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Chapter 20 - A Psychodynamic Approach to Working with People Experiencing Multiple Exclusion Homelessness

from Other Forms and Settings of Psychotherapeutic Work

Published online by Cambridge University Press:  25 August 2023

Adam Polnay
Affiliation:
The State Hospital, Carstairs and Royal Edinburgh Hospital, Edinburgh
Victoria Barker
Affiliation:
East London NHS Foundation Trust, London
David Bell
Affiliation:
British Psychoanalytic Society
Allan Beveridge
Affiliation:
Royal College of Psychiatrists, London
Adam Burley
Affiliation:
Rivers Centre, Edinburgh
Allyson Lumsden
Affiliation:
NHS Greater Glasgow and Clyde
C. Susan Mizen
Affiliation:
Devon and Exeter NHS Foundation Trust, Exeter
Lauren Wilson
Affiliation:
Royal Edinburgh Hospital, Edinburgh
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Summary

This chapter provides a brief introduction to the relational dynamics underlying ‘multiple exclusion homelessness’ and an approach to working in this area. Adults experiencing multiple exclusion homelessness have often, during their developmental years, experienced multiple homes, disrupted attachments, un-forecasted endings, multiple and short-lived figures of support – all experiences that can lead a person to develop an understandable anxiety about trusting anyone to remain stable in their life. These dynamics may inadvertently be recreated in the person’s adult life through the impermanency of different organisations they are involved with. Multiple exclusion homelessness can be understood as a late emerging symptom of underlying difficulties in someone’s relationships with care. A psychologically informed approach for staff working in the homeless sector is outlined. The staff-service user relationship, while often viewed as important within mainstream services, is commonly seen as a vehicle through which treatments can be completed rather than as the treatment itself. By contrast, a psychologically informed service for people experiencing multiple exclusion homelessness understands that the reverse is often more accurate: that the tasks and activities are really just the vehicle through which a relationship can develop that carries the possibility of developing a sense of safety, trust, and continuity.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Brown, P, Morris, G, Scullion, L et al. Losing and finding a home: homelessness, multiple exclusion and everyday lives [Internet]. Manchester: University of Salford; 2012. http://usir.salford.ac.uk/id/eprint/35876/Google Scholar
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Fairbairn, WRD. Psychoanalytic Studies of the Personality. London: Routledge & Kegan Paul; 1952.Google Scholar
Theodorou, N, Johnsen, S, Watts, B, Burley, A. Improving multiple exclusion homelessness (MEH) services: frontline worker responses to insecure attachment styles. The Journal of Mental Health Training, Education and Practice 2021;16(6):421–32.Google Scholar
Tsemberis, SJ. Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction. Minnesota: Hazeldean Publishing; 2010.Google Scholar
Johnsen, S, Blenkinsopp, J, Rayment, M. Scotland’s Housing First Pathfinder Evaluation: First Interim Report (full report). 2021; https://doi.org/10.17861/c5n3-0h95CrossRefGoogle Scholar

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