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Successfully Housing People with Substance Use Issues

2. The research, development, and publication of this curriculum was funded by the Housing Opportunities for Persons with AIDS (HOPWA) National Technical Assistance Program in partnership with the U.S. Department of Housing and Urban Development's Office of HIV/AIDS Housing. The substance and findin

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Successfully Housing People with Substance Use Issues

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    1. Successfully Housing People with Substance Use Issues

    2. 2

    3. 3 Training Sessions I. Understanding the Issues Your Tenants Face

    4. 4 Session 1 Understanding the Issues Your Tenants Face

    5. 5 Three Classes of Drugs Stimulants (“Uppers”) Depressants (“Downers”) Psychedelics/ Hallucinogens

    6. 6 “Uppers” Cocaine / “crack” Amphetamines Over-the-counter stimulants Nicotine

    7. 7 Physical Effects of “Uppers” Constricted blood vessels

    8. 8 Behavioral Effects of “Uppers” Confidence Alertness Euphoria Irritability Restlessness

    9. 9 “Downers” Opiates/opioids Sedative hypnotics Alcohol

    10. 10 Physical Effects of “Downers” Slowed respiration Depressed heart rate Decreased coordination Sleepiness Pain messages blocked

    11. 11 Behavioral Effects of “Downers” Diminished anxiety Inability to concentrate Euphoria Sluggishness

    12. 12 Psychedelics/Hallucinogens LSD Marijuana PCP Ecstasy Mushrooms

    13. 13 Physical Effects of Psychedelics and Hallucinogens Increased heart rate, blood pressure, and body temperature Dizziness Dilated pupils Sweating Visual distortion

    14. 14 Behavioral Effects of Psychedelics and Hallucinogens Impaired reasoning Slow reaction time Extremes of euphoria and panic/paranoia Delusions of persecution Feelings of grandeur

    15. 15 Recognizing Behaviors – Substance Use vs. Mental Health Issues

    16. 16 The Cycle of Use

    17. 17 Symptoms of Withdrawal Seizures Sweating Goose bumps Vomiting Diarrhea Tremors

    18. 18 Stages of Change

    19. 19 Relapse – A Natural Stage in a Recovery Process

    20. 20 Signs of Relapse Arguing Forgetfulness Stress symptoms Returning to old habits

    21. 21 Relapse Triggers Lack of or loss of a support network Troubled relationships Social pressure Negative life events Positive life events

    22. 22 Tenants Every tenant brings a history, a culture, and a set of expectations and behaviors

    23. 23 Drug and Alcohol Use Creates Its Own Community

    24. 24 The Goal – Keeping Tenants Housed

    25. 25 Session 2 The Housing Context

    26. 26 Applicable Federal Laws and Regulations Equal Protection Clause Fair Housing Act Americans with Disabilities Act Rehabilitation Act of 1973 Age Discrimination Act HUD regulations (including “One Strike”) Confidentiality laws

    27. 27 Other Rules and Regulations to Consider Agency rules, policies, and procedures

    28. 28 Your Role in Compliance Complying with the Fair Housing Act Ensuring reasonable accommodation Maintaining tenant confidentiality

    29. 29 Resources - Housing Emergency shelters Transitional housing Residential treatment programs Permanent housing Population- specific housing

    30. 30 Resources – Internal Team

    31. 31 Resources – Service Providers

    32. 32 Other Resources Family Friends Faith-based organizations Neighbors Library Internet

    33. 33 Qualities of an Effective Team Clearly defined goals Clearly defined roles Relevant skills Clear communication Personal accountability Unity of approach Trust of tenants and co-workers Commitment to learning Leadership

    34. 34 Keep the Lines of Communication Open Community service providers Off-site property management staff and landlords On-site service staff and property management staff

    35. 35 Session 3 The Effective Tool Kit

    36. 36 Goals of Engagement Care for immediate needs Development of trust Provision of services Connection to social networks Increased housing stability

    37. 37 Engagement Strategies Set the stage Initiate your engagement strategy Sustain the relationship Maintain momentum

    38. 38 Tips on Engagement

    39. 39 Employment as an Engagement Strategy

    40. 40 Motivational Interviewing – An Engagement Tool

    41. 41 Five Principles of Motivational Interviewing Express empathy

    42. 42 The Role of Community Creates a vested interest Fosters self awareness Develops self-esteem Builds skills

    43. 43 Building Community Welcome and orient new tenants Encourage, support, and reinforce community norms Offer group activities Develop leadership qualities and peer support

    44. 44 Understanding Assessment Identify drug- and non-drug-related risk behaviors Prioritize service needs

    45. 45 The Purpose of Assessment Determine what you need to know to help the tenant stay housed Identify what you need to know to protect the stability of your other tenants

    46. 46 Identify Stress Points Economic/financial issues Health-related concerns Loss of community/family Parenting pressures

    47. 47 Key Issues in Assessment Ability to meet basic needs Environmental and behavioral triggers Predatory behaviors Interests Stability

    48. 48 Key Approaches in Assessment Be clear and calm about your purpose Don’t fear being too intrusive Avoid yes/no questions Avoid being manipulated Be consistent Ask about past behaviors

    49. 49 Service Planning Fundamentals Involve the tenant Be realistic Develop achievable goals Have a “Plan B”

    50. 50 Health and Safety Checks

    51. 51 Conflict Resolution Ask questions and listen Define the problem Brainstorm solutions Evaluate options Use behavioral contracts

    52. 52 Handling Crisis Situations Calm the tenant Listen carefully Maintain personal safety Debrief Receive training Keep emergency numbers at hand

    53. 53 Working with Tenants at Risk of Eviction Mobilize your resources Step up the intensity Develop a behavioral plan with the tenant Communicate with the tenant

    54. 54 Eviction as a Reality Understand local landlord-tenant laws Follow legal procedures Document behaviors Be prepared to go to court Learn to let go

    55. 55 Session 4 Separating the Personal from the Professional

    56. 56 Professionalism Means: Self awareness Understanding your role Reliability and consistency Knowledge of resources Commitment to learning Teamwork Understanding cultural competency

    57. 57 Boundaries – Rules for Maintaining a Professional Relationship

    58. 58 Warning Signs of Boundary Blur Seeking out tenant outside work Anticipating appointments Disclosing considerable detail about yourself Taking responsibility for the tenant’s success Accepting gifts

    59. 59 Formal Policies vs. Informal Practice

    60. 60 Appropriate Boundary Crossing Action directly relates to housing or clinical needs Professional literature supports your action Risk-benefit analysis supports your decision

    61. 61 Tips for Self Care Clarify expectations Have realistic expectations Keep a sense of humor Celebrate small successes Roll with the punches Set limits Recognize strengths

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