This phase begins about the time the person has settled in, completed their initial assessments, and identified a few priorities. This phase lasts until the member receives their housing match.

Phases 1 and 2 focused on helping members begin to feel safe, supported, accustomed to their new environment, and more motivated to engage in treatment. Phase 3 is your biggest opportunity to promote long-term wellness by focusing not only on the member’s substance use, but also on the other assets the person will need to live successfully once they leave your program. Phase 3 reflects all JOH core values.

In this phase, support members with building the personalized set of skills that each person will take with them to sustain their wellness and housing, and to fully rejoin their communities after leaving the residential treatment setting. Phase 3 work should be intentional, strengths-based, and empowering to the whole person.

Why is Phase 3 important?

Phase 3 Goals

In Phase 2, we invited members to dream and to set goals for their lives. In this phase, we have a responsibility to help them get the skills and resources they need to pursue their goals.

Based on their overall vision for their life and changes that they would like to make, support members in identifying two or three short-term goals (that is, goals that could be accomplished within a matter of days or weeks) and, together, outline a way to achieve the goals. These steps should not be documented or recorded as generic clinical activities such as “attending groups.” Instead, focus on what the member would get out of attending particular groups, such as learning specific skills. Ensure the record reflects the skills the member is improving and the long-term end those skills will serve.

In phase 3, the treatment plan should be refined and further individualized to support all of the goals and steps that the person has identified.

Individualizing services means, in part, ensuring that your program offers a range of services that will meet the needs of diverse members. But it also means ensuring that the menu of services is never static, that it changes as individual members themselves change. Stay continually aware of member needs for services, particularly when it comes to enhancing skills related to community integration.

Individuals cope with stress in conscious and unconscious ways, and in ways that are more or less healthy. Members may not have learned strategies for increasing their resilience to stressful situations. Help members get enough experience with a variety of strategies to decide if those strategies could be added to their self-care toolkit. Watch the video to learn more about strategies to help members deal with stress.

Nine of 10 individual receiving publicly funded behavioral health services report a history of trauma, and chronic homelessness is a trauma in itself. Individuals cope with their trauma in different ways, and many won’t feel the need to disclose their traumatic experience to clinicians, peer staff, or anyone else. It’s a given that trauma-informed approaches must be a part of our engagement with JOH members and others. But our core value of healing-centered engagement aims to go further, to acknowledge not only personal trauma, but also collective trauma, and to address trauma at multiple levels to empower individuals and their communities.

Clinical care can help launch recovery, but members sustain their recovery in communities. Developing these skills takes time. So don’t wait until the person is preparing to leave the residential portion of the JOH Project to think about the community-based supports that would serve them. Instead, starting as soon as possible, provide opportunities for members to learn or enhance a range of adult living skills and to practice those skills in real-world settings.

Because it’s impossible to predict when a member may receive a housing match, it’s important to start as soon as possible to assess the member’s natural support system and strategically strengthen it.

Phase 3 Resources

New Use Protocol

Naloxone Protocol

Circles of Support Tool

Published 2020

Program Manager

Project Assistant