ENGAGEMENT MODEL:
WHERE RECOVERY IS THE
EXPECTATION!
STEVE MICCIO
Engagement and the Recovery
Model
“How's That Working
For ya?”
ASKING QUESTIONS
• When we come into contact with people that we serve, do these
questions resonate?:
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“Are we asking the people we serve the right question(s)”
“What works with our engagement style?”
“What doesn’t work?”
“Do we invest in and embrace wellness and does it show
in how we engage others?”
• “How Do we Know?” and “How does our
customer know?”
ENGAGEMENT
Engagement signifies that a person is involved
in a process through which he/she
harmonizes robust information and
professional advice with his/her needs,
preferences, and abilities in order to address
health and/or mental health issues.
WHAT IS ENGAGEMENT?
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It is a partnership between you and the person
served.
It is a person being self determined to WANT to
engage in services/help for all of the right
reasons.
It is mutual respect and dignity.
It is reflected in the “hope” that one shows
concerning a person’s ability to recover.
Engagement can deliver the message that
Recovery is the Expectation!
WHAT CAN GOOD ENGAGEMENT DO?
Build trust through genuine interest in a
person’s welfare
Can improve recovery/all health outcomes as
both parties focus on shared/partnered goals
Can decrease fear of “punitive”
action/outcomes/behaviors
Foster self-determination to do something
“different” (meaningful) that may provide a
better outcome
COMPONENTS USED IN USEFUL AND SUCCESSFUL
ENGAGEMENT
• Orientation
• Environment
• Language/Listening/Communication
ORIENTATION
How do we orient people to our services?
Who greets people as they enter your facility?
Is it a trauma informed greeting?
How is/are your service(s) described?
Is the information required explained in a
dignified and respectful way?
• Is the discussion of payment or finances
private and discreet?
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ORIENTATION
• Is a tour given if people enter your office or
facility?
• If in-take is needed, is the process
transparently explained?
• If it is a long in-take process can it be broken
up for the person?
• Is the treatment process or service explained
clearly?
ORIENTATION
• Are expectations discussed?
• Are people given an orientation packet when
first being introduced to the service (health
home, Care Coordination)?
ENGAGEMENT QUESTIONS
When meeting people in community or at the
office does it “feel” inviting and safe?
Is there a choice of where to engage where
people “feel” safe and respected?
What is your engagement style when greeting
someone that you serve?
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Do you say “hello”?
Shake hands, hug?
Are you genuine in your greeting?
LANGUAGE
LANGUAGE
What type of language style is used in your agency?
Using “I” Statements can help with successful
engagement
“I feel confused; help me understand.”
 Rather than: “You’re not making any sense, you’re
confusing me.”
Use Statements that Empower
“What can I do to assist you in your recovery?”
Rather than: “You need to take this medication and
follow this treatment plan and you will feel better.”
LANGUAGE
Use people first language
◦ “We serve people living with mental
illness”
rather than
◦ “We work with mentally ill people or Bipolars or Schizophrenics, etc.”
(Corrigan, 1998)
LANGUAGE… WHAT NOT TO SAY
“I know how you’re feeling”
“You shouldn’t feel that way”
“You should do this….”
“You don’t mean that”
“I know what’s wrong with you or what's wrong?”
“It’ll get better”
“If you would just follow the program…”
LANGUAGE… WHAT TO SAY
“It sounds like you feel …..”
“Please explain more and help me understand
why you feel that way”
“What would you like to do?”
“Here is what I heard you say”
“Tell me what happened to you”
“What is helpful to you in this situation?”
NON-VERBAL
Research suggests that anywhere from 60% to 70% of communication is non-verbal.
(Engleberg, 2006)
Body language: Are you open, arms/legs uncrossed and inviting the person to talk.
Lean in and let the guest know you are interested and not judgmental. Look at the
person. They need to know you care.
Examples of what people report/observe:
 Rolling eyes
 Non-verbal critical body language to other staff
 Staff turning back towards person
 Ignoring person completely
 Threatening stance
 Staff talking about issues amongst one another disregarding the person
NON-VERBAL
Does your body language communicate your
values and beliefs toward recovery?
Do you exhibit fear or assume dangerousness of
people served?
Is there a glass barrier, desk or some object
between you and the person?
PARA VERBAL COMMUNICATION
Communication that encompasses intonation,
cadence, volume, and pace of saying words.
When we are angry or excited, our speech tends
to become more rapid and higher pitched.
When we are bored or feeling down, our speech
tends to slow and take on a monotone quality.
When we are feeling defensive, our speech is
often abrupt.
PARA VERBAL COMMUNICATION
Tone
Volume
Rate of speech
“ I didn’t SAY you were lazy”
“I didn’t say YOU were lazy”
“I didn’t say you were LAZY”
PERSON CENTERED LISTENING
This is a term we use in our agency to describe
our way of listening to one another through
mutuality and the lived experience.
It’s active listening by being fully present and
aware of what someone is saying, feeling,
experiencing and how they are behaving.
It is void of distractions
(Taken from McKay, Davis & Fanning, 1995)
LISTENING STYLES WE AVOID
Comparing: This refers to the constant selfdialogue that happens when the listener
competes with the speaker. Essentially,
listening is being hindered by how much a
person is comparing him/herself to the
speaker.
LISTENING
(TAKEN FROM MCKAY, DAVIS & FANNING, 1995)
Mind-reading: This refers to the listener who cuts
off the speaker in an attempt to speed up the
process or get to the “truth of the matter.” The
fact is we do not know what the speaker is
going to say and we cut them off before they
are done speaking thus not allowing the
speaker’s message to fully come through.
LISTENING
(TAKEN FROM MCKAY, DAVIS & FANNING, 1995)
Rehearsing: This is when we begin to review and
create our response before another person is
done speaking. When we do this we are not
allowing the speaker’s full message to come
through.
Filtering: This is when we only hear part of the
message because we are listening for certain
things. This gets in the way because, again,
we do not hear the full message.
LISTENING
(TAKEN FROM MCKAY, DAVIS & FANNING, 1995)
Judging: This refers to the act of putting labels or judging
people before they speak or even during their
comments. If we do not listen from a neutral standpoint
we again miss the message.
Identifying: This refers to someone who is always referring
back to one’s own experiences while someone is talking.
While it is good behavior to do in order to relate with the
person speaking, if you self-identify too much you
completely miss how that person is feeling in his/her
given situation and you ultimately think about how you
felt.
LISTENING
(TAKEN FROM MCKAY, DAVIS & FANNING, 1995)
•Advising: This refers to actively seeking to “solve”
someone’s problems.
•Sparring and being right: This refers to arguing and
debating with people based on your personal
experiences
LISTENING
(TAKEN FROM MCKAY, DAVIS & FANNING, 1995)
•Placating: This refers to agreeing with everything a
person is saying so that you get approval of the
speaker. If you constantly try to agree with them then
you are not truly listening to them.
•Derailing: This refers to changing the subject being
discussed to another topic because you are either
bored or uncomfortable with the subject.
STRATEGIES FOR ACTIVE LISTENING
Maintain appropriate eye contact
Lean your body forward to show that you are
listening
Avoid fidgeting or external distractions
STRATEGIES FOR ACTIVE LISTENING
Paraphrase the speaker when he or she is
finished speaking
Ask questions to clarify (be genuinely curious)
Listen objectively and keep personal feelings
aside
Expectations
EXPECTATIONS FOR ALL
• When engaging with a person that you serve
do you offer a transparent approach to what
they can expect from your service(s)?
• Do you discuss what you may expect from
them while in your care?
EXPECTATIONS
What to expect from us
• Comprehensive Care
Management
• Care Coordination and health
promotion
• Comprehensive transitional care
from in-patient to other settings,
including appropriate follow up
• Individual and family support
• Referral to community and social
support services
• Open and honest dialogue
What we expect from you
• Open and honest dialogue
• Self determined initiative
• Making every attempt to follow
through on your care plan
• Informing us of challenges and
successes based on your care
plan
• Feedback on the quality of our
services
• Good health and wellness
DECISION MAKING
Do you encourage people to brainstorm on possible
solutions to an issue? (Motivational Interviewing)
Empowerment
Responsibility
Crisis Planning
Self Determination
Quality of life
Center on Adherence and Self-Determination:
http://www.adherenceandselfdetermination.org/
DECISION MAKING
Are you able to be transparent and share your fears,
concerns and possible risks, yet allow the person to
make the ultimate decision?
• What is your perception of Choice?
• Does your engagement influence choice
unconsciously?
• Who really makes the choice(s)?
TRAUMA INFORMED CARE
Do you treat all people as possible victims of
trauma?
Do you understand that some traditional methods of
treatment may exacerbate the symptoms of
people who have experienced trauma?
Are you conscious of Iatrogenic Treatment?
Do you understand that trauma can come from
many sources?
http://mentalhealth.samhsa.gov/nctic/trauma.asp
HOPE
W H Y I S H O P E I M P O R TA N T ?
• H O P E I S T H E B E L I E F T H AT A P O S I T I V E
OUTCOME LIES AHEAD
• H O P E I S A W AY O F T H I N K I N G , F E E L I N G A N D
A C T I N G T H AT M A Y H E L P O N E F I N D W A Y S T O L I V E
W I T H D I F F I C U LT S I T U AT I O N S
• HOPE IS FLEXIBLE AND HOPE CHANGES AS
ONE’S LIFE CHANGES
HOW DO I LEND A VISION OF HOPE?
STEVE MICCIO, CEO
PEOPLE, INC.
STEVEMICCIO@PROJECTSTOEMPOWER.ORG
WWW.PROJECTSTOEMPOWER.ORG
THANK YOU!