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Employment Audio Lecture Series

Lecture 2 Script: Outreach and Employment

Section 1: Introduction to HUD Employment Lecture Series, Lecture #2 "Outreach and Employment"

Colleagues:

This lecture is the second in a series of nine lectures that are being developed on employment-related topics. This lecture is intended for outreach workers and case managers working in homeless and community rehabilitation programs. To order or download lectures from this series, please go to www.hudhre.info.

Today's topic is outreach and employment.

When outreach workers meet people who are homeless on the streets, in shelters, or at other places, they try to help them meet their basic housing, food, and treatment needs. Job training or finding a job may not be a priority for either staff or the homeless person even though self-sufficiency through employment is a way out of homelessness.

This lecture affirms the value of introducing the topic of work into street outreach techniques at the earliest opportunity in order to help people make a lasting transition from homelessness. It will focus on understanding the principles and the practices of effective outreach as well as using the offer of employment to engage people. It is intended for outreach workers, case managers, and their supervisors working in homeless and community-based programs that are part of HUD's Continuum of Care.

We will focus on serving homeless adults. You might, however, also find the information useful if you are helping clients other than homeless adults, such as youth and families.

There are nine sections in this audio lecture. The topics contained in the remaining eight sections are as follows:

Along with this overview is a pamphlet that provides a more in-depth analysis and includes a list of resources and examples of commonly used outreach practices.

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Section 2: Characteristics of Successful Outreach Strategies

Outreach is an important component of helping people who are homeless improve their lives through treatment, housing, and employment, and, ultimately, help them obtain and remain in permanent housing. It is a particularly important component of reaching those who would otherwise be unserved.

Homeless outreach is conducted not only in HUD McKinney-Vento programs, but also by mental health, street outreach teams; the US Department of Labor homeless veterans programs; and other agencies serving people who are homeless.

Critical to outreach is developing successful interactions with the person and building trust. The key is to communicate with people who are homeless in their environment and on their terms.

Although there are many different ways to approach outreach, current literature describes some common characteristics of successful outreach strategies, which we'll discuss now.

  • First, the location is very important. Outreach needs to occur in the homeless person's own environment and in a location that feels safe and non-threatening to the homeless person. For example, this could mean in homeless "camps," under a bridge, or on the street. So-called "in-reach" can take place in shelters, or jails or prison with those who will be released to shelters or on the street potentially.
  • Second, in order to be successful, outreach workers should be persistent and patient. Multiple contacts over time might be needed to gain the person's trust and engage him or her. The person might not be responsive during the initial contacts. However, if you build a regular relationship, you will gain the person's trust and begin engaging the person in activities such as seeing a case worker to seek out vocational training opportunities, counseling, treatment, and housing.
  • Third, additional characteristics of successful outreach include a quick response to a person's needs and flexibility in what services are offered. Based on the conversations you've had with a person, you would assess immediate needs and make an appropriate "offer of assistance" without strings. This initial "offer of assistance" can be basic items, such as blankets or food or more complex items, such as housing, vocational training, and help with benefits assistance and treatment. If you begin meeting a person's needs, you will be more likely to gain his or her trust and engage him or her in other services and activities.
  • Lastly, it is important for outreach workers to make sure that people choose to participate and do not feel coerced into participating.

Among current practices, Assertive Community Treatment or ACT and "motivational interviewing" stand out as effective practices.

  • Organizations with established ACT teams are better able to respond quickly to a client's needs, both during initial outreach and on an ongoing basis. The ACT team approach is designed to provide comprehensive, community-based services, that include case management, initial and ongoing assessments, substance abuse services, psychiatric services, and employment and housing assistance, among others. Peer specialists are often members of an ACT team. This type of service coordination positions ACT teams to offer a broad range of services during an initial "offer of assistance." In addition, the ACT approach varies from more traditional case management because it delivers services in vivo or to the homeless person in his or her own environment, such as over coffee or while panhandling on the street, rather than requiring the client to come into the office.
  • Motivational interviewing is an approach that can be used during outreach, and is sometimes a strategy used in Assertive Community Treatment teams. In an informal, but directed conversation, the practitioner can help the client articulate his or her own goals and choose services that will help to achieve these goals.

Motivational interviewing is a skill that every outreach worker should have and use. If your agency has an ACT team, that staff may already be using motivational interviewing in their work.

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Section 3: Attributes of a Successful Outreach Worker

It takes a certain type of personality to do outreach work. Agencies that conduct outreach typically have a strong organizational commitment to social justice, and it is a strong sense of altruism that keeps outreach workers doing what is often a difficult job.

Doing outreach relies on a tolerance for unpredictability. Your schedule might vary greatly as you try to find people who are homeless, and your job can vary greatly from week to week, day to day. In addition, it is not unusual for people living on the streets to ignore you or speak belligerently to you, even though you are trying to help them. Tenacious efforts are needed, along with an understanding that people who are unable or unwilling to accept help now might do so in the future.

Outreach workers should be aware that people who are homeless might be less amenable to outreach efforts because of negative experiences they might have had in the past. This could mean that services were promised but never delivered, or that a person sought assistance but was turned off by an overly complex or unresponsive system. A broad knowledge about community programs and services as well as good connections to a variety of services will give you multiple options for assisting someone, but be careful not to "over-promise" and under-deliver.

An outreach worker should have positive, but realistic expectations. While fostering positive goals among clients is critical to change, it is also important to remember to think in terms of incremental successes.

Outreach requires working with clients where they are and being sensitive to how their willingness or resistance to change can fluctuate. If you will, people go through "Stages of Change" when they are more or sometimes less ready to make changes in their lives. We will talk more about this in Section 6.

An outreach worker also needs to have patience because engagement and trust-building can take a long time. Recovery is cyclical, and relapse is part of the process and considered normal. Rather than evaluating the person, you should focus on getting to know the person. When doing so, remember that moral judgments interfere with engagement. Successful engagement depends instead on continual efforts to motivate change rather than arguing with the person, trying to shame him or her into doing something, or labeling the person or his or her behavior.

Successful outreach also depends on active listening, which means that you need to:

  • Tune out distractions and focus exclusively on what the person is saying;
  • Face him or her and maintain eye contact as appropriate;
  • Reflect what he or she is saying or use gestures to show how you comprehend what they are telling you; and
  • Lastly, ask questions that are open-ended when you are not clear on what the person means.

Doing outreach also requires the ability to discuss drug use with a client, using vocabulary and terminology that will allow you to converse with the client and understand the client's behavior. It is critical to carry this conversation without judging the person's behavior.

Finally, no discussion of outreach is complete without a discussion of safety issues. Any agency conducting outreach should have safety guidelines. These might include the following seven rules of thumb:

  • First, make sure someone knows where you're going;
  • Second, work in pairs;
  • Third, carry a cell phone;
  • Fourth, avoid closed buildings or other locations that appear dangerous;
  • Fifth, leave immediately if you see drug use, possession, or dealing;
  • Sixth, develop a relationship with local law enforcement personnel; and
  • Seventh, above everything else, trust your instinct – if you don't feel safe, take yourself out of the situation and get to a safe place.

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Section 4: Steps in the Outreach Process

Outreach is an ongoing process comprised of different stages:

  • Finding people who are homeless where they live or spend time;
  • Engaging them in a trusting relationship;
  • Working with them to assess their needs;
  • Offering them some form of immediate assistance; and finally,
  • Linking them to services or providing them directly, or some combination of the two.

However, these do not always occur in a particular order.

The first step in outreach, which might seem obvious, is to seek out people living on the street or other places not suitable as a place to live. Some of this outreach can be conducted in conjunction with services to the homeless, such as soup kitchens. However, finding the most difficult-to-serve people requires additional legwork. The types of places that people congregate when they are homeless might include:

  • Public places, such as libraries, parks, bus stations, and train stations;
  • Places offering some shelter from the elements, such as bridges, abandoned buildings, subway grates or entrances;
  • Places offering affordable short-term shelter, such as cheap motels or boarding houses;
  • Tourist attractions and other places that present opportunities for panhandling; and
  • Other places to make cash such as recycling centers or blood donation facilities; as well as
  • Places that are relatively secluded, such as wooded areas, beaches, and rural locations.

As you develop relationships with people living on the street, you are likely to learn where others are staying. Be mindful of your surroundings and use caution when selecting locations and times to meet.

Perhaps the most important part of street outreach is the engagement. This means building a relationship in which people trust you and that is built on positive regard. Although the ultimate goal is connecting people with services, the building of trust should come first.

  • Ways to build trust might include:
  • Asking questions about the person and showing a genuine interest;
  • Finding out what activities they enjoy and joining them;
  • Helping them with needed tasks or transportation or concrete items; and
  • Following through on promises to meet them at certain times or certain locations or to do certain tasks.

You can further build trust by providing something of immediate value to the person. While some people who are homeless might be hesitant to accept shelter, treatment, or other services such as helping to find work, they might be willing to accept a sandwich, a cup of coffee, a blanket, a cigarette, or a winter coat. However, not everyone is open to even a simple offer of assistance, and patience is required. Many successful outreach workers report months of regular contact before people are willing to accept offers of help.

As you build trust with someone, you can begin an assessment of their needs. Some needs might be obvious and related directly to their homelessness, while others might be identified through your observations, or what the person tells you, or what others say about them.

Organizations are increasingly adopting a low-demand approach, a very flexible approach, that is an effective way to reach out to chronically homeless people. This type of approach typically offers clients something that they want and need, particularly housing, rather than offering them a service that the organization perceives that they need, such as treatment. That's not to say that treatment is unimportant, but it is the order in which these are offered that becomes important in a low-demand approach.

Clients are more likely to accept an offered service if they can benefit from the service right away, or at least sooner rather than later. If they have to jump through several hoops, they are less likely to be interested in your offer. Generally, a low-demand approach places few requirements on clients.

It is crucial to understand that successfully engaging people who are homeless in services means that you should be able to follow through on what is offered. Putting clients in a "holding pattern" will alienate them. Successfully engaging clients in services is not the last step because ongoing contact is often needed to maintain services or to connect to new services.

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Section 5: Values and Principles of Outreach

Certain principles and values should guide the outreach process, informing everything that the agency and its workers do on a daily basis.

Above all, agencies conducting outreach to people living on the streets should take a "people-first" approach. Every person involved in the agency should view the people they serve as people first, and as clients second.

When you go out to the street and approach someone on his or her own turf, you should act as a guest in that person's home, even if that home is on the street, under a bridge, or in an abandoned building People often want to have privacy and do not want to have their routines interrupted.

Another guiding principle of outreach should be what is often referred to as self-determination or empowerment. At the core of self-determination is giving people the necessary skills and knowledge to make decisions about the issues that affect their lives. Incorporating self-determination in your outreach approach also means accepting the principle that people should set their own goals-in other words, adopting the practice of "person-centered planning."

Outreach workers should seek to instill confidence in the people they serve rather than trying to force or coerce change. It is important to meet people "where they are at." Instead of imposing goals on someone, you should help him or her identify goals and reach the goals the person has identified.

Agencies conducting street outreach should adopt a stance of celebrating positive changes made by the people it serves, even the small changes. In outreach work, getting someone to make an appointment, or even to take an agency brochure, can be a step in the right direction.

Similarly, you should promote a realistic hope among the very people you serve. Help people to understand that significant changes can take time, but that they can reach their goals in an incremental manner. Help people realize that achieving their goals is possible, even if progress ebbs and flows or is measured by a series of setbacks and successes and that each setback can be a learning opportunity.

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Section 6: The Stages of Change Approach

Outreach workers and case managers should understand that people who are homeless are apt to go through a number of stages as they move from outright rejection of any services or help, through awareness of need, engagement with staff, and participation in services.

The Stages of Change model, which is covered in greater detail in the accompanying pamphlet, provides a framework for understanding the process. The model emphasizes that people who are homeless proceed along their pathways to recovery at an individual pace, and their motivation levels vary for different areas of need. They choose their own priorities, timeframes, and process, and it is important for you to know that you do not "own" the process – the client does.

The ability to make positive changes might feel hopeless to people who have had numerous setbacks in their lives. Often, they can't imagine how they could ever break the cycle of despair and deprivation that are among the consequences of homelessness.

Outreach workers thus have a three-fold goal:

  • First, to help re-instill hope;
  • Second, to help develop motivation to make positive changes; and
  • Third, to help develop tangible opportunities for those changes to occur.

It is important to note that people do not move sequentially through the Stages of Change. In fact, it is a process characterized by cycles, and often a person might take as many steps backward as forward. Furthermore, changes takes time, often years, to occur. With this firmly in mind, consider the Stages of Change approach as a basis for engaging clients in employment.

The Stages of Change approach begins by understanding that many people are in a state of what is called "pre-contemplation," in which there is little or no perception of a need to change. At this stage, your role is to remain constant in their lives, engender deeper trust, and provide information, instill hope, and be attuned for signs that the person might be ready to move to the next stage.

The next stage is called "contemplation." In this stage, people are beginning to consider the possibility that the positive aspects of change could outweigh the fear of change or the pain of remaining with the status quo. This ambivalence gives you an opportunity to tip the scales toward the next stage. Try in a nonjudgmental way to strengthen the feelings of ambivalence, by helping the person to think about the advantages and disadvantages of changing, as well as the advantages and disadvantages of staying the same.

A practical example could be a client named Ron who needs new shoes because he has constant back pain, but he can't afford to buy them. To get new shoes, he needs money. The question here is whether or not it's worth it to consider obtaining a job with your help and work long enough to be able to make the purchase. Ron doesn't need to commit to a long-term job or a career, just a short-term fix to his problem.

Between contemplation and action is a stage called "preparation for change." The preparation stage is really a time of insight development, internal and external exploration, and preparing a firm launching pad for action. It does, and should, take some time and is characterized by planning.

In this planning stage, you help the client understand what it would really be like to work. What would it be like to change routine, friendships, and an independent lifestyle? What are factors that could trigger a job loss and how do you plan and prepare for them? These are some of the questions that help people recognize the need for an action plan for employment. During this stage, you should also help people prepare by nurturing hope. One way to do that is to help clients develop insight not only into the challenges of working, but also into their own core strengths, gifts, abilities, and skills. This is an opportunity to help them informally assess the unique attributes that they could bring to an employer.

Using a plan as a springboard, it is possible to move to the next stage – "action" – at which time your client will take action to pursue an employment objective. Examples of taking action might include developing a resume, attending pre-employment skills classes, registering at a local One-Stop Career Center for job search and placement assistance, or even taking on a part-time job a few hours a week. It is a "working" plan, as well as a plan for working, because these plans evolve as people learn more about themselves, their environment, and the skills and supports needed for employment success.

The process of change is a dynamic one that is constantly informed by new experiences and insights. Having set the process in motion through trust-building, you should remain available to the client throughout the process to support the change they're trying to make.

In the Stages of Change model, relapse is viewed as part of the recovery process, not something that occurs outside of it. When supporting clients through the change process, keep two activities in mind–first, planning for the experience of relapse, and second, planning to prevent relapse. In employment terms, dealing with relapse means, for example, that even if a client loses a job, he or she can stay on track by getting another job as quickly as possible or enrolling in a job-training program.

With these principles of Stages of Change in mind, we can now apply them more directly to the issue of employment in Section 7.

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Section 7: Work as a Tool for Engagement

People learn by doing. Confidence and self-esteem are improved by successes, no matter how small they might be. Hope for the future is built upon knowledge, confidence, and opportunity. A person who is homeless might not be ready for what we normally define as competitive, mainstream employment, yet many programs define employment using only these benchmark criteria.

People who are homeless might not feel that they have hope for success if the only options you are providing are making job referrals to either part- or full-time jobs in the local economy. You need other options to help them rebuild their confidence and skills. This is, in a sense, the practical equivalent of the strategies you use in nudging the process from pre-contemplation to contemplation, which was discussed in Section 6.

You can help your client build a solid foundation of skills and insights that makes mainstream employment possible. First, include questions about work in your conversations, such as:

  • What work are you doing now?
  • What skills are you using to do that work?
  • What work do you want to do?
  • What work did you like in the past?
  • Would you like help to get a job?

By including work as a topic of conversation, you are not only gathering valuable, preliminary information, but you are also helping clients understand what they have done, are doing now, and can continue to do for work in the future.

Another important aspect of an employment-focused outreach is letting clients know where they can get help if they are thinking about work. For example, if the individual is a veteran, you might ask the person if they heard about the Department of Labor's Homeless Veterans Reintegration Program. Or, if the client needs help with a resume or job search, you might let the person know that you could make a connection for them with your local One-Stop Career Center. In many communities, day labor is an option for people to consider. However, even if someone is not interested in any of these options at this time, at least the person has more information to shape future directions.

People who are homeless often focus on their immediate needs, not necessarily future goals. Given that they are in a survival mode, it's easy to understand that. Therefore, theoretical discussions about employment goals at the outreach stage probably will not be enough to result in people deciding that they want to consider employment.

You need to have more immediate, tangible, and flexible employment options available that allow people to test their own commitment, limits, and skills.

Think in terms of a two-pronged strategy:

  • First, include encouraging conversations about work at each meeting to help move clients from the stage of "pre-contemplation" to "contemplation."
  • Then, offer access to low-impact, flexible work with supports to provide the experience of working, self-confidence, and trust-building that could help clients move from "contemplation" to a decision to accept employment services. This is called using a "Standing Offer of Work", and we will describe this practice in Section 8 of this lecture.

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Section 8: The Standing Offer of Work

Let's return to our example of Ron, the client in Section 6 who wanted a new pair of shoes. If he decides to work only as long as it takes to make enough money to get his shoes, outreach and case managers are faced with an obvious challenge. What employer will hire someone, who probably is still struggling with alcohol or substance use or mental health issues and who has no recent work history or resume?

Referring Ron to casual day labor will probably not be effective. Work is too inconsistent, and it does not provide an opportunity for outreach or case management staff to be present and deepen the relationship.

One alternative is hiring him in-house, which offers the opportunity to involve him in some type of work with close supervision and support. Each time he shows up for work, there is also another opportunity to have conversations about work and tip the scales from ambivalence to planning.

To make it easier to hire clients in this manner, staff should have a 'standing offer of work' available. A 'standing offer of work' would entail having access to several low-impact jobs, usually provided by the non-profit agency in-house, that is within their own organization, that pay a wage and include necessary on-site supports. It is a form of work experience. Some agencies offer these flexible jobs in areas like building or grounds maintenance, desk services, or minor repairs. Some agencies operate their own day labor businesses that provide a wider range of flexible work. The important point is that the purpose of these jobs is to use work as a tool for engagement, providing it on the client's terms, but still recognizing basic work safety, task, and quality criteria.

Agencies can develop a standing offer of work by first looking inward to identify jobs that can be split or re-allocated to employ clients and that are able to be supervised. Then, a budget line supporting the wages needs to be secured. In the case of Ron who needs shoes, he and staff might agree to set aside a certain amount of each day's pay in a fund for shoes, with the remainder paid to Ron to meet his other needs. Hopefully, when his goal is reached and he has his shoes, he might feel motivated to continue the work relationship and start to work with staff on vocational planning and next steps.

A standing offer of work is only one dimension of an agency that is 'vocationalized,' meaning that the culture and infrastructure support employment. A 'vocationalized' agency has outreach workers and case managers who understand employment services and techniques, hires clients, and has job postings, training opportunities, and agreements with partners like Vocational Rehabilitation and One-Stop Career Centers to help clients access training and employment opportunities. A 'vocationalized' agency also has trained employment specialists. In essence, a vocationalized agency sees helping clients obtain meaningful jobs at a living wage as one of their major goals, and all staff supports the employment process.

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Section 9: Conclusion

We would like to provide some guidance to outreach workers who might be wondering, "Now that I understand how employment can be part of outreach, what skills do I need to accomplish the task?"

Fundamentally, good employment-focused outreach workers are first and foremost good outreach workers who possess excellent client engagement, trust-building, and support skills. They meet clients "where they are at" – both in terms of the areas in which they live as well as where they are along their path of recovery. They understand how to use motivational interviewing and how change occurs and is facilitated over time.

To successfully incorporate employment as part of outreach, outreach workers should participate as members of integrated service teams where they have opportunities to report on the progress people are making in accepting vocational services. It is essential, however, that they receive support in their role from agency managers.

Outreach workers should also understand how to conduct informal vocational assessments, such as those discussed in Audio Lecture #1 of this series titled, "Integrating Vocational Services in Client Service Planning." They should also know about and be able to influence their agency's employment services so that clients can have access to standing offers of work and the support they need to deepen their vocational involvement.

In all that they do, outreach workers should possess hope, creativity, resilience, and perseverance, which are, in essence, many of the same skills they see in the people who are surviving each day on the streets.

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