MODIFIED THERAPEUTIC COMMUNITY FOR HOMELESS MENTALLY ILL

此应用程序提供了一个手册和评估计划的治疗 无家可归的精神病患者和滥用化学品的人。 该手册适应治疗社区（TC）的原则和方法， 药物治疗领域，并描述了一个新的模型（修改TC）， 无家可归的精神病患者化学滥用（云母）个人。手动 描述了社区居住环境中修改后的TC计划， （第一阶段至第三阶段）和一个以TC为导向的计划， 第四阶段（Stage 4）。评价计划涉及 仅限住房计划。这两个项目都是不断发展的 全面的综合服务体系。此应用程序是 设计、记录和评估组件的系统工作计划 这个新兴的服务提供系统。 修改后的TC是一个以恢复为导向的计划，使用社区作为- 法在这种方法中，社区提供了上下文和 改变的技术，而社区是愈合剂。手动 描述了方案设计、启动和实施的原则， 以及改进的TC处理结构和工艺。探讨了 恢复阶段、治疗阶段、护理水平（即， 住房和社区。它记录了修改后的干预措施 TC社区住宅和干预措施在TC为导向的支持 住房计划。它开发了一个逻辑模型， 技术合作概念框架、干预措施和成果。它启动了 技术转让的修改TC程序到心理健康领域。 研究设计评估无家可归的云母客户从TC为导向的 支持住房计划（n=50），并将其与无家可归者云母进行比较 在社区加强精神病康复条件的客户 （n=50）和无家可归的云母客户在一个密集的案件管理 基线（进入圈养）、基线后6个月时的状况（n=50） （治疗后6个月）和基线后12个月（治疗后6个月） 治疗）。过程评价的主要目标包括：a） 建立以TC为导向的住房计划， 无家可归的云母个人;和B）证明， 干预措施的发生，并符合方案设计。主要 成果评价的目标包括：a）显示 以传统文化为导向的支助性住房方案的长期执行情况;以及B） 证明该方案的有效性， 标准程序。另一个研究目标是检查 过程和结果之间的关系，开始实证 鉴定TC治疗的活性成分。 该项目有助于在治疗的最先进的 无家可归的云母个人在精神健康和药物治疗领域。 它提供了一个创新的治疗模式（修改TC为 社区住宅和面向TC的简易住房方案）， 培训（它指导精神卫生工作者在TC为导向的 方法）、研究（它提供关于过程、结果及其 相互关系），规划（它传播信息，并开始 技术转让）和政策（现在是推荐的模式之一 在纽约州）。

This application presents a manual and evaluation plan for the treatment of homeless individuals with mental illness and chemical abuse disorders. The manual adapts therapeutic community (TC) principles and methods from the drug treatment field and describes a new model (the modified TC) for the homeless mentally ill chemical abuse (MICA) individual. The manual describes both a modified TC program in a community residence setting (Stages One through Three) and a TC-oriented program in a supported housing setting (Stage Four). The evaluation plan addresses the supported-housing program only. Both programs are part of an evolving comprehensive and integrated service system. This application is part of a systematic plan of work to design, document, and evaluate components of this emerging service delivery system. The modified TC is a recovery-oriented program using the community-as- method. In this approach the community provides both the context and the techniques for change, and the community is the healing agent. The manual describes the principles of program design, launch and implementation, and the modified TC treatment structure and process. It discusses the integration of recovery stage, treatment stage, level of care (i.e., housing), and community. It documents the interventions of the modified TC community residence and the interventions in the TC-oriented supported housing program. It develops a logic model that integrates the modified TC conceptual framework, interventions, and outcomes. It initiates the technology transfer of modified TC programs into the mental health field. The study design evaluates homeless MICA clients from a TC-oriented supported housing program (n=50) and compares them with homeless MICA clients in a community enhanced psychiatric rehabilitation condition (n=50) and with homeless MICA clients in an intensive case management condition (n=50) at baseline (entry into housing), 6 months post-baseline (6 months in treatment), and 12 months post-baseline (6 months post- treatment). The main process evaluation objectives include: a) establishing that the TC-oriented supported-housing program reaches homeless MICA individuals; and b) demonstrating that the delivery of interventions occurs, and is consistent with the program design. The main outcome evaluation objectives include: a) demonstrating the effectiveness of the TC-oriented supported housing program over time; and b) demonstrating the effectiveness of the program in comparison with standard programs. An additional study objective is to examine the relationship between process and outcome, to begin the empirical identification of the active components of TC treatment. The project contributes to the state-of-the-art on the treatment of homeless MICA individuals in the mental health and drug treatment fields. It provides an innovative treatment model (the modified TC for the community residence and the TC-oriented supported-housing program), training (it instructs mental health workers in the TC-oriented approach), research (it provides data on process, outcome and their interrelationship), planning (it disseminates information and begins technology transfer), and policy (it is now one of the recommended models in New York State).