Short-term therapy sessions with parents and their children in homeless shelters could help improve parenting skills and reduce parental stress and children's post-traumatic stress symptoms, according to a pilot study published by the American Psychological Association.
Researchers from Florida International University partnered with Lotus House in Miami, one of the largest women's homeless shelters in the U.S. The study included 144 families (mother and one child) with children from 18 months to 5 years of age. The research was published online in the Journal of Consulting and Clinical Psychology.
Shelter staff worked daily with the families to build trust with the mothers – many of whom weren't seeking therapy – and 99% of them agreed to take part in the study, said lead researcher Paulo Graziano, PhD, a professor of psychology at Florida International University.
We're excited to find that evidence-based parenting interventions can be implemented within a shelter setting with wonderful benefits to the mothers and children. I think more community-university partnerships are essential towards addressing the mental health needs of our most vulnerable families and children in a setting where they normally wouldn't receive it."
Paulo Graziano, PhD, Professor of Psychology, Florida International University
More than 2 million children in the U.S. experience homelessness every year, and homeless children face heightened challenges from poverty, traumatic experiences, mental illness and behavioral problems. Previous research has also found that homelessness is associated with increased parental frustration and negative parenting behaviors, including aggression. Those issues can be exacerbated by the parents' chronic medical, mental health or substance use issues and their own histories of trauma.
Graziano and his team trained Lotus House staff to provide two types of evidence-based therapy to the mothers and their children in weekly sessions over three or four months. Half of the participants received Parent-Child Interaction Therapy while the other half received Child-Parent Psychotherapy.
Parent-Child Interaction Therapy includes positive parenting techniques to reduce critical statements and negative interactions with children during observed play sessions. Child-Parent Psychotherapy uses play and language to help identify and address traumatic triggers, provide emotional support and offer assistance with daily living issues.
Mothers in both therapy groups reported reductions in their stress and their children's post-traumatic stress symptoms. The mothers also made more positive statements during observed play sessions. Parent-Child Interaction Therapy also helped reduce children's behavior problems so may be more effective in a shelter setting, the study noted.
With adequate training and supervision, homeless shelter staff may not need mental health degrees to provide effective therapy, Graziano said. His team and Lotus House are working on a larger randomized trial to see if the successes from this pilot study can be replicated at other homeless shelters. He also hopes that other researchers will conduct their own studies.
Constance Collins, president of the Sundari Foundation, which operates Lotus House, said the project has produced dramatic results.
"It was a game changer that transformed homelessness into a window of opportunity for our children," she said. "We're sharing our experiences with other homeless shelters across the country with hopes that critically needed therapy will become more available to homeless parents and their children."
Graziano, P. A., et al. (2023). Early intervention for families experiencing homelessness: A pilot randomized trial comparing two parenting programs. Journal of Consulting and Clinical Psychology. doi.org/10.1037/ccp0000810.