Caring with Care: VITAE’s integrative and therapeutic model towards socially vulnerable individuals

Background: Homelessness and social vulnerability are increasing in the Portuguese social paradigm. VITAE, in collaboration with governmental and private partners, is dedicated to provide housing, healthcare, and social support to approximately 1,500 individuals. Our clients are heterogeneous, comprising individuals facing mental health challenges (such as addictions and psychiatric disorders), unemployment, financial instability, unsupported migration, and homelessness. These diverse issues required the development of an intervention model, taylor made and designed to address the multifaceted needs of our population.
Our intervention strategy includes a variety of contexts and methodologies, focusing on homeless individuals, shelters, housing, follow-up services, low threshold methadone program, alcohol harm reduction programs, needle exchange, emergency food kit’s, and specialized support for employability and legal matters. This broad spectrum of services is ensured by a multidisciplinary team that includes clinical, social, legal support and peer workers. Note that, each client as a designated psychosocial worker that manages their process, integrating various aspects of each individual's needs to promote holistic and personalized care delivery.
Method: The current aim of this work is to present our integrative-intervention model, which aims to empower our clients while respecting their individual choices and backgrounds. Our model employs a psychotherapeutic and socially integrative approach aimed at reducing risk, and trauma. It incorporates the stages of change theory, motivational interviewing, and Scott Kellogg's gradualism framework. Note that, each dimension is crucial to provide effective support across various contexts and needs.
Specifically, trauma-informed care acknowledges and addresses the needs of individuals with trauma histories, thereby preventing further trauma. The stages of change model offers targeted support throughout the behavior change process. Motivational interviewing encourages clients to reflect on their ambivalence towards change and fosters intrinsic motivation. Scott Kellogg's gradualism supports individuals in making incremental changes by setting realistic and achievable goals. Integrative harm reduction psychotherapy proposed by Andrew Tatarsky, offers personalized treatment for substance use issues and mental health, supporting sustainable recovery and overall well-being. 
Conclusion: In conclusion, our primary aim is to provide the most integrative approach to empower those in need by ensuring that their individual backgrounds and aspirations are respected and valued.