In November 2005, NASW-NYC convened a focus group of eight professional social workers employed in homeless services. These professionals worked in a variety of settings providing transitional housing and services to individuals and families.

This discussion was one in a series of focus groups that NASW-NYC’s Center for Social Work Policy and Practice has been conducting since 2003, to explore the variety of service delivery systems in which professional social workers practice. 

Professional social workers who work in homeless services help people with their immediate need for housing but, frequently, need to also address the issues that contribute to their situation. In addition to low income, factors often include domestic violence (including child abuse and elder abuse), unemployment and underemployment, mental illness, poor healthcare, and alcoholism as well as other addictions.

Homelessness is usually more complex than needing a home, and some housing advocates, recognizing this, contend that Mayor Bloomberg’s plan to decrease the shelter population by two-thirds in five years should consider increased levels of professional social work services.

The social workers in the focus group shared stories about some of their clients’ difficulties. Their stories reflected interventions that often made a life or death difference in those clients’ lives. The discussion centered on individuals and families who live in temporary housing, rather than on those who live on the streets and do not enter shelters.

Overcoming Fears and Reuniting a Family

One social worker told a story of a seventy-six year old retired city employee rendered homeless by a granddaughter whose emotional abuse and serious thefts left her continuously without money. This woman was eventually evicted for nonpayment of her rent.

According to the social worker, the woman appeared to have a medical problem, but she resisted being examined despite regular and profuse bleeding. The social worker said that her immediate task was to engage this woman and develop sufficient trust in order to be able to explore her reasons for refusing medical treatment. Once this was done, the woman subsequently changed her mind and agreed to see a physician.

The social worker said that the woman revealed that she had been afraid to go to the hospital because she didn’t think she would ever leave there alive. The social worker discussed the woman’s fears and arranged for a staff member to accompany her to ensure that the woman would find her way to where she needed to go and to assure that she would be treated with respect.

As it turned out, the woman was diagnosed with terminal cancer. The social worker said that the situation created a greater urgency to try to locate any close relatives who might be able to provide emotional support and comfort to her.

Despite the problematic relationship between the woman and her granddaughter, the social worker decided to talk to her. As a result, the social worker learned that the woman had a son living in another state. It turned out that the son was quite concerned and immediately came to New York and became an important and supportive resource. The social worker said the woman appreciated the reunion and gratefully returned home with him, where she died within a few weeks.

This social worker’s intervention resulted in a family being reunited, and an abused woman was able to spend her last days with her long-lost son, at his home, rather than in a shelter. Clearly, being homeless was only the most visible aspect of this woman’s situation.

Hope Restored - Permanent Housing Obtained

Another social worker shared a story about a woman who was a senior citizen and an untreated schizophrenic who had been homeless for the past 20 years. She arrived at the shelter, not through the usual intake process, but by a direct referral from a high-level city administrator who had sent her there in a cab in a last-ditch effort to try to get her help.

The social worker said that the staff experienced the woman as loud, cynical, and very resistant to efforts of help, and that she denied that she had a mental illness. As a result of that denial, she was refusing the very medications that could help stabilize her behavior and allow her to benefit from the interventions and support the social worker sought to provide.

The social worker’s initial plan was to help her to acknowledge her mental illness. As a result of this, the woman finally talked about her fears; they included being alone as well as concerns about possible side effects that she would experience if she were to take any treatment medications. The social worker assured the client that a physician would monitor any side effects.

When she finally agreed to take the medication, the social worker said: “Magic happened…she relaxed and she engaged.” The woman soon began to believe that it was possible to bring about change in her life and that she could be helped. After 20 years of homelessness, the woman finally moved into permanent housing, and was at the time of this focus group meeting, living there for six months.

Setting Limits

In another story shared by one of the focus group participants, the client was a young mother who was methadone-dependent and was escaping from a domestic abuse situation. She was described as intelligent, manipulative, and as someone who “loved the streets;” but, she had lost faith in her own ability to make progress in her life.

The social worker determined that this woman was not capable of setting limits on her own activities or dealing with the consequences. The social worker helped her to set goals, including paying closer attention to her family’s needs, obtaining permanent housing, reducing her methadone intake, and furthering her education. The social worker imposed a curfew with specific consequences when it was violated. This, and the requirement of taking responsibility for her actions, helped the woman to focus on her goals and become more aware of her strengths in the process.

The social worker reported that the young woman gradually reduced her methadone dosage to zero, became more stable and began caring for her children on a consistent basis. She subsequently began long-term planning for her family, including preparing to obtain permanent housing, instead of moving from shelter to shelter. She also enrolled in college courses.

Focusing on Strengths

Another social worker spoke about working with a 28 year old woman with four children who had recently returned to New York from Florida to escape an abusive boyfriend.

This woman had, at first, intended to live with her own mother in her mother’s apartment, but, the Administration for Children’s Services (ACS) informed her that she faced losing her children if she stayed there since her mother had abused her when she was a child. According to ACS, her mother’s home was not an acceptable place for her children to stay. As a result, the woman took her children to a shelter to avoid being on the street.

Soon after, the woman was discovered beating her oldest son after she found him shaking her infant. As a result, ACS removed the boy from her care. Subsequently, the social worker made a plan with the woman to help her develop better parenting skills and to work towards ultimately getting her child back. This was in addition to working toward obtaining permanent housing.

The social worker said that while the situation has not yet been resolved, the mother is saying that she won’t give up, and that she appreciates that the social worker has not given up on her.

Challenges to Effective Practice

In addition to sharing their stories, the social workers participating in the focus group were also asked to comment on the challenges they faced in being able to do their own work effectively. Several of their comments are listed below:

•     Beyond the need for immediate housing, it is essential to identify the underlying problems requiring attention.

•     The lack of affordable housing in New York makes it difficult to help clients to obtain permanent housing.

•     The established time frame for moving shelter residents into permanent housing makes it difficult to adequately address the clients’ underlying challenges.

•     Low salaries make it difficult to maintain qualified, well-trained staff. One social worker commented that low salaries put staff, themselves, at risk of homelessness.

•     Given the multiple problems that shelter residents are contending with, including their having experienced numerous traumas, social work staff, themselves, are vulnerable to experiencing “vicarious trauma”, making it difficult to do the work effectively.

•     More resources are needed for staff training.

•     There are limited resources to serve undocumented clients.

•     The number of problems that people who are homeless are experiencing is increasing, yet the funding to support social work services has remained limited.