Qualitative synthesis finds that psychological interventions for people experiencing homelessness may benefit from an individualised approach, focus on relationships and accessibility.
1.1 The Review in Brief
Evidence from 7 studies with views and experiences of 84 adults experiencing homelessness suggest that individual goals and motivation, relationships with staff and peers, and the accessibility of services, are important factors.
1.2 What Is This Review About?
Adults experiencing homelessness are more likely than the general population to experience mental ill-health and problematic substance use. They are also more likely to face challenges when accessing services to address these issues.
Psychosocial interventions focus on an individual’s psychological development and their engagement with society and the community. They promote change in behaviour or thinking, and intend that these changes lead to reduced substance use, more stable housing, or improved mental health.
This review looked at the views and perceptions of adults experiencing homelessness when they used psychosocial interventions. The aim was to see what challenges they faced when accessing services, and what factors supported intervention success.
1.3 What Is the Aim of This Review?
The aim of the review was to understand the experiences of adults experiencing homelessness when they access and use psychosocial interventions.
1.4 What Are the Main Findings of This Review?
The review team identified and considered 96 studies that might be relevant, and finally included 7 studies in the analysis. The studies covered various different interventions. A total of 84 adults experiencing homelessness were included in the 7 included studies. There was an even mix of women and men. Three studies were conducted in Canada, three in the United States, and one in Scotland. All were published after 2009. The studies used a variety of data collection and analysis methods that capture the views and experiences of people using the interventions.
None of the included studies were assessed as high quality. The most significant area of concern across the included studies concerned relationships between researchers and research participants, where five included studies were assessed as low quality. Areas of higher quality were clarity of the research questions and methods.
This review used ‘thematic synthesis’, finding themes across the studies to analyse and draw conclusions. This is a three-stage process of extracting, analysing, and summarising study findings. Each line (sentence) was given a descriptive code. There were 118 total codes, of which 55 were direct quotes from adults experiencing homelessness. These codes were then grouped into 14 ‘descriptive themes’. The final analysis stage grouped the 14 descriptive themes into three overall (analytic) themes: (1) the individual plays a key role in their recovery and change journey; (2) accessibility is a key component of intervention success; (3) relationships are an important intervention ingredient.
1.5 What Do the Findings of This Review Mean?
There are three implications identified in this review. First, the hope, motivation, and goals of individuals using these interventions could be an important ingredient, but most research does not consider this. More research is needed to understand whether these are important success factors. Second, drawing on this review and a companion review on the effectiveness of psychosocial interventions, there is no direct connection between the interventions covered by the two types of study. This lack of complementarity limits the explanatory potential across both types of study and their contribution to knowledge and policy. Finally, there is a limited geographic range of relevant studies. More research is needed outside North America.
1.6 How Up-to-Date Is This Review?
The review search was conducted in September 2021. Subject to funding, the authors aim to update this review in the future.