Algorithm-Driven Substance Use Disorder Treatment for Inner-City Clients With Serious Mental Illness and Multiple Impairments.

Mental health clients with serious mental illness in urban settings experience multiple chronic stresses related to poverty, unemployment, discrimination, homelessness, incarceration, hospitalization, posttraumatic stress disorder, pain syndromes, traumatic brain injury, and other problems. Substance use disorder exacerbates these difficulties. This study examined the efficacy of algorithm-driven substance use disorder treatments for 305 inner-city mental health clients with multiple challenges.

Moving toward trauma-informed practice in addiction treatment: a collaborative model of agency assessment.

Clients in substance abuse treatment need, in addition to evidence-based and sensitive treatment services in general, a system of care that takes into account the impact of trauma and violence in so many of their lives. In addition, services need to be delivered in a way that avoids triggering trauma memories or causing unintentional re-traumatization. To that end, this article describes an agency self-assessment process that combines a trauma-informed assessment, a NIATx process of "walking-through" and use of the Institute of Healthcare Improvement's Plan-Do-Study-Act (PDSA) cycles, and a user-friendly format.

The Trauma Recovery and Empowerment Model: A Quasi-Experimental Effectiveness Study.

Objective: A quasi-experimental study tested the effectiveness of the Trauma Recovery and Empowerment Model (TREM), a group intervention for women trauma survivors, in comparison to services as usual.

Methods: Two hundred fifty-one women with histories of physical and/or sexual abuse and co-occurring serious mental illnesses and substance use disorders completed comprehensive study assessments at baseline and at 6 and 12 months. TREM groups were added to standard services at two community mental health agencies in Washington, DC (n = 153).

Refuge or rehabilitation? Assessing the development of a women's empowerment center for people with severe mental illness.

Recent calls for psychiatric services to focus upon psychosocial recovery for people with severe mental illness has led to a renewed interest in recovery communities. Hence, Community Connections (Washington DC) set up a Women's Empowerment Center as an intentional recovery community. The aim of this paper is to qualitatively chronicle the development of this center to assess emerging challenges.

Safety and security in small-scale recovery housing for people with severe mental illness: an inner-city case study.

Objective: The authors examined the lived experience of residents with severe mental illness in a small-scale recovery-housing building in the inner city. They attempting to identify and understand factors that influenced adjustment and stability.

Methods: Four focus groups with 17 residents and participant observation with residents, case managers, and supervisory staff were conducted longitudinally over a two-year period.

Qualitative interviews on substance abuse relapse and prevention among female trauma survivors.

Objective: Complex relationships among trauma, substance abuse, and mental disorders raise significant questions for the study of long-term recovery. The purpose of this qualitative study was to examine key themes in sustaining recovery among women with co-occurring disorders who had survived trauma.

Methods: In semistructured interviews conducted at one of the nine sites of the Women, Co-occurring Disorders, and Violence Study, 27 female trauma survivors described the influences they considered most important in sustaining and hindering their recovery, with an emphasis on recovery from substance abuse.

A randomized controlled trial of integrated versus parallel housing services for homeless adults with severe mental illness.

This study compared two contemporary approaches to linking housing and mental health services. In the integrated housing program, case management and housing services were provided by teams within a single agency and were closely coordinated. In the parallel housing condition, case management services were provided by mobile assertive community treatment teams and housing by routine community-based landlords.

The Trauma Recovery and Empowerment Model (TREM): conceptual and practical issues in a group intervention for women.

This article describes the Trauma Recovery and Empowerment Model (TREM), a manualized group intervention designed for women trauma survivors with severe mental disorders, and discusses key issues in its conceptualization and implementation. TREM recognizes the complexity of long-term adaptation to trauma and addresses a range of difficulties common among survivors of sexual and physical abuse. Focusing primarily on the development of specific recovery skills and current functioning, TREM utilizes techniques shown to be effective in trauma recovery services.

Case management with the chronically mentally ill: a clinical perspective.

While case management is frequently seen as a valuable part of treatment for chronically mentally ill patients, the focus is often on its managerial rather than its clinical elements. A rationale for case management as an intervention with clinical merit of its own is presented.

Reassessing the revolving door: a developmental perspective on the young adult chronic patient.

Recent literature has described the young adult chronic patient as a subgroup of the chronically mentally ill whose high demand for a variety of mental health services places a strain on the delivery system. This paper suggests that the revolving door syndrome reflects deficits among the target population at three different levels: intrapsychic, dyadic, and societal. A treatment program that includes strategies responsive to the deficits at each level is described.