Working with supportive housing tenants, particularly in an environment in which services are voluntary, can be challenging. It also may represent a significant shift for staff accustomed primarily to seeing tenants in their office on a set schedule. In order to be successful in implementing this model, staff must have appropriate training and support. In other words, they need the right tools in their toolkit to work with tenants effectively. This section outlines some of those tools and provides links for more information. This is not meant to represent an exhaustive list, and staff should seek out additional information and examples.
Motivational interviewing is a collaborative, person-centered form of guiding to elicit and strengthen motivation for change. It utilizes open-ended questions, affirms the person, reflects feelings and summarizes topic areas related to change. It is intended to resolve ambivalence (particularly useful to change-reluctant persons) and to get a person moving along the path to change.
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In addition to the traumatic experience of homelessness itself, many persons experiencing homelessness also have histories of trauma. In some cases, the trauma may have resulted from a one-time event, and in others, there were multiple incidents over a period of years, possibly beginning in childhood. These experiences can impact every aspect of how an individual functions and responds to a given situation. Trauma-Informed Care is based on an understanding of the significant ways in which trauma impacts lives and ensures that services and supports are delivered in a manner consistent with supporting survivors of trauma.
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Stages of Change and Harm Reduction
Similar to Housing First, the Harm Reduction philosophy prioritizes housing stability among persons who have experienced homelessness and who may be facing disabilities. Although recovery from mental health and substance abuse disorders is always the goal, harm reduction acknowledges that persons may be at different places along the continuum of behavior change.
Harm reduction focuses on meeting tenants where they are and assisting them to set and achieve goals. In this process, a trusting relationship is established with the provider. This relationship has been proven to be key to many individual change processes. Services focus on helping tenants stay housed by managing problems that interfere with their ability to meet the obligations of tenancy, such as paying rent. Tenants also are encouraged to explore obstacles toward their goals in an open and non-judgmental atmosphere in which they can contemplate costs and benefits of receiving services addressing their special needs. This way, staff does not alienate tenants or cause them to begin a dishonest game of hiding their drug use, psychiatric symptoms, etc. Like any other tenant, tenants receiving services using this philosophy must still pay rent and comply with the terms of their lease.
In working with tenants to reduce harm, it may be helpful to understand the stages of change model. With any change, regardless of whether it is related to health behavior, people go through a process. This process ranges from Pre-Contemplation , in which the person does not see the behavior as a problem, all the way through Maintenance, in which the person has made the change and integrated it into their daily life.
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