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The history of mental health service delivery has been marked by an emphasis on clients’ vulnerabilities and deficits. As treatment programs have moved out of hospitals and into communities, however, the need to work with clients in developing real-world, practical skills, such as job training, has never been more important. Versions of this approach traditionally include skills training classes, job clubs, and sheltered employment, but have not been successful in helping people with severe mental illness gain competitive employment. This book describes the theory, empirical support, and practice of the Individual Placement and Support (IPS) approach to supported employment. IPS is the most widely studied and validated approach to supported employment for people with severe mental illness. The overall goals of IPS are to assist clients in finding jobs that are consistent with their preferences and skills, and to support their efforts in working. The book is divided into three sections: 1) Conceptual and Empirical Support for Individual Placement and Support; 2) Practice Guidelines for Implementing Supported Employment; and 3) Special Issues. Many vignettes and sample documents that provide practical information are included.

For the last thirty years, the nation's mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery rendering them incapable of ensuring the safety, security, and recovery of their clients. The resulting organizational trauma both mirrors and magnifies the trauma-related problems their clients seek relief from. Just as the lives of people exposed to chronic trauma and abuse become organized around the traumatic experience, so too have our social service systems become organized around the recurrent stress of trying to do more under greater pressure: they become crisis-oriented, authoritarian, disempowered, and demoralized, often living in the present moment, haunted by the past, and unable to plan for the future.Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place. Healing is possible for these clients if they enter helping, protective environments, yet toxic stress has destroyed the sanctuary that our systems are designed to provide.This thoughtful, impassioned critique of business as usual begins to outline a vision for transforming our mental health and social service systems. Linking trauma theory to organizational function, Destroying Sanctuary provides a framework for creating truly trauma-informed services. The organizational change method that has become known as the Sanctuary Model lays the groundwork for establishing safe havens for individual and organizational recovery. The goals are practical: improve clinical outcomes, increase staff satisfaction and health, increase leadership competence, and develop a technology for creating and sustaining healthier systems. Only in this way can our mental health and social service systems become empowered to make a more effective contribution to the overall health of the nation.Destroying Sanctuary is a stirring call for reform and recovery, required reading for anyone concerned with removing the formidable barriers to mental health and social services, from clinicians and administrators to consumer advocates.

This book reviews the evidence-based treatments relevant to family treatment in human services and social services settings. It addresses some of the main reasons families are seen in mental health and social service settings: child maltreatment, intimate partner violence, attention-deficit hyperactivity disorder, conduct problems, substance use disorders, schizophrenia, depression, and dementia. For each problem area, a detailed case study provides step-by-step guidelines on how the evidence-based theory can be applied in practice. Interventions include psychoeducation, behavioral parent training, solution-focused therapy, cognitive-behavioral treatment, structural family therapy, and multisystemic treatment.

This book presents an approach to therapeutic contact with clients that capitalizes on people's resilience, strengths, and capacities. The helper works in collaboration with the individual to identify and amplify these capacities to resolve problems and improve quality of life. Clients are empowered to find their own answers and solutions that will fit their particular worldview and their unique strengths (De Jong & Miller, 1995). These principles are operationalized through solution-focused therapy and motivational interviewing. The helper also identifies areas in which clients can use education on how to meet more effectively life's challenges. A focus on coping skills is represented by cognitive-behavioral therapy. These theoretical approaches are woven together for the purpose of maximizing a person's ability to enhance the strengths they bring and also learn new skills that can help them. The resultant strengths- and skills-building model is applied, throughout the book, to various problems and populations that helping practitioners may encounter.

This is a book about how people change their minds and how mental health practitioners can help this process along. It addresses a gap in the literature on cognitive therapy that results from an almost exclusive focus on the constructed aspects of personal meaning, and a lack of attention to the ways in which information that we pick up from life circumstances also influences what we know, feel, and do. Conceptions that ignore the role that current life conditions and interpersonal events play in creating or revising meanings limit the utility of cognitive therapy approaches for clients whose lives are marked by ongoing deprivation, threat, and vulnerability. In laying out a broader perspective, a Cognitive-Integrative perspective, the book expands the internal focus of traditional cognitive therapies to take more account of the role of information generated by environmental events and conditions in impeding or promoting change. It contends that mind draws on organized memories of previous experiences as well as currently available information to generate cognitive, emotional, and behavioral responses. The theoretical grounding for this perspective is drawn from a range of cognitive, neurological, social, psychological, and social work theories. Theoretical explanations are laid out. They are balanced with practice guidelines and grounded in an offering of clinical examples.