Residential care is increasingly recognized as an invaluable therapeutic resource for homeless, severely mentally ill, and substance-abusing clients. However, those managers and staff seeking to provide residential care can be perplexed by the communications of these clients and would benefit from a conceptual framework for planning psychosocial interventions to address these clients' diverse problems. This paper describes how a comprehensive psychology-intrapsychic humanism-can be used as a flexible, consistent guide for serving this population in residential care. Based on a central principle that staff-client relationships can be a path to healing, intrapsychic humanism's other precepts include treatment planning that recognizes clients' conflicting motives and strengthens their constructive motives, understanding clients' self-destructive responses to positive experiences, and helping clients govern their self-destructive behavior while enhancing their self-respect.
Get full access to this article
View all access options for this article.
References
1.
AllenF., & GoldfingerS. M. (1986). “Treating” a homeless mentally ill patient who cannot be managed in the shelter system. Hospital and Community Psychiatry, 37, 577–579.
2.
Assembly Task Force on Homelessness, New Jersey State Legislature. (1989a). Public hearing before assembly task force on homelessness on the delivery of social services to homeless persons (Vol. 2). Trenton, New Jersey: Office of Legislative Services, Public Information Office Hearing Unit.
3.
Assembly Task Force on Homelessness, New Jersey State Legislature. (1989b). Public hearing: to elicit testimony regarding creative solutions to the problem of homelessness (Vol. 3). Trenton, New Jersey: Office of Legislative Services.
4.
AxleroadS. E., & ToffG. (1987). Outreach Services For Homeless Mentally Ill People: Proceedings Of The First Of Four Knowledge-Development Meetings On Issues Affecting Homeless Mentally Ill People (Clearinghouse on Homelessness Among Mentally Ill People [Sponsors], Trans.). Washington, DC: National Institute of Mental Health.
5.
BachrachL. L. (1989). The legacy of model programs. Hospital and Community Psychiatry, 40(3), 234–235.
6.
BassukE. L. E. (1986). The Mental Health Needs of Homeless Persons.San Francisco, London: Jossey-Bass Inc.
7.
BelcherJ. (1991). Moving into homelessness after psychiatric hospitalization. Journal of Social Service Research, 14, 63–77.
8.
BelcherJ., & EphrossP. (1989). Toward an effective practice model for the homeless mentally ill. Social Casework, 56, 421–427.
9.
BelcherJ. R., & DiBlasioF. A. (1990). Helping the homeless: Where do we go from here?Lexington, MA: Lexington Books.
10.
BrownK. S., & ZiefertM. (1990). A feminist approach to working with homeless women. Affilia, 5, 6–20.
11.
ChamberlinJ. (1990). The ex-patients' movement: Where we've been and where we're going. Journal of Mind and Behavior, 11, 3–4.
12.
ChristW., & HaydenS. L. (1989). Discharge planning strategies for acutely homeless inpatients. Social Work in Health Care, 14, 33–45.
13.
CohenD. (1989). Biological basis of schizophrenia: The evidence reconsidered. Social Work, 34, 255–257.
14.
CourseyR. D., FarrellE. W., & ZahniserJ. H. (1991). Consumers' attitudes toward psychotherapy, hospitalization, and aftercare. Health and Social Work, 16(3), 145–224.
15.
DrakeR. E., TeagueG. B., & WarrenS. R. (1990). Dual diagnosis: The New Hampshire program. Addiction and Recovery, 10, 35–39.
16.
EstroffS. (1981). Making it crazy: An ethnography of psychiatric clients in an American community.Berkely, CA: University of California Press.
17.
GlynnS. M. (1990). Token economy approaches for psychiatric patients: progress and pitfalls over 25 years. Behavior Modification, 14, 383–407.
18.
GoldmanH. H., & GattozziA. A. (1988). Murder in the cathedral revisited: President Reagan and the mentally disabled. Hospital and Community Psychiatry, 39(3), 505–509.
19.
GottesmanI. I. (1996). Blind men and elephants: Genetic and other perspectives on schizophrenia. In HallL. L. (Ed.), Genetics and mental illness (pp. 51–77). New York, NY: Plenum Press.
20.
HarpH. (1990). Independent living with support services: The goal and future for mental health consumers. Psychosocial Rehabilitation Journal, 13(4), 85–89.
21.
HarrisM. (1988). Interaction fit and patients with character disorders. New directions for mental health services No. 40.San Francisco: Jossey-Bass.
22.
Heineman (Pieper)M. (1981). The obsolete scientific imperative in social work research. Social Service Review, 55, 371–396.
23.
IshibashiN. (1991). Multicultural students: What do they want?School Social Work Journal, 16, 41–45.
24.
JacksonR., PurnellD., AndersonS. B., & SheaforB. W. (1996). The clubhouse model of community support for adults with mental illness: An emerging opportunity for social work education. Journal of Social Work Education, 32, 173–180.
25.
KohnA. (1995). Punished by rewards: The trouble with gold stars, incentive plans, A's, praise, and other bribes.New York: Houghton Mifflin Co.
26.
LambH. R. (1984). The homeless mentally ill.Washington, DC: American Psychiatric Association.
27.
LeeteE. (1988). A consumer perspective on psychosocial treatment. Psychosocial Rehabilitation Journal, 12, 45–52.
28.
LePageJ. P. (1999). The impact of a token economy on injuries and negative events on an acute psychiatric unit. Psychiatric Services, 50(7), 941–944.
29.
LevineI., & HuebnerR. (1991). Homeless persons with alcohol, drug, and mental disorders. American Psychologist, 46, 1113–1114.
30.
LevineI. S., & RogD. J. (1990). Mental health services for homeless mentally ill persons: Federal initiatives and current service trends. American Psychologist, 45, 963–968.
31.
LiptonF. R., NuttS., & SabatiniA. (1988). Housing the homeless mentally ill: A longitudinal study of a treatment approach. Hospital and Community Psychiatry, 39(1), 40–45.
32.
MansouriL., & DowellD. A. (1989). Perceptions of stigma among the long-term mentally ill. Psychosocial Rehabilitation Journal, 13(1), 79–91.
33.
MartinM. A., & NayowithS. A. (1989). Creating community: Groupwork to develop social support networks with homeless mentally ill. Social Work With Groups, 11(4), 79–93.
34.
MechanicD., & RochefortD. A. (1990). Deinstitutionalization: An appraisal of reform. Annual Review of Sociology, 16, 301–327.
35.
MorrisseyJ. P., & LevineI. S. (1987). Researchers discuss latest findings, examine needs of homeless mentally ill persons. Hospital and Community Psychiatry, 38, 811–812.
36.
PieperM. H. (1989). The heuristic paradigm: A unifying and comprehensive approach to social work research. Smith College Studies in Social Work, 60, 8–34.
37.
PieperM. H., & PieperW. J. (1990). Intrapsychic humanism: An introduction to a comprehensive psychology and philosophy of mind.Chicago: Falcon II Press.
38.
PieperM. H., & PieperW. J. (1992). It's not tough, it's tender love. Child Welfare, 71, 369–377.
39.
PieperM. H., & PieperW. J. (1995). Treating violent, ‘untreatable’ adolescents: Applications of intrapsychic humanism in a state-funded demonstration project. In TysonK. (Ed.), New foundations for scientific social and behavioral research: The heuristic paradigm (pp. 455–472). Needham Heights, MA: Allyn & Bacon.
40.
PieperM. H., & PieperW. J. (1999). The privilege of being a therapist: A fresh perspective from intrapsychic humanism on caregiving intimacy and the development of the professional self. Families in Society, 80, 479–487.
41.
PieperM. H., & PieperW. J. (1999). Smart love: The compassionate alternative to discipline that will make you a better parent and your child a better person.Boston: Harvard Common Press.
42.
RappC. A., KisthardtW., GowdyE., & HansonJ. (1994). Amplifying the consumer voice: Qualitative methods, empowerment, and mental health research. In ShermanE., & ReidW. J. (Eds.), Qualitative research in social work (pp. 381–395). New York: Columbia University Press.
43.
RidgwayP., & ZippleA. M. (1990). The paradigm shift in residential services: From the linear continuum to supported housing approaches. Psychosocial Rehabilitation Journal, 13(4), 11–31.
44.
RogersC. R., & SkinnerB. F. (1956). Some issues concerning the control of human behavior: A symposium. Science, 124, 1057–1066.
45.
RothbardA. B., SchinnarA. P., and GoldmanH. (1996). The pursuit of a definition for severe and persistent mental illness. In SoreffS. M. (Ed.), Handbook for the treatment of the seriously mentally ill (pp. 9–26). Seattle, WA: Hogrefe & Huber.
46.
SaleebeyD. (Ed.). (1992). The strengths perspective in social work practice.New York: Longman.
47.
SegalS. P., & BaumohlJ. (1985). The community living room. Social Casework, 66, 111–116.
48.
SheridanM. J., GowenN., & HalpinS. (1993). Developing a practice model for the homeless mentally ill. Families in Society, 74(7), 410–421.
49.
SpitzD. (1996). Treatment of the seriously and persistently mentally ill on an acute psychiatric unit of a general hospital. In SoreffS. M. (Ed.), Handbook for the treatment of the seriously mentally ill (pp. 391–409). Seattle, WA: Hogrefe & Huber.
50.
SullivanW. P. (1992). Reclaiming the community: The strengths perspective and deinstitutionalization. Social Work, 37(3), 204–209.
51.
SusserE., GoldfingerS. M., & WhiteA. (1990). Some clinical approaches to the homeless mentally ill. Community Mental Health Journal, 26, 463–480.
52.
TowerK. D. (1994). Consumer-centered social work practice: Restoring client self-determination. Social Work, 39(2), 191–196.
53.
TsuangM. T., & FaraoneS. V. (1996). The inheritance of mood disorders. In HallL. L. (Ed.), Genetics and mental illness: Evolving issues for research and society (pp. 79–109). New York: Plenum Press.
54.
TysonK. (1991). The understanding and treatment of childhood hyperactivity: Old problems and new approaches. Smith College Studies in Social Work, 61, 133–166.
55.
TysonK. (1994). Heuristic guidelines for naturalistic qualitative evaluations of child treatment. In ShermanE., & ReidW. J. (Eds.), Qualitative research in social work (pp. 89–111). New York: Columbia University Press.
56.
TysonK. (1999). An empowering approach to crisis intervention and brief treatment for preschool children. Families in Society, 80(1), 64–77.
57.
TysonK., & CarrollE. (1992, July). Empowering the disenfranchised: A new, effective, humanistic approach to residential treatment with homeless, mentally ill, and substance-abusing clients. Poster Presentation, National Association of Social Workers, annual meeting, Washington, D.C.
58.
TysonK. E. (Ed.). (1995). New foundations for scientific social and behavioral research: The heuristic paradigm.Needham Heights, MA: Allyn & Bacon.
59.
WalshS. (1986). Characteristics of failures in an emergency residential alternative to psychiatric hospitalization. Social Work in Health Care, 11, 53–64.
60.
WitkinS. L. (1993). A human rights approach to social work research and evaluation. In LairdJ. (Ed.), Revisioning Social Work Education: A Social Constructionist Approach (pp. 239–254). Binghamton, NY: Haworth Press.
