4c - multidimensional advocacy - glenwell panel symposium... · provide – brief mental health...

Multidimensional AdvocacyWorking at the Intersections of Domestic Violence and Behavioral Health2017 DOMESTIC VIOLENCE SYMPOSIUM

Today’s Panel

Alicia Glenwell• Trauma and Behavioral Health Systems Coordinator, Coalition Ending

Gender-Based Violence

Kellie Rogers• Program Manager - Community Advocacy Program, Domestic Abuse

Women’s Network (DAWN)

Maria Williams• Services Director, LifeWire

Theresa Epstein• Behavioral Health Consultant, Refugee Women’s Alliance (ReWA)

Tigist Negash• Program Manager, Refugee Women’s Alliance (ReWA)

9th Annual Domestic Violence Symposium The Bigger Picture

Session 4C - Multidimensional Advocacy Panel Presentation

September 7 & 8, 2017 of 15

Key Background Information

Behavioral health concerns used as a system of power and control (abusive partners and systems)

Behavioral health treatment separated from DV advocacy

DV advocacy and behavioral health services changed, adopting a trauma informed perspective of service

Now, addressing intersection of behavioral health and DV is most often essential in helping survivors heal from trauma

Trauma and Behavioral Health Systems Coordination

ALICIA GLENWELL




Systems Coordination

Policy and Practice Review Relationship Building Consultation Training, training, training!

Key Lessons

Have a willingness to initiate and participate in relationship-building across professions

Not just about training – policies and practices must reflect intersections of DV/BH

Build the policies, relationships, knowledge etc. before you need them!




Therapy Services Co-Located at Community-Based DV Agencies

ALICIA GLENWELL

KELLIE ROGERS

MIDD-Funded Mental Health Services

Mental health therapists who are employees of and located at domestic violence agencies

Free of charge No diagnosis/careful documentation




Why This Model?

Looking at all service provision through the lens of safety

Ease of access Increases skills and cross training for

both advocates and therapists. People untrained in DV or in BH issues can unintentionally cause harm (ex: documentation , not recognizing signs); working together increases appropriate support for survivors

MIDD-Funded Mental Health Services

Culturally and linguistically appropriate Trained in criminal/civil law issues and how that

can impact a survivor Connection to holistic services provided by DV

agencies (from 24 hour DV crisis line, shelter, legal, housing, etc.)




MIDD-Funded Mental Health Services – The ReWA Model

TIGIST NEGASH

THERESA EPSTEIN

What’s Different?

Based on the unique cultural & linguistic needs of the clients

Advocates/para professionals are the BH Counselors

Provide – Brief mental health treatment• Individual and group support

• Referrals to community mental health & other resources as needed




How Does this Work?

MH Consultant provides individual and group consultation• Mandatory bi-monthly education/training

meetings with the advocates/counselors.• Individual consultation with advocates

providing counseling to new and ongoing clients to discuss:

o Risks and safety concerns

o Client’s primary MH issue

o Possible treatment modalities

Core Values & Beliefs

Different cultures have different ways of perceiving and understanding DV, power, control and counseling. A western model does not fit all.

Using non- threatening and non- labeling language to describe and explain BH services. • How many ways can you talk about

“counseling” without using the word?

Survivors are having normal reactions to abnormal experiences. Their mental health issues are a result of trauma and dislocation.

Institutional support for advocate/counselors essential for good outcomes and retention.




Challenges & Successes

Wearing 2 hats – advocate and counselor

Clients have multiple traumas Confidentiality / small

communities Clients fear of being seen as

“crazy” MH viewed differently in

different cultures. Refugee and immigrant

women who are victims of DV/SA also face complex issues regarding their immigration states.

Increased trust with advocates who are trained as counselors and are bilingual and bicultural.

All women are served regardless of immigration status

No interpreter needed Non-western approach Increased safety working

with 1 person

Behavioral Health-Focused Advocacy at LifeWire

MARIA WILLIAMS




LifeWire – My Friend’s Place

Up to 24 months of transitional housing for survivors with children

Offers on site DV advocacy, access to individual substance abuse treatment and groups, access to individual mental health, trauma focused therapy and groups

Key service offering in an array of behavior health supports at LifeWire (MIDD funded therapy, family trauma healing groups, connection with substance abuse treatment providers, CDVRT)

Services and program model based in survivor driven, trauma informed advocacy and from a social justice framework




Trauma-Informed Services

NCDVTMH Definition of Trauma-Informed: The term trauma-informed is used to describe organizations and practices that incorporate an understanding of the pervasiveness and impact of trauma and that are designed to reduce re-traumatization, support healing and resiliency, and address the root causes of abuse and violence (NCDVTMH 2013, adapted from Harris and Fallot 2001)

Survivor-Driven, Trauma-Informed services

Survivors have choice

Services are strengths based

Services are flexible

Services are physically accessible

Services are culturally accessible

Services are voluntary

Advocates bear witness

Organization itself is trauma informed




Harm Reduction Philosophy, Social Justice Framework

Housing is a human right

Healthcare and healing from trauma is a human right

Systems of oppression lead to depression, anxiety and trauma

The most marginalized of survivors should be given the most options

Sobriety is not required

Treatment is not required

Danger in a survivor’s relationship has direct correlation to danger of using – so what does she/he identify as safe?

Opportunity to learn new coping mechanisms is presented

Children’s Domestic Violence Response Team (CDVRT)

KELLIE ROGERS




The Children’s Domestic Violence Response Team (CDVRT)

Collaborative program in partnership with Sound Mental Health, DAWN, LifeWire, and New Beginnings

Partners survivors with therapists trained in DV and advocates (community, legal, and children’s)

Wrap-around model; Survivor lead On-going consulting and coming

together

CDVRT, cont.

No parameters on length of time Therapeutic practice focuses on

trauma informed modalities : TF-CBT, PCIT, and others

Advocacy-intent to allow easy access to all programs (the CDVRT advocate is conduit)




Lessons Learned

Agency policies can be a barrier/need a champion

Team building is very important to nurture trust Trust fosters learning and growth “Advocacy” looks different dependent on

which field one is coming from

Key Concepts

Practice beliefs that Inform this work:

1. Everything needs to be looked at through the lens of safety

Is therapy safe? (Parenting Plans, abuser’s use of therapy, etc.)

Is the meeting space safe?

What about some of the “homework” asked in therapy, what about mandated reporting, etc.?




Key Concepts, cont.

2. Understanding that behavioral health issues do not necessarily affect parenting.

Are the concerning behaviors actually a strategy for coping with the coercive control/abuse (ex: disassociation, lack of assertiveness, lack of boundary setting)

Living with fear and abuse changes family dynamics and often leads professionals to see the victim as the problem (the children don’t behave that way when their father is around.)

Understanding that the abuser undermines her parenting at every opportunity and doesn’t allow her to parent in ways that make sense to her. (Not allowed to pick up a crying baby)

Key Concepts, cont.

3. Advocacy (empowerment model) may look different for someone affected by behavioral health issues.

Harm reduction

There are reasons that our “interventions” may not work

Really listening to the survivor. (Ex: woman who has a plan that allows her to become homeless.)




Key Concepts, cont.

4. Willingness to consult/listen and learn from professionals

Agency policies may get in the way

Learn and understand processes and what guides those in other disciplines; the more you know, then better able you are to navigate on behalf of clients

Avoid making decisions in a vacuum …..consult, consult, consult

Thank you!

Alicia Glenwell, Coalition Ending Gender-Based Violence• 206-568-5454, [email protected]

Kellie Rogers, Domestic Abuse Women’s Network (DAWN)• 253-893-1617, [email protected]

Maria Williams, LifeWire• 425-562-8840, [email protected]

Theresa Epstein, Refugee Women’s Alliance (ReWA)• 206-789-8732, [email protected]

Tigist Negash• 206-721-3846, Ext 27, [email protected]




4c - multidimensional advocacy - glenwell panel symposium... · provide – brief mental health...

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