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Department of Behavioral Health and Intellectual disAbility Services

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Guide to Providing Values-Based Support

Phase 2 begins after a person has had their immediate needs addressed and has been oriented to the program. This crucial phase can be thought of as the person’s transition from the newness of joining JOH to settling into a daily routine in your program. Timing differs from person to person, but phase 2 will probably last one to six weeks.

Some members will join the JOH community before they are 100 percent committed to recovery. That’s okay. Providing individualized treatment is a core value that means respectfully meeting the person at whatever stage of change they’re in.

Intentionality is another core value of this—and every—phase. Don’t wait for members to reach a point at which you feel they’re “ready” for treatment services. Instead, deliberately begin to build rapport with the member while starting to identify and address each member’s habilitation needs and goals.

Regardless of the person’s investment in treatment services, paying attention to their nonclinical needs may increase their motivation for treatment and help them to succeed in the residential program and beyond. Services that initiate engagement and habilitation include the spectrum of activities that enhance readiness for treatment and increase adult living skills, such as improving hygiene, housekeeping, or communication. Use this phase productively, and document in the treatment plan how the nonclinical aspects of your work with the individual serve to support treatment or contribute to treatment-related goals.

Why is Phase 2 important?

Phase 2 Goals:

1. Help new member settle in

Check in with the new member about how they’re feeling in the program and ask about what the program can do to help them feel comfortable. Instead of asking a general question such as “How are you doing?”, ask specific questions about how they’re adjusting to the program in several specific areas, such as with undertaking household responsibilities, participating in groups, and working with their peer specialist. Help new members stay positive about their transition to residential treatment and acknowledge the skills and flexibility it requires. Also seek to engage new members as full human beings with interests, needs, and experiences that extend beyond those related to recovery.

Goal 1 strategies:
  • Create opportunities for new participants and peers to get to know one another.
  • Support members with identifying areas where they are the most and the least comfortable, and brainstorm ways to improve their experience.
  • Spend time listening to the person’s story and reflect back to them the strengths that you hear. Listen for and comment on positive attributes that you genuinely admire.
  • Identify the skills required to live in residential treatment. Applaud the skills they have and ask if they’d like to build new interpersonal skills.
  • Help the person create a schedule for themselves so that they know where and when to be at different activities.
  • To the degree possible, give JOH members options for outlining which program activities they’d like to attend and how they’ll spend their free time.
2. Intentionally build trust

Expect to earn trust slowly, but work to build trust with intention and don’t assume it will happen “naturally.” It’s important to always approach members with respect and engage them with transparency, honesty, and sincerity. Show interest in a person outside of their formal treatment encounters, such as by starting a conversation when you pass them in the hallway. Also demonstrate your trustworthiness by asking individuals about their priority concerns and then helping them accomplish those priorities first.

Goal 2 strategies:
  • To the degree it remains therapeutic, share your lived experience or your reasons for doing this work.
  • Ask the person how they would like JOH services to be different from the services they’ve received in the past.
  • Ask members about what concerns are most urgent to them, and document their responses in a way that works best in your program. Ask them to prioritize what they would like to work on first. Use team meetings or other ways to ensure that all team members are aware of the person’s stated priorities.
  • Explore with members how case managers, peer specialists, and counselors could participate in addressing their priorities, and connect them with these people if they haven’t met them already.
  • Identify needs that you have observed that the individual may not have noted, such as the benefits of improved hygiene. Identify the right staff person to talk with the member in ways that are non-threatening or shaming. Ask the member if they would like help addressing this need and be prepared to provide concrete examples of how team members could help. Also be prepared to communicate why you think addressing this need is important. If it goes unaddressed, how might it negatively impact the person in the future? Motivate the person, but don’t force the issue. Forcing is contrary to JOH values and will undermine trust.
  • Connect the individual to community resources that address their priorities. Don’t just make a referral, but accompany them (such as with a peer specialist) to the community resource to ensure that their need is fulfilled.
  • Have a conversation with the member about staying connected. Explain the locator form, and come to an agreement about who in the member’s life can be contacted by JOH staff and under what circumstances. Fill out the locator form together.
3. Support the individual in connecting to larger life goals

Individuals in JOH may never have been asked what they want for their lives, or they may have given up on their dreams long ago. Members who have been in and out of traditional treatment services may have stock answers to questions about what they want in life. Dig deeper. Work with someone to renew their willingness to dream and to inspire hope in their future. Try to learn about what they genuinely want for their lives.

Goal 3 strategies:
  • Help members envision their ideal life after they get permanent housing. You could ask:

“Let’s fast forward and imagine that you are already in your own apartment. What does your day look like? What are some of the things you’re doing?”

“Can you tell me a bit about your hopes or dreams for the future?”

“What kind of dreams did you have before you started having problems with alcohol or drug use?”

“If you went to bed and a miracle happened while you were sleeping, what would be different when you woke up? How would you know things were different?”

  • Form a Peer Advisory Council to connect members to new opportunities.
  • Invite alumni to speak to groups.
  • Host informal social events that connect new participants with alumni.
  • Connect members with peer staff who work intentionally to inspire hope. Ask peer staff to help members explore new activities and interests.
4. Explore barriers to achieving goals

Use motivational interviewing, storytelling, and other activities to help a person identify their personal challenges to achieving what they want out of life. Help the person use these insights and connections to motivate or strengthen their commitment to recovery as a condition for achieving their hopes and dreams.

 

Goal 4 strategies:
  • In groups and individual sessions, ask probing questions such as, “What has gotten in the way of your being able to create this life for yourself in the past?”
  • Ask individuals to reflect on and share the impact that substance use has had on their life so far, specifically how it has affected their goals.
  • Ask individuals to reflect on how substance use might affect their future goals and dreams.
  • Create ways for peer staff to share how substance use has affected their lives.
  • Support the person in thinking through how they can build on their strengths, reduce their vulnerabilities, and take steps toward their dreams.
5. Support the person's holistic assessment of their skills and assets

Building concrete skills that the person wants for themselves is a core JOH value. In practice, it begins with a skills assessment. In preparation for pursing recovery and other goals, complete the BPS assessment and also work with the person to identify strengths and personal assets, self-care skills, life skills, and recovery capital, including their individual, family, social, and community assets. Use a recovery-oriented approach that looks at skills in a variety of domains.

Individuals may come into your program believing that they have no particular skills, or they may underestimate the skills they have. You can help them identify skills by listening carefully to their stories and naming or re framing some of the skills you see. This approach also reflects the goal of healing-centered engagement. For example, a history of chronic homelessness might suggest the person has strong survival skills, and joining your JOH program may suggest the person has a positive outlook. Using a recovery-oriented approach doesn’t mean that you ignore areas of vulnerability. If a person has to increase skills in a certain area for their well-being or to achieve goals, it’s important to document those areas and ask them to prioritize building those skills.

Goal 5 strategies:
  • Use a skills inventory to have people assess themselves along various self-care and life skills dimensions.
  • Assume people have skills. Ask, “What are your strongest skills?” not “Do you have any skills?” Other fruitful questions include:

“Have you experienced a time when you were able to sustain your recovery or sense of wellness for a day? What worked?”

“What are you good at? What have you been good at in the past?”

“How have you survived the things that have happened in your life? What strengths have kept you going?”

  • Share your observations about the member’s skills.
  • Invite people to share their story. Listen to how they frame the narrative of their life and explore what they view as their primary challenges.
  • Discuss strengths, and collaboratively identify area to be strengthened. What is most important to the person and the community to work on first? For example, learning to sleep in a bed, showing up on time for sessions, keeping their room clean, learning to cook, and so on.
  • Use the BPS assessment as a guide for a dialogue in which you explore the person’s current and past experience in various life domains.
  • Support the person in identifying strategies, actions, and staff or other resources that will support their growth in two or three priority areas.

Phase 2 Resources:

Published 2020

Program Manager: Deanna.Lear@phila.gov

Project Assistant: Tina.Newstead@phila.gov