Mindful Continuing Education

Enhancing Behavioral Health Services for Homeless Populations

Did You Know?

1. People who are homeless often have well-developed street, skills, resourcefulness, and knowledge of the services system, which are important strengths that can be built upon in treatment.

A. True B. False

2. People with substance use or mental disorders who are homeless are often likely to face immediate life-threatening situations, and the first step toward healing may be access to:

A. Behavioral health care that prioritizes self-care B. Positive and helping relationships C. Medical care and a safe and healthy place to live D. Community support across a variety of services

Preventive Services for People Who Are Homeless

3. In most communities, universal prevention efforts are targeted to persons who are homeless because of the recognition that homeless populations are a critical part of the larger community.

A. True B. False

Housing as Prevention

4. Effects of homelessness may be especially acute in children, for whom homelessness may mean a loss of family stability, disruptions in school attendance or performance, and:

A. Being ostracized by peers B. A decrease in critical social connectedness C. The beginning of a chaotic and fear-based existence D. Exposure to victimization and harm

Recommendations of the Consensus Panel

5. Solving homelessness is more than just having a safe place to live since it typically presents with multiple problems such as substance abuse, mental health issues, medical problems, legal/criminal justice issues, social challenges and so forth.

A. True B. False

What Factors Contribute to Homelessness-Individual Factors

6. In addition to substance use and mental disorders, a range of complex, interrelated individual risk factors are related to homelessness, and in particular each of the follow EXCEPT:

A. Trauma related symptoms and cognitive impairment B. Disadvantaged experiences in adolescence and interpersonal difficulties C. Medical conditions and lack of support from family D. Limited education, poor job skills and incarceration

Are There Different Types of Homelessness?

7. The most common type of homelessness is the acute type in which individuals and families repeatedly enter and leave homelessness.

A. True B. False

8. An example of a candidate for transitional housing is an individual leaving addiction treatment who has no place to live, needs a sober environment to support recovery, and can be expected to regain employment in the near future.

A. True B. False

Homelessness and Behavioral Health Services

9. Which of the following is an accurate statement about homelessness and mental health issues and services:

A. Substantial progress toward recovery and self-sufficiency may require significant engagement efforts and repeated attempts at treatment and housing rehabilitation B. Clients who relapse and exhibit symptoms of their mental disorder C. People who are homeless or at risk for homelessness and have a substance use or mental disorder likely need services ranging from safe and stable housing, food, and financial assistance to medical care, mental health treatment, child care and more D. All of the above

10. Behavioral health workers engaged in providing services to clients who are dealing with homelessness can benefit from understanding that many clients who are experiencing homelessness are on a long recovery pathway, and that change is:

A. Personal and individual B. Varied C. Incremental D. Divergent

11. For many people with substance abuse and mental health issues, homelessness often serves as motivation to make behavioral changes since they recognize that they have "bottomed-out" and need help.

A. True B. False

Managing Responses to Working With People who are Homeless

12. Behavioral health professionals may be better able to manage their responses to working with the homeless if they maintain healthy boundaries between their work and personal lives and recognize their role in helping people help themselves.

A. True B. False

Critical Stages of Recovery- Exhibit 1.4

13. During the dependent/aware stage of recovery, the role of the service provider is to:

A. Demonstrate hope and encourage self-acceptance B. Engage family and other social supports C. Encouage individual coping strategies to deal with symptoms and distressing events D. Promote readiness to make choices about life roles/goals

Stages of Homelessness Rehabilitation

14. The stages of homelessness rehabilitation include outreach and engagement, transition to intensive care, intensive care, transition to ongoing rehabilitation, and ongoing rehabilitation.

A. True B. False

Intensive Care

15. During the intensive care stage of homeless rehabilitation, an individual should not necessarily focus on maintaining the gains made through previous substance abuse and mental health services, as setbacks are common and placing unrealistic expectations on oneself may increase failures.

A. True B. False

Ongoing Rehabilitation

16. Ongoing rehabilitation is an open-ended phase in which people gradually establish an identity as no longer homeless, and it includes a continuing counseling relationship and:

A. Continued participation in prevention programs as appropriate B. Continued access to medical care for any problems C. Continued participation in positive community activities D. Continued integration of behavioral health services and ongoing healthcare, legal, and social services

Initial Screening and Evaluation

17. Within treatment settings, a first contact with a person who is homeless or facing homelessness will usually involve initial observations and, potentially, decisions about care.

A. True B. False

Early Interventions and Stabilization

18. Stabilization is a prerequisite for beginning an ongoing recovery program, yet for some people, particularly those who have been living in ambiguity, chaos, or from crisis to crisis, stabilization can be uncomfortable.

A. True B. False

Case Management

19. Which of the following is NOT a correct statement about case management for homeless individuals?

A. Case management is essential in addressing clients' manifold needs and preventing clients from becoming lost in the maze of community services B. The job of case management will generally fall to to a professional trained in assertive case management C. Clients who are homeless have unique needs and may require assistance with such tasks as arranging transportation D. With people who are homeless, case management services need to begin when the client enters the service system

Relapse Prevention and Recovery Management

20. Wellness self-management, also termed illness self-management, includes interventions that are typically delivered through a series of classroom like group sessions that capitalize on interpersonal techniques that focus on here-and -now aspects of living a healthy lifestyle.

A. True B. False

21. Supportive employment is an evidence-based practice that uses tangible rewards for housing, work training, and work opportunities and provides direct monetary reinforcement for accomplishing clearly defined weekly rehabilitation goals.

A. True B. False

Special Issues in Service Delivery

22. Some of the most pressing issues for people who are homeless include addressing acute and chronic medical conditions, recognizing cognitive problems, making the transition from incarceration or impatient hospitalization, and:

A. Facing general rejection or discrimination from other people B. Having access to healthy relationships with the mainstream population C. The lack of ability to maintain employment or education placement D. Dealing with a history of trauma that may trigger adverse responses or reactions

Cultural Competence

23. Culturally competent service providers understand that homeless people and their family members may reject services because of cultural norms and/or past negative experiences with the service system.

A. True B. False

Housing Services for Individuals with Substance Use and/or Mental Disorders

24. Housing services for people with a substance use disorder and/or a mental illness can be divided into two broad categories, including housing specifically provided for clients in early and ongoing recovery from substance use and mental disorders, and housing that offers a safe place to live along with social, health, and behavioral health services, and:

A. A variety of options for homeless rehabilitation B. A focus on minimizing trauma and dislocation caused to individuals, families, and communities by homelessness C. Homeless management information systems D. Case management and outreach

Services for Veterans Who are Homeless

25. In addition to services available in the community and local treatment system, veterans who are homeless may be eligible for VA services, and nearly every VA hospital has a Health Care for Homeless Veterans (HCHV) Program caseworker who has information about local services and eligibility criteria.

A. True B. False


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