Addressing the Holistic Needs of Crime Victims
Steve Dakai, Lydia Watts  -  2014/3/12
http://ovc.ncjrs.gov/ovcproviderforum
 
 
Are multidisciplinary teams, no matter the type of victimization they are addressing, considered holistic? If not, can you explain the differences? Is a holistic approach more a philosophy rather than a "type" of service?
 
1.  Lydia Watts
 Multi-disciplinary means more that at least a few types of professionals/advocates/areas of expertise are working together. For example, a financial planner and a divorce attorney working together on behalf of a client who is going through a divorce is a multi-disciplinary team. There are ethical and reporting issues that need to be addressed in teams working together no matter how they describe themselves as "multi-disciplinary" or "holistic."
 
2.  Lydia Watts
 Holistic services means trying to meet as many of those needs and concerns as possible. Is there attention to the emotional/trauma/counseling needs? To the financial impact? To the need for a civil attorney? If law enforcement is involved, how are they working with the survivor to make sure the survivor's concerns and interests are being addressed and taken into consideration?
 
3.  Dr. Steve
 I believe MD Teams are holistic in nature in the fact that the victim is telling her story one time to the Team rather than several times over and over again. Holistic to me is both. More so a service as you are working with the whole human being rather than say just the mental and physical quadrants of the human being.
 
4.  Lydia Watts
 The terms "holistic" and "multi-disciplinary" are often used interchangeably. I believe the difference is from the standpoint of the consumer/survivor of crime. Holistic means that the needs and concerns of the survivor are paramount and central to the delivery of services.
 
 
Are there good examples of programs and organizations that offer a holistic approach to serving victims that could act as a model?
 
1.  Lydia Watts
 The Network for Victim Recovery of DC (http://www.nvrdc.org) in Washington, DC is another great model. I am the founding board chair there. They have advocates, counselors and attorneys (civil and those who represent victims of crime in criminal proceedings) working together on behalf of crime victims in DC.
 
2.  Dr. Steve
 You can contact Michelle Bailey who is our Program Manager for both Victims Shelter and Crime Victims at 715-799-3835 go to your local or state advocacy organization. Many Native American Tribes who have Victims Programs is another resource for you to check into.
 
3.  Lydia Watts
 Other examples I know of are: Bread for the City in Washington, DC - has lawyers, medical clinic, food pantry, job training and other supportive services for homeless people and those living in deep poverty.
 
4.  Lydia Watts
 The organization that I founded in Washington, DC called Women Empowered Against Violence, Inc. (WEAVE) was a great example. Unfortunately, it closed its doors in February 2012. However, I would be happy to share resources with anyone interested in replicating the model. I can be reached at lydia.watts@greatergoodconsulting.com.
 
 
Can you briefly explain how you approach a holistic view with your programs and staff? Do you have to train for this.
 
1.  Lydia Watts
 There are also cultural differences between how different professions/advocates approach their work, their interactions with survivors, etc. This takes quite a bit of organizational work to find ways for these difference to complement each other for the survivors' benefits.
 
2.  Lydia Watts
 There are many ethical issues and reporting requirements (as two examples, there are lots of others) that staff will need to be trained on so that victims are served well and not put into a precarious position by not understanding the differing obligations of the differing professions/helpers/advocates.
 
3.  Dr. Steve
 From my philosophy and perspective we offer and help the whole person not just one or two segments of the victim. Imagine if you can a newborn who is wrapped up to feel safe, warm and secure. It is the same concept, wrap all your service providers around the victim.
 
4.  Lydia Watts
 If there are a regular array of needs that often go hand-in-hand: legal services and counseling for survivors of intimate partner violence, for example; then staffing structures, fundraising and institutional partnerships will need to be formed to be able to regularly address those issues at that same place, with some or all overlap of timing, etc.
 
5.  Lydia Watts
 If a survivor "shows up" with needs we have not currently explored/addressed with others, we will be resourceful through partnerships with other organizations, trainings, finding additional resources ($ and staff time) to try to address that rather than saying, "we only do this."
 
6.  Lydia Watts
 From my perspective, the commitment to providing holistic services is a values-based decision on how best to serve survivors. So to make that transition within an organization would require an organizational shift toward "breaking free" of the silos that we are often trained to work within. No longer do we say, "this is the narrow thing we do", but instead we try our best to meet survivors wherever they are.
 
 
How do you explain or pursuade others to join this view in addressing the needs of victims?
 
1.  Dr. Steve
 I would look at taking a Trauma Informed Care Training and then set up a training for the other members, this is a great way to get started.
 
2.  Lydia Watts
 I always viewed it as the way to have the greatest impact on victims' lives. If we really want to allow victims an opportunity to overcome the victimization and live more fulfilled lives, we have to address the many issues that have either been brought on by or exacerbated by the victimization. If we don't address those need holistically, our services are just drops in a bucket. When we work holistically, the drops come together to really make a difference. It makes sense both in terms of being able to meet our missions, but also from a resource ($ and staff) standpoint, it make sense. Otherwise, we are not investing our $ and staff time wisely.
 
 
Our question is a two-parter: a) we're wondering what we mean by "holistic" approach to victim support, and b) we're wondering whether there are suggestions on how we can evaluate whether we're actually meeting the holistic needs of victims. Thanks!
 
1.  Lydia Watts
 To identify if you are holistic, I would ask the victims/clients who come to you. Maybe an anonymous survey to identify if their array of concerns were identified and addressed; what were those concerns; how responsive was the staff; how satisfied were the victims with the assistance. Were there additional concerns related to the victimization that were not identified? If so, how could those issues been "unearthed" and addressed. You may be surprised by what you hear!
 
2.  Lydia Watts
 When a victim "shows up" needing an array of services: counseling for trauma, child care assistance, job training and legal services - all related to a victimization - that you are set up to identify those needs (at intake, broad questions about needs) and to address those needs through your program.
 
3.  Lydia Watts
 Holistic means that you are striving to meet victims' needs within your program - that could mean in partnership with other organizations, but with an eye toward reducing barriers (like having to travel to different locations, meeting all new staff, new place, etc.) to availing oneself of the services.
 
4.  Dr. Steve
 If your MD Team is in harmony with each other and working together to assist the victim from the time of the incident to the final outcome then you are working holistically.
 
 
Whose responsibility is it to make sure that victims needs are met as a whole? How does teh holistic part get taken care of when everyone is focusing on their specialization?
 
1.  Dr. Steve
 Again, there needs to be an agreement by all parties to leave egos at the door and the one common goal or denominator is the safety of the victim and ensuring the victim receives the best possible care and help. As the Director it is my responsibility to ensure the staff working with me have that collaborative team mindset, in addition it is my responsibility to coordinate with the other Directors to foster the holistic team approach to providing help and services.
 
2.  Lydia Watts
 We also had subcommittees of staff members - deliberately made up of people from different sections of the organization - to work on larger issues when they came up - like a change in database and what were fields that could and could not be shared, as an example. Or revamping intake form to include more information about trends we were seeing. Data collection to support funding application so we could hire someone to address identity theft when the expanded use of the internet made that issue come up more and more often. Etc.
 
3.  Lydia Watts
 The three hours per month in meetings: 1 hour that was a support group for staff, facilitated by an outside social worker (at $125/hour - which is only $1,500 per year!) - this was to address vicarious traumatization and develop trusting relationships across silos/disciplines; 1 hour org-wide staff meeting to address processes fixes; 1 hour in team-building - to address more complex conflicts, differences in approaching work.
 
4.  Lydia Watts
 I do think there needs to be a commitment from leadership that this shift will take place. It will mean a change in processes and priorities, perhaps even in what kind of "case load" people can take on. At WEAVE (the holistic organization I started in 1995), we also spent quite a bit of time (about 3 hours per month EVERY month) on organization-wide meetings to make sure we were thinking through ways to make our systems work better for victims.
 
 
What do you think are the most significant barriers to overcome when implementing a holistic approach? How have agencies you've worked with overcome those barriers (lack of training, PII/info sharing, etc)?
 
1.  Lydia Watts
 If resources are scarce (and they always are), I would be willing to share resources on how to make sure that good systems are in place for relatively little cost. Lydia.watts@greatergoodconsulting.com.
 
2.  Lydia Watts
 Information sharing is VERY important to think through BEFORE you place a victim at risk by sharing information by mistake or to the detriment of the survivor. Survivors must also be informed of when they are talking to someone with different obligations. However, none of this is insurmountable particularly with good firewalls and passwords that can be established with electronic information sharing/case management systems.
 
3.  Lydia Watts
 I would not skimp on training, developing clear processes, team-building and ways to healthily address conflict (because it will come up between staff). It will require strong leadership and commitment to all of these necessary aspects of implementing a holistic service model.
 
4.  Lydia Watts
 I think the biggest obstacles are: differing ethical and reporting (i.e., re: child abuse and neglect) obligations; differing cultural approaches to the work, how to work with clients/survivors; how to work together when we come from different cultures.
 
5.  Dr. Steve
 The largest barrier is the silos. Eliminating individual silos, having the common goal of working for and with the victim and leaving egos at the door. We created a MD Team of volunteers, we did not want supervisors telling their personnel they had to be a part of the Team. Then we set a planning meeting up, developed goals and objectives, prioritized what was important, what we would like to have and what we could live without for a short time period. We then agreed to work together, titles, job descriptions were not important, just human beings helping human beings and it works!
 
 
Do you know of any current successful examples of collaborative programs involving multiple independent agencies that address the holistic needs of victims at local or state levels?
 
1.  Lydia Watts
 Medical-Legal Partnerships are also a great model. There is a National Center on Medical-Legal Partnerships with a great website and resources on holistic service delivery. http://www.medical-legalpartnership.org
 
2.  Lydia Watts
 The Lighthouse Center for Healing in DC (http:www.lighthousedc.org). The Family Justice Center model that started in San Diego and has been replicated with federal funds across the country (Boston, Brooklyn are two I am familiar with).
 
3.  Lydia Watts
 The Lighthouse Center for Healing in DC (http:www.lighthousedc.org). The Family Justice Center model that started in San Diego and has been replicated with federal funds across the country (Boston, Brooklyn are two I am familiar with).
 
4.  Dr. Steve
 I can only speak from a WI and Tribal outlook. We do here on the Menominee Indian Reservation. Many of the Counties here in WI have MD Teams working for victims. A good example is Outagamie County, they were the first to create a MD Team to assist young adults who were victim of sexual assault.
 
 
Do you have suggetions as to how Victim Adocates can implement holistic approch in thier interactions with various victims?
 
1.  Lydia Watts
 Imagine a victim of sexual assault coming to an agency for counseling/support group - so s/he has come in the door for trauma support. However, they may also have lots of questions about: reporting to police; telling parents/bosses/school officials; changing work/school schedules/locations; housing and whether they can move (particularly if the sexual assault happened where they live); privacy - who else might know about this and what will they be told; pictures that were taken and might be posted online; can I get the school to expel the assailant; etc. etc. But if they only think this place is where I get counseling, not all these other questions answered, they may never bring up these other questions.
 
2.  Lydia Watts
 I would start at the intake/introduction stage of interacting with victims. Are your intakes very structured or do you have chances to ask more open-ended questions to (a) create a safe space for sharing; and (b) allow the victim to identify an array of needs - not "just" the one s/he walked in the door with.
 
3.  Dr. Steve
 Start with the okay of your Program Supervisor or Manager. If you are a community wide Advocate request or send out invitations to a discussion group to get started with. You can also obtain assistance from your state advocacy group. OVC has helpful information you can also utilize in helping you start.
 
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