Mission Statement Client Demographics Presenting Problems Dual Identity Program Goals & Objectives Description of Program Program Accomplishments and Outcomes

BIENESTAR is committed to enhancing the health and well-being of the Latino community and other underserved communities impacted by poverty, HIV/AIDS, substance abuse, mental illness and issues relating to gender identity and/or sexual orientation. BIENESTAR accomplishes this through community education, prevention, mobilization, advocacy and the provision of direct social support services.

Provide a safe and substance abuse free environment Reduce and/or eliminate the use of substances Reduce high risk sexual behaviors Reinforce healthy and effective coping skills to manage life stressors and triggers of substance abuse

Goal for end of year 3: 260 Currently: 235 For today’s presentation: 138

DemographicsCategoryn (%) Age18 to to (43%) 79 (57%) EducationLess than 12 th grade 12 th Grade/Diploma/GED More than 12 th grade 66 (48%) 40 (29%) 32 (23%) Living statusShelter Street/Outdoors Housed 5 (4%) 7 (5%) 126 (91%) EmploymentFull time Part time Unemployed Other 39 (28%) 38 (28%) 58 (42%) 3 (2%)

During the past 30 days, did you use any of following? Yesn (%) Cocaine/Crack13 (9%) Marijuana/Hashish64 (46 %) Methamphetamines or other amphetamines47 (34%) Inhalants26 (18%)

During the past 30 days, how many days have you used any alcohol? CategoryFrequency% 03022% 1 – % 11 – % 21 – 3043%

In the past 30 days, not due to your use of alcohol or drugs, have you… # of pairs Baseline Experienced Serious Depression % Experienced serious anxiety or tension % Experienced trouble understanding, concentrating or, remembering % Experienced trouble controlling violent behavior % In the Past 30 days, not due to your use of alcohol or drugs, how many days have you … Average days Experienced serious depression8.25 Experienced serious anxiety or tension7.83 Experienced trouble understanding, concentrating or, remembering 4.05 Experienced trouble controlling violent behavior1.05

YMSM of Color Religious & Cultural Messages Internalized Homophobia Family Rejection Self- Destructive Behaviors Substance Use/Abuse

Assist clients to: Live a healthy and substance-free life Repair relationships impacted by substance use Process thoughts and feelings related to childhood and adolescent trauma/abuse Repair their self-esteem Address issues related to sexual orientation Lower their risk for HIV infection if HIV-negative Engage in HIV medical care and cope with HIV constructively if HIV-positive

Program Components Individual, group and/or family therapy Substance abuse counseling Substance abuse and 12-step support groups HIV & hepatitis C testing and education Weekly substance abuse screening

Free Confidential 20-weeks of treatment Personalized individual treatment plan Interdisciplinary team: mental health clinicians, substance abuse counselors and peer counselors Services can be provided at the San Fernando Valley, East Los Angeles and Hollywood Bienestar offices

Ages: years old Target population: Latino men Sexual orientation: Gay, bisexual and other men who have sex with men (MSM) Presenting problem: Substance abuse or have co- occurring substance abuse and mental health illness Admission into the program is not affected by HIV serostatus, income level, immigration status or sobriety.

Matrix Model adapted for gay men, “Getting Off” Cognitive Behavioral Therapy Motivational Interviewing

Goals Reduce drug use and high risk sexual behaviors Link drug use with high risk behaviors Address co-factors for HIV infection and transmission Techniques Gay-specific Cognitive Behavioral Therapy (CBT) Skill building Abstinence promotion Intervention CBT group sessions Support groups Urine samples

Assessment stage: building a therapeutic relationship between therapist and client; identifying central issues; forming a treatment plan; determining treatment length Cognitive stage: understanding client’s thoughts; discussing significant past events Behavior stage: identifying new patterns of thinking; applying new patterns of thinking to new behaviors Learning stage: identifying techniques to assure that the changes are permanent

Express empathy: use of non-judgmental reflective listening Develop discrepancy: contrast present behavior with broader goals Avoid argumentation: use of soft confrontation and persuasion Roll with resistance: involve client in the process of problem solving Support self-efficacy: increase client’s perception of his ability to cope with obstacles and succeed in change

3 masters-level clinicians (MSW) Clinical supervisor (LCSW) Program evaluator (MSW, Ph.D.) Masters-level biostatistician (MS) Certified substance abuse counselor Certified HIV/hepatitis C tester/counselor 2 outreach workers Peer counselor

Drug use Marijuana/ hashish Methamphetamines or other amphetamines use Inhalants Any illegal drug use Alcohol use Any alcohol Alcohol to intoxication (5+ drinks in one sitting) Mental health Serious depression Serious anxiety or tension Trouble understanding, concentrating or remembering Trouble controlling violent behavior

During the past 30 days, how many days have you used Baseline6 month follow-up Marijuana/hashish Methamphetamines or other amphetamines Inhalants Any illegal drugs

During the past 30 days, how many days have you used Baseline 6 month follow-up Any alcohol Alcohol to intoxication (5+ drinks in one sitting)

In the Past 30 days, not due to your use of alcohol or drugs, how many days have you … Baseline 6 month follow-up Experienced serious depression Experienced serious anxiety or tension Experienced trouble understanding, concentrating or remembering Experienced trouble controlling violent behavior

Acknowledgements: USCA SAMHSA, Dr. Ed Craft Bienestar Human Services Inc. Audience