Worthy and able: How helping relationships alter the trajectories of young people who face severe and multiple disadvantages

Housing first, connection second: the impact of professional helping relationships on the trajectories of housing stability for people facing severe and multiple disadvantage

Background

Despite the accumulating evidence on the role of professional helping relationships for highly disadvantaged populations, methodological shortcomings have made it difficult to establish a robust relationships-outcomes link. This study sought to establish the impact of professional helping relationships on the trajectories over 24 months of housing stability for 2141 people facing severe and multiple disadvantage using data from the Housing First controlled trial in Canada.

Method

The study used a mixed method design. Latent growth curve and growth mixture models assessed the impact of working alliance across the sample as a whole and within subgroups with different patterns of housing stability. Thematic analysis explored the factors that may affect the quality of working alliances within different subgroups.

Results

Three distinct trajectories of housing stability emerged (i.e., Class 1: “sharp rise, sustained, and decline housing”; Class 2: “hardly any time housed”; Class 3: “high rise, sustained, and decline housing”) with professional helping relationships having different effects in each. The analysis revealed structural and individual circumstances that may explain differences among the classes.

Conclusions

The findings underscore the role of professional helping relationships, as distinct from services, in major interventions for highly disadvantaged populations, and draws new attention to the temporal patterns of responses to both the quality of relationship and targeted interventions.

What is the profile of workers who build effective relationships with young people facing severe and multiple disadvantages?

Family-like professional helping relationships have the potential to alter the trajectories of young people facing significant disadvantage. This study seeks to identify the worker attributes that allow the formation of deep bonds with young people in these circumstances. Access to young people in difficult circumstances was secured via organisations that provided support to this population. Interviews about positive-helping relationships were conducted with young people (n = 30) and support workers (n = 35) from 11 UK and 5 US not-for-profit organisations. Thematic analysis was used to analyse the data. Three sets of worker qualities were identified and linked to how relationships change young people's trajectories in the context of adversity. This study has implications for the selection, training, and support of workers who provide support to young people facing difficult challenges underscoring the qualities needed to provide support and change young people's outcomes.