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Continuum of Care for the Homeless

By on April 20th, 2013

continuum

Many people still think of rescue missions as places where homeless people find housing, food and spiritual instruction. Yet, those of us who are involved in this field know that unless their deeper spiritual, emotional, physical, and social needs are addressed, homeless people will never attain stability in their lives. Many suffer from mental illness, addiction to alcohol and/or drugs, and various medical problems. Some cannot read, lack high school diplomas, and do not possess basic skills needed to find and keep a job. These and other complex problems keep people on the streets.

In 1995, after years of attacking homelessness by focusing on more affordable housing, the Department of Housing and Urban Development promoted a new system and philosophy, called a “continuum of care.” It involves a comprehensive approach with three fundamental components: emergency shelter, transitional housing with social services, and permanent housing.

By the time HUD began talking about a continuum of care approach to helping the homeless, rescue missions affiliated with the  Association of Gospel Rescue Missions  had already been leading the way by offering a broad spectrum of innovative programs and services.

Outreach, Intake & Assessment

A continuum of care approach requires a case management strategy in which the needs of each homeless person seeking help at the mission are accurately identified. The intake and assessment process is essential in order to develop strategies to address these needs in a systematic and individualized fashion.

A written plan would involve creating a schedule of which mission services would be utilized at certain points during the individual’s stay. It would specify which staff members would work with the person and which outside agencies would be used. Specific outcomes that would signal the completion of each phase of the service delivery (i.e. the expectations that would need to be met before the client can move onto another program or set of activities).

Emergency Shelter & Transitional Housing

In a continuum of care approach, emergency shelter is only for a few weeks. It is most appropriate for those who have experienced a catastrophe, like losing a home to a fire, or are experiencing another sort of short-term difficulty. Transitional housing involves a longer stay at the mission. This component is intended to help individuals and families to address the life problems that led to their becoming and remaining homeless.

Supportive Housing

Any individual who applies for a longer term stay in the missions facilities should do so with the understanding that they must have a good reason for staying there. This is determined in the assessment and case management process. For some, the plan may be very simple, such as saving up enough money to get into their own housing. For others, it can be more complex, integrating addiction treatment, learning to read, completing a high school diploma, and working to enter into gainful employment.

If this process is adopted, the mission will move away from being a place that just provides a cheap place to stay. Instead, it is truly interventive; a place where homeless and troubled people can actually address some of the following issues during a longer-term stay in the mission’s facilities:

Mental health issues  — Some experts believe that up to one third of homeless persons suffer from some form of mental illness. Therefore a definite strategy must be in place to identify these individuals and develop plan to provide appropriate supervision and services in conjunction with community-based resources. In some cases, these individuals can attain a reasonable quality of living with minimal supervision which may involve a more permanent living arrangement. In some cases, missions have become agent payees for such individuals who are eligible for Social Security Disability Income, maintaining a more or less permanent arrangement to assist them.

Substance abuse  — Because addiction is a major cause of homelessness, identifying those with alcohol and drug problems is a vital component of the continuum of care strategy. To be truly interventive, drug testing should be mandatory for  all  who stay in the missions facilities on a long-term basis.

A test positive test would then be followed by an addiction screening. Then, if appropriate, they are then required to become involved in a program, either in-house or in the community, to address their addiction problems.

Two very good resources that can be utilized in this aspect of the mission’s programming are the Recovery Education Modules by Terrence Gorski (800-767-8181  ) and the ASAP computer-based addiction assessment and case management system (800-324-7966  ). The latter, based on the Addiction Severity Index is a very reasonably priced package with several different components for managing service delivery to addicted clients. Free demo disks are available.

Job training  – Formal employment programs, like WorkNet (818-855-5404  ), are being successfully used by rescue missions to assist homeless individuals to adopt healthy work attitudes, gain new job skills, and learn how to find a job that fits their unique skills and interests.

Family support  — Teaching of basic parenting and relationship skills, along with counseling for couples and family members, support and nurture the family unit. This might be an area where something could be developed that could be available to individuals in both the men’s and women’s in the latter stages of their stay at the mission.

Education  — I recommend that serious consideration be given to developing a Learning Center that provides basic literacy, English as a Second Language, and High School Completion (GED) instruction. The Nova Program, offered by Innovative Learning Systems (213-255-1883  ), is a computer-based approach that is being successfully utilized by almost fifty AGRM-affiliated missions. Some time needs to be spent in determining more definitely how these programs fit into the overall scheme of providing services to the mission’s clients.

Independent Living Skills  — Courses can be offered on such topics as money management, personal hygiene, and basic domestic proficiencies such as cooking, menu planning, shopping and sewing.

H.I.V/Medical Needs  — Many missions operate health clinics, often staffed by volunteer physicians and nurses. Be a basic health screening, followed by appropriate care, is an important starting point on the road to a stable life, it should be required for all who stay at the mission for a longer period of time.

Permanent housing

Mission programs are usually considered successful when formerly homeless residents return to society as productive citizens with their own homes. However, not everyone we work with can live independently. This is especially true of those who are mentally and physically handicapped and otherwise infirm. In response to this need, many missions now provide supportive housing on a longer term or permanent basis in what might be termed “adult foster care” programs.

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Using Recovery Principles in Christian Programs

By on April 10th, 2013

How can we properly use ideas, principles, and techniques from the secular treatment in Christian recovery programs?

A. Stay true to the scriptures – Anything we use in rescue ministry — whether in the area of fund-raising, business practices, or rehabilitation — must be subjected to the light of the Word of God. Therefore, we must throw out any principles or philosophies that contradict God’s Word! Christian counselors must reject any philosophy or approach that lifts from a sinner his sense of responsibility for his own actions and his need for repentance and brokenness at the Cross of Christ. The Bible is perfectly clear on the fact that real, lasting change can only occur when an individual can experience true repentance — which implies a sense of personal accountability for his actions and their consequences.

B. Be discerning – A creationist scientist will reach a set of conclusions on a certain geological formation that is very different from those of his evolutionist counterpart. In a similar fashion, while dealing with factual data, conclusions reached by non-Christian researchers or counselors often reflect a godless “world-view.” Despite this dilemma, we must not reject the whole body of factual knowledge about addiction and successful treatment approaches that is accessible and useful to us as Christian counselors.

C. Use what you can and discard the rest – Certainly, some of the ideas that are coming out of the secular treatment world do contradict the scriptures (especially on the topics of morality and spirituality). Yet, many of the successful methods they use to establish addicts in a life of sobriety have their origins in the Word of God! In a very real sense, they have re-discovered some deep spiritual principles that have been almost lost to the modern Western Church. Some of these are: the power of accountable relationships, the healing nature of deep and intimate sharing between believers, the indisputable connection between rigorous honesty and true spirituality, and the principle of comforting others through sharing how the Lord brought us through similar situations (2 Corinthians. 1:3-7). While secular and atheistic people may see these principles in a totally different light, we ought to be able to discern, with the Holy Spirit’s help, what aspects of this field of knowledge we can integrate into our mission programs without compromising on revealed truth.

 

 

Rescue Magazine Summer 1993

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Creating Hope in Our Clients

By on March 25th, 2013

I have often said that the residential recovery program’s first goal is to create hope in our clients. What are some ways we can accomplish this?

Before people can begin the process of change they must fully understand two basic truths; 1) that change is needed in a certain area of their lives and 2) that change is possible.

In previous articles, I have discussed strategies of breaking through the addict’s denial system, which is the starting point for his or her accepting the need for change. But if we only convince people that their lives are a mess we may leave them in a place of despair. We must create an environment full of hope where they can catch a vision for how their lives could be in Christ, along with giving the tools to build a life of faith and recovery.

A. Share the Word — In chapel services and Bible studies with new residents spend time studying scriptures like Jeremiah 29: 11 – “’For I know the plans I have for you,’ declares the LORD, ‘plans to prosper you and not to harm you, plans to give you hope and a future.’” Addicts tend to be “spiritually dysfunctional” and need to gain a clear perspective of God the Father, His character, His power, and His intentions for them.

B. Addiction Education – Gaining more knowledge about addiction serves two very important functions. First, it helps the addict in denial accept his or her condition. Secondly, this knowledge can be a tremendous source of comfort and hope for those struggling with post acute withdrawal symptoms and the emotional difficulties that come with early recovery. Many addicts believe they are “terminally unique.’ — that no one has experienced the same struggles and that their problems are so bad they can’t be fixed. Newly sober addicts need to understand that they are suffering from a malady that is shared by others. Many resources are available: lending libraries, literature, videos, and local professionals who can speak at the mission. Contact AGRM’s Education Office for information on educational resources for use in a mission setting.

C. One-on-One Counseling – Every participant in a long-term program needs at least one hour a week with a staff member who understands addiction to help them through the struggles of early recovery. One very important goal of the first few counseling sessions is to help addicts to work through the toxic shame that them tells them they can’t change. They need to know that God loves them and that His power is available to help them to overcome addiction.

D. Support Groups – Good support groups provide recovering addicts with a safe, non-judgmental setting to share their struggles, thoughts, and feelings without fear of rejection. Hearing the stories of others with similar difficulties and how they overcame them provides valuable encouragement for them to go on in a life of sobriety.

E. Hearing the Stories of Staff Members and Program Graduates – People who are new to our programs need to get acquainted with those who have completed the program and have gone on to lead successful, sober lives. Find ways to get them involved in formal meetings and informal gatherings like alumni picnics. In a similar way, it’s important to give other members of your staff who might not be directly involved with the recovery program a chance to share who they overcame addiction, as well. Both program graduates and staff members who are themselves in recovery stand as living proof that the principles shared in your program really do work!