DYNAMIC RECOVERY: IMPROVING TREATMENT IN SHELTERS

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This research will conduct a three year effort to significantly improve drug treatment at the nation's only public shelter (Greenpoint) having a systematic program to introduce and refer homeless men to long-term treatment. The Short Term Assessment and Referral (STAR) program at Greenpoint II shelter provides a three-month introduction to the therapeutic community approach. Approximately 15 percent who enter STAR, the majority of whom are crack/cocaine abusers, are subsequently referred to long-term therapeutic communities. Resistance to and rejection of therapeutic community drug programs are widespread among these homeless men. The proposed research will accomplish the following specific aims: 1. Increase scientific understanding about the beliefs, folkways, resistance to, and involvements in drug treatment and other social services by homeless men. 2. Conduct careful studies of programmatic innovations designed to increase retention, program completion, and entry rates to long-term treatment by homeless men. 3. Conceptualize and model a "dynamic recovery process" paradigm by carefully studying the activities, choices made, and progress toward stable living during the first three months in a shelter-therapeutic community. 4. Compare and determine the short-term and long-term (post- program) outcomes for participants in the STAR program and employed/general homeless clients, in terms of reduced drugs-alcohol abuse and criminality, reduced residence in public shelters, decreased criminal activity, and less AIDS risk behavior. Information will be routinely compiled on STAR program retention, client activity and service utilization, referral to long term treatment, and outcome at departure, 30-days and 12 months post treatment for specified samples of STAR clients and comparison persons (those living at other Greenpoint shelters for employed and general homeless men). Baseline information will be collected during months 7-18, and three innovative improvements in following years. Study A will develop specialized skills among case managers. Study C will use a Senior Professor model to encourage retention in and referral to TCs. These models will be experimentally introduced, appropriate before, during, and after measures obtained, and major reports developed.