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Helping Homeless Families
    Find Their Strength and
Build Stability One Step at a Time


       Susan Dargon-Hart, LICSW
      Institute for Health and Recovery
          susanhart@healthrecovery.org




             Institute for Health and Recovery
Philosophy of Care




    Hope Rising
    IHR Video




   Institute for Health and Recovery
Who are our clients?

• Homeless families struggling with SUD/COD
  – Children of clients
  – Partners not living in the shelter
• Temporarily housed in state Department of
  Housing and Community Development
  (DHCD)-funded motels, shelters, and
  temporary housing
• DHCD/Housing Authority/Housing First
  Programs
                  Institute for Health and Recovery   3
Engagement

• Reluctant to meet with yet
  another provider
• Assessment – whole
  person, family-based,
  resiliency approach
• Children
   – Present during assessment
   – Focusing on children’s
     needs


                   Institute for Health and Recovery   4
Goal is to Reduce Harm:

Creating a safer environment for ALL
family members no matter where they
              are living



            Institute for Health and Recovery   5
Client-Driven Process

• Family-based, “home visiting” interventions
  – Going to where the family is located
  – Driving family to appointments
• Tools integrated from:
  – MI, Stages of Change, CBT, Care
    Coordination, SUD/COD psycho-
    education, SUD/COD treatment, Trauma-
    Informed Care - Seeking Safety &
    Nurturing Program
                Institute for Health and Recovery   6
Philosophy of Care

RISE is:
• Family focused
• Evidence-based
• Consumer directed
• Trauma informed
• Culturally relevant
• Strength-based
• Relationship valuing

                Institute for Health and Recovery
                                                    7
Motivational Interviewing

• Provide evidence-based
  practices based on MI
• Focuses on strengths and
  competencies of each person
  so she/he can become a
  leader in her/his own service
  plan and personal progress
• Provide MI training to
  shelter/DHCD staff




                     Institute for Health and Recovery   8
Seeking Safety

• Cognitive-behavioral integrated, trauma-
  substance use recovery curriculum, specific
  strategies and tools to promote physical and
  emotional safety
• Provides tools to avoid/prevent relapse from
  substance use, mental health issues and trauma
• A non-judgmental approach towards active use
• RISE conducts Seeking Safety individually
• Provides Trauma-Informed Services training to
  DHCD and shelter staff
                  Institute for Health and Recovery   9
The Nurturing Program for Families in
    Substance Abuse Treatment and Recovery
• Nurturing Program (NP)
  Parenting group is a well
  established, evidence-based
  parenting intervention, on
  NREPP
• Cognitive-behavioral model;
  encourages women to
  explore similarities between
  ways they were parented and
  ways they are currently
  parenting
• NP curriculum also
  integrated within individual
  sessions

                      Institute for Health and Recovery   10
“Those who work well, play well,
  love well, and expect well.”
                                  (Werner and Smith, 1982)



         Institute for Health and Recovery                   11
Stabilization Skills

• Sharing, teaching and modeling life management
  skills
   – Better reactions, better results
   – Motivate to take action around job and/or
     education
   – Housing and tenancy skills
• Relapse Responsive
• Risk Reduction
• Treatment retention issues

                  Institute for Health and Recovery   12
Graduation


• Determine a good
  time to end services
  – “They end us”
  – Mutually agreed
    closure
• Satisfaction Survey



                 Institute for Health and Recovery   13
IHR Homeless Services
             Systems Integration
Agency Level
• Regional cross trainings
  – SUD, COD, trauma-informed services
  – Motivational Interviewing
  – Impact on family & housing stability
• TA, support & consultation on families impacted
  by SUD/CODs, treatment & recovery
  – Emergency family shelter staff, Transitional Housing, Housing
    First
  – Other agencies providing services to homeless families
  – Domestic Violence organizations
  – Local child welfare offices


                       Institute for Health and Recovery            14
How does this model fit into
         Healthcare Reform?
• Shift model to fit into a traditional 3rd party
  payer design without losing non-judgmental
  approach
• Using paperwork as engagement tools
• Outpatient home-based services
• Doing a diagnostic evaluation in a risk
  reduction framework


                 Institute for Health and Recovery   15
How do you engage homeless
         families?




       Institute for Health and Recovery

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2.7: Addressing the Substance Abuse Challenges of Homeless Families

  • 1. Helping Homeless Families Find Their Strength and Build Stability One Step at a Time Susan Dargon-Hart, LICSW Institute for Health and Recovery susanhart@healthrecovery.org Institute for Health and Recovery
  • 2. Philosophy of Care Hope Rising IHR Video Institute for Health and Recovery
  • 3. Who are our clients? • Homeless families struggling with SUD/COD – Children of clients – Partners not living in the shelter • Temporarily housed in state Department of Housing and Community Development (DHCD)-funded motels, shelters, and temporary housing • DHCD/Housing Authority/Housing First Programs Institute for Health and Recovery 3
  • 4. Engagement • Reluctant to meet with yet another provider • Assessment – whole person, family-based, resiliency approach • Children – Present during assessment – Focusing on children’s needs Institute for Health and Recovery 4
  • 5. Goal is to Reduce Harm: Creating a safer environment for ALL family members no matter where they are living Institute for Health and Recovery 5
  • 6. Client-Driven Process • Family-based, “home visiting” interventions – Going to where the family is located – Driving family to appointments • Tools integrated from: – MI, Stages of Change, CBT, Care Coordination, SUD/COD psycho- education, SUD/COD treatment, Trauma- Informed Care - Seeking Safety & Nurturing Program Institute for Health and Recovery 6
  • 7. Philosophy of Care RISE is: • Family focused • Evidence-based • Consumer directed • Trauma informed • Culturally relevant • Strength-based • Relationship valuing Institute for Health and Recovery 7
  • 8. Motivational Interviewing • Provide evidence-based practices based on MI • Focuses on strengths and competencies of each person so she/he can become a leader in her/his own service plan and personal progress • Provide MI training to shelter/DHCD staff Institute for Health and Recovery 8
  • 9. Seeking Safety • Cognitive-behavioral integrated, trauma- substance use recovery curriculum, specific strategies and tools to promote physical and emotional safety • Provides tools to avoid/prevent relapse from substance use, mental health issues and trauma • A non-judgmental approach towards active use • RISE conducts Seeking Safety individually • Provides Trauma-Informed Services training to DHCD and shelter staff Institute for Health and Recovery 9
  • 10. The Nurturing Program for Families in Substance Abuse Treatment and Recovery • Nurturing Program (NP) Parenting group is a well established, evidence-based parenting intervention, on NREPP • Cognitive-behavioral model; encourages women to explore similarities between ways they were parented and ways they are currently parenting • NP curriculum also integrated within individual sessions Institute for Health and Recovery 10
  • 11. “Those who work well, play well, love well, and expect well.” (Werner and Smith, 1982) Institute for Health and Recovery 11
  • 12. Stabilization Skills • Sharing, teaching and modeling life management skills – Better reactions, better results – Motivate to take action around job and/or education – Housing and tenancy skills • Relapse Responsive • Risk Reduction • Treatment retention issues Institute for Health and Recovery 12
  • 13. Graduation • Determine a good time to end services – “They end us” – Mutually agreed closure • Satisfaction Survey Institute for Health and Recovery 13
  • 14. IHR Homeless Services Systems Integration Agency Level • Regional cross trainings – SUD, COD, trauma-informed services – Motivational Interviewing – Impact on family & housing stability • TA, support & consultation on families impacted by SUD/CODs, treatment & recovery – Emergency family shelter staff, Transitional Housing, Housing First – Other agencies providing services to homeless families – Domestic Violence organizations – Local child welfare offices Institute for Health and Recovery 14
  • 15. How does this model fit into Healthcare Reform? • Shift model to fit into a traditional 3rd party payer design without losing non-judgmental approach • Using paperwork as engagement tools • Outpatient home-based services • Doing a diagnostic evaluation in a risk reduction framework Institute for Health and Recovery 15
  • 16. How do you engage homeless families? Institute for Health and Recovery