Transcript Slide 1

Taking a Holistic Approach to Addressing
the Needs of a Farm Family in Crisis
Presented by: Jennifer Hobby, CSW
Program Coordinator
AgrAbility of Utah
Workshop Objectives
•Assessing the environmental, emotional and social support
needs of a farm family in crisis
•Creating, organizing and maintaining a comprehensive
crisis support team to provide a multi-level interventions
system
•Effectively utilizing resources for post-crisis, follow up
sustainability and support
Stress vs. Crisis
• Stress:
• Crisis:
• Any event in which
environmental and/or
internal demands tax or
exceed the adaptive
resources of an individual
• A major upset in our
psychological equilibrium
due to some harm, threat
or challenge with which
we cannot cope
Three stages of crisis episodes:
1. Level of tension increases sharply
2. Attempts to cope with the stress have
failed. Resulting in further increases in
tension and a sense of being overwhelmed.
3. The crisis is resolved positively or
negatively
We are particularly receptive to seeking out or
receiving help at stage two
Understanding Stress in Farming
Occupational Stressors
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Uncertain weather conditions
Complex world economic markets
Little price control over their product
Changing agricultural tax policies
Agricultural diseases and livestock predators
Land development pressures
Limited rural resources
Increasing operational costs
Limited sources for operating loans
High rates of job related injury and disability
Utah Farming and Ranching
• The critical economic facts:
– Total number of farms: 16,700
– Farm households contain 63,981 individuals
– Average household size for a farm family in
Utah: 3.83
– Net income per farm/ranch in 2007: $15,533
– The Federal poverty level for a household size
of four: $22,040
– 60% of Utah farms reported a net loss in 2007
Additional Stressors
• Lack of health insurance coverage
• Complex extended and farm family
relationships
• Limited access to and utilization of medical
and mental health services
• Social Perception
• Cultural identity and accountability
• Societal expectations
Access to health care and related services
• The rural west has the lowest
availability of primary care
providers of any region in the
country.
• A higher percentage of frontier
people live in poverty. All 50 of
the poorest counties in the US
are frontier counties
• Isolated nature of farming as an
occupation increases risk of
injury and limits access to
formal support systems
Weigel, R.R., (2004) Ranching in the west is it Hazardous to your Health? Traumatology, 10 (3)
Complex familial relationships
The family that works together
• Most often, a farm family’s relationship with each other is
very intertwined with their relationship to the farm.
• The value and legacy related to an operation often lead to
tension or conflict within a family with respect to
succession planning.
Social Perception
• Positive-stereotyping
• Social Status
• Positive stereotyping can generate an enormous
communication gap by preventing the farmer from talking
about his problems and preventing the listener, whether
professional or not, from understanding (or believing) that
this person needs help
Cultural identity and accountability
• Farming is an identity, a heritage and a
legacy.
• Farmers internalize these aspects of their
occupation and are accountable for
maintaining this identity
“Ownership of a family farm-sometimes a farm that has been
in the family for generations-is the triumphant result of a
multitude of struggles. Losing the farm or the livestock is
viewed as an ultimate loss, one that brings shame to the
generation which has let down it’s forbearers and has
dashed the hopes of successors”
Mike Rosmann, PhD
Executive Director AgriWellness
Societal Expectations
• Social norms expect positive statements about
rural living
– The mythology of farm life is that it is hard work, but
rewarded by peace and quiet and therefore superior to
the urban rat race
• Farming has deep ties to the founding of our
nation.
– This can create an obligation for modern farmers to
“live up” to the mythological giants that set current
expectations.
Of Note…:
• Taking a holistic approach means not only
assessing the identified client but also
family.
– More often than not one individual within the
family system will draw the most attention (e.g.
the one who is injured, exhibiting negative
behavior or under obvious distress).
– Nevertheless the strain on other family
members cannot be overlooked.
Assessing a farm family in crisis
• Farm families in crisis experience:
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Hopelessness
Financial burdens
Difficulty managing the operation
Depression/anxiety, strain in inter-family relations
Confronting the expectation that they can or should
“suck it up” and put their best face forward
Barriers for a farm family in crisis:
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Financial constraints
Lack of accessible healthcare/health insurance
Lack of knowledge of resources
Lack of ‘bridging’/transitional services and
coordination of care
• Lack of accessible resources
– Namely resources to provide on farm support
• Unaddressed these can result in chronic
problems such as:
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Chronic mental/behavioral health problems
Serious losses of farm productivity
Operation loss
Overwhelming medical expenses
Long-term interrelation problems within the
family
The Essential Assessment
• Assessment defined: The process of
gathering and analyzing relevant
information
– Beyond understanding what is wrong
assessments should consider:
• Strengths
• Resources
The essential assessment
• Important aspects of an assessment:
– Interviewing: An effective means for eliciting
essential information
– Confidentiality: Client must be assured the
information shared will not be disclosed
without their consent (see consent form)
– Ethics: The interviewer should adhere to a
organizational code of ethics (see NASW code of ethics,
for example)
Interviewing
• A face to face conversation between the
client and the worker
– Outcomes should include
• Building rapport and a working relationship with the
client
• Identifying the needs of the client and environment
(family, operation etc.)
• Setting a preliminary course of action to address
identified needs
• Instilling hope that things can and will improve
• Important Aspects of Interviewing:
– Setting the client at ease: Remember to be a human being. Be
relaxed
– Ask pertinent questions. Even if it feels awkward. When asked
openly and in a non-judgmental fashion, people will open up.
– Listen: Listen to what is said, tone of voice and manner of speaking.
– Silence: Give the client enough time to muster their thoughts
– Summarizing: Periodically summarize what is said to ensure what
is being said is being accurately understood
– Structuring: Use time wisely and be organized
– Convey interest nonverbally: this is done with tone of voice, facial
expressions, gesture, posture attentiveness etc.
Desired assessment outcomes
Understanding:
• The nature of the client’s problems.
• The functioning of clients and significant others (how are
they coping?)
• Whether the client is motivated for change
• Relevant environmental factors which contribute to the
problems
• Resources needed to address the client’s difficulties
• Goals should be:
– Collaboratively decided on between the helper
and the client
– Achievable
– Measureable
– Believable
– Value-oriented (client’s values)
– Ultimately and primarily the client’s
responsibility to obtain
• Reality check
– You cannot work miracles
• “We the unwilling led by the unknowing are doing the
impossible for the ungrateful. We have done so much for so
long with so little we are now qualified to accomplish anything
with nothing”- Mother Teresa
• “In this life we cannot to great things we can only do small
things with great love”-Mother Teresa
Never underestimate the value of simply listening
Creating, organizing and maintaining a
comprehensive crisis support team to
provide a multi-level interventions system
• Ensure that your agency has established
protocols:
– Staff have identified roles and responsibilities
for addressing the needs of clients and
maintaining the project’s status and goals
Example:
• Case management:
– Service delivery model which emphasizes working with
the individual in their environment and community
– Primary functions are to
• Assess: the client’s needs
• Link: the client with services which can support their
goals
• Coordinate: the delivery of services and
• Monitor the delivery of services and client progress
The Players
Legal
Advisors
Financial
Advisors
Clergy
Human
Services
Client/
Family
AgrAbility
(case
manager)
USDA
Staff
Members
Community
Extension
Extended
Family
Creating a Network
• Step One:
– Identify potential network partners
• Beyond VR and independent living centers consider:
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Medicaid
Community mental health centers
Area Aging Authorities
Federal Housing Programs
Assistive Technology programs
Food and Financial assistance
Local non-profit organizations
• Step Two:
– Homework time!
• Research the services, goals and objectives of
potential network partners.
• Identify common objectives
• Inform key individuals within the proposed network
of AgrAbility, the services provided, and specific
areas where collaboration would benefit the client
population
Strengths in the AgrAbility Projects:
(A.K.A. How to get these agencies attention)
– Farmers and Ranchers are a sympathetic population
– Policy beginning to reflect improving services in rural
communities
– Emphasis on preservation of family farms
– Emphasis on encouraging individuals to remain in
employment despite age/ability barriers
Handy read: President’s New Freedom Commission on Mental
Health, 2002 (recommends a mandate for human services to
focus on service delivery in rural areas)
Strengths of AgrAbility Projects: cont.
• Increased interest in addressing civil rights issues
and violations within the USDA.
– Handy Read: Memo from Secretary Vilsack dated April 21,
2009, A New Civil Rights Era for USDA
Most Importantly, AgrAbility Projects have (or should
have) a positive relationship with farmers and ranchers
within their state. As such the projects are uniquely
poised to be the essential link between human services
and other programs and our clientele.
• Step Three:
– Once the need has been established (e.g. access
to Medicaid services). Discuss collaborative
means for addressing the need
Tip: encourage agencies initially to identify a
specific individual to work with AgrAbility staff.
This enables:
• Cross training on program rules and regulations
• Consistency in working out kinks in the process
Networking: Points to remember:
• Not all individuals in an agency will be responsive
to collaboration. (Even when doing so will allow both
parties to meet program goals)
• It is strongly encouraged that the projects
administrative staff meet with the administrative staff
and boards of directors first where possible. (Just make
sure to do your homework)
Networking: Points to remember:
– Disagreement is part of the process
• Advocacy requires assertiveness, most
individuals within other agencies know
this.
• …Its okay to be wrong
Effectively utilizing resources for postcrisis, follow up sustainability and support
• Effective networking requires consistent
maintenance
– AgrAbility is an essential link between farmers
and ranchers. This link must remain
consistent through the process.
Effective Networking tips:
• Know your partner contacts by name. Maintain a
respectful relationship Meet regularly and follow through
• Follow through. Only slightly less effective than no
referral is a referral which consists simply handing the
client a business card.
• Understand that linking can take a long time (e.g. it can
take up to two years to receive social security disability
benefits)
• Save the venting of frustration for colleagues. With
clients be honest about the length of the process-but
continue to assure them that achieving the ultimate goals
(health and independence) are worth it.
Agri-Culture
Barriers to Help Seeking Behavior
•strive to be respected for successful
achievement (and own their success)
•not show weakness
•seek out adventure and risk
•maintain independence and selfreliance
•Releasing some of their control, by
seeking help, taking advice and
participating in a team approach is
foreign. This simultaneously
heightens their sense of failure and
can bitter the sense of
accomplishment that comes from
success
Agri-Culture cont.: Stigma
• Concern that revealing their disability to
eligibility staff may hinder their chances for
operating loans
• Anxiety that they will be seen as incapable and be
viewed as a "welfare case" or marginal producer
• Worry that they will be considered inadequate
because of confusion about where and how to
apply for a variety of programs and services
• Concern that their disability may prevent them
from meeting the standards of the assistance
program
Agri-Culture
• Farmers are sole-proprietors. The weight of struggle or
failure, generally rests solely on their shoulders.
• Farmers have a daily, love/hate relationship with stress.
When stress is overcome, and the crisis resolved, the
farmer is validated that he can maintain control
• When attempts to resolve the crisis have failed, or
problems become too numerous to address the farmer is
most vulnerable. And the most likely to seek, or accept
assistance
Contact Information
Jennifer Hobby
Program Coordinator
AgrAbility of Utah
USU ASTE Dept
UMC 2300
Logan, UT 84322-2300
Phone: (877) 225-1860
E-mail: [email protected]