title: Evolving a model for integrated treatment in a residential setting for people with psychiatric and substance use disorders.
abstract: This paper discusses the implementation of a residential, integrated treatment program serving dually diagnosed people with histories of homelessness. Attention is focused on the program structure and how the program developed over time. Program modifications tended to relax program rules and embrace a motivational, stage-wise model using harm-reduction principles. Despite initial skepticism regarding these modifications, outcomes such as program retention, abstinence from substances, employment, and hospitalization improved.
authors.affiliation: Thresholds. johnmayes@thresholds.org
authors.forename: John
authors.initials: J
authors.lastname: Mayes
authors.forename: Samantha
authors.initials: S
authors.lastname: Handley
mesh_terms: D000293:Adolescent; D000328:Adult; D019033:Delivery of Health Care, Integrated; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D040261:Harm Reduction; D006284:Health Plan Implementation; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission; D011618:Psychotic Disorders / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational; D012112:Residential Facilities; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000534:rehabilitation*