Characteristics and Dynamics of Homeless Families with Children. Treatment and Service Matching

10/01/2007

The concept of treatment or service matching refers to decision rules designed to facilitate matching to optimal treatment modality, service intensity, and ancillary services.  An important consideration in the development of a typology of homeless families is the kinds of services that the typology might relate to in terms of treatment, prevention, and other needs.  Obviously, the typology should be relevant to the types of services that are appropriate, feasible, and available to homeless families.  These services include the following:

  • Shelter facilities to deal with immediate and short-term housing needs
  • Child care, preschool, and school placement to deal with children’s needs
  • Housing subsidies to deal with economic barriers to housing
  • Supported housing and other housing programs to deal with long-term housing needs
  • Services to keep families intact and to improve family dynamics
  • Employment counseling
  • Welfare programs to provide for basic needs
  • Medical care, including sexually transmitted diseases and pregnancy care
  • Clinical preventive services, including family planning, HIV prevention, and childhood immunizations
  • Mental health counseling, especially for PTSD, depression, and domestic violence
  • Treatment for substance abuse
  • Case management to integrate and coordinate individual services

Services to help with stable housing or to rectify personal problems have to face unusually high obstacles. No matter how much help is given to finding housing, low income housing is often so limited (McChesney, 1992a) that only a small number can be rehoused unless the supply is increased.

Services to help with stable housing or to rectify problems have to be appropriately gauged to avoid a mix of insufficient and wasteful services. There is now ample evidence that the majority of homeless families can achieve stable housing based only on housing subsidies (Shinn et al., 1998; Stretch and Krueger, 1992; Wong et al., 1997).  In other studies when subsidies and a variable set of support services or case management were given, the strongest predictor of housing stability was subsidized housing regardless of the intensity of services (Weitzman and Berry, 1994; Rog, Gilbert-Mongelli and Lundy, 1998). Thus in the majority of instances, housing subsidies should be sufficient to achieve stable housing, and there is no need to provide additional case management for those families.  However, a small proportion of families return to homelessness during a 5-year follow-up period (Stojanovic, Weitzman Shinn et al., 1999). Thus an important role of a typology of homeless families would be to help in the identification of those families that need supportive services in addition to housing subsidies, and what kind of services are needed (e.g., case management, intensive case management, specialized services).

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