Assertive Outreach: An Effective Strategy for Engaging Homeless Persons with Substance Use Disorders into Treatment

Abstract

The purpose of this study was to examine substance abuse treatment referrals that were made by outreach workers in a homeless outreach project. Ten outreach workers completed questionnaires on each of their clients who they had referred to a substance abuse treatment program over the previous year. Additional data was collected on the client's motivation level at the point the referral was made, which agencies the client was referred to, and if the client was rejected from any of the treatment programs. Bivariate correlation analyses were used to examine relationships between the variables. Of 73 project clients who were referred to substance abuse treatment in a one-year period of time, 41% successfully entered treatment. As might be expected, there was a statistically significant relationship between clients' motivation level and completed referral, and between referrals made and program acceptance. This study provides evidence that assertive outreach is effective in engaging and linking homeless persons with substance use disorders to substance abuse treatment services.

Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders

“…Case managers have to be more active to prevent less motivated individuals with SMI and SUD from falling through the cracks in the mental health care system. There are some very innovative proactive programs reaching out to homeless, drug-abusing individuals with SMI where treatment providers go onto the streets and begin discussions on behavior change using MI principles (Fisk, Rakfeldt, & McCormack, 2006). Although not always controlled trials, the engagement of some of these clients into treatment and movement into stable housing supports the notion of being proactive in engaging the less motivated patients.…”

A Comparison of Three Interventions for Homeless Youth Evidencing Substance Use Disorders: Results of a Randomized Clinical Trial

“…Homeless youth present with challenges not faced by those who are not experiencing homelessness. In particular, they are less connected to familial, institutional or other supports, and rarely enter substance use treatment on a voluntary basis, though they can be engaged in treatment through outreach (Fisk, Rakfeldt, & McCormack, 2006). Because of the range of difficulties, providing substance use treatment for people who are homeless cannot be separated from the larger needs for assistance with housing, employment and income (Kertesz et al, 2007; Milby et al, 2000).…”

Innovations in Recovery Management for People Experiencing Prolonged Homelessness in the City of Philadelphia: “I wanted a new beginning”

“…Homeless persons with severe substance use disorders rarely enter addiction treatment on a voluntary basis, but they can be engaged in such treatment through assertive outreach programs (Fisk, Rakfeldt, & McCormack, 2006;Tommasello, Myers, Gillis, Treherne, & Plumoff, 1999). Duration of addiction treatment is a significant predictor of posttreatment outcomes, particularly for clients with high problem severity/complexity/ chronicity and low recovery capital (internal and external assets to initiate and sustain recovery) (White, 2008b).…”