Promoting parent–infant responsiveness in families experiencing homelessness

My Baby's First Teacher is an intervention designed specifically for parents with infants staying in emergency homeless shelters. Infants are overrepresented in shelter populations and face considerable risk to their development, including mental health. We utilized a randomized controlled design across three family shelters to evaluate the program's effectiveness with 24 dyads assigned to the intervention compared to 21 dyads in care-as-usual. Dyads were randomized by round at each site to account for shelter effects. We used path analysis to illustrate change over time and in relation to intervention assignment.     

Caring,Social Policy,and Homelessness

Care theory offers a way to overcome a weaknessof liberalism – its reluctance to intervene inthe private lives of adults. In caring for thehomeless, we must sometimes use a limited formof coercion, but our intervention is alwaysinteractive, and the process of finding asolution is one of negotiation between theneeds expressed by the homeless and the needswe infer for them.     

Longitudinal Impact of a Family Critical Time Intervention on Children in High-Risk Families Experiencing Homelessness: A Randomized Trial

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence‐based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time‐limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children—99 ages 1.5–5 years, 113 ages 6–10 years, and 99 ages 11–16 years—included mother‐, teacher‐, and child‐reports of mental health, school experiences, and psychosocial well‐being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool‐aged children and externalizing for adolescents 11–16. The intervention led to declines in self‐reported school troubles for children 6–10 and 11–16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness.     

Understanding the Lived Experience of Formerly Homeless Adults as They Transition to Supportive Housing

The researchers conducted in-depth interviews with formerly homeless adults who had moved to supportive housing to understand their perceived occupational needs and the factors that affected their transition. A qualitative research design with four participants who had a history of substance abuse and mental illness was used. Participant interviews that addressed categories of daily living and personal satisfaction produced data that were coded for analysis using conventional content analysis. Mega themes emerged that related to factors shaping the housing transition and maintenance experience. Occupational therapists can use these findings to create informed interventions to enhance this population's occupational performance.     

Voices from the Street: How Structural and Individual Factors Influence Homelessness

This study compared structural and individual factors related to persons who are homeless and how these factors affected their ability to utilize and benefit from available services. A qualitative case study design was used to conduct in-depth interviews with two participants receiving hospice care in a residence for the homeless. Results support previous findings that chronic homelessness is the result of multiple structural and individual factors that occur over time. Contrary to the literature on chronic homelessness, however, both participants were unique in their history of employment and strong desire to work, despite having limited work skills. Responses from both participants underscored the value of daily structure and meaningful occupation in residential addiction treatment.     

Locked Up,Then Locked Out

SUMMARY

Women prisoners face tremendous psychological, emotional, and physical hardships inside prison. These include isolation, separation from their families and children, lack of medical care and general abuse of their basic human rights. When they are released from prison, women confront institutional as well as psychological barriers to a successful return to their communities     

Risk and Protective Factors for Comorbid Posttraumatic Stress Disorder among Homeless Individuals in Treatment for Substance-Related Problems

Homeless individuals undergoing treatment for substance use disorders (SUD) can pose clinical challenges. Posttraumatic stress disorder (PTSD) symptoms have been observed in the most difficult clients. The study sample consisted of 51 homeless individuals, 9 women and 42 men, undergoing consultation for SUD in Montreal. The mean age was 46 years (SD = 7.19). Of the sample, 49% had a potential PTSD diagnosis. Most participants had the following characteristics: an alcoholic parent, a history of an early trauma, and little social support. The participants with a potential PTSD diagnosis were significantly more likely to have had an alcoholic parent, to have experienced an early trauma, and to use more maladaptive coping strategies. The study results and limits are discussed.     

Homelessness and the problem of containment

Homelessness is a problem that is hardly spared to any society in our modern world. Usually discussed by people concerned with social policy, sociology, public health and politics, homelessness has only quite recently begun to command the attention of professionals concerned with psychological and psychotherapeutic processes. Following from the author's experience of working therapeutically with homeless people, as well as in discussions with homeless services, the paper follows a line of thinking around homelessness that is explicitly psychodynamic in orientation. The central argument here is that homelessness is an experience that is, so to speak, waiting to happen. Homelessness is portrayed as a natural extension of an underlying experience of the sister states of uncontainment and alienation. I argue that the homeless person not only experienced a lack of containment in his earliest interactions, but has grown through life with significant difficulties in this area. Homelessness then is an extreme response to a deeper psychological reality that projects into a part of the person's life the agonies associated with uncontainment. Homelessness is the realization of an internal situation –a shifting of a personal struggle into a new and more visible stage. This view of homelessness is designed to provide an amendment to current views that privilege the roles of poverty and social exclusion in the origins of homelessness rather than as an alternative account of the origins of homelessness.