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pdfAttachment I TLP Program Overview Survey: Program Staff Interview Guide
Attachment I
TLP OVERVIEW PROGRAM SURVEY:
PROGRAM STAFF INTERVIEW GUIDE
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
TLP Program Overview Survey: Program Staff Interview Guide
Contents
Introduction .................................................................................................................................................. 5
Respondent Roles ......................................................................................................................................... 5
TLP Overview ................................................................................................................................................ 5
Partnerships .................................................................................................................................................. 5
Staffing .......................................................................................................................................................... 6
Program Eligibility and Admission ................................................................................................................ 7
TLP Services ................................................................................................................................................... 8
Housing ..................................................................................................................................................... 8
Individual Service/Action Plans ............................................................................................................... 10
Programming .......................................................................................................................................... 11
Life Skills .................................................................................................................................................. 20
Trauma-Informed Services.......................................................................................................................... 22
Trauma-Informed Approach ................................................................................................................... 22
Trauma Screening ................................................................................................................................... 24
Staff Training on Trauma ........................................................................................................................ 26
Program Structure, Policies, and Rules ....................................................................................................... 26
Structure ................................................................................................................................................. 26
Privileges and Rules ................................................................................................................................ 27
Typical Day in TLP.................................................................................................................................... 28
Program Discharge .................................................................................................................................. 28
After Care ............................................................................................................................................ 28
Program Outcomes ..................................................................................................................................... 29
Closing ......................................................................................................................................................... 30
Program Data Tables ................................................................................................................................... 30
Budget ..................................................................................................................................................... 30
Service Statistics...................................................................................................................................... 30
Housing ................................................................................................................................................... 31
Program Service Tables ............................................................................................................................... 32
Education Services Tables ....................................................................................................................... 32
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Employment Services Tables .................................................................................................................. 35
Other Service Tables ............................................................................................................................... 38
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
TLP Program Overview Survey: Program Staff Interview Guide
[INTERVIEWER: PREFILL THE FOLLOWING]
Name of the agency: ___________________________________________________________________
Name of the TLP: ______________________________________________________________________
Location (City and State): ________________________________________________________________
Name(s) of Interviewee(s): ______________________________________________________________
Title(s) of Interviewee(s): _______________________________________________________________
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Introduction
[INTERVIEWER: INTRODUCE STUDY, THANK FOR PARTICIPATION, AND GIVE OVERVIEW OF PURPOSE OF
SITE VISIT, INCLUDE THE FOLLOWING LANGUAGE:]
This interview is intended to gather information about your TLP program, such as who it serves,
how it is structured, and what services it provides. We know that TLP programs differ with
regard to how they are funded and structured. In some cases, an agency’s FYSB TLP grant covers
the entire cost of the program. In others, agencies combine multiple sources of funding to
support their program, with FYSB funding used to cover a portion of the program’s beds, units, or
services. In this survey, we want to understand the design and functioning of the transitional
living program as a whole, not just those beds or services funded through your FYSB TLP grant.]
Respondent Roles
1. What are your roles and responsibilities at [name of agency]? And for the TLP specifically?
TLP Overview
2. What would you say are the TLP’s primary objectives?
3. Does the TLP target any particular population(s) of youth?
[INTERVIEWER ASK ABOUT ALL OF THE FOLLOWING POPULATIONS]
Pregnant/parenting youth
GLBTQ youth
Migrant youth
Immigrant youth
Minority youth
Native American youth
Other (Please specify): ________________________________________________
4. Does the TLP exclude any particular population(s) of youth? If so, please describe.
Partnerships
5. Does the agency partner or collaborate with any other organizations to deliver TLP program
services? If so, what organizations and what are their roles?
[INTERVIEWER: COMPLETE TABLE BELOW]
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Partner Agency
Role in TLP
Describe arrangement
Formal or informal arrangement?
(Formal would entail an MOU,
contract, or other signed
document)
Staffing
6. How is the TLP staffed?
[INTERVIEWER: LIST THE STAFF POSITIONS FOR THE TLP PROGRAM. THEN INDICATE THE NUMBER
OF FULL-TIME EQUIVALENT EMPLOYEES FOR EACH POSITION. FOR EXAMPLE, THREE HALF-TIME
CASE MANAGERS EQUALS 1.5 FTE.]
Title
Role
Area of
expertise/specialization
(or generalist)
# FTE
Position 1
Position 2
Position 3
Position 4
Position 5
Position 6
7. Can you tell me about the supervisory structure among TLP staff? (What are the lines of
supervision and accountability? Who you report to, and who reports to you?)
[INTERVIEWER: IT MAY BE USEFUL TO DIAGRAM AN ORG CHART (IN ADVANCE IF POSSIBLE) AND
CONFIRM IT. IF THERE ARE PARTNERS WHOSE STAFF ADMINISTER THE PROGRAM, INCLUDE THEM
IN THE ORG CHART]
8. Given the youth population you serve, do you feel there are any staffing gaps in the program right
now?
[IF YES:]
a. Please describe.
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
b. How do you go about filling those gaps?
9. Are there any trainings that are required of staff – either when they are first hired or on an
ongoing basis? If so, what are types, amounts, and timing?
10. How involved are you in staffing the TLP?
[IF INVOLVED ASK:]
a. What are the criteria for selection?
b. What qualifications and skills do you look for?
Program Eligibility and Admission
11. What criteria must youth meet to be eligible for the program?
[INTERVIEWER: ASK ABOUT ALL OF THE FOLLOWING ELIGIBILITY CRITERIA: ]
Age limitations (specify)
Gender (male only vs. female only)
Transgendered
Homeless (according to HHS definition)
Foster youth (i.e., “system” youth)
Pregnant or parenting
Clean and sober (if substance abuse history)
Length of sobriety
In substance abuse treatment (if substance abuse history)
No serious mental health history/acute symptomatology
In treatment for mental health issues (if diagnosed mental health condition)
Mental health treatment adherence
Employed
Enrolled in high school (if not yet graduated)
Completion or participation in program separate from TLP
Anything else
12. What are the most common referral sources?
13. What percentage of youth referred into the program typically complete the application process?
a. Why do some drop out of the application process?
14. Of youth who complete the application process, what percentage is usually accepted into the
program?
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
15. Does the program maintain a waiting list?
[IF YES, ASK:]
a. How many youth are currently on the list?
b. How are youth on the waiting list prioritized?
c. Where do youth typically stay when they are on the wait list?
d. Are any services provided to youth while they are on the wait list? If so, what are they?
16. On what basis and how are admission decisions typically made?
[IF NECESSARY, ASK:]
a. If you have two candidates who are both eligible and who submit applications on the same
day but only have one bed available on what basis will a decision about who is admitted be
made?
17. Once youth are accepted into the program are there additional assessments that are conducted?
If so, what are they and what do they entail? [INTERVIEWER: PROBE FOR FULL TITLE OF
INSTRUMENTS]
18. What requirements must youth meet and maintain to participate in the program?
[INTERVIEWER: READ ALL; ASK FOR DESCRIPTION OF EACH REQUIREMENT]
Attend high school/GED classes
Acquire and maintain employment
Place percentage of earnings in savings account
Pay rent
Anything else
TLP Services
Housing
19. What type of physical accommodations (housing options) are available to TLP youth?
[PROBES BELOW]
Residents live in host family homes
Residents share bedrooms in group home with house parents
Residents share bedrooms in one facility
Residents have private bedrooms in one facility
Residents share apartments, units clustered in one building
Residents have private apartments, units clustered in one building
Residents share scattered site apartments
Residents have private scattered site apartments
Anything else
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
[IF SHARED BEDROOMS ASK:]
a. How many residents per room? Does each room have an adjoining bathroom?
[IF PRIVATE BEDROOMS ASK:]
b. Does each room have a private bathroom?
[IF RESIDENTS SHARE APARTMENTS IN ONE BUILDING, ASK:]
c. What size units? How many youth per unit?
[IF RESIDENTS ARE IN SCATTERED-SITE APARTMENTS, ASK:
d. Are youth clustered in certain buildings? How many in each building?
[IF THE PROGRAM SERVES BOTH YOUTH UNDER AND OVER THE AGE OF 18, ASK:]
e. Are living units segregated by age? Please describe.
[IF FACILITY-BASED HOUSING ASK:]
f. Who manages the facility [probe for TLP agency, other agency, private entity]?
[IF MORE THAN ONE PHYSICAL ACCOMMODATION GIVEN, ASK NEXT TWO QUESTIONS, ELSE SKIP.]
20. Does the TLP have a phased approach to housing in which youth move from supervised to more
independent living as they move through the program?
a. If yes, what is this progression?
[INTERVIEWER: ASK RESPONDENT TO RANK THE HOUSING OPTIONS AVAILABLE IN THE PROGRAM
FROM THE MOST SUPERVISED ACCOMMODATION TO THE MOST INDEPENDENT. EXAMPLES OF
HOUSING OPTIONS BELOW.]
____ Residents live in host family homes
____ Residents share bedrooms in group homes with house parents
____ Residents have private bedrooms in group homes with house parents
____ Residents share bedrooms in one facility
____ Residents have private bedrooms in one facility
____ Residents share apartments, units clustered in one building
____ Residents have private apartments, units clustered in one building
____ Residents share scattered site apartments
____ Residents have private scattered site apartments
____ Other: ____________________________________________________________________
b. How is this phased approach to housing reflected in your program activities?
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
21. Do youth pay rent? Security deposit? If so, how much?
[INTERVIEWER: PROBE FOR WHETHER YOUTH PAY A PERCENTAGE OF THEIR INCOME AND WHAT
THIS PERCENTAGE IS]
22. If youth pay rent, is this money saved for youth and returned at exit?
23. Do youth sign a lease or housing agreement? If so, who is the lease/housing agreement with?
What does it stipulate?
Individual Service/Action Plans
[INTERVIEWER SCRIPT:]
We’d like to understand more about the service planning process that guides the delivery of services
for each youth. Would you be willing to share a copy of a blank individual service plan (transitional
living plan)?
24. What areas does the individual service plan (transitional living plan) cover?
[INTERVIEWER: PROBE FOR TRAUMA-INFORMED SERVICES]
25. Who participates in the service planning process and what are their roles?
[INTERVIEWER: PROBE FOR WHETHER THE YOUTH AND/OR OTHER MEMBERS OF THE YOUTH’S
SERVICE TEAM (BOTH WITHIN AND EXTERNAL TO THE AGENCY) ARE INVOLVED]
26. How much choice do youth have in the services they receive or how they receive them? Could you
provide some specific examples of that?
[PROBES BELOW]
Choice of provider gender, age, race/ethnicity, sexual orientation]
Choice of timing, location of services
27. How is progress toward service plan goals and objectives/action steps monitored and tracked?
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Programming
28. What types of services do you provide to assist TLP youth in advancing their educational goals and
opportunities?
(Select all that apply.)
Education Service
a.
GED classes
b.
Alternative high school classroom
c.
Education planning/counseling
d.
Education scholarships
e.
f.
Education application and enrollment assistance (high school or
post-secondary)
Education center with access to computers, internet, and other
education resources
g.
Other (Please specify): ________________
h.
Other (Please specify): ________________
i.
Other (Please specify): ________________
29. What types of services are provided to assist youth in preparing for, acquiring, and sustaining
employment?
(Select all that apply.)
Employment Service
a.
Employment readiness preparation (e.g., resume development,
presentation and interviewing guidance, job search strategies and
resources)
Employment/career center with access to computers, internet,
on-line job search, etc.
Job training (e.g. certificate programs in entry level career track
fields)
Employment internships
b.
c.
d.
e.
f.
Transitional jobs program (i.e. time-limited, subsidized
employment with services to address employment barriers)
Employment placement
g.
Employment retention support
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Employment Service
h.
Other (specify): ________________
i.
Other (specify): ________________
j.
Other (specify): ________________
30. What other services are provided as a part of [name of TLP]?
(Select all that apply.)
Other Service
a.
Case management
b.
Life skills classes/training
c.
Mental health counseling
d.
Substance abuse counseling
e.
Services to address trauma or traumatic stress
f.
Health screening
g.
Health care treatment/nurse
h.
Alternative medicine clinic/services
i.
Nutrition counseling
j.
Legal services
k.
Aftercare
l.
Other (specify): ________________
m. Other (specify): ________________
n.
Other (specify): ________________
31. Given the youth population you serve, do you feel there are any service gaps in the program right
now?
[IF YES:]
a. Please describe.
b. How do you go about filling those gaps?
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
32. How engaged are youth in the activities/content of the program? What aspects of the program
are youth most/least responsive to?
33. TLPs differ in how they prioritize education and employment goals and the relative emphasis they
place on one versus the other. Please describe your program’s approach or philosophy.
[INTERVIEWER: RECORD THEIR ANSWER THEN SELECT THE STATEMENT THAT BEST REFLECTS THEIR
ANSWER AND CONFIRM WITH “SO WOULD IT BE FAIR TO SAY THAT YOUR TLP….?”]
Prioritizes/emphasizes employment over education
Prioritizes/emphasizes education over employment
Prioritizes/emphasizes education and employment equally
The relative priority of employment and education is determined on an individualized basis,
as part of the service/action planning process, in response to the goals of each youth
Other: _____________________________________________________________________
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Education Services
34. I’d like to learn a little more about the education services you provide. Could you describe them for me?
Education Service
a. GED classes
b.
Alternative high school classroom
c.
Education planning/counseling
d.
Education scholarships
e.
Education application and enrollment assistance (high
school or post-secondary)
f.
Education center with access to computers, internet,
and other education resources
g.
Other (specify): _____________________________
h.
Other (specify): _____________________________
i.
Other (specify): _____________________________
Description
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
35. Is the service required for participants?
(Select yes or no for each.)
Education Service
a.
GED classes
b.
Alternative high school classroom
c.
Education planning/counseling
d.
Education scholarships
e.
Education application and enrollment assistance (high school or post-secondary)
f.
Education center with access to computers, internet, and other education resources
g.
Other (Please specify): ________________
h.
Other (Please specify): ________________
i.
Other (Please specify): ________________
Not
applicable
Yes
No
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Employment Services
36. I’d like to learn a little more about the employment services you provide. Could you describe them for me?
Employment Service
a. Employment readiness preparation (e.g., resume
development, presentation and interviewing guidance,
job search strategies and resources)
b. Employment/career center with access to computers,
internet, on-line job search, etc.
c. Job training (e.g. certificate programs in entry level
career track fields)
d. Employment internships
e. Transitional jobs program (i.e. time-limited, subsidized
employment with services to address employment
barriers)
f. Employment placement
g. Employment retention support
h. Other (specify): _____________________________
i. Other (specify): _____________________________
j. Other (specify): _____________________________
Description
37. Is the service required for participants?
(Select yes or no for each.)
Employment Service
a.
b.
Employment readiness preparation (e.g., resume development, presentation and
interviewing guidance, job search strategies and resources)
Employment/career center with access to computers, internet, on-line job search, etc.
Not
applicable
Yes
No
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
c.
Job training (e.g. certificate programs in entry level career track fields)
d.
Employment internships
e.
f.
Transitional jobs program (i.e. time-limited, subsidized employment with services to
address employment barriers)
Employment placement
g.
Employment retention support
h.
Other (specify): ________________
i.
Other (specify): ________________
j.
Other (specify): ________________
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Other Services
38. I’d like to learn a little more about the employment services you provide. Could you describe them for me?
Other Service
a. Case management
b.
Life skills classes/training
c.
Mental health counseling
d.
Substance abuse counseling
e.
Services to address trauma or traumatic stress
f.
Health screening
g.
Health care treatment/nurse
h.
Alternative medicine clinic/services
i.
Nutrition counseling
j.
Legal services
k.
Aftercare
l.
Other (specify): _____________________________
Description
m. Other (specify): _____________________________
n.
Other (specify): _____________________________
o.
Anything else? (specify):
_____________________________
39. Is the service required for participants?
(Select yes or no for each.)
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Other Service
a.
Case management
b.
Life skills classes/training
c.
Mental health counseling
d.
Substance abuse counseling
e.
Services to address trauma or traumatic stress
f.
Health screening
g.
Health care treatment/nurse
h.
Alternative medicine clinic/services
i.
Nutrition counseling
j.
Legal services
k.
Aftercare
l.
Other (specify): ________________
Not
applicable
Yes
No
m. Other (specify): ________________
n.
Other (specify): ________________
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Life Skills
40. My understanding is that your TLP works to build a number of life skills. Which of these are a
major focus of your life skills service component?
[INTERVIEWER: REFER TO AND COMPLETE TABLE BELOW. PROBE FOR ANY SERVICES NOT
MENTIONED; PROBE FOR “ANYTHING ELSE?”]
Service
Major focus?
Yes
No
Budgeting/money management and saving.
Tenant rights and responsibilities.
Housekeeping.
Shopping on a budget
Cooking
Nutrition/healthy eating habits
Time management
Education planning (e.g., college search and application,
financial assistance application)
Study habits
Employment search, resume writing, and interviewing
Employment retention skills
Social skills (e.g., conflict resolution)
Emotion regulation/ constructive coping strategies
Goal setting and planning for the future
Other (specify): _________________
Other (specify): _________________
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Service
Major focus?
Yes
No
Other (specify): _________________
41. Please describe the methods or ways the program helps youth develop life skills?
a. Who is involved?
b. Do you use group-based instruction (for example a life-skills class)?
c. Do you use one-on-one instruction?
d. Do you use hands-on experiences? (e.g., staff shop or cook with participants)
e. Is peer-to-peer coaching or mentoring involved?
f. Where do lessons and activities take place? (Examples: Classroom only, outside
classroom/real world experiences)
g. Are there opportunities for skill use or practice?
[IF GROUP-BASED INSTRUCTION/ LIFE SKILLS CLASSES MENTIONED, ASK:]
42. Does the program use a particular life skill curriculum? If so, please give title or describe.
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Trauma-Informed Services
[INTERVIEWER SCRIPT:]
For the next set of questions, I want to ask you about your program’s approach to providing
services, especially to the extent that you may have incorporated a trauma-informed approach.
Trauma-Informed Approach
43. Has your program implemented a trauma-informed approach to care?
44. Can you please describe the trauma-informed approach you use?
[INTERVIEWER: RECORD ANSWER AND USE THE CHECK LIST BELOW TO INDICATE CHARACTERISTICS
OF THE APPROACH.ASK ABOUT ANY NOT MENTIONED. THIS HELPS TO UNDERSTAND THE KIND OF
TRAUMA-INFORMED METHODS THE PROGRAM USES, AND IF THEIR DESIGN RELATES TO THE
SPECIFIC POPULATION BEING SERVED.]
Trauma-Informed Approach Checklist:
Yes
No
Element
Recognize the interrelation between trauma and symptoms of or responses to
trauma
Recognize the survivor’s sense of physical and emotional safety
Create safe and comforting physical environments
Learn about and understand survivor’s history with trauma
Identify and support a survivor’s trauma-related needs (supporting and guiding
the heal process, while promoting wellness and resiliency)
Collaborate with and empower survivor in their treatment
Collaborate with family members to:
learn about and understand the family’s history with trauma, and/or
learned methods of coping that may cycle from generation to generation
promote family wellness and resiliency (as appropriate)
support the survivor in their treatment and the healing process
Collaborate with survivor’s friends and peers to:
support the survivor in their treatment and the healing process
Recognize survivor’s need to be respected, informed, connected, and hopeful
regarding their own recovery and healing
Offer effective, evidence-based treatments for trauma [SEE LIST BELOW FOR
EXAMPLES]
Partner with other agencies/organizations serving the survivor
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Yes
No
Element
Foster wellness and resiliency among program staff while preventing vicarious
trauma and compassion fatigue
[IF NOT ALREADY DESCRIBED, ASK:]
45. Have you implemented a particular trauma-informed care model or trauma-specific intervention?
[INTERVIEWER SEE LIST BELOW OF THE MOST POPULAR AND RECOGNIZED TRAUMA-INFORMED
CARE MODELS AND INTERVENTIONS]
Please describe.
a. How was the model or intervention selected?
b. Do you know if the trauma-informed model or intervention you use has gone through an
evaluation to determine its effectiveness?
REFERENCE LIST: Examples Trauma-Specific Interventions
Addiction and Trauma Recovery Integration Model (ATRIUM)
Combined Parent Child Cognitive-Behavioral Approach for Children and Families At-Risk for
Child physical Abuse
Culturally Modified Trauma-Focused Treatment
Essence of Being Real
Heartland Health Outreach
Integrative Treatment of Complex Trauma
International Family Adult and Child Enhancement Services
Multimodality of Trauma Treatment (aka Trauma-Focused Coping in Schools)
Neurofeedback
Parent-Child Interaction Therapy
Real Life Heroes
Risking Connection
Sanctuary Model
Seeking Sanctuary
Sensory Motor Arousal Regulation Therapy
Structured Psychotherapy for Adolescents Responding to Chronic Stress
Trauma Affect Regulation: Guide for Education and Therapy (TARGET)
Trauma Affect Regulation: Guide for Education and Therapy for Adolescents and PreAdolescents (TARGET-A)
Trauma Systems Therapy
Trauma, Addiction, Mental Health, and Recovery; Trauma and Grief Component Therapy
Trauma-Focused Cognitive Behavioral Therapy
Trauma-Focused Cognitive Behavioral Therapy for Child Traumatic Grief
Trauma-Informed Organizational Self-Assessment and Trauma Recovery and Empowerment
Model (TREM and M-TREM)
Trauma-Informed Yoga
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Trauma Screening
46. Do you conduct a trauma screening as part of your normal intake or enrollment procedures?
[IF YES, ASK:]
a. Do all youth who enroll receive the screening – or just some? What prompts the screening
for some but not others?
b. Do you use a specific screening tool? If yes, which one?
c. Can you please describe the key areas that are covered in your screening tool?
[INTERVIEWER: USE THE CHECK LIST BELOW TO INDICATE THE AREAS COVERED BY THE
SCREENING. ASK ABOUT DOMAINS NOT COVERED IN THE RESPONSE.]
Screening Checklist:
Yes
No Domain Assessed
Description/Explanation of What Would Be Assessed
Violence, Abuse, and/or
Assess extent to which witnessed or experienced
Neglect at Home
violence, abuse (physical, verbal, or sexual), or
neglect at home.
Relationships at Home
Determine if relationships at home are supportive or
(Positive and/or Negative)
contribute to the trauma. (Looking into whether there
is emotional support from the family, if family
members are good caregivers?)
Social Engagement (school, Gauge social supports that provide connectedness,
clubs, etc.)
build resilience, and foster healing.
Ability to Engage in
Assess the person’s ability to gain and maintain
Employment and/or
employment and/or attend/stay in school (as
Education
applicable). (Determine whether there’s a longer
history of employment/education challenges and if
trauma could be a contributing factor)
Relationships/Friends
Inquire about ability to connect with individuals in
(Positive or Negative)
friendships or relationships, or if isolation is more
prevalent. Consider whether relationships provide
emotional support.
Frequency of Relationship
Examine how often close or trusted
Turnover
relationships/friendships end, which can be an
indicator of attachment concerns and trust issues.
Change in Residence
Determining how often and how many times the
person has moved residences
Reason for Homelessness
Determine the circumstances that led to
homelessness (run away, throw away, etc.)
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Yes
No
Domain Assessed
Smoking
Substance Use (alcohol and
drugs)
Parental Substance Use
Exercise
Mental Health
Criminal Activity
Sexual Activity
Aggression
Safety
Self-Value
Description/Explanation of What Would Be Assessed
Determine whether the person smokes cigarettes and
if so the frequency of use (Prevalence of smoking is
significant with young trauma survivors)
Determine whether the person uses substances, and
if so, the frequency of use and age of onset..(This can
be helpful to address trauma as a co-occurring
condition.)
Inquire about parent history of substance use. (This
can indicate learned coping behavior and
intergenerational substance abuse concerns that can
complicate healing and recovery).
Ask how often, for how long, and the kind of exercise
the individual engages in. (Exercise is useful to assess
stress management and anxiety reduction.)
Evaluate for prior mental health treatment and/or
diagnosis. This should include a query about family
members that may have struggled with mental health
or depression. This area could also explore suicide
attempts as a serious risk factor.
Determine if the individual and/or anyone in his/her
household committed a crime.
Explore if promiscuous and self-destructive or abusive
factors come out in intimate relationships. (This can
be related to childhood sexual abuse)
Determine if the individual has a pattern of anger and
aggression and if there was/is a family history of this.
Determine whether there was a place the individual
felt safe during childhood and if so how often they
could be there. (Safe place does not have to be home)
Determine whether there was a person or activity
that boosted the survivor’s esteem or who made
them feel important or valued.
47. How are the results of the trauma screening used—both for those who screen positive for trauma
and for those who do not?
[EXAMPLES BELOW]
Determine whether to conduct a comprehensive trauma-focused clinical assessment
Use to inform individual service plan (transitional living plan)
Use to determine other aspects of service delivery
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Attachment I TLP Program Overview Survey: Program Staff Interview Guide
48. Do you provide self-soothing items, tools, or spaces (e.g., weighted blankets, fidgets (or finger
toys), a comfort room) for youth who experience trauma?
Staff Training on Trauma
49. Do program staff receive any training in trauma or trauma-informed care? If so, please describe
the training, who receives it, and when it occurs.
[EXAMPLES BELOW]
In-person training
Online training
Workshop participation
Consultant-assisted implementation
Mentoring from outside the organization
Staff check-ins to discuss TIC implementation and troubleshoot problems
Other
Program Structure, Policies, and Rules
[INTERVIEWER SCRIPT:]
Now I’d like to ask you some questions about how the program works on a day-to-day basis and how
certain issues and decisions are handled.
50. Do youth receive a copy of a resident handbook or other document that outlines the program
rules and expectations? If so, may we have a copy of the handbook?
[IF THE HANDBOOK IS NOT READILY FORTHCOMING, ASK:]
a. What do these materials cover?
Structure
51. Do youth have chores or daily responsibilities within the residential community?
a. If so, how are they determined and what types of chores/responsibilities are they?
b. What happens when a youth fails to complete a given chore/responsibility?
52. In what ways are youth involved in program design, implementation, and governance/decision
making? If so, how?
[EXAMPLES BELOW]
Youth advisory committee
Resident constitution or peer covenant
TLP Youth involved in service delivery within the agency
▌pg. 26
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Privileges and Rules
53. Do youth gain more privileges during their time in the TLP program? If yes, what are these
privileges?
[EXAMPLES BELOW]
Use of personal car
Cellular phone use
Increased free time
Overnight/weekend passes
Later curfew or later wakeup
Increased program allowance
Visitor privileges
Anything else
54. What, if any, rules must a youth follow while staying at the TLP? Please describe.
[EXAMPLES BELOW; ASK IF TLP HAS A FORMAL LIST OF RULES. IF SO REQUEST A COPY.]
Curfew
Visitor restrictions
Weapons prohibited
Alcohol or drugs prohibited on program property
Random drug screening
Smoking prohibited on program premises
Sexual activity between residents prohibited on premises
Cell phone restrictions
Searching of youth property by staff
Borrowing/lending of possessions among youth
Chores/cleanliness
Savings or budgeting requirement
Anything else
55. What happens when a youth fails to adhere to a given rule? [INTERVIEWER: PROBE FOR WHETHER
THE PROGRAM UTILIZES THERAPEUTIC TIME OUTS, OTHER SANCTIONS/PUNISHMENTS]
56. What, if any, rules seem to generate the most friction between youth and staff?
57. Are there any rule violations that result in an automatic discharge? If yes, what are they?
[EXAMPLES BELOW]
Fighting/assaulting on premises
Destroying property
▌pg. 27
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Possession of weapon
Pregnancy
Substance use on premises
Positive drug test
Verbal aggression
Anything else
58. In these instances (of discharge), may the youth reapply to the program at a later date?
59. What is the grievance procedure for youth who feel unfairly treated?
60. When youth are expelled from the program, what, if any, assistance is provided to youth and how
are they prepared for departure?
Typical Day in TLP
61. So far, we’ve talked a lot about the program’s services, structure, and policies. Taking a step back,
can you give me a sense of what a typical day or week would be like for a youth who has been in
the TLP for some time?
Program Discharge
62. How does the program define a safe exit?
63. What criteria are used to determine when a youth has successfully completed the program and is
ready to be discharged?
64. What process does the program follow for making discharge decisions?
[INTERVIEWER: PROBE FOR WHO IS INVOLVED IN THE DECISION; WHAT SUPPORT IS PROVIDED TO
YOUTH IN PREPARING FOR DISCHARGE AND/OR HOW ARE THEY PREPARED FOR THEIR DAY OF EXIT]
65. What process does the program follow for making and carrying out voluntary early departure
decisions?
[INTERVIEWER: PROBE FOR WHO IS INVOLVED IN THE DECISION; WHAT SUPPORT IS PROVIDED TO
YOUTH IN PREPARING FOR DISCHARGE AND/OR HOW ARE THEY PREPARED FOR THEIR DAY OF EXIT]
After Care
66. What, if any, aftercare services are provided to youth who exit the TLP? Please describe.
[EXAMPLES BELOW]
▌pg. 28
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Staff-initiated check-in/follow-up phone calls
Home visits
Staff available as needed for follow-up support (youth-initiated)
Alumni aftercare group
Participation in other agency services
67. Do all, some, or none of exiting youth receive aftercare services?
[INTERVIEWER: IF NO, ASK:]
a. What is the process for determining who will receive aftercare services and what these
services will be?
68. In what, if any, ways do youth remain involved with the TLP once they have exited the program?
Please describe.
[EXAMPLES BELOW]
Participate in alumni group
Serve on program committee or advisory group
Share their experiences at community meetings, life skills groups, or other program events
Invited to holiday events and graduation ceremonies
Serve as peer mentors
Speak at agency events (e.g., annual fundraisers)
Attend other program alumni events
Program Outcomes
69. How do you define success for the TLP?
70. How do you measure the program’s level of success or effectiveness? Do you measure and track
progress or
[IF RESPONDENT UNSURE:]
a. For example, does the program have outcome targets by which it determines its effectiveness?
If so, what are these targets?
[EXAMPLES BELOW]
Housing
Education
Employment
Health
Life Skills
Relationships or social functioning
b. Do you use a pre- and post-program youth assessment? If so, what is the full name of the
assessment tool used?
▌pg. 29
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
71. Are there factors that seem to contribute to a youth’s likelihood of success, or the likelihood that
they will exit to a safe housing location? If yes, please describe.
[THESE COULD BE YOUTH’S PRIOR EXPERIENCES OR PERSONAL ATTRITBUTES AND/OR EXPERIENCES
IN THE PROGRAM]
72. Are there factors that seem to increase the likelihood that youth will become homeless again or
leave the program without completing it? If yes, please describe?
[THESE COULD BE YOUTH’S PRIOR EXPERIENCES OR PERSONAL ATTRITBUTES AND/OR EXPERIENCES
IN THE PROGRAM]
Closing
73. We’re just about finished. Before we end, is there anything else that you feel it is important for us
to understand about the program that we haven’t asked about?
[THANK INTERVIEWEE FOR THEIR TIME. ASK IF THERE ARE ANY QUESTIONS ABOUT THE INTERVIEW.
PROVIDE YOUR CONTACT INFORMATION IN CASE OF ANY FOLLOW UP THEY’D LIKE TO DO.]
Program Data Tables
[INTERVIEWER: PREFILL WITH AVAILABLE RHYMIS DATA AND CONFIRM]
Budget
74. What is the agency’s total annual budget (from all sources)?
$
75. What is the budget for the TLP (from all sources)?
$
76. What is the total amount of FYSB TLP grant?
$
Service Statistics
Looking back over the past few years of data….
77. How many youth are referred to the TLP
annually?
78. How many youth are served by the TLP
annually?
79. How many youth enter the TLP annually?
▌pg. 30
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
80. How many youth exit the TLP annually?
81. What is the average length of stay in the TLP i?
82. What is the average age at entry of youth
served by the TLP?
83. What is the age range of youth served by the
TLP?
84. What is the ethnic composition of the youth
served by the TLP in the last fiscal year?
85. What is the racial composition of the youth
served by the TLP?
86. What is the gender composition of the youth
served by the TLP?
________ % Hispanic or Latino
________ % Not Hispanic or Latino
________ % Not Provided
________ % American Indian or Alaska Native
________ % Asian
________ % Black of African American
________ % Native Hawaiian or Other Pacific Islander
________ % White
________ % Not Provided
________ % Male
________ % Female
________ % Transgender Male to Female
________ % Transgender Female to Male
________ % Other
________ % Unknown
Housing
87. What is the total number of TLP beds in the program?
88. What is the total number of TLP units in the program?
▌pg. 31
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Program Service Tables
Education Services Tables
89. Typically, where are your education services delivered? [REFERENCE ONLY THOSE ENDORSED BY EARLIER IN INTERVIEW]
(Select all that apply.)
Employment Service
Not applicable
On-site at
residential
program
At TLP
agency
offices
At participants’
apartments
At other community locations
a.
GED classes
(Please specify):
__________________________
b.
Alternative high school
classroom
(Please specify):
__________________________
c.
Education planning/counseling
(Please specify):
__________________________
d.
Education scholarships
(Please specify):
__________________________
e.
Education application and
enrollment assistance (high
school or post-secondary)
Education center with access to
computers, internet, and other
education resources
(Please specify):
__________________________
(Please specify):
__________________________
f.
g.
Other (Please specify):
________________
(Please specify):
__________________________
h.
Other (Please specify):
________________
(Please specify):
__________________________
▌pg. 32
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Employment Service
i.
Not applicable
On-site at
residential
program
At TLP
agency
offices
At participants’
apartments
At other community locations
(Please specify):
__________________________
Other (Please specify):
________________
90. Typically, who provides your education services? [REFERENCE ONLY THOSE ENDORSED BY EARLIER IN INTERVIEW]
(Select all that apply.)
Education Service
a.
GED classes
b.
Alternative high school
classroom
c.
Education planning/counseling
d.
Education scholarships
e.
Education application and
enrollment assistance (high
school or post-secondary)
Education center with access to
computers, internet, and other
education resources
f.
Not
applicable
TLP Staff
Other Staff or
Programs
within the your
agency
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
Partner
Agency
Referral (not
partner)
▌pg. 33
Other service provider
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Education Service
Not
applicable
TLP Staff
Other Staff or
Programs
within the your
agency
Partner
Agency
Referral (not
partner)
Other service provider
g.
Other (Please specify):
________________
(Please specify):
__________________________
h.
Other (Please specify):
________________
(Please specify):
__________________________
i.
Other (Please specify):
________________
(Please specify):
__________________________
91. Typically, what is the frequency of the service?
(Select one for each row.)
Education Service
a.
GED classes
b.
Alternative high school classroom
c.
Education planning/counseling
d.
Education scholarships
e.
Education application and enrollment
assistance (high school or post-secondary)
Education center with access to computers,
internet, and other education resources
f.
g.
Other (Please specify): ________________
h.
Other (Please specify): ________________
Not
applicable
Less than 1
time a month
1 time a
Month
2 or 3 times a
month
More than 1
time a week
▌pg. 34
1 time a week
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
i.
Other (Please specify): ________________
Employment Services Tables
92. Typically, where are your employment services delivered? [REFERENCE ONLY THOSE ENDORSED BY EARLIER IN INTERVIEW]
(Select all that apply.)
Employment Service
a.
b.
c.
d.
e.
f.
g.
Employment readiness
preparation (e.g., resume
development, presentation and
interviewing guidance, job search
strategies and resources)
Employment/career center with
access to computers, internet,
on-line job search, etc.
Job training (e.g. certificate
programs in entry level career
trck fields)
Employment internships
Transitional jobs program (i.e.
time-limited, subsidized
employment with services to
address employment barriers)
Employment placement
Employment retention support
Not applicable
On-site at
residential
program
At TLP
agency
offices
At participants’
apartments
At other community locations
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
__________________________
(Please specify):
▌pg. 35
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Employment Service
Not applicable
On-site at
residential
program
At TLP
agency
offices
At participants’
apartments
At other community locations
__________________________
h.
i.
j.
Other (specify):
________________
(Please specify):
__________________________
Other (specify):
________________
(Please specify):
__________________________
Other (specify):
________________
(Please specify):
__________________________
93. Typically, who provides these services?
(Select all that apply.)
Employment Service
a.
b.
c.
Employment readiness
preparation (e.g., resume
development, presentation
and interviewing guidance,
job search strategies and
resources)
Employment/career center
with access to computers,
internet, on-line job
search, etc.
Job training (e.g. certificate
programs in entry level
career track fields)
Not
applicable
TLP Staff
Other Staff
or Programs
within the
your agency
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
Partner
Agency
Referral
(not
partner)
Other service provider
▌pg. 36
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Employment Service
d.
Employment internships
e.
Transitional jobs program
(i.e. time-limited,
subsidized employment
with services to address
employment barriers)
Employment placement
f.
g.
h.
i.
j.
Employment retention
support
Other (specify):
________________
Other (specify):
________________
Other (specify):
________________
Not
applicable
TLP Staff
Other Staff
or Programs
within the
your agency
Partner
Agency
Referral
(not
partner)
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
Other service provider
94. Typically, what is the frequency of the service?
(Select one for each row.)
Employment Service
a.
b.
c.
Employment readiness preparation (e.g.,
resume development, presentation and
interviewing guidance, job search strategies
and resources)
Employment/career center with access to
computers, internet, on-line job search, etc.
Job training (e.g. certificate programs in entry
level career track fields)
Not
applicable
Less than 1
time a month
1 time a
Month
2 or 3 times a
month
1 time a week
More than 1
time a week
▌pg. 37
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
d.
Employment internships
e.
f.
Transitional jobs program (i.e. time-limited,
subsidized employment with services to
address employment barriers)
Employment placement
g.
Employment retention support
h.
Other (specify): ________________
i.
Other (specify): ________________
j.
Other (specify): ________________
Other Service Tables
95. Typically, where are your other services delivered? [REFERENCE ONLY THOSE ENDORSED BY EARLIER IN INTERVIEW]
(Select all that apply.)
Other Service
a.
Case management
b.
Life skills classes/training
c.
Mental health counseling
d.
e.
Substance abuse counseling
Services to address trauma or
traumatic stress
Not
applicable
On-site at
residential
program
At TLP
agency
offices
At
participants’
apartments
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
At other community locations
▌pg. 38
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Other Service
f.
Health screening
g.
Health care treatment/nurse
h.
Alternative medicine clinic/services
i.
Nutrition counseling
j.
Legal services
k.
Aftercare
l.
Other (specify): ________________
Not
applicable
On-site at
residential
program
At TLP
agency
offices
At
participants’
apartments
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
m. Other (specify): ________________
n.
Other (specify): ________________
At other community locations
96. Typically, who provides these services?
(Select all that apply.)
Other Service
a.
Case management
b.
Life skills classes/training
c.
Mental health counseling
Not
applicable
TLP Staff
Other Staff
or Programs
within the
your agency
Partner
Agency
Referral
(not
partner)
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
Other service provider
▌pg. 39
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Other Service
d.
e.
Substance abuse counseling
Services to address trauma or
traumatic stress
f.
Health screening
g.
h.
Health care treatment/nurse
Alternative medicine
clinic/services
i.
Nutrition counseling
j.
Legal services
k.
l.
Aftercare
Other (specify):
________________
m. Other (specify):
________________
n. Other (specify):
________________
Not
applicable
TLP Staff
Other Staff
or Programs
within the
your agency
Partner
Agency
Referral
(not
partner)
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
(Please specify): __________________________
Other service provider
97. Typically, what is the frequency of the service?
(Select one for each row.)
Other Service
a.
Not
applicable
Less than 1
time a month
1 time a
Month
2 or 3 times a
month
Case management
▌pg. 40
1 time a week
More than 1
time a week
Attachment I TLP Program Overview Survey: Program Staff Interview Guide
Other Service
b.
Life skills classes/training
c.
Mental health counseling
d.
e.
Substance abuse counseling
Services to address trauma or traumatic
stress
f.
Health screening
g.
Health care treatment/nurse
h.
Alternative medicine clinic/services
i.
Nutrition counseling
j.
Legal services
k.
Aftercare
l.
Other (specify): ________________
Not
applicable
Less than 1
time a month
1 time a
Month
2 or 3 times a
month
More than 1
time a week
1 time a week
m. Other (specify): ________________
n.
Other (specify): ________________
▌pg. 41
| File Type | application/pdf |
| Author | Jessica Thornton Walker |
| File Modified | 2015-05-28 |
| File Created | 2014-10-09 |