1 / 25

Working with Active Users: approaches

Working with Active Users: approaches. GPD Webinar. AGENDA. Intro to the session Overview Techniques Assessment Intervention Negotiation Case Study Discussion. GOALS. E xplore strategies that extend to previously hard to engage substance using Veterans

nolen
Télécharger la présentation

Working with Active Users: approaches

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Working with Active Users: approaches GPDWebinar

  2. AGENDA • Intro to the session • Overview • Techniques • Assessment • Intervention • Negotiation • Case Study • Discussion

  3. GOALS • Explore strategies that extend to previously hard to engage substance using Veterans • Reduce risk and optimize outcomes for Veterans who use and/or abuse substances • Assist Veterans access housing • Connect motivational interviewing/harm reduction techniques to recovery process • Discuss practices to support recovery within the context of transitional housing

  4. Substance Abuse Diagnosis • Recurrent use resulting in failure to fulfill major role obligation at work, home or school • Recurrent use in physically hazardous situations • Recurrent substance related legal problems • Continued use despite persistent or recurrent social or interpersonal problems caused or exacerbated by substance

  5. WHYPEOPLE USE • Self medicate symptoms • To socialize • Works for them • Biological vulnerability • Learned behavior • To get a break from problems • Isolation • Feels good • Decreases inhibitions • Estimate 10% of the population has SA problem but 1% is homeless

  6. Housing Risks Associated with Use • Rent Arrears • Unable to Maintain Unit • Noise Violations • Guests and Occupancy Violations • Problems with bills –lights, food • Arguments with neighbors • Illegal drugs in unit • Borrowing money

  7. Goals for GPD Programs • The purpose is to promote the development and provision of supportive housing and/or supportive services with the goal of helping homeless Veterans achieve residential stability, increase their skill levels and/or income, and obtain greater self-determination. • The performance metric is at 65% for Veterans discharged from GPD to permanent housing

  8. Regs regarding Substances • Grant and Pre Diem • 38 CFR Part 61.80 section 14 • Residents must be provided a clean and sober environment that is free from illicit drug use or from alcohol use that: could threaten the health and/or safety of the residents or staff; hinders the peaceful enjoyment of the premises; or jeopardizes completion of the grantee’s project goals and objectives

  9. Why Veterans access GPD • Discussions with GPD Liaisons: • What are the identified gaps in service in helping homeless Veterans move towards housing? • How do the VA Homeless Programs see GPD as a resource? • Is GPD being used to provide a safe environment until VASH or other Subsidized/ unsubsidized Housing is available? • Is the GPD program seen as resource to address substance use issues? • Why would a Veteran be referred to GPD as opposed to VASH or other housing programs? • What resources does your program need to assist Veterans with the transition to housing?

  10. Case Examples • Peter Smith has been referred to GPD. Peter has been homeless for over a year. He has been denied benefits multiple times and has expressed a desire to work. He has been unemployed for over 5 years. He had been employed as a roofer but drinking and falling got in the way. He says he wants to be sober but he has had multiple relapses since he has been in the program. • Is Peter appropriate for your GPD program? • What are Peter’s barriers to accessing and maintaining housing? • How will these barriers be addressed

  11. Peter • Can Peter be accommodated in the program with multiple relapses? • Income is a barrier to housing Peter has not been housed for a year but what worked for him in the past? Could Peter be considered for a subsidized program such as S+C or VASH 3. Are there resources to assist with benefits and employment, tenancy skills, treatment and support around SA?

  12. Techniques • Assessment • Stages of Change • Intervention • Motivational Interviewing • Negotiation • Harm Reduction Strategies

  13. STAGES OF CHANGE • Pre Contemplation • Contemplation • Preparation • Action • Maintenance • Relapse

  14. VALUE OF STAGES OF CHANGE • Stages of Change was based on research with self-changers • Intervention can begin before the action phase • Normal for people to try to change several times • Relapse is often part of the process • Interventions can be designed to match Veteran’s stage • Resistance is often the result of not understanding where a person is at • Instead of sobriety, the focus in on raising awareness and increasing motivation to change  • SoC handout

  15. Motivation for Change • Look at Veteran’s goals and behaviors to discuss importance of components • Ask for examples and elaboration • Link tenancy barriers to identified behaviors • Look at competencies based on history and other successful changes • Look at barriers to the goals • Assess barriers using stages of change • Establish how negotiable some barriers are: guests, upkeep, rent • Looks at importance to person of the behaviors associated with barriers: such as drinking with friends in the house

  16. Motivation for Change • Ensure a common understanding • Develop several paths to desired change • Weigh cost / benefits of components of each • Look back for competencies to build confidence • Look forward for hope and inspiration • Lay the foundation for future planning • Accept behavior may not fully change but outcome can be different

  17. Working toward Recovery • Changing behavior is a long process • In order to achieve long lasting change the Veteran has to be fully engaged • Reducing/ stopping use can assist Veterans to attain their goals • Discussion of Recovery can be involved in all aspects of care • Once decision is made to access treatment it must be readily available • This requires coordination with all levels of care and support within the VAMC and community

  18. Harm Reduction: Negotiating Change Harm Reduction is a perspective and a set of practical strategies to reduce the negative consequences of drug use, incorporating a spectrum of strategies from safer use to abstinence.

  19. MOST SUBSTANCE USERS ARE NOT READY TO CHANGE

  20. HARM REDUCTION • Offers Services to Active Users • Works on needs and goals identified by Veteran • Could have recovery as a means to the goal • Raises awareness of risk and strategies to reduce harm • Abstinence may be possible, but accepts alternatives that reduce risk associated with use • Prioritizes risks that may cause serious harm • Sees recovery as a non-linear process • Offers user friendly services • Low barriers, informal atmosphere, extended hours, location

  21. HARM REDUCTION: examples • Harm Reduction can be applied to many behaviors that have negative consequences • Examples include: • Sleeping medication is someone is responding to voices all night and will not consider anti psychotics • Changing shifts if someone is not able to wake up early for whatever reason • Coming to an AA meeting when a person is using or have just had a slip

  22. Enabling? Harm reduction connects use to harm • Goal focused: Reduces resistance • Begins the stages of change • Harm reduction requires person to look at behavior • HR requires an evaluation of priorities • Treatment is always one of the options • Uses the same rules as everyone else • This is the beginning of the conversation

  23. Program Design • What are the stated goals of your program? • Does this reflect the goals of the Veterans referred to your program? • Does this reflect the priorities of the VA Homeless Programs? • How does 38 CFR Part 61.80 section 14 affect the program structure? • Are Veterans required to be sober when they come in? • How is relapse and/or use handled? • How does the program facilitate the transition to housing • What resources do you have access to • What are the gaps

  24. Program Design • Clearly defined goals: making the program a choice • What is the population the program serves? • Will you serve active users, Veterans with psychiatric symptoms, Veterans with medical problems? • Structure to move towards goals: what are the paths to the goals. • Breaking down housing options with paths and timeframes • Availability of services: service agreements and/or staff competencies clearly stated: • Example: benefits advocacy, access to employment services, access to legal assistance, financial management skills, tenancy skills, medical/psychiatric assistance, substance abuse treatment resources • Looking at outcomes: does this meet GPD and Program outcomes

  25. Wrap up and Discussion Follow up: Andrea White awhite@housinginnovations.us

More Related