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Understanding IPS Fidelity:
SERVICES #14
Assertive Engagement and Outreach by Integrated tx team
Rationale: The reasons people stop attending IPS appointments vary. The goal is to understand what these reasons are and to respond accordingly. ESs work with tx team practitioners and family members to make services accessible to the person.
Some reasons people may miss appointments are memory issues, transportation or babysitting barriers, concerns about loss of benefits, or low expectations for employment. Other reasons may be based in fear or shame.
After two months of unsuccessful (and varied) attempts to re-engage a person, the ES may close the person’s case without negative effects on the rating for this indicator.
The six strategies for engagement and outreach as per IPS:
- Service termination is not based on missed appointments or fixed time limits.
- Systematic documentation of outreach attempts.
- Engagement and outreach attempts made by integrated tx team members.
- Multiple home/community visits
- Coordinated visits by ES with integrated team member(s).
- Connect with family, when applicable.
Coordinated visits with integrated team members mean that practitioners are coordinating visits, not that they are necessarily both present for a client meeting. E.g. A case manager may share they are meeting a client at 2pm allowing the ES to connect with the client in the waiting room before the 2pm meeting.
IPS is an evidence-based practice. As such, IPS Reviewers assess implementation of this fidelity item through sources such as clinical records and agency policies, interviews with agency staff and clients and observations of meetings.
Treatment team reflection questions:
- Have you ever missed an appointment? Why?
- Have you forgotten about a 24 hr. cancellation window for an appointment? Why?
- Have you experienced confusion about the details of an appointment? Why was that?
- Have you ever canceled late due to issues such as illness, transportation, or child/elder care?
- Have you ever "blown off" an appointment for a better option at the time?
- Have you ever felt embarrassed to reschedule a missed appointment?
We're all the same in so many ways.
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