25 Beulah Road New Britain, Pennsylvania. 18901 VOLUNTEER APPLICATION NAME: DATE: ADDRESS: TELEPHONE: EDUCATION: WORK EXPERIENCE: 1.) Why do you want to become a volunteer in the Recovery Center? 2.) How would you like to use your abilities and talents? Are there things that you would not like to do? (Please specify) 3.) How much time do you see yourself having available? When? (Day time, evenings, weekends, etc. 4.) How will a commitment to the Recovery Center fit into your personal schedule? 5.) Do you have previous volunteer experience? If so where? 6.) What reservations do you have about working in the Recovery Center? 7.) Are you in recovery and if so for how long?
2. Please list three references: NAME: ADDRESS: PHONE NUMBER: RELATIONSHIP: MAY WE CONTACT THEM? YES NO NAME: ADDRESS: PHONE NUMBER: RELATIONSHIP: MAY WE CONTACT THEM? YES NO NAME: ADDRESS: PHONE NUMBER: RELATIONSHIP: MAY WE CONTACT THEM? YES NO Please return to: Women s Recovery Center C/O Judie Weiss Signature
25 Beulah Road New Britain, Pennsylvania. 18901 PLEDGE OF CONFIDENTIALITY I, do hereby pledge to maintain strict standards of confidentiality and professional ethics. I understand it is the policy of Bucks County Council on Alcoholism and Drug Dependence (The Council) that client information should be respected and protected under all circumstances in order to insure privacy for clients. I am also aware of the provision of the Privacy Act of 1974, and that I may be subject to disciplinary action and criminal prosecution for knowing and willful violations of the Act. I realize that questions about whether someone is or has ever been a client, when asked must be answered noncommittally. I will consult with a supervisor prior to taking any action where there is doubt whether such action in compliance with the Privacy Act. I have been informed that clients who desire information sent to other agencies must so stipulate in writing on a release agreement exactly which information is to be released and that no blanket consent documents will be used. I will make disclosure of client records only to a Council employee who has a legitimate need to know the information in the course of his/her official duties. I know that violations are punishable by fines up to $500.00 for the first offense and that any violation will be cause to terminate my relationship with The Council. I have read and fully understand the above. Signature Signature of Council Representative Date Date
25 Beulah Road New Britain, Pennsylvania. 18901 REFERENCE QUESTIONNAIRE Name of Applicant 1.) How do you view this person s ability to interact with other in a non-judgmental manner? 2.) In your opinion, what are this person s strengths? 3.) What concerns might you have for this person s effectiveness? 4.) Absolute confidentiality is a must. What is you view of this person s ability to work within this framework? 5.) Other comments that would be helpful in placing this individual in our Program? Thank you for your participation in a very necessary process. Please return to: Judie Weiss Delaware Valley Women s Recovery Center 25 Beulah Road New Britain, Pennsylvania. 18901
25 Beulah Road New Britain, Pennsylvania. 18901 VOLUNTEER CONTRACT, a Women s Recovery Center Volunteer, and, Women s Recovery Center Manager, do hereby enter into contractual agreement in order to reach the following goals: A. To provide a general understanding of the organization of the Bucks County Council on Alcoholism and Drug Dependence, as well as the Women s Recovery Center. B. To use the skills and resources of the volunteer to the best advantage. In attaining the stated goals, the Women s Recovery Center will provide the volunteer with a network of resources. The Women s Recovery Center staff will: A. Give all volunteers comprehensive education in listening and referral skills. B. Provide training in self-awareness. C. Be available to listen and provide assistance when a problem arises. D. Place the volunteer in tasks that will be rewarding. E. Maintain a supportive relationship with volunteers. F. Will listen to ideas of the volunteer, and be willing to share together in the planning of objectives. The volunteer will help in the attainment of these goals by: A. Attending all required training sessions. B. Attending monthly meetings. C. Demonstrating a sense of responsibility by showing up at agreed times to work. D. Bringing any problems to the Center staff, or the monthly meeting, so that they may be dealt with constructively. E. Developing and maintaining a working relationship with Center and Council staff. F. Sharing ideas and suggestions for the improvement of the program. G. Agreeing to attend workshops and seminars which relate to the skills required of a Women s Recovery Center volunteer whenever possible. H. Being aware that any breach of confidentiality will result in the volunteer s immediate dismissal from the Women s Recovery Center. This contract is subject to review and renewal at regular intervals or at other times desired by either of the undersigned persons. Women s Center Volunteer: I have received a copy of this contract and a copy of the Purpose, Policy and Procedures, and Pledge of Confidentiality. Women s Recovery Center Manager Date
PURPOSE, POLICIES AND PROCEDURES PURPOSE: The purpose of the Women s Center Volunteer is to provide residents and community women with a trained network of volunteers who will be able to listen, support, educate and refer those in need of further assistance to the most appropriate resources. POLICY I The Women s Center volunteers will treat all people with dignity and respect, empathy and compassion. Procedure: Volunteers will be: Disciplined Volunteers will maintain an attitude toward all people that reflects their training and commitment. Aware Humble Discreet Volunteers will understand the warning signs of distress and will be knowledgeable of the resources available to help. Volunteers will be aware that there is a perceived power inherent in this Position, and care and caution are needed when working with vulnerable people. Maintaining confidentiality is as important to the integrity of the group as it is to the integrity and dignity of the total program. Volunteers will not discuss persons, cases or contacts openly in the presence of others. POLICY II- CONFIDENTIALITY Volunteers will maintain the trust of the population served, fellow volunteers and Women s Recovery Center staff by keeping information confidential and sharing information ONLY WITH THOSE WHO HAVE A NEED TO KNOW. All volunteers will read, understand and sign a Pledge of Confidentiality. Volunteers will create a friendly and trusting atmosphere where people feel comfortable enough to talk freely. Volunteers will never discuss a particular case with anyone other than professional staff. Such discussions should be for the purpose of problem solving or to share pertinent information. Any outside professionals seeking information about participants or residents will be referred to the Program Manager.
POLICY III As a member of the Recovery Center Team, volunteers must remain mindful of NOT WORKING IN ISOLATION. There is a team approach to the care of all participants. Any information that is life threatening or that may, in your judgment, put someone in danger, should be reported to the Women s Center staff immediately. For data collection purposes, volunteers will keep an activity log that will be submitted on a monthly basis. It is incumbent upon all volunteers to create close working relationships with the Women s Center staff so that issues and concerns that fall under the category of mandated reporting are appropriately addressed. POLICY IV - REFERRALS When participants and/or clients are in need of outside referrals, volunteers should discuss resources with the Center staff. It is our policy to give clients three (3) referrals so that people have the opportunity to select resources that are appropriate to their individual circumstances. All volunteers will be given a list of referral resources. Prior to giving out referral information, other than one that is listed, the volunteer must have Center approval. POLICY V - RESPECT, RESPONSIBILITIES AND BOUNDARIES Volunteers are asked to treat each other with respect and loyalty. A volunteer s association with the Women s Recovery Center places volunteers in a trusted and respected position in the community. The reputation of the Women s Recovery Center, in part, rests with the attitudes and behaviors that the volunteers and staff members display while in the community. Procedure: Volunteers are encouraged to bring concerns about another volunteer directly to that person. Resolving problems within the group prevents splitting of loyalties. The Program Manager is available to resolve problems with staff or volunteers. Recognize that if your public behavior reflects the goals of the program, to which you belong, it may reflect negatively on the group as a whole and lead questions to the trustworthiness and credibility of the program. Such circumstances as: Serving alcohol to minors, exhibiting personal abuse of chemicals or alcohol, exhibiting personal instability, or imposing one s personal, religious and/or political views, while associated with the Recovery Center, is inappropriate. THESE CONCERNS COULD JEOPARDIZE THE SUCCESS AND INTEGRITY OF THE PROGRAM. Volunteers should always be mindful of their surroundings. We recommend that you not put yourself in any position where your safety can be jeopardized. It is also recommended that a
volunteer not make contact with the children of anyone at the Center, outside of the Women s Recovery Center. Protocol: When a volunteer suspects a case of child abuse, verbal abuse, physical abuse or sexual abuse or neglect, the volunteer must verbally report all details to the Women s Recovery Center Program Manager within 24 hours of obtaining the information. The Program Manager will make the determination as to the reporting of this information to the proper authorities.
TRAINING PLAN: For Recovery Coach Positions 1.) ORIENTATION: What is a recovery coach? What is a Life Skills facilitator? Getting acquainted with The Council Purpose, policies and procedures Contract (sign-off) Scheduling, keeping track of your time Daily Activity Log What are the benefits of being a Recovery Center volunteer Review of the Life Skills Program Transportation 2.) TRAITS OF AN EFFECTIVE COACH 3.) EMPATHY VS. SYMPATHY 4.) ACTIVE LISTENING AND COMMUNICATION SKILLS 5.) HOW TO DEAL WITH DIFFICULT PEOPLE 6.) RECOGNIZING THE NEED FOR REFERRAL 7.) RELAPSE PREVENTION Taking care of yourself 8.) BOUNDARIES- professional vs. personal 9.) RESOURCES 10.) WOMENS SPECIAL NEEDS Abuse issues/domestic Violence Legal, custody issues Stigma of motherhood and addiction Childcare issues Employment for one parent family The trainings will be held at the convenience of the majority of volunteers. The total training hour commitment is 24 hours. This could be completed in one weekend, two Saturdays or over a period of 2 weeks at the rate of 2 hours per night, for the initial group of volunteers. Subsequent volunteer trainings will be scheduled throughout the year as needed. No volunteer will begin service until all of the trainings listed above have been completed. A certificate of completion will be given for each training. Each volunteer will be responsible for giving this certificate to Recovery Center Staff for placement in their volunteer file.
BENEFITS FOR VOLUNTEERS WOMEN S RECOVERY CENTER Gain satisfaction from helping others Accept a challenge Meet new people Make a difference Learn something new Create change Have fun Discovery your skills and talents Support recovery Give back Feel pride Reinforce your recovery Improve your self-esteem For those working in the chemical dependency field, gain credit hours Instill hope