This Frontline interview is with Nora, our Outreach Psychotherapist, she is part of our Advice and Support team. She helps homeless people recognise and manage psychological triggers and traumas, which prevent them from overcoming addiction, other destructive behaviours and, ultimately, building a life away from the streets.
I am an outreach psychotherapist, and I work with people who are experiencing homelessness – either on the streets, in temporary accommodations, sofa surfing, or in institutions.
On a typical pre-COVID-19 day, I have appointments with clients wherever they feel comfortable. This often means they take place outside- in the park, in a café, in a library, or if the client prefers, in one of my psychotherapy adapted spaces.
Due to Covid-19, I had to adapt to working remotely with my clients – over the phone and online. This is very difficult because it is not a secret that homeless clients do not always have the means to be contacted. I've had to become even more flexible in my working, especially concerning timings, issues with connections, or inability to get in touch to ensure they make appointments.
Social distancing makes psychotherapy a challenge. As the sessions are not taking place in a shared space- we can't see each other's' reactions. There is valid and important information in the unspoken – tension, body language, a smile, tears. Usually, I would use these physical presentations in the session, but it is difficult to do this remotely. However, there have been some positives. Clients are now taking greater responsibility for their visibility and discoverability by using their phones more, learning to be accountable for attending appointments and meetings. The pandemic has made it clear that society can adapt to anything, and people experiencing homelessness are some of the most adaptable. Some clients have seen this situation as an opportunity to start over and try something different. Recently, a client made a point about changing his priorities, he said:
"If I stand a chance against this virus, I think I will rethink my entire life." - a psychotherapy client.
This is great, but my clients also have many valid concerns. Firstly, they worry about their health. They know they are vulnerable, and some have underlying health issues, so not having the opportunity to isolate safely has been a huge concern. They are scared for their lives. Secondly, and, paradoxically, isolation in itself also concerns them. If you are homeless, you are often surrounded by hundreds of people on the street. Waking up to an empty city has been described as being in a horror movie because being around people is their norm and makes them feel safe. This is on top of concerns about getting regular meals and medications. For example, some of my clients are struggling to get their medications for depression and anxiety since GPs have closed for routine appointments. The pandemic is hurting mental health.
We have a good opportunity to engage our clients, so they don’t have to return to the streets. As a psychotherapist, the pandemic has reconfirmed my need to be more adaptable and flexible. To continue creating psychotherapy opportunities for clients who would not otherwise have the chance. Moving forward, I will have the confidence to challenge myself, and my clients, to be proactive and to stay connected.
As a society, I hope we can learn that we depend on each other, that what we do has positive or negative consequences. To begin acting more empathetically and see what really matters – being together and responsible.
"We are in this together, we are all the same." – a psychotherapy client.
This pandemic is a reminder of how fragile human life is, and how much effort it takes to save it. I hope our appreciation and value for human life will be reborn.
Providence Row is a charitable company limited by guarantee registered in England and Wales with company number 07452798 and registered charity number 1140192. Its registered office is at The Dellow Centre, 82 Wentworth Street, London, E1 7SA.