Keyworking at different stages of the journey
As well as underpinning the scales of the Outcomes Star™, the ladder of change can be a useful framework for thinking about the immediate goals of keywork with different service users and what kinds of interventions are most likely to be successful. The following guidance to keyworkers is based on the ladder of change as described in the homelessness and mental health versions of the Star.
The goals for keyworking with someone at this stage are preventing or minimising harm to self and others, developing trust, making a fuller assessment and building on occasional moments of dissatisfaction to open a discussion about change.... morehide
People at this stage are unlikely to be interested in or able to talk about change in this area of their life. You may perceive that they are at points 1 or 2 on the ladder and they may say they are at points 9 or 10. This is fine, just part of what it is like to be in the ‘stuck’ stage. You can explain your reasons and record your different views, or may need to do a worker-only assessment – people at this stage will almost certainly not engage meaningfully with completing the Star. The goals for keyworking with someone at this stage are preventing or minimising harm to self and others and containing the person and their situation to avoid things from getting any worse. You will also want to build on the occasional moments when the service user has a sense of dissatisfaction with how things are to open up a discussion about change and gradually build trust, moving the person closer to the next stage.
The goal at this stage is to improve their situation in practical ways and give support. This gives the stability and space they need to address other issues and may build their hope that things can be better.... morehide
People in the accepting help stage will discuss this area of their life but may not be feeling very hopeful or have a clear sense of what it is they want to work towards. They just know they don’t like how things are. The goal of keyworking at this stage is to improve their situation in practical ways and give support. These practical improvements help to bring increased stability, giving them access to the resources to address more issues or see thing differently. They may also build their hope that things can be better. It is important not to have unrealistic expectations.
At this stage people won’t be taking the initiative so they engage best with interventions offered within the service and may need to be accompanied for any external referrals. It is most appropriate to involve people in activities or services that are available within the project.
As the practical circumstances of their life improve the service user may show signs of greater self-confidence and being ready to take more initiative. It is important to build on these moments by offering opportunities for them to take more of a lead.
Now the goal is to support the inner shift towards believing in themselves and their future and help the person to translate the new momentum into specific goals and small, practical, achievable steps.... morehide
At this stage people are likely to be engaged in discussing or thinking about this part of their life. There is a feeling that this person is really on board with making changes. They may be quite excited and thinking about goals for the future; they may also be extremely nervous about change.
The goal of keywork at this stage is to support this inner shift and help the person to translate the new momentum into specific goals and small, practical, achievable steps towards them. Although the person can start to do things on their own initiative now, it is quite likely that they may need even more support because doing new things can be scary as well as exciting. But the support is now more about encouragement and helping them to plan what they are going to do, rather than doing it for them. As they try new things there will be successes and failures which will provide an opportunity for learning and reflection. By taking time to look at what has worked and why you will help them move to the next stage of the journey.
The focus at this stage is on celebrating their achievements and supporting them through the setbacks, helping the person reflect on their experiences to support their learning.... morehide
At the learning stage people are still interested in discussing this part of their life. They have made some progress towards their goals and feel positive about that. However change is not easy and this can be a difficult stage. They may have some knock-backs as well as successes and may from time to time get dispirited. The goal of keywork at this stage is to celebrate the achievements and support them through the setbacks. Another important goal is to help the person reflect on their experiences and support their learning. What can they learn from the things that went well, and from the difficulties they experienced? How will they apply this learning over the coming weeks and months? The emphasis at this stage should be on supporting the person to deal with the difficulties themselves and building their self-knowledge and resilience. This will help them move to the fifth and final stage.
The goal of keywork at this final stage is to continue to reinforce the learning that has taken place, to help the person build support networks outside the project and ensure that they know how to spot for themselves the warning signs that they might need help in this area.... morehide
At this stage a service user's need for support is reduced. To all intents and purposes they are able to manage this area of their life on their own. However at the beginning of this stage it is helpful for there to be continued support just in case a difficulty arises that the person can’t deal with on their own. The goal of keywork at this stage is to continue to reinforce the learning that has taken place, to help the person build support networks outside the project and ensure that they know how to spot for themselves the warning signs that they might need help in this area. Some people may find it hard to let go of professional help, even when they don’t really need it any longer. In this case it is important to support the growth of self-confidence and give people practice in drawing on other, more informal sources of support.
Detailed guidance for keyworkers on using the Star is provided in the User Guides for different versions of the Outcomes Star™. Download the User Guide for homelessness and User Guide for mental health.