| Transitional Living Program |
Because the well-being of people with HIV/AIDS is tied to three basic needs - proper nutrition, consistent healthcare and stable housing - the first step of the case manager is to address these basics for each resident through an assessment evaluation. Once these basic issues are addressed, the case managers guide the residents in expanding their focus to other issues that will help them maintain a healthy lifestyle. Every resident is assigned an on-site case manager upon being accepted into the program.
Together, the resident and case manager share the overall responsibility for the development, implementation, and execution of a comprehensive and individualized service plan for the resident.
Case Managers monitor, assess, advocate, and refer, to address the complex interaction of HIV/AIDS on a wide spectrum of issues: psychosocial, life skills, mental health, recovery, and spiritual care.
Case Managers are also responsible for assisting residents in securing the appropriate resources that they will need to manage their healthcare and basic human needs.
Using a multidisciplinary team approach that addresses the diverse challenges of each resident, a carefully structured tier system is developed that helps each resident progress step-by-step toward independent living over the course of their maximum 24-month residency.
- Individualized therapeutic sessions
- Groups which engage residents in risk reduction and relapse prevention
- Therapeutic social activities
- Recovery Committee
- Peer led Alcoholic and Narcotics Anonymous Meetings
- Random drug testing and breathalyzer
At Bonaventure House and The Harbor the occupational therapy department uses both groups and individual sessions as intervention strategies.
Groups are a facilitated discussion that encourage residents to identify strategies needed to overcome barriers. Common barriers discussed include: money mangement, problem solving skills, decision making strategies, dealing with change, coping mechanisms, healthy relationships, self advocacy, and maintaining a healthy routine.
Individual sessions allow the occupational therapist to explore the unique interplay between the individual, their environment, and the task they are trying to accomplish. Theories that guide these sessions include: The Model of Human Occupation, The Person Environment Occupation Model, Transtheoretical Stages of Change, and Cognitive Perceptual Model.
Upon entering the house, each individual meets with the occupational therapist in order to complete formal assessments: the Occupational Self Assessment, the Narrative Slope portion of the Occupational Performance History Interview II, a quality of life index, and a locus of control index. Following the assessments, the individual and occupational therapist collaborate on goals which are then implemented into the Individual Service Plan (ISP) in conjunction with the Case Manager.
Currently, the occupational therapy department accepts both level I and level II students to complete their fieldwork in a community based practice area. Please contact the occupational therapist for more information regarding fieldwork assignments.
This holistic view of people means that we attend to our residents' physical needs (via housing and healthcare), their emotional needs (via therapy and counseling), their intellectual needs (through occupational therapy and schooling), and finally their spiritual needs through Spiritual Care.
What does it mean to care for a person's spirit? At Bonaventure House and The Harbor, it means providing an opportunity for people to share and understand their own stories and journeys; it means connecting residents with local faith communities that will support them after they graduate; it means maintaining a chapel as a permanent space for prayer and reflection; it means ministering to diverse people who follow various spiritual paths; it means offering prayer services, spiritual direction, meditation groups, spiritual retreats, Bible Study, and out-trips to enjoy moments of worship, art, and beauty.
The testimony of our residents gives witness to the value of spiritual care. Most experience the healing process as a spiritual rebirth. It is miraculous to watch residents transition from the darkness of despair to the brightness of hope during the course of their residency. The transformation that takes place points to a higher power or a Holy Spirit at work in their lives. Spiritual Care gives them the space and encouragement to trust and follow that Spirit.
The commitment that our residents make towards their recovery and well-being is evidence that spirituality is central to the transformative work that happens through Alexian Brothers AIDS Ministry.
Many of our constituents may wonder: What happens to residents of Bonaventure House or The Harbor after they leave? Do our former clients remain healthy and stably housed? How often do former residents relapse?
The answer to these questions is found in our After Care program. This program is unique in two ways:
- Former residents stay connected to a community that they've been a part of for two years by returning to a weekly Aftercare group.
- Current residents can learn from the collective experience of those once in their situation, and plan appropriately for life after Bonaventure House and The Harbor.
As Bonaventure House Social Work Supervisor David Dempsey says, "After Care starts the minute a new resident walks through the doors of Bonaventure House and The Harbor."
The theme of the program is connection. The After Care program provides an opportunity for former residents to form stronger connections with each other, current residents, and staff in order to provide the additional support a former resident may need or want. It offers supportive services to ensure long-term stability, success, and housing for each former client. Services include emergency financial assistance for utilities, rent, food, and transportation in times of crisis. Staff follows up with them for a year to monitor their progress and offer any supportive assistance needed.
Since we've started the After Care program, Alexian Brothers AIDS Ministry can concretely see the success of our Transitional Living Program and our residents. We now know that:
| Adhered to their HIV medication regimen | 96% |
|
| Remained engaged in HIV primary care | 96% |
|
| Remained engaged in behavioral health care | 94% |
|
| Have been able to maintain their sobriety | 83% |
|
| Have remained stably housed | 100% |
|
| Paid rent monthly | 96% |
|
| Received rental assistance | 4% |
|
| Have had consistent access to food | 100% |
|
| Have maintained employment | 43% |
|
| Began an educational program since leaving BH | 12% |
|
| Began volunteer activities since leaving BH | 20% |
|
| Obtained employment | 12% |
|






