EmBRACE the Journey

By: SUE IRWIN, MA (Education), PGCE, BSc (Physics – Hons) 

Within the UK and across the World more people are becoming aware of Adverse Childhood Experiences (ACEs), how common they are and the impact they can have on behaviour and health. So many people have been able to resonate with the subject within their own lives, whether that is on a personal or professional level or both. Having this realisation and an awareness of ACEs is important, but this is just the starting point. As a society it is paramount that we weave the ACEs science through our communities, address the impact of ACEs and understand how to make the necessary changes needed. However, it is evident from the question ‘how do we take the research and put it into practice?’, which I am very often asked, people do not always know how to do this. In response to the emerging evidence on ACEs, and to address such a poignant question, I founded a new and dynamic cultural change and  

leadership programme. Initially focussed within an educational setting, the programme has evolved to enable multi-agency programmes to adopt the approach and become Trauma-Informed. The cultural change programme is called ‘Emotionally and Brain Resilient to Adverse Childhood Experiences’, or EmBRACE for short. The strength of EmBRACE is that it is implemented over a period of time to embed and consider how the organisation becomes ACE Aware and ACE and Trauma Informed. EmBRACE also challenges resistance to change and recognises that each establishment is different. To achieve this various change management tools are implemented.

The use of language and buy in from staff have been two critical components which have provided the foundations for cultural change within the organisations I have worked with. Staff need to be given the time and: supported with their thinking; opportunities to reflect. Subsequently, they have been able to recognise that EmBRACE is not an initiative and identify already trauma informed good practice, which is empowering for practitioners. Staff need to feel confident with the trauma informed language and any new practices they may implement. Building this into procedures and policies must be addressed and led by the senior management team to ensure capacity building and sustainability. 

Inspire Blackburn with Darwen (BwD), UK is an integrated Prevention and Drug Recovery Service. As an organisation they recognised the prevalence of ACEs for clients/service users and wanted to explore how they could make the necessary changes to become ACE and Trauma Informed to support further their service users. Subsequently, I was commissioned to work with them to implement EmBRACE. Recovery Support Coordinator from Inspire (BwD), and now lead ACE Champion, James Houghton, also recognised ‘There are reasons underpinning peoples’ negative behaviours, which are because of something else. All services e.g. substance mis-use, social services, dealing with depression, in general, are geared up to manage the symptoms. A high percentage of the causes and conditions of negative behaviours are based in the person’s thinking, often being that they have a negative perception of life in general, including the perception they have of themselves. This can lead to a manifestation of not only ACEs but adversity in adulthood too, which can come in various forms. The common denominator is perception and how this manifests within the thought process e.g. “I’m not as good” or “I’ll never be able to achieve what they have” The negative thoughts are then displayed in the behaviour. As a result of this, someone won’t then engage in activities they want to go to or apply for a job etc. For society in general, these negative thought patterns don’t manifest into something major. However, for the extremes, which are a minority of society, there are organisations like Inspire who deal with them. Because of an adverse experience people find coping strategies and display a variety of behaviours. The more adversity somebody experiences, the more susceptible they become to more negative behaviours. When this happens, what people do is mummify themselves. They protect themselves with a ‘bandage’ which enables them to manage, a process which will have no doubt taken years for them to do. Then as ‘Services’ we unwrap them without dealing with the issues as to why they are doing this’.  

A number of key components when supporting Inspire (BwD) with their Trauma Informed Journey was for them as an organisation to strategically: realise the science and impact of ACEs; know how to weave this into practice, procedures and policies.

Working with James Houghton, these key components have been addressed through the delivery of the EmBRACE Workshops, which have also provided a platform for clients to reflect through an ACE lens. Below are the aims and objectives for the EmBRACE Workshops:

  • show how identifying causes and conditions of negative behaviours opposed to finding solutions to address the by-product of those. This has provided clients with the ownership and confidence to have control of their own recovery
  • Explain the brain’s structure and operation so that clients can relate to this within their own life
  • Provide opportunity for discussion and examples of how thoughts, feelings, behaviours and consequences can dictate decision made/choices which ultimately affect behaviours 
  • Provide opportunities for reflections so that breaking the cycle can be achieved and managed by the client during recovery
  • To educate around the physical health complications trauma can cause

The quotes below demonstrate the impact the EmBRACE Workshops have had on the clients/service users and the significance of understanding about ACEs, particularly in relation to their own lives and behaviours, breaking the cycle and looking at addiction from a different perspective: 

‘I found the subject matter really interesting and a new way to look at addiction’

 ‘The workshops have helped me understand a lot about ACEs and helped put things into perspective’

 ‘ACEs are a major key part of the recovery process’ which highlights the need for ACE and Trauma Informed Practice to be an integral part of the culture within the organisation rather than a bolt on.

‘Understanding about ACEs has impacted on my decision making as well. My whole thought process on making a decision has been influenced through an ACE Lens. It has helped me to rationalise my thoughts rather than act on impulse’.

‘The focus in service has really shifted with the ACEs definitely’.

 ‘Being ACE Aware has affected more than just me. I have been able to reflect on the fact that my own children will have ACEs and how to address this. Breaking the Cycle has been a big part of this. The relationship with my siblings and mum has improved (now reconciled). In addition to this other people have cascaded their knowledge about ACEs which is a fantastic testament to the ACEs movement’.

James Houghton stresses “The EmBRACE Workshops explain that you have a drug solution, you don’t have a drug problem”. Looking at the bigger picture, James continues “Street homelessness is a big by-product of substance mis-use. The negative thought process of ‘I’m ok on the streets’ becomes part of someone’s belief system. People in this situation can’t function in society. Paying the bills or caring for their children is of secondary importance. The brain overrides this”. He nicely summarises “EmBRACE Workshops look at the root cause and are set up to educate around this. EmBRACE empowers the person to take responsibilitywhich is a fantastic testament to the ACEs movement and a key part of Cultural Change through an ACE Lens.

—Sue Irwin is a very experienced consultant, with over 24 years in education and learning. As a national lead in England, UK, on Adverse Childhood Experiences (ACEs) and founder of EmBRACE, Sue effectively leads other professionals to reflect and develop their practice, provide change management through an ACE Lens and build trauma-informed cultures. 

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Research Round-Up: The Latest in Homelessness Scholarship

This blog post features 10 recently published, peer-reviewed journal articles on homelessness – some written by faculty from our partner schools. These publications cover a range of topics related to homeless youth and adults, permanent supportive housing, homeless service provision, and service learning. Consider adding one of these to your course syllabi next semester or citing one in your next article. And, if you’re looking for additional readings to include in your classes, check out our curriculum resource page.

  1. Aparicio, E. M., Birmingham, A., Rodrigues, E. N., & Houser, C. (2019). Dual experiences of teenage parenting and homelessness among Native Hawaiian youth: A critical interpretive phenomenological analysis. Child and Family Social Work, 24(2), 330-339. Read more here.
  2. Byrne, T., Montgomery, A. E., & Fargo, J. D. (2019). Predictive modeling of housing instability and homelessness in the Veterans Health Administration. Health Services Research, 54(1), 75-85. Read more here.
  3. De Marco, A. C., & Kretzschmar, J. (2019). The impact of cocurricular community service on student learning perceptions of poverty and homelessness. Journal of Poverty, 23(1), 21-43. Read more here.
  4. Burns, V. F., & Sussman, T. (2019). Homeless for the first time in later life: Uncovering more than one pathway. Gerontologist, 59(2), 251-259. Read more here.
  5. Lee, W., & Ferguson, K. M. (2019). The role of local businesses in addressing multidimensional needs of homeless populations. Journal of Human Behavior in the Social Environment, 29(3), 398-402. Read more here.
  6. Marie, D. S., Gallardo, K. R., Narendorf, S., Petering, R., Barman-Adhikari, A., Flash, C., Hsun-Ta, H., Shelton, J., Ferguson, K., & Bender, K. (2019). Implications for PeEP uptake in young adults experiencing homelessness: A mixed methods study. AIDS Education and Prevention, 31(1), 63-81. Read more here.
  7. Metzger, M. W., Bender, A., Flowers, A., Murugan, V., & Ravindranath, D. (2019). Step by step: Tenant accounts of securing and maintaining quality housing with a housing choice voucher. Journal of Community Practice, 27(1), 31-44. Read more here.
  8. Waegemakers Schiff, J., & Lane, A. M. (2019). PTSD symptoms, vicarious traumatization, and burnout in front line workers in the homeless sector. Community Mental Health Journal, 55(3), 454-462. Read more here.
  9. Travis, R., Rodwin, A. H., & Allcorn, A. (2019). Hip hop, empowerment, and clinical practice for homeless adults with severe mental illness. Social Work with Groups, 42(2), 83-100. Read more here.
  10. Gwadz, M., Freeman, R., Leonard, N. R., Kutnick, A., Silverman, E., Ritchie, A., Bolas, J., Cleland, C. M., Tabac, L., Hirsch, M., & Powlovich, J. (2019). Understanding organizations serving runaway and homeless youth: A multi-setting, multi-perspective qualitative exploration. Child and Adolescent Social Work, 36(2), 201-217. Read more here.

The 2018 Annual Homelessness Assessment Report to Congress

With the U.S. Department of Housing and Urban Development closed as a result of the current government shutdown, the effects for people experiencing homelessness and people living in government subsidized housing have been far reaching. Communities across the country rely on funds from HUD to provide crucial outreach, emergency shelter, housing, case management, and support services to people experiencing or at risk of homelessness. The impacts of these efforts can sometimes be hard to see or quantify.

Last month, HUD released the first part of the 2018 Annual Homelessness Assessment Report (AHAR) to Congress. For those unfamiliar with this report, it’s an annual summary of point-in-time and housing inventory counts conducted during the previous January. It includes national, state, and continuum of care (CoC)-level estimates of homelessness, with specific breakdowns for chronically homeless persons, homeless veterans, and homeless children and youth, as a well as information abocaptureut housing units.

Nearly 553,000 people were homeless on a single night in January of 2018. This number is a very slight (.3%) increase from 2017, and this is the second year in a row that an increase has been observed. Much like the 2% increase between 2016 and 2017, this year’s change was the result of an increase in people living unsheltered in cities across the country. Approximately 35% of people were living unsheltered, such as on the street, in abandoned buildings, or in other places not meant for human habitation. The states with the highest rates of unsheltered people experiencing homelessness were California, Oregon, Nevada, Hawaii, and Washington. The number of people experiencing chronic homelessness also increased slightly between 2017 and 2018.

Of the roughly 553,000 people experiencing homelessness captured in last year’s point-in-time counts, more than 36,000 were unaccompanied youth (individuals under the age of 25). Compared to the overall homeless population and compared to homeless single adults, unaccompanied homeless youth were more likely to be living unsheltered – just over half (51%) of youth were unsheltered. States with the highest rates of homeless youth were Nevada, California, Hawaii, Washington, and Oregon. In general, CoCs are new to the process of conducting point-in-time counts of unaccompanied homeless youth, which can require innovative approaches to ensure estimates are as accurate as possible. The Voices of Youth Count project offers some guidance for youth count methods and has published a series of briefs from their own study of the prevalence and characteristics of homeless youth across the country.

Overall, homelessness has declined by more than 84,000 people since 2010, a 13% reduction. In fact, family homelessness has declined by 23% since 2007, chronic homelessness has declined by 26% since 2017, and veteran homelessness has declined by 48% since 2009. States that have seen the largest decreases in homelessness between 2007 and 2018 are Florida, Texas, Georgia, California, and New Jersey.

While the increase in the number of people experiencing homelessness over the past two years is relatively small, it’s worth paying attention to as an indicator of what may be a gradual reversal of the positive trends of the last decade. Perhaps it is a clarion call to the federal government and local jurisdictions to take action to prevent larger upticks in years to come. Further, the fact that the increase continues to be entirely driven by more individuals experiencing unsheltered homelessness in cities, rather than being evenly spread across groups and homeless experiences, suggests there are distinct place-based factors at play in urban areas, including a widespread lack of affordable housing and inadequate emergency shelter in urban areas. More than 50% of unsheltered people were living in CoCs that encompass the nation’s 50 largest cities. The states that saw the largest increases in homelessness between 2017 and 2018 were Massachusetts, New York, Texas, Washington, and Arizona.

While the point-in-time count data upon which the AHAR is based likely under-counts the actual number of people experiencing homelessness, the report is a useful tool for framing homelessness at the national, state, and local levels. It’s a valuable resource for community agencies, researchers, and academics for writing grant applications, advocating for funding or programmatic changes, and providing background for research and evaluation write-ups.

Communities across the country are conducting their overall and youth counts this month, with the help of a range of community partners and volunteers. The data from these counts will be the basis for the 2019 Annual Homelessness Assessment Report to Congress.

Blog Post Author: Amanda Aykanian, MA, Research and Project Lead at the National Center for Excellence in Homeless Services

 

 

Students’ Excellence in Homeless Services and Research Recognized at NYU Silver School of Social Work’s Annual Awards Night

On April 20th, NYU’s Silver School of Social Work Annual Awards ceremony included awards given for Excellence in Homeless Services and Research to MSW student Julianna DiPinto and PhD student Yeqing Yuan. Made possible by the National Center’s National 2017 Student Awards-Yeqing Yuan4Homelessness Social Work Initiative (funded by the New York Community Trust), these awards included a check for $1,500 and a plaque. Ms. DiPinto was recognized for her internship at the Coalition for the Homeless where she excelled at working with and advocating for homeless adults and families. Ms. Yuan was cited for her commitment to helping homeless persons, from her social work practice in Boston to her current research involving services for persons at risk of homelessness, serious mental illness, and substance abuse.

Ms. Yuan (pictured right) said:

“I’m extremely grateful for having received this award. I would like to thank the National Center for Excellence in Homeless Services for making this award possible. I also thank my faculty mentors, Drs. Jennifer Manuel and Deborah Padgett, for their generous support and guidance. I’m very proud to be part of the homeless services community and will continue to strive toward ending homelessness.”

NYU Silver faculty members, and National Center faculty contacts, Peggy Morton and Deborah Padgett, oversaw the award’s creation and the selection of recipients.

2017 Student Awards-Julianna DiPinto

Like this post?
Check out this one written by a student at the University of South Florida about a recent Hack for Homelessness event at the school.

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National Homelessness Social Work Initiative – Year 2 Updates

The National Center is part way through Year 2 of the National Homelessness Social Work Initiative (the Homelessness Initiative). We’ve had an exciting year so far that included adding new partner schools and launching a regional hub model. We are now a consortium of 19 partner schools of social work across the U.S. Six partners serve as Regional Hub Leaders to advance work in key geographic areas. In the NY/NJ region, collaboration is fostered among seven NY partners and nine liaison schools in NY and NJ. The Council on Social Work Education (CSWE) continues to be a key partner of the National Center, supporting activities and helping to develop partnerships with other organizations, including the U.S Department of Veterans Affairs (VA).

Supporting the Grand Challenge to End Homelessness
A key aspect of our work is supporting implementation of the American Academy of Social Work and Social Welfare’s Grand Challenge to End Homelessness (GCEH), an effort co-led by faculty from two of our partner schools – Deborah Padgett (NYU) and Ben Henwood (USC). The partnership between the National Center and the GCEH continues to evolve. In July, we formed a workgroup to develop a homelessness research agenda. Workgroup members include representatives from the National Center, the GCEH, and the VA’s National Center on Homelessness Among Veterans.

Working with the U.S. Department of Veterans Affairs
Our work with the VA has also continued to develop since we held initial meetings with them this past winter. We formed a workgroup to explore opportunities for infusing veteran homelessness content into social work education and expand field placements for students with dual interests in homelessness and veterans.

Working with the Council on Social Work Education
CSWE has been a key partner in our work since the initial launch of the Homelessness Initiative. This summer, we began working with CSWE’s Learning Academy to develop a learning series on homelessness to support faculty development and for use in course curriculum. The series, titled “Homelessness in Social Work Curriculum”, will be released this fall.

The learning series is one example of how the National Center and CSWE have joined forces to promote curriculum integration and faculty professional development. We also want to create opportunities for students to gain expertise in skills especially relevant for working with homeless and at-risk clients. We are particularly excited to announce developing efforts to support the SSI/SSDI Outreach, Access, and Recovery (SOAR) program.

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) provide crucial income and insurance for those with health issues and other disabilities. However, applying for these benefits is a complicated process and access is often challenging for people experiencing or at-risk of homelessness. In fact, the initial SSI/SSDI approval rate for people who are homeless is about 10-15% when the application is submitted without assistance.

SOAR was established to increase access to SSI/SSDI for people experiencing or at risk of homelessness. The SOAR Technical Assistance (TA) Center, established by the Substance Abuse and Mental Health Services Administration, supports the implementation of state- and local-level SOAR initiatives. The TA Center provides case manager trainings on the SSI/SSDI application process and technical assistance to support states and communities as they develop and implement their SOAR Action Plan.

Developing SOAR Pilot Projects
Social workers can help ensure the success of SOAR, especially in communities with particularly high rates of homelessness. Training social work students to assist clients with the application process will benefit field placement agencies by increasing the number of staff capable of supporting this process.

In an effort to support the goals of SOAR, the National Center held multiple meetings with representatives from SAMHSA’s SOAR TA Center and the Council on Social Work Education. We formed a SOAR workgroup to bring together partner schools interested in developing pilot initiatives at their schools. Below are brief descriptions of activities emerging from this workgroup.

The University of Texas at Austin is testing a SOAR field placement project, an effort led by Cal Streeter (Professor of Social Work) and supported by partnerships with community-based agencies. SOAR has been identified by the local homeless service network as a priority issue. Four MSW students will complete the SOAR certification and be placed in one of two participating homeless service agencies where SOAR will be a focus of the internship. Students will receive ongoing guidance and supervision from the Austin/Travis County SOAR lead. A small stipend will be given to students for each semester in this role. If successful, BSW students will be added in the spring.

Catholic University of America (CUA)
Linda Plitt Donaldson, Associate Professor at the CUA National Catholic School of Social Service, has initiated discussions with the SOAR Coordinator in Washington, DC. In September, she will attend the area’s next SOAR Leadership meeting to brainstorm ways the school can support SOAR efforts, including and beyond creating SOAR field placements dedicated to preparing SOAR applications at various agencies.

California State University, Long Beach (CSULB) and the University of Southern California (USC)
CSULB is developing an advanced practice elective in their MSW program covering best practices working with clients who are homeless or at-risk for becoming homeless. As part of this course, students will complete the SOAR training and gain experience using the tool. Additionally, the school is collaborating with USC to develop a plan to provide SOAR training to interns from both universities who are placed in agencies serving homeless populations.

As we head into another school year, we expect this momentum to continue. Keep up-to-date with our activities by following us on social media. Additionally, our blog features monthly spotlights on partner activities, including Regional Hub Leader progress.

Like this post?

Check out this one on Regional Hub Leader Hunter College.

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Visit our website to learn more about us and our National Homelessness Social Work Initiative.

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NCEHS Regional Hub Leader: Hunter College

In Year 2 of the National Homelessness Social Work Initiative, the National Center for Excellence in Homeless Services (NCEHS) selected the Silberman School of Social Work (SSW) at Hunter College to be one of six Regional Hub Leader Schools.

Located in New York City, Hunter College’s SSW recognizes the importance of a strong homeless service system and workforce. This commitment is reflected in their many partnerships with community-based homeless service agencies, including several that host BSW and MSW student interns. In addition to their work within New York City, the school also partners with New York’s Office of Temporary Disability Assistance (OTDA) to develop curricula and deliver training to shelter workers throughout the state.

CTI-logoThe SSW is home to the Center for the Advancement of Critical Time Intervention (CACTI). CTI is a time-limited evidence-based practice used to promote stability and prevent homelessness for individuals during periods of transition by mobilizing community-based supports. CACTI disseminates research, provides training and implementation support, and fosters collaboration between practitioners, trainers, and researchers through its Global Network.

Dan Herman, PhD, (professor of social work) directs CACTI and has been a leader in CTI research efforts for the past fifteen years. Dr. Herman is also a key contributor to NCEHS activities nationally and across New York State, often working closely with leadership staff at the University at Albany.

As a Regional Hub Leader, the school has committed to further advancing the CTI model. Hunter College has a robust network of partners to help facilitate their success, including: the National Alliance to End Homelessness; the New York City Department of Homeless Services; and OTDA. Specifically, the school’s Regional Hub Leader goals are to:

  • Engage policymakers to support broad dissemination of CTI.
  • Partner with provider and policy advocacy organizations in New York State and nationally to adapt CTI for homeless families in rapid rehousing programs, and to explore how CTI can inform the development of a model to prevent homelessness and other adverse outcomes among young adults leaving foster care.
  • Inform the broader social work community of CTI and identify supports to develop and disseminate a CTI training curriculum.
  • Build partnerships with local and state government agencies, as well as national provider and advocacy organizations, to systemize CTI adaptation and dissemination.

Since being named a Regional Hub Leader School earlier this year, Hunter College has been actively engaged in pursuing its goals. To support national dissemination, CACTI held several meetings with the National Alliance to End Homelessness (NAEH) to discuss how CTI could be adapted for use in rapid rehousing programs across the country. In line with this, in February, Dan Herman presented on CTI in the context of rapid rehousing at the national NAEH conference on family and youth homelessness in Oakland, California and a second workshop is planned for NAEH’s main conference in July in Washington, DC. Additionally, the school recently finalized a CTI training curriculum for homeless shelter workers, through its training partnership with OTDA, to further local dissemination and workforce development.

CACTI is also pursuing new partnerships. They recently met with Mark Hurwitz, Head of Strategy and Special Projects at OneCity Health (the NYC Health + Hospitals-sponsored Performing Provider System (PPS)) to begin discussions about how CTI could be applied to serve homeless and high-risk individuals within their developing care coordination system. They have also held several meetings with other NYC officials charged with reform of the City’s homelessness system to discuss how CTI could contribute to improved service delivery for homeless individuals and families.

The NCEHS blog and social media will periodically post updates on Hunter College’s activities and accomplishments. Additionally, be on the lookout for posts about our other five Regional Hub Leader Schools.

Like this post?

Check out this one on the launch of the Center for the Advancement of Critical Time Intervention.

Want more info?

Visit our website to learn more about us and our National Homelessness Social Work Initiative.

On social media?

Follow us on Facebook and Twitter.