Creating psychological space with Outreach Psychotherapy
Blog posted by: Nora Gudev, Monday, 20 January 2020.
Nora Gudev is an Outreach Psychotherapist at Providence Row. In this blog, Nora explains the work of the Outreach Psychotherapy Service.
Psychotherapy is more popular than ever before. It exists in many forms and has the potential to reach many more clients who benefit from exploring their patterns of behaviour, fears, anxieties, traumas, and aspirations. My service was created with some of the most vulnerable clients in mind – the homeless population.
Kath Dane, who is the Rough Sleeping Commissioner for Tower Hamlets, identified a destructive pattern within the homeless population in the borough – from street to prisons, to hostels, and back to the streets. As much as they need safe accommodation, our clients need to create the psychological space to understand their needs, triggers, the roots for their addictions, and ultimately, the core reason for their homelessness.
The idea of the Outreach Psychotherapy service in Tower Hamlets is to reach clients who have cut off most connections with services, rarely engage with outreach, and have little motivation to seek further help. They are the clients who have experienced some type of trauma in their past, leaving them frozen with fear, sadness, depression, lack of meaning and lack of positive interactions.
Those clients understand that the issues they experience are far beyond the lack of housing. Some clients have developed drug and alcohol addictions as a coping mechanism to deal with the weight of their traumas, to separate themselves from the public, and to detach themselves from their feelings. This combination of issues is extremely difficult to address, because as well as the psychological factors, there are physical and health concerns, and a continuous need to find sources to support their addictions.
I prefer to use existential psychotherapy approach to work with my clients. It allows for a deep exploration of the human condition. This means that I will take into consideration one’s entire construct of life, rather than one isolated issue to work on. We discuss relationships, differences, responsibilities, death, trauma, anxiety, choices, and our roles in the world. I explore the client’s traumatic experiences with an open-minded attitude, rather than with a dogmatic one, and the aim is to help them understand their triggers, anxieties, and fears and work towards successfully becoming independent and agents of change.
On average, I see between 15 to 20 people per week. Some clients can only tolerate a short session at first, working towards building resilience, and others are happy to use up to one hour per session. The only source of referrals into the service is Tower Hamlets Outreach Team, this has been done on purpose to support the service’s main target – the most entrenched and vulnerable people who do not usually engage easily. I am based at and employed by Providence Row at the Dellow Centre, where I have a dedicated space to see the clients who are willing to come in.
Some of the outcomes I have achieved so far are several clients moving into independent flats, getting in touch with their families after many years, volunteering to support other vulnerable people, stopping the use of drugs and alcohol, and going into professional courses. In the first year of the service, 23 people were successfully accommodated and kept their accommodations for longer than 3 months.
Providence Row Dellow Centre, based in Tower Hamlets, is looking into hiring more psychotherapists who will work with clients on-site, addressing their psychological issues, addictions, and wellbeing. I believe that the future of the Outreach Psychotherapy Service is bright, and it will become a necessary and permanent element of what we offer to people who are experiencing homelessness, by addressing the issues from their source.
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