Planning for Success throughout Phases of Housing Stability

Part Nine: Planning for Success throughout Phases of Housing Stability

My pal (and Founding Partner of OrgCode), Dr. John Whitesell, has reinforced in me over the past dozen years the usefulness of the Sigmoid Curve to represent change, growth and development within people and organizations. He has also ingrained in me the ability to chunk the S-Curve into three main phases: Formative; Normative; and, Integrative.

While appreciating that everyone experiences housing support services somewhat differently, John and I meticulously went about trying to typologize various client characteristics in program phases relative to the S-Curve. Upon review of a whack of case files, interviews with staff in some highly successful housing programs, interviews with dozens of clients, mining of various data sets and reflecting on my own experience in creating and leading a rather successful housing program, we arrived at the following broad-stroke phases as experienced by the client, and as supported by the case manager:

Stage Client Characteristics What the Case Manager Should Do & Expect
Formative
  • Period of adjustment in being housed and becoming oriented to the new environment and supports
  • Characterized by new learning and adaptation
  • Goals and priorities more likely to shift
  • More likely to be pre-contemplative or contemplative in many areas of individualized service plan
  • Changes to social network are common
  • May feel a sense or urgency or panic to be “normal” or “do the right things”, yet more likely to miss appointments
  • Often emotionally unpredictable
  • Expect unpredictability & do not be frustrated
  • Focus on small wins
  • Drop by
  • Ask exploratory probing questions about future
  • Expect more teaching and modeling
  • Expect longer visits or more frequent shorter visits
  • Be clear about what is in scope for their help and what clients need to do on their own
  • Appropriately challenge
  • Stimulate early stages of change discussion
  • Use active listening & motivational interviewing
  • Create the individualized service plan with the client
  • Use of assertive engagement is more likely
  • Create a client-centered crisis plan
  • Assess and address risks through people, processes or technology
  • Introduce the concept of exit planning from the program
Normative
  • Characterized by development and growth
  • Active engagement in goal setting; sees results of goals
  • Learning strategies to deal with adversity
  • Will assert greater independence in setting and attending appointments
  • Routines starting to set in
  • Increased awareness of triggers and situations
  • Be prepared to address clients who relapse in any areas of their case plan—those that feel they are stuck, as well as those so elated by progress they feel like they can “go it alone” now
  • Acknowledge success and begin to decrease frequency of visits
  • Talk about strategies to deal with conflict and adversity
  • Keep the client stimulated with new opportunities
  • Have client engage in their own research about options relative to the service plan
  • Begin to use visual tools more to show progress changes
  • Start adding more details to exit plan
  • Use active listening & motivational interviewing
  • Update service plan
Integrative
  • Skill mastery and greater independence
  • Independently sets goals and puts actions into place
  • Improved confidence and self-esteem
  • Sustainable links to other community supports as necessary
  • Has strategies for dealing with adversity and conflict
  • Has knowledge and skills to independently manage tenancy
  • Reinforce and respect client autonomy
  • Use visual tools to show client progress over time — graphs, bar charts, etc.
  • Review challenging scenarios and ask client how they will respond when these situations come up in the future
  • Reinforce and increase connectivity to “mainstream” opportunities and services
  • Update service plan – which should indicate most/many activities as solely being within the client’s domain to undertake
  • Complete, review and operationalize exit plan

The key is to use the understanding of stages of change and objective-based home visits to assist clients in moving through the program stages.

You may also have noticed reference to things like the Crisis Plan and the Exit Plan, as well as Risk Assessment. If you want copies of any of these sorts of documents, drop me a note at idejong@orgcode.com

And there are, of course, other tools and techniques that you can put into place through each phase of the program to help track progress and work on increased success. Some of my favorites (click on any of them if you want more information from the source documents) include:

If we plan for success, have a sense of what to expect along the journey of housing and life stability, support appropriately without coercion or misguided expectations, use tools & strategies to increase the likelihood of success and remain focused on the major outcome of helping people achieve greater independence over time, more success will be had.

Iain De Jong has considerable experience helping organizations better understand how to support clients in moving from one phase to the other, and thinking about resource allocation and time management of staff in supporting clients in each of the phases. Feel free to drop him a line or ask questions idejong@orgcode.com

Iain De Jong

About Iain De Jong

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