Mission Statement Client Demographics Presenting Problems Dual Identity Program Goals & Objectives Description of Program Program Accomplishments and Outcomes BIENESTAR is committed to enhancing the health and well-being of the Latino community and other underserved communities impacted by poverty, HIV/AIDS, substance abuse, mental illness and issues relating to gender identity and/or sexual orientation. BIENESTAR accomplishes this through community education, prevention, mobilization, advocacy and the provision of direct social support services. Provide a safe and substance abuse free environment Reduce and/or eliminate the use of substances Reduce high risk sexual behaviors Reinforce healthy and effective coping skills to manage life stressors and triggers of substance abuse Goal for end of year 3: 260 Currently: 235 For today’s presentation: 138 Demographics Age Category 18 to 24 25 to 29 n (%) 59 (43%) 79 (57%) Education Less than 12th grade 12th Grade/Diploma/GED More than 12th grade 66 (48%) 40 (29%) 32 (23%) Living status Shelter Street/Outdoors Housed Full time Part time Unemployed Other 5 (4%) 7 (5%) 126 (91%) 39 (28%) 38 (28%) 58 (42%) 3 (2%) Employment During the past 30 days, did you use any of following? Yes n (%) Cocaine/Crack 13 (9%) Marijuana/Hashish 64 (46 %) Methamphetamines or other amphetamines 47 (34%) Inhalants 26 (18%) During the past 30 days, how many days have you used any alcohol? Category 0 1 – 10 11 – 20 21 – 30 Frequency % 30 68 36 4 22% 49% 26% 3% In the Past 30 days, not due to your use of alcohol or drugs, how many days have you … Average days Experienced serious depression 8.25 Experienced serious anxiety or tension 7.83 Experienced trouble understanding, concentrating or, remembering 4.05 Experienced trouble controlling violent behavior 1.05 Religious & Cultural Messages Substance Use/Abuse SelfDestructive Behaviors YMSM of Color Internalized Homophobia Family Rejection Assist clients to: Live a healthy and substance-free life Repair relationships impacted by substance use Process thoughts and feelings related to childhood and adolescent trauma/abuse Repair their self-esteem Address issues related to sexual orientation Lower their risk for HIV infection if HIV-negative Engage in HIV medical care and cope with HIV constructively if HIV-positive Program Components Individual, group and/or family therapy Substance abuse counseling Substance abuse and 12-step support groups HIV & hepatitis C testing and education Weekly substance abuse screening Free Confidential 20-weeks of treatment Personalized individual treatment plan Interdisciplinary team: mental health clinicians, substance abuse counselors and peer counselors Services can be provided at the San Fernando Valley, East Los Angeles and Hollywood Bienestar offices Ages: 18-29 years old Target population: Latino men Sexual orientation: Gay, bisexual and other men who have sex with men (MSM) Presenting problem: Substance abuse or have cooccurring substance abuse and mental health illness Admission into the program is not affected by HIV serostatus, income level, immigration status or sobriety. Matrix Model adapted for gay men, “Getting Off” Cognitive Behavioral Therapy Motivational Interviewing Goals Reduce drug use and high risk sexual behaviors Link drug use with high risk behaviors Address co-factors for HIV infection and transmission Techniques Gay-specific Cognitive Behavioral Therapy (CBT) Skill building Abstinence promotion Intervention CBT group sessions Support groups Urine samples Assessment stage: building a therapeutic relationship between therapist and client; identifying central issues; forming a treatment plan; determining treatment length Cognitive stage: understanding client’s thoughts; discussing significant past events Behavior stage: identifying new patterns of thinking; applying new patterns of thinking to new behaviors Learning stage: identifying techniques to assure that the changes are permanent Express empathy: use of non-judgmental reflective listening Develop discrepancy: contrast present behavior with broader goals Avoid argumentation: use of soft confrontation and persuasion Roll with resistance: involve client in the process of problem solving Support self-efficacy: increase client’s perception of his ability to cope with obstacles and succeed in change 3 masters-level clinicians (MSW) Clinical supervisor (LCSW) Program evaluator (MSW, Ph.D.) Masters-level biostatistician (MS) Certified substance abuse counselor Certified HIV/hepatitis C tester/counselor 2 outreach workers Peer counselor Drug use Marijuana/ hashish Methamphetamines or other amphetamines use Inhalants Any illegal drug use Alcohol use Any alcohol Alcohol to intoxication (5+ drinks in one sitting) Mental health Serious depression Serious anxiety or tension Trouble understanding, concentrating or remembering Trouble controlling violent behavior During the past 30 days, how many days have you used Baseline 6 month follow-up Marijuana/hashish 4.97 2.57 Methamphetamines or other amphetamines 3.90 0.92 Inhalants 1.73 0.30 Any illegal drugs 9.15 3.51 During the past 30 days, how many days have you used Baseline 6 month follow-up Any alcohol 8.20 3.83 Alcohol to intoxication (5+ drinks in one sitting) 4.21 2.28 In the Past 30 days, not due to your use of alcohol or drugs, how many days have you … Baseline 6 month follow-up Experienced serious depression 8.50 3.10 Experienced serious anxiety or tension 8.30 2.90 Experienced trouble understanding, concentrating or remembering 4.91 1.73 Experienced trouble controlling violent behavior 1.09 0.33 Acknowledgements: • USCA • SAMHSA, Dr. Ed Craft • Bienestar Human Services Inc. • Audience