Saturday, May 31, 2014

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Though               not               directly               responsible               for               the               clients               on               the               CMTM's               caseload,               you               as               an               intern               will               still               find               many               opportunities               to               directly               engage               with               and               for               those               clients.

Of               these               tasks,               I               think               you               will               most               frequently               be               asked               to               outreach               to               those               clients               who               may               be               lost               to               follow-up.

Essentially,               this               means               contacting               or               trying               to               get               into               contact               with               those               clients               the               CMTM               haven't               seen               in               a               while.

When               you               outreach               to               clients,               you               sort               of               act               as               a               broker               between               the               client               and               the               CMTM,               linking               the               two               together.
               It's               very               likely               for               a               Housing               Works               client               to               not               have               a               reachable               phone               number               and               also               for               him/her               to               be               homeless,               and               thus,               many               clients               can               be               hard               to               contact               and               meet.

This               may               not               be               the               case               for               many               other               clients,               but               as               there               can               be               many               other               reasons               why               the               CMTM               may               not               have               been               able               to               see               the               client               in               a               month,               outreaching               is               an               important               duty,               and               one               that               is               required               rather               frequently.
               As               with               all               follow-up               responsibilities,               outreaching               starts               not               with               the               action               of               outreaching               itself,               but               with               some               basic               understanding               of               the               client               you're               going               to               be               outreaching.

Try               to               learn               as               much               as               you               can               about               the               client               before               dialing               that               phone               number               and               definitely               before               going               out               of               the               office               to               knock               on               the               door               of               his/her               residence.

As               mentioned               before,               take               advantage               of               the               CMTM               meetings               and               the               client               charts,               starting               with               the               basic               information               such               as               the               client's               phone               number               and               address               and               going               so               far               as               to               become               familiar               with               what               has               occurred               between               the               client               and               the               CMTM               thus               far.

Do               this               to               be               prepared               but               do               NOT               make               any               assumptions               based               on               what               you               read               and/or               hear               about               the               client.

Information               is               a               resource               to               help               you               work               effectively,               but               they               do               not               supersede               the               client's               personal               input.
               Outreaching               is               much               easier               when               you               can               contact               them               on               the               phone.

It's               an               effective               way               to               learn               what's               been               going               on,               what               the               client               currently               needs               assistance               with,               what               day               and               time               the               client               would               like               to               meet               with               the               CMTM,               and               then               pass               this               info               onto               the               CMTM.

Still,               since               you're               still               invisible               to               the               client               on               the               phone,               you               must               make               sure               to               audibly               demonstrate               your               respect               and               empathy.
               Introduce               yourself               honestly               and               be               clear               in               representing               the               CMTM.

Like               I               stated               before,               you               act               as               a               broker;               you               are               not               the               case               manager.

If               the               client               wishes               to               discuss               something               that               is               beyond               your               role               as               an               intern,               it               would               be               best               for               both               you               and               the               client               for               you               to               hand               the               phone               over               to               the               CMTM               member               the               client               would               like               to               speak               with.

If               the               CM               or               the               CMT               happen               to               be               out               of               the               office               and               not               available               to               talk               on               the               phone               at               the               moment,               have               the               client               know               that               he/she               can               discuss               it               with               the               CMTM               the               next               time               they               meet               or               talk               with               each               other.

If               the               client               really               desires               to               talk               to               you               about               an               issue,               I               personally               don't               think               you               need               to               be               so               clear-cut               in               your               role               as               an               intern               to               cut               the               conversation               off               and               tell               them               to               just               wait               until               the               next               time               they               talk               to               the               CM               or               the               CMT.

However,               I               have               learned               from               my               time               as               an               intern               that               being               clear               about               your               role               as               a               sort               of               a               mediator               is               very               important,               especially               on               the               phone.

Thus,               the               client               should               be               made               aware               that               the               issues               they               bring               up               during               the               phone               conversation               will               ultimately               be               resolved               not               by               you,               but               by               the               CMTM               members               communication               and               working               as               a               team,               with               each               member               having               clearly-defined               roles               and               duties.
               Remember               that               your               role               as               an               intern               in               this               phone               conversation               is               to               schedule               a               time               for               the               client               to               meet               and               talk               with               a               CMTM               member.

This               purpose               should               be               expressed               professionally               and               clearly.

Try               to               schedule               exactly               with               who,               when               and               where               the               client               would               like               to               meet.

Just               for               good               measure,               you               may               also               want               to               have               the               client               repeat               scheduling               information.

The               client               should               also               know               to               call               the               CMTM               if               it               turns               out               that               the               client               will               not               be               able               to               make               the               appointment.

This               encourages               the               client               to               set               a               specific               time               to               meet               the               CMTM,               and               it               also               helps               the               CMTM               prioritize               their               duties.
               Many               times,               outreaching               is               not               so               quick               and               easy               as               having               a               phone               conversation               with               the               client.

After               all,               one               reason               you               may               have               been               asked               to               outreach               is               because               the               client               has               been               unreachable               for               so               long.

You'll               find               that               often               times,               the               client               doesn't               pick               up               the               phone.

Some               clients               won't               answer               the               call               unless               you               leave               a               message               on               their               answering               machine.

This               is               why               you               should               always               leave               a               voice               message               when               you               call.
               One               thing               to               mindful               of               when               leaving               voice               messages               is               that               many               Housing               Works               clients               are               concerned               about               their               HIV/AIDS               status               being               disclosed.

There's               a               chance               that               someone               other               than               the               client               may               be               able               to               listen               to               the               messages               left               on               the               answering               machine.

Perhaps               that               someone               doesn't               know               that               the               client               is               living               with               HIV.

Moreover,               it's               possible               that               person               knows               what               Housing               Works               as               an               agency               does               and               so               will               be               able               to               figure               out               that               the               client               is               living               with               HIV               if               he/she               learns               from               the               answering               machine               that               Housing               Works               has               contacted               the               client.

For               these               dangerous               possibilities,               you               do               not               want               to               leave               a               voice               message               stating               that               you're               calling               from               Housing               Works.

It's               better               instead               to               introduce               yourself               as               a               representative               of               the               case               manager               and               the               case               management               technician.
               When               I               left               voice               messages               on               a               client's               answering               machine,               I               usually               said               something               like,               "Hi,               my               name               is               David               Kwon,               and               I'm               calling               on               behalf               of               Ms.

H____               [the               CM].

We               haven't               talked               to               you               in               a               while               and               was               wondering               what               was               going               on.

Please               call               her               when               you               hear               this               message.

As               always,               you               can               contact               her               at               (212)966-0466               ext.

#___.

Again,               that's               (212)966-0466               ext.

#____.

Thank               you               and               we               hope               you're               doing               well."
               Of               course,               all               this               is               assuming               that               the               client               has               a               functioning               answering               machine.

Well,               this               is               also               assuming               that               the               client               has               a               phone               number               at               which               he/she               can               be               reached.

Unfortunately,               for               a               good               amount               of               clients               that               haven't               been               seen               by               the               CMTM               in               a               while,               these               assumptions               will               not               be               correct.

When               this               is               the               case,               you               will               have               to               try               other               ways               to               contact               the               client,               which               include               phone               call               to               the               client's               primary               care               physician,               e-mail,               snail               mail,               home               visit,               visiting               the               client's               methadone               clinic,               etc.
               The               next               best               thing               to               a               phone               call               is               e-mail.

When               I               was               an               intern               in               Housing               Works,               neither               the               pre-screening               form               nor               the               intake               form               asked               for               the               prospective               client's               e-mail               address,               but               when               I               conducted               these               two               procedures,               I               always               made               sure               to               ask               of               it.

It               is               very               possible               for               a               person               to               not               have               a               phone               number               or               a               place               of               residence,               and               have               e-mail               as               the               only               means               of               contact.

For               some               clients,               you               don't               necessarily               have               to               go               out               of               the               office               to               outreach               to               a               client               that               can't               be               reached               on               the               phone;               you               can               simply               send               them               an               e-mail               their               way.

One               of               the               advantages               of               this               kind               of               communication               is               that               unlike               leaving               voice               messages               on               the               answering               machines,               you               don't               have               to               hide               your               association               with               Housing               Works.

E-mail               is               a               private               form               of               communication               and               a               user's               internet               inbox               is               accessible               only               to               that               individual.

In               that               sense,               it               can               perhaps               be               more               comfortable               way               to               contact               the               client.

The               downside               however               is               that               it               may               take               some               time               for               the               client               to               respond.

There's               also               the               possibility               that               the               client               may               never               respond               back               via               e-mail.

So               even               when               you               send               a               message               to               the               client's               e-mail               address,               you               will               most               likely               still               have               to               outreach               in               other               ways.
               Just               as               outreaching               is               easy               if               you               know               the               client's               phone               number,               it               is               likewise               easy               when               you               know               where               the               client               can               be               reached.

If               you               know               that               the               client               is               currently               in               a               transitional               housing               unit               in               Bowery               for               example,               then               you               can               go               there               and               meet               the               client               at               his/her               residence.

This               can               be               a               really               awkward               experience               especially               if               you               and               the               client               have               never               seen               each               other               before.

Some               clients               may               not               be               very               receptive               to               you.

Still,               meeting               these               clients               is               still               very               helpful               to               the               CMTM               and               ultimately               to               the               client,               because               your               actions               will               link               the               client               to               the               CMTM.

Just               as               with               any               interaction               you'll               have               with               a               client,               introduce               yourself               honestly               and               respectfully,               representing               the               CMTM               in               a               professional               manner.

Be               concise               and               straightforward.

Be               willing               to               listen               if               the               client               wishes               to               talk.

As               with               the               phone               conversation               however,               your               role               in               outreaching               is               very               definite               -               to               schedule               a               time               and               location               for               the               client               to               meet               with               the               CMTM.

Remember               that               the               appointment               doesn't               always               have               to               be               at               the               Housing               Works               office,               but               at               the               client's               residence               if               the               client               so               wishes.

You               want               to               leave               knowing               for               certain               that               the               client               knows               the               appointment               time               and               that               the               client               knows               how               to               contact               the               CMTM.

For               this               you               may               want               to               write               that               information               down               and               hand               it               to               the               client.
               Sometimes,               the               client               won't               be               home               when               you               get               there,               but               again,               at               least               you               know               where               the               client               is               staying               and               can               therefore               leave               some               kind               of               mark               to               let               the               client               know               that               you               were               there,               that               the               CMTM               is               expecting               to               meet               with               the               client.

This               mark               is               usually               the               outreach               letter               you               can               take               with               you               and               leave               in               the               client's               mailbox               or               underneath               the               door               of               the               client's               residence.

The               outreach               letter               is               a               very               basic               document               that               addresses               the               client               that               the               CMTM               has               been               trying               to               reach               and               is               desiring               to               talk               and               meet               with               him/her.
               But               of               course,               what               if               you               have               no               way               of               contacting               the               client               and               also               don't               know               where               the               client               is               currently               staying               at?

This               can               pose               a               rather               frustrating               challenge,               but               outreaching               is               still               not               impossible.

First,               check               the               client's               HIPAA               consent               form
               .This               important               document               records               the               people               and               the               organizations               the               client               has               allowed               the               CMTM               to               contact               and               share               information               with.

These               can               include               the               client's               HASA               worker,               the               client's               social               worker,               the               client's               primary               care               physician,               the               client's               brother-in-law,               etc.

Most,               if               not               all               the               people               listed               in               that               form               will               not               be               willing               to               disclose               information               about               the               client               nor               even               their               association               with               the               client               unless               they're               ensured               that               they're               listed               on               the               HIPAA               form.

That's               why               you'll               most               likely               need               to               meet               them               in               person               and               show               them               the               copy               of               the               HIPAA               form.

Once               that               necessary               formality               is               out               of               the               way,               you               will               want               to               find               out               if               they               know               anything               about               the               client's               whereabouts               and/or               status.
               If               it               turns               out               that               the               client               has               regular               contact               with               them,               you               should               ask               that               they               let               the               client               know               that               Housing               Works               is               wanting               to               meet               with               the               client.

Try               to               leave               some               kind               of               physical               mark               behind               to               the               person,               like               an               outreach               letter               to               the               client.

It's               also               a               good               idea               to               hand               your               contact               info               to               the               person               you               talked               with.

After               all,               even               after               all               this               there's               still               a               chance               that               the               client               will               not               contact               the               CMTM               so               try               to               establish               a               good               professional               relationship               with               the               person               that               was               approved               of               in               the               client's               HIPAA               consent               form               so               that               you               can               contact               them               regularly.

This               way,               when               they               meet               with               the               client,               they               can               update               you               and               the               CMTM               of               the               client's               current               status.
               You'll               want               to               try               whatever               you               can               to               link               the               client               to               the               CMTM               but               the               one               final               possibility               is               that               outreaching               may               ultimately               may               not               be               successful.

I               can               personally               recount               the               times               when               the               client               was               finally               deemed               to               be               "lost               to               follow-up
               "               after               the               CFW               and               I               visited               the               client's               methadone               clinic               several               times               and               being               unable               to               locate               her.

I               was               able               to               collaborate               frequently               with               one               of               the               case               managers               at               the               clinic               that               saw               the               client,               but               because               the               client's               visits               to               the               clinic               was               so               infrequent               and               random               that               the               CMTM               ultimately               wasn't               able               to               meet               with               her               and               the               client's               case               had               to               be               closed.

For               clients               without               a               telephone               or               an               e-mail               address,               it               definitely               can               be               hard               for               the               CMTM               to               follow-up               with               them               regularly               and               it               is               definitely               possible               for               a               client's               case               to               be               closed               because               the               CMTM               couldn't               contact               the               client.

It               can               be               a               frustrating               experience               but               since               those               former               clients               can               always               come               back               and               reopen               their               cases               (as               long               as               they're               eligible               for               the               services),               it's               not               the               end               of               the               world               for               the               case               to               be               closed.
               Outreaching               is               a               simple               task               in               which               you'll               be               clear               of               exactly               what               your               role               is               but               it's               nonetheless               a               very               important               one,               as               you'll               be               acting               as               a               brokering               force               between               the               client               and               the               CMTM,               linking               the               two               together.

It               can               sort               of               force               you               into               awkward               situations,               particularly               when               the               client               has               never               spoken               to               you               before,               but               as               with               pre-screening,               this               duty               gives               you               the               opportunity               to               introduce               yourself               to               the               client               and               come               to               learn               about               them               and               their               situations               directly.

The               act               of               outreaching               itself               is               also               a               great               learning               experience,               as               it               requires               you               to               effectively               apply               and               utilize               the               limited               information               you               have               about               the               client.

More               than               that,               it               may               also               require               you               to               collaborate               your               efforts               with               other               people               or               organizations               that               may               know               the               client's               whereabouts               and/or               status.
               Like               outreaching,               your               other               duties               to               the               client               also               has               you               acting               as               a               sort               of               a               broker               for               the               client.

When               you               outreach               those               clients               nearly               lost               to               follow-up,               you               are               essentially               linking               the               client               to               the               CMTM.

In               a               similar               manner,               when               you               escort               the               client,               you               are               linking               that               client               to               the               person(s)               the               client               will               be               meeting               with,               such               as               the               client's               HASA               worker,               the               representative               at               the               Medicaid               office,               the               physician               in               Housing               Works               Medical,               etc.
               The               client               most               likely               will               be               visiting               these               places               and               meeting               with               the               people               there               for               the               first               time.

If               not,               maybe               the               client               feels               that               your               presence               as               a               Housing               Works               representative               would               really               support               them.

Or               perhaps               the               CMTM               feels               that               the               client               will               be               more               motivated               to               meet               the               appointment               if               you               went               to               that               appointment               with               the               client.

Whatever               the               case               may               be,               there               will               be               times               when               you               will               be               escorting               your               client               to               where               he/she               needs               to               go.
               As               with               everything,               preparation               is               important,               particularly               so               if               you               have               personally               have               never               been               to               the               place               where               you               will               be               escorting               your               client               to.

Before               heading               out               of               the               office,               you               must               know               with               absolute               certainty               exactly               where               you'll               be               going               to.

Use               an               Internet-enabled               computer               in               the               office               to               determine               which               subway               train               or               bus               you'll               be               taking               to               get               to               your               location               and               the               exact               walking               directions               to               your               destination.

Write               these               directions               down,               or               print               them               out.

You               shouldn't               rely               on               your               memory               for               this               information.

It's               always               better               to               be               safe               than               to               be               sorry.

The               resources               I'd               recommend               for               path-finding               are               Google               Map               (maps.google.com)               and               Hop               Stop               (hoptstop.com).
               Often               times,               you               won't               be               able               to               predict               when               you'll               be               asked               to               escort               a               client.

A               client               may               come               into               the               office               to               meet               the               CMTM,               and               the               client               consequentially               being               referred               to               the               client's               HASA               worker.

You               may               then               be               asked               the               client               to               go               with               the               client               to               the               HASA               office,               given               that               you               don't               have               something               more               urgent               to               do               at               that               time.

In               these               abrupt               instances,               if               you               choose               to               agree               to               escort               the               client,               first               meet               with               the               client               (and               introduce               yourself               if               this               is               the               first               time               meeting               the               client),               explain               where               the               client               will               be               going               and               for               what               purpose,               and               then               communicate               to               the               client               that               you               will               need               a               short               moment               to               prepare               for               the               trip.

Politely               ask               the               client               to               wait               in               the               waiting               room               for               a               few               moments               and               then               you               can               take               some               time               to               make               sure               you               get               acquainted               with               the               client's               situation               and               issues               (look               through               the               client's               charts,               or               through               the               cheat               sheet               summary               if               you               formulated               one               regarding               this               client)               and               to               figure               out               how               to               get               to               where               you'll               be               going.
               There               are               of               course               times               when               your               escorting               of               a               client               is               planned               from               the               beginning.

In               this               case,               you               can               make               all               the               necessary               preparations               before               the               date               and               time               that               you               have               scheduled               for               escorting               the               client.

I               would               advise               you               to               outreach               to               the               client               a               few               days               before               the               appointed               date               so               that               the               client               is               aware               of               the               scheduled               date               and               does               not               forget               about               the               appointment.

This               of               course               may               be               difficult               if               the               client               doesn't               have               a               reachable               phone               number.

or               an               e-mail               address.

In               that               case,               you               just               may               not               be               able               to               outreach               to               the               client.

However,               if               you               have               the               time,               it               might               be               a               good               idea               to               go               and               visit               the               client               to               remind               him/her               of               the               appointment.
               The               starting               point               of               escorting               is               usually               the               Housing               Works               office.

Some               times               though,               you               may               find               it               beneficial               for               the               client               to               start               the               journey               at               his/her               residence.

The               more               uncertain               you               are               of               the               client's               willingness               and/or               ability               to               get               to               his/her               appointment               on               his/her               own,               the               wiser               it               is               to               schedule               your               meeting               at               the               client's               residence.

On               the               appointment               day,               get               to               the               meeting               location               ten               minutes               early               just               in               case.

As               stated               before,               preparation               is               important               so               make               sure               to               be               knowledgeable               about               where               the               client               is               going               and               what               the               client               should               expect.

By               escorting               the               client,               you               act               as               a               support               to               the               client,               as               the               client's               representative,               as               the               client's               guide               to               the               planned               destination.
               You               don't               necessarily               need               to               do               any               specific               duty               while               escorting               the               client.

You               don't               need               to               conduct               an               assessment               interview               or               anything               of               the               sort.

There               is               no               detailed               script               to               follow,               nor               a               clearly               defined               role               to               assume               in               this               stage.

All               that               is               expected               of               you               during               the               train               ride               to               the               destination               is               to               provide               reassuring               and               optimistic               support               to               the               client,               genuinely               listening               to               any               concern               the               client               may               have,               and               engaging               in               an               empathic               conversation.

You               will               likely               end               up               learning               a               great               deal               about               the               client               and               even               gain               the               client's               confidence.

That's               what               makes               escorting               such               a               great               opportunity               for               you               as               a               social               work               intern.

However,               make               it               your               goal               to               not               be               confused               with               your               role               here;               you               are               not               the               client's               friend,               but               a               representative               of               the               client's               CMTM.

Do               not               ever               forget               that               role               distinction.
               When               you               and               your               client               arrive               at               the               destination,               you               will               assume               a               slightly               altered               role               -               that               of               a               client's               advocate,               representing               the               client's               interests.

You               become               the               client's               professional               voice,               a               guide               should               the               client               not               know               how               to               explain               why               he/she               is               there,               and               an               empowering               force               should               the               third               party               involved               doesn't               take               the               client               seriously.

In               a               way,               you               are               an               agent               of               the               client's               will               and               by               that               same               token,               you               are               the               client's               translator.

You               enforce               onto               the               third               party               what               it               is               that               the               client               wishes               from               them               and               then               you               explain               empathically               to               the               client               the               third               party's               response.
               The               biggest               struggle               to               overcome               during               this               process               is               your               own               bias.

From               the               time               you               started               on               your               escorting               journey               to               the               second               you               arrived               at               the               destination,               your               knowledge               of               the               client's               issues               was               based               on               the               conversation               you               had               with               the               client.

Up               to               this               point,               you               only               know               the               client's               perspective               of               the               story.

Do               not               be               surprised               to               be               find               that               the               third               party               you               come               to               meet               has               a               different               version               of               the               story               than               the               one               the               client               has               told               you.
               For               example,               I               once               escorted               a               client               to               his               HASA               caseworker.

The               client               wished               to               be               transferred               to               a               different               SRO
               because               he               felt               very               unsafe               in               his               current               placement               in               a               hotel               room.

In               fact,               for               the               past               two               weeks,               he               had               chosen               to               sleep               on               the               streets               and               live               as               a               homeless               person               because               he               felt               that               the               streets               were               safer               for               him               than               the               hotel.

He               believed               that               there               was               a               man               who               followed               him               around,               occasionally               entering               his               hotel               room               to               disturb               him               in               the               bathroom.

When               I               relayed               all               this               to               the               client's               HASA               worker,               the               HASA               worker               said               he               wished               to               speak               to               me               privately.

The               HASA               worker               showed               me               a               report               made               by               the               client's               social               worker,               which               stated               that               the               client               had               a               history               of               cocaine               use.

The               HASA               worker               then               told               me               that               the               client               was               delusional               and               suffering               from               the               effects               of               illicit               drugs,               and               thus               would               suffer               the               same               issues               if               he               were               to               be               placed               in               a               new               SRO.

The               HASA               worker's               statements               were               very               different               from               the               client's               telling               of               his               issues.

He               had               after               all               adamantly               told               me               that               he               had               only               done               cocaine               when               he               was               very               young               and               that               he               had               only               met               his               social               worker               once               in               his               life               for               a               psychiatric               evaluation.
               I               was               personally               biased               for               the               client               and               against               the               HASA               worker.

Dislike               of               the               agency               known               as               HASA               was               an               undesired               side-effect               of               being               an               intern               in               Housing               Works.

This               bias               made               me               want               to               investigate               deeper               into               this               discrepancy               between               the               social               worker's               report               and               the               client's               account.

But               I               made               sure               not               to               do               this               when               I               remembered               that               my               reason               for               coming               to               the               HASA               office               was               to               escort               the               client               here               and               to               act               as               the               client's               advocate.

I               was               not               a               journalist,               not               a               muckraker.

Thus,               after               listening               to               what               the               HASA               worker               had               to               say,               I               relayed               this               back               to               the               client               and               asked               how               the               client               would               like               to               proceed.

The               client               still               wished               to               transfer               to               a               different               SRO               so               I               went               back               to               the               HASA               worker               and               asked               what               it               would               take               for               the               client               to               be               considered               for               a               transfer.

The               HASA               caseworker               persistently               advised               against               doing               such               a               thing,               but               ultimately               told               me               that               the               client               will               have               to               apply               to               close               his               current               placement               and               come               back               to               the               HASA               office               after               that               closure.
               If               I               had               acted               on               my               bias,               I               most               likely               would               have               started               a               dispute               between               the               HASA               caseworker               and               the               client.

Perhaps               it               could               be               argued               that               such               a               dispute               would               have               been               necessary               to               clear               up               the               miscommunication               between               the               client               and               the               worker,               and               while               I               see               that               argument               as               potentially               valid,               I               felt               it               wiser               to               be               more               practical               about               the               matter,               and               to               stay               true               more               to               my               role               as               a               social               work               intern               than               to               my               emotions.
               After               thus               advocating               for               the               client,               you               should               ask               the               client               if               he/she               wishes               to               be               escorted               back.

The               client               may               want               to               go               back               to               the               Housing               Works               office               or               may               need               to               go               back               home.

In               the               case               of               the               client               needing/wanting               to               go               back               to               the               office,               escorting               the               client               back               is               a               rather               natural               thing               to               do.

In               the               other               case               of               the               client               wanting/needing               to               go               somewhere               else,               you               can               simply               offer               if               he/she               would               like               to               be               escorted               back.

If               you               feel               assured               that               the               client               will               safely               be               able               to               go               back,               it'll               be               easy               for               you               to               agree               should               the               client               decide               that               he/she               doesn't               need               your               assistance               with               the               return               trip.

If               you               feel               strongly               that               the               client               needs               your               escorting               back,               you               can               politely               insist               that               you               go               with               them.
               Once               you               return               to               the               office               from               having               escorted               the               client,               document               the               event               in               the               form               of               a               Progress               Note.

You               may               also               want               to               jot               down               some               of               the               important               things               that               happened               just               so               that               you               don't               forget               to               communicate               it               later               to               the               CMTM.

If               some               things               that               happened               trouble               you               -               such               as               your               bias               towards/against               client               affecting               your               advocacy               for               the               client               -               you'll               also               want               to               talk               it               over               with               your               supervisor               during               your               supervision               session.
               In               regards               to               the               example               I               gave               about               the               discrepancy               between               the               story               of               the               client               wanting               an               SRO               transfer               and               the               report               of               the               client's               social               worker,               I               talked               with               the               CMTM               in               detail               about               it               and               then               talked               about               it               with               my               supervisor               during               the               supervisory               session               with               her.

Talking               with               the               CMTM               let               the               CMTM               know               of               the               client's               situation               while               talking               with               my               supervisor               helped               me               better               understand               my               role               as               a               social               work               intern.
               In               many               other               situations,               you               will               be               referring               the               client               to               an               appropriate               resource               or               a               service               provider.

Principally,               you               are               still               acting               as               a               broker               for               the               client.

When               you               were               outreaching,               you               were               actually               linking               the               client               to               his/her               case               management               team.

In               the               same               vein,               by               providing               referrals,               you               are               linking               the               client               to               an               appropriate               resource.
               Some               examples               of               providing               referrals               are:
               -helping               to               allow               the               client               to               use               Housing               Works               clothing               voucher
               -handing               out               to               the               client               an               informative               list               of               free               HIV               clinics               located               around               the               client's               place               of               residence
               -connecting               the               client               to               a               mental               health               counselor
               More               so               than               outreaching,               escorting,               or               advocating,               preparation               is               the               biggest               and               the               most               important               component               of               referring.

To               provide               appropriate               choice               of               referrals               to               a               client,               you               must               inevitably               spend               a               good               amount               of               time               and               effort               in               researching               the               best               resources               for               the               client.

You               would               no               longer               be               just               representing               the               CMTM               or               the               client,               but               aiding               the               client               to               choose               other               resources               and               service               providers               that               would               best               serve               the               client.
               For               certain               referrals               you               can               make               sure               to               always               be               prepared.

When               I               was               an               intern,               I               was               able               to               create               a               big               folder               in               which               I               kept               all               my               research               on               resources               the               clients               could               use.

This               included               an               informative               list               of               food               pantries               and               clothing               drives,               categorized               by               which               borough               of               the               city               they               were               located               in.

The               lists               contained               information               such               as               the               name               of               the               organization               providing               the               housing               pantry/clothing               drive,               the               eligibility               criteria,               the               exact               address               of               the               event,               the               kind               of               services               provided,               and               contact               information               (phone               number               and/or               e-mail               address).

Contained               also               in               my               blue               folder               were:               lists               of               free               HIV               clinics               in               all               boroughs               of               NYC,               lists               of               housing               programs               for               the               formerly               incarcerated,               lists               of               COBRA               case               management               programs               in               NYC,               lists               of               job               training               centers,               lists               of               MediCaid               centers,               and               lists               of               the               different               departments               of               Housing               Works.
               Preparing               all               this               might               sound               like               too               much               work               and               be               too               time-consuming,               but               most               of               these               lists               are               already               compiled               by               government               websites               and               by               non-profit               organizations.

If               you               use               the               right               key               words               in               search               engines               like               Google,               you'll               find               large               lists               available               for               download               and               print.

For               list               of               food               pantries,               type               in               "food               sources"               along               with               a               NYC               borough               like               "Manhattan"               and               "Queens"               and               the               first               search               result               will               usually               be               a               .pdf               file               formulated               by               nyc.gov.

For               example,               type               in               "manhattan               food               sources"               and               you'll               be               able               to               find               this               link:               http://www.nyc.gov/html/dhs/downloads/pdf/crh_food_ny.pdf.

You               could               find               similar               lists               for               "clothing               sources"               and               "free               clinics               health               services."               There               are               many               other               sources               to               turn               to               for               such               helpful               lists,               such               as               nycfoodbank.org               and               NYC               AIDS               Housing               Network.

Searching               these               files               individually               and               printing               them               out               might               end               up               somewhat               tedious               but               it               shouldn't               end               up               to               be               too               time-consuming.
               When               you               give               these               lists               to               interested               clients,               give               out               a               copy               (utilize               the               copy               machines               in               the               office               if               you               don't               have               any               more               extra               copies),               not               the               original               version.

Having               access               to               all               the               resources               you               have               compiled               so               far               at               any               time               will               allow               you               to               be               more               efficient.

Though               it               may               be               a               hassle               to               always               have               to               use               the               copy               machine               every               time               you               find               a               client               that               is               interested               in               one               of               your               referral               lists,               that               hassle               is               comparatively               less               time-consuming               than               having               to               look               up               that               resource               and               print               it               out               once               again               for               future               use.
               The               great               thing               about               the               lists               of               resources               is               that               they               offer               the               clients               with               lots               of               options               to               choose               from.

They               are               not               forced               to               choose               one               service               provider,               granting               the               clients               the               right               to               self-determination.

Granting               this               right               to               the               clients               makes               you               the               clients'               empowering               advocate,               not               their               boss.

At               the               same               time,               this               right               can               be               too               burdensome               for               many               of               the               clients.

That's               why               referring               is               never               as               simple               as               handing               clients               a               stack               of               informative               papers.

It               may               begin               with               such               a               simple               action,               but               the               right               kind               of               referral               is               all               about               guidance               and               follow-up.

It's               wrong               to               tell               the               client               what               to               choose,               and               instead               you               want               to               educate               the               clients               about               what               resources               would               be               great               to               consider               and               also               to               support               however               you               can               to               link               the               clients               to               whatever               resource               they               have               chosen               to               utilize.
               This               is               why               research               for               appropriate               referrals               is               ongoing.

Take               the               time               to               learn               more               about               the               resources               listed               in               the               agencies.

If               you               have               time,               call               some               of               them               and               ask               about               how               they               provide               services               and               what               they               do.

You               can               even               visit               them               to               learn               more.

Do               this               especially               for               resources               that               the               clients               are               hesitant               but               curious               about.

Knowing               more               about               your               referral               sources               makes               you               better               able               to               educate               and               support               the               clients.
               After               the               clients               choose               which               service               provider               they               would               like               to               seek               aid               from,               follow-up               with               them               on               what               happened.

You               want               to               be               asking               if               they               found               what               they               were               looking               for               when               they               got               there.

Even               a               referral               that               seemed               perfect               for               the               clients               may               end               up               unsatisfactory,               but               that's               okay               because               what               matters               is               that               you               continue               to               help               the               client               get               linked               to               a               service               provider               that               is               the               right               fit               for               them.
               This               principle               -               respectful,               empowering               guidance               and               ongoing               follow-up               to               referrals               -               is               all               the               more               crucial               when               referring               the               clients               to               service               providers               that               would               be               beyond               your               general               lists               of               resources.

The               referrals               in               those               lists               mostly               showcase               providers               that               satisfy               immediate               and               short-term               needs,               such               as               ones               that               hand               out               winter               clothes               or               clinics               that               offer               free               HIV               testing.

It's               easy               to               research               lists               of               such               providers               but               then               there               are               cases               such               as               when               a               client               may               need               to               be               referred               to               a               program               that               helps               people               with               substance               abuse               issues.

In               another               case               a               client               may               want               to               be               linked               to               a               mental               health               counselor.

To               develop               a               similar               list               for               these               kinds               of               resources               will               most               likely               take               more               time               and               effort.

This               is               why               when               you               are               tasked               with               providing               such               referrals,               you               probably               will               not               have               a               ready-made               list               to               hand               to               a               client.
               In               most               cases,               this               lack               of               preparation               is               actually               not               a               bad               thing.

Clients               needing               long-term               referrals               often               have               a               very               good               idea               of               which               service               provider               they               want               to               be               linked               with.

They               will               most               likely               be               much               more               informed               than               you               about               the               resources               they               want               to               be               linked               to.

These               referrals               aren't               about               formulating               the               most               perfect               lists,               but               about               guidance,               brokering,               and               constant               follow-up.
               Find               out               how               to               link               the               client               to               provider               you               want               to               refer               the               client               to.

Utilize               all               the               tools               at               your               disposal               (Internet,               staff,               your               supervisor)               to               research               the               referral.

You               should               also               contact               the               provider               (phone               is               probably               the               best               way,               though               you               can               try               e-mailing               as               well)               and               really               learn               all               the               steps               necessary               to               refer               to               client               to               there.

You               may               need               to               escort               the               client               to               the               provider's               site               and               advocate               on               behalf               of               the               client.

Finally,               after               the               client               has               been               referred               to               a               provider,               try               your               best               to               follow               up               on               that               referral.

Try               to               determine               how               satisfactory               the               referral               ended               up               for               the               client,               and               if               not,               you'll               need               to               start               this               process               from               the               beginning,               researching               more               appropriate               referrals,               linking               the               client               to               that               referral,               and               continuing               to               follow               up               on               that,               until               you               can               deem               that               the               referral               ended               out               to               be               satisfactory.
               In               order               to               be               great               at               referring,               you               really               need               to               become               great               also               at               the               three               duties               (you               can               consider               them               as               skills               as               well)               I               mentioned               previously               -               outreaching,               escorting,               and               advocating.

It's               a               challenging               task               that               really               requires               for               the               whole               case               management               team               to               be               on               the               same               page.

Communication               is               crucial.

Always               keep               the               CMTM               on               the               loop               of               what               you're               doing               and               how               you're               doing               to               make               this               referral               happen.

On               that               same               line               of               thought,               also               always               try               to               be               in               the               loop               of               what               the               CMTM               is               doing               and               thinking               about               the               referral.

Try               your               best               to               keep               the               clients               aware               of               what               you               and               the               CMTM               are               doing               to               help,               which               will               keep               the               clients               on               the               same               page               as               you               and               the               CMTM.

Keep               a               good               rapport               with               the               referral               source               so               that               you               can               easily               conduct               follow-up               activities               after               the               client               has               been               referred.
               Lastly,               seek               the               assistance               of               the               program               director               when               serious               challenges               come               up               with               a               referral(and               trust               me,               they               will).

While               this               guide               tells               you               what               you               generally               need               to               do               in               order               to               be               great               at               referring               clients               to               other               service               providers,               it's               the               program               director               that               can               offer               you               practical               advice               in               particular               situations.
               Written               like               this               on               paper,               I               get               the               feeling               that               these               duties               sound               complex               and               hard,               but               I               can               promise               you               that               you               will               really               begin               to               get               a               good               feel               for               these               duties               the               more               you               do               them.

The               staff               members               and               the               clients               themselves               will               help               you               immensely               along               the               way.

Just               as               you               are               an               advocate               for               the               clients,               so               they               will               also               end               up               to               being               a               great               support               network               and               sources               of               knowledge               for               you.

Many               of               the               staff               members               are               used               to               doing               the               exact               same               tasks               that               you               will               be               learning               to               do               so               even               if               you               forget               a               lot               of               what               you               just               read               in               this               section,               you               will               constantly               be               surrounded               by               living,               breathing               guides               whom               you               can               follow               and               be               supported               by.






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