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Psychological therapies could be key to helping homeless back into society

Published: 
18 November 2008

The key to solving the issue of repeat homelessness is to focus on an individual's psychological needs and not to force them back into a society they are emotionally and practically ill-equipped to deal with, says a leading cognitive therapist.

Dr Nick Maguire, a chartered clinical psychologist and lecturer in cognitive therapy at the University of Southampton, argues that evidence-based psychological therapies could be effective in supporting people in the homelessness community, by countering individuals' negative beliefs about themselves and helping them to relate to others more positively.

The majority of people in the homelessness community lack the psychological and practical skills necessary to live independently and hold down a job long term. Frequently they turn to drugs and alcohol to cope with their emotions.

As yet unpublished research studies, carried out by Dr Maguire and Clinical Psychology doctoral students at the University of Southampton, indicate that people who repeatedly find themselves homeless - usually single men - have often suffered traumatic abuse and/or neglect in childhood. This trauma results in attachment difficulties and mental health problems in later life that are sometimes labelled 'Personality Disorder' (PD).

Around 60 per cent of homeless people may be diagnosed with some form of personality disorder, and ongoing research at Southampton is looking into whether this is linked back to childhood trauma.

Dr Maguire believes that, because homeless people are almost always excluded from accessing the evidence-based psychological therapies available to treat personality disorders in the NHS, specialist psychological services should be set up in front-line homelessness services.

He says: "We need to acknowledge that people who find themselves homeless again and again are suffering from severe psychological problems. The Government's 'Supporting People' initiative for homeless people aims to equip them with practical skills, such as finding a place to live, advice on claiming benefits and getting a job.

"But there are currently no services on offer to help them develop emotional and psychological skills, build self-esteem or set meaningful life goals. This means that they never get to sort out the complex emotional and psychological problems which lie behind their homelessness."

Additional funding should be made available to provide treatments such as cognitive behavioural therapy (CBT), which influence the way individuals think about themselves in the world and can positively affect beliefs and actions, contends Dr Maguire, and specialised homelessness teams should be trained in the relevant psychological therapies.

Although expensive, he maintains that, in the long term, treatment would be more cost-effective than the services on offer at the moment.

His comments come as the Government today announces its intention to eradicate rough sleeping throughout England by 2012.

The novel approach is being used on the ground to combat homelessness for the first time. Dr Maguire has trained Westminster City Council staff and outreach workers in cognitive behaviour therapy so that they can work with homeless people to help them evaluate their lives.

The Council recently recorded a drop of more than 20 per cent in rough sleepers, the lowest-ever level of homeless people in the city area, and has also received reports of rough sleepers passing details on to friends to improve their own lifestyles. The project was short listed for the 2008 Andy Ludlow Homelessness Award.

The next phase planned in the Southampton research is a series of clinical trials with the homelessness community to assess the most effective methods of treatment, for which Dr Maguire is seeking funding.

"Research into this area is under funded, but it could prove crucial in helping get homeless people off the streets for good and leading meaningful lives back in society," concludes Dr Maguire.

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