Use of Group Treatment among Case Managers in Department of Veterans Affairs Supported Housing Program

By Tsai, Jack; Rosenheck, Robert A. | Journal of Rehabilitation Research & Development, April 2013 | Go to article overview

Use of Group Treatment among Case Managers in Department of Veterans Affairs Supported Housing Program


Tsai, Jack, Rosenheck, Robert A., Journal of Rehabilitation Research & Development


INTRODUCTION

Permanent supported housing programs successfully house homeless adults by providing subsidized housing coupled with intensive community-based case management. The "Housing First" model of supported housing particularly has gained attention both in the United States [1] and abroad [2] as a way to address the needs of homeless clients with severe mental illness. Intensive case management, following the Assertive Community Treatment model, is not, however, likely to be needed by all homeless adults [3-4], many of whom have less serious mental illnesses or primarily have substance use disorders. Intensive case management is also expensive [5] and can be socially isolating and stigmatizing [6]. In fact, one of the most common complaints of adults with severe mental illness living in independent housing is their loneliness and lack of social interaction [7-10].

The Department of Veterans Affairs (VA) healthcare system, one of the nation's largest healthcare systems, has set itself the goal of ending homelessness among veterans and has dramatically increased its funding and resources for homeless services, including expansion of the flagship supported housing program, the Department of Housing and Urban Development (HUD)-VA Supportive Housing (HUD-VASH) [11] program. * As the size of HUD-VASH programs increases, greater critical examination of the specific case management needs of the diverse clients served by HUD-VASH is warranted in terms of both the intensity of community-based services needed and also the potential role of group treatment approaches. Group treatment approaches have been given scant attention, although they may offer important opportunities for peer support and may improve program efficiency. Groups may foster a greater sense of community integration and encourage social integration between members while allowing case managers to meet with several clients at the same time.

Several group-based models of case management for homeless veterans have been developed within VA. One demonstration program called Peer Housing Location Assistance Groups (PHLAG) [12] offered homeless veterans peer support groups led by a case manager to help them find and obtain housing in the open market. The PHLAG program showed success in helping clients obtain independent housing and illustrates one approach to peer support. Another program, the Group-Intensive Peer Support (GIPS) [13] model, provides peer-oriented group treatment as the default mode of case management, with intensive, community-based individual case management provided only when clinically necessary. A recent study of GIPS at one VA site showed that its implementation was associated with greater social integration and faster acquisition of housing vouchers compared with other sites [14]. However, except for the PHLAG and GIPS service models, the extent to which groups are being used in supported housing programs is not well understood.

Aside from the benefits of peer support, the potential of groups to facilitate increased contact with clients in supported housing programs needs to be examined. Groups allow case managers to provide services to multiple clients simultaneously, which can lead to more efficient care. For example, in psychotherapy, group therapy can be more cost and time effective than individual therapy [15-16]. While case management may be different from psychotherapy, the potential for providing services to groups of clients rather than clients individually may be particularly pertinent to examine as HUD-VASH programs grow and staff seek to deliver more efficient clinical services.

This study examined the current practices and attitudes regarding groups among HUD-VASH programs and case managers in the New England region, where a current project is underway to develop and disseminate the GIPS model. We examined administrative data on the use of groups in HUD-VASH and case manager responses to an online survey.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Use of Group Treatment among Case Managers in Department of Veterans Affairs Supported Housing Program
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.