Academic journal article Child Welfare

Treatment Implementation in a Short-Term Emergency Shelter Program

Academic journal article Child Welfare

Treatment Implementation in a Short-Term Emergency Shelter Program

Article excerpt

From October 1985 to June 1988, more than 44,000 homeless and runaway youths were served at federally funded shelters [General Accounting Office (GAO) 1989], a number that underscores the great need for safe and effective short-term emergency shelter programs for youths in crisis. Youths who receive services at these shelters report significant personal and family problems, including depression and physical or sexual abuse, and many have previous histories of suicide threats and attempts [GAO 1989; Kurtz et al. 1991; Mundy et al. 1990; Teare et al. 1992]. It is therefore incumbent upon service providers to provide effective and harm-free programs. When this goal is not attained, the result may be a shelter environment that is at least as chaotic and dangerous as the youths' previous living environment.

Chaotic environments have been a particular problem for some large urban shelters for homeless adults. Gruneberg and Eagle [1990: 523], for example, described one shelter for the homeless in New York City as being pervaded by crime and a place where "everything is up for grabs--the resident's personal belongings, his bed or locker, his bodily safety, and his privacy." They described a process--"shelterization"--that the residents undergo to cope with shelter living [Gruneberg and Eagle 1990]. This process is characterized by a decrease in interpersonal responsiveness, a neglect of personal hygiene, increasing passivity, and increasing dependency on others. Similarly, homeless mothers report that their preschool children exhibit regressive behaviors after moving into shelters [Bassuk and Gallagher 1990]. These authors concluded that the emergency shelters they studied actually exacerbated the children's existing problems, and created others. The need for effective and harm-free shelter programs is obvious.

Shelter programs for runaway and homeless youths, however, appear to be more able to provide a range of services to their clients than shelters for adult populations. A recent nationwide survey of 185 agencies offering shelter to runaway and homeless youths found that these agencies provided, on average, 14 different services to their clients [National Network of Runaway and Youth Services (NNRYS) 1991]. It would appear that these agencies' shelters would be more effective than those discussed above, but virtually no data exist that specify the treatment received by youths in these shelters. This article describes in some detail the treatment activities in one shelter for runaway and homeless youths.

Documenting the quality of life and the outcome treatment activities in short-term shelters is important for several reasons. First, the main objective of crisis shelters must be to provide a safe respite for youths who may be coming from chaotic or abusive family environments. Because risk for maltreatment in out-of-home care in some cases may be higher than in the youths' own home [Spencer and Knudsen 1992], we must be able to document that the environments in which these youths receive services provide both safety and effective treatment. Second, programs must be accountable to their funding sources, and must be able to document prescribed levels and outcomes of treatment. Finally, documenting program activities becomes an integral part of a systematic and ongoing program evaluation process that can produce regular feedback to managers about the program's effectiveness.

A number of important structural program elements characterize safe, effective environments. Among them are a model of care, caregiver support, a focus on positive behavior, a consumer orientation, training, program evaluation, and an internal program audit [Daly and Dowd 1992]. As these elements relate to emergency shelter programs, they presuppose that the shelter is oriented toward active treatment rather than offering only food and a place to sleep.

PROGRAM DESCRIPTION

In developing an emergency youth shelter program, the staff of Father Flanagan's Boys' Home incorporated these structural elements. …

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