Incorporating Harm Reduction and Trauma Informed Care into Community Residential Care


I'm looking to connect with other champions of change working in the realm of adult mental health/substance abuse residential care.

In June, I became the program director of a dual diagnosis (mental health and substance abuse) community residence (New York state, overseen by Office of Mental Health, Congregate Care Level II). Since then I have been working to shift policy, procedure and best practices using a harm reduction model and trauma informed approaches. Although I am absolutely thrilled to have the opportunity to pilot a program like this, I am feeling overwhelmed and could use support.

Here are a few examples of things that I am currently working on or pondering while I should be sleeping at night...

  • Revamping Resident Rights and Responsibilities
    • hot topic here is not discharging if a resident relapses, which is the way it has always been done. MUCH conversation and debate about this one!
  • House Expectations (formally House Rules)
    • the shift from making things like chores, meetings, dinner, etc to "expected" instead of "mandatory" has been difficult. We are working to normalize the experience and remove staff from authoritarian positions, but getting away from using consequences to promote change has been tough! It feels like common sense but successful implementation has been difficult.
  • Designing the intake process to include trauma-informed assessments and questions, including resident information packets on ACEs science and harm reduction principles.
  • Service Planning
    • soooo much work to be done!
  • Staff trainings
    • the majority of my staff are open to the new language and practices but will benefit from increased training on toxic stress, regulation, and resilience building, particularly those who were trained within the medical/brain disease/12 step recovery models.

I'm eager to hear from and learn from others on this same journey. If you have tools, resources, examples, thoughts, etc on any of what I've stated above, please reach out. There is little out there it seems directly related to adult residential care, any support will help!




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