Academic journal article The Qualitative Report

Making Meaning Together: An Exploratory Study of Therapeutic Conversation between Helping Professionals and Homeless Shelter Residents

Academic journal article The Qualitative Report

Making Meaning Together: An Exploratory Study of Therapeutic Conversation between Helping Professionals and Homeless Shelter Residents

Article excerpt

Greg's Story

Until recently, Greg was a foreman in a successful construction company. After suffering from frostbite on the job, osteomyelitis set in with the resulting loss of several fingers and both of his legs just below the knees. Unable to work or get fair compensation for his injuries, Greg lost his home, his partner, and ended up at a homeless shelter. "I dream in Technicolor ... " Greg said. "... I am running and playing sports. Then I wake up and see my wheelchair at the end of my bed and look at my legs ... Mornings are the hardest for me, and I don't always know if I can make it ... " Greg's gift freely offered was the living example of being real, or authentic, and the inherent call for respectful acknowledgement of him as a person.


Interventions designed for the optimal health of persons who are homeless have been initiated with a broad range of goals varying from addressing basic physical needs and improving mental and emotional health to eradicating homelessness altogether (Christensen, Hodgkins, Garces, Estlund, Miller, & Touchton, 2005; Shinn, Baumohl, & Hopper, 2001; Toro, Rabideau, Bellavia, Daeschler, Wall, Thomas, et al., 1997). Within the realm of mental and emotional health, therapeutic conversation is a means of empowering individual persons who are homeless (Bohn, Wright, & Moules, 2003; Levy, 1998) to meet the challenges of their present circumstances or to ultimately escape the cycle of homelessness. Under the auspices of a community-university partnership and the mentorship of an interprofessional leadership team, two undergraduate students from nursing and social work faculties explored the use of therapeutic conversation as a means for optimizing health of homeless shelter clients in Calgary, Alberta. The Making Meaning Together study produced knowledge regarding therapeutic conversation with individuals who are homeless.

Therapeutic conversation

Sluzki (1992) describes therapeutic conversation as conversation in which opportunities for personal transformation take place through a healing change/alteration in the way in which people perceive their life circumstances. According to Weingarten (1992), therapy consists of the connection and collaboration that takes place between client and helping professional within conversation. The conversation becomes therapeutic when meaning, and thus intimacy, is created together by both client and helping professional (Weingarten). Conversation requiring the exchange of both attentive listening and respectful response is the necessary therapeutic venue in which positive personal transformations take place (Bakhtin, 1984; Levy, 2004; Seikkula & Trimble, 2005).

For a conversation to be truly therapeutic, there cannot be one sole monological expert (the therapist) devising solutions for and acting upon a non-contributing subject (the client; Bakhtin, 1984; Seikkula & Trimble, 2005). Therapeutic conversation, it is argued, requires the helping professional/therapist to relinquish the right to speak from an expert position of power and authority and to engage as a partner in healing conversation (Bakhtin; Guilfoyle, 2003; Seikkula & Trimble). For a life-giving or healing exchange to occur there must be a sense of equality, of kindred and equal participation, of giving and receiving; qualities constituting true dialogue (Bakhtin; Guilfoyle; Seikkula & Trimble).

Therapeutic conversation with persons who are homeless

Engagement is a necessary prerequisite of therapeutic conversation and relationship development, with the quality of this phase being critical to the success of therapeutic conversation (Levy, 1998). Therapeutic conversation with persons who are homeless requires trust and the formation of a common language through open dialogue between client and helping professional (Levy, 1998; Seikkula & Olson, 2003).

Open dialogue, a therapeutic function grounded in the belief that healing ultimately lies in the elements of conversation and the social connections it strengthens, allows the participants to tolerate uncertainty in the conversation (Bakhtin, 1984; Seikkula & Olson, 2003). …

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