Mini Paper #1:Intervention Research with the Homeless
The effects of homelessness as a social condition are both wide reaching, and difficult to grasp in its scope. It is a circumstance of varying severity, which people may move through for different lengths of time and for different reasons, making it challenging to establish an accurate breadth of its range (Biswas-Diener & Diener, 2006; Parsell, 2011). Link and colleagues (1994) have estimated that 14% of the United States may experience homelessness at some point in their life. According to The US Department of Housing and Urban Development (2011) there may be as many as 400,000 homeless individuals in the United States on a given day, and that 1,500,000 people may experience homelessness within the span of a year (HUD, 2011). A person’s familiarity with the homeless condition will vary depending on whether they experience it chronically, temporarily, or periodically (Rivlin, 1990). People may experience homelessness as a result of unemployment, natural or human-constructed adversity, mental illness, or a combination of factors (Hagen, 1987). The influences that contribute to the condition of homelessness may also play a hand in the progression and outcome of the person experiencing it, be it mental health or substance abuse issues, personal crisis, or systemic pitfalls (Chamberlain & Johnson, 2013). As a result of the potential reasons someone may enter homelessness, the rates and demographics of the homeless population vary among regions of the United States (HRI, 2012), and fluctuate in time. From the period of 2009 to 2012, homelessness as a whole decreased by 1% despite the conditions of the economic downturn, while the number of people who would have been homeless but instead doubled up with friends or family increased by 13% during this same time period (HRI, 2012).
Predictors – risk & problem
While any number of circumstances may contribute to the condition of homelessness, The Homeless Research Institute (2012) has identified four population groups who are at an increased risk of entering homelessness; people living with family and friends for economic reasons, prisoners who have been recently released, people aging out of foster care, and the medically uninsured. At its core, whether or not someone will enter or exit the condition of homelessness is influenced by a person’s income, their access to supports and social service resources, and the cost of available housing. As a result, other socioeconomic conditions associated with marginalization can increase a person’s risk of entering homelessness, such as unemployment or mental illness, and the condition of homelessness itself may even serve to fortify these things (Goodman, Saxe, & Harvey, 1991; Thoits, 1982).
Knowledge base/theoretical explanations
No clear theory explains the phenomenon of chronic homelessness better or more appropriately than another, although the perspective adopted will affect the explanations and constructs that are accounted and controlled for within research. For example, the social estrangement model posits that upon entering homelessness people experience a general sense of alienation and proceed to adapt to a lifestyle that reinforces this estrangement (Grigsby, Baumann, Gregorich & Roberts-Gray, 1990). The concept of estrangement has been adapted into a measured scale, and this model has been used in research to examine the reintroduction of employment into the lives of the homeless as a potential intervention to decrease one’s sense of estrangement and reintegrate back into society (Ferguson et al., 2012). Social constructionism has been used to explain homelessness as an artificial construct that is used to describe an extreme form of poverty that actually exists on a spectrum, and is not the binary distinction that is used to give a blanket idea to what actually amounts to a diverse range of experiences within the homeless population (Tosi, 2010). This idea has led to research and programs that operate with a continuum definition of homelessness (Anderson, & Tulloch, 2000). Social alienation theory has also been tested in the form of measuring the change of social support network of homeless adults across time spent homeless (Eyrich, Pollio & North, 2003).
Key research questions/intervention proposals
Because of the variety of factors that may exacerbate or contribute to homelessness, there are consequently any number of potential interventions and areas of concern to address. Researchers have found it useful to distinguish among cultural or demographic subgroups within the homeless population to address the concerns that appear to be more pertinent to a given subgroup (Aubry et al., 2012). Such distinctions may seek to reduce destructive behaviors or victimization associated with the homeless lifestyle itself (Justus, Burling & Weingardt, 2006). From a broader perspective, investigators may attempt to identify how the homeless will best establish and maintain long-term housing (Groton, 2013), as well as how to maximize retention and participation of services for the homeless in general (Padgett et al., 2008).
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Intervention research that concerns itself with the homeless population must make educated assumptions about the most salient issues worth addressing, the causes of those issues that may be controlled, and the types of outcomes that should be attained. Meaningful intervention research should attempt to identify questions that address the preventative conditions of homelessness, the exacerbating conditions that may prolong someone’s experience with it, and the opportunities available to exit it.
Social networks play an important role in people’s lives, and the homeless are no exception. Some forms of social support may serve to normalize the homeless experience (Auerswald and Eyre, 2002), while others may offer support for exiting homelessness (Zlotnick, Tam, & Robertson, 2003). An appropriate research question in this area would ask; what are the characteristics of social networks that serve to contribute to a person’s successful attempts to exit homelessness? An intervention program that would attempt to capitalize on known social support networks that reinforce a person’s decision to exit homelessness could be as simple as incorporating a series of questions into existing outreach programs that are designed to identify such relationships. Once these relationships are identified, practitioners could be instructed to attempt outreach with these social network members to include them in their work with their clients.
One of the issues associated with homeless encampments is their proximity to necessary services (Chamard, 2010), of these healthcare access may be included. To build off of research which has identified that demographics as well as distinct lifestyles among the homeless may mean the difference between healthcare access or not (Nakonezny & Ojeda, 2005), a further relevant research question may ask how can people living in homeless encampments attain more consistent and accessible healthcare? Intervention work in this vein could seek to implement medical outreach programs in areas known to have higher concentrations of homeless encampments, identify how medical conditions are impacted as a result, and further modify outreach techniques depending on the results.
Homeless youth have been shown to have increased rates of victimization relative to their housed counterparts (Tyler, Gervais & Davidson, 2013; Tyler & Melander, 2012), and that victimization is associated with higher rates of substance use (Bender et al., 2012). Potential interventions in this area could include fusing a program designed to address substance use among homeless youth with training staff to have heightened awareness of who may be at risk for increased victimization, and address individual cases as needed. The potential for intervention research within the homeless population is plentiful.
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