Online Program

Differentiation between shame and dignity-based housing service provision and policy making

Monday, November 2, 2015

Sabina Dhakal, MPH, Department of Research and Wellness, Caring Health Center, Springfield, MA
Aline Gubrium, PhD, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
Cristina Huebner-Torres, M.A, Caring Health Center, Springfield, MA
Background: The accumulation of material wealth is commonly denoted as a symbol of success in the world; its deficiency is recognized as having detrimental social consequences. However, psychosocial meanings of wealth and poverty go beyond the material, with poverty defined as a shameful and corrosive social relation characterized by a lack of voice, disrespect, humiliation and reduced dignity and self-esteem. While the shame experienced by persons in poverty has long been recognized, little attention has been paid to the implications of the poverty/shame nexus for the design of effective anti-poverty measures – including policies directed at the housing insecure. Shame is an important dimension to consider when developing and delivering housing assistance measures. Attention to this dimension across the spectrum of professional practice will enhance the effectiveness of these measures by promoting human dignity and social cohesion.

Objectives:To investigate the perspectives and experiences of provider and recipients (“participants”) of housing assistance programs, including those directed at homeless women and young families.

Methods: Data was collected through individual interviews with providers and recipients and through observation of participant-recipient interactions at intake sessions and activities based at two housing sites/shelters, one a local housing authority apartment complex, the other a shelter for young families. The program stated goals are to help low-income clients transition into temporary housing to increase their self-sufficiency, and eventually leading to home ownership. Programmes offered are aimed at improving recipient skills, including English language courses, financial literacy courses, job search workshops and career advancement services.

Findings: Preliminary findings highlight the need for advance training for staff focused on respectful communication. In addition, we note key themes around the need for staff support, namely in the areas of clear and realistic work expectations (i.e. especially in the realm of paperwork and documentation), number of staff supported at each site, continuous training opportunities, and work/life balance. Shame-proofing modifications directed at recipients include more individualized/personalized follow-up by an assigned caseworker and attention to how discretion is used in housing decisions. 

Conclusion/Discussion: Social service agencies may find employment of “motivational interviewing” useful in improving communication and rapport. More opportunity for provider-recipient interactions might also be beneficial. Further interviews and interactions will provide insight for crafting concrete guidelines for dignity-based service delivery.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe the structural role played by the social emotions, notably shame, in the delivery of anti-poverty services. Explain the implications of the poverty-shame nexus for the design of effective anti-poverty measures. Analyze the changing world of anti-poverty measure implementation through a poverty-shame lens. Differentiate shame and dignity based housing service provision. List key features of dignity-focused service provision.

Keyword(s): Poverty, Homelessness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on community-based research projects for over four years. I have extensive experience working with vulnerable population, especially those from lower socio-econonomic level. Currently, I am the lead researcher on a global based research project investigating experience and perspective surrounding anti-poverty service provision, and lead quantitative researcher on a four year NIH study focused on health literacy and medical adherence among five ethnic groups.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.