Sandy Sheller understands that, sometimes, the best counseling session might take place just waiting for the bus.
Sheller, the coordinator of mental health training for the Salvation Army of Greater Philadelphia, vividly remembers a client who was having trouble making it to a drug rehabilitation program. A caseworker informed Sheller that the woman, who was in her late 30s, was being "noncompliant" by refusing to go to the rehab program, which was a requirement for her to stay in the shelter.
Instead of lecturing the woman, demanding an explanation or jumping to conclusions, Sheller asked the client to talk about her situation. The key, Sheller says, was asking in an empathetic, nonjudgmental way. "I wasn't trying to make her do anything, and she knew that," says Sheller, who worked as an art and family therapist in an inner-city Salvation Army family shelter for about five years before becoming a coordinator a year ago.
The client explained that the rehabilitation program had changed locations, meaning she now had to take multiple buses to get there. Waiting for the first bus, the client had experienced panic attacks that prevented her from making it to the rehab program. Eventually, Sheller says, she and the client worked on the triggers and history that fed into the woman's panic attacks, but first they took it slow and brainstormed more immediate solutions.
Sheller asked if going to the program was something the woman wanted to do and thought she could do, and the woman confirmed that it was. Together, they decided it would help if Sheller stood outside the shelter with the client as she waited for the bus. "She said, 'I think I just need somebody to be there, to remind me it's just waiting for a bus and I'll be OK,'" Sheller remembers. After about a week of waiting for the bus together, the client felt she was ready to handle the wait on her own. From then on, she came back to Sheller each day and reported how things had gone.
Much of the work Sheller does with clients facing the challenges of homelessness is simply about recognizing them as fellow human beings, she says. Given different situations or circumstances, any of us could find ourselves in the same position. "If I had gone through your life experiences," Sheller tells her clients, "there's no telling if I wouldn't be where you are."
Waiting at that bus stop was one of many experiences that taught Sheller the importance of simply being there for clients who are confronting homelessness. "To work effectively in the shelter means you have to really be where they are and go where they need to go," says Sheller, a member of the American Counseling Association and assistant clinical professor in Drexel University's Hahnemann Creative Arts in Therapy Program. "It requires you to be open and nonjudgmental, to be there for what's needed. Get rid of the preconceived ideas that counseling is sitting in an office — be there in a very humanizing way."
Nowhere to turn
Homelessness leaves people feeling they have no one to turn to and nowhere to go, Sheller says. "It's the sense of feeling very isolated, very helpless, very alone and, at the same time, very stigmatized by society. You feel like a failure. The sense of feeling helpless is one of the hardest things that we, as human beings, endure. No one who's homeless wants to be homeless." There are complex situations underlying why each person becomes homeless, says Sheller, adding that she's never met anyone who wants to be in that situation.
Michael Brubaker, an assistant professor at the University of Cincinnati's School of Human Services and academic coordinator in the addiction studies program, says the stigma surrounding homelessness stems in part from the Protestant work ethic on which the United States was built. Not only are people thought to be responsible for pulling themselves up by their bootstraps and getting themselves out of homelessness, he says, but there also exists a general bias that these individuals are solely responsible for their becoming homeless in the first place.
Brubaker has worked with homelessness for the past 12 years and conducted a study that involved taking counseling students to a shelter to learn from the residents. "We realized that we, as counselors, are not immune to influences from society," he says. "(The shelter residents) can probably teach us better than we can teach them what their circumstances are about." Brubaker, a member of ACA, emphasizes that homelessness is more of a situation and less of a population. Approximately 80 percent of those who become homeless in a given year are transitionally, not chronically, homeless, he says.
A large percentage of people in shelters have trauma in their history, Sheller says. Many of the shelter residents she sees grew up in foster care, aged out of the system, had children and are now homeless. They've had little or no consistent support for the long haul, she says.
The experience of being homeless can be traumatic in itself. "That experience of losing support — of realizing that family is not there to support, that friends are not there to support, to realize that society is not there to support — can be a very disheartening and even traumatic experience," Brubaker says. The physical aspect of being on the streets is also traumatic, he says, in part because people experiencing homelessness are vulnerable to attacks by youth and predators, as well as harassment from authorities.
Sonya Lorelle, a doctoral candidate in the Old Dominion University Department of Educational Leadership and Counseling, says systemic barriers can provide significant hurdles for people attempting to overcome homelessness. Lorelle, an ACA member who spent time as a counselor in a shelter system in Norfolk, Va., recalls instances in which parents secured a job on the late shift in hopes of providing their family some financial stability. But, Lorelle says, barriers popped up from every angle — the bus route back home would stop running at a certain hour or child care wouldn't be available after 6 p.m. "During a holiday when child care and school were closed or when the child became ill or had a doctor's appointment, the balance would be thrown off," she says. "More than once, I saw a parent lose a job for having to take a day off to take care of their children, putting them back at square one. Everything had to be perfectly balanced."
Telling the story
Because of the struggling economy and the shortage of housing, Sheller estimates the current average length of stay for residents in many of the Salvation Army shelters is approximately a year. "It's a really long time that you can get to work with them and create healing environments for them," she says. Many shelters must refer clients out to other agencies for mental health care, but Sheller and other counselors who work with homelessness say having in-house mental health services, whenever possible, is helpful.
Although none of the shelter residents were required to see Sheller for counseling, she tried to build relationships with them and improve their experience within the "system." Many shelter residents had encountered authority figures elsewhere who were supposed to help them but instead made them feel powerless and at fault for their circumstances, which only added to their sense of shame. "We (as counselors) are changing the paradigm," she says. "We tell them in words and in actions, 'You're not sick. You're not bad. It's what has happened to you. Let's tell the story, and let's help you out of it.' It's a trauma-informed perspective counselors should adopt when working with the homeless and one I have found extremely useful."
Society's biases against the homeless are often internalized by the people who experience homelessness, Brubaker says. "We offer something unique as counselors in our ability to help expand the perspective and encourage change," he says. That means helping people take the blame and burden off themselves, while simultaneously empowering them to take the lead in changing their circumstances.
The counselors interviewed for this article agree that the first step in helping is simple and straightforward: Simply listen. "Having someone just listen to your story is really important. They haven't been heard, they haven't been validated. They would tell me, 'I feel like a number. No one cares about me,'" says Lorelle, reflecting on her work in the shelter system.
The real key is listening with an open mind, Sheller adds. "Homelessness doesn't fit into a neat, stereotyped box. It's an experience that anyone could have. Therefore, we shouldn't have any preconceived ideas about what a homeless person is and what he needs — it has to come from the person." Someone might arrive at a shelter with the attitude that all people in authority roles are evil, she says. Rather than telling the individual that isn't true, it's important to be respectful, listen and try to understand how that perception has been formed by the person's past experiences, Sheller says. Many of the systems the homeless go through want these individuals to change themselves, she says. "But they just want someone to understand them first."
Given their immediate needs and their sometimes-negative experiences within systems theoretically set up to "help" them, it may seem a daunting task to convince shelter residents that counselors have much to offer. "Much of our convincing will not be in words, but rather in our deeds," Brubaker says. "Are we physically available to those in need? Are we willing to step out of our offices and meet with individuals on a park bench or over a meal at a shelter? Are we quick to judge a person who lives without a home? A caring presence can make a huge difference."
A place to belong
The specific approach counselors use with these individuals isn't the most important thing, Sheller says. "Whatever (technique) you use, the basic ability to relate to people and to build those relationships are really the most important," she says. Homelessness can feel isolating and disconnecting, she explains, so forming relationships can build connection and empowerment. "From that, people can rise up. You're fostering an experience where they feel like they're OK and it's going to be OK."
Building relationships with homeless clients begins with simply getting to know them, Sheller says. Counselors can strengthen the relationship by being open, joining them where they are and focusing on being with them instead of imposing requirements or restrictions, she says. Counselors should strive to reach a level in the relationship where they can readily recognize when the person is struggling. If Sheller noticed that a resident didn't seem quite right, she might ask that person to take a walk with her to Dunkin' Donuts. Counseling in shelters doesn't adhere to hourly appointments in an office, Sheller says. "You have to build relationships and build community, not just be in an office waiting. You're just there and available and real."
One part of getting to know clients is understanding why they act in certain ways, Sheller says. She recalls a particular shelter resident who seemed to be having unnecessary trouble getting food stamps and setting up her gas and electric accounts so she could move to available housing. Instead of jumping to conclusions, Sheller sat down with the client and asked what the problem was.
"What I really needed to understand was that it wasn't her being noncompliant or resistant, but something else was going on that was preventing her from doing that," Sheller says. The woman revealed she was frightened that if she followed through on those tasks and moved into new housing, a perpetrator from her past would be able to find her at her new address. Avoiding the move and remaining at the shelter felt safer, she told Sheller. Sheller helped the woman find ways to make herself safer, including getting a restraining order, and also helped her work through some of the trauma she had experienced. After that process, the woman was able to fulfill the requirements to move out of the shelter. "Don't always assume the behaviors that seem to be uncooperative or unmotivated are really that," Sheller says. "They may be behaviors people have adapted to help them survive."
Many people who have experienced homelessness have also experienced trauma, which often makes them hypervigilant and hyperalert, Sheller says. Creating a safe environment — an environment that isn't further disempowering or demoralizing — will encourage these clients to seek out the counselor. "If people can't feel safe, it's really going to be hard for them to move forward in their lives," she says. Safety encompasses feeling safe within yourself and learning how to handle your own emotions, Sheller says.
Loss is also inherent in homelessness, Sheller adds. Many people find themselves in shelters after a loved one becomes ill or dies, someone loses a job or a home burns down. Helping people deal with their losses is critical, Sheller says, and one way of doing that is through building a sense of community because when people break through their isolation, they realize they aren't alone in their problems. In addition to community meetings and therapeutic groups, Sheller has organized rituals to help shelter residents deal with loss. For example, she led a "balloon memorial" during which individuals wrote down a loss they wanted to let go of and then attached the paper to the string of a balloon. "It could be a tangible loss or a loss such as loss of missed years while I was using, loss of childhood innocence because of abuse, etc.," Sheller says. "The balloons were simultaneously released as a group on the grounds of the shelter. We held hands and had a few minutes of silence together. It was very powerful."
The most important component to building trust with homeless clients is following through and doing whatever you say you're going to do. "If I said I was going to make a call for them, I needed to make that call. Otherwise, the trust was broken," Lorelle says.
Contrary to what most traditional counseling teaches, Sheller says it can be helpful for counselors to be vulnerable and share their feelings when working with homeless clients. Let these clients know that you're sad or hurt or angry about what has happened to them, Sheller tells counselors.
Changing the path
Looking back, Brubaker says the most important thing he learned about helping people who have experienced homelessness is to focus on their strengths — what they are doing well and what has enabled them to survive on the streets. "The mere use of the word homeless is a deficit-based identifier," he says. "The biggest change for me was seeing the strengths of individuals and being mindful of that. I wish I had been trained from the beginning to really look for that. That's made a huge difference in my approach and how effective I can be."
Considering the high incidence of trauma among people who experience homelessness, Brubaker says training in trauma would serve counselors well. "This will hopefully wake up many counselors to their need to obtain training in the area of crisis and trauma work," he says. "Counselors should also know their limitations, consult with others who know this population and advocate for the best services possible. No counselor should feel alone in their pursuits, so networking with competent professionals, indigenous healers and other service providers is essential."
Counselors agree that working with homelessness is very demanding. It's challenging emotionally, Lorelle admits, and if a counselor feels hopeless for too long, burnout might be waiting around the corner. "The lesson I learned is that you have to find that hope and find the value in what you're doing. It may not (come in) huge leaps and bounds, but appreciating the small things along the way and celebrating their successes, that's an important piece, and that's what kept me going."
No counselor can fix everything, Sheller says, and it's important for counselors to accept that truth while maintaining the proper perspective. "You might not ever see the change; you might just be planting the seed," she says. "You have to go in there and believe that if you can create an experience that is different, that you're setting the course. You're changing the path for that person, and that's all you ever have control of."
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