Client Services

HHCLA's Client Services program provides a continuum of outreach, assessment, drug and alcohol treatment, mental health services, case management, and an array of social services for homeless persons with co-occurring mental health and substance use disorders.

HHCLA recognizes the essential human dignity of each person who comes to our program. We take a holistic, multidisciplinary, team treatment approach to providing care for our clients. The first step in this process is to meet the client where they are, without judgment. Each client receives individualized care within the Integrated Harm Reduction model, which seeks to reduce harm associated with current behaviors and increase each client’s motivation to change in positive directions. Warmth, generosity of spirit and empathy are the hallmarks of the HHCLA approach. Client Services at HHCLA are predicated on a simple belief: that our most vulnerable brothers and sisters deserve care as comprehensive, compassionate and efficacious as our most affluent neighbors.

Treatment Model - Integrated Harm Reduction for Co-Occurring Disorders

HHCLA utilizes the principles of harm reduction, motivationa interviewing, stages of change and mindfulness in providing an integrated treatment program for homeless persons with co-occurring psychiatric and substance use disorders. Upon entering the core program, each client receives a comprehensive assessment of his or her health status, including:

• evaluation of addiction severity;
• a mental health assessment;
• medical history;
• physical examination;
• a personal ecology assessment of strengths and desired changes;
• analysis of psychosocial functioning; and
• a psychiatric evaluation.

In addition, each client is assessed for his or her stage of readiness to change. Results from this global assessment and subsequent evaluations guide the individualized treatment plan and services to be provided. Substance use issues and mental health issues are addressed simultaneously.

Services Provided Directly by HHCLA Include:

Health services including physical exams, health screenings, assessment and monitoring of chronic conditions (e.g. Hepatitis C, TB, diabetes and hypertension);

• HIV, Hepatitis and other infectious disease testing and counseling;
• basic needs, such as shelter (emergency & permanent) and food;
• individual and group psychotherapy;
• individual and group peer counseling;
• psychiatric evaluation and treatment;
• health education;
• drug/alcohol treatment;
• acupuncture treatment;
• life skills education;
• vocational counseling;
• relapse prevention skills;
• mindfulness meditation;
• child and family services including developmental assessments and initial health screenings for children, childcare, parenting classes, daily activities for children designed to nurture their learning and growth, and monthly family activities.

Additional services that are not offered on site, such as dental care, pharmacy, and lab services, are provided via contracts and collaborations with outside providers. In these cases, HHCLA serves as a safety net and helps to facilitate access to available community resources.

Collaborative Treatment

Case managers review assessments with each client and integrate both health and social services into an Individual Care Plan. The plan identifies readiness to change, and short and long-term goals. Together, clients and counselors plot the treatment course and identify a specific treatment regime including: group sessions, individual drug/alcohol treatment, therapy, ongoing consultation with our staff psychiatrist, medical services, education sessions, and referrals/linkages to other supportive services. Case Managers meet at least weekly with the client to identify progress on the individual care plan, celebrate successes in meeting objectives, address advocacy issues and any other needs that have emerged. The Individual Care Plan is updated at least every ninety days.

Group treatment is based on a client's readiness to change. Once a client enters the wheel of treatment, they move through a series of groups that are based on the University of Rhode Island Change Assessment (URICA). This assessment helps clients identify their current Stage of Change. Counselors and therapists work to help clients:

• increase motivation to change;
• develop discrepancy between clients' current behaviors and/or circumstances and their desired changes;
• develop mindfulness skills and engage in radical acceptance;
• define and reevaluate clients’ personal values;
• assist clients in working through ambivalence about change;
• replace negative self-talk with positive change talk;
• identify and challenge outmoded core beliefs;
• process and integrate past trauma;
• manage stress and cravings;
• identify and build on clients' inherent strengths and resiliency; and
• develop strategies for replacing old, habitual responses to stressors with adaptive, positive responses.

Clients continue to receive comprehensive case management and health assessments throughout their participation in the HHCLA program.

Community Assessment Service Center (CASC)

Community Assessment Service Center (CASC) services are provided in partnership with substance abuse and mental health community-based organizations, such as Homeless Health Care Los Angeles. More on CASC.

After-Care

When a client is ready to exit the wheel of treatment, he or she works with counselors and case managers to develop an after-care plan that includes relapse prevention techniques, social services, education and vocational resources and participation in alumni activities. Clients leave the HHCLA program with new tools for living, for developing and maintaining positive relationships, for maintaining the positive changes they have made, and for more fully participating in their family and community.

Resources:

• Harm Reduction: http://www.harmreduction.org/
• Motivational Interviewing: http://www.motivationalinterview.org/
• Stages of Change: http://www.addictioninfo.org/articles/11/1/Stages-of-Change-Model/Page1.html
• Mindfulness: http://www.umassmed.edu/cfm/index.aspx

Additional resources are available within our Resource Directory.

For more information on HHCLA's Programs, contact Programs or call 213-744-0724.