. Can I talk about anything? 3. Is there a man/woman there that I could speak to? 4. I’ve never called before.

5. Are you understanding? 6. Will you talk to me? 7. I have an embarrassing problem. 8. I’m lonely.

Do’s Get help and support from supervisors. Information and Referral Program – Training Manual

Put responsibility for the majority of the talking on the inquirer. Confront and/or interrupt inquirer. Refer inquirers requesting sexual information to authoritative sources. Give one warning to such inquirers that you will hang up and why, if their behaviour doesn’t change If the inquirers refuse to change their behaviour, then terminate the call. Follow through with hanging up immediately after you have said you are going to. Don’t Talk to inquirers who are masturbating or fantasizing Debate with inquirer after you have said you are going to hang up. Allow the inquirer to give you sexual details. Give sexual information or advice Promise inquirer anything before you know what this promise will entail Feel obligated to be and do as the inquirer dictates Sample Script “You are doing _________. That is inappropriate for this call. If you don’t stop, I will hang-up. do you need?”

What referrals

“It sounds like this is an inappropriate call for an information and referral service. Unless you are in need of a referral to a social service agency, I will terminate this call.” Dealing With Difficult Inquirers – Exercise How would you respond to the following situations dealing with difficult inquirers? In particular, what questions would you ask or what actions would you take? 1. Inquirer’s 3rd call today: “The 4 numbers you gave me don’t work. I need someone to pay my rent by 1pm today. Why can’t you help?” 2. Inquirer is yelling and clearly angry: “I am tired of nobody wanting to help me! People need help and you guys do nothing!” Inquirer begins to become verbally insulting to you and increasingly angered. 3. Inquirer calls every day: “Hi I&R Specialist’s Name, let me tell you what happened to me this weekend. My roommate and I got in a fight again and I am still a little mad at her. Remember I told you last week that she was being rude to me. Do you think I should look for a new roommate?” 4. End of a call: “Thank you for the information. You are so nice and helpful. If I have any problems getting help can I call you back? What is your number at home?” 5. Inquirer is crying: “I’m tired, nobody wants to help me, and everyone keeps telling me to call you so you can help me before they shut my lights off. Can you call the electric company to tell them what I am going through? They will listen to you.” 6. “I need to get some clothes, but don’t give me numbers because they won’t help.”

Information and Referral Program – Training Manual

People in Crisis Non-Violent Crisis Intervention What is a crisis? A temporary state of upset and dis-equilibrium, characterized chiefly by an individual’s inability to cope with a particular situation using customary methods of problem solving. Goals The basic goals of crisis intervention • Safety and Security • Ventilate and Validate • Predict and Prepare Crisis Calls – a Background: Some possible causes might include: • date rape, • school violence, • substance abuse, • suicidal thoughts • marital abuse, • reaction to a medical diagnosis, cancer, HIV positive • mental health crisis • situational crisis related to job, relationship, finances, family dynamics

Inquirers in Crisis Inquirers may demonstrate behaviours and emotions that arise from stressful situations, urgent needs, confusion or frustration. Their sense of well being may be devastated. I&R providers can assist by focusing on the problem-solving process. It may be necessary to acknowledge and validate a inquirer’s feelings before problem-solving begins. Please keep in mind that we are an Information and Referral Service, not a crisis hotline. Crisis calls have been very rare in Community Connection to date. However, we need to be prepared, you can get one at any time. Many people will call and say they are “in crisis”, or having a “crisis”. The first step for I&R would be to determine what the caller means by being in crisis. The word crisis means different things to different people, and the severity of the situation can be different, for example… Caller 1:“I’m having a crisis here, I just got my hydro bill, and it’s $360, and I don’t have the money to pay it” (caller is not having suicidal thoughts, just needs help to pay his bill) Caller 2 :”I’m thinking of killing myself” Using the two calls above, it can be seen that crisis can be used to describe different scenerios. This does not depreciate the caller’s emotional state, but does change how the I&R will react. Steps for a Crisis Call: 1. Determine urgency. Urgency will determine Step 2 Assess: Information and Referral Program – Training Manual

•

Elements of Assessing o Determine the severity of the crisis. o Assess potential lethality or physical harm to the person or others. o Identify coping patterns, strengths and resources

•

Techniques for Assessing o Find out if the person is suicidal, homicidal, or both. o Find out to what extent the crisis has disrupted the person's normal life pattern. Are daily routines with family, friends, work, etc. affected? o Find out if the level of tension has distorted the perception of reality. o Find out how the person deals with anxiety, tension, or depression. Have they been proactive? o Find out what coping methods were used in the past. Do they have a variety? o Find out if family and social resources are potential resources. Are the resources positive or negative? o Find out what the person used as support systems in the past. Are they present, absent, or exhausted? Can the combine or use the systems in a new way?

Quickly Assess the situation. • Is the inquirer is in a life-threatening situation or other crisis? • Ask the inquirer what precipitated the crisis. • What meaning does the event have for the inquirer. • Ask about suicide -have an understanding of suicide and the associated levels of lethality (section on suicide below). • NOTE: In some cases it does not take long to determine urgency. In some cases a caller will immediately tell you they are suicidal or demand the crisis line. Step2. Outcome determined by urgency: (choose 1 option) - call 911 if caller is actively suicidal with a plan and method or - caller does not require 911: warm transfer to local crisis line if caller having a mental health or situational crisis, with mild suicidal thoughts or would benefit from speaking to a crisis worker or - caller does not need above: I&R can screen further, de-escalate, assess need, make referrals Help journey the person from a vulnerable crisis state to one of equilibrium and empowerment Help move the person from an emotional to a cognitive state • To help the person regain or develop new coping skills Strategies The goal of an I&R provider’s communication with inquirers who are demonstrating challenging behaviour is to assist the inquirer to move from an emotional state to a cognitive state. In a cognitive state, the inquirer is aware of the impact of their emotions and how they relate to the problem or situation. The following strategies are helpful when interacting with inquirers in crisis. Standard crisis operating procedures 1.

Plan and conduct crisis assessment (including lethality measures)

Information and Referral Program – Training Manual

Establish rapport and rapidly establish relationship

Identify Major Problems (including the last straw or crisis precipitants)

Deal with feelings and emotions (including active listening and validation)

Generate and Explore Alternatives

Develop and Formulate an Action Plan

Crisis Resolution

Listen: •

Elements of Listening o Establish rapport and trust. o Identify precipitating problems. o Help the person deal with, identify, and diffuse feelings.

•

Techniques for Listening o Use first names, ask if it OK to use the person's first name. o Use content questions. o Ask or use feeling questions or statements.

Establish a relationship/ rapport: It is important that the interaction with the inquirer begins well. Personalizing the interaction • use appropriate voice tone • offer your name, ask the inquirer their name. • let the inquirer know that you're glad they decided to call someone for help. • assure the inquirer that the I&R provider’s role is to try and help. Acknowledge and Validate: • •

It is helpful to acknowledge and validate how the inquirer is feeling. It demonstrates an understanding of the person’s feelings and lets the inquirer know that they have been heard. The I&R provider does not necessarily have to agree with the inquirer in order to acknowledge and validate feelings. Express your feelings of concern.

Remain Non-judgmental: • •

I&R providers should avoid using words that appear judgmental. Being non-judgmental requires accepting the inquirer and being aware of one’s own biases.

Be Supportive: •

Effective use of voice, body language and eye contact provides reassurance that the I&R provider is there to help the inquirer.

Information and Referral Program – Training Manual

Non-Response: •

Recognizes when the inquirer is not responding to attempts to defuse the situation and outside intervention is required.

Define your Role: • • •

Be clear with the inquirer about the role and responsibilities of the I&R provider and the organization. Do not set unrealistic expectations about what can be done for the inquirer. The I&R Specialist must prevent his/her own reactions to crisis from affecting the situation

Defuse anxiety: • • •

Defuse the inquirer’s anxiety to the point where s/he can be rational Build hope by emphasizing the temporary nature of the crisis. Listen for and use ambivalence as a tool. Identify possible solutions to the crisis or alternative scenarios of resolution. Help the inquirer focus on these solutions and actions

Empower the Inquirer: • •

It is important to foster the concept of empowerment. Helping inquirers understand the steps to take to obtain needed services fosters independence, so the inquirer can advocate on their own behalf.

Focus Discussion: • • •

Focus the discussion. Help the inquirer separate and prioritize problems beginning with physical safety. Identify resources, personal strengths, prior coping abilities.

Set Limits: •

• • • •

Develop an Action Plan: •

Elements of Developing an Action Plan o Selectively choose and use appropriate approaches to action planning. o Assist in modifying previous inadequate coping skills. o Negotiate a contract or action plan. o Select appropriate referral resources. o Plan for immediate action and implementation.

• Information and Referral Program – Training Manual

•

Techniques for Developing an Action Plan o Use three basic approaches: 1. Start by being non-directive. 2. Be collaborative by working together on a joint plan. 3. Be directive if the person does not or will not make a plan. o When making an action plan, keep it simple and manageable. o Keep the action plan short-term, 24 hours to three days. o Keep the action plan achievable and focused.

Understanding and Helping the Suicidal Person

Objective: The objective of this section is to equip the I&R Specialist with some knowledge of suicidal people’s signs/ symptoms, degree of lethality and some strategies to try and assist these people Some Facts About Suicide

from “Suicide Awareness Facts”, LivingWorks Education Inc. Suicide is a global concern. In all 105 countries providing causes of death information to the WHO, suicide is now one of the three leading causes of death among people aged 15–35 years. Although once primarily a concern among the elderly, it now predominates in younger people in a third of all countries. WHO, Figures and Facts about Suicide, 1999 Some things we know about suicide are true, worldwide… It happens to people of all kinds who are sad, distressed and often desperate to stop their suffering. Many of these people did not want to die. Some, perhaps many, deaths by suicide could be prevented. Schmidtke and others, Suicide rates in the world, Archives of Suicide Research, 1999 Each week, about 3% of people consider ending their lives. Thinking about suicide is very common. This is a relatively new .finding from researchers in Australia. There is nothing surprising in this information, except that it took so long for it to be noticed. Offering great hope is the calculation that the very largest majority of these people never actively harm themselves, despite being at risk. It appears that actively considering suicide is so unpleasant or distressing that people want to .nd better choices.

Goldney and others, Suicidal ideation and health-related quality of life in a community, MJA, 2001 Suicide occurs in all states, provinces and countries. Of all deaths each year, suicide is the cause in 2%. Society counts the ways that people die. They do this to follow changes in the causes of mortality. Most governments publish the data. The information is often used to make decisions about spending money for prevention programs. Deaths by suicide are listed in every such reporting. More people die by suicide than by homicide or liver diseases or AIDS and, in many places about the same or more than those dying from traffic accidents. Relative to how large a problem it is, suicidal behavior and its prevention receive very little funding support from governments or public health authorities around the world. WHO, The Injury Chart Book, 2002 Many things, big and small, can lead towards suicide. Seldom does a single catastrophic event lead to suicide, though that does occur. Much more common are events and experiences that eventually overwhelm the person and lead to a loss of their usual Information and Referral Program – Training Manual

effective coping. Suicide may become an option at this point but life can also be chosen and usually will be if there is someone to help sort out the choices. Heikkinen and others, Age-related variation in recent life events preceding suicide, Journal of Nervous and Mental Disease, 1995 For many, suicide is about escaping pain. Suicide is usually not about seeking death. Death may be the outcome, but the goal was to escape a life where the burden of suffering and pain can be removed. Warning signs There is no typical suicide victim. It happens to young and old, rich and poor. Fortunately there are some common warning signs which, when acted upon, can save lives. Here are some signs to look for: A suicidal person might be suicidal if he or she: Talks about committing suicide Loses interest in hobbies, work, school, etc. Takes unnecessary risks Is preoccupied with death and dying Loses interest in their personal appearance They may prepare for death by giving away prized possessions, making a will, or putting other affairs in order. They may withdraw from those around them. Change in Sleep Patterns - insomnia, often with early waking or oversleeping, nightmares Change in eating habits - loss of appetite and weight, or overeating A sudden, intense lift in spirits may also be a danger signal, as it may indicate the person already feels a sense of relief knowing the problems will be ended. One or more mental health diagnosis or including physical or sexual abuse substance abuse disorder Family history of mental or substance abuse disorder Family history of suicide including family, peers Family violence, including physical or sexual abuse Prior suicide attempt/attempts Firearm in the home Exposure to the suicidal behaviour of others, including family, peers, or in the news or fiction stories Recent Loss - through death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, loss of interest in friends, sex, hobbies, activities previously enjoyed Change in Personality - sad, withdrawn, irritable, anxious, tired, indecisive, apathetic. Change in Behaviour - can't concentrate on school, work, routine tasks Diminished Sexual Interest- impotence, menstrual abnormalities (often missed periods). Fear of losing control- going crazy, harming self or others Low self esteem- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me" No hope for the future - believing things will never get better; that nothing will ever change Suicidal impulses, statements, plans; agitation, hyperactivity, restlessness or lethargy. Increased alcohol and/or other drug use Inability to tolerate frustration Inability or unwillingness to communicate Sexual promiscuity Theft &/or vandalism Depression, unusually long grief reaction Exaggerated &/or extended boredom Information and Referral Program â&#x20AC;&#x201C; Training Manual

Carelessness &/or accident prone Unusually long grief reaction Hostile behaviour Truancy Family disruption, especially divorce Running away from home Abrupt ending of a romance Poor performance in school.

Be Aware of Feelings Many people at some time in their lives think about committing suicide. Most decide to live, because they eventually come to realize that the crisis is temporary and death is permanent. On other hand, people having a crisis sometimes perceive their dilemma as inescapable and feel an utter loss of control. These are some of the feelings and things they experience: Can’t stop the pain Can’t think clearly Can’t make decisions Can’t see any way out Can’t sleep, eat or work Can’t get out of depression Can’t make the sadness go away Can’t see a future without pain Can’t see themselves as worthwhile Can’t get someone’s attention Can’t seem to get control If you experience these feelings, get help! If someone you know exhibits these symptoms, offer help! How to Help a Suicidal Person Here are some ways to be helpful to someone who is threatening suicide: Do an initial PLAID check to determine if there is a high lethality rate. Plan: - Do they have one? Lethality: - Is it lethal? Can they die? Availability: - Do they have the means to carry it out? Illness: - Do they have a mental or physical illness? Depression: - Chronic or specific incident(s)? Getting a Suicide Call If the person is telling you either in person or over the phone that they ARE going to kill themselves, you need to call 911 RIGHT NOW. Get their contact information. Find out where they are. You cannot send someone to them if you don’t know where to find them. Flag a coworker to call 911. If you are working alone, keep caller active on your phone and use another phone to call 911. Law enforcement will come to the person’s home and take them to be evaluated by a mental health person. Even if you feel in your heart, that they will not take their life, you go by what they are telling you. If the suicidal person forbids you to call, is angry about it or upset, you call ANYWAY.

Information and Referral Program – Training Manual

What if that person has you in confidence and makes you swear that you will not tell anyone how they are feeling? Do you keep that confidence? NO! Would you be a lousy friend, mother, etc. if you broke that confidence? NO! Suicidal discussion automatically ends confidentiality. What if the person does not "qualify" for the above statements? Do you not take them seriously? YES! ALWAYS take people seriously when suicide is discussed. If they truly want to die, they may not tell you the truth about their plan. Many people have taken their lives when people thought their statements about suicide were "manipulative" or the person was being "melodramatic." Many people have died "accidentally." They may take some medication for example just to get others to hear them and feel they will be discovered and saved. Instead of calling attention to their needs, they in fact, died. When law enforcement comes, they will assess the person. They will talk to the person. There are times where the person is not "taken" by law enforcement, it is helpful to have law enforcement there to talk with them.

Emergency Suicide In-Progress If you have someone on the phone and you believe the suicide is in progress, document the information as you learn it – you may forget the details in the ‘heat of the moment’. You will need, Caller’s name, address, phone number. If caller has made a suicidal attempt before calling you can get details such as..

What did caller do? ________________________________________________________ If Pills or Overdose: What did caller take? _____________________________________________________ When? _________________________________________________________________ How many? _____________________________________________________________ What kind of pill are they? (sleeping pills, pain pills, etc.) _________________________ How much have they had to drink today? _____________________________________ ** Keep the Caller Awake ** Call Poison Control If in Doubt of Lethality of Substance or Combination If a Weapon is Involved: What kind of weapon? ___________________________________________________ If a gun is involved: Is it loaded? Yes or No Where is the weapon located? ______________________________________________ ** Keep The Caller On The Phone ** Keep The Caller Talking (Awake if Overdose) ** Inform 911 of a Suicide in Progress – 2nd phone or pass a note to another I&R Specialist

How to Help a Suicidal Person When No Immediate Risk After you have taken emergency measures as described above, or the person is not in immediate risk, what do you say to them?

Information and Referral Program – Training Manual

Acknowledge and accept their feelings even if they appear distorted - "you sound like you are feeling abandoned...," "that must have hurt you terribly...," how does make you feel"? "are feeling like there is no hope"? etc. Be an active listener- repeat some of their statements back to them to let them know you are listening. For example, "so what you are saying is..., "I’m hearing you saying you hate yourself...," so receiving that letter made you feel abandoned..." etc Try to give them hope and remind them what they are feeling is temporary, without provoking guilt. "I know you feel you cannot go on, but things will get better," "What you are feeling is temporary," "I believe in you and that you will get better," "There is a light at the end of the tunnel - it’s ok if you don’t see it now." Give encouragement. Allow them to show their feelings. Allow them to cry, to show anger, etc. Let them know you hear them. Let them know it is ok to feel what they feel, even if it is distorted Help them get some help - counseling, drug recovery, doctor - encourage them to make these calls. Is there a child or children of the suicidal person witnessing their parent’s crisis? You might need to tell the police. Or perhaps the person might take the child somewhere, or, reminding the person of their love to/from the child might assist in not carrying through with the suicide. Be direct. Talk openly and matter-of-factly about suicide. A person in crisis may not be aware that they are in need of help or be able to seek it on their own. They may also need to be reminded that effective treatment for depression is available, and that many people can very quickly begin to experience relief from depressive symptoms. Be willing to listen. Allow expressions of feelings. Accept the feelings. Be non-judgmental. Don’t debate whether suicide is right or wrong, or feelings are good or bad. Don’t lecture on the value of life. Don’t dare him or her to do it. Don’t act shocked. This will put distance between you. Don’t be sworn to secrecy. Seek support. Get caller’s name if possible and continue to use caller’s name in a caring personal way. Find out what is still meaningful to the person – what has kept him/her alive up to now. Assess internal and external resources. Help identify coping strategies which have worked in the past. Refer for treatment, support, therapy. Get help from persons or agencies specializing in crisis intervention and suicide prevention.

DO Reinforce the person for calling. Encourage ventilation of feeling and respond to them. Information and Referral Program – Training Manual

DO NOT Challenge. Give a “Guilt Trip”. Make promises we can’t keep. 93

Exude confidence and concern. Stress our willingness to be involved. Remind that situation can change in time.

Immediately offer referrals. Judge them Show anger toward them Discount their feelings Tell them to "snap out of it"

Remember: The risk of suicide may be greatest as the depression lifts. They may now have the energy to commit the act. Also remember, that you can only do what you are able to do. You are NOT responsible for their behaviour. None of us can control others. This is a myth that some of us hold on to. If you witness some of the above signs, try to talk with the person and get them some help. If you feel the person is at risk of ending their life, even if they deny it, call 911 so that they may be evaluated.

Below are 2 different formats of a Suicide Assessment Checklist. They both contain the same criteria, but are formatted differently. It is good to review, so you know the types of questions to ask. Also, you can print out 1 copy to post at your desk as a quick guide to have nearby when you get a call. Suicide Lethality Checklist

Nature of Inquirerâ&#x20AC;&#x2122; Situation Describe plan and method Method availability When? Where? Previous attempts Method of attempt(s) and when alcohol/drugs ingested today Final arrangements made? Hearing voices to kill self CURRENT FUNCTIONING Significant others, friends, relatives? Name and phone numbers Daily functioning Sexual Orientation issues? Alcohol/drug use? Physical health History of violence or impulsivity? Withdrawal/isolation Tone of Voice Recent loss/other traumatic events Tunnel vision Involvement with the law Eating/sleeping disturbance? Family history of suicide Talked to others about suicidal ideation/intent Current/past abuse Spending/gambling problem

LOW RISK Ideation

MEDIUM Threat

HIGH RISK Attempt

unavailable unplanned unplanned none

could be available vague plans vague plans

present/used specific specific yes

no no

yes yes (will, suicide note, giving away things) yes

several available

Questionable availability

normal activities/ losing interest in job, school, family relationships none Questions about orientation none/recovery sporadic no medical problems illness/repeated injuries None violent fantasies will accept help appropriate none open to options no no change

hesitant vague/ doesn't match words ambivalent to future pending court cases recent, mild changes

no no no none

Information and Referral Program â&#x20AC;&#x201C; Training Manual

occasional, mild

none no interest-activities or relationships, wants death struggling with "coming out" chronic recent problems/chronic current/past historyviolence to self/ others refuses help flat / detached / hysterical yes: hopeless/closed to options recent arrest/court date imminent weight gain/loss, excessive/minimal sleep yes yes yes: physical /sexual /emotional compulsive/ chronic/ serious 94

Currently in treatment? Where/whom? Medications? Clients lethality (beginning of call) Clients lethality (end of call)

yes Diagnosis?

Low

Medium

High

Low

Medium

High

Police or EMS Referred to Mental Health centre/Screening Centre

requested arrived

INTERVENTIONS Abrupt Termination Family/other support arrived Referred to Crisis Help LIne Agreed? Yes Offered "no suicide contract" Agreed? Yes

No No

Suicide Risk Assessment Guide Age/Sex Marital Status

Risk Present, but Lower __Male/Female Under 15 __Female 15-34 __ Stable marriage

Suicide Plan

__ Vague __ No specific time

Means

__Non-prescription drugs

Availability of Means Intervention Chance

__ Not readily available __ Others present most of the time __None or one of low lethality

Previous Attempts

Moderate Risk __ Female 35-49 __ Male 15-34 __ Unhealthy marriage __ Single __ Some specifics __ Plans to do it in a few hours __ Drugs & alcohol; car wreck: carbon monoxide; drowning __ Available nearby __ Others available if called on __ Multiple of low or one of medium lethality __ Changes in environment; routine; or lifestyle __ Criminal involvement; legal entanglements

Stressors

__No significant current stress __ Increased responsibility

Symptoms

__ Mild or no depression __ Mild or no anxiety __ Little or no hostility __ Feeling isolated but no withdrawal

__ Moderate depression __ Miderate anxiety __ Some hostility __ Some helplessness, hopelessness __ Some withdrawal

Drug/Alcohol Abuse (prescription drugs also) Attitude Toward Life

__ None or infrequent use

Mental Health

__ No history of mental illness

Medical Status

__ No significant medical problems

__ Frequent use, currently using __ Reasons for dying equal or outweigh reasons for living __ Ambivalent about suicidal thoughts __ Previously sought counseling __ Acute but short term or psychosomatic illness

Coping Behavior

__ Daily activities continue with little change

Resources and Support

__ Employed or has finances

__ Gives good reason for living __ Upset by suicidal thoughts

Information and Referral Program â&#x20AC;&#x201C; Training Manual

__ Some daily activities disrupted __ Disturbance in eating or sleeping __ Financial problems

High Risk __ Female 50+ __ Male 35+ __ Divorced/Separated __ Widowed __Well thought out, knows how, when, where __ Plans to do it immediately __ Gun; hanging; jumping, barbiturates; anti-depressants __ Has means in hand __ No one nearby; isolated __ One of high lethality or multiple of medium __ Mental illness (adds extra danger) __ Serious illness, accident, surgery __ Loss of job, money, prestige, status __ Loss (or perceived loss) of a loved one through death, divorce, etc. __ High anxiety or panic state __ Severe depression __ Feeling helpless, hopeless __Withdrawing and selfdepraciating __ Excessive use, currently using __ Sees no reason for living __ Makes no attempt to keep suicidal thoughts in control __ Diagnosed or treated now or in past __ Chronic debilitating or acute catastrophic illness __ Major disturbances in daily functioning (hygiene, work, play) __ No financial resources

__ Significant others concerned and willing to help

Total Checks:

Lower: ____

__ Family/friends available but unwilling or unable to help

Moderate: ____

__ Family/friends unavailable, hostile, exhausted, and/or damaging __ Has not told anyone of plan High: ____

Borrowed from the 2-1-1 & Hotline Services Division ,Crisis Center â&#x20AC;&#x201C; Crisis Center of Tampa Bay, Inc.

Information & Referral in Times of a Disaster In times of disaster within a community, the function of the 211 system becomes increasingly important. An I&R service provides practical assistance in pre-disaster planning, during the disaster itself, its immediate aftermath and the disaster recovery period. In the event of an emergency such as a flood, tornado, extended power outage, or apartment fire, affected residents will be often be directed by emergency services personnel and the media to call 211 to obtain information. People will need a place to call. I&R Specialists need to be prepared to listen to a variety of needs, many times just the need for people to connect with someone. Calls may come in that do not fall into the inclusion/exclusion guidelines for 211 such as locations for laundromats, landscape companies, hardware stores, where to buy ice, etc, which I&R would still answer in times of an disaster. Volunteer management and donation management could be another role I&R will take on during a disaster. 211 is an easy to remember number that concerned individuals can call if they want to donate funds or items to disaster victims, or volunteer at the disaster site. I&R can be used to accept calls and maintain a list of people interested in donating or volunteering. The incidence of spontaneous volunteerism and the urge to donate is enormous following a disaster, and can happen within hours of the event. In many cases a resource data base specific to the particular disaster will be created and updated as new information becomes available. Information gathered will be constantly monitored and updated in an effort to effectively serve the community during the time of emergency. Community Connections has a written emergency operations and business contingency plan which specifically addresses disaster preparedness for the community and for the organization. Preparation includes development plan that enables the I&R service to continue to provide services if its building is damaged or destroyed; and to support its ability to effectively accumulate and disseminate accurate disaster-related information, provide information and referral assistance for individuals impacted by a disaster and provide community reports regarding inquirer needs and referrals. Procedures are in place to maintain service in event of an internet failure, such as the usage of an off-line resource data base.

Information and Referral Program â&#x20AC;&#x201C; Training Manual

Abuse/ Assault/ Violence Child Abuse and Neglect Introduction Children need protection and help. Child abuse is one of the most terrifying and heart-wrenching problems that you will encounter as an I&R Specialist. It is a problem laden with emotional reactions for all concerned. There are three basics in dealing with child abuse cases: legal responsibilities, awareness of feelings, and the provision of safety and support. Information Child abuse is any wilful or negligent act that results in significant physical injury, sexual contact or harassment, endangerment of mental health, malnutrition, or failure to provide sustenance, clothing, or medical attention. In child abuse cases, the law requires that any person who knows or suspects that a child is being abused must report this information to the Children’s Aid Society (CAS). No person is exempt from the law. If a counsellor acquires identifying information, then it must be reported. Optimally, the abuser will report him/herself, but the specialist is responsible for ensuring that a report is made. With respect to child abuse, 2-1-1 functions to facilitate emergency services to abused children through police, medical, and the Children’s Aid Society (CAS): • • • • •

To prevent child abuse by offering referrals to persons concerned with parent-child relationships and through community education To provide information concerning child abuse and channels through which reports are made To encourage the reporting of child abuse To keep accurate statistics to be used in planning and evaluating services to abused children, abusers, and potential abusers The top priority is to assist in the protection of the child!

Questions to Ask: • • • • •

Is the child in a safe place right now? Is the child making the accusation or another party (mother, aunt, neighbour)? When did the abuse happen (today, two months ago)? Are there visible signs of abuse, such as physical bruises? Has the caller made a complaint to CAS before? Was there an investigation?

What should I do if I think that I know about a case of child abuse? If you think that a child is being abused, you should immediately contact the Children’s Aid Society. You may also call the police to report your suspicions. What if I just suspect child abuse? What should I look for? There are some indicators that may help you to recognize child abuse: • • • •

Unexplained bruises, welts or injuries, particularly in places where children don't normally hurt themselves through play Burns which leave an outline of an object that might have been used to inflict the injury such as a cigarette or stove burner A child who is continually hungry, dirty or unsuitably dressed for the weather A young child who is often left alone

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A child who is unusually aggressive, hostile or angry with other people A child who shows a unusual knowledge of sexual matters A child who is extremely withdrawn A child or adolescent who repeatedly runs away from home

Individuals who have reasonable grounds to believe a child is in need of protective services must report those suspicions. Some people, such as professionals who work with children must report suspicions of child abuse. Write down the facts: • Record all the facts the child has disclosed to you • Avoid interpreting what the child has said, use the child’s exact words • Contact Children’s Aid Society (CAS) Reporting: Everyone has a duty to report child abuse. As soon as a child discloses abuse to you, contact Children’s Aid Society (CAS). Even if a child has not disclosed abuse to you but you have reasonable grounds to suspect abuse is taking place, report it immediately. Delaying to report could place a child at further risk. To make a report does not require absolute certainty. Anyone who has a reasonable suspicion that a child is or may be in need of protection is required by law to report the information. People who report suspected child abuse or neglect cannot be sued unless they did so maliciously or without reasonable grounds. Jot down the following information to help in reporting abuse. Name of child/children (or senior etc…): • Corresponding ages of child/children: • Address: • Telephone number: • Others in household: • Describe the situation: • What has caller observed? • Nature/Type of injury • Name of physician or other agency involved in case: • Is there anyone else who can provide information on this case? • Name: • Telephone number: • Name of alleged abuser: • Complainant’s Name: • Telephone # • Address: • Date & Time report was made to CAS: • Name of CAS Worker • 2-1-1 Staff’s Name • Type of Child Abuse

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Type of Child Abuse Neglect: Failure to give due attention or care to a child resulting in serous emotional or physical harm.

Behavioural Indicators - pale, listless, unkempt - frequent absence from school - inappropriate clothing for the weather - dirty clothes - inappropriate acts or delinquent behaviour - abuse of alcohol/drugs - begging /stealing food - frequently tired - seeks inappropriate affection - reports there is no caretaker Emotional: Verbal attacks - depression or demeaning actions that - withdrawal or aggressive behaviour impact on a childâ&#x20AC;&#x2122;s self - overly compliant esteem and self worth. - too neat and clean - habit disorders (sucking, biting, rocking, etc.) - learning disorders - sleep disorders - unusual fearfulness - obsessive compulsive behaviour - phobias - extreme behaviour - suicide attempts - developmental delays Physical Abuse - the intentional use of force - inconsistent explanation for injuries or cannot against a child resulting in remember injury or causing bodily - wary of adults harm - flinch if touched unexpectedly - extremely aggressive or extremely withdrawn - feels deserving of punishment - apprehensive when others cry - frightened of parents - afraid to go home

Physical Indicators - poor hygiene - unattended physical or medical needs - consistent lack of supervision - underweight, poor growth, failure to thrive - constant hunger - under nourished

Sexual Abuse - any form of - sexual knowledge or play inappropriate to age sexual conduct (touching, - sophisticated or unusual sexual knowledge exploitation, intercourse) - prostitution directed at a child. - poor peer relationships - delinquent or runaway - reports sexual assault by caretaker - change in performance in school - sleeping disorders - aggressive behaviour - self-abusive behaviours - self mutilation

- unusual or excessive itching in the genital or anal area - stained or bloody underwear - pregnancy - injuries to the vaginal or anal areas - venereal disease - difficult in walking or sitting - pain when urinating - vaginal/penile discharge - excessive masturbation - urinary tract infections

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- bed-wetting - headaches - nausea - speech disorders - lags in physical development - disruptive behaviour

- injuries not consistent with explanation - numerous injuries in varying stages of recovery or healing - presence of injuries over an extended period of time - facial injuries - injuries inconsistent with the childâ&#x20AC;&#x2122;s age and developmental phase

Facts about child abuse: • • •

Child abuse usually reflects patterns of behaviour rather than an isolated incident. The vast majority of child abusers are parents, relatives, or trusted adults, not strangers. Children rarely lie about abuse. They are more likely to deny abuse and take back truthful statements than to make false reports • Child abuse knows no class boundaries

Elder Abuse Introduction Abuse of the elderly is gained public attention. With an increasing life expectancy, there are more elderly who are at risk for abuse. People 85 and older make up the fastest growing segment of the population. Yet, modern society as not moved quickly enough in meeting the changing needs of providing for this group of people. Types of abuse: • Physical assault or injury • Verbal harassment • Malnutrition • Theft or financial mismanagement • Unreasonable confinement • Over sedation • Sexual abuse • Withholding of medication or required aids (e.g., glasses, hearing aids, false teeth)

Questions to Ask: • Is the caller in a safe place? • What type of abuse is it? • Is the elderly caller capable of reporting the abuse himself or herself? Things to Consider: • We can report the abuse if the elder is incapable or incompetent of doing so • This does not include a capable adult who chooses not to report the abuse There are many reasons why people might not report abuse. They include: • Shame that a family member treats them badly and a need to keep it in the family • Fear of more abuse • Fear of being placed in an institution • Fear of losing a caregiver or contact with a family member • A belief that they are getting what they deserve, for example, if they feel they were not a good parent • A belief that police or social services cannot help them • A belief that they cannot prove the abuse is happening Reporting Elder Abuse: If there is any possibility of immediate danger of physical harm, then you should consider notifying the police or Elder Abuse Hotline, or regional Elder Abuse agency. Otherwise, it is important to deal with cases of suspected abuse with a degree of care, particularly because the abuser might retaliate against the elderly person. It is also important to respect the dignity of the elderly person who might choose to accept or reject help. Information and Referral Program – Training Manual

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Agreement on the part of the elderly person to any subsequent actions is very important, unless the person is not mentally competent. For this reason, you should speak with the individual before taking any action and be sure that all possible outcomes of intervention are considered. In order to help them make their decision, you may bring to their attention many resources on elder abuse and the names of agencies that can offer assistance. Depending upon the individual, strategies that you might use include: Directly and respectfully asking if any abuse is occurring Encouraging them to contact others such as a doctor, lawyer, social worker, public health worker, or home care worker Describing the benefits which could help them to be more independent Providing information about counselling services for the abused or the abuser Helping to dispel myths about abuse, for example, that protecting the abuser's reputation will not help the abuser change, that there is no "perfect family", and that abuse can exist at any education or income level Helping them understand that nobody deserves to be abused Encouraging them to get out and use community service programs, such as drop-in centres Encouraging them to get a thorough health assessment from her doctor or a health unit Agencies and personnel differ in the various provinces and territories, but there are agencies that can lead you to information and to more specialized agencies in your location: • • • • • • • • • •

Police Health units Social service agencies Mental health clinics Public Health Agency of Canada (National Clearinghouse on Family Violence website Family doctors Hospitals Office of public trustee, public guardian, if victim is mentally incompetent Community Care Access Centre (CCAC) OakNet: Abuse of Older Adults website

Spousal Abuse Spousal abuse is the deliberate attempt by a partner in an intimate relationship to control or intimidate the other partner. The couple may be married, or unmarried. Abuse can be physical, psychological, sexual or financial. A person may experience more than one kind of abuse. How might someone tell if abuse is going on in a family? Abuse almost always occurs in private so that it is hard to detect. There are some signs that might indicate abuse is going on such as: • A track record of violence in the past • A history of family abuse from when spouses were children • Impulsiveness demonstrated by temper tantrums, possessiveness, excessive dependence on spouse, emotional immaturity • Rigid views of men and women and their roles in society • Problems with children such as aggressive behaviour, school problems, night time problems, physical complaints, crying hopelessly or very little. Information and Referral Program – Training Manual

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History of suicidal thoughts or attempts Substance abuse

You can report a criminal matter to the police even if it does not directly involve yourself. If you want the police to investigate the possibility of charging someone, you may have to lay a charge/ provide information at the police station. This is a statement that describes what you believe is going on. The police will then investigate the situation, which would likely involve interviewing the people involved, and any other relevant witnesses. The police will then decide if they have enough evidence to charge the person with a criminal offence. Creating a Safety Plan Developed by The Peel Committee Against Woman Abuse Many women have escaped and survived abusive situations. This information package was put together by women who have survived and offer their advice to you. Introduction It is important to know that although you do not have control over your (ex) partner’s violence, it is possible to increase your own, as well as your children’s, safety when being subjected to this abuse. Creating a safety plan involves identifying action steps to increase your safety, and to prepare in advance for the possibility of further violence. This information package offers many suggestions and ideas that we hope you will find useful. However, don’t try to do everything right away. Take it a step at a time, and start with the ideas that seem most doable for you. Safety Plan In creating a safety plan it is important to remember that: • Although you cannot control your (ex) partner’s violence, it may be possible to increase your own and your children’s safety • A safety plan is needed whenever the possibility of abuse is identified • This safety plan information is specifically designed for actions that you can take • This safety plan information also includes actions you can take to increase your children’s safety • It is important to become familiar with and to review and/or revise your safety plan regularly. Abusive situations and risk factors can change quickly An Emergency Escape Plan The Emergency Escape Plan focuses on the things you can do in advance to be better prepared in case you have to leave an abusive situation very quickly. The following is a list of items you should try to set aside and hide in a safe place (e.g. at a friend’s or family member’s home, with your lawyer, in a safety deposit box): a) Take a photocopy of the following items and store in a safe place, away from the originals. Hide the originals someplace else, if you can. • • • • • • • • • • •

Passports, birth certificates, immigration papers, for all family members School and vaccination records Driver’s license and registration Medications, prescriptions, medical records for all family members Welfare identification Work permits Divorce papers, custody documentation, court orders, restraining orders, marriage certificate Lease/rental agreement, house deed, mortgage payment book Bank books Insurance papers Address/telephone book

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Picture of spouse/partner Health cards for yourself and family members All cards you normally use e.g. Visa, phone, Social Insurance, ATM

b) Try to keep all the cards you normally use in your wallet: • Social insurance cards • Charge cards • Phone card • Banking cards • Health cards c) Try to keep your wallet and purse handy, and containing the following: • Car/house/office keys • Chequebook, bank books/statements • Driver’s license, registration, insurance • Address/telephone book • Picture of spouse/partner • Emergency money (in cash) hidden away d) Keep the following items handy, so you can grab them quickly: • Emergency suitcase with immediate needs • Special toys, comforts for children • Jewellery • Small saleable objects • Items of special sentimental value • A list of other items you would like to take if you get a chance to come back to your home later Open a bank account in your own name and arrange that no bank statements or other calls be made to you. Or, arrange that mail be sent to a friend or family member. • Save and set aside as much money as you can - out of groceries if necessary • Set aside, in a place you can get to quickly, $10 to $15 for cab fare, and quarters for the telephone • Plan your emergency exits • Plan and rehearse the steps you will take if you have to leave quickly, and learn them well • Hide extra clothing, house keys, car keys, money, etc. at a friend’s house • Keep emergency suitcase packed or handy/ready to pack quickly • Consider getting a safety deposit box at a bank that your partner does not go to The Police will bring you back to the home later, to remove additional personal belongings, if it is arranged through the local division. Take the items listed above as well as anything else that is important to you or your children. When you leave, take the children if you can. If you try to get them later, the police cannot help you remove them from their other parent unless you have a valid court order. Creating a Safer Environment: There are many things a woman can do to increase her safety. It may not be possible to do everything at once, but safety measures can be added step by step. Here are a few suggestions: At Home: If you are living with your abusive partner/spouse: • Get your Emergency Escape Plan in order and review it often Information and Referral Program – Training Manual

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• • • • • • • • •

Create a telephone list with numbers of local police, nearest shelter, assaulted women’s help line, crisis help line, family members, counsellors, children’s friends Make arrangements with friends or family so that you can stay with them if necessary Try to predict the next likely violent episode and make plans for the children to be sent to friends, family etc. Teach the children to let you know when someone is at the door, before answering the door Teach your children how to use the telephone (and your cellular phone, if you have one) to contact the police and the fire department Create a code word with your children and/or friends so they know to call for help Teach your children how to make a collect call to you and to a special friend if your partner takes the children Plan your emergency exits, teach your children and know them well Teach your children their own Safety Plan

If you are not living with your abusive partner/spouse: • Change the locks on the doors and windows. Install a peephole in the door Change the locks on your garage and mailbox • Teach your children to tell you if someone is at the door and to not answer the door themselves • Keep your restraining order near you at all times • Make sure that the school, day care, and police have a copy of all court orders, including restraining orders, custody and access orders, as well as a picture of the abusive partner • If possible, try to predict the next likely violent incident and be prepared • If you have call display on your phone, be careful about who can get access to the store numbers (example, last number dialed, etc.) • Have your telephone number unlisted, block your number when calling out • Consider getting a cell phone and pre-program numbers of people to call • Consider moving your furniture around differently as this is something your partner may not anticipate, and cause him/her to bump into it and give you warning that he/she is in the house. Also put your kitchen utensils and knife block in the cupboards so they are not as accessible • If you live in an apartment, check the floor clearly when getting off the elevator. Look in mirrors and be aware of doorways in hallways. Speak to security, or make an anonymous call, requesting safety in your building • Purchase rope ladders to be used for escape from upper floors • Replace wooden doors with steel/metal doors if possible • Install smoke detectors and fire extinguishers for each floor • Consider the advantages of getting a guard dog • Install an outside lighting system that lights up when a person is coming close to your house • Do whatever you can to install security systems, including additional locks, window bars, poles to wedge against doors, an electronic system, etc. – anything to provide added security In the Neighbourhood: • Tell your neighbours that you would like them to call the police if they hear a fight or screaming in your home • Tell people who take care of your children which people have permission to pick up your children • Tell people in your neighbourhood that your partner no longer lives with you, and they should call the police if he/she is seen near your home. You may wish to give them a photo and description of him/her and of their car. • Ask your neighbours to look after your children in an emergency • Use different grocery stores and shopping malls, and shop at hours that are different from when you were living with your abusive partner • Use a different bank or branch, and take care of your banking at hours different from those you used with your abusive partner • Change your doctor, dentist and other professional services you would normally use Information and Referral Program – Training Manual

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Do not put your name in your apartment building directory Hide clothing and your Emergency Escape Plan items at a neighbour’s house. These items

At Work: Each woman must decide for herself if and/or when she will tell others that her partner is abusive and that she may be at risk. Friends, family and co-workers may be able to help protect women. However, each woman should consider carefully which people to ask for help. If you are comfortable, you may choose to do any or all of the following: • Tell your boss, the security supervisor, and other key people or friends at work of your situation • Ask to have your calls screened at work. It would also help to have these calls documented • Discuss the possibility of having your employer call the police if you are in danger from your (ex) partner When arriving or leaving work: • Let someone know when you’ll be home • Carry your keys in your hands • Get a remote or keyless entry car door opener • Walk with someone to your car • Scan the parking lot • Walk around your car, look under the hood and check if anything has been tampered with and check brakes. Remember to keep your car seats forward, so you know if someone is hiding in the car. • If your partner is following you, drive to a place where there are people to support you, e.g. a friend’s house, police station • If you have underground parking, consider parking across the street • Keep a sign in your car saying "call police" • If you are walking, take a route that is populated • Change the patterns of when you arrive and leave work and the routes you take home • If you see your partner on the street, try to get to a public place, e.g. a store • If you see your partner on the street, call attention to yourself and request help An Emotional Safety Plan The experience of being abused and verbally degraded by partners is usually exhausting and emotionally draining. The process of surviving and building a new life requires much courage, and incredible energy. To conserve your emotional energy, and to support yourself in hard emotional times, there are a number of things you can do: • Attend as many Crisis Counselling group sessions as you can • Become involved in community activities to reduce feeling isolated • Take a part-time job to reduce isolation and to improve your finances • Enrol in school to increase your skills • Join support groups of other women to gain support and strengthen your relationships with other people • Take time for yourself to read, meditate, play music, etc. • Spend time with people who make you feel good and provide support • Take part in social activities, e.g. movie, dinner, exercise • Take care of your sleep and nutritional needs • Keep your Inquirer Profile up to date to help you feel prepared for upcoming events • Keep a personal journal to write about your feelings, especially when you are feeling low or vulnerable, keep it in a safe place or burn it • Take time to prepare yourself emotionally before entering stressful situations like talking with your partner, meeting with lawyers, or attending court • Try not to overbook yourself - limit yourself to one appointment per day to reduce stress • Be creative and do whatever makes you feel good Information and Referral Program – Training Manual

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• • • • • •

Write something positive about yourself everyday - your own personal affirmations Do not find your comfort in excessive use of alcohol or food - it only serves to increase your depression Avoid excessive shopping and impulse buying Join a health club or start an exercise program. It will increase your energy level and increase your sense of well being It’s OK to feel angry, but find positive and constructive ways to express your anger Remember that you are the most important person to take care of right now

A Child's Safety Plan This plan was developed to help mothers teach their children some basic safety planning. It is based on the belief that the most important thing that children can do for their mothers and their families is to get away from the area of violence! They cannot stop the abuse, although they often try by distracting the abuser or directly interfering in the abusive episode. It is important to tell the child that the best and most important thing for them to do is keep themselves safe. Children who experience woman abuse can be profoundly affected. It is very traumatic for them to be faced with violence directed at them or at someone they love. Personal safety and safety planning are extremely important and necessary for children whose families are experiencing violence. Children should learn ways to protect themselves. There are several ways to help you develop a safety plan with your children. • • •

• • •

Have your child pick a safe room/place in the house, preferably with a lock on the door and a phone. The first step of any plan is for the children to get out of the room where the abuse is occurring. Stress the importance of being safe, and that it is not the child’s responsibility to make sure that his/her mother is safe Teach your children how to call for help. It is important that children know they should not use a phone that is in view of the abuser. This puts them at risk. Talk to your children about using a neighbour’s phone or a pay phone if they are unable to use a phone at home. If you have a cell phone, teach your children how to use it. Teach them how to contact police at the emergency number Ensure that the children know their full name and address Rehearse what your child/children will say when they call for help

For example: Dial 911 An operator will answer: "Police, Fire, Ambulance." Your child says: Police. Then your child says: My name is ______________. I am ____years old. I need help. Send the police. Someone is hurting my mom The address here is _______________. The phone number here is ______________. •

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It is important for children to leave the phone off the hook after they are done talking. The police may call the number back if they hang up, which could create a dangerous situation for yourself and your child/children. Teach your children about Neighbourhood Block Parents and how to use them. Pick a safe place to meet your children, out of the home, after the situation is safe for you and for them (so you can easily find each other).

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Teach your children the safest route to the planned place of safety for them.

During a Violent Incident: Women cannot always avoid violent incidents. However, in order to increase your safety, here are some things you can do: • Remind yourself that you have an Emergency Escape Plan, and go over it in your mind • Start to position yourself to get out quickly or near a phone so you can call 911, if necessary • Try to move to a space where the risk is the lowest. (Try to avoid arguments in the bathroom, garage, kitchen, near weapons, or in rooms without access to an outside door. • Use your code word with your children so they can call for help • Use your judgement and intuition - if the situation is very serious, you can agree with your partner or give him/her what he/she wants to calm him/her down. You have to protect yourself until you are out of danger • When, or after, you have been assaulted, call the police at 911 if you can. Tell them you have been assaulted by a man/woman, (don’t say your husband/partner), and leave the phone off the hook after your call. • Make as much noise as possible (set off the fire alarm, break things, turn up the stereo or TV) - so that neighbours may call the police for you. Crisis Intervention with Assaulted Women: The are two primary tasks at this stage of intervention. They are: 1. Creating an atmosphere of trust and respect 2. Dealing with the practical aspects of the crisis

To create an atmosphere of trust and respect with the assaulted woman, an I&R Specialist must: 1. Assure her that you believe her story 2. Let her know she is not the only person this has happened to. 3. Inspire her confidence in your skills. Let her know of your experience and your belief that this problem can be solved. This will begin her process of turning despair into hope for change. 4. Validate her feelings and experience. Help her to mobilize her inner resources to deal with the immediate crisis. 5. Focus her energies. She may tend to ramble, be disjointed in her thinking or overwhelmed by her own story. 6. Keep your message clear and simple (e.g. her safety and her children’s safety are your first priority.) 7. Give her realistic feedback based on what she told you. 8. Stay Calm even if you feel overwhelmed by her story. She needs to believe in your strength. You are there to contain her anxiety and fears. (Source: the North York Women’s Centre)

Safety With a Restraining Order • Keep Order With You Keep your Restraining Order on you at all times. When you change your purse that should be the first thing that goes in it. Or make multiple copies to keep in different places. •Call the police if your partner violates the Restraining Order. Information and Referral Program – Training Manual

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• Notify Local Police Department Notify your local police department that you have a restraining order against your partner. Make sure they have a copy of the Restraining Order on file. Think of alternative ways to keep safe if the police do not respond right away. • Inform Others Inform family, friends, neighbours and your employer that you have a Restraining Order against your partner. Domestic Violence Lethality Assessment: Factors To Consider 1. Domestic violence perpetrator’s access to the victim 2. Pattern of the perpetrator’s abuse a. Frequency/severity of the abuse in current, concurrent, past relationships b. Use and presence of weapons c. Threats to kill d. Hostage taking, stalking 3. Perpetrator’s state of mind a. Obsession with victim; jealousy b. Ignoring negative consequences of his violence c. Depression/desperation 4. Individual factors that reduce behavioural controls of either victim or perpetrator a. Substance abuse b. Certain medications c. Psychosis, other major mental illnesses d. Brain damage 5. Suicidality of victim, children, or perpetrator 6. Adult victim’s use of physical force 7. Children’s use of violence 8. Situational factors: a. Separation violence / victim autonomy b. Presence of other major stresses Domestic Violence Lethality Assessment: Safety plans are guidelines to help victims figure out what they need to do for their safety. While all batterers are dangerous, some batterers are more likely to murder. Before developing a safety plan, a victim needs to understand a batterer’s potential to inflict lethal violence. A lethality assessment is not an exact science. A victim can utilize the indicators below to make an assessment of a batterer’s potential to inflict lethal violence. Note, these factors may or may not reveal actual potential for homicide. However, the likelihood of a homicide is greater when these indicators are present. The greater the number and/or intensity of indicators present in a batterer’s behavior, the greater the likelihood of homicide. Below is a list of behaviors that are exhibited by potentially lethal batterers: • Threats of homicide or suicide • Fantasies of homicide or suicide • Possession, access, and/or use of weapons • Belief that victim has no right to life separate from him/her • i.e. - "Death before divorce," "If I can’t have you know one will," and "You belong to me and no one else" • Idolizes and has extreme dependence on victim • Inability to envision life without victim or separation from victim causes great despair and/or rage • Experiences acute depression and sees little hope for moving beyond depression • Dangerous behaviour increases with little regard for consequences Information and Referral Program – Training Manual

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Access to victim and children History of violence, prior calls to police, and hostage-taking

If any of the above indicators are present, the victim may be in lethal danger. It is important for the victim to immediately contact a Domestic Violence Agency for help. Even if none of the above indicators are present, developing a safety plan is still very important for the victim. ALWAYS THINK OF SAFETY FIRST!

Violence Purpose: To provide detailed information on the definition of violence and how to differentiate physical, verbal, and emotional abuse. It seeks to give the I&R Specialist a comprehensive understanding of how to provide victims of violence with appropriate referrals and to increase their awareness of some of the emotional and psychosocial issues experienced by victims of violence. What is Violence? Violence is not just hitting with a fist or getting hospitalized with an injury. It includes many different actions. Below is a list of different kinds of violence and some examples of each type. 1. Physical Violence Any use of size, strength, or presence to control or hurt someone else is physical violence. This can be divided into three categories: • Physical Contact Between People • Physical Use of Objects • Use of Size or Presence 2. Verbal Violence This includes any use of words or voice to control or hurt another person: • Threats • Yelling • Insults 3. Emotional Violence Usually involves a psychic and/or physical reaction dominated by emotions: • Threatening to harm self or commit suicide • Following you • Trying to control your behaviour through guilt, shame, or anger Facts About Domestic Violence: 1. Nationally, Ninety-two percent of women say that reducing domestic violence and sexual assault should be a top priority of any formal efforts taken on behalf of women today, according to a new study by the Centre for the Advancement of Women. 2. Around the world, at least one in every three women has been beaten, coerced into sex or otherwise abused during her lifetime. 3. In the year 2001, more than half a million American women (588,490 women) were victims of nonfatal violence committed by an intimate partner. 4. Women of all races are about equally vulnerable to violence by an intimate (partner). 5. Approximately one in five female high school students reports being physically and/or sexually abused by a dating partner.6 The study also found that abused girls are significantly more likely to get involved in other Information and Referral Program – Training Manual

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risky behaviors. They were four to six times more likely to get pregnant and eight to nine times more likely to have tried to commit suicide. 6. Estimates range from 960,000 incidents of violence against a current or former spouse, boyfriend, or girlfriend per year7 to three million women who are physically abused by their husband or boyfriend per year. 7. For 30% of women who experience abuse, the first incident occurs during pregnancy. 8. As many as 324,000 women each year experience intimate partner violence during their pregnancy. Typical Battered Woman Profile: Has low self-esteem, is socially isolated, and generally has few marketable skills. Even if she is employed, she may not have control over the money she earns. She may have grown up in a home where battering occurred. She tends to have a traditional view of marriage and to feel a need to make the marriage work at any cost. Battered women are at risk for depression, home accidents, and alcohol and drug abuse. Typical Batterer Profile: Has poor impulse control, limited tolerance for frustration, and an explosive temper, often exacerbated by drug or alcohol use. He may well have grown up in a home where battering occurred. He has probably battered other wives or girlfriends. He tends to be extremely jealous and possessive.

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Time Management for I&R In general, these are some suggestions on how to eliminate time wasters and work more efficiently.

Prioritize: Management and employees have to work together to understand which tasks/ projects have a higher priority. When any information about the task/ project is known e.g. deadline, specifications, quantity required or any pertinent information related to the project, this information should be passed to the employee. Members of the Management Team should help the employee prioritize any work that they assign – often the employee will have work from other managers. As well, it is important that the employee communicate with the Manager in question if they haven’t been told about how important a particular task/ project is, in the grand scheme of things. Plan and Schedule: When you have a better understanding of your priorities, list what you are going to do and identify any particular deadline associated with each task. This can always be reviewed by the management team to make sure the plan makes sense. Spend five – ten minutes each morning to revise your plan.

Best Time: Everyone has high and low periods of attention and concentration. Are you a "morning person" or a "night person". Use your power times to do more complex work; use the down times for routine tasks Difficult First: Take on Difficult Tasks First - When you are fresh, you can process information more quickly and save time as a result. Handle Items Once: As far as possible, deal with something once – paper, email, voice mail. If you have to pick it up again, read it, try to remember the situation again, find back-up again, talk to someone again – obvious time waster. If you don’t have time to deal with it – don’t pick it up! Step Away: Take breaks. Even if it’s a little exercise in your chair, getting a glass of water etc. This keeps you from getting fatigued and "wasting time." While you are taking a break, the brain is still processing the information. You might even get a good idea because you’ve ‘stepped away’ for a few minutes.! Make Sure you Have Time to Sleep and Eat Properly: Lack of sleep results in less effective work habits because you will need a couple hours of clock time to get an hour of productive time. This is not a good way to manage yourself in relation to time. Use a Diary: Put deadlines and follow-up dates (for you and others) in your day timer/ calendar / PDA. Block off times to work on special projects when you need no interruptions. Reduce your paperwork: Information and Referral Program – Training Manual

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Throw away everything you can. Do not file it. Delete emails. Sort yourself out and set an example: • • • • • • •

If someone else can do it, delegate it - but don't delegate it if you cannot control it. Use a "to do" list. (Ticking off the tasks when they are completed can bring some satisfaction to an otherwise boring day.) Start earlier. Stop procrastinating - take the first step and finish it. Be clear about your priorities. What's important to you? Get results, not perfection. Don't waste the time of others.

Written Communications: • • • •

Don't send the memo or email to someone who doesn't want it. Don't respond to "as soon as possible". If it's your boss or a helpful colleague, ask them for a realistic deadline. When you write memos or emails, keep them to one page maximum. Think before you write. When you write memos or emails, give deadlines but nicely. ("I'll need this back by 24th January please contact me if this is a problem" or "It would helpful if you returned this by no later than 15 May").

Attack Meetings (not all suggestions relevant / reasonable for all employees) • Attend for a "slot" - join when you have to, leave when you can. • Specify the purpose of the meeting. What will it achieve? ("To discuss the new project" is not a purpose, it states what you will do. What will the discussion achieve?). • Always have an agenda and stick to it. • Write the agenda in terms of outcomes or results. • Start and finish on time - as you promised when you called the meeting. • Keep to the point in discussions. • Reach conclusions and match actions with deadlines. • Ensure follow-up on conclusions and actions. Control Use of the phone • Jot down what you want to achieve before you make the call. • At the beginning of the conversation, set a time limit for the call. • Finish calls when they're finished. Don't let them drag. • If you’re too busy to take calls, put your phone on call forward (within reason). • When not at your desk, put you phone on call forward – that saves the callers’ time as well! • Don't phone the chatty person, email them. • Ask someone to email you on the matter.

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Importance

Adopt a strategy to time management that brings personal excellence

Important But not Urgent

Important And Urgent

Plan and Chunk

Survive

Not Important And Not Urgent

Not Important But Urgent

Dump

Expedite

Urgency URGENT means that something is better done sooner. IMPORTANT means it brings you benefit. If you don't treat importance in a different way to urgency, you'll do things you don't need to, you'll give prime time to low return activities and you'll work well below your capability. 1. Expedite the urgent and unimportant - get them done but to a "good enough" standard. Excellence is not perfectionism. 2. Plan the important. Break projects into manageable chunks. Allocate quality time to these chunks. 3. Do the best you can with the important and urgent. Look into stress management. 4. Dump the low importance and low urgency. 5. Expediting means: • Don't waste time on low importance tasks. • Don't do a "high quality" job when a "moderate quality" job will suffice. • There are ways to overcome procrastination - use them. Tackle your procrastination: You avoid doing things because they are unpleasant, difficult or because you are indecisive. Reason for procrastination

Technique Try the sandwich technique. Start with a pleasant activity, next do the unpleasant then finish on a pleasant activity. Putting the unpleasant in the middle hurts less.

Unpleasant Try chunking the unpleasant into smaller pieces. If you cannot suffer the whole task, you might be able to suffer a smaller dose of it. Information and Referral Program – Training Manual

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Try a leading task. Find some part of the task that can be done quickly, requires little or no planning, and requires little conscious effort. Try getting a new job. Try finding new things in your job that stimulate and motivate you. Chunking works here - break the task up into smaller parts. The size of the chunks will be partly determined by the job and partly determined by your time. The trick is to break an unpalatable or complex task into smaller, tablet-size work packages. Difficult Do difficult tasks and chunks in prime time. Prime time is when you are at your best. For example, if you're a "morning person", then do challenging or difficult tasks then. You are paid for results - indecision impedes results. Let's face it, a certain percentage of your decisions will not be perfect. Recognize this. Make trivial decisions quickly. Indecision

Make high risk decisions following these steps: 1 Obtain the best information you can get in the time available. 2 Weigh up the options by considering the consequences. 3 Write these considerations down. 4 Make the best decision you can given the information and time available - and move on. What else can you do?

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Stress Management for I&R Objectives: To review some causes and results of stress in the workplace and examine ways in which to cope with that stress in a positive way.

Overview There is often confusion between pressure or challenge and stress in the workplace. Pressure in the workplace is unavoidable due to the demands of the contemporary work environment. Pressure perceived as acceptable by an individual my even keep workers alert, motivated, able to work and learn, depending on the available resources and personal characteristics. However, when that pressure becomes excessive or otherwise unmanageable it leads to stress. Stress can damage employees health and business performance. Stress results from a mismatch between the demands and pressures on the person, on the one hand, and their knowledge and abilities, on the other. It challenges their ability to cope with work . This includes not only situations where the pressures of work exceed the worker’s ability to cope but also where the worker’s knowledge and abilities are not sufficiently utilized and that is a problem for them. A healthy job is likely to be one where the pressures on employees are appropriate in relation to their abilities and resources, to the amount of control they have over their own work, and to the support they receive from people who matter to them. As health is not merely the absence of disease or infirmity but a positive state of complete physical, mental and social well-being (WHO 1986), a healthy working environment is one in which there is not only an absence of harmful conditions but an abundance of health promoting ones. How Can Stress Affect Your Health? Your body first reacts to stress as if it were in a "fight or flight" situation. Your heart speeds up, you breathe faster, and a hormone called adrenaline is pumped into your bloodstream to give you the energy you need to fight or run. All of these changes help you deal with a stressor that lasts for only a short time. But if the stressor lasts a long time, these changes can harm your health. For example, prolonged stress can lead to: • irritability • fatigue • headaches • increased number of infections (colds, 'flu, etc.) • diarrhea or constipation • changes in appetite, leading to weight gain or loss • ulcers • high blood pressure • depression • heart disease • Prolonged exposure to high levels of stress may also be linked to some forms of cancer and other chronic diseases. How Can Stress Affect Your Work?

When you're under too much stress at work, you may: • feel rushed and helpless • get angry or upset easily Information and Referral Program – Training Manual

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• • • • • • • •

find it hard to concentrate make more mistakes find it hard to make decisions waste more time be less creative find it hard to get along with co-workers and your boss be less courteous with customers miss work more often

Companies often notice that absenteeism levels rise and productivity and quality drop during times of change and high stress. There also may be more accidents and illnesses. How Much Stress is Too Much? The important thing to understand is that we all need some level of stress in our lives. Like food, stress is an important source of energy. However, too much stress (or too little) can be harmful. In general, the more stress you're under, and the longer you're under it, the more likely your health and work will suffer. Take Control and Reduce Stress: Most people would like to reduce at least some of the stress in their lives. But, how do you do this? Think positively: The way you think about a stressor can greatly affect how your body responds to it. If you try to think positively and talk to yourself and others in a positive way, you can keep your stress levels in check. But, if you flood your mind with negative ideas you will only increase your stress levels and your chances of harming your health. Learn new skills: Sometimes learning a new skill can help you to reduce the stress in your life. Here are some examples: • Take assertiveness training to help you deal with demanding co-workers, family members or friends. • Learn time-management skills to help you better use your time and reduce the stress of deadlines. • Develop problem-solving skills to help you find solutions to stressful events.

Make changes in your lifestyle: Here are some other ways to take control of your stress: • Exercise regularly. For example, try brisk walking. • Use relaxation techniques such as deep breathing and muscle relaxation. • Make time for enjoyable activities. • Talk to your family members and friends for support. • Eat well-balanced meals. • Get plenty of sleep.

Ask for Help at Work: If there are conditions at work that you feel add to your stress please contact your Supervisor with this information, or bring it up at a staff meeting. These might be some of the things that the management of Community Connection might be able to do? Some issues may be related to: • physical condition of the workplace. Information and Referral Program – Training Manual

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• • •

change the way work is organized. Training. Polices and procedures that are unclear, inadequate etc.

Making Changes: • Making changes to control workplace stress takes time and effort. And, it means getting everyone involved. Get all employees and the Management Team to understand how workplace conditions and the organization of work can cause stress and how stress can harm employee health and productivity. • Changing the way you personally deal with stress also takes time. It often requires you to change the way you think about events in your life. There are many resources that can help you better deal with stress. Talk to your doctor or call your nearest public health unit for more information. • You'll never get rid of all the stress in your life – nor would you want to. But any changes you and your employer can make to reduce workplace stress will help. It takes work, but it's worth the effort. (This material was taken from primarily from publications of the IAPA (Industrial Accident Prevention Association) and WHO ( World Health Organization))

Resiliency: Resiliency enables people to face the multiple demands of a busy, complicated life and ‘sty on high ground’. Resilient people are flexible, adaptable, open to new ideas and can put situations into perspective. The following model can help you strengthen your ability to cope:

ACTION A – Be aware of how you feel and react to pressure and demands C – Check out your perceptions and choose how you will respond. See the connection between your view of the world and your thoughts, moods and behaviours. T – Test the situation by using problem-solving skills – ask yourself critical questions to address issues and concerns which bother you I – Implement life management habits such as: eating well, resting, exercising, relaxing, having fun and laughing, getting support, doing breathing techniques, and learning how to shut off work and concerns so you can enjoy yourself and give your body a chance to recoup its energy. O – Be optimistic about life, and believe in positive outcomes N - Never forget your ability to take control or let go when you are in a stressful situation Ten Ways to Bounce Back 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Find a sense of purpose and commitment Have a positive outlook Take pleasure in the small joys of life Take an active approach to solving your problems Rely on the help of others Take care of yourself Keep learning and growing Be ready for change Be a doer, not a complainer Work on reducing stress in your life

Exercises 1. List some of the Hats You wear During the Day 2. List some of the Hats You Wish you didn’t wear Information and Referral Program – Training Manual

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3. Who else could wear some of your hats? 4. List some of the hats you love wearing? More than 100 ways of Coping with Stress (as a group, list ways you might cope with stress – get creative but not too personal! ;-) – in the training material there are lists for the trainer, if necessary) Personal Action Plan - Making Changes that Make Sense to You 1. 2. 3. 4. 5.

Maybe I don’t need to ________________________________anymore. Maybe I need to ____________________________________some more. Maybe I need to ____________________________________sometime soon. Maybe I need to ____________________________________once again. Maybe I need to ____________________________________sometimes.

The first statement clarifies what you would like to change. The second is what you want to hang on to. The third is a statement of future goals. The fourth recalls a resource from the past.

The last clarifies an area where you need more flexibility.

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