Homeless and Hospitalized: A Case Study of Intervention to Support Collaborative Behavior and Safety

ABSTRACT

For unhoused patients, hospitalization is often a potentially life-altering event that evokes distress and triggers reactive behaviors that may undermine treatment and safety. Societal stigmatization, isolation, and disempowerment act to marginalize unhoused hospital patients, impacting their autonomy, sense of self-worth, and capacity for social interaction and collaboration. This article examines the ways in which Relational-Cultural Theory (RCT) can be utilized to better understand unhoused patients’ behaviors as influenced by the relational violations and trauma they experience and suggests that relationally and culturally focused interventions are both reparative and necessary. A composite case study is employed to demonstrate the application of RCT to a behavioral and safety crisis and evidence opportunities for meaningful intervention. Implications for enhanced support of unhoused patients in hospitals are discussed, as is the need for continued research on the use of RCT to inform therapeutic intervention in acute care settings.

KEYWORDS:

• Relational-cultural theory
• RCT
• behavior
• homelessness
• healthcare
• hospitalization

Acknowledgments

The authors gratefully acknowledge Dr. E. Goldblatt Hyatt and Dr. C. Kephart for their insights and guidance during initial work on this case study.

Disclosure statement

No potential conflict of interest was reported by the author(s).