Homelessness and Psychotherapy

Christos has worked at St Mungo’s since 1994. Now a fully qualified psychotherapist, he provides life changing support to people who have experienced homelessness at St Mungo’s psychotherapy service: LifeWorks.

What made you want to become a psychotherapist?

I used to be a project worker at St Mungo’s and I spent some time at one of our mental health services. It made me realise how closely linked mental health and homelessness are, and I decided that the best way I could help was to train as a psychotherapist.

Why is it important that people who have been homeless can access psychotherapy?

The vast majority of the people we work with experienced trauma in their childhood. And it’s those unresolved traumas which lead to other issues – homelessness, substance use, and even physical health problems.

The ACE Study, one of the largest investigations into childhood trauma and later life health and well-being, shows that that people who experience childhood traumas are more likely to get cancer and other common diseases as an adult. Childhood trauma has a huge impact on every aspect of a person’s life, and psychotherapy is the best way to work through it.

You have to listen to people in an open, nonjudgemental way. And then you have to be able to put the things they’re saying back together in a way that makes sense.

How is LifeWorks different from other psychotherapy services?

LifeWorks is designed to work for people who have experienced homelessness. It’s different from private psychotherapy because it’s free. And it’s different from NHS psychotherapy because it’s open ended. On the NHS, you can only see a psychotherapist for a set period of time; at LifeWorks, you can keep coming for as long as you need.

“Most psychotherapy services are also off limits to people who use substances. Many of the people we work with use drugs or alcohol as a way of coping – they won’t be able to stop until they’ve worked through their trauma, and psychotherapy is the best way to do that.”

I remember Alice*, who I worked with for three years, had experienced sexual abuse as a child. She kept having flashbacks and she was using drugs to try to stop them. She couldn’t access other psychotherapy services because of her drug use.

It took her a whole year to open up about her trauma. When she finally told me, she wrote it down on a piece of paper because it was too difficult to say out loud. The things her parents did to her were horrific. If she had been having therapy on the NHS, her time would have already been up before she was ready to talk.

How do you get people to open up about their trauma?

“You have to listen to people in an open, nonjudgemental way.  And then you have to be able to put the things they’re saying back together in a way that makes sense.”

It sounds easy, but there’s years of training behind it! The real challenge is making all the theoretical knowledge appear natural – it’s a tricky balance betweem being a professional and a friend.

It’s particularly challenging in cases like Alice’s. I’ll always remember the day she told me about what had happened to her. I was really nervous – I knew that it was going to be horrific because it had taken her so long to open up. She was on my mind all the way home. But at the same time it was really rewarding because I knew that I was helping her. I knew that she’d been able to tell me something that she’d never told anyone before.

Alice has finished therapy now and she’s living in her own place. That’s what she always wanted.

*Alice’s name has been changed to protect her identity.

Interested in finding out more about LifeWorks? Look at how St Mungo’s helping homeless people in recovery with our psychotherapy project, LifeWorks.