"La esperanza nunca termina…La esperanza es infinita," ( Hope never ends … Hope is infinite.) said Spanish playwright Buero Vallejo. Hope is certainly what one needs after falling again and again in the web of addiction.

For those who relapse, there is Casa Esperanza, or House of Hope

This grassroots organization was founded in 1984 in an effort to bring help to Latinos coping with alcoholism and drug abuse in Boston , Massachusetts . It provides them with the tools to recover from addiction, regain their independence and reenter their families and communities.

Casa Esperanza works through the social, economic and personal factors that cause drug and alcohol abuse in each individual client to keep him or her clean, says Wilfred Labiosa, relapse prevention and outpatient services program director.

"Based on our experience, we have seen persons who isolate themselves from society because they don't know how to ask for help," said Labiosa. "Racism triggers situations of drug abuse as well," he said.

The population served by Casa Esperanza reflects the Latino community: ninety seven percent of clients are Hispanic, mostly from Puerto Rico , and many of them are not bilingual.

"There are some clients who are Latinos and don't speak Spanish," said Diliana De Jesus, development and educational associate of Casa Esperanza. "It's a pretty good mix," De Jesus said.

Who Comes to Casa Esperanza?

In two words, the excluded and the vulnerable.

De Jesus said about 90 percent of the women and 75 percent of the male clients have been through traumatic experiences, including episodes of domestic violence and sexual abuse.

"We try to address the whole scope, not just one piece," she said.

One of the most important goals of Casa Esperanza is bringing family members together and assisting them in the process of family reunification. "We have clients who are detached from their direct families," Labiosa said.

Since nearly 80 percent of individuals in treatment have children, Casa Esperanza also teaches parenting skills.

Almost 75 percent of the individuals who receive Casa Esperanza's services are homeless and 94 percent of them are jobless or don't have any source of financial income.

The situation of many Latinos in Massachusetts "is alarming," said Labiosa, and when they come to Casa Esperanza they receive support in the areas of recovery and relapse-prevention. Counselors and social workers teach them life skills to help them become productive and have control over their lives. They receive anger management counseling and job-seeking training, including free use of Casa Esperanza's computer labs to apply for jobs.

In an effort to provide a sustainable recovery process, Casa Esperanza also offers residential treatment to support individuals in overcoming their addictions and living drug-free.

A collaborative research project between Casa Esperanza and the Boston University Center for Addictions Research and Services of the School of Social Work followed up on patients' responses to the "Familias Unidas" residential treatment program. Since its implementation three years ago, the project reported that mental health diagnosis, depression and anxiety tend to interfere with the patient's treatment.

"When clients report significant psychiatric problems, they are more likely to drop out of the program," said Deborah Chassler, associate director of the Center. "We found how difficult it is for anybody, Latino or otherwise, to enter into a residential treatment program, because there's a lot of adjustment needed."

Casa Esperanza addresses those issues by providing referrals for mental health services, facilitating medical attention and developing partnerships to support the recovery, wellness and healthcare of people in need.

"We recognize that our clients have many, many needs and we try to provide as much as possible," De Jesus said. "Within the first week that our client is here, we immediately ensure that they are referred to the medical center and get signed up for a primary care doctor. We work closely with the Boston Medical Center, which is only a couple of blocks away from us."

Casa Esperanza also works with the Boston Health Care for the Homeless Program and has two nurse practitioners and a registered nurse who provide services at their facilities.

"We are making progress and we have very positive outcomes," Labiosa said.

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Isaac Itman is a writer for the OMHRC. Comments? E-mail: info@minorityhealth.hhs.gov

Casa Esperanza, Inc.
http://www.casaesperanza.org

Substance Abuse and Mental Health Services Administration (SAMHSA)
http://www.samhsa.gov/

National Institute on Drug Abuse
http://www.drugabuse.gov

National Institute on Alcohol Abuse and Alcoholism
http://www.niaaa.nih.gov

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