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A new therapeutic approach to helping young homeless people

A UCD trial in acceptance and commitment therapy seeks to limit shame and self-stigma

One homeless young woman told researchers shame around her experience makes her ‘want to be invisible’

Young people are one of the most vulnerable groups experiencing homelessness in Ireland. Since 2014, the number of 18 to 24 year olds homeless has doubled, according to Focus Ireland.

At a time in their lives when careers, stability and prospects for the future should be at the forefront of their minds, they are faced with stigma, shame, negativity and instability. A worrying issue is the long-term impact homelessness has on this generation.

A recent UCD study, aimed at testing Acceptance and Commitment Therapy (ACT) with a single-session intervention in order to mitigate the harmful effects of shame which homeless youth encounter, has had positive results. Varsha Eswara Murthy, doctoral researcher at UCD, whose work centres on developing and evaluating ACT interventions for individuals experiencing homelessness, will be presented these findings at the ACBS World Conference this month. Promoting wellbeing and reducing shame and self-stigma is a necessity for the future welfare and prospects of our youth who find themselves in difficult circumstances.

Louise McHugh, associate professor at UCD’s School of Psychology, says, “stigmatising people experiencing homelessness is an extremely problematic societal issue. From our research, a big barrier for this group is that they have internalised the stigma they have experienced and struggle with the shame attached to this. The stigma isn’t without consequences. We can help individuals not internalise it, which can lead to people experiencing intense shame over something that is not their fault and is a structural issue.”

‘It plays tricks on you’

Mary (23), from Dublin, told researchers: “I never thought I’d be homeless. I always visualised my life with my partner and, I never thought things would go belly-up for me. I would go into town thinking that people know she’s homeless. And it’s just this mindset that you have. I used to always think they are looking at me, and they are looking at my clothes, and they are looking at my hair. Or if I go into a store, they are going to know I’m homeless, and they don’t. You could put on a lovely pair of jeans, a nice pair of heels and nobody knows what goes on behind closed doors. It’s just, it plays tricks on you.”

'Homelessness ruins your confidence ... sometimes when people look at me, I just want to rip my face off. I just want to be invisible'

An issue with stigma, according to Murthy, is the particularly disadvantaged position this group face as their circumstances are often believed to be self-inflicted. Murthy says: “Labelling someone as ‘homeless’ tends to activate common stereotypes such as thinking that the person is likely to be unreliable, deceitful, or weak. This often leads to some sort of social sanction or devaluation, reducing the probability of the person being hired, or being trusted as a parent, friend, or partner.”

Anne (24), believes the image of herself has been damaged due to her situation. “People assume, because you are homeless, you are on drugs or you have an alcohol problem or you are going to be dirty or sleeping rough. When they hear someone is homeless, they literally think that you are sleeping on the street. Nobody chooses to be homeless, you know. When you are younger and someone says that, you start thinking, ‘is that what everyone thinks about me?’. It ruins your confidence, because you are looking at yourself, asking yourself questions. Sometimes when people look at me, I just want to rip my face off. I just want to be invisible.”

The researchers recognised many young people experiencing homelessness avoid treatment, contact with others and seeking help. Developing a brief, cost-effective intervention which is easy to train others in, and can adequately addresses the impact of shame and stigma is of great importance when serving the needs of those encountering homelessness.

'ACT aims to aid individuals in discovering they can choose their responses to their internal experiences, such as thoughts and feelings, instead of reacting to them'

Anne avoided seeking help as she saw it as a failing. “I see it as a weakness. I used to always think, if I can’t pull myself out of it nobody is going to do this for me, and that’s where that block comes in.”

Choosing responses

Shame can promote problem and self-defeating behaviours. The researchers garner that ACT can help create a rich, full and meaningful life, while effectively handling the pain and stress that life inevitably brings. Murthy says: “The therapy, quite uniquely, seeks to contextualise people’s suffering and highlights environmental circumstances as the possible root of suffering, which would greatly aid those experiencing homelessness to recognise patterns of internalised oppression and help them to recognise that their suffering could be due to the environment and large-scale structural inequalities, as opposed to inherent qualities of themselves, helping tackle shame and self-stigma. ACT aims to aid individuals in discovering they can choose their responses to their internal experiences, such as thoughts and feelings, instead of reacting to them.”

Linda (22), found the therapy grounded her in a way that was new for her. “I suppose, for me, it’s kind of to ground myself, to kind of get in touch with myself, how I’m doing, how I’m feeling, just aware of my own self. It kind of focuses me on setting a good vibe and a good thought for the day. Because sometimes you can rush out of bed, you are throwing the coffee in, you are out the door. You’re not even thinking. It’s just robotic and it just gives you the meditation and that, just time to kind of sit with yourself and have that bit of peace to be with yourself and check in on yourself. You know, what I need to do for me today. And to keep myself well and safe.”