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Introduction
Many factors contribute to a person experiencing homelessness. However, the presence of past and current trauma for those accessing social care providers is high (Yatchmenoff et al., 2017) and both trauma, and responses to it, may take a causal role in the initiation and re-experiencing of homelessness (Bassuk et al., 2001). Adverse childhood experiences (ACEs) have long been associated with difficulties in mental health, physical health and well-being (Felitti et al., 1998). Trauma experiences reportedly have a dose-dependant relationship with the likelihood of homelessness (Bassuk et al., 2001). Half of all people experiencing homelessness have experienced four or more ACEs (Bellis et al., 2014) and higher ACE rates are associated with repeated homelessness (Bassuk et al., 2001; Bellis et al., 2014). While trauma is a key factor in entering homelessness, homelessness services’ programmes, processes and settings can be traumatic in themselves (Coates and McKenzie-Mohr, 2010; Hopper et al., 2010; Yatchmenoff et al., 2017; Bloom and Farragher, 2011). Continuing trauma exists in the form of neglect, physical and psychological abuse and community violence (Coates and McKenzie-Mohr, 2010). These stressors and ways of coping with them, such as substance misuse, compound and increase the difficulty in exiting homelessness (Bassuk et al., 2001; Cockersell, 2018).
Trauma effects and potential coping strategies, in conjunction with trauma survivors’ difficulties in forming trusting relationships and engagement with services, can result in multiple disadvantages (Fisher, 2015; Watson et al., 2019). This complexity can lead to homeless services feeling overwhelmed as they lack the resources to address barriers to sustained recovery (Hopper et al., 2010). However, such services are in a unique position to provide lasting change to an often-overlooked group – supporting the healing from trauma, establishing relationships and developing connections in the community (Hopper et al., 2010).
Homeless Link (2017) and European Federation of National Organisations working with the Homeless (2017) published briefings on psychologically informed environments (PIE) and trauma informed care (TIC). PIE is an overarching framework wherein services are supported to develop psychologically informed practice and service design (Keats et al., 2012) but does not require an explicit focus on trauma, as is the case with the complementary TIC framework. TIC has been a...