Day 2
Warm-up Activity
Lotus Bingo
Review
Homework
My Plan Worksheet (page 6)
Day 2
A-B-C’s
of
Peer Advocacy
A = advocacy
B = believing in what you do
C = concepts to address the
challenges of peer advocacy
What are Challenges of Peer
Advocacy?
Challenges of Peer Advocacy
• Have to wear many hats
• It’s personal
• Knowing how to take care of
ourselves
• Countertransference
• Wanting to do everything
• Working with difficult
providers
• Not enough funding for jobs
4
concepts to Address
challenges of Peer Advocacy
1.Communication
2.Confidentiality
3.Countertransferance
4.Creating Boundaries
Barbara – Peer Advocate
Sonya (client)
Cindy – Social Worker
Barbara’s Case Study
(page 10-11)
Barbara’s Case Study
• Barbara is a peer advocate living with HIV.
• Sonya has recently tested positive for HIV (not an AIDS
diagnosis) and was referred to Barbara by a social worker
at a local medical clinic.
• Cindy, the social worker is Sonya’s social worker and
refers her clients to Barbara when they need a peer
advocate and the two of them sometimes coordinate care
for their mutual clients. Cindy is also Barbara’s
personal social worker—and to this day helps Barbara
with some matters. Barbara and Cindy are therefore, in
two different kinds of relationships. Cindy is Barbara’s
social worker, and the two of them are also colleagues.
The Many Hats Barbara Plays
Peer Advocate
Client
Resource provider
Employee
Co-worker
Educator/Teacher
Listener
Questioner
Assures
confidentiality
Supporter
Health advocate
FIRST
Communication
WHAT
DO
YOU
SEE?
WHAT DID
YOU SEE?
Cash Register Story
Page 12
•Read the story with your
neighbor.
•Answer the questions together.
• 3 minutes.
Cash Register Story Answers
• Answers:
– #6 True
– #3 False
– The rest are all Don’t Know
• We make many assumptions
to fill in the blanks.
• Need to communicate to get
the story right!
How Do We
Communicate?
Good Communication
1.
Eyes – see other’s facial
expressions, make eye contact
2. Ears –concentrate on what is
being said; Be impartial and don't
form an opinion, just listen.
3. Mouth – reflect back, summarize
what has been said.
4. Mind- to soak it all in and
brainstorm ideas.
Communication Skills (Pg 13)
1. Affirming
2. Open ended questions
3. Active Listening
4. Nonverbal Messages
5. Express Thoughts and
Feelings
6. Communicate Without
Making Other Feel
“Wrong”
Affirming
A positive confirmation.
Providing support and encouragement.
What is an example???
Affirming Statements
“That’s good.”
“I’m glad you asked that.”’
“You’ve come to the right place.”
“That’s a great question.”
“You’re on the right track.”
“You really seem to have given this
a lot of thought.”
Open-ended Questions
Questions that cannot be answered with a
yes or no.
Open-ended Questions
Always ask…
Stay away from:
•
•
•
•
•
•
•
•
•
•
•
When
Where
How
Who
Why
Tell me more
Could you
Would you
Should I
Can you
Do you
Active Listening
•
Using your eyes, ears, mouth, and body
language to listen.
•
Name the feeling the client is having…
“you seem ______ (upset/frustrated/sad)”
etc.
•
We let the person know its okay to have
feelings; permission to express and let feeling
go, so she can hear the information we are
giving.
Nonverbal Messages
Facial expression
Other Nonverbal Messages
Posture
Equal positioning
Gestures
Facial expression
Don’t just notice client’s nonverbal messages
but know that they are watching yours too…
Express Thoughts and Feelings
• Be open and honest
• Speak clearly
• Make the distinction between
facts, beliefs, and feelings.
– “The best medical regimen for
all clients is …” ---don’t say this.
– “I’m so pleased you’ve been
taking your meds.” ---ok to say.
– “Many PLWH experience …”
Communicate
Without Making Others Feel
“Wrong”
• Express concerns
non-judgmentally
• "I" statements
Practicing
Communication
Activity
Break into pairs
Decide who will be #1 and #2
#1 Barbara , #2 Sonya
Barbara will:
– Ask Open-ended
questions to
Sonya
– Respond with
affirming
statements
– Reflect back what
Sonya is saying
and feeling
Sonya will:
- give feedback to
Barbara about her use
of communication
skills.
So Why Is Good
Communication Important
Between Peer and Client?
• Can get the most information about
situation
• Clear up myths vs. facts
• Better understanding
• Builds trust
• So you can do your job well
Next
Page 14, 15, 16
Confidentiality
Shared information that is kept private
between two or more people.
What to Keep Confidential?
•
•
•
•
•
HIV status
Housing
Sexuality
Housing
Others????
Why Should Peers Maintain
Confidentiality?
•
•
•
•
Build trust
Code of Ethics
Rule of organization you work with
You have been there and know how
important it is…
• Others?
Breaking Confidentiality
If the client is:
1. suicidal
–
–
–
–
QPR (question, persuade, refer)
assistance from supervisor
Call 911
1-800-273-TALK – National 24hour hotline
2. threatens homicide
–
assistance from supervisor
3. physically abusing a child or dependant
adult
–
assistance from supervisor
Summary
1.
Confidentiality is an important part of a peerclient relationship
2. Many reasons why a peer advocate must do all
she can to maintain a client’s confidentiality
including building trust, to provide support,
etc.
3. A client may have several things she wants kept
confidential and peer should be mindful about
them.
4. A client’s confidentiality may have to be broken
for her own safety or the safety of others.
What Were Confidentiality
Issues That Came Up in
Barbara’s Case Study?
Next
Countertransference
Page 17, 18
Countertransference
Any thought, feeling, wish, hope or fear that
might come up for a peer advocate, that is
directed towards the client.
What Pushes Your Buttons?
People, Places, and Things:
•
•
•
•
Domestic Violence
Substance Abuse/Use
Co-infection With Hepatitis
Pregnant Client Not Wanting To
Take Meds
• Newly Diagnosed Client’s Fear
• Depressed/Suicidal Client
What Was It For Barbara?
•
She was hurt in a domestic violence
incident
•
She has to be aware that she can’t
get overly afraid for her client.
•
She can’t fear that client might get
hurt in the same way, or to the same
degree that she did.
Strategies to Manage
Countertranference
•
Talk to colleague, supervisor,
therapist
•
Stress reduction activitiesjournal, exercise
•
Re-assess your boundaries
with client(s). Do you need to
spend more or less energy on
this person?
Last
Creating Boundaries
Page 19
Create Boundaries By:
Open communication with clients
Follow through with your promises in a timely
manner
Address your limitations
Seek support from your supervisor
Refer, refer, refer
It is ok to not know.
Don’t feel pressured to share your story each and
every time
Being professional
Putting your personal values aside
Values
What are values?
Where do values come from?
Value Activity – Page 21
1.
Discuss with your group whether you agree or
disagree with the value statements on page 21
and why you feel that way.
(Remember it is not about who is right or
wrong but sharing various view points and
listening to each other.)
2. Discuss the question on the bottom of page 21.
Peer Advocates’ Job…
Provide information and support and
don’t try to change their client’s values .
Personal Stories
Worksheet
Page 20- for you to review.
Worksheet will help peer advocates
tell their stories in an effective way,
without burning out.
Working With Grief
(page 22)
When do we Grieve?
When we have suffered a loss that is somehow
permanent:
•
Being diagnosed with a chronic illness (like HIV)
•
Loss of freedom
•
Break up, divorce
•
Friend who moved away
•
Death
•
Loss of a pet
•
Child who got married
•
Place in our life we had to leave behind
•
Aging…getting older…menopause
Early Stages of Grief
•
•
•
•
•
•
•
•
Shock
Denial/Unreality
Fear
Bargaining
Loneliness
Anger
Shame
Sadness
Later Stages of Grief
As peer advocates we help clients move
through initial crisis to the later stages
where there is :
• Understanding – growth &
positive change.
• Acceptance
• Sense of meaning
• Found purpose
• Wholeness
Grief vs. Depression
Depression:
Grief:
1. Usually temporary 1. Can be long-term feeling
2. Range of emotions 2. Feel only sadness, despair
3. Sense of hopelessness
3. Life will go on
4. Sense of purpose for 4. Feel a lack of purpose
future
5. Need time alone and 5. Only want to be alone
with others
6. Many can work it out 6. Needs professional
on their own
support to work through
Grief Case Scenarios
Activity
page 24, 25
1. In your group read your assigned case
scenario
2. Answer questions 1-7 together
3. Pick 1 person to report back to larger
group
Those that conceals their grief
find no remedy for it…
There is no grief like the grief that
does not speak…
The risk of love is loss,
and the price of loss is grief But the pain of grief
Is only a shadow
When compared with the pain
of never risking love.
Thing we can do to take
care of ourselves…
Self Care Ideas
(pages 26-32)
Stress
•
“a physical, chemical, or emotional
factor that causes bodily or mental
tension and may be a factor in
disease causation.”
•
problems caused by stress? --heart
disease, high blood pressure,
irritable bowel syndrome
•
benefits of stress? --learn coping
strategies, deal with emergencies,
motivates us…
Self Care At Home
What Do You Do?
Self Care Work?
• Take small breaks
• Eat good lunch
• Get support from supervisor,
colleague
• Time management
Self care
can prevent burn out,
reenergize you and keep
you motivated.
Most importantly, if you
are feeling good, you will be
a better peer advocate to
your clients.
Homework
Complete the Self Care Contract Page 33
&
Do 1 self-care activity tonight
&
Write down 2 questions you want to ask the
providers who are coming for the panel
tomorrow.