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About ICL : : Our Treatment Approach

Our Treatment Approach

Over the last decade, the Institute for Community Living (ICL) has been in the forefront of integrating best-practices and evidence-based treatments throughout its wide array of behavioral health programs. After extensive education and training, and with ongoing support, ICL staff are implementing the following practices:

Motivational Interviewing Strategies

Motivational Interviewing is an evidence-based practice that seeks to increase a person's intrinsic motivation for change, sense of self-efficacy, and ability to identify and reconcile ambivalence.  While motivational interviewing originally emerged out of the substance abuse literature, it is now widely applied across mental health settings and populations. Motivational interviewing strategies are used, for example, to assist a person in taking the necessary steps to obtain substance abuse services; supporting an individual in coming to terms with and proactively managing her diabetes; or reinforcing a person's consistent efforts at maintaining his recovery. ICL offers regular agency-wide trainings in motivational interviewing strategies throughout the year. These trainings are based on SAMHSA TIP 35: Enhancing Motivation for Change in Substance Use Disorder. 

For more information about the SAMHSA Tip 35, visit:
http://ncadistore.samhsa.gov/catalog/ProductDetails.aspx?ProductID=15543

Fresh Start

Fresh Start is a brief intervention for individuals with histories of co-occurring substance use and mental health diagnoses.  It seeks to enhance motivation for change and develop a sobriety plan via 4 main topics: Values Clarification, Psycho-Education, Weighing Pros and Cons of Drug Use, and Making a Personal Sobriety Plan. It is grounded in the Integrated Dual Disorder Treatment (IDDT) model, a SAMHSA evidence-based practice.  Fresh Start can be implemented in a group format, and/or individually.

For more information on IDDT, visit:
http://www.ohiosamiccoe.cwru.edu/library/media/iddtoverview.pdf

Positive Behavior Support (PBS)

PBS is an evidence-based approach that seeks to promote an increase in human dignity and quality of life.  ICL is currently using PBS in residences that serve people with intellectual and developmental disabilities (I/DD), and will be implementing the practice agency-wide in 2010..  The focus of ICL's initiative is to create a more proactive environment in the consumer's residence, where staff can identify negative environmental triggers and proactively respond by establishing a positive setting for the client that supports improvements in both behavior and quality of life.  Through an emphasis on seeing the person behind the disability, staff is taught how to proactively create an environment that is consistent with the consumer's wants and preferences.   

For information on PBS, visit:
http://www.eric.ed.gov/ERICWebPortal/detail?accno=ED501870 

http://www.aamr.org/content_281.cfm?navID=98

Wellness Self-Management (WSM)

WSM is the New York State adaptation of the SAMHSA Illness Management and Recovery EBP Toolkit, which educates and empowers participants in self-advocacy and managing their own recovery. WSM offers a broad spectrum of psychoeducational and skills training interventions that have been found helpful in managing symptoms of serious mental illness, promoting medication maintenance, reducing substance abuse relapse, enhancing social skills, teaching self-advocacy, promoting physical and mental wellness, and fostering optimism about community re-integration and recovery. Implementation through a group format generates peer support, and components are reinforced through individual discussion with case management staff.

ICL was one of the original pilot agencies for WSM through its involvement with the Urban Institute for Behavioral Health, and ICL has continued to participate in the New York State Office of Mental Health statewide roll out of the WSM model. WSM, including its adaptations for young adults (KEY) and individuals with mental health and substance use diagnoses (WSM+), is currently being implemented at several ICL programs. 

For further information on WSM and the SOMH statewide rollout, visit: http://www.omh.state.ny.us/omhweb/wellness/ 

Family Empowerment Program (FEP) 

The Family Empowerment Program was designed by ICL in 2003 to enhance internal family functioning.  It addresses the need for everyone who is working with a family (for example, a child welfare worker, a parole officer and the mental health clinician) to collaborate in their efforts to help the family.  The "team" meets together with the family, so that they mutually establish goals and work together to achieve progress.   The most commonly needed interventions are embedded within ICL's community mental health clinic or are provided through an interdisciplinary team that partners with the family. 

The components of FEP include:

  1. Parent and youth advocacy and support provided by advocates from ICL's Family Resource Center,
  2. Entitlements counseling,
  3. Linkage with relevant outside service providers, and
  4. Strength based family therapy. 

The intervention is predicated on the evidence-based and best-practice principles of structural family therapy, brief strategic family therapy, and Systems of Care.  Systems of Care is a SAMHSA recognized approach that emphasizes the need to build a network of community-based supports in order to meet the psychosocial needs of children with mental health diagnoses and their families.

For information on BSFT and Systems of Care, visit:
http://nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=157

http://systemsofcare.samhsa.gov

Clinical Pathways

The Clinical Pathways are designed to be user-friendly tools that facilitate the implementation of evidence-based assessment and treatment practices into everyday clinic services. Each Clinical Pathway includes "at-a-glance" worksheets that summarize evidence-based and best-practice assessment and treatment processes. Clinicians are encouraged to utilize the pathways in supervision and case planning as part of clinical decision making that also takes into account the strengths, needs and preferences of individual clients and families.

There are Integrated Health Pathways for Diabetes and Healthy Living that also include resource manuals expanding on the processes described in the "at-a-glance" worksheets. 

For more Information on Evidence-Based Practices and Practice Guidelines, visit:
www.psych.org/MainMenu/PsychiatricPractice/PracticeGuidelines_1.aspx

http://www.socialworkers.org/research/naswResearch/0108EvidenceBased/default.asp

http://abct.org/SCCAP/

Seeking Safety

Seeking safety is an intervention that offers an integrated approach to working with people with histories of trauma and substance use. It can be implemented in group or individual format to help people attain safety from trauma,Post Traumatic Stress Disorder and substance abuse.  Currently, Seeking Safety is being implemented by ICL at a New York City women's shelter as part of a SAMHSA funded program, Project Aspire, which was awarded a SAMHSA Science and Service Award in 2008.  It is also offered in other ICL clinics and congregate sites.  

For more information on Seeking Safety, visit :
www.seekingsafety.org/

For information on ICL's SAMHSA Science and Service Award, visit:
www.samhsa.gov/Scienceandservice/mentalRSS2008.aspx

Critical Time Intervention Case Management (CTI)

CTI is a time-limited intervention designed to provide transition specific case management support for people with serious mental illness following discharge from hospitals, shelters, prisons and other institutions.  The goal of CTI is to reduce homelessness and other adverse outcomes often associated with these transition periods.  During these transitions, CTI case managers maintain contact with and provide support to participants, including a lot of help with accessing needed community services. Currently, ICL staff are implementing CTI in a SAMHSA funded program, Project Aspire, serving women with histories of mental illness and co-occurring substance use who are living in a homeless shelter.  Project Aspire was recently awarded a SAMHSA Science and Service Award. 

For more information on CTI, visit: CriticalTime.org

For more Information on the SAMHSA Science and Service Award, visit:
www.samhsa.gov/Scienceandservice/mentalRSS2008.aspx

Multiple Family Groups (MFG)

ICL offers a group for families with school age children ages 7 to 11 with disruptive behavior diagnoses, called the Multiple Family Group. This intervention was developed by Mary McKay, a researcher at Mt. Sinai in conjunction with urban parents who have children with oppositional behaviors. The group focuses on the 4 R's which are: rules, responsibilities, relationships and respectful communication. The group is also designed to address the areas that most impact use of mental health services and service outcomes, specifically, parenting supports and resources, and the stigma associated with accessing mental health care. The group is co-led by a clinician from the mental health clinic, and a parent advocate who works at ICL's Family Resource Center. ICL is implementing this intervention as part of a federally funded grant to examine the effectiveness of the model.

 





FACT:  5,000 people with histories of homelessness have entered ICL housing since 1990. Most have remained housed and stable in NYC communities.