Facilitator s Guide Hoarding

Transcription

1 Facilitator s Guide Hoarding Primary Authors Natasha Amjed, Boston University Wayne LaMorte, Boston University School of Public Health, Professor of Epidemiology Contributing Authors Christiana Bratiotis, Boston University School of Social Work James Feeney, Arlington Health Department, Health Inspector Dion Irish, Boston Public Health Commission Boston Inspectional Services, Assistance Comissioner Gail Steketee, Boston University School of Social Work Special Acknowledgements Advisory committee members of the Local Public Health Institute of Massachusetts for their many contributions to this module Paul Halfmann, Bureau of Environmental Health Community Sanitation Program, Massachusetts Department of Public Health, Assistant Director Disclaimer This training module is brought to you by the Local Public Health Institute of Massachusetts (the Institute) and by the New England Alliance for Public Health Workforce Development (Alliance). The Institute is a Massachusetts Department of Public Health funded entity created to strengthen local public health through training and education. It is managed by the Boston University School of Public Health's Office of Public Health Practice and is supported in part by the Center for Disease Control and Prevention (CDC)'s Grant/Cooperative Agreement Number 5U90TP , Public Health Preparedness and Response for Bioterrorism and the Alliance, funded by the Health Resources and Services Administration (HRSA) from The contents of this module are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the HRSA. The authors of this module have no financial interests or relationships to disclose.

2 Table of Contents Instructions... 3 Teaching Tips... 4 Webpage Webpage Webpage Webpage Webpage of 11

3 Facilitator s Guide This is an online learning tool that can be accessed anytime for independent learning at: However, in order to meet the training needs of a variety of audiences across Massachusetts, this Facilitator s Guide (Guide) has been designed to assist with a group-based delivery in flexible time segments. Please note that the Guide provides suggestions and guidelines for how to conduct the training. Each facilitator can adapt the guidelines and/or incorporate his or her own training methods to best meet the needs of any given group who will partake in this training module. Two options for a facilitator-led training are available: 1. Access via high-speed internet 2. Access via CD. A CD is available if you do not have high speed internet access to the online module. To request a copy of this training on CD, please contact the Local Public Health Institute of MA at lphi@bu.edu. For either option, move through the module by following the Table of Contents. Use the scroll bar on the righthand side to move up and down the page. Click on next page or a page number to move between pages. The course contains multiple webpages with subject content, links to other websites, activities and exercises, and video clips. You should discuss all of the content, play the videos, and conduct the activities and exercises. You should also illustrate some of the links and resources, as time allows. Be sure participants understand that this module is the equivalent of an online Resource Manual so they should be encouraged to access it frequently. The Guide also provides teaching tips, estimated times for completion, facilitator notes, and supplemental activities or discussion topics. Please note that the online module serves as a valuable resource to all classroom facilitators because it has dozens of links to: statutes and regulations that explicitly outline roles, responsibilities and authority carefully selected online resources that provide valuable information for dealing with public health issues We hope that you find the content and the suggestions provided in this Guide useful. We invite you to submit your comments your opinions and suggestions help to improve our Guides. May 2012 Kathleen MacVarish Wayne LaMorte Jennifer Tsoi 3 of 11

4 Before you begin Plan approximately 2 hours to complete this online module. For a classroom setting, plan an additional 1-2 hours to allow time for group discussion and activities. Complete the online module on your own. Read this Facilitator s Guide to become familiar with the content and flow. We suggest you print this Guide before you start the online module so you can take notes as you complete the training. As you complete the module and review the Facilitator s Guide, look for segments to include examples specific to your audience and your own experience. Decide if you want to print out any of these webpages, links, or resources for activities or discussion. You can find all answers to the discussion questions in their related webpages. Determine what equipment you want to incorporate into delivering the training. Think about other tools you might wish to supplement the training with, such as flipcharts, diagrams, icebreakers, or activities. If your participants are seeking contact hours, tell them to complete the pre-test online before attending your training and remind them to complete the post-test and evaluation online at the end of the training. o Go to: o Participants must register to establish a learner profile and complete the pre-test, post-test, and the evaluation for a certificate of completion with contact hours. Teaching Tips Alternatives to Are there any questions? Often asking, Are there any questions? only elicits response from the same few people who are willing to speak up. These alternatives are designed to involve learners more actively. Ask participants what they want/expect to learn from this training At the beginning of the class, ask participants to write down one or two questions they believe this session will answer. Whether or not the question is on target, this exercise helps engage participants in looking for answers or revising their questions. Diagrams After a reading assignment or a lecture, ask individuals or small groups to draw a diagram that illustrates the material. Flowcharts, cause and effect diagrams, pro/con charts, and mind maps are all powerful tools for synthesizing information. They allow learners to test whether they really understand the material. Unanswered Questions After presenting material, ask individuals in small groups (5-7) to write down one or two questions they still have. Individuals discuss their unanswered questions with their group to see if other group members can answer each other s questions. The group then selects one or two important remaining unanswered questions to submit to the facilitator or to another group. This method filters out trivial questions and increases confidence of individuals who are unlikely to speak up in the larger group. Exam Questions Ask participants to generate potential exam questions and answer them. 4 of 11 Working with small groups Having learners work in small groups is a good way to increase involvement. Making Small Group Assignments Groups should be no larger than seven people. Assign a group leader or reporter. Give specific and simple directions. Ask for specific and concrete products - list, diagram, summary, illustration, etc. Set a time limit. Let the learners do the work. Facilitate discussions rather than lead them.

5 Webpage #2 Introductions. Introduce yourself and provide some background information on your public health experience. Have participants introduce themselves and describe where they work, what they do, and what their backgrounds are. Participants should also state what they hope to learn from the course. This might be a great time to introduce an icebreaker activity to encourage open discussion. Take 5-10 minutes to ask a few questions and have the group report responses. Sample icebreaker questions can be found: Discuss the purpose of the course. Describe the local health inspectors role in the prevention and management of hoarding cases. Provide the information necessary to identify a hoarding case and guide others as to how to prevent and control hoarding. Discussion Questions. Why is hoarding a public health concern? What harm or health hazard might hoarding pose? What are risk factors of hoarding LBOH professional can identify to prevent or control hoarding cases? What are some of the treatment methods to address hoarding? Explain that besides providing training, this module will also serve as a valuable resource to all LBOH members and staff of health departments because it has links to: statutes and regulations that explicitly outline roles, responsibilities and authority carefully selected online resources that provide information on prevention and management of hoarding Review Learning Objectives. After successfully completing this module, you will be able to: Define what is meant by hoarding Identify the causes of hoarding Explain some reasons as to why people hoard Summarize what is known about the psychology behind hoarding Describe the signs and symptoms and diagnostic criteria Identify and describe types of hoarding Identify individuals in the community who would be classified as hoarders Explain measures that might be taken to prevent and control the problem Understand the role of the LBOH in investigation and code enforcement Learn about resources available to assist in hoarding solving 5 of 11

6 Webpage #3 Discussion Questions. What is hoarding? How does hoarding affect hoarders (people who hoard) lives? Ask participants to identify reasons why hoarding is a public health concern. 6 of 11

7 Webpage #4 Discussion Questions. What are some possible signs of hoarding? Who is at risk of hoarding? Who should be contacted to address a hoarding case? Discuss the BU Today article on hoarding and watch the video attached to the article. Additional activity (optional): Test Your Knowledge. Participants should work individually for this activity. Select the Quiz Group button to reveal the quiz questions. Inform participants of the time limit they have to answer the questions. Have participants report and discuss answers to generate discussion. 7 of 11

8 Webpage #5 Review the symptoms of hoarding and view the photo album. Additional activity (optional): Case scenario. Participants should work in small groups for this activity. Give groups a time limit of 10 minutes to review the scenario and answer any related questions. Small groups should share their responses to generate discussion. John files a complaint with the local police department regarding his neighbor, Fiona. John is claiming that Fiona is living in unsanitary and deplorable conditions and now it is having an effect on his home. He claims that he hears animals making noises all day and throughout the night even though he never sees them. He states there is the foul smell of animal urine and feces emanating from her home. She is not taking care of her lawn and the grass is grown quite high with the weeds and pests making their way into John s garden destroying his tomato plants. Based on John s complaint, can you confirm this is hoarding? If not, what steps might you take to confirm whether or not this is a case of hoarding? What are the public health concerns based on John s complaint? 8 of 11

9 Webpage #6 Explain how hoarding is diagnosed, types of hoarding, as well as ways to identify it. Review the Fact Sheet Identify the people who are at risk of developing hoarding disorder. Discuss some of the challenges with identifying hoarding. Review the key Information when in contact with a hoarder. Ask who has used any of the listed tools. Discuss the tools and identify who should use them and when. Ask for best practice examples. Ask participants to explain how the health concerns of hoarding inanimate objects differ from that of hoarding animals? What are health concerns of each type of hoarding? Ask if anyone has experience with animal hoarding and how they resolved the case. Who were their partners? Discuss experience with recidivism. Ask if anyone has had success resolving cases without reoccurrence. 9 of 11

10 Webpage #7 Discussion Questions. What agencies might comprise of hoarding community task force? What are some of the state laws and regulations that relate to hoarding? How can LBOH enforce compliance with state regulations regarding house and sanitary codes? Summarize the concepts behind organizing a hoarding community task force. Review the information provided on enforcement. Ask participants to think of the first steps to addressing a potential hoarding case. How is the case confirmed? Summarize the State Sanitary Code regulations as they pertain to cases of hoarding by reviewing hazards commonly found in the dwelling of a hoarder. Discussion Questions. What if an occupant refuses to let you enter their apartment for a house inspection? What if a homeowner refuses to let you enter their home for a house inspection? What is the process for obtaining an administrative search warrant? When might you need a search warrant? Additional activity (optional): Community Task Force. Participants should work in small groups for this activity. As members of Townville s local board of health, you have been assigned with the responsibility of forming a hoarding community task force. Your team should come up with an outline of your task force that addresses the following questions: a. What is the objective of your task force? b. What agencies will be involved in the task force? Briefly explain the reason for including the mentioned agencies. c. What is the model of response for your task force? (i.e. CBT intervention, case management, risk reduction, harm reduction, etc.) Give participants minutes to write down responses. Have small groups share their responses to generate discussion points. 10 of 11

11 Webpage #8 Review the Hoarding Scenario. Highlight the possible hoarding violations under SSC 105 CMR , the MDPH State Sanitary Code on the minimum standards of fitness for human habitation. Review the diagram that provides a step-by-step overview for obtaining and using an administrative search warrant. Review the Quiz Group questions. Give participants a few minutes to answer the questions. Have participants report and discuss answers. At the conclusion, remind participants that if they would like a certificate of completion and contact hours, they must log in to the Institute website and complete the pretest, posttest and evaluation. 11 of 11