Toward Differentiated Decision-Making: Family Systems Theory with the Homeless Clinical Population

Abstract

The clinical treatment of the homeless population typically focuses on issues of mental illness and drug/alcohol dependency. This treatment, however, does not address the problems of the homeless who are not mentally ill or those without a dependency problem. Because of the nature of the presenting problems of the homeless, Bowen family systems theory provides an appropriate framework from which to view these cases. An effective framework of therapy using Bowen's family systems theory to work with the homeless clinical population is described. The four phases of this treatment framework include connection, assessment, treatment/consolidation, and crisis intervention. Through these phases, therapists work to help the homeless client identify emotional patterns and to make different decisions at key decision points, thereby breaking the pattern of behavior leading up to and maintaining homelessness. Clinical examples of each phase are provided.

Notes

¹Bowen systems theory, due to its emphasis on interrupting emotional process, is often misunderstood and interpreted as a cognitive theory as the goal is to reduce reactivity to stimuli. This misinterpretation is likely due to the use of the word “emotional” in the discussion of emotional processes. When Bowen refers to emotional processes, he is referring not to affect, but patterns of action and reaction over time. These processes are part of evolution and occur in every organism, at even the cellular level. An emotional system not only encompasses feelings, but thoughts, fantasies, connections with our past, connections to the future, etc.