Professor Carolyn Weisz has worked extensively to understand the complexities of homelessness and the multiple factors that play a role in keeping people unhoused. Within this research, she has worked collaboratively with others to analyse the structural systems that produce homelessness and the psychological factors that can contribute to or result from homelessness. In the US, homelessness results from a lack of access to safe and affordable housing alongside histories of racism and structural inequities in wealth, housing, and economic opportunity. Once homeless, people without financial resources often face structural barriers and stigma which make securing housing difficult and can negatively affect physical and psychological health. For some individuals experiencing homelessness, traumatic stress, mental health conditions, or addiction to alcohol or drugs may create additional challenges to securing or maintaining employment or housing. A variety of social service agencies and programmes work with limited resources to help people meet basic needs for food and shelter, identify personal strengths, and engage resources to heal and exit homelessness.
Addiction, Homelessness, and Recovery
Although most people experiencing homelessness do not suffer from addiction or serious mental health problems, for some people, substance misuse plays a role in losing housing or makes the pathway out of homelessness especially difficult. For some, using drugs or alcohol can lead to a cycle of dependency that makes it is difficult for the individual to function. This cycle of addiction can result in adverse outcomes such as family breakdown, financial hardship, involvement with the criminal justice system, and homelessness. Individuals may also experience unsuccessful attempts to stop using especially without access to support for recovery.
Residential recovery programmes for people experiencing homelessness can play an important role in helping people achieve abstinence and improve their life circumstances. In the US, most residential recovery programmes available to people experiencing homelessness are offered by faith-based organisations or include mandatory faith-based components. These programmes connect people with a wide variety of personal, social, and practical resources, some which relate directly or indirectly to religious or spiritual aspects of the programmes. Professor Carolyn Weisz and her colleague Kayla Lovett have recently undertaken research with individuals recovering from addiction to understand the role that religion, spirituality, and other factors have played in their recovery.
One way of understanding the complexities of homelessness, addiction, and recovery is to spend time speaking with individuals to learn about their personal stories. The researchers undertook a series of interviews with 14 men and women (aged 23 to 64) to hear their personal stories. The individuals in the research were all participating in residential recovery programmes for people who were previously homeless. The residential programmes offered housing, faith-based recovery services, and a sense of community. Within this study, ten participants reported a history of addiction to multiple drugs and four reported an addiction to alcohol only. All of the participants had been clean and sober for at least 30 days.
One way of understanding the complexities of homelessness, addiction, and recovery is to spend time speaking with individuals to learn about their personal stories.
The research was conducted using methodology based in grounded theory to explore themes emerging from interview conversations with the research participants. The interviews explored the role of religion in recovery from addiction, as well as individual substance use history. The interviews were transcribed and analysed to identify themes emerging from the conversations. The research team used NVivo qualitative analysis software, and the final analysis of each interview transcript was done by two raters to ensure reliability of the emerging themes. The qualitative data analysis indicated three global thematic areas emerging from the conversations (substance use history, faith-based factors in recovery, and other factors in recovery), along with 13 major themes and 50 subthemes that emerged within these areas.
Substance Use History
Many of the interview respondents reported loss at multiple levels as contributing to or resulting from their substance use and addiction. These losses included jobs, family, relationship trust, and housing. Along with these losses, nearly all the participants described psychological experiences of worthlessness and a loss of autonomy while in the midst of their addiction, as well as feeling that they had let others down. Predictors of use which emerged from the conversations included using substances to cope, early onset of substance use, family substance use, and mental health issues. Participants mentioned multiple factors as precipitating continued use of substances, including increased physical or psychological dependence on the substance, unsuccessful rehabilitation attempts, and access to substances in the individual’s social network. Individuals who mentioned positive motivation for pursuing recovery made reference to social pressure, criminal justice pressure, and survival needs.
Factors in Recovery from Addiction
All of the interviewees were asked about the role of religion and spirituality in their recovery. They described a variety of ways the faith-based programmes encouraged recovery and helped them face challenges created by their substance use. At the level of the individual self, participants described how they had been able to establish new, more positive ideas about themselves, as persons who were helpful to others, capable of prosocial behaviour, and able to feel humble and grateful. These perceptions were grounded in new experiences which helped improve their sense of self-esteem and self-worth.
Participants also reported developing new coping skills as a replacement to using substances to cope with life stress. Specific ways in which individuals described these new skills included feeling able to use their religious beliefs to guide their decisions, and thinking that “God had a plan” and “would provide for them.” These coping skills resulted in people feeling a greater sense of purpose and control, as well as hope for their futures. Participants also described the usefulness of self-reflection including better understanding of their own addictive behaviour and triggers for substance use.
Participating in the programmes also provided ways of occupying time and being involved in meaningful activities such as group meetings, recreation, and prayer,
that did not involve substance use.
Relationships had been a key loss that accompanied the addiction experience, and many of the research participants reported that at a social level, the religious community provided relationships of spiritual guidance and mentoring, and an opportunity to re-establish trust in relationships, as well as a sense of belonging to a group with similar goals and beliefs. More generally, participants discussed the value of being part of a sober community which provided mutual support, accountability, and an alternative to old networks. Participants also reported that reconnecting with family was a positive factor in motivating their recovery efforts.
Participating in the programmes also provided ways of occupying time and being involved in meaningful activities such as group meetings, recreation, and prayer, that did not involve substance use. Finally, an additional way in which the faith-based recovery programmes assisted people in moving forward from addiction was through instrumental support by means of opportunities to access jobs, housing, and education.
Complex Real-World Problems and Structural Solutions
Professor Carolyn Weisz and Kayla Lovett say that one of the reasons why faith-based recovery programmes may be effective in helping people overcome addiction is that they give individuals opportunities to develop a positive sense of self and the future. Additionally, the practical, psychological, spiritual, and relationship resources these programmes offer may not only assist with recovery from addiction, but may also provide opportunities to recover some of the losses people encountered as a result of substance use, including access to housing, employment, and social relationships. In many communities in the US, faith-based organisations are currently the primary providers of such residential recovery services for people experiencing homelessness. Learning about the experiences of people engaging in these programmes may help providers to improve or expand programmes that address behavioural health and housing needs simultaneously.
Homelessness and addiction are both complex problems, and individuals facing either or both of these challenges have diverse life experiences and needs. Participants in this study pointed to a range of ways that faith-based and non-based aspects of residential recovery programmes were valuable to them in creating pathways to sobriety, well-being, and self-sufficiency. The researchers note that there were some limitations to this particular study in that the participants were a small sample and were mostly white rather than racially diverse. They also point out that participants represent people who agreed to enter the programme and talk with researchers, and who had been in recovery for at least 30 days. They suggest that not all people experiencing homelessness and addiction might feel comfortable in faith-based programmes, and that some who do enter programmes may feel unwelcome pressure to conform to the values and activities of the programme cultures. Additional research is needed to better understand which aspects of faith-based programmes are most important for recovery, who benefits from such programmes, and the degree to which benefits relate to religion and spirituality or to other factors.
Beyond this research project, Professor Weisz says that understanding homelessness requires a broad lens which encompasses multiple issues around structural inequalities within societies, such as histories of anti-Black racism in the US, displacement of Native peoples, criminalisation of homelessness, and policies related to banking, lending, eviction, and housing development. Strategies to prevent and end homelessness need to address affordable housing, healthcare, transportation, criminal justice, education, and employment opportunities to create stronger communities and multiple pathways for individuals to meet basic needs and thrive.
What are the challenges and advantages of qualitative research?