Transcript I. Back-on-track training - NeighborWorks Blackstone River Valley

ACCESSING HOME
Back-on-Track Eviction Prevention Training
Introductions

Laura Roach, Accessing Home Program Manager
 [email protected]
 401-257-6236
 Previously
served as an AmeriCorps VISTA at
NeighborWorks Blackstone River Valley and focused
specifically on eviction prevention
Eviction Prevention
Overview and Evidence
Mission




Provide quality affordable housing
Link residents with services that can stabilize their
housing
Move residents beyond poverty where possible
Improve financial bottom line
Evidence
Overview of Eviction Prevention Practices
Your Role As an AMC/BSW
What are some reasons people may
be evicted?

What are the consequences of eviction?
The Process – Property Management
Delinquency
Policies &
Procedures
The Process – Resident Services
The Process – Resident Services, cont.

Resident contacts RSC; the following actions may be
taken
Offer referral services over the phone (see phone script)
 Set up an in-person meeting; sign confidentiality notice and
conduct resident intake (see intake form)
 Have the resident fill out a household budget (see budget)
 Refer the resident to relevant services (remember: asset
mapping)
 Write up a payment plan (see payment plan)
 Enter resident information in Family Metrics

Phone Script
Resident Intake
Screen Residents for Support Programs
Payment Plan
Motivational Interviewing
Approaching Behavior Change
Adapted from a presentation by Prantik Saha, MD, MPH, Columbia University
How do we establish a habit?




There are pros and cons to every behavior
We engage in a particular behavior based on an
assessment of these pros and cons
Ambivalence is the unresolved conflict between the
pros and cons, and leads to continues engagement
of the behavior
Persistent ambivalence is the principal impediment
to change
Transtheoretical Model of Change
Prochaska &
Di Clemente:
Transtheoretic
al Model of
Behavior
Change
Stages Involved in Behavior Change
1.
2.
3.
4.
5.
Identifying the
behavior
Identifying a
problem
Desiring a Change
Feeling confident
about a change
Doing it!
Motivational Interviewing –
Background


First described in the 1980’s by William Miller and
Stephen Rollnick, two psychologists who had
experience in treating alcoholism
Spirit or philosophy of MI and behavior change
considered most important; techniques follow
accordingly.
Goal of Motivational Interviewing
Finding out which stage the client is at, and
addressing the concerns specific to their stage
 Have the client articulate their “pros” and
“cons” so they can better process and
ultimately resolve the conflict between them.
 Empathizing and empowering the client to take
steps towards change by affirming their
strengths as well as the centrality of their
initiative in lasting change

MI and evidence


Systematic reviews and meta-analyses have shown
some beneficial effect of MI interviewing
techniques compared to traditional advice giving
in various contexts outside of the addictions, such
as with diet, exercise and adherence to
medications.
Some reviews have even shown statistically
significant change in direct measures such as
blood pressure, cholesterol, and body mass index
(Rubal, Sandbaek, et al. Motivational
Interviewing: A Systematic Review and MetaAnalysis. British Journal of General Practice 2005;
55: 305-312).
Case Presentation

Emily is referred to you by the property
management company for falling behind on rent.
While you are discussing payment plan options with
her you find out she just moved into the apartment 1
month ago and it is her first apartment; she is 20
and she previously lived with her parents. She
promises to start paying the rent on time.
What stage is the client at?
You get more information



She has been spending a lot of extra cash to furnish
her new apartment; she has purchased some new
furniture from IKEA and she is considering going to
a rent-to-own furniture store for a living room set
It is really important to her that her home is
comfortable so she can have friends over
She believes once she has furnished the apartment
she will be able to catch up on rent because she will
have fewer expenses
Use of Scales



A common way of assessing as well as cultivating
confidence or importance is the use of scales.
Scales can help clients/patients to verbalize and
process their ambivalence further. In this case,
“On a scale of 1 to 10, how important do you think
it is for you pay rent on time every month?” (Patient
says 10 out of 10)
“On a scale of 1 to 10, how important do you think
it is for you to furnish your apartment?” (Patient
says 7 out of 10)
So, what do we do now?

Reflecting and empathizing with the “pros” and “cons”
“It seems that making your apartment beautiful and
comfortable is important to you, but you also know it’s
really important to pay rent on time.”
“It’s great that you’ve been able to make your home a
great place for your friends to hang out.”

“Roll” with resistance
“Yes, it’s important to have a comfortable home.”

Emphasize the significance of this patient’s level
“Why did you rate furnishing your apartment lower than
paying rent on time?”
Well, what if we got this info?


Emily has been stressed about moving into the new
apartment; she has never had to keep track of so
many expenses
She is afraid she will be evicted but communicating
with the property management is intimidating
Use of Scales



A common way of assessing as well as cultivating
confidence or importance is the use of scales.
Scales can help clients/patients to verbalize and
process their ambivalence further. In this case,
“On a scale of 1 to 10, how important do you think
it is for you pay rent on time every month?” (client
says 10 out of 10)
“On a scale of 1 to 10, how confident are you that
you can take control of your expenditures?” (client
says 3 out of 10)
So, now what do we do?
•
•
•
Affirmations: recognizing client strengths and counter any
defeatist attitude
“Why did you give yourself a 3 instead of a 2?”
“Moving into a new apartment is really intimidating. It’s
impressive that you’re living on your own at such a young
age.”
Reflecting the pros and cons
“So, you are living independently in a new place, but you also
are struggling to track your bills.”
Look for client driven strengths
“What would make you go up to a 6 or 7?”
Resistance


In motivational interviewing philosophy, resistance is
elicited when we try to push clients farther than they
are ready to go.
Resistance also occurs when clients have not been
given sufficient opportunity to direct their actions
and have simply been given instructions from their
providers.
How to tackle resistance

Empathizing with the client
“Moving into a new place is really difficult. I understand
why you would be nervous speaking with the property
management company.

EMPOWER the client
“You know, it’s up to you what you would like to do with
your spending; you worked hard for you money and you
deserve to spend it how your see fit.”
“It is important to know your own priorities. You know your
own needs better than anyone.”
Try using a decisional matrix
Status Quo (i.e. spending
cash as expenses arise,
including large expenses)
Pros
Cons
Change (i.e. tracking and
planning monthly
expenses)
Try using a decisional matrix
Status Quo (i.e. spending
cash as expenses arise,
including large expenses)
Change (i.e. tracking and
planning monthly
expenses)
Pros
Having a fully furnished
apartment; feel
comfortable entertaining
guests
Confident in ability to
afford rent and utilities
Cons
Overdraft fees, late notices Time-consuming
and fees
So what about our habits?





Break out into pairs
One person will describe a habit or behavior that
they, a family member, or friend have struggled
with
The other person will assess what stage his/her
partner is at as well as their “pros” and “cons”
Use the Scales and the Decisional Matrix
Reverse roles!
Some final thoughts on MI
It is a client-centered philosophy
 A non-judgmental tone and attitude helps
clients be more open about their “pros” and
“cons”
 Focus on the stage the client is at – e.g., don’t
address confidence issues if the client is not yet
interested in changing their behavior
 We should dismantle the assumption that we
have failed if clients don’t make decisions
toward change at each visit

Case Study



Do resident intake
Come up with an action plan
Consider SMART goals