Substance Use and Health and Safety among Homeless Youth

This study examines how substance use is associated with the health and safety of homeless youth using cross-sectional, self-report data from 285 homeless adolescents. Path models were used to examine concurrent relationships between youth’s substance use and multiple aspects of their health and safety, including measures of psychological distress, housing risk and instability, and medical problems. Substance use was examined with both global (i.e., a composite of days of use across various drugs and alcohol) and specific (i.e., rates of use of specific drugs, injection drug use) measures. After controlling for demographic and historical variables, number of days of use was significantly related to psychological distress, whereas injection drug use was significantly related to housing risk. Examination of specific drugs revealed relationships between psychological distress and the use of alcohol, cocaine, and amphetamines, and a specific relationship between housing risk and the use of heroin. None of the measures of substance use was significantly related to youth’s medical problems. Implications for interventions with homeless adolescents are discussed.     

Self-determination in relation to quality of life in homeless young adults: Direct and indirect effects through psychological distress and social support

The self-determination theory emphasizes the importance of satisfaction with autonomy, competence, and relatedness for a person’s psychological growth and well-being. This study examines associations between autonomy, competence, and relatedness with quality of life in homeless young adults; and whether possible associations are mediated by psychological distress and perceived social support. By means of face-to-face interviews, 255 homeless young adults who receive care from 10 Dutch shelter facilities for homeless young adults have been interviewed (M age = 20, 77% male, 51% Dutch Nationality) shortly after entering the facility. Autonomy, competence, and relatedness are all associated with quality of life, with competence as the highest correlate. Psychological distress mediates both competence and autonomy, and social support mediates competence as well as relatedness. These findings emphasize the importance of intervention programs for homeless young adults, focusing on the enhancement of self-determination, especially competence, to improve their quality of life.     

Advisory working alliance, perceived English proficiency, and acculturative stress

The aim of this study was to examine the moderators of (a) general or cross-cultural advisory working alliances and (b) perceived English proficiency on the association between acculturative stress and psychological distress. A total of 143 East Asian international students completed an online survey. Results from a hierarchical regression indicated significant three-way interactions of (a) General Advisory Working Alliances × Perceived English Proficiency × Acculturative Stress on Psychological Distress and (b) Cross-Cultural Advisory Working Alliances × Perceived English Proficiency × Acculturative Stress on Psychological Distress. Specifically, the present results indicated that acculturative stress was significantly associated with psychological distress only when students perceived lower English proficiency and had a stronger general or cross-cultural advisory working alliance. However, acculturative stress was not significantly related to psychological distress when these students perceived lower English proficiency and had a weaker advisory working alliance (i.e., general or cross-cultural). In addition, acculturative stress was also not significantly related to psychological distress when these students perceived higher English proficiency and had a stronger or weaker advisory working alliance (i.e., general or cross-cultural).     

Homelessness as psychological trauma. Broadening perspectives.

Most mental health literature on homelessness has focused on characteristics that may be risk factors for homelessness. The authors of this article argue that homelessness itself is a risk factor for emotional disorder and use the construct of psychological trauma--focusing on social disaffiliation and learned helplessness--to understand the potential effects of homelessness. Psychological trauma is likely among homeless individuals and families for three reasons. (a) The sudden or gradual loss of one's home can be a stressor of sufficient severity to produce symptoms of psychological trauma. (b) The conditions of shelter life may produce trauma symptoms. (c) Many homeless people--particularly women--become homeless after experiencing physical and sexual abuse and consequent psychological trauma. Research suggests that negative psychological responses to traumatic events can be prevented or mitigated by a supportive and empowering posttrauma environment. The implications of trauma theory for improving the psychosocial conditions of homeless people are discussed.     

Loss of Control,Attributions, and Helplessness in the Homeless1

Control has emerged as an important psychological variable. The purpose of this project was to extend the concept of environmental control to the homeless shelter environment. Data from interviews conducted with residents of a homeless shelter supported the hypothesis that perceived loss of control over the shelter environment would be positively related to giving up on finding a home and employment. The hypothesis that the helplessness created by low control environments is consistent with the external, stable attributional style of “universal” helplessness was partially supported. Suggestions for future research are provided. Changes in the shelter environment are recommended for the treatment of helplessness in the homeless though helplessness is expected to persist as long as poverty, expensive housing, and prejudice against the homeless make efforts and outcomes noncontingent.     

Valuing clients' perspective and the effects on the therapeutic alliance: a randomized controlled study of an adjunctive instruction

The patterns of growth and development of the therapeutic alliance over the course of therapy have been of continued interest to psychotherapy researchers. The purpose of this study was to investigate whether a simple institutional metacommunication intervention with clients had an effect on the development of the alliance. This adjunctive instruction involved inviting therapy clients to take a proactive role in their treatment by encouraging feedback to their therapist about various aspects of the therapy process. In this randomized controlled study (N = 94), clients were assigned to 1 of 2 conditions: (a) an institutional adjunctive instruction condition in which patients were contacted by clinic personnel at the beginning of the remediation phase (Session 5) and encouraged to take a proactive role in their treatment and (b) a control condition that contained no institutional adjunctive instruction. Between-condition differences in the alliance were tested, controlling for baseline influences and the early therapeutic alliance. Clients' postsession reports from Sessions 1 to 24 indicated that the adjunctive instruction increased the alliance over the course of therapy vis-à-vis the control condition. The adjunctive instruction appeared to have fostered clients' evaluation of their therapists' interest in their welfare. The results indicate that interventions, even brief or subtle, can produce lasting benefits in the alliance when targeted at specific psychological processes. Systematic metacommunication from the institutional level appeared to reinforce clients' therapeutic alliance with their therapists in individual treatment.     

An Indicator of Suicidal Ideation on the Rorschach Test

We examined the impact of patient- and therapist-rated alliance developed during psychological assessment on the subsequent alliance measured early and late in formal psychotherapy. We hypothesized that a working alliance developed during psychological assessment conducted from a collaborative therapeutic model of assessment (TMA; Finn &; Tonsager, 1992, 1997; Fischer, 1994) between the patient and therapist would carry into formal psychotherapy. We also hypothesized that alliance for those patients receiving a TMA would be significantly greater than patients receiving psychological testing as usual. To test this hypothesis, we administered the Combined Alliance Short Form-Patient Version (Hatcher &; Barends, 1996) and the Combined Alliance Short Form-Therapist Version (Hatcher, 1999) to a sample of outpatients and their therapists at the end of the assessment feedback session, early, and late in psychotherapy. The hypotheses were supported as alliance scales rated at the assessment feedback session demonstrated positive and significant relationships with alliance throughout formal psychotherapy and in relation to a control group. The clinical utility and research implications of these findings are discussed.     

The development of therapeutic alliance during psychological assessment: patient and therapist perspectives across treatment

We examined the impact of patient- and therapist-rated alliance developed during psychological assessment on the subsequent alliance measured early and late in formal psychotherapy. We hypothesized that a working alliance developed during psychological assessment conducted from a collaborative therapeutic model of assessment (TMA; Finn & Tonsager, 1992, 1997; Fischer, 1994) between the patient and therapist would carry into formal psychotherapy. We also hypothesized that alliance for those patients receiving a TMA would be significantly greater than patients receiving psychological testing as usual. To test this hypothesis, we administered the Combined Alliance Short Form-Patient Version (Hatcher & Barends, 1996) and the Combined Alliance Short Form-Therapist Version (Hatcher, 1999) to a sample of outpatients and their therapists at the end of the assessment feedback session, early, and late in psychotherapy. The hypotheses were supported as alliance scales rated at the assessment feedback session demonstrated positive and significant relationships with alliance throughout formal psychotherapy and in relation to a control group. The clinical utility and research implications of these findings are discussed.     

Utilizing Participatory Mapping and GIS to Examine the Activity Spaces of Homeless Youth

Although previous studies have informed our understanding of certain aspects of youth homelessness, few studies have critically examined the spatial and social environments utilized by youth as they navigate life on the streets. This study employed participatory mapping and Geographic Information Systems (GIS) to examine the activity spaces of homeless youth as they relate to sense of community and psychological well‐being. Participants were 28 youth experiencing homelessness in Portland, Oregon, USA. Results suggest that youth engage most frequently in service‐related activities, and their activity participation is significantly associated with sense of community and psychological well‐being. The utility of innovative participatory methods for better understanding the diverse experiences of homeless youth is discussed alongside examination of their practical implications.     

人际同步性现象：探索心理咨询过程中同盟关系的新视角

人际同步性是指两个或两个以上的人的言语特点、行为表现、生理指标以及神经生理活动在时间上出现重合的现象, 得益于近10年内技术上的突破, 研究者开始对心理咨询领域的人际同步现象进行初步的探索, 试图从该视角揭示心理咨询过程中咨访双方的互动模式和同盟建立的内在机制。近期研究主要关注非言语同步、生理同步、人际脑同步与同盟及其影响因素之间的关系, 并针对它们各自对同盟的作用机制发展出了相应的理论。未来的研究者可以更多地关注同盟动态变化过程中的人际同步性, 发展整合理论来回应同盟建立的内在机制, 并在临床应用上促进具有人际同步性的心理咨询互动过程。     

A Dyadic Analysis of the Between‐ and Within‐System Alliances on Distress

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ). This study examines the relationship between the therapeutic alliance and distress using the couple rather than the individual as the unit of analysis. One hundred and seventy‐three couples receiving treatment for relational distress at two university clinics participated in this study. The actor–partner interdependence model was used to analyze the relationship of each partner's between‐ and within‐system alliance scores and distress at session four. Results provide support for actor effects on relational distress for both male and female partners and for actor effects on psychological distress for female partners. Limited support was found for partner effects on distress. Furthermore, results indicate that the alliance between partners is a stronger predictor of improvement in early sessions in comparison with the alliance between the individual and the therapist.     

Individual,Housing, and Neighborhood Predictors of Psychological Integration Among Vulnerably Housed and Homeless Individuals

The current longitudinal study evaluated the individual, housing, and neighborhood characteristics predictive of feeling psychologically integrated within one's neighborhood among a population of homeless and vulnerably housed individuals. Participants were recruited at homeless shelters, meal programs, and rooming houses in Ottawa, Canada and participated in three in‐person interviews, each approximately 1 year apart. Prospective and cross‐sectional predictors of psychological integration at Follow‐up 1 and Follow‐up 2 were examined. There were 397 participants at baseline, 341 at Follow‐up 1 and 320 at Follow‐up 2. A hierarchical multiple regression uncovered several significant predictors of psychological integration. The most salient and common predictors were being older, having greater social support, living in high quality housing, and residing in a neighborhood with a positive impact. Implications for service provision and policy advancements are discussed.     

Psychache and suicide ideation among men who are homeless: a test of Shneidman's model

Suicide ideation among the homeless is 10 times more common than in the general population. Cognitive theories of depression and hopelessness propose to explain suicidality; however, as yet, none of these fully account for the phenomenon. Shneidman has suggested a theory of psychache or unbearable psychological pain to explain suicidality. This theory has found support among low-risk populations but has not been extensively tested within a high-risk population. The current research assessed the utility of psychache among men who are homeless (N = 97). In support of Shneidman's theory, analyses revealed that psychache was a stronger predictor of suicide ideation than was depression, hopelessness, or life meaning.     

Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness

Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven “Housing First” program or “treatment as usual” requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choice, mastery, and psychiatric symptoms were measured at six time points. Results indicate a direct relationship between Housing First and decreased homelessness and increased perceived choice; the effect of choice on psychiatric symptoms was partially mediated by mastery. The strong and inverse relationship between perceived choice and psychiatric symptoms supports expansion of programs that increase consumer choice, thereby enhancing mastery and decreasing psychiatric symptoms.     

Spirituality Development for Homeless Youth: A Mindfulness Meditation Feasibility Pilot

Few resilience enhancement interventions are available to help homeless youth at high risk for mental health problems and substance abuse. Mindfulness meditation has demonstrated effectiveness in persons who deal with some of these issues. Our purpose was to examine the feasibility of delivering a spirituality development class—a minimally modified version of Yale University’s 8-session Spiritual Self-Schema (3-S) program—to homeless youth in a shelter in an urban center in the Southeastern United States. We used a quasi-experimental, one group, pre- and post-intervention design with standardized self-report measures of impulsiveness, resilience, spirituality, mental wellness, and psychological symptoms. Seventy-one youth enrolled in the study; 39 of the youth attended at least four sessions of the class and completed the posttest. The spirituality development class was well received by the youth and, overall, participants demonstrated improvement on measures of spirituality, mental wellness, psychological symptoms, and resilience on the posttest. There were no statistically meaningful changes in impulsiveness scores. We concluded that mindfulness meditation programs are feasible for this population. Future studies of high-risk youth should use a randomized controlled trial design to examine the long-term impact of such training on psychological status and behavioral outcomes such as educational path, work attainment, and drug and alcohol abuse.     

Homelessness and strategies of identity maintenance: a participant observation study

In order to investigate identity maintenance strategies used by a low status group, a covert participant observation study was conducted in a shelter for the homeless. From Social Identity Theory and previous research on the homeless, it was hypothesized that the identity maintenance strategies used would differ as a function of longevity of homelessness: the short‐term homeless (<2 years) would be less likely to identify themselves as homeless (social mobility), while the longer‐term homeless (>2 years) would identify themselves as homeless but engage in various types of social creativity to mitigate their situation. In addition to the strategies described in SIT, it was conjectured that some of the longest‐term homeless would have given up making any intergroup or other social comparisons. Of the various strategies found, some were beyond SIT. The pattern of strategy use was best interpreted mainly as a function of longevity of homelessness, but this was moderated by both experience and personality. A trajectory of change in identity strategies with longevity of homelessness was offered as a plausible frame of reference for further research. Methodological limitations, implications for Social Identity Theory and recommendations for improving the situation of the homeless were discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

Representing Rebellion: Memory and Social Conflict in Sixteenth-Century England

This paper takes key insights from social psychologists and interrogates them as methodological tools for historians, applying these theories to a large-scale uprising that occurred in southern England in 1549. In a social order based on notions of paternalism and deference, a diverse band of rebels were able to forge an alliance strong enough to pose a serious threat to local authorities in Norwich. Social psychological approaches to collective memory and evolving social representations are deployed to highlight contested memories of rebellion as central to Tudor state formation, and to understand how a rebel group with many competing interests was able to sustain their alliance. I argue that the imperative to understand individual behaviour in a collective context illuminates the way that this group could form a vision of the world which contradicted deferential social ideals without ranging themselves against central government. The article also suggests ways in which historical approaches can inform social psychological concepts.     

La perception parentale de la pratique du bilan psychologique de l’enfant et de l’adolescent

The psychological assessment is a widespread approach in child and adolescent psychology, but few studies have examined the experiences of the main stakeholders during this process. This study was conducted among 105 parents consulting for their child in a psychological counseling centre, and investigated by ad-hoc questionnaires the dimensions that can be involved at different moments of the assessment: expectations and perceptions, motivation for change, working alliance, and satisfaction with care. The results highlight the importance of parents’ initial representations and the quality of first contact with psychologists. This study enhances our understanding of procedural elements little studied and yet determinant for the engagement of parents in the psychological assessment and the intervention that would follow.     

The Influence of Retention,Turnover, and Alliance on Process and Outcomes in Rolling Group Psychotherapy for Cocaine Disorder

A longitudinal repeated measures design was used to investigate the influence of treatment retention, and membership turnover on individual outcomes, and the relationship between individual-level and group-level therapeutic alliance in rolling group psychotherapy for individuals with cocaine abuse disorder. Eighteen patients were studied; data were collected prior to therapy and then monthly for 24 months. Patient outcomes and process were assessed. Improvements in symptoms and psychological functioning were associated with retention in psychotherapy. Membership turnover had a negative influence on symptoms. Development of an individual alliance was affected by the development of group-level therapeutic alliance, but not by time spent in therapy.     

Effects of psychosocial and situational variables on substance abuse among homeless adults

Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing.