Intervention Strategies with the Homeless Population

Article excerpt

A literature review describing psychological and sociological factors of homelessness. Methods of estimating the frequency of homelessness are described, along with recent point-in-time and period-of-time estimates. Models of service delivery are reviewed. A biopsychosocial model of intervention is proposed that describes stages of intervention and the treatment provider's role. Interventions with the homeless family are discussed. References to professional organizations and implications for future research are provided.

Keywords: homelessness, interventions, counseling

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Homelessness represents the ultimate event of downward mobility for many people, yet the explanations of factors contributing to homelessness remain many and varied. Given the multiplicity of interacting factors contributing to homelessness, and the heterogeneity of the homeless population; many intervention strategies are available, which places many demands upon the treatment providers to provide competent and evidence-based intervention to address the needs of this client population.

Background

Incidence and prevalence. The U.S. Department of Housing and Urban Development (HUD) (2010) defines the homeless person as one who lacks a fixed, regular, and adequate nighttime residence and who has a primary nighttime residence that is either (a) a supervised shelter providing temporary living accommodations or (b) an institution providing residence for individuals intended to be institutionalized or (c) a public or private place not designed for regular sleeping accommodations for human beings. Chronic homelessness is looked upon as a condition in which an individual has a disabling condition and who has either been continuously homeless for more than one year or has experienced at least four episodes of homelessness during the past three years (HUD, 2010). The National Coalition for the Homeless (2009) expands upon this definition by also including those individuals with no permanent residence,yet residing temporarily with friends or relatives in what is often an overcrowded living arrangement. Given these definitions, the human face of homelessness embraces many facets of the human condition, including individuals who have experienced unemployment, natural disaster, medical or mental illness, and financial hardship. Children represent in increasing percentage of the homeless population, which includes runaways and throwaways as well as children living in homeless families.

The number of people living in streets, shelters, cars and campgrounds will vary by definition and method of counting (National Coalition for the Homeless, 2009). Two methods of estimation are frequently used: point-in-time estimates will count the number of homeless persons on a given date, and period-of-time estimates will make a count of persons experiencing homelessness over an extended period of time. Point-in-time estimates often misrepresent the prevalence of homelessness by only counting people who are temporarily homeless on a given night (i.e., the temporary unemployed or the temporary adolescent runaway). For instance, the National Coalition for the Homeless (2009) describes a National Survey of Homeless Assistance Providers' point-in-time estimate of 842,000 homeless individuals on a given night in February 1996 and a point-in-time estimate of 444,000 on a given night in October 1996; yet the period-of-time estimate of homelessness in 1996 was approximated as ranging from 2.3 million to 3.5 million. Most currently, the National Law Center on Homelessness and Poverty (2009) estimates that approximately three million to five million people will experience homelessness in any given year, which represents approximately 1% of the national population.

Pathways to homelessness and prevailing myths. The two most frequently referenced pathways to homelessness include economics and mental status. The economic pathway includes such factors as unemployment, housing shortages and foreclosures, bankruptcies, medical indebtedness and lack of insurance. …