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Nobody's Listening: Giving People Experiencing Homelessness a Voice through Counselling
By Andrea Koenigstorfer – Dublin Simon Community Sure Steps Counselling Service
The root causes of homelessness are multifaceted and wide-ranging. While a large percentage of individuals who are without a home have been exposed to previous trauma, many people affected by homelessness also present with depression, substance use issues and severe mental health conditions. Homelessness leaves people isolated and alone and also hugely stigmatised by society, who can often consider these individuals responsible for their situation and unwilling to pull themselves out of homelessness. These biases are often internalised by the people who experience homelessness, resulting in a severe lack of self-esteem and feelings of extreme guilt and shame.
The Dublin Simon Community Sure Steps Counselling Service was established in 2012 and has since developed into a specialised trauma-informed counselling service. Currently about 20 pre-accredited and fully accredited counsellors are providing psychological support to an average of 70 clients per month, presenting with a wide variety of issues. The range of services encompasses one-to-one counselling across treatment services and housing/emergency accommodation services, weekly drop-in clinics in treatment services as well as in the Mobile Health Unit, in-reach and outreach crisis intervention and a counsellor-led emotional wellbeing group programme.
The trauma clients experiencing homelessness have been exposed to in their lives includes physical, psychological and sexual abuse, neglect and (domestic) violence. This trauma is often at the root of many clients’ pathway into homelessness and makes it difficult for them to cope with the numerous hurdles they have to master in order to exit homelessness. Loss is another inherent factor in homelessness. Many people are affected by homelessness after a loved one becomes ill or dies, someone loses a job or a home burns down. It is essential to help clients process their losses and one way of doing so is through helping them find a sense of connectedness to break through their isolation.
The experience of being homeless is traumatic in itself. Clients lack a stable home and the uncertainty of whether they are going to sleep in a safe environment or get a decent meal puts them under constant stress. The lack of financial resources, life skills and social supports makes it extremely difficult for them to change their life circumstances. The physical aspect of rough sleeping is equally traumatic and puts rough sleepers at risk of being attacked by predators as well as being challenged by the authorities
How do we support these clients?
We are a trauma-informed counselling service, which means as counsellors we need to be aware of the traumatic experiences of our clients and incorporate an understanding of their trauma into our work. Clients who are homeless with a history of trauma often feel unsafe – the counselling process therefore needs to work towards building their physical and emotional safety. Because control is often taken away in traumatic situations and because homelessness in itself is highly disempowering, counselling needs to emphasise the importance of choice for these clients. This allows them to re-build a sense of self-efficacy and control over their lives. Last but not least, a trauma-informed counselling approach focusses on the strengths rather than the weaknesses of the clients. Clients affected by homelessness are often pigeonholed (or judge themselves!) in terms of negatives – substance use issues, illiteracy, severe physical or mental health issues, unemployment, forensic history etc. We support these clients in identifying and highlighting their own strengths and develop coping skills to further develop their own resilience.
Given their background, for many clients experiencing homelessness learning to trust their counsellor is a first step towards rebuilding trust with others. The importance of our work lies in recognising and accepting these clients as human beings – or in other words, simply listen to them tell their story. A lack of validation is a common theme among clients affected by homelessness. They feel judged, they feel nobody listens to them, nobody cares about them. They feel powerless, dirty and a sense of shame that is overwhelming. It is essential for us counsellors to change this paradigm, build a relationship with them and improve their experience within “the system”. To be able to achieve this, we need to listen to each individual client with an open mind, without any preconceived ideas about what a homeless person is. Contrary to what most counsellors would have learned during training, it can be useful for counsellors to allow themselves to be vulnerable and share their feelings when working with clients who are homeless. It is okay as a counsellor to let these clients know that you’re sad or hurt or angry about what has happened to them.
One way of getting to know clients experiencing homelessness is to understand what drives them to act in certain ways rather than jumping to conclusions. Clients affected by homelessness are often emotionally and cognitively dysregulated. A client that shows a high absence rate in a class might have anxiety issues and is afraid of waiting alone at the bus stop to go to and from the class. Staff may interpret his absences as a lack of motivation or disinterest. A client may have a history of rejection and therefore be extremely vulnerable to any signs of being rejected. A counsellor cancelling an appointment might be interpreted as yet another abandonment and result in a violent or angry outburst that does not fit the facts – and therefore be met with a lack of understanding on behalf of the counsellor, yet another instance of being invalidated. Rather than jumping to conclusions, it is important to sit down with the client and explore what the problem is. At the same time, we can use their story to expand their perspective and encourage change, taking away the blame, while empowering them to take charge in changing their current circumstances.
To work effectively with clients affected by homelessness means we have to meet the client where they are at and go where they need to go. This entails being open and non-judgmental and often to give up on the idea that counselling happens in your own office. We need to reach out to clients in a very humanising way. Sure Steps Counsellors see clients in their current environment, whether this is in emergency accommodation, supported housing or treatment services. For clients who may not yet be ready for counselling we provide weekly drop-in clinics in the Dublin Simon Community Detox and Stabilisation Units as well as in a Mobile Health Clinic which operates in Dublin City, where clients who are too frightened of engaging with a counsellor inside a building can make initial contact with a counsellor in their usual environment.
The specific theoretical approach used with clients affected by homelessness is not the most important factor. What matters most is our ability to relate to the client. Because clients who are homeless feel isolated and disconnected, building a relationship with the counsellor for them is a way of connecting and feeling empowered.
In conclusion, addressing the issue of homelessness needs to incorporate addressing the underlying trauma that is so closely linked with the experience of homelessness. As counsellors working in homeless services we have the opportunity to reach out to trauma survivors who otherwise are often disregarded. Providing immediate crisis relief in the form of food, shelter and clothing needs to go alongside with helping individuals heal from past trauma and build healthy, supportive connections in the community.
Working with clients affected by homelessness is very demanding. It challenges counsellors emotionally and it is easy to become discouraged and disheartened in view of the apparent inability to help facilitate change. In light of this feeling of hopelessness, as well as the traumatic history some of these clients present with, there is a risk of burnout if this is not managed properly. What is important is to find the value in what we are doing and appreciate that success might not come in huge leaps and bounds. Accepting this truth is essential – we often may just be planting a seed by creating an environment and experience for the person experiencing homelessness that is different. This is all we have control over. There is no quick fix with clients affected by homelessness, yet counselling offers opportunity to understand why they may react to certain situations and teach them more pro-active coping mechanisms as an alternative. Together with other interventions this does open up new prospects for the future for them.
Simon Sure Steps is an associate member of AACI. For further information on Simon Sure Steps Counselling Service please visit www.dubsimon.ie
Andrea Koenigstorfer is an accredited psychotherapist in private practice with experience in a wide range of settings, including individual and group therapy and residential treatment programmes. She is also working as a contract counsellor with the Dublin Simon Community Sure Steps Counselling Service providing one-to-one therapy and a psychoeducational group programme. Andrea holds a BA (Hons) in Counselling and Psychotherapy from Glyndwr University and an MSc. in Mental Health from Trinity College Dublin.