Homelessness Workers Negotiating the Relationship between Identity and Practice: How Gender, Age and Background Influence Worker-Service User Relationship

Galbraith, Jennifer

doi:10.1080/14036096.2019.1584585

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…58,59 Specifically, regarding those experiencing homelessness, the development of trusting, consistent and reliable relationships is also essential to facilitate access to services. 47,51,[60][61][62][63] Although the experience of homelessness and problem substance use can be highly stigmatising, these experiences do not necessarily dominate individuals' sense of self, as they attempt to hold on to their dignity and self-worth, and succeed in doing so. 64 Neale and Stevenson 65 interviewed people who were homeless with problem substance use living in hostels in England to examine the nature and extent of their social and recovery capital.…”

Section: Homelessness and Substance Use In Contextmentioning

confidence: 99%

“…These inexorably shaped the relationships they developed with the participants and the support they gave to their participants, as is documented elsewhere. 60 Given this, assessing the level of consistency of delivery across the host sites was a challenging research endeavour. Overall, we found that the ethos and values of the study remained consistent across all PN approaches.…”

Section: Fidelity and Adherencementioning

confidence: 99%

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A peer-delivered intervention to reduce harm and improve the well-being of homeless people with problem substance use: the SHARPS feasibility mixed-methods study

Parkes

Matheson

Carver

et al. 2022

Health Technol Assess

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Background For people experiencing homelessness and problem substance use, access to appropriate services can be challenging. There is evidence that development of trusting relationships with non-judgemental staff can facilitate service engagement. Peer-delivered approaches show particular promise, but the evidence base is still developing. This study tested the feasibility and acceptability of a peer-delivered intervention, through ‘Peer Navigators’, to support people who are homeless with problem substance use to address a range of health and social issues. Objectives The study objectives were to design and implement a peer-delivered, relational intervention to reduce harms and improve health/well-being, quality of life and social functioning for people experiencing homelessness and problem substance use, and to conduct a concurrent process evaluation to inform a future randomised controlled trial. Design A mixed-methods feasibility study with concurrent process evaluation was conducted, involving qualitative interviews [staff interviews (one time point), n = 12; Peer Navigator interviews (three or four time points), n = 15; intervention participant interviews: first time point, n = 24, and second time point, n = 10], observations and quantitative outcome measures. Setting The intervention was delivered in three outreach services for people who are homeless in Scotland, and three Salvation Army hostels in England; there were two standard care settings: an outreach service in Scotland and a hostel in England. Participants Participants were people experiencing homelessness and problem substance use (n = 68) (intervention). Intervention This was a peer-delivered, relational intervention drawing on principles of psychologically informed environments, with Peer Navigators providing practical and emotional support. Main outcome measures Outcomes relating to participants’ substance use, participants’ physical and mental health needs, and the quality of Peer Navigator relationships were measured via a ‘holistic health check’, with six questionnaires completed at two time points: a specially created sociodemographic, health and housing status questionnaire; the Patient Health Questionnaire-9 items plus the Generalised Anxiety Disorder-7; the Maudsley Addiction Profile; the Substance Use Recovery Evaluator; the RAND Corporation Short Form survey-36 items; and the Consultation and Relational Empathy Measure. Results The Supporting Harm Reduction through Peer Support (SHARPS) study was found to be acceptable to, and feasible for, intervention participants, staff and Peer Navigators. Among participants, there was reduced drug use and an increase in the number of prescriptions for opioid substitution therapy. There were reductions in risky injecting practice and risky sexual behaviour. Participants reported improvements to service engagement and felt more equipped to access services on their own. The lived experience of the Peer Navigators was highlighted as particularly helpful, enabling the development of trusting, authentic and meaningful relationships. The relationship with the Peer Navigator was measured as excellent at baseline and follow-up. Some challenges were experienced in relation to the ‘fit’ of the intervention within some settings and will inform future studies. Limitations Some participants did not complete the outcome measures, or did not complete both sets, meaning that we do not have baseline and/or follow-up data for all. The standard care data sample sizes make comparison between settings limited. Conclusions A randomised controlled trial is recommended to assess the effectiveness of the Peer Navigator intervention. Future work A definitive cluster randomised controlled trial should particularly consider setting selection, outcomes and quantitative data collection instruments. Trial registration This trial is registered as ISRCTN15900054. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 14. See the NIHR Journals Library website for further project information.

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Section: Homelessness and Substance Use In Contextmentioning

confidence: 99%

Section: Fidelity and Adherencementioning

confidence: 99%

A peer-delivered intervention to reduce harm and improve the well-being of homeless people with problem substance use: the SHARPS feasibility mixed-methods study

Parkes

Matheson

Carver

et al. 2022

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…Finally, it is important to highlight that, in contrast to many homelessness services internationally, staff working in homelessness services in Scotland (including but not limited to HF) do not typically come from a social work background. While they are required to possess health and social care qualifications, they do not have the same formalized training social workers receive (Galbraith, 2020). This is likely to shape their experience of delivering a frontline service to individuals presenting with complex needs.…”

Section: Introductionmentioning

confidence: 99%

‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland

Miler

Foster

Hnizdilova

et al. 2021

Drugs: Education, Prevention and Policy

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Housing First (HF) represents a significant shift in the way that the problem of homelessness and cooccuring challenges including problem substance use, is addressed. HF interventions have been the focus of much research. Quantitative studies have consistently shown positive findings regarding housing outcomes, with results regarding health and well-being outcomes more mixed. To date, limited attention has been paid to the experiences and perspectives of HF service providers, and few studies have explored the views of those HF recipients. In enabling providers and recipients to share their professional and personal experiences of HF, qualitative insights can help inform, and improve, service provision and practice. Semi-structured interviews were conducted with seven HF staff members and 11 clients in a single third sector service in Scotland. Overall, clients experienced HF positively and described how involvement in HF had enabled positive changes in their lives. Service providers reported positive views on HF alongside ways to maximize the effectiveness of the model. While our findings provide support for current efforts to promote HF as an approach to help end homelessness, a number of challenges exist. To address these, we propose a set of recommendations for those planning and implementing HF services.Glossary:

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Young People and Homelessness: Place-making and Home in Hostels

Hoolachan,

Howell

2023

Handbook of Children and Youth Studies

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Homelessness Workers Negotiating the Relationship between Identity and Practice: How Gender, Age and Background Influence Worker-Service User Relationship

Cited by 4 publications

References 19 publications

A peer-delivered intervention to reduce harm and improve the well-being of homeless people with problem substance use: the SHARPS feasibility mixed-methods study

A peer-delivered intervention to reduce harm and improve the well-being of homeless people with problem substance use: the SHARPS feasibility mixed-methods study

‘It maybe doesn’t seem much, but to me it’s my kingdom’: staff and client experiences of Housing First in Scotland

Young People and Homelessness: Place-making and Home in Hostels

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