Housing and
Substance Use:
Using a
Client-Centered
Philosophy of Care

© All rights reserved by Victory Programs, Inc.
VPI’s Philosophy of Care

Victory Programs delivers care to clients            in
accordance with our “Standards of Excell...
The Challenge
• Housing and Shelter Providers may or may not
  have substance use & treatment
  expertise/capacity on staf...
A First Thought…
         …For Providers
Feel like you’re ‘running against the wind’
        sometimes with your clients?
...
One Way to Work With the Wind
• Motivational Interviewing is a well-tested, evidence-
  based practice that can be used to...
Motivational Interviewing -
           Defined
“Motivational Interviewing is a directive, client-
centered counseling styl...
Cookie Cutters are not for People
Assumptions of MI
• Hesitance to change is natural and should be
  expected and explored, not punished.


• People have re...
Assumptions of MI
• Planning and motivating for change (whether
  about substance use, employment, housing
  search, paren...
Principles of Motivational
             Interviewing
• Express Empathy - understanding of the client through
  the skill o...
Principles of Motivational
                Interviewing
•   Support Self-efficacy - increase client perception about their...
Spirit of Motivational
              Interviewing

• It is collaborative, not a power struggle.

• It is provocative, for ...
Research shows that…

“…the counselor need only offer these three
  critical conditions to prepare the way for natural
  c...
Tools of Motivational Interviewing
• Stages of Change – Pre-contemplation,
  Contemplation, Decision-making, Action,
  Mai...
Basic Elements of MI Practice
• Listen more than you talk.


• Ask open-ended questions that evoke real responses.


• Use...
In Practice
•   Rules are negotiated based on behavior, not on substance use per
    se.


•   Studies show, confrontation...
VPI Philosophy Of Care Homes For Families 2010
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VPI Philosophy Of Care Homes For Families 2010

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Presentation @ Homes For Families \'New Approaches for Ending Family Homelessness\' 6/16/10 Conference in Worcester, MA. Topic: "Housing & Substance Use: Using a Client-Centered Philosophy of Care"

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VPI Philosophy Of Care Homes For Families 2010

  1. 1. Housing and Substance Use: Using a Client-Centered Philosophy of Care © All rights reserved by Victory Programs, Inc.
  2. 2. VPI’s Philosophy of Care Victory Programs delivers care to clients in accordance with our “Standards of Excellence”. All services are individualized and client-driven, focusing on client strengths, and supporting clients in establishing individualized goals. In order to provide the most effective services, we utilize evidence-based techniques such as Motivational Interviewing (MI) in a harm reduction setting.
  3. 3. The Challenge • Housing and Shelter Providers may or may not have substance use & treatment expertise/capacity on staff • Alcohol and substance use can amplify a family’s constellation of barriers to stability. • How can housing and shelter providers effectively respond to substance use in a non- clinical setting?
  4. 4. A First Thought… …For Providers Feel like you’re ‘running against the wind’ sometimes with your clients? ______________________ “You can’t change the direction of the wind, but you can change the direction of your sails.”
  5. 5. One Way to Work With the Wind • Motivational Interviewing is a well-tested, evidence- based practice that can be used to structure goal oriented interactions. • It works with the myriad of possibly contradictory motivations, desires and goals that people have. • It assumes that people may be deeply ambivalent about changing their lives. • That includes substance use but also being a parent, finding work, moving to a new community, even finding their own home.
  6. 6. Motivational Interviewing - Defined “Motivational Interviewing is a directive, client- centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. MI takes the health care professional past technique and humanizes the counseling session. MI is more than just a series of techniques; it changes how the professional interacts with the client in a positive way. MI is a client centered approach for behavior change.” Miller and Rollnick, 2002
  7. 7. Cookie Cutters are not for People
  8. 8. Assumptions of MI • Hesitance to change is natural and should be expected and explored, not punished. • People have real reasons for behaving the way that they do. • Clients are the experts on themselves and their lives.
  9. 9. Assumptions of MI • Planning and motivating for change (whether about substance use, employment, housing search, parenting skills, etc) will ONLY be effective if based in the client’s perspective and own goals. • Goal of client work is to foster readiness and support plans for change.
  10. 10. Principles of Motivational Interviewing • Express Empathy - understanding of the client through the skill of reflective listening • Roll with Resistance – symptom of client/staff misalignment of goals, not inherent traits • Develop Discrepancy – explore gap between client goals and behavior
  11. 11. Principles of Motivational Interviewing • Support Self-efficacy - increase client perception about their skills, resources and abilities that they may access to achieve their desired goal. • Avoid Argumentation - Client opinions, thoughts and beliefs are explored, reflected and clarified, not contradicted
  12. 12. Spirit of Motivational Interviewing • It is collaborative, not a power struggle. • It is provocative, for both parties • It is evocative, drawing out and exploring • It is based in autonomy and choice
  13. 13. Research shows that… “…the counselor need only offer these three critical conditions to prepare the way for natural change: - accurate empathy, - nonpossessive warmth, - and genuineness.” Miller and Rollnick, 2002
  14. 14. Tools of Motivational Interviewing • Stages of Change – Pre-contemplation, Contemplation, Decision-making, Action, Maintenance • Decisional Balance – discussing pros and cons of making changes/taking action vs. status quo • Making Plans for Change – based on pros and cons, recognizing resistance and challenges
  15. 15. Basic Elements of MI Practice • Listen more than you talk. • Ask open-ended questions that evoke real responses. • Use more reflections than questions. • Focus on what an action or change means for the resident, the pros and cons.
  16. 16. In Practice • Rules are negotiated based on behavior, not on substance use per se. • Studies show, confrontational strategies do NOT work. • Plans of action are developed collaboratively and based on the goals of the client. • Ambivalence and ‘resistance’ are understood to be a part of the process. • Dancing, not wrestling.

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