One Size Does Not Fit All: Lessons Learned in Baltimore, MD

by Laura Winn
July 06, 2011

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A couple weeks ago I attended a SAMHSA workgroup meeting for programs offering sober housing and treatment options for women experiencing homelessness. The workgroup began as a technical assistance (TA) request from Lori Criss of Amethyst Programs, a program in Columbus, Ohio. Amethyst offers integrated sober housing and treatment to women experiencing homelessness and substance use issues. Amethyst staff have sometimes felt isolated because this integrated approach is a unique model in their community. Lori knew that there was interest among other programs across the country, and was seeking an opportunity to begin this dialogue on a national level.

In response, SAMHSA’s Homelessness Resource Center helped to convene a workgroup of similar programs, along with SAMHSA’s Women, Children, and Families TA Center. With such a strong national focus on Housing First, sober living models often struggle to find their place. Programs find themselves straddling a divide between housing and addictions treatment. Some identify primarily as housing providers, some as treatment providers, and others as both, adding to the difficulty of seeking funding in various continuums of care. However, sober housing can be a tremendously beneficial model for women with children, trauma histories, and safety concerns.

Based on the clear desire of workgroup members to connect in person and further define key elements of this integrated model, SAMHSA convened a meeting in Baltimore, MD. Sixteen representatives of sober housing and treatment programs for women attended. The group shared their program designs, discussed what works (and what doesn’t), and explored commonalities, challenges, and promising strategies.

Having worked in this field for a year and half, it has become clear that there are no one-size-fits-all models for individuals experiencing homelessness, substance use disorders, or mental health issues. However, I’ve never seen this so clearly illustrated as I did at the workgroup meeting. Not only were providers recognizing a need for alternatives to Housing First for some individuals and families, but they were also highlighting differences among their own gender-specific sober housing models. For some women, being allowed to live with their children and within a community is an important step toward recovery. This demanded more restrictive relapse policies, in recognition of the safety and recovery of children and other families. For others, living independently, becoming economically stable, and thriving in healthy relationships is central to success.

Programs differed on drug testing policies, services for fathers and children, relapse policies, and approaches to treatment. However, it was clear that these programs were each finding success with their participants. I spend a lot of my time trying to understand what works in homeless services. Through the process, I sometimes forget that there are many paths to success. Flexibility to respond to the needs of consumers is essential.

I was inspired by the providers I met in Baltimore. They were committed to finding the best individualized options for women. These providers, many of whom were in recovery themselves, exemplified that fact that one-size-fits-all is not always possible – or necessary – when working with individuals and families.

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Category: HRC Insight

Comments

6/16/2012 1:33:52 AM #

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6/16/2012 1:36:11 AM #

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Clarence Estes