MODIFIED THERAPEUTIC COMMUNITY FOR HOMELESS MENTALLY ILL

此应用程序提供了治疗手册和评估计划 患有精神疾病和药物滥用障碍的无家可归者。 该手册改编了治疗社区(TC)的原则和方法 并描述了一种新的模型(改进的TC)，用于 无家可归的精神病药物滥用(MICA)个人。手册 描述了社区居住环境中的修改后的TC计划 (第一阶段到第三阶段)和一个面向TC的计划 住房环境(第四阶段)。评估计划针对的是 仅限保障性住房计划。这两个项目都是不断发展的 全面、综合的服务体系。此应用程序是 设计、记录和评估组件的系统工作计划 这一新兴的服务提供系统。 修改后的TC是一个面向恢复的计划，使用了社区-AS-AS- 方法。在这种方法中，社区既提供了上下文又提供了 技术的改变，而社区是治愈的媒介。手册 描述了程序设计、启动和实施的原则， 以及改进后的TC处理结构和工艺。它讨论了 综合康复阶段、治疗阶段、护理水平(即， 住房)和社区。它记录了修改后的 TC社区居住及其在TC导向支持下的干预 住房计划。它开发了一个逻辑模型，集成了修改后的 TC概念框架、干预措施和结果。它启动了 将修改后的TC计划的技术转让到精神卫生领域。 研究设计从面向TC的评估无家可归的MICA客户 支持住房计划(n=50)，并与无家可归者MICA进行比较 社区强化精神康复条件下的当事人 (n=50)与无家可归的MICA客户进行密集的病例管理 基线(进入住房)时的状况(n=50)，基线后6个月 (治疗中6个月)和基线后12个月(治疗后6个月 治疗)。主要过程评价目标包括：a) 确立以TC为导向的保障性住房计划达到 无家可归的MICA人；和b)表明 干预措施的发生，并与方案设计相一致。主 成果评价目标包括：a)展示有效性 随着时间的推移，面向TC的支持住房计划；以及b) 展示了该计划的有效性与 标准程序。另一个研究目标是检查 过程与结果的关系，开始经验性的 TC治疗中有效成分的鉴定。 该项目有助于最先进的治疗方法 精神卫生和药物治疗领域的无家可归的MICA人。 它提供了一种创新的治疗模式(修改后的TC用于 社区住宅和面向TC的保障性住房计划)， 培训(它指导精神卫生工作者以TC为导向 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(它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).