“A Port in a Storm”: Client Perceptions of Substance Abuse Treatment Outreach in a Soup Kitchen

ABSTRACT

Substance use is associated with many problems, including homelessness, mental illness, isolation, and poverty, yet ambivalence about change leads many affected individuals to defer treatment or drop out prematurely. This paper describes a manualized, time-limited, low-threshold group model for treatment outreach to residentially unstable drug and alcohol users who, though wanting help, are not yet committed to ending or reducing substance use. The model is based on principles of group work, motivational enhancement, and cognitive-behavioral therapy. Findings from a qualitative analysis of progress notes, illustrated with case studies, tie participant goals to strategies of the treatment model and participant perceptions of the change process.

KEYWORDS:

• Motivational enhancement
• cognitive-behavioral therapy
• group work
• treatment outreach
• soup kitchen