Practice Dilemmas, Successes, and Challenges in the Delivery of Homeless Services: Voices from the Frontline
This chapter draws upon data from a 5-year National Institute of Mental Health-funded qualitative study of homeless programs to describe how frontline providers experience the implementation and delivery of homeless services. Interviews with frontline workers and observations of practice in the field are used to elucidate common practice dilemmas, successes, and challenges from the perspective of those “on the ground.” Areas discussed include provider experiences with managing risk and recovery in their work with service users who have active addiction and psychiatric issues, approaches for working with and around limited resources and policy constraints, implementation strategies for the delivery of harm reduction and “treatment first” program orientations, and how providers work to honor consumer choice and self-determination within the confines of program rules.
KeywordsFrontline practice Service delivery Homeless services Frontline providers Housing first “Treatment first” Practice dilemmas Service provision Intimacy Working relationship Direct services Being in personal space Reading the surroundings Negotiating frontline roles Privacy Transitional housing Shelter programs Program rules Managing risk Crisis intervention Social relationships in homeless services Loneliness and isolation Exploitation Right to self-determination Supervision, use of Control, exercising Control, relinquishing Liability Client-centered practice Consumer-driven services Harm reduction Sobriety Treatment mandates Stress Self-care Services funding Documentation Burnout Compassion fatigue Secondary traumatic stress Organizational culture Hope
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