Home Visiting in a Homeless Setting By: LaTanya Gray and Nancy Radner

Icebreaker How many of you have: Served homeless families? Done home visiting? Done home visiting for homeless families?

Homeless Families- Who Are They? A typical sheltered homeless family is comprised of a mother in her late twenties with two children under 6

Homeless Families- Who Are They? Homeless Moms:  Often experience repeated episodes of residential instability  93% have experienced physical or sexual abuse  Have significantly higher rates of major depressive disorders, PTSD and substance use disorders – 50% have PTSD (3x greater than the general pop); 85% have clinical depression (12% among all women, 25% among poor women) Trauma is a major component of their lives

Homeless Families-Who Are They? Homeless Children:  66% have been exposed to violence  are sick at twice the rate of housed children  have twice the rate of learning disabilities and three times the rate of emotional and behavioral problems  50% experience anxiety depression or withdrawal, compared to 18% of non- homeless children  By age 8, 1 in 3 homeless children have a diagnosable mental health condition. Trauma is a major component of their lives

Homeless Families-Who Are They? Trauma in Adults:  Can lead to a state of apathy, hopelessness, and rage.  Can manifest as anxiety disorders, panic attacks, obsessive-compulsive behaviors, addictions, and self-injury.

Homeless Families-Who Are They? Trauma in Children:  They can be easily triggered or “set off” and are more likely to react very intensely.  They may struggle with knowing how to calm down and may lack impulse control  They may lack the ability to think through consequences before acting.  They may behave in ways that appear unpredictable, oppositional, volatile, and extreme.

The Primo Center for Women and Children 2 nd largest provider of transitional housing for families in Chicago Also provides:  Permanent supportive housing  Community-based counseling for youth at risk of violence  On-site early childhood center  Rapid re-housing for veterans and families

The Primo Center for Women and Children All families receive a unique mix of  trauma-informed behavioral health services  clinical case management  a therapeutic housing community from which to break the cycle of violence and to heal and grow.

The Primo Center for Women and Children All Services are Trauma-Informed:  All staff are trained to understand the families’ experiences through a trauma lens.  In every interaction, providing safety, security and support is the number one priority.  “Lovies”

The Primo Center for Women and Children This mix of trauma-informed services & housing has resulted in outstanding outcomes:  More than 91% of the families in transitional housing were placed in stable permanent housing  Fewer than 5% of the families return to homelessness.

The Primo Center for Women and Children This mix of trauma-informed services & housing has resulted in outstanding outcomes:  70% of mothers and 60% of children with demonstrated traumatic stress had major reductions in their clinical levels of stress.  75% of families showed improvement in overall family functioning.

What is Home Visiting? Home visiting is an evidence- based practice that promotes children’s healthy development by nurturing the parent-child relationship.

What is Home Visiting? Home visitors meet one-on-one weekly with families in the home from the time of pregnancy until the children are three years of age or more. Families also participate in ongoing socialization activities where children of a similar age and their parents can interact with each other in a group setting.

Why is Home Visiting Excellent for Homeless Families? Home visiting supports parents and children by nurturing strong parent-child relationships promoting positive parenting practices building the confidence and knowledge of parents Studies are emphatic---home visiting enhances parenting skills, prevents child abuse, and supports healthy child development.

Why is Home Visiting Excellent for Homeless Families? Home visiting is ideally suited for homeless families like those at the Primo Center because it works directly to break the cycle of trauma and violence. “I didn’t know how to do all those things a baby needs.”

Why is Home Visiting Excellent for Homeless Families? “She showed me how not to get angry. She’s coached me on disciplining Ally the right way. I don’t want Ally to be afraid or get hurt when she gets in trouble like I did.” “She answers my questions about baby stuff. She brings books for me to read to Ally. We work together to make sure Ally is doing things a baby should do at her age.”

The Home Visiting Model  Ounce of Prevention  Why we began using the Home Visiting Model?  Purpose-Why Home Visiting at a Shelter?

Ounce of Prevention  In 2015, Primo Center partnered with the Ounce of Prevention on a demonstration project to bring Home Visiting services to Homeless families. This may be the only demonstration project in the country that provides home visiting services in the shelter.

Ounce of Prevention Cont..  The project places the emphasis on the parent becoming the teacher and playing an active role in their child’s development.  The Play Activities are designed for children between the ages of 0-5yrs old.  Parents As Teachers is the evidence based curriculum that provides the framework for the home visiting sessions.

Why we began using the Home Visiting Model?  The Parent-Child Relationship is a major component in the development of a child. The emotional and developmental needs of young children are often not addressed in the shelter setting.  Working with Families in their living space gives them a convenient, safe and familiar setting.  Our philosophy of care is centered around meeting the family “where they are” and allowing them to guide the direction of the treatment.

Why Home Visiting at a Shelter?  Parent-Child Relationship  Children begin to Develop and learn through play.  Preventing Child Abuse  Parents becoming the expert on their children.  Parents are given a safe place to voice concerns and ask questions regarding their child’s development.

Let’s get Started!!!  Our Population  Assessments  Description of the Home Visiting Sessions

Our Population

Assessments and Testing  All of the children that participate in the Home visiting program are given the Ages and Stages Questionnaires and the Ages and Stages Questionnaires Social Emotional for a baseline assessment.  All of the parents are given the Parental Stress Index (PSI)and the Trauma Symptom Inventory (TSI) as a baseline assessment.  The results of the testing are instrumental in identifying the families’ needs, area of concern and a recommended course of treatment.

Home Visiting Sessions

Description of Sessions  Each family has a Parent Educator that is assigned to that family.  The Parent Educator’s role is only to facilitate the parent-child activity and increase the parent’s knowledge of their child’s development.  The Home Visiting sessions are individualized for each family with a personalized visit plan, parent handouts and activity for each session. These plans are taken directly from the Parents As Teachers curriculum and are the foundations for each individual session.

Description of Sessions Cont…  Each session is designed to create a partnership between the parent and the parent educator.  The Parents As Teachers personal visit plans target three main areas. 1. Parent-Child Interaction-Parent/Child activity, parenting behaviors and child development. 2. Development-Centered Parenting-family routines, child’s developmental level and families environment. 3. Family Well-Being-The families perspectives, influences, and dreams.

Strengths  What are the Strengths of doing Home Visiting? 1. Increased knowledge of child’s development. 2. Improved parenting practices 3. Healthy parent child relationships 4. Improved family functioning

Challenges  What are the Challenges of doing Home Visiting in the shelter? 1. The transiency of homeless families. 2. Boundaries between staff and families. 3. Home Visiting services are directly tied to the shelter. 4. Transitioning to Community based home visiting.

Q & A