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Quantum Units Education

Behavioral Health for the Homeless

Introduction

1. Homelessness often occurs in conjunction with other social and health problems, and therefore cannot be addressed in isolation.  

A. True

B. False


Did You Know?

2. More than __________ of people seeking substance abuse or mental health treatment in the public health system in the U.S. are homeless.

A. 4 percent

B. 6 percent

C. 8 percent

D. 10 percent


Preventive Services for People Who Are Homeless

3. Services which are delivered to individuals and target people who are exhibiting early signs of problem behaviors are:  

A. Selective prevention services

B. Specific prevention services

C. Indicated prevention services

D. Practical prevention services


Housing as Prevention

4. Homelessness effects may be especially acute in children, for whom it may mean a loss of family stability, disruptions in school attendance or performance, and being ostracized by peers.

A. True

B. False


Recommendations of the Consensus Panel

5. Developing a person-centered treatment or prevention plan is the bulwark of recovery for a person who is homeless and has a substance use or mental health disorder.

A. True

B. False


Homelessness in America

6. The HEARTH definition of a person or family who is homeless includes each of the following EXCEPT:

A. Anyone who resided in a shelter or place not intended as a home and is now leaving an institution where he or she temporarily resided

B. Someone who is losing his or her housing in 28 days or fewer and cannot obtain housing through his or her support networks or other resources

C. A person who has experienced domestic violence, sexual assault, and/or other dangerous or life-threatening conditions in a housing situation that he or she is leaving

D. An unaccompanied youth who is homeless


How Many People Are Homeless?

7. It is difficult to count the number of people who are homeless accurately because they move frequently, but HUD has estimated that 429,502 persons where homeless at a single point in time in January 2009.

A. True

B. False


Individual Factors

8. As many as ______________ of people who are homeless exhibit cognitive impairment, which can affect their social and adaptive functioning and their ability to learn new information and new skills.

A. 50 percent

B. 60 percent

C. 70 percent

D. 80 percents


Are There Different Types of Homelessness?

9. Which of the following is an accurate statement about the different types of homelessness?

A. About a quarter of people who are homeless have been continuously so for at least 3 years

B. About half of people who are homeless have gone in and out of homelessness numerous times

C. A first or second episode of homelessness ranging from a few weeks or months to less than a year is considered transitional homelessness

D. About 30% of the homeless population falls into the category of transitional homelessness


How Do Communities Respond to Homelessness?

10. Transitional supportive housing provides stable housing along with social and health services but is more often used with individuals and families in crisis or transition.

A. True

B. False


Homelessness and Behavioral Health Services

11. For the homeless, substantial progress toward recovery and self-sufficiency may require significant engagement efforts and repeated attempts at treatment and housing rehabilitation.

A. True

B. False


Counselor Competencies for Working With People Who are Homeless- Knowledge

12. Counselors must possess knowledge of the impact of homelessness, how it acts as a barrier to services for other problems, and how it can become:

A. Self-perpetuating

B. Paralyzing

C. Endless

D. Debilitating


Skills

13. With homeless clients, a priority should be developing systems-centered treatment plans that focus on the relationships with others rather than individual needs.    

A. True

B. False


Attitudes

14. As a precondition to a positive working relationship, the professional should meet clients where they are rather than where they should be.

A. True

B. False


Reactions and Assumptions About People Who Are Homeless

15. One myth about homelessness is that most homeless people are unemployed, when in fact many are employed full or part time.

A. True

B. False


The Impact of Homelessness on Children and Families

16. Children are especially affected by homelessness as demonstrated by:

A. Children who are homeless are sick three times as often as other children, have five times the rate of asthma, and six times more diarrhea and stomach problems

B. More than one fourth of preschoolers who are homeless have emotional problems

C. Children who are homeless are twice as likely to repeat a grade as those with homes

D. Children who are homeless have twice the rate of emotional and behavioral problems compared with children who are not homeless


Myths and Realities about People Who are Homeless

17. People who have substance use and mental disorders tend to become more responsive to interventions after they become homeless.

A. True

B. False


Managing Responses to Working With People Who are Homeless

18. When working with people who are homeless, it may be beneficial to work in teams, establish networks, and discuss feelings and issues with teammates to lower stress and maintain objectivity.

A. True

B. False


Stages of Change

19. Clients who decide to make a change and have perhaps already begun to change problematic behavior are in which stage of change?

A. Action

B. Preparation

C. Contemplation

D. Precontemplation


Critical Stages of Recovery

20. The stages of recovery model addresses developmental goals that are related to the degree and nature of ____________________, and the relationship between an individual and the service delivery system.

A. Social connectedness

B. Ongoing stability

C. Daily functioning

D. None of the above


Exhibit 1-4. Behavioral Health Service Provider Roles and Best Practices According to Stage of Recovery

21. The service provider should educate family about available choices and offer support in designing a recovery plan during the Independent/Aware stage of recovery.

A. True

B. False


Processes in Recovery From Substance Use and Mental Disorders

22. Prevention activities can play a central role in recovery, especially those that relate to skills development and wellness self-management.

A. True

B. False


Stages of Homelessness Rehabilitation

23. The amount of time a person spends in any of the stages of homelessness rehabilitation depends on barriers to and providing and accepting services.

A. True

B. False


Transition From Intensive Care to Ongoing Rehabilitation

24. In which stage of homelessness rehabilitation are individuals preparing for optimal social reintegration?

A. Transition to intensive care

B. Intensive care

C. Transition to ongoing rehabilitation

D. Ongoing rehabilitation


Clinical Interventions and Strategies for Serving People Who Are Homeless

25. Those who work with the homeless must have knowledge of community resources that address ___________________ in addition to housing services.

A. Physical health care and dietary needs

B. Financial crises

C. Criminal justice

D. All of the above


Outreach

26. Professionals will probably find that outreach efforts with people experiencing homelessness are usually less aggressive and proactive than those used in traditional mental health and substance abuse settings.

A. True

B. False


Initial Screening and Evaluation

27. Within treatment settings, a first contact with a person who is homeless or facing homelessness will ordinarily involve initial observations and potentially decisions about care.

A. True

B. False


How Does SBIRT Work?

28. Brief intervention (BI) is appropriate for clients identified through screening to be at ___________ for substance use problems, and it can be provided through a single session or multiple sessions of motivational interventions that focus on increasing a client’s insight into and awareness about substance use and behavioral change.

A. Low risk

B. Low to moderate risk

C. Moderate risk

D. Moderate to high risk


Treatment and Prevention Planning

29. Treatment plans for clients with complex needs should include each of the following EXCEPT:

A. Biopsychosocial goals relevant to the individual and his or her living situation

B. Firm deadlines for accomplishing these goals

C. Appropriate treatment and prevention approaches

D. Follow-up activities during ongoing rehabilitation


Retaining Clients in Treatment and Maintaining Continuity of Care

30. For clients who have been living with chronic housing and other crises, it becomes important to keep treatment and prevention goals realistic and achievable, relatively short term, and measurable.

A. True

B. False


Relapse Prevention and Recovery Management

31. CTI is a time-limited adaptation of intensive case management to bring problem-solving resources, community advocacy, and motivational enhancement to clients who are homeless.

A. True

B. False


Evidence-Based Practices in Homelessness Rehabilitation

32. Which of the following correctly describes evidence-based practices in homelessness rehabilitation?

A. Supportive employment uses tangible rewards for housing, work training, and work opportunities and can provide direct monetary reinforcement for accomplishing clearly defined goals

B. The Curriculum-Based Support Group (CBSG) Program is a support group intervention designed to increase resiliency and reduce risk factors among children and youth ages 8 through 18 who are identified as being at-risk

C. Say it Straight is a communication training program that helps students and adults develop empowering communication skills and behaviors and increase self-awareness, self-efficacy, and personal and social responsibility

D. All of the above


Family Services To Reduce the Risk of Intergenerational Problems

33. Family programs involving homeless parents and their children are critical and may include parent participation in school-based programs, home visit programs, and intensive parent-child interactions.

A. True

B. False


Cultural Competence

34. Race, ethnicity, and culture influence how people ___________, seek help, and accept services.

A. Express problems

B. Acknowledge struggles

C. Engage in strategies

D. View interventions


Community Housing Services for People Who Are Homeless

35. Temporary housing services are generally limited to 3-6 months’ duration, and after stabilization, individuals and families may move to either transitional or permanent supportive housing.

A. True

B. False


What the Behavioral Health Service Provider Should Know

36. The permanent supportive housing approach, a major focus of Federal housing assistance today, does not mandate mental health, substance abuse, or other care or social services as a condition of participation.

A. True

B. False


Housing Services for Individuals With Substance Use and/or Mental Disorders

37. Supportive housing offers an affordable place to live and provides safe housing for people at a very vulnerable point in their lives.

A. True

B. False


Services for Veterans Who are Homeless

38. Drop-In Centers are services that give veterans who are homeless 1-3 days of safety and security where they can obtain food, shelter, clothing, and other types of assistance.

A. True

B. False


Housing Designations and Readiness to Change Substance Use

39. Damp housing includes each of the following characteristics EXCEPT:

A. Abstinence is recommended but not required, and intervention occurs if safety becomes an issue

B. Staff creates consistent, empathic relationships with clients and addresses behaviors related to substance use

C. Residents are engaged in treatment and other services as they are needed

D. This type of housing is suited to precontemplation or contemplation stages of change


Homelessness Services in Rural Areas

40. People who are homeless in rural areas are often difficult to identify and have less job opportunities, transportation, health and social services, and fewer shelter opportunities than those in urban settings.

A. True

B. False


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