Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings

Abstract

It is reasonable to assume that individuals and families who are homeless have been exposed to trauma. Research has shown that individuals who are homeless are likely to have experienced some form of previous trauma; homelessness itself can be viewed as a traumatic experience; and being homeless increases the risk of further victimization and retraumatization. Historically, homeless service settings have provided care to traumatized people without directly acknowledging or addressing the impact of trauma. As the field advances, providers in homeless service settings are beginning to realize the opportunity that they have to not only respond to the immediate crisis of homelessness, but to also contribute to the longer-term healing of these individuals. Trauma-Informed Care (TIC) offers a framework for providing services to traumatized individuals within a variety of service settings, including homelessness service settings. Although many providers have an emerging awareness of the potential importance of TIC in homeless services, the meaning of TIC remains murky, and the mechanisms for systems change using this framework are poorly defined. This paper explores the evidence base for TIC within homelessness service settings, including a review of quantitative and qualitative studies and other supporting literature. The authors clarify the definition of Trauma-Informed Care, discuss what is known about TIC based on an extensive literature review, review case examples of programs implementing TIC, and discuss implications for practice, programming, policy, and research.

Inside the Open Door: Considerations of Inclusivity Among Women Accessing an Open Door Housing Service in Canada

“…How do we amplify the inclusionary bonding service users expressed towards one another despite identity differences? Emerging discourses of traumainformed care (TIC) in homeless services aim to create safer spaces and ensure that diversity amongst users is addressed and respected (Hopper et al, 2010). Open door policies promote TIC's inclusionary approach to diversity, requiring service providers to practice openness and engage with the diversity of service users.…”

Factors That Influence Quality of Life in People Experiencing Homelessness: A Systematic Mixed Studies Review

“…These findings collectively suggest that future research with PEH should be aimed at addressing trauma informed care. Trauma informed care encompasses services that recognize the impact of trauma on the lives of PEH by emphasizing collaboration, choices, and client strengths through respectful, consistent health, and social care (Hopper et al, 2010). Further support for the exploration of trauma informed care in homeless services was provided by the strong inverse relationship between QoL and substance use among PEH (Magee et al, 2019;O'Brien et al, 2015;Stergiopolous et al, 2014) and the reported high rates of substance use among PEH in highincome countries (Fazel et al, 2014).…”

Interventions to treat post-traumatic stress disorder (PTSD) in vulnerably housed populations and trauma-informed care: a scoping review

“…One approach recommended in clinical guidelines is trauma-informed care. [18][19][20] The Substance Abuse and Mental Health Services Administration has defined trauma-informed care as a programme, organisation, or system that realises the widespread impact of trauma and understands potential paths for healing; recognises the signs and symptoms of trauma in staff, clients, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, practices, and settings. 21 In 2010, Hopper 18 described the four core principles of trauma-informed care in homeless services as trauma awareness, safety, choice and empowerment and a strengths-based approach.…”

“…[18][19][20] The Substance Abuse and Mental Health Services Administration has defined trauma-informed care as a programme, organisation, or system that realises the widespread impact of trauma and understands potential paths for healing; recognises the signs and symptoms of trauma in staff, clients, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, practices, and settings. 21 In 2010, Hopper 18 described the four core principles of trauma-informed care in homeless services as trauma awareness, safety, choice and empowerment and a strengths-based approach. The National Centre on Family Homelessness outlined several reasons why programmes need to be trauma informed, 22 including that trauma can impact how people access services, including viewing people and services as unsafe; recognition that people adapt to trauma to keep themselves safe including abusing substances, becoming aggressive, or withdrawing; and, programmes and services cannot be 'one size fits all'.…”