EXPLORING THE COPING STRATEGY SKILLS OF HOMELESS WOMEN A Project Presented to the faculty of the Division of Social Work California State University, Sacramento Submitted in partial satisfaction of the requirements for the degree of MASTER OF SOCIAL WORK by Bette-Lee M. Axiak SPRING 2014 EXPLORING THE COPING STRATEGY SKILLS OF HOMELESS WOMEN A Project by Bette-Lee M. Axiak Approved by: __________________________________, Committee Chair Kisun Nam, Ph.D., MSSW ______________________________ Date ii Student: Bette-Lee M. Axiak I certify that this student has met the requirements for format contained in the University format manual, and that this Project is suitable for shelving in the Library and credit is to be awarded for the Project. ___________________, Graduate Coordinator Dale Russell, Ed.D., LCSW Division of Social Work iii ________________________ Date Abstract of EXPLORING THE COPING STRATEGY SKILLS OF HOMELESS WOMEN by Bette-Lee M. Axiak Statement of the Problem The fastest growing subgroup in the homeless population is families headed by single women (National Coalition for the Homeless, 2009; Rosenheck, et.al.,1999; Hodnicki, Horner, Boyle, 1992). These homeless mothers may use unique strategies that assist them through their experience of being homeless. In order for there to be a better understanding of how to assist homeless mothers, the coping mechanisms that are used by them must be identified. Sources of Data Eight homeless mothers and two homeless fathers were recruited through a family shelter and community center in the County of Tuolumne. The purpose of the study was to explore coping strategies of homeless mothers who had children between the ages of 0 and 18. Two fathers asked to participate in the study so their contributions are included. The participants were between the ages of 21 to 39. Five participants were married and the remaining five were single at the time of the interviews. Conclusions Reached There are four important findings that were revealed in this research study. The first finding is that homeless parents go through similar phases of homelessness as noniv parenting homeless adults, and they often use the same coping mechanisms in each phase of their homelessness (denial, substance abuse, reliance on family and friends, avoidance of available community resources). Finding number two in the research was that regardless of age, marital status, or gender, causes of homelessness are the same for homeless mothers and non-mothers. Some of these causes are poverty, alcohol or drug use, domestic violence, weak social networks, and an absence of knowledge about available resources in their communities. The third finding was that hope is crucial in overcoming homelessness. The fourth and final finding was that homeless mothers have unique needs (such as the need for prenatal care, assistance in giving birth, parenting classes, and child care) when compared with all other subgroups of homeless populations (Stoner, 1983; Merves, 1992; Rosenheck, et. al.,1999). Therefore, the focus of future research may not need to be on the coping mechanisms of homeless mothers but on their particular needs. __________________________________, Committee Chair Kisun Nam, Ph.D. MSSW ______________________________ Date v Table of Contents Chapter 1. THE PROBLEM ........................................................................................................... 1 Background of the Problem .......................................................................................... 3 Statement of research problem................................................................................ 9 Study purpose.............................................................................................. 9 Assumptions.............................................................................................. 11 Social work research justification ............................................................. 11 Study limitations. ...................................................................................... 12 2. REVIEW OF THE LITERATURE ............................................................................ 13 History of Family Homelessness ................................................................................ 13 Homeless Families in Urban Verses Rural Communities..................................... 14 Causes of Homelessness ....................................................................................... 16 Poverty. ..................................................................................................... 17 Decreasing governmental monetary assistance. ....................................... 18 Lack of affordable housing. ...................................................................... 18 Lack of education. ..................................................................................... 19 Domestic violence. .................................................................................... 19 Lack of a positive social network. ............................................................ 20 vi Aging out of foster care. ........................................................................... 21 Drug and alcohol abuse. ............................................................................ 22 Mental illness. ........................................................................................... 22 Coping Skills......................................................................................................... 23 Active-behavioral coping mechanisms. .................................................... 25 Active-cognitive coping mechanisms. ...................................................... 27 Avoidant coping mechanisms. .................................................................. 28 Combining coping mechanisms. ............................................................... 30 Gender Factors ...................................................................................................... 31 Summary ............................................................................................................... 33 3. METHODS ................................................................................................................. 35 Study Objectives ................................................................................................... 35 Study Design ......................................................................................................... 36 Sampling Procedures ............................................................................................ 37 Data Collection Procedures................................................................................... 37 Measurement. ............................................................................................ 38 Instruments ............................................................................................................ 38 Data Analysis ........................................................................................................ 38 vii Protection of Human Subjects .............................................................................. 39 4. STUDY FINDINGS AND DISCUSSIONS ............................................................... 40 Overall Findings.................................................................................................... 41 Specific Findings .................................................................................................. 42 Demographics. .......................................................................................... 42 Interpretations to the Findings .............................................................................. 44 Past employment experiences. .................................................................. 44 Past experiences that contributed to being homeless. ............................... 46 Past coping strategies used when homeless. ............................................. 46 Past survival skills utilized including sexual favors in exchanged for necessities. ................................................................................................ 48 Current shelter experiences. ...................................................................... 49 Current survival skills while in the shelter. .............................................. 51 Participants’ views of how the community perceives their current homelessness. ............................................................................................ 52 Future plans to prevent homelessness. ...................................................... 53 Summary ............................................................................................................... 56 5. CONCLUSIONS, SUMMARY, AND RECOMMENDATIONS.............................. 59 Summary of Study ................................................................................................ 59 viii Implications for Social Work ................................................................................ 62 Recommendations ................................................................................................. 65 Limitations ................................................................................................ 65 Conclusion ............................................................................................................ 66 Appendix A. Focus Group Questions ........................................................................ 67 Appendix B. Individual Interview Questions ............................................................ 69 Appendix C. Letter of Consent .................................................................................. 71 References ................................................................................................................... 72 ix LIST OF TABLES Table 1. Gender ................................................................................................................ 43 Table 2. Race/Ethnicity .................................................................................................... 43 Table 3. Age (two participants chose not to disclose) ...................................................... 43 Table 4. Number of Children Living with Participants .................................................... 43 Table 5. Marital Status ..................................................................................................... 43 Table 6. Length of Stay at Current Shelter (two participants chose not to disclose) ....... 44 Table 7. Level of Education ............................................................................................. 44 x 1 Chapter 1 THE PROBLEM Homelessness is a major social, economic, and political problem in the United States. It is estimated that three million homeless people are in the United States (National Law Center on Homelessness & Poverty, 2012). Homeless individuals reside in motels, shelters, on the streets, in vacant buildings or find themselves relying on the kindness of different friends or relatives who are willing to provide an overnight space (National Coalition for the Homeless, 2009). Women and children make up the fastest growing group of the homeless population (Rosenheck, Bassuk, & Salomon, 1999; Weinreb, 1996; Arangua, Andersen, & Gelberg, 2006; National Coalition for the Homeless, 2007). As the number of homeless women and families continues to increase, the importance of developing strategies for homeless women and their children becomes even more critical. Social Workers are faced with the realities of homelessness as they interact with communities and clients in those communities. Social Workers need to facilitate the transition out of homelessness and empower homeless people. If Social Workers are to be affective, they need to have a better understanding of the world of homeless individuals and see their situations through new lenses. In this researcher’s role as a case manager for mothers with children under the age of five, it was apparent that many of the mothers seen were homeless mothers with children in tow. The same discovery was made when this researcher assisted families in finding low income housing using resources allocated by a homeless prevention fund 2 awarded to Tuolumne County in 2009 (American Recovery and Reinvestment Act, 2009). In this researcher’s present volunteer position at the David Lambert Center in Tuolumne County, the marginalization of being a homeless mother was evident. In order for a homeless mother to survive the experience of being homeless with children, a woman must use coping mechanisms to survive this challenge. In many cases, the coping skills were appropriate in providing a new direction for the lives of the homeless mother while other skills that were used were detrimental. Given the fact that many, if not all, homeless women are marginalized, those professionals providing services for homeless mothers need to be aware of the invisible mechanisms that such women use to survive. For example, homeless women are confronted with major changes in lifestyle and environment, causing them to be at risk for life changing emotional distress and health problems (Rosenheck et al., 1999; Schultz-Krohn, 2004). Many homeless mothers lack adequate skills and resources to change their environment significantly in ways that would positively influence their lives (Rosenheck et al., 1999; Kourgialis et al., 2001; Driskel & Simon, 2006; Hopper, Bassuk, & Olivet, 2009). Before change can occur, we must first recognize that the problem of homelessness exists and that the number of women and children in this situation is growing (Bray, 2010; National Center On Family Homelessness, 2011; Meadows-Oliver, 2002; U. S. Conference Of Mayors, 2009), and that without a commitment to action, the problem is not going away. Those working with homeless populations must have knowledge of the skills homeless mothers use to survive their very stressful life 3 circumstances in order to assist them in overcoming the problem of being homeless and being homeless with children. Background of the Problem The homeless population has been a problem on the streets of America for many decades. Research shows that families, single mothers, and their children make up the largest group of people who are now homeless in rural areas (Vissing, 1996; U.S. Department of Health and Human Services, Health Resources and Services Administration & Office of Rural Health Policy, 2005; Silver & Panares, 2000; National Coalition for the Homeless, 2009). Approximately 90% of homeless families are headed by a single female parent (Markos & Lima, 2003; United States Interagency Council on Homelessness, 2010; Hodnicki, Horner, & Boyle, 1992; Jarrett & Tchen, 2012). Today in America over 600,000 families, and an additional 1,000,000 children are homeless, living in shelters, on the streets, with their families’ friends, in cars, and in campgrounds (Nunez & Caruso, 2003; National Coalition for the Homeless, 2009; Shinn, Rog, & Culhane, 2005; United States Interagency Council on Homelessness & Federal Strategic Plan to Prevent and End Homelessness, 2010). Sadly, these families are suffering from poverty, hunger, and poor physical and mental health. Homeless families are thought to be the fastest growing subgroup of the homeless population (Novac & Bourbonnais, 1996; Rosenheck et al., 1999; Fischer, 2000; National Coalition for the Homeless, 2009; U. S. Conference of Mayors, 2009; National Center on Family Homelessness, 2011). The majority of such families are headed by women with two or three children (Bassuk, Rubin, & Lauriat, 1986; Schultz-Krohn, 2004; Novac & 4 Bourbonnais, 1996; Rosenheck et al., 1999). Acknowledgement of gender differences in the homeless population by professionals is lacking, and still fewer professionals focus on homeless women’s special circumstances (Bachrach, 1987; Novac & Bourbonnais, 1996; Arangua et al., 2006; Bassuk, Volk, & Olivet, 2010). The special circumstances of homeless women include, but are not limited to, the following: lower earning capacity compared with men; childcare responsibilities; they are less visible to the general populous; physical and sexual victimization; and, they have unique health issues (Bachrach, 1987; United States Interagency Council on Homelessness, 2010; National Center on Family Homelessness, 2011). Women bring their gender responsibilities into the homeless situation and, as a result, many authors have called for programming to meet their unique needs (Stoner, 1983; Bachrach, 1987; Merves, 1992; Rosenheck et al., 1999). The fact that women earn less than men can be verified by comparing the salaries women receive with their male counterparts. On April 6, 2012, President Obama announced the release of a new report by the White House Council on Women and Girls, “Keeping America’s Women Moving Forward,” that details the progress the administration has made in helping women economically (Jarrett & Tchen, 2012). In spite of the efforts mentioned in this report, the wage gap has remained statistically unchanged in the last few years; women earned 77.0% of what men earned in 2009 and 77.4% in 2010 (National Committee on Pay Equity, 2012). Looking at a broader picture, one can see that the wage gap between the years 1990 and 2010 has only marginally 5 improved and has actually gotten worse in some years (National Committee on Pay Equity, 2010). Homeless mothers not only have the added hardship of the above-mentioned wage gap, but they are also the ones who are usually caring for the children without the help of a second parent (Rosenheck et al., 1999; Novac and Bourbonnais, 1996; National Coalition for the Homeless, 2009). Having to care for children without help significantly hinders one’s ability to seek employment and vocational training. Another gender differences is that fact that less is known about homeless women compared with homeless men (Novac and Bourbonnais, 1996; Arangua, Andersen, & Gelberg, 2006; Gla dstone, 2008). Most research on gender differences between male and female homeless people is obtained from shelter and street populations and may not comprehensively reflect the homeless woman’s experience (Novac and Bourbonnais, 1996; Anderson & Lowe, 1999; Arangua, Andersen, & Gelberg, 2006). Homeless women usually spend the night on the streets or at the home of family or a friend and are less transient than homeless men (Bachrach, 1987; National Coalition for the Homeless, 2009; Borchard, 2007). Homeless women have deeper local origins compared to homeless men, meaning they often know the people in their community and do not venture far from that community (McGerigle & Lauriat, 1983; National Coalition for the Homeless, 2009; Rosenheck, Bassuk, & Salomon, 1999). Men also tend to have longer durations of homelessness than women (McGerigle and Lauriat, 1983; Calsyn & Morse, 1990; Cosgrove & Flynn, 2005) and this may be due to the fact that there is a higher occurrence of alcoholism in homeless men compared with homeless women (McGerigle 6 and Lauriat 1983; Hagen & Ivanoff, 1988; Hodnicki, Horner, & Boyle, 1992). All of these factors contribute to the fact that less is known about homeless women compared with homeless men. One of the most concerning differences between homeless women and homeless men is the role abuse plays in one’s life. More than 80% of homeless mothers with children experienced domestic violence prior to becoming homeless (United States Interagency Council on Homelessness, 2010; Aratani, 2009; U. S. Conference of Mayors, 2007; Kennedy, 2007). Women in domestic violence shelters and homeless shelters share many characteristics, including the fact that they are fleeing from a violent home life (Rukmana, 2008; Stainbrook & Hornik, 2006; Rosenheck et al., 1999). Homelessness is a complex phenomenon with individuals following multiple paths into homelessness (Hagen & Ivanoff, 1988; Milburn & D'Ercole, 1991; National Coalition For The Homeless, 2009). As mentioned above, domestic violence is a common reason mothers caring for children become homeless. In addition to this, homelessness is caused by other factors such as poverty (National Coalition for the Homeless, 2009; Vissing, 1996; Cummins, 2001), lack of affordable housing (National Coalition for the Homeless, 2009; Vissing, 1996; Cummins, 2001), and a lack of positive social networks (Aratani, 2009; Guarnaccia & Henderson, 1993; Zugazaga, 2007. People living in poverty are almost always on the brink of homelessness (Bassuk & Cohen, 1991; Bassuk & Rosenberg, 1990; Rosenheck, Bassuk, & Salomon, 1999; Vissing, 1996) and spend more than half of their net income on rent (Aratani, 2009; Choi & Snyder, 1999; Cummins, 2001; Cummins, First, & Toomey, 1998). The majority of 7 homeless mothers rely on public assistance (Bassuk et al., 1997; Choi & Snyder, 1999; Cummins et al., 1998; National Coalition for the Homeless, 2007). The economic recession that has occurred over the past several years (beginning in December 2007) has caused a dramatic increase in the number of homeless families (Aratani, 2009; National Coalition for the Homeless, 2007; Cummins, 2001; Rosenheck et al., 1999). The lack of affordable housing, coupled with the above-mentioned poverty factor, is another key cause of homelessness. The availability of affordable housing has declined over the past ten years by 13 percent because of the loss of privately held properties (Aratani, 2009; Choi & Snyder, 1999; Vissing, 1996). The total number of households with children reporting dire housing problems has increased from 8 percent in 1978 to 13.8 percent in 2005 (Aratani, 2009; National Coalition for the Homeless, 2009; National Center on Family Homelessness, 2011; American Recovery and Reinvestment Act, 2009; Bray, 2010). The lack of a social network is another cause of homelessness (Aratani, 2009; Choi & Snyder, 1999; Vissing 1996). Research has shown that homeless families tend to have a very unstable and weak social network (Aratani, 2009; Bassuk et al., 1997; Cummins, 2001). If, for example, a mother and her children flee their home because of domestic violence, this mother will most likely become homeless if the other factors of poverty, lack of affordable housing and a poor social network are present. A great many of the homeless mothers studied fall into this category (National Coalition for the Homeless, 2009; Cummins, 2001; Arangua, Andersen, & Gelberg, 2006). 8 Homelessness is an independent stress that creates its own set of difficulties that must be faced (Anderson & Lowe, 1999; Bassuk, 1990). Some of these stresses are accessing and effectively utilizing the shelter system or navigating the social stigma of being without a permanent home (Rosenheck et al., 1999; National Coalition for the Homeless, 2009). A stress and coping approach to solving the homeless mothers’ problems would provide a framework for documenting the events that lead up to homelessness as well as understanding the strengths, skills, and actions mothers take to address their situations (Milburn & D'Ercole, 1991; National Coalition for the Homeless, 2009; Rosenheck et al., 1999). Until now, there has been little written about the coping process among mothers who are homeless (Milburn & D'Ercole, 1991; National Coalition for the Homeless, 2009). This researcher discovered that a lot was written about coping and homeless men (Rosenheck, Bassuk, & Salomon, 1999; Henry, 2009; Burt & Cohen, 1989). Men have extensive support networks and develop community systems of exchange centering on bartering which they use to procure personal items (Calsyn & Morse, 1990; Borchard, 2007). The time has come when we must extend our knowledge to include an understanding of women’s experiences of homelessness and how they cope with their problem of homelessness. Researchers have emphasized that individuals tend to use a variety of strategies, including those that act directly on the problem, and on those that alter its emotional impact in dealing with a situation (Rosenheck et al., 1999; Novac & Bourbonnais, 1996). Over the past several decades, coping revisionists have raised questions about the 9 adequacy of standard coping research for studying women in poverty (Banyard, 1995; Banyard & Graham-Bermann, 1995; Dill, Feld, Martin, Beukema, & Belle, 1980; Fine 1985; Stein & Nyamathi, 1998). Researchers have raised the question that historical findings have relied less on action or problem-oriented coping and more on emotionbased coping (Stein & Nyamathi, 1998; Gladstone, 2008). It has also been noted that coping questionnaires may be limited in their ability to describe the unique responses of various groups (Gladstone, 2008; Guarnaccia & Henderson, 1993; Banyard, 1995). In addition, questionnaires may not adequately place the coping process in its broader context (Gladstone, 2008; Guarnaccia & Henderson, 1993; Banyard, 1995). What remains unexamined are the ways that access to power and resources may influence coping (Banyard & Graham-Bermann, 1995; Dill et al., 1980; Lykes, 1983). Researchers must not only look at the stresses one experiences and how a situation is appraised but also at the range of coping responses that are available to homeless mothers caring for children. Statement of research problem Homeless mothers have survival techniques that can have negative and positive outcomes that need to be understood and explored if society is to assist homeless mothers in overcoming their homelessness. Study purpose. The general purpose of the study is to acquire a better understanding about the coping strategies that homeless mothers use to navigate and negotiate their experience of homelessness. The primary purpose of this study is to gain knowledge of the coping strategies homeless mothers use. The secondary purpose is to 10 acknowledge those coping strategies that mothers use to attain self-sufficiency and suggest possible changes needed in resources and services available to homeless mothers so that these women can become independent and successful people. Theoretical framework. The theoretical framework which the author used is the systems theory (Anderson & Lowe, 1999). According to Anderson & Lowe (1999), the systems theory focuses on the relationship of individuals with their social environments. The systems theory addresses many of the problems homeless families face. This theory can be used to focus on the whole ecological picture of homeless families and, in particular, homeless mothers. Systems theory also focuses on how assistance can be provided to meet the unique needs of each individual thereby providing a balance within each environmental system. An example of the systems theory in practice is Sonora Family Shelter in Tuolumne County, which is run by Amador Tuolumne Community Action Agency. This shelter provides housing, food, transportation, education, employment assistance, counseling and sometimes financial assistance (Sonora Family Shelter, 2012). Another example of the systems theory in practice is the Public Health Nursing Home Visiting Program, an agency within the Tuolumne County Health Department that provides case management by public health nurses. These nurses provide help with setting appointments, medical transportation, health recommendations, pharmaceutical assistance, and counseling (Resource Directory for Family Services in Tuolumne County, 2012). 11 Assumptions. This study makes certain assumptions about homeless mothers’ survival skills. All homeless mothers utilize coping skills that they have learned as they travel down the road to homelessness. Some of these skills are old skills that they have learned in the past and others are new skills that they have acquired along the way. These survival skills either assist homeless mothers out of homelessness, or bring the homeless mother further into homelessness. The barriers many homeless mothers face in overcoming their homelessness are often created by the professionals who are seeking to help them because they do not address these survival skills. This lack of knowledge does not empower homeless mothers but, rather, keeps them in a perpetual state of neediness. Another assumption this study makes is that it is harder to obtain a job or education if one is the sole caretaker of children. Although it is possible to obtain data that supports this assumption, this researcher felt it was unnecessary because this conclusion is obvious. Social work research justification. By becoming better acquainted with the coping and survival skills homeless mothers use to overcome homelessness, social workers will understand what is needed to serve this population appropriately. As social workers gain insight about these survival skills, they will be able to provide homeless mothers with skills that can help them to become self-sufficient. The National Association of Social Workers (NASW) Code of Ethics (National Association of Social Workers, 2008) states that one of the main goals of the Social Work profession is to enhance human well-being thus meeting the basic human needs of all people, with particular attention to the needs and empowerment of people who are 12 vulnerable, oppressed, and living in poverty. Social workers do this by promoting social justice and social change on behalf of their clients. In accordance with the NASW Code of Ethics, social workers can assist homeless people by understanding the experiences and survival skills homeless mothers have as these mothers move toward self-sufficiency. By having this knowledge, social workers will be better equipped to advocate on behalf of the homeless population in order to develop effective programs and provide homeless people with a better toolbox to overcome their obstacles of being homeless. Study limitations. The focus of this study is on homeless mothers; however, two fathers asked to participate in the study so their contributions were included. Generalizations to homeless fathers are not anticipated. This study was limited to the small group of homeless mothers residing in Tuolumne County, a rural community with limited resources. With that in mind, the findings in this study cannot be generalized to include all single mothers in all areas. Finally, the homeless women in this community were all Caucasians so this study cannot be generalized to other ethnicities. 13 Chapter 2 REVIEW OF THE LITERATURE Homelessness continues to be a tragic social problem that is experienced by single adults, families and unaccompanied youth. Individuals who are homeless represent our nation’s diversity and their individual characteristics and needs must be identified, respected, and addressed. There are many subgroups of the general population of homeless Americans. These subgroups include: age; gender; social unit (families vs. single individuals); racial or ethnocultural groups; health status (psychiatric illness, substance abuse, HIV/AIDS and those with a dual diagnosis); and, social status groups (such as veteran vs. citizen vs. criminal vs. illegal immigrant, etc. (Rosenheck, Bassu, & Salomon, 2011; Rossi, 1989; Burt, 1992; Robertson & Greenblatt, 1992). This diversity illustrates how difficult it is to be able to meet the needs and challenges of homeless individuals. This literature review will focus specifically on the subgroup of homeless mothers caring for children in a rural area. History of Family Homelessness During the Great Depression of the 1930’s, large numbers of able-bodied men were forced into homelessness along with their families due to unemployment rates that approached 25% (Rosenheck et al., 1999; Rossi, 1994; American Free Press, 2012; Miller, 1991; DeOllos, 1997). However, with the onset of World War II, the federal government provided employment for almost 218 million men and many millions of women virtually eliminating homelessness in America (Rosenheck et al., 1999; Duffield, 2001; Coates, 2007). During the 1950s, homelessness in the urban skid row was largely a 14 problem of older alcoholic men (Rossi, 1990; Levinson & Ross, 2007). With the advent of Social Security Retirement and disability benefits, poverty among the elderly declined from 50% in 1955, to 11% in 1975 (Rosenheck et al., 1999; Weir, Orloff, & Skocpol, 1988) with the risk of homelessness for older Americans being vastly reduced (Rossi, 1989). In spite of the above-mentioned statistical improvements, since the mid 1980s there has been a dramatic increase in the number of homeless women caring for their children (Bray, 2010; National Center on Family Homelessness, 2011; Novac & Bourbonnais, 1996; Meadows-Oliver, 2002). It is estimated that the ratio of homeless men to homeless women was three to two in 1999 (Rosenheck et al., 1999; U. S. Conference of Mayors (2007)). Women raising children constitute the largest subgroup of homeless families (Axelson & Dail, 1988; Bassuk & Cohen, 1991; Bassuk & Rosenberg, 1990; Hagen, 1987; Kozol, 1988; McChesney, 1986; Rafferty, 1991; Solarz, 1988; United States Interagency Council on Homelessness, 2010; National Law Center on Homelessness & Poverty, 2012; Jarrett & Tchen, 2012). In a comparison of homeless single men to homeless women, it is estimated that 40% of single men who are fathers are less likely to have been married and are not active caretakers (Rosenheck et al., 1999; Burt & Cohen, 1989; Calsyn & Morse, 1990). Homeless Families in Urban Verses Rural Communities Research indicates that homelessness is mainly an urban problem (National Coalition for the Homeless, 2009; Cummins, First, & Toomey, 1998; Choi & Snyder, 1999; Vissing, 1996). The percentage of homeless people that reside in rural areas is 15 roughly 7% to 9% (National Coalition for the Homeless, 2009; Henry, 2009; Cummins, First, & Toomey, 1998; Fitchen, 1991; U. S. Conference of Mayors, 2007). However, as mentioned above, research shows that families, single mothers, and their children make up the largest group of people who are now homeless in rural areas (Vissing, 1996; U.S. Department of Health and Human Services, Health Resources and Services Administration & Office of Rural Health Policy, 2005; Silver & Panares, 2000; National Coalition for the Homeless, 2009). Unfortunately, little is known about homeless women in rural areas (Cummins, First, & Toomey, 1998; Fitchen, 1991; Roth, Bean, Lust, & Saveanu, 1985; Roth, Toomey, & First, 1987; Cummins, 2001) or the applicability of the data gathered on urban homelessness to rural homelessness (Cummins et al., 1998; Center For Student Leadership, 2012; Miller & Weber, 2003). Research indicates that the causes of homelessness among women differ between those in urban areas versus those in rural areas. For example, women who become homeless in urban areas tend to do so because of alcohol and drug dependence (Anderson, Boe, & Smith, 1988; Bassuk, 1990; Stovall & Flaherty, 1994;Weinreb & Bassuk, 1990; National Coalition for the Homeless, 2009 ), a weak social network (Rossi, 1990; Solarz & Bogat, 1990; Stovall & Flaherty, 1994; National Coalition for the Homeless, 2009 ), mental illness (Buckner, Bassuk, & Zima, 1993; D'Ercole & Struening, 1990; National Coalition for the Homeless, 2009; Choi & Snyder, 1999), and domestic violence (Anderson et al., 1988; D'Ercole & Struening, 1990; Hagen & Ivanoff, 1988; Homeless Information Exchange, 1994; Zorza, 1991; National Coalition for the Homeless, 2009; Choi & Snyder, 1999). Homelessness in rural areas is most often 16 caused by economic factors such as the loss of energy-related jobs and the transition from an industrial society to a high-tech labor market (Cummins et al., 1998; Deavers & Hoppe, 1992; Flora & Flora, 1989; Housing Assistance Council, 1995; Hobbs, 1988; National Coalition for the Homeless, 2009; Cummins, 2001). Another difference between urban and rural homelessness is the fact that there are fewer resources available to rural homeless people compared with urban homeless people. For example, public transportation is much more accessible in an urban setting compared with a rural setting (Cummins et al., 1998; Bassuk, 1993; Burt, 1991; Housing Assistance Council, 1995; Karger & Stoesz, 1994). The lack of public transportation highlights another difference between urban and rural homeless, which is the distance one needs to travel to reach services designed to help homeless people such as shelters and childcare assistance (National Alliance to End Homelessness, 2010; Cummins et al., 1998; National Coalition for the Homeless, 2007). Those in rural communities often have to travel long distances to access services and, without public transportation it is very difficult for them to do so (Cummins et al., 1998; National Alliance to End Homelessness, 2010; Housing Assistance Council, 1995; Toomey, First, Greenlee, & Cummins, 1993; Bassuk, 1993; Burt, 1991; Karger & Stoesz, 1994). Causes of Homelessness Research has shown that homelessness has increased quite rapidly since the 1980’s with the subgroup of homeless families being the fastest growing group of homeless people (Rosenheck et al., 1999; Bassuk et al., 1997; National Center on Family Homelessness, 2011; National Coalition for the Homeless, 2009; U. S. Conference of 17 Mayors, 2009). According to The National Center on Family Homelessness (2011), Rosenheck et al. (1999) and many other researchers (Choi & Snyder, 1999; Cummins, First, & Toomey, 1998; U. S. Conference of Mayors, 2007; Vissing, 1996), family homelessness is caused by a combination of poverty, decreasing governmental monetary assistance, lack of affordable housing, no education, domestic violence, lack of positive social support systems, aging out of foster care, drug and alcohol abuse, and mental illness. What follows is a literature review regarding these causes of family homelessness. Poverty. The economic downturn beginning in 2007 resulted in the increase in the number of homeless families (U. S. Conference of Mayors, 2009; National Coalition for the Homeless, 2009). On the basis of a point-in-time estimate, Bray (2010) concluded that sixty-two percent of homeless people at that point were individuals, and thirty-eight percent were part of a family unit. Fifty percent of the people in the point-in-time survey were concentrated in five states. They were California, New York, Florida, Texas, and Michigan (Bray, 2010). While there are significant differences between extremely poor families with housing, and those families in the general population, few differences exist between extremely poor families with housing and those without housing (Bray, 2010). Homelessness has a connection to economic instability and an insufficient supply of affordable low-income housing (Bray, 2010). A significant majority of people who lose housing are extremely poor (Bray, 2010; United States Interagency Council on Homelessness, 2010; National Coalition for the Homeless, 2009). 18 Decreasing governmental monetary assistance. The safety net that our society has set up for the poor also is a contributing factor to the increase in the poor and homeless families because the financial assistance it provides is below the poverty level and some of the rules associated with the safety net are unreasonably burdensome (Choi & Snyder, 1999). For example, one of these programs was Aid to Dependent Families (AFDC). According to Choi & Snyder (1999), the dollar value of AFDC has been declining since 1975. Poor single mothers often have to depend on public assistance as a major income source, but the benefits they receive are not high enough to reach even seventy-five percent of the poverty line (Choi & Snyder, 1999). Temporary Assistance to Needy Families (TANF) replaced AFDC in 1996 under welfare reform, but this program also poses a threat to homeless families because the assistance is limited to five years and hinges on one’s ability to find a job yet most homeless mothers cannot find a job that pays enough to transition out of homelessness (Choi and Synder). Lack of affordable housing. For many of the poor, decent and affordable housing is an unattainable goal (Choi & Snyder, 1999). Since the 1980’s there have been economic booms and busts, however poor renters have an even tougher time trying to bear increasing rent burdens (Choi & Snyder, 1999), This is due to the fact that the income of poor people remained stagnant or dwindled in the face of gross rents increasing (Choi & Snyder,1999). Much of the rent increase is due to housing programs’ having been cut back since the 1980’s (Choi & Snyder, 1999). There has been a squeezing of subsidized and low-cost housing (monthly rent of $300 or less), and subsidized housing units despite an increasing number of poor renters (Choi and Snyder). 19 This increase in the numbers of poor renters is attributed to the increase of very-lowincome and single-parent families (Choi and Snyder; National Center on Family Homelessness, 2011; United States Interagency Council on Homelessness, 2010). In addition, according to Aratani (2009), between 1993 and 2003, the shrinkage of low-cost rental units by 13% was due to the loss of older, lower-quality apartments in the private market place. Lack of education. Another contributing factor that leads to homelessness is that homeless individuals are lacking academically when compared to the population at large (The National Center on Family Homelessness, 2011, Nunez, Collignon, Mellow, & Smith, 1998). Although the proportion of high school graduates is roughly comparable in the homeless and non-homeless populations, fewer of the homeless have attended college (National Center on Family Homelessness, 2011; Zugazaga, 2007; Arangua, Andersen, and Gelberg, 2006; Nunez et al., 1998). According to the National Center on Family Homelessness (2011), 53% of homeless mothers do have a high school diploma. Cosgrove and Flynn (2005) found that, out of 17 women interviewed in a shelter in the Northeastern United States, twelve had a least a high school degree, one woman had earned an associate’s degree, four had taken some college classes, six had graduated from high school, and one women had received a GED. Domestic violence. Domestic violence is a major factor of homelessness (Rosenheck et al., 1999, Caton, 1990, National Center on Family Homelessness, 2011). Over 92% of homeless mothers have experienced severe physical and/or sexual abuse during their lifetime (National Center on Family Homelessness, 2009). Sixty-two percent 20 of homeless mothers have suffered abuse by an intimate partner (National Center on Family Homelessness, 2009). The risk of victimization is heightened in neighborhoods plagued by extreme poverty in situations where women are alone and lack protection, and in their relationships with men who suffer addictions (Bassuk & Rosenberg, 1990). Not only is situational victimization a concern for homeless single women, homeless women both single and married often have had violent experiences as children that contribute to their plight of being homelessness (National Center on Family Homelessness, 2009). Choi & Snyder (1999) have identified domestic violence as a significant cause of homelessness rather than mental illness and/or substance abuse. Those mothers who are fleeing domestic violence are more than likely to become homeless because of problems of finding housing due to poor credit, poor rental and employment histories, and the fact that they have few tangible social supports (National Center on Family Homelessness, 2009; Bray, 2009). Compounding the problems faced by low-income women in violent relationships are the rules that govern public housing (National Center on Family Homelessness, 2011). Women who have experienced a violent situation may be evicted for a violent activity regardless of the cause of the violent act (National Center on Family Homelessness, 2011). This is known as a onestrike policy that might violate federal and state housing acts (National Center on Family Homelessness, 2011). Lack of a positive social network. Lack of a positive social network for homeless mothers contributes to the homeless mother’s situation. When people end up in shelters or on the streets it is because the safety net of supportive family and friends has 21 failed (Caton, 1990). Social networks are often based on reciprocity. Homeless people have little to exchange and, therefore, they find themselves isolated. The lack of possessions, neighborhoods, and important attachment figures such as extended family members and friends, is destabilizing for children and adults alike (Cowan, 2007). Families who have experienced homelessness have a much higher rate of family separation than other low-income families (National Center on Family Homelessness, 2011). The separation of families many times is dictated by the shelter system. According to the US Conference of Mayors (2009), about fifty-five percent of cities surveyed reported that families may have to break up in order to be sheltered. Aging out of foster care. Being placed in foster care as a child is a predictor of family homelessness during adulthood (National Center on Family Homelessness, 2011; Bray, 2009). Mothers with a childhood history of foster care placement are more likely to become homeless, and they tend to become homeless at an earlier age than those who do not have a foster care history (National Center on Family Homelessness, 2011; Bray, 2009). Many homeless mothers who have been in foster care simply grew up, and out of childhood or foster care and have established their own families without having developed the skills to live independently (Nunez et al., 1998). The pathway between foster care and adult homelessness is complex (Herman, Susser, & Link, 1997). Families without homes are more likely than those that are housed to have their children removed and placed in foster care systems (Bassuk et al., 1997). By some estimates, up to thirty percent of children in the foster care system have parents who are living without homes (Harburger & White, 2004). 22 Drug and alcohol abuse. Homeless parents, the majority of whom are single mothers, are more likely than mothers who are homeless and married to have abused drugs (National Center on Family Homelessness, 2111). However, mothers experiencing homelessness have the twice the rate of struggling with drug and alcohol dependence when compared to housed mothers (National Center on Family Homelessness, 2011; United States Interagency Council on Homelessness, 2010). Bassuk, Buckner, Perloff, and Bassuk (1998) found that the difference in substance use disorders between housed mothers, and those who were not housed disappeared when income was controlled. It was also concluded in their research that substance abuse may be more a result of poverty than simply of being labeled homeless. Mental illness. Mothers experiencing homelessness struggle with mental health issues (National Center on Family Homelessness, 2011). There appears not to be significant differences in mental disorders between housed and non-housed mothers (Bassuk et al., 1998). However, the rate of mental illness among people who are homeless is higher when compared to the general population (Bassuk et al., 1998). And, about 50 percent of homeless mothers experienced a major depressive episode since becoming homeless which is twice the rate of women in the general population (National Center on Family Homelessness, 2011; Bray, 2009). Women living in shelters as compared to homeless women living on the streets have a significantly increased risk of depression (Bray, 2009). While mental illness may lead to problems that result in homelessness, it does not appear to be a significant factor on its own (Bassuk, et al., 1998). The symptoms of 23 mental illness and substance abuse may not only contribute to a person’s vulnerability for homelessness, but it may also be exacerbated by the experience of being homeless (O'Hara, 2007). Coping Skills Traditional coping theories define coping as an interaction between the individual and the perceived stressful situation (Banyard, 1995; Billings & Moos, 1981; Folkman & Lazarus, 1980; Pearlin & Schooler, 1978). According to these theories, coping consists of various stages that include appraising the situation, investigating the situation, determining what coping options are available and acting upon these assessments (Banyard, 1995; Billings & Moos, 1981; Folkman & Lazarus, 1980; Pearlin & Schooler, 1978). Some researchers have concluded that coping mechanisms fall into two main categories: coping with the problem directly; and, coping with the emotional impact of the situation (Banyard & Graham-Bermann, 1998; Folkman & Lazarus, 1980; Pearlin & Schooler, 1978). Other researchers believe there are three categories of coping: activebehavioral; active-cognitive; and, avoidant (Banyard & Graham-Bermann, 1998; Moos, Cronkite, & Finney, 1984). The problem with these traditional coping theories is that they seem to assume women rely less on action or problem-oriented coping and more on emotion-based coping, which is not the case based on subsequent studies (Banyard, 1995; Banyard & Graham-Bermann, 1993; Milburn & D'Ercole, 1991; Dill et. al., 1980; Fine, 1985). Another inadequacy of these theories is that they do not examine the ways that accessing resources may impact the level of stress homelessness causes, how homelessness as a situation is appraised by homeless mothers and the range of coping 24 responses that are available to them (Banyard, 1995; Banyard & Graham-Bermann, 1993; Dill et. al., 1980; Fine, 1985; Lykes, 1983). Another complication a researcher faces when analyzing the coping mechanisms of homeless women is that each woman is a unique individual with a unique sense of herself. How a homeless woman feels about herself morally and intellectually significantly influences her ability to cope (Milburn & D'Ercole, 1991; Pearlin, Lieberman, Menaghan, & Mullan, 1981). Given this, standardized methods of categorizing coping mechanisms may be inadequate (Milburn & D’Ercole, 1991). One of these standardized methods used in some of the studies cited herein is the Family Crisis Orientated Person Scales or F-COPES (Tischler & Vostanis, 2007; McConachie & Waring, 1997; Wagner & Menke, 1991 ). F-COPES was developed by McCubbin , Olson & Larson (1991). According to Tischler & Vostanis, the F-COPES consist of the following items: Reframing (looking at the situation in a positive manner); Acquiring Social Support (developing relationships with others who can help in some way); Mobilizing the Family (searching out and utilizing help from community resources and other agencies); Passive Appraisal (minimizing one’s response to difficulties); and, Seeking Spiritual Support (relying on prayer, religious/spiritual beliefs). What follows is a literature review of the studies conducted that pertain specifically to the coping mechanisms used by homeless mothers. These coping mechanisms will be broadly categorized according to the three categories (activebehavioral; active-cognitive; and, avoidant) mentioned above from the work of Moos et al. (1984) even though some of the studies did not rely on the work of Moos et al. 25 Active-behavioral coping mechanisms. Active-behavioral coping mechanisms include, but are not limited to, direct confrontation of daily stressors (Banyard, 1995), acquiring social support (Banyard, 1995; Wagner & Menke, 1991; Tischler & Vostanis, 2007; Milburn & D'Ercole, 1991; Gladstone, 2008; Shinn, Knickman, & Weitzman, 1991; Thrasher & Mowbray, 1995), and investigating options/resources and then creating a plan of action (Banyard, 1995; Banyard & Graham-Bermann, 1998; Tischler & Vostanis, 2007; Wagner & Menke, 1991). Some researchers found that these direct problem-solving strategies occurred more often in those who had endured long periods of stress (Banyard & Graham-Bermann, 1998; Holahan & Moos, 1990). Direct confrontation of daily stressors. Banyard (1995) states that almost all (97%) of those she interviewed directly confronted their daily problems. Some examples Banyard offers are: confronting rude shelter staff; talking to the supervisor of an unhelpful caseworker; and, using various forms of discipline to set limits for their children. Acquiring social support. As mentioned above, the F-COPES (McCubbin et al., 1991) was used by some researchers, who found that a coping mechanism among homeless women is to utilize social networks to overcome various problems (Wagner & Menke, 1991; Tischler & Vostanis, 2007). Research has suggested that coping styles are significantly related to an individual's capacity to use resources such as social support (Milburn & D'Ercole, 1991; Pearlin & Schooler, 1978) Some examples of utilizing social networks as a means of coping with homelessness that the researchers provided included doubling-up and living 26 intermittently with friends and relatives as a source of temporary shelter before entering the public shelter system (Gladstone, 2008; Shinn, Knickman, & Weitzman, 1991; Thrasher & Mowbray, 1995). Banyard (1995) found that 89% of the women she interviewed sought social support from other people, including family, friends, shelter staff, and shelter residents, to cope with everything from housing to interpersonal difficulties. According to Banyard (1995), 17% of the women she studied developed some kind of group identification with other women in the shelter in the context of discussing how they were coping with being homeless or living in the shelter. Banyard found that these women were able to see their own situation in the lives of others, which, in turn, helped them develop a sense of comfort and strength. She explained that these connections helped to reduce feelings of isolation and marginalization. Investigating options/resources and then creating a plan of action. Banyard and Graham-Bermann (1998) found that many homeless women investigated their situation to find out all they could about their options, created a plan of action and followed it. Some researchers, through the use of the F-COPES (McCubbin et al., 1991), stated that mobilizing the family in an attempt to obtain help from community resources and other agencies was a form of these coping mechanisms (Tischler & Vostanis, 2007; Wagner & Menke, 1991). Banyard (1995) refuted the notion that women are more emotion-focused in their coping efforts (Folkman & Lazarus, 1980; Stone & Neale, 1984). The women in Banyard’s study were often quite active in their coping efforts. Banyard explains that 27 these mothers reported spending long hours looking for apartments or calling agencies for financial help and they did a great deal of planning both for the present and the future. Active-cognitive coping mechanisms. Active-cognitive coping mechanisms include, but are not limited to, distancing (Banyard, 1995), patient endurance (Wagner & Menke, 1991; Tischler & Vostanis, 2007; Banyard, 1995), reframing or thinking positively (Wagner & Menke, 1991; Tischler & Vostanis, 2007; Banyard, 1995), and prayer (Wagner & Menke, 1991; Tischler & Vostanis, 2007; Banyard, 1995). Distancing. Banyard (1995) found that distancing oneself from daily pressures helped 44% of the women in her study cope with being homeless and the problems that arose from shelter life. Banyard uses such examples as going to one’s room to be alone and going to a park with her children. Patient endurance. Again, as mentioned above, the F-COPES (McCubbin et al., 1991) were used by some researchers, who found that some homeless women utilize passive appraisal as a coping mechanisms (Wagner & Menke, 1991; Tischler & Vostanis, 2007). According to Tishchler & Vostanis, passive appraisal involves simply being patient and calm in response to being homeless. According to Banyard (1995), having patience and doing what one could to put aside the stress of homelessness was the third most common coping response. Banyard provided examples of such as taking one day at a time and trying not to dwell on circumstances beyond their control. Banyard points out that these women were not accepting their situation or avoiding it but rather dealing with it by reserving their energy until such a time that it could be used most effectively. 28 Reframing or thinking positively. Some researchers who used the F-COPES (McCubbin et al., 1991) found that many homeless women cope by reframing, which is described as a coping mechanism whereby stressful situations are handled by looking at the positive aspects of the situation (Wagner & Menke, 1991; Tischler & Vostanis, 2007). According to Banyard (1995), positive thinking is an emotional coping technique and manifests in ways such as self-statements to reassure oneself. Banyard posits that such responses may lessen the impact of the stress of being homeless and help to preserve enough hope and self-esteem to enable these women to take action in other areas where they have more control. Banyard gives examples such as talking to oneself in a reassuring and positive way and looking for the positive side of the situation. Prayer. The same researchers mentioned above who used the F-COPES (McCubbin et al., 1991) found that homeless women use prayer or seeking spiritual support as a means of coping with being homeless (Wagner & Menke, 1991; Tischler & Vostanis, 2007). According to Banyard (1995), prayer seemed to provide homeless women with the power to deal with difficult decisions and space in which to think about their situation. Banyard found that church seemed to help relieve the burden of homelessness it was a source of comfort because they knew they were not alone and were being cared for as well as perhaps helping them to find a larger meaning in their experiences. Avoidant coping mechanisms. Avoidant coping mechanisms include, but are not limited to, the use of alcohol and drugs (Banyard, 1995; Gladstone, 2008; Bassuk & Rosenberg, 1988; Weitzman, Knickman, & Shinn, 1992; Milburn & D'Ercole, 1991; 29 Tischler & Vostanis, 2007; Nyamathi, Longshore, Galaif, & Leake, 2004; National Center On Family Homelessness, 2011; Milburn & D'Ercole, 1991), denial (Banyard & Graham-Bermann, 1998), not expressing one’s feelings (Banyard & Graham-Bermann, 1998) and finding distractions (Banyard, 1995). Use of alcohol and drugs. In general, alcohol and other drug problems are reportedly less prevalent among homeless women than among homeless men (Robertson, 1991). According to Robertson, homeless women with dependent children are a distinctive subpopulation among homeless adults, with lower rates of substance use and related problems compared with homeless men or homeless women without children. Robertson states that estimating the use of alcohol and other drug abuse in homeless mothers is difficult because the ability to estimate such use is limited by the scarcity of empirical data. Milburn and D'Ercole (1991) found that even though one third of all homeless people suffer from chronic substance abuse the estimates of alcohol and drug problems among homeless women vary dramatically. According to Milburn & D’Ercole, various studies offer estimates ranging from 3% to 36% for alcohol disorders and 3% to 26% for drug disorders. Milburn & D’Ercole note that these variations across studies reflects the differences among homeless women, as well as differences in sampling methods, definitions of the disorder, assessment techniques, and sites of the studies. Tischler and Vostanis (2007) point out that drug and alcohol abuse has been commonly reported in previous studies of homeless women but the studies are inconsistent and, therefore, important data on coping strategies in this area may have been missed. 30 In spite of the above-mentioned limitations, Robertson feels that the available literature does suggest a high prevalence of alcohol and other drug use and related problems among homeless women with children compared with other poor women with children. In fact, many researchers have found that homeless mothers are more likely than housed mothers to abuse drugs (Gladstone, 2008; Bassuk & Rosenberg, 1988; Weitzman, Knickman, & Shinn, 1992). Denial. Banyard and Graham-Bermann (1998) found that denial was a form of coping. In their study they found that some homeless mothers simply refused to believe they were really homeless. Not Expressing. FeelingsBanyard and Graham-Bermann (1998) found that many of the women in their study coped with homelessness by keeping their feelings to themselves. Those that did this had very low levels of trust in other people and felt keeping all their emotions bottled up was the best way to navigate through their plight. Distractions. Banyard (1995) found that many homeless women in her study did things that distracted them from reality. Some examples Banyard gives are painting one’s nails, cooking and reading. Banyard notes that these behaviors are different from the avoidance techniques noted above in that they were productive and positive because they insulated these women from the emotional trauma of being homeless by providing a break from the constant fretting and drudgery of some of the tasks that needed to be completed like chores, searching for resources and the general stress of shelter life. Combining coping mechanisms. Many of the researchers noted that homeless mothers utilize a variety of the above-mentioned coping mechanisms (Wagner & Menke, 31 1991; Banyard, 1995). According to Banyard, 90% of those she studied used more than one coping strategy. Banyard further explains that of those 90%, 83% of them reported using a combination of emotion-focused and problem-focused coping techniques. Banyard points out that there was some overlap between the categories of coping strategies. She provides the example of how homeless women use their children. According to Banyard, sometimes children were a means of distancing (going to the park with one’s children to escape the shelter) and other times they were a source of motivation (getting on the phone to find services in order to protect one’s children). Banyard and Graham-Bermann (1995) point out that the coexistence of contradictory coping mechanisms, such as confrontational and avoidant, indicates that increased stress precipitates an elevation in all coping efforts. Gender Factors When the numbers of homeless families began to increase, it became evident that the ratio of men to women who are homeless is 3:2 (Rosenheck, et al., 1999). Women now comprise more than one-fifth of the overall homeless population (Burt & Coohen, 1989; Calysn & Morse, 1990). When contrasting differences between the men and women who are homeless, it is estimated that forty percent of homeless men who are fathers are less likely to have been married than unmarried and they are not active care takers of their children (Rosenheck, et al. 1999). Examples of other gender differences between homeless men and women is that homeless women have limited earning power, job skills, education, differences in health issues, and are overwhelmed by childcare responsibilities (Bachrach, 1987; National Center on Family Homelessness, 2011; 32 Rosenheck, Bassuk, & Salomon, 1999). Both Rosenheck et al. (1999) and Fisher (2000) state that female-headed households are generally poorer due to the presence of a single income and the cost of child care. Single women do not have a realistic place in the current labor market that is designed to support nuclear families with male breadwinners. An example of this is the gap between women’s and men’s income, and occupational and gender related discrimination. Women earn less over their lifetime then men do, however the economic burden of divorce often falls on their shoulders (Rosenheck, et al. 1999; Hagen, 1987). For women with limited education and job skills the economic picture becomes even bleaker because many homeless mothers have worked sporadically at low-paying service jobs (Rosenheck, 1999). Examples of these are sales clerks, waitresses, cashiers, and babysitters. It needs to be mentioned here though that generally speaking homeless women were not working at any of these jobs the year before they became homeless (Hagen, 1987). Homeless mothers report higher rates of health problems than other homeless people (US Interagency Council on Homelessness, 2008; Rog, Holupka, and Patton (2007). Some examples of homeless mothers’ physical problems are that onethird had a chronic physical health condition such as asthma, chronic bronchitis and hypertension (The National Center on Family Homelessness 2011; US Interagency Council on Homelessness, 2008). They have ulcers at four times the rate of housed mothers, and twenty percent have anemia as compared to two percent of other women under the age of forty-five (US Interagency Council on Homelessness, 2008; The National Center on Family Homelessness, 2011). 33 Summary This chapter reviewed previous research studies by starting with comparing homeless families in urban verses rural communities. The causes of homelessness which included poverty, decreasing governmental monetary assistance, lack of affordable housing, lack of education, domestic violence, lack of a positive social network, aging out of foster care, drug and alcohol abuse, and mental illness were outlined next. The chapter also reviewed the coping skills or strategies that homeless mothers use. These skills were divided into groups. They are the active-behavioral, active-cognitive, and avoidant. The active-behavioral coping mechanisms include direct confrontation of daily stressors, acquiring social support, and investigating options or resources that led to creating a plan of action. Distancing, patient endurance, reframing or thinking positively, and prayer were cited examples of active-cognitive coping mechanisms. Avoidant coping mechanisms are the use of alcohol and drugs, denial, not expressing feelings, and distractions. Previous research also indicated that coping mechanisms that the homeless mother uses can be combined at times. The chapter ended with a comparison of male and female coping mechanisms. The coping strategies outlined in this study by other researchers were similar to what was discovered in this study. However, this research differed from other studies that have been conducted because not many studies have been conducted in rural areas, and in particular not in Tuolumne county. In addition, a consideration for this research study was that the researcher had been working with the homeless for the past twelve years and observed coping strategies that the homeless mother used. The researcher was 34 seeking a better understanding of these coping skills hoping that the discoveries in the study would assist the researcher to be able to serve the homeless mother with clearer understanding. Some questions that previous research and the present research have not answered include how would coping mechanisms differ between the sheltered versus the unsheltered homeless mother? Would the camaraderie diminish between participants if they were living in a homeless camp? If basic survival life skills were taught to individuals in childhood, would the results produce independent thinkers as adults, and perhaps prevent homelessness in some individuals? In conclusion, homeless among mothers is an urgent social problem that those working with these individuals need to see through new lenses if we are to make any difference in these mothers’ lives and the lives of their children. 35 Chapter 3 METHODS Study Objectives As stated previously, the purpose of this study is to explore the coping strategies of homeless mothers. This research was conducted using a qualitative exploratory design and uses a qualitative method. Exploratory research designs are used with topics about which very little information is available (Royce, 2011). Research indicates that exploring the coping mechanisms of homeless mothers, both single and married, has not been studied extensively. The primary purpose of the qualitative approach is to sift and sort the masses of words collected from the research participants in such a way as to derive patterns related to the research topic (Williams, Unrau, & Grinnell, 1998). Qualitative research methods are valuable tools for helping individuals to understand clients and the world in which they live. The analysis used in this study will be narrative in nature. As categories emerge, a codebook will be created to reference each category. In this case, the themes recorded will be gathered from oral communication and will make inferences based on the incidence of these codes. As the data is collected, and patterns emerge, these patterns will be grouped into common themes. The reader must be cautioned that the researcher’s conclusions will be made at one point in time. The researcher’s assumption is that homeless mothers do learn to adapt to their homeless situations and choose and reject certain strategies in order to survive their lived 36 experience. It is the hope that these skills will become apparent in interviewing the mothers. Previous research points to the fact that there is an increase in the numbers of single homeless mothers in our society today. Uncovering how homeless mothers cope with their homelessness will provide insight for those working with homeless mothers to understand what coping skills they use in an effort to improve the homeless services provided to these women. Study Design The participants for this study were homeless single women, homeless married mothers, and two fathers who were housed in Tuolumne County’s local family homeless shelter and The Center for Non-violent Community Shelter. One participant was living in one of homeless camps in the county, and came into the Lambert Center (a drop in center in the county) to be interviewed. Two of the participants were single homeless woman who never had had any children. One of the women was interviewed at the Center for Non-violent Community Shelter, and the other woman came for services at the David Lambert Center where the researcher was placed at an internship. Two of the participants were men that were residing at the Family Shelter when a focus group was conducted there. One of men was married with two children, and the other man was single and had one child with him at the time of the interview. All of the participants were over the age of 18, residents of Tuolumne County, Caucasian, were not working, and had been homeless at a previous time in their life. 37 Sampling Procedures The researcher interviewed a total of 10 individuals using questionnaires developed by the researcher (see Questionnaires, Appendix A and B). The researcher had spoken before any interviews took place to the Director of the Family Shelter and outlined the intention of the study. See Appendix C requesting permission from the Director to use the shelter as a point of contact for the interviews. The one interview held at the Family Shelter was a small focus group consisting of two married individuals. At the end of the focus group, a single homeless father wanted to be interviewed, and the researcher did so. Two other female participants were interviewed individually at their request. Data Collection Procedures In the initial stages of planning this research, the target number of mothers to be interviewed was to be eight. As it turned out, the researcher had the privilege of being able to interview ten people. The interviews were to be focus groups with the possibility of some participants being interviewed by snowball sampling. Snowball sampling is defined as individuals who are referred to the researcher by other participants (Royce, 2011). The researcher had one person who was referred to me by another co-worker, but we did not have the opportunity to meet each other. Initially, it was also intended that the demographic information of the participants in the focus groups would be provided to the researcher by the manager of the shelter/shelters, however, due to logistical challenges; the demographics were included in the interview process. 38 Each participant was given a consent form to sign before the interviews began. In all cases, the participants agreed to be tape recorded along with the interviewer taking notes as the participants were speaking. At the conclusion of the interview, each participant was given a $10 gift certificate to Wal*Mart as a thank you gift. Measurement. As stated elsewhere, this study involves homeless mothers with children between birth and 18 years of age. A questionnaire was prepared and approved by the Director of the Shelters and it was administered orally to focus groups that were assembled by the shelter staff. The answers were divided into themed categories of two to six depending upon the topic. Instruments The instruments for this study included 2 questionnaires, one designed for individual interview and another designed for use in a focus group. The focus group questions were not directed to anyone in particular but to the group at large. The types of questions included demographic questions, questions regarding the participants’ history of homelessness, questions regarding the cause and effect of homelessness on themselves and their children and questions regarding how the shelter staff and general community could improve in the area of helping homeless people. The questions were asked in an open ended manner with an effort to avoid leading questions. Data Analysis The data from this study was collected and analyzed using an ethnographic approach. Data analysis in a qualitative study involves what Creswell (1998) describes as 39 a data analysis spiral. A data analysis spiral begins with the raw data which is conducted using the following steps: organization (file creation, creation of computer data bases, sorting ideas in to subcategories); perusal (getting an overall sense of the data and starting a list of ideas regarding interpretations); classification (grouping the data into categories or themes and looking for the meaning of it all); and, synthesis (posing hypotheses, creating visual aids such as graphs to convey the author’s points) (Creswell, 1998). Once this is all complete, one then finalizes the report (Creswell, 1998). Protection of Human Subjects The participants in this study were each given a consent form, which all participants agreed to sign. There also was agreement among the participants that they could be audio taped. At the conclusion, the interviews, all tapes, and written notes by the researcher were locked in a metal box. See Appendices A and B for a sample of the questions used. The Sub-Committee for the Protection of Human Subjects of the Division of Social Work at California State University, Sacramento, approved this research protocol. 40 Chapter 4 STUDY FINDINGS AND DISCUSSIONS Nine of the participants in this study were in public housing provided by the county of Tuolumne. One was homeless but living outside of the family shelter. All but one parent had children who were dependent on them. The findings that will be presented in this chapter were the result of interviews of mothers and fathers that were housed either in Sonora's family shelter managed by Amador-Tuolumne Community Action Agency (ATCAA). One participant was living outside of the shelter, and the remaining of the participants was living in housing managed by the Center for a Non-Violent Community. This chapter examines the results of the 10 interviews with eight women and two men. A sample of the questionnaire is presented in Appendices A and B. Nineteen questions were presented in separate focus group. One of the focus groups contained three parents; the other focus group consisted of five parents. A different set of twentythree questions was presented to two individuals that requested they be interviewed after learning that a survey was being conducted. Three parents were asked to interview in the first focus group, and three complied, with a success rate of 100%. Five parents were asked to interview in the second focus group, and five complied, with a success rate of 100%. The demographic information in all the groups was presented as separate questions. Originally, this researcher had planned on receiving the demographic information from the manager’s of the housing units before the interviews took place. This seemed to be inconvenient for the manager’s, so all groups and individuals were 41 asked their demographic information as separate questions. Included in this category was employment, education level achieved, length of current stay in a shelter, and number of children living with the participant. The first set of questions centered on their past experiences in shelters, such as what lead to their homelessness, had they been homeless in the past, what steps were taken to prevent being homeless, and challenges faced finding housing. The next questions centered on their current shelter experiences, such as how homelessness changed your life and your children’s lives, what has helped you coping with your difficulties in being homeless, and where how do you draw your strengths in this situation. The last set of questions asked about their future plans to avoid homelessness. There was one question left open for the responder to add anything that they thought the researcher left out or should know. The data was analyzed for themes, which will be presented here in narrative explanations and graphs. The demographics of the participants will be presented first. Next a presentation of themes from the open-ended interview questions will follow and a summary of important findings will conclude the chapter. Overall Findings Overall the participants in this study were using their experience of homelessness to expand their world view and to do accomplish a personal compilation of their situation. They were now able to be themselves. One participant commented surprisingly, “I can now embrace my womanhood.” This particular individual had been in an abusive relationship previously that required complete dependence on her male partner 42 for survival. The freedom she now enjoyed allowed her to be the woman she wanted to be without the disability of negative restraints. Another participant stated, “I have a new appreciation of life. Nothing is more important than a person's freedom.” Both of these individuals were experiencing the joy of being free to be themselves and to make choices without being told how bad or negative or stupid they were. Many of the participants stated that they had always wanted to stand up for themselves but lacked appropriate skills to do so. Now they were given a new set of skills, proper motivation, and a sense of renewed determination. Specific Findings The researcher obtained this demographic data at the time of the interviews. The responses were obtained by verbal inquiries to the participants. As has been mentioned previously, this researcher’s original intention was to have the participant’s demographic information before the focus groups took place. However, this researcher discovered that asking the demographic information before the interview questions appeared to put the participants at the shelters at ease. The participants at the Sonora Shelter were willing to provide their demographic information. At the Center for a Non-Violent Community some of the participants disclosed only portions of their relevant data. Demographics. A summarization of the demographic information is presented below. 43 Table 1. Gender Male Female 20% 80% Table 2. Race/Ethnicity Caucasian Native American 90% 10% Table 3. Age (two participants chose not to disclose) 18-24 years of age 25-39 years of age 57% 43% Mean age 25.857 Table 4. Number of Children Living with Participants No child 1 child 2 children 3 children 10% 30% 30% 30% Mean number of children 2 Table 5. Marital Status Married Married but separated Single 20% 30% 50% 44 Table 6. Length of Stay at Current Shelter (two participants chose not to disclose) 14 days or less 15 – 30 days 30 days Table 7. Level of Education GED High School Diploma Some College Bachelor’s Degree Interpretations to the Findings Past employment experiences. When it came to the participant’s answers regarding employment past and present, the theme was that they all were employed in the past, but the effort to stay employed was too overwhelming for them, therefore they were all presently unemployed but seeking employment. They now acknowledged the importance of being employed but realized that additional training would be necessary in order to be able to provide adequately for their families. Several of the participants stated that they did not have the luxury of limiting their job choices to those that resonated with their hopes and dreams regarding a career because they needed to overcome their stigma of homelessness. As one mother stated, “I have finally realized that if I am going to support my family I am going to have to work. I need money, but I want to earn it in a meaningful, positive way that would eventually benefit my family.” 45 The participants had worked in a variety of vocations, including unskilled labor, skilled trades, and professional vocations. The unskilled labor category included the food service industry, retail, child care, customer service, and monitoring video cameras in a casino. The skilled trades included working in construction, operating a computer, tending bar, owning a bakery, tracking a company's profits and losses, acting in local theater groups, repair and construction of roadways, hairdressing, and caring for patients. One participant from a professional trade reported that she had had a teaching position in the past. However, the participants encountered numerous obstacles when they ventured out of the shelters looking for employment. One of the fathers stated that he was instructed by the shelter staff to go to Job Connection for assistance with job-hunting. This agency was located across town, so it took him considerable time and effort to get there. However, the venture proved fruitless, since there were no jobs available for him. In addition to going to Job Connection, the participants were also told to look for newspaper ads and to search for employment and find positions themselves. Even when the participants had jobs they had trouble keeping them due to lack of dependability and not fully understanding the scope of the job. Another difficulty for the participants was being dismissed from a job for reasons they felt were beyond their control. These included lack of transportation or car problems, lack of child care, an unexpected emergency, failure to set their alarm clock, lack of any reliable system to remind them of the schedule for any particular day, and a lack of money. Furthermore, they tended to blame the employer for a lack of understanding of their situation. 46 Past experiences that contributed to being homeless. The theme that surfaced was that all of the participants had been homeless in the past either as a child or an adult. Their homeless experiences varied from living with family and friends or in motels to living in cars and/or on the street. They participants accepted their homelessness because they had experienced it in the past. A number of the participants stated that they had been homeless previously with their mothers. Homelessness had become an accepted way of life for them. Some of the participants were not raised in a secure, loving home, and they lacked the necessary life skills to survive. The two fathers observed that they felt their childhood in foster care had a great deal to do with their homelessness today. They were fed, housed, and clothed, but they had no idea about the world outside their foster care home (should I reference here). As one of the fathers noted, “I did not know how to survive when I turned 18; they just dumped me on the street. I had to learn to survive in the world on my own.” One participant realized her desire to be loved and her naiveté resulted in her subsequent homelessness. She stated that she had owned her own home before she became involved with her last partner. She consequently lost her home and everything she had because she thought she would keep her partner if she signed everything over to him. When he kicked her out, she did not realize that he would now have control of all her property. This client also mentioned that her partner wanted her out of his life because she was pregnant and refused to have an abortion. Past coping strategies used when homeless. A defense mechanism that some participants used to block out the ugliness of their homelessness was to sink into 47 depression and avoid thinking about their problems. When interviewed, they stated that they did not realize how depressed they were until the shelter staff pointed out the problem to them. As they were able to recognize and deal with their feelings, they also realized the benefits of improving their self-worth and self-esteem as they worked with the staff and community resources. The parents were not the only ones affects by the family’s homelessness. A common theme among the respondents was that when they became homeless their children showed increased stress and anxiety, which in turn affected their behavior. One of the changes was an increase in acting out. One father noted that his daughter's grades suffered when they were homeless, and because of this she was put back two grades. This same father also stated that his other child had to enter counseling and was subsequently put on medication. Many of the participants observed that since coming to the shelter, many children had a hard time understanding the rules, which are different from what they encountered prior to entering the shelter. One mother stated, “Since living in the shelter, my older child is now looking out more for her younger siblings. She reminds me of my responsibilities as a caregiver.” On a positive note, this same mother said that she now has more time to listen to her children and that they are now more affectionate to her and to each other. She added that her family is now more relaxed, since they are no longer living with their abusive father. She also stated that being able to finally speak up for herself was an empowerment and strength that she had never had before. 48 Past survival skills utilized including sexual favors in exchanged for necessities. Several of the women stated that they had used a bartering system (Zugazaga, 2007) in which they exchanged sexual favors for food, physical protection, and other goods. This bartering system became a “necessity” when the participants realized that in order to keep their children they had to have a place for them to live. This included not only a place fit to live, but also such essentials as food, water, heat and cooling, and refrigeration of some sort. Other survival “skills” included using drugs and alcohol to block out reality, smoking cigarettes for comfort, and in some cases selling drugs for income (Novac, & Bouronnaise, 1996). Obviously, using these behaviors to survive eventually would lead to physical problems for the participants, such as respiratory and sexual ailments (Arangua et al., 2006). In addition, some of their survival techniques led to mental deterioration (US Interagency Council on Homelessness, 2010). The participants accepted that they had to live on the fringes of society in order to survive. According to the participants, lying and stealing also became a way of life to ensure their survival (National Center on Family Homelessness, 2011). Several women stated they would lie to get what they wanted or needed to stay ahead of the game. Stealing was also a beneficial survival skill because whatever was stolen could either be used for themselves or family or else be sold for monetary gain. The participants stated that whenever possible they took advantage of their friends and family (Cosgrove & Flynn, 2005). For example, they would lengthen their stay with individuals and not contribute to household expenses. They would also request the use of the friend's car, 49 knowing full well that they did not have a driver's license or car insurance. The participants would expect the person they were living with to care for their children whenever asked to do so. One woman admitted, “I relied on the good-heartedness of people. I burned my bridges behind me. That's why I'm in the homeless shelter now, and this is a different ballgame.” Even with these survival skills, most of the participants realized they needed comfort or guidance from a higher power All the participants in this study felt that accessing their faith (Banyard, 1995) eased the situation for them, even if they did not always abide by the tenets of belief. However, under dire circumstances it gave them someone or something else to lean on. Current shelter experiences. Generally speaking, the participants agreed that they were grateful to have a place to live. However, several mentioned that they felt the shelter staff did not understand the unique needs of the homeless. The following are indicative of some of their primary needs that were not recognized by the staff. All but one of the participants felt that the shelter should relax its expectations regarding rules and regulations for the residents (Banyard, 1995). The reasons given were that they had too many more important things to do, such as finding work, caring for their children, looking for housing, and attending required meetings. One participant said, “By the time the day comes to an end, you are worn out and just want to sit and relax.” The theme that surfaced in regard to the shelter rules and regulations is that the participants in this study felt they should be granted privileges because they had a lot of responsibilities to fulfill in a limited amount of time. On a lighter note, one participant stated that she was completely happy at the shelter, which was like home to her. “I liked 50 the shelter's rules,” she added, “because I knew what was expected of me and my son.” Some of the participants found these rules and regulations unrealistic when it came to looking for employment. One father who talked about the lack of assistance at Job Connection also felt that the shelter should have a computer that the residents could use to assist them in finding a job, instead of having to travel across town to another agency or to search for employment on their own without a vehicle. Both of the shelters are located in the downtown area of Sonora. However, the service agencies, as well as most jobs that are available in the county, are located away from the downtown area. Since most homeless individuals lack a car, not to mention money they have difficulty finding a job. There was only one participant in this study who had her own car. The rest were without any vehicle. Lack of personal transportation not only affected their ability to find and keep a job, but there were other hindrances to finding employment and ending their homelessness. As has already been noted, all but one of the participants had children with them, but there were no child care services available at the shelter. Both of the shelters expected the participants to be able to care for their own children. They were also expected to fulfill a list of requirements enabling them to end their homelessness. The list included the obvious, such as finding a job and locating housing. It also included practical matters, such as attending court in order to clear up a record and setting up a payment plan with creditors. One of the participants stated that she wanted to find a job but did not have enough money to pay for child care. There is an agency in the county 51 that does provide free child care, but applicants are required to go through several steps before their children are accepted into the program. Some found the process discouraging because it was confusing to them. The steps to gain acceptance involve filling out paperwork, arranging transportation to the agency, testing drug-free, etc., after which they are put on a waiting list. The “fly in the ointment” is that homeless people lack jobs and therefore income and tend to feel as if they are on a dead-end street. Because the participants lack financial resources, one person suggested that the shelter should have a system for lending emergency funds to the residents until they could obtain a regular income. In addition to food and shelter, the participants were confronted with other expenses before they could remedy their homeless situation. Some that were mentioned included obtaining a birth certificate, legal paperwork to clear a felony, outstanding warrants, unpaid fines (for instance, driving without a license), and money to pay off debts, as well as unexpected occurrences. However, bad credit is the most common obstacle. A low credit score excludes them from low income housing, and in addition they have to show that they have enough income and its legal source in order to qualify. An applicant’s income has to be 1/3 over the amount of their rent (Choi & Synder, 1999) which in itself creates a huge obstacle for them overcome. Current survival skills while in the shelter. Living in a homeless shelter required a different set of survival and coping skills from what the clients were accustomed to. For the first time in the lives of many of them, they came to the realization that they could learn new survival skills. Many of these skills have been mentioned previously. Some of them include applying for and using resources available 52 to them in the community, selecting different partners and friends, and filling out job and housing applications. Another survival skill that gained increasing importance in the thinking of the participants was the ability to communicate clearly and with confidence. At the shelter, the staff taught them communication skills, such as expressing themselves without anger, accepting criticism without recrimination, using eye contact when engaged in conversation, avoiding bad language, enunciating words clearly, and speaking distinctly (as opposed to mumbling or yelling from another room). Perhaps for the first time, the participants were able to realize that good communication was necessary when they were applying for any assistance. In addition, they were beginning to understand the importance of being able to communicate effectively with their acquaintances both in and out of the shelter. They were thus enabled to gain the respect of those people around them in order to receive the services they needed. The participants realized their old methods of communication might be keeping them from reaching their full potential. One father realized that he should no longer communicate in anger. He stated, “I have learned the importance of controlling my anger, and how to control my outbursts of anger.” Even though the participants' skill sets were changing, many stated that at times they reverted to the survival skills they had used in the past. Participants’ views of how the community perceives their current homelessness. Many of the participants felt that the community did not understand them and did not have compassion for them. One person stated, “We’re just trying to survive. I'm not trying to take advantage of the system, as I've been accused of doing. I'm just 53 trying to feed my kids and keep them safe.” Another client identified Child Welfare Services as a negative agency in the community when she stated the following: “I only came to the shelter because Child Welfare Services told me I had to or they would take away my kids.” The unanimous theme was that the community did not understand the difficulties that the participants faced in their homeless situation and several of the participants noted that the community did not have adequate resources. Many of the participants felt that the county should have more than one family shelter. The participants stated that they were given vouchers to ride the bus but that the county's bus schedule was very limited. Many of the services that the participants needed, such as Interfaith (a church-affiliated charity), the ATCAA food bank, and Infant Child Enrichment Services (ICES), did not have a bus stop at their facilities. One mother also pointed out that she would have to ride the bus with her children in tow in order to get services. The participants felt that the community assumed that just because the participants had free bus vouchers they should be able to get a job and child care: however, the participants felt the community was minimizing their plight. The overall theme was that the participants' experience of homelessness was upsetting at best and in many ways out of their control. They felt that the community should realize that they were surviving as best they could in order to provide for themselves and their children. Future plans to prevent homelessness. To avoid homelessness in the future, some of the participants realized they had to be clean and sober and test free of illegal drugs and alcohol. In order for this to happen, several were enrolled in a Twelve-Step 54 program so that they could overcome their addictions and be accountable for their actions. Other participants were involved in counseling and beginning to realize they had to make changes in their lives. Most of the women, and one of the fathers, had been in abusive relationships. In listening to their experiences of abuse, the researcher noted that as the participants became aware of the causes of their abuse, they resolved not to repeat this mistake of the past. Many of the participants felt that since coming to the shelter they now had the power within themselves to be able to make better choices when selecting a partner. The participants came to realize that they also needed to stay connected to the available resources in the community in order to prevent homelessness in the future. A common thread that surfaced at this juncture was that they came to recognize that their previous survival skills were not enough to prevent homelessness in the future. The participants were also able to recognize that many of the skills they had used in the past to survive homelessness involved using people in a negative manner. Two lessons emerged in their thinking: the necessity of not taking advantage of other people and the need to be more selective when choosing their friends. The participants felt they were now able to recognize negative versus positive relationships. They could see the importance of having a social network while at the same time the need to cultivate friends who were a positive influence. As has been stated previously, employment was the one essential needed in order for the participants to overcome their homelessness. For many, this meant that they would have to become employable by improving their skills. Some of them stated that 55 they recognized the need to complete some additional formal training in the future in order to be marketable. The current economic crisis has resulted in a serious reduction of available jobs thus leading to being unemployed. Unemployment in Tuolumne County is above the national average (U.S. Conference of Mayors, 2009), thus reducing significantly the number and variety of jobs available to them. In addition, there has been a cutback in some services and resources that had been previously available. An example of this, as stated by several of the participants, was the cutbacks imposed by the State on funding these services, such as less cash aid, fewer subsidized work programs, and fewer opportunities for state paid drug and alcohol rehabilitation programs. Along with fewer resources was the comprehension that that prior felonies or living with a felon prevented them from being hired for many jobs or receiving cash aid. As the participants' resources began to dwindle, they found themselves using credit to survive. If they owned a car, they would drive without a license or insurance because of the expense involved. When they were able to secure living accommodations, if money became tight, they just avoided paying the rent rather than making some sort of arrangements with the landlord before they were evicted. These evictions became a problem for the clients because their previous history with a landlord would prevent them from finding other accommodations. Along this line, the participants were surprised when they were evicted. They did not seem to understand the importance of having a good credit history. One participant stated it this way: “I could not keep up with the changing rules to be able to rent.” All of the participants could not emphasize with the 56 plight of the landlord. Summary In summary, four main themes emerged as a result of the interviews. The first theme that will be discussed is the shelter experience for the participants, and the importance of it. Secondly, the majority of these participants, had experienced homelessness in the past, and many of their experiences were similar in nature. Third, the coping mechanisms these participants employed in the past whether they were male or female were also similar and have been referred to in previous research (Burt et al, 1999; Hagen, & Ivanoff, 1988; National Alliance to End Homelessness, 2010). Lastly, these participants all valued their children, and loved them in their own way. Even though there was some dissatisfaction with living in a shelter, the overall experience proved to be an eye-opener for the participants and generally proved to be beneficial. Some of the benefits that the participants stated was the fact that they now were aware of the need for further education so that they could provide adequately for their families, the necessity of communicating without anger, the need to take advantage of the resources that are available to them in the community, and the importance of changing how they thought about their homelessness. All the participants expressed appreciation for the fact that they were in a safe place and their children were safe. However, many of the participants in this study complained that the shelter staff expected too much of them. For example, a mother of a young child said that she was too busy with caring for her child to go to “all these 57 meetings” that were expected of her. In spite of some unhappiness of having to be committed to shelter rules, there was a strong sense of camaraderie (Banyard, 1995) among these participants that helped them to get through the shelter experience. The second theme that emerged was that most of the participants had been homeless in the past. Some of them had been homeless with their caregivers in their childhood, while others had been homeless due to poor choices they had made, and some did not have the benefit of examples of good parenting from their caregivers. Another theme that emerged from this study was that the causes of homelessness appeared to be the same for all these participants. It did not matter if the caregiver was male or female; their needs were similar, causing them to use similar coping mechanisms. Many of the mechanisms that the participants had used included lying, using drugs, alcohol, sex, smoking, and selecting unwise partners. They were now able to realize how these behaviors contributed to their homelessness. The last theme that emerged was that all of the participants expressed concern and love for their children. While they were in their state of homelessness, they thought they were doing what was right at the time for themselves and their children. However, they could now see how negatively their experience of homelessness affected their children. All except one of the participants in this study stated that they could survive living in a shelter, or anywhere else, as long as they were with their children, because their children were their number one priority. In conclusion, they now had new ways of thinking and had a more positive outlook on their future life. They had developed better attitudes and were willing to 58 implement new skills that they could use to survive changing circumstances. There was a general sense of feeling empowered and in control of their future. “Hope” was now part of their vocabulary. With this new hope for the future, the participants began to recognize that overcoming their homelessness could be a reality. 59 Chapter 5 CONCLUSIONS, SUMMARY, AND RECOMMENDATIONS Summary of Study The hypothesis at the beginning of this study was that homeless mothers have special coping mechanisms to assist them through their experience of homelessness. The literature review revealed that homeless mothers' strategies do not significantly differ from those of other homeless populations. However, they do have unique needs when compared with other subgroups of the homeless populations (Stoner, 1983; Merves, 1992; Rosenbeck, et al., 1999). The main difference is that a homeless mother has a complex situation which presents her with unique problems associated with parenting dependent children while homeless. Some needs are difficult to fulfill, such as obtaining prenatal care, education regarding childbirth, information on parenting, child care, birth control, etc. These are hard to obtain if a mother has no transportation, money, social support, or job training. The review of the literature revealed that while there are some differences in the coping mechanisms used by different subgroups, certain strategies are employed by all these subgroups. Those mechanisms that are used by all subgroups include lying, stealing, taking advantage of friends and relatives, not using resources available to them, and using drugs and alcohol. A concomitant question raised by the researcher was why the population of homeless mothers has been slowly increasing since the 1980s. The literature review 60 pointed to the current economic downturn in our society as one of the reasons for this increase. Other more basic reasons include previous exposure to homelessness as either a child or an adult, drug and alcohol use, mental illness, abusive relationships, lack of education, becoming a mother at a young age, and poverty in general. In comparing the literature findings with those in this study, the researcher discovered many similarities, a fact that is hardly surprising. It should be noted, however, that many of the reviews presented in this study were completed in large metropolitan cities, whereas this study was conducted in a small rural community. Interestingly, the difference in the size of the city or the location of the city or town did not change the causes or the coping mechanisms of the homeless. Homelessness is endemic in our society today, and many of the causes are the same. The literature included in this study also revealed that it did not matter if the head of a household was male or female; the causes of homelessness were almost the same, and they relied on the same coping mechanisms. A finding that was unique to the researcher in this study was the fact that there were at least three phases of homelessness that this subgroup passed through. These phases are as follows. The first phase is what the researcher identifies as the denial phase. While in this phase, the participants did not consider themselves homeless but rather just survivors overcoming a bad time in their lives. Some of the coping mechanisms that the participants used in this phase were lying, stealing and taking advantage of family, 61 friends, and in some cases taking advantage of the community. However, as their resources begin to dwindle, their coping mechanisms escalated. Even though their circumstances were declining, most still felt that they had control over their situation. As one of the participants in the study admitted, “I was burying my head in the sand.” During this phase, such individuals are either unaware of the resources that are available in the community or they are reluctant to seek them out. Most of the participants tended to use such resources very sporadically. In the second phase of the participant’s homelessness, their homelessness deteriorates even further. This researcher labeled this phase of their homelessness as the acknowledgment, phase, because the participants in this phase of their homelessness could now acknowledge that they were homeless. Some continued to use their former coping skills, while others took the necessary steps to change their situation, such as entering a shelter and developing a new set of skills. In this phase of their homelessness their homeless state is overwhelming, and they need relief from the calamities that are descending on them. The participants in this study were in the third phase of their homeless which this researcher labels as the recovery phase. At this point in their homelessness, the participants were ready to accept positive help to overcome their situation. In this phase, the participants realized that if they are able to move in with a friend, they will do what they could to keep the relationship functional and upbeat. The participants were also able to look for outside assistance from social services. All of the participants, except one, in this study had sought admission to a shelter. This is the point at which the participants 62 were the most open to change. Hopefully, as some of the participants slip back into homelessness they will remember how much better their circumstances were when food and shelter were readily available to them. In this last phase, the participants were assisted in coming up with a plan to help them through this period of homelessness. If the participants choose to continue to live in a shelter, they have the added bonus of learning to get along with people, allowing others to support them, and availing themselves of the resources offered. It became apparent in the course of interviewing people for this study, and also from experiences gleaned while working as a public health nurse in the community, that a homeless individual might pass through these phases again and again before there is any noticeable change in his or her life. It was also while the participants were in this phase of their homelessness that they were encouraged to pursue changing the way they think about themselves. As their thought process changed, they were empowered with hope that their life would improve and that their children would have a better future. Hope is a necessary ingredient to keep individuals focused on reaching an attainable goal when circumstances are bleak. As the participants had renewed hope, they were able to see light at the end of the tunnel perhaps for the first time in their life. Implications for Social Work Homelessness is a serious social problem that has existed over time. In our present day, especially in First World countries, the composition of the homeless now includes a large number of families with children, the majority of which are headed by 63 single mothers. Research on this subgroup of the homeless must be conducted because more and more individuals are falling into this category. This study has pointed out the unique needs of the homeless mothers as compared to other homeless individuals. The primary victims, of course, are the children, who through no fault of their own are in a situation where they lack basic needs. Keeping the above thoughts foremost in our minds, the following are some considerations for future research. As ongoing research reveals the unique needs of the homeless mothers, those in the service professions will become more aware of the homeless mother’s needs which might reveal the necessity for shelter rules and regulations to change. A few areas that might come under consideration for change in the shelter could include child care, mental health counseling, financial and job training. If a shelter makes the decision to accommodate more of the needs of the residents, there might be a need for additional staff. The services of a Public Health Nurse could be considered as an addition to the present staff at shelters to educate the residents regarding health matters, and to be an additional resource person. Most research studies have relied on self-reporting by the homeless participants. Another suggestion is to use shelter staff observation and record-keeping to get beyond some of these difficulties. In addition, here needs to be broader research into the consequences that children suffer when they are dependent on a homeless mother for their basic needs. If the children’s needs are allowed to continue to languish, these same children may become uneducated adults, unable or unwilling to work and dependent on public assistance which 64 pushes the process of homelessness into the next generation. Such an outcome can have serious financial consequences in our communities and in society as a whole. This research recorded the findings of Caucasian homeless individuals, and did not include responses from Alaskan and only one Native American which Tuolumne County has a higher percentage of as compared to the rest of the California (U.S. Conference of Mayors, 2009). Future research could focus on Alaskan and Native Americans coping strategies living in Tuolumne County so that that their unique needs can be met. Another area of interest is the evaluation of those who seem to survive well after leaving in a shelter. The literature can always accommodate more information as to which coping responses are more effective over time than others, and what new ones can be implemented in the future. Some considerations for future changes that were suggested by the participants were that policy and programs need to change. Policy makers must look at the social forces that helped to shape an individual's current circumstances, as well as restraints that these factors had on their coping choices. This researcher must point out that this study was done during the end of the winter months and on into spring. The question that arises, “Do coping strategies of the homeless change depending on the time of year”. Another consideration is that the sample size in this study only involved ten participants. Would the responses differ if there were more participants? At the conclusion of this section it became apparent that homeless mothers are unique individuals, and they need unique interventions to be able to improve on their 65 homelessness, and that more research needs to be done to make these interventions a reality. Recommendations A practicing social worker needs to keep abreast of the conditions that lead to homelessness before attempting to solve the problems faced by clients. The social worker will be hampered without up-to-date information about homelessness and how homeless mothers in particular survive their ordeal. Social workers are in a unique position in society to influence those working with the homeless, as well as homeless individuals themselves. As stated above, continuing research needs to be done so the social worker can be effective in rendering useful assistance at all levels of their work. Since the social worker is probably an early responder in the case of homelessness, he or she needs to be well informed in order to assess the needs, strengths, and weaknesses of their clients and direct them to the proper resources that are available in their particular county. According to the National Association of Social Workers Code of Ethics, a social worker should empower those that are marginalized. A working knowledge of how to assess needs and provide competent guidance to appropriate resources can go far toward empowering the homeless and instilling hope for the future in their lives. Limitations Homelessness in general is on the rise, and the subset of homeless families in particular is increasing markedly. Many of these families are headed by single mothers. Society has put programs in place to help alleviate the problem. Some of these programs 66 have been quite successful, while others have failed. Before we provide more programs for homeless mothers, we need to understand and anticipate the special needs of the homeless mother. What are those needs? This study has attempted to understand the coping mechanisms of homeless mothers but recognizes that more attention must be given to identify the homeless mother's unique needs and how they can be met. Conclusion For a better understanding of how to improve the situation of homelessness for families, we first much understand their special needs and then the strategies they use to cope with their circumstances. As these needs and strategies are understood, those that are working with this subgroup of the homeless can provide meaningful assistance to these families. In order for the world to be a better place to live in, we must all work together to assist those in need. This we can do only if we have up-to-date knowledge and can make available appropriate resources in an accessible way to meet the urgent needs of the homeless mother. 67 Appendix A. Focus Group Questions QUESTIONS FOR FOCUS GROUP PARTICIPANTS The focus group’s demographic data (age, gender, race, number of children) will be taken from their intake form when they entered the shelter to provide general background information on each client. See attached letter signed by the Sonora Shelter Director granting permission to use the client data. The clients will be de-identified by the fact that their names will be blocked out from their demographic information. 1. How long have you lived at the shelter? 2. Places you have lived before you came to the shelter. 3. Level of education. 4. Types of employment. 5. What you feel has led to your being homeless? 6. Have you been homeless in the past? 7. What steps you have taken to prevent being homeless? 8. Describe the challenges the mothers have faced in the past in finding housing. 9. What effect has homelessness had on your children? 10. How has homelessness changed you and your children’s lives? 11. What could you do differently to prevent you from being homeless in the future? 12. What can workers at the shelter do differently to prevent homelessness? 13. What can other workers in the community do differently to prevent homelessness? 14. What steps have you taken to survive your experience of being homeless? 68 15. How has your experience of homelessness made you a better person? 16. What are your personal strengths? 17. How has homelessness made you a stronger person? 18. What have your children done to cope with homelessness? 19. What would you like to include in this survey that has not already been asked of you? 69 Appendix B. Individual Interview Questions QUESTIONS FOR INDIVIDUAL INTERVIEWS Demographic Data: 1. Age 2. Number of children 3. Marital status. 4. Monthly income. 5. Race. 6. Source of income 7. Types of employment. General Questions: 8. What do you feel has led to your being homeless? 9. Have you been homeless in the past? 10. What steps you have taken to prevent being homeless? 11. Describe the challenges you have faced in the past in finding housing. 12. What effects has living at the shelter had on your homelessness? 13. What effects has the community had on your homelessness? 14. How has homelessness changed you and your children’s lives? 15. What has helped you in coping with this difficulty? 16. Where and how do you draw your strengths to cope with this difficult period of your life of being a mother of a young child and homeless? 17. What can the community do differently to prevent homelessness? 70 18. What steps have you taken to survive your experience of being homeless? 19. How has your experience of homelessness made you a better person? 20. What are your strengths? 21. How has homelessness made you a stronger person? 22. What have your children done to cope with homelessness? What would you like to include in this survey that has not already been asked of you? 71 Appendix C. Letter of Consent Letter to Sonora Family Shelter October 2011 Sonora Shelter Sonora, CA I am a 3rd year MSWS student at Sacramento working on my thesis. I would like to explore the survival skills of homeless mothers who live in Tuolumne County. With your permission, I would like to conduct a focus group with homeless mothers living in your shelter. The University requires that they receive a permission letter from the facility that I plan to use for my focus group. I would appreciate if you would send your acknowledgement allowing me to use participants from your Shelter for this study on letterhead from your facility to Bette Axiak, PO Box 1304, Jamestown, CA 95327. Any questions regarding this request can be directed to me at xxx-xxx-xxxx. Thank you so much for your attention to this matter, Bette Axiak, PHN, Social Work Intern Sacramento State University, Sacramento 72 References American Free Press. (2012, January 15). Family homelessness in U.S. epidemic [Audio podcast]. Washington, DC: American Free Press. American Recovery and Reinvestment Act. 42 U.S.C. §§300jj et seq.; §§17901 et seq. (2009). Anderson, R. E., & Lowe, G. R. (1999). Human behavior in the social environment (5th ed.). New York: Aldine de Gruyter. Anderson, S. C., Boe, T., & Smith, S. (1988). Homeless women. Affilia, 3, 62-70. Arangua, L., Andersen, R., & Gelberg, L. (2006). The health circumstances of homeless women in the United States. International Journal of Mental Health, 34(2), 6292. Aratani, Y. (2009, September). Homeless children and youth, causes and consequences. Retrieved May 30, 2012, from http://www.nccp.org/publications/pdf/text_888.pdf Axelson, L., & Dail, P. W. (1988). The changing character of homelessness in the United States. Family Relations, 37, 463-469. Bachrach, L. L. (1987). Homeless women: a context for health planning. The Milbank Quarterly, 65(3), 371-396. Retrieved from http://www.jstor.org/discover/10.2307/3349944?uid=3739560&uid=2&uid=4&ui d=3739256&sid=56266585663. Banyard, V. L. (1995). Taking another route: Daily survival narratives from mothers who are homeless. American Journal of Community Psychology, 23(6), 871-886. 73 Banyard, V. L., & Graham-Bermann, S. A. (1995). Building an empowerment policy paradigm: Self-reported strengths of homeless mothers. American Journal of Orthopsychiatry , 65(4), 479-491. Banyard, V. L., & Graham-Bermann, S. A. (1998). Surviving poverty: Stress and coping in the lives of housed and homeless mothers. American Journal of Orthopsychiatry, 68(3), 479-489. Bassuk, E. L. (1990). The problem of family homelessness. In E. L. Bassuk, R. W. Carman, L. F. Weinreb, & M. M. Herzig (Eds.), Community care for homeless families: A program design manual (pp. 7-11). Washington, DC: Interagency Council on the Homeless. Bassuk, E. L. (1993). Social and economic hardships of homeless and other poor women. American Journal of Orthopsychiatry, 63, 340-347. Bassuk, E. L., & Cohen, D. A. (1991). Homeless families with children: research perspectives. Washington, DC: National Institute of Mental Health and the National Institute on Alcohol, Abuse and Alcoholism. Bassuk, E. L., & Rosenberg, L. (1990). Psychosocial characteristics of homeless children and children with homes. Pediatrics, 85, 257-261. Bassuk, E. L., Buckner, J. C., Weinreb, L. F., Browne, A., Bassuk, S. S., Dawson, R., & Perloff, J. N. (1997). Homelessness in female-headed families: Childhood and adult risk and protective factors. American Journal of Public Health, 87(2), 241248. 74 Bassuk, E. L., Rubin, L., & Lauriat, A. S. (1986). Characteristics of sheltered homeless families. American Journal of Public Health, 76(9), 1097-1101. Retrieved June 19, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1646563/pdf/amjph002720043.pdf. Bassuk, E. L., Volk, K. T., & Olivet, J. (2010). A framework for developing supports and services for families experiencing homelessness. The Open Health Services and Policy Journal, 3, 34-40. Bassuk, F. I., Buckner, J. C., Perloff, J. N., & Bassuk, S. S. (1998). Prevalence of mental health and substance use disorders among homeless and low-income house mothers. American Journal of Psychiatry, 155, 1561-1564. Billings, A., & Moos, R. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4, 139-157. Borchard, K. (2007). The word on the street: Homeless men in Las Vegas. Reno, NV: University of Nevada Press. Bray, J. H. (2010). Helping people without homes: The role of psychologists and recommendations to advance research, training, practice, and policy. Retrieved May 31, 2012, from Presidential Task Force on Psychology's Contribution to End Homelessness website: http://www.apa.org/pi/ses/resources/publications/endhomelessness.aspx. 75 Buckner, J. C., Bassuk, E. L., & Zima, B. T. (1993). Mental health issues affecting homeless women: Implications for intervention. American Journal of Orthopsychiatry, 63, 385-398. Burt, M. (1991). Causes of the growth of homelessness during the 1980s. Washington, DC: Urban Institute. Burt, M. F., & Cohen, B. E. (1989). Differences among homeless single women, women with children and single men. Social Problems, 36, 508-524. California Department of Social Services (2012). CalWORKS Welfare to Work Program. Retrieved July 27, 2012, from http://www.cdss.ca.gov/cdssweb/PG141.htm. Calsyn, R., & Morse, G. (1990). Homeless men and women: Commonalities and a service gender gap. American Journal of Community Psychology, 18, 597-608. Caton, L. M. (1990). Homeless in America. New York, NY: Oxford University Press. Center For Student Leadership (2012). Urban & rural poverty. Retrieved July 30, 2012, from http://www.ncsu.edu/csleps/service/Facts%20on%20UrbanRural%20Poverty.pdf Choi, N. G., & Snyder, L. J. (1999). Homeless familes with children. New York, NY: Springer Publishing Company, Inc. Coates, R. C. (2007). Ending chronic homelessness in america’s major cities—The justice systems’ duty. University of San Francisco Law Review, 42, 427-456. Cosgrove, L., & Flynn, C. (2005). Marginalized mothers: Parenting without a home. The Society for the Psychological Study of Social Issues, 5, 127-143. 76 Cowan, B. A. (2007). Trauma exposure and behavioral outcomes in sheltered homeless children: the moderating role of erceived (Doctoral dissertation, Georgia State University). retrieved from http://digitalarchive.gsu.edu/psych_diss/39/. Creswell, J. W. (1998). Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks, CA: Sage. Cummins, L. K. (2001). Homelessness among rural women. In R. M. Moore, III (Ed.), The Hidden America (pp. 57-100). Cranbury, NJ: Associated University Press. Cummins, L. K., First, R. J., & Toomey, B. G. (1998). Comparisons of rural and urban homeless women. Affilia, 13(4), 435-453. Deavers, K. L., & Hoppe, R. A. (1992). Overview of the rural poor in the 1980s. In C. M. Duncan (Ed.), Rural poverty in America (pp. 3-20). New York, NY: Auburn House. DeOllos, I. Y. (1997). On becoming homeless: the shelterization process for homeless families. Lanham, MD: University Press of America, Inc. D'Ercole, A., & Struening, E. (1990). Victimization among homeless women: Implications for service delivery. Journal of Community Psychology, 18, 141-152. Dill, D., Feld, E., Martin, J., Beukema, S., & Belle, D. (1980). The impact of the environment on the coping efforts of low income mothers. Family Relations, 29, 503-509. Driskel, M. R., & Simon, C. E. (2006). Breaking the cycle of homelessness: A look at selected program components provided in transitional housing programs. The University of Alabama McNair Journal, 6, 35-62. 77 Duffield, B. (2001). Poverty amidst plenty: Homelessness in the United States. In Valerie Polokow & Cindy Guillean (Eds.), International perspectives on homelessness (1st ed., pp. 195-214). Westport, CT: Greenwood Press. Fine, M. (1985). Coping with rape: Critical perspectives on consciousness. Imagination, cognition, and personality, 3, 249-267. Fischer, R. L. (2000). Toward self-sufficiency: Evaluating a transitional housing program for homeless families. Policy Studies Journal, 28(2), 402-420. Fitchen, J. M. (1991). Homelessness in rural places: Perspectives from upstate New York. Urban Anthropology, 20, 177-210. Flora, C., & Flora, J. (1989). Rural area development: the impact of change. Forum for Applied Research and Public Policy, 4(3), 50-52. Folkman, S., & Lazarus, R. (1980). Analysis of coping in a middle-aged sample. Journal of Health and Social Behavior, 21, 219-239. Gladstone, A. (2008). Homeless mothers: Coping and Adaptation (Doctoral dissertation). Available from ProQuest LLC, ID No. 1609286731. (AAT 3330873). Guarnaccia, V., & Henderson, J. J. (1993). Self-efficacy, interpersonal competence, and social desirablility in homeless people. Journal of Community of Psychology, 21, 335-338. Hagen, J. L. (1987). Gender and homelessness. Social Work, 32, 312-316. Hagen, J. L., & Ivanoff, A. M. (1988). Homeless women: A high-risk population. Affilia , 3(1), 19-33. 78 Harburger, D. S., & White, R. A. (2004). Reunifying families, cutting costs: Housing Child wellfare partnerships for permanent supportive housing. Child Welfare Journal, 83, 493-508. Henry, M. Geography of Homelessness Series (2009). Homelessness by geographic type. Retrieved June 26, 2012, from http://www.endhomelessness.org/section/data/interactivemaps/urbanruralhomeles snessmap. Herman, D. B., Susser, E. S., & Link, B. L. (1997). Adverse childhood experiences: Are they risk factors for adult homelessness. American Journal of Public Health, 87, 249-255. Hobbs, D. (1988). Factors influencing the demand for rural infrastructure. In T. G. Johnson, B. J. Deaton, & E. Segarra (Eds.), Local infrastructure investment in rural America (pp. 51-63). Boulder, CO: Westview. Hodnicki, D. R., Horner, S. D., & Boyle, J. S. (1992). Women's perspectives on homelessness. Public Health Nursing, 9(4), 257-262. Holahan, C. J., & Moos, R. H. (1990). Life stressors, resistance factors, and improved psychological functioning: An extension of the stress resistance paradigm. Journal of Personality and Social Psychology, 58, 909-917. Homeless Information Exchange (1994, March). Domestic violence: A leading cause of homelessness (Fact Sheet 10). Washington, DC: Homeless Information Exchange. 79 Hopper, E. K., Bassuk, E. L., & Olivet, J. (2009). Shelter from the storm: Traumainformed care in homelessness services settings. The Open Health Services and Policy Journal , 2, 131-151. Housing Assistance Council (1995, September). The poorest of the poor: Female-headed households in nonmetro America. Washington, DC: Housing Assistance Council. Jarrett, V., & Tchen, C. (2012, April). Keeping America's women moving forward, the key to an economy built to last. Retrieved from The White House Council on Women and Girls website: http://www.whitehouse.gov/sites/default/files/emailfiles/womens_report_final_for_print.pdf. Karger, H. J., & Stoesz, D. (1994). American social welfare policy: A pluralist approach. New York, NY: Longman. Kennedy, A. C. (2007). Homelessness, violence exposure, and school participation among urban adolescent mothers. Journal of Community Psychology, 35(5), 639654. Kourgialis, N., Wendel, J., Darby, P., Grant, R., Kory, W. P., Pruitt, J, Redlener, I. (2001, May). Improving the nutrition status of homeless children: Guidelines for homeless family shelters. Retrieved June 22, 2012, from The Children's Health Fund, The Bureau of Primary Health Care website: http://childrenshealthfund.org/sites/default/files/HFSNI-report.pdf. Kozol, J. (1988). Rachel and her children: Homeless families in America. New York, NY: Crown. 80 Levinson, D., & Ross, M. (2007). Homelessness handbook. Great Barrington, MA: Berkshire Publishing Group, LLC. Lykes, M. B. (1983). Discrimination and coping in the lives of black women: Analysis of oral history data. Journal of Social Issues, 39(3), 79-100. Markos, P. A., & Lima, N. R. (2003). Homelessness in the United States and its effect on children. Guidance and Counseling, 18(3), 118-124. McChesney, K. Y. (1986). New findings on homeless families. Family Professional, 1, 165-174. McConachie, H., & Waring, M. (1997). Child psychology portfolio: Parental coping and support. Windsor, UK: NFER-Nelson. McCubbin, H. I., Olson, D. H., & Larsen, A. S. (1991). Family crisis oriented personal scales, F-COPES. Retrieved June 6, 2012, from http://friendsnrc.org/component/joomdoc/doc_details/208-family-crisis-orientedpersonal-scales-annot. McGerigle, P., & Lauriat, A. S. (1983). More than a shelter: A community response to homelessness . Boston, MA: United Community Planning Corporation. Meadows-Oliver, M. (2002). Mothering in public: A meta-synthesis of homeless women with children living in shelters. Journal for Specialists in Pediatric Nursing, 8(4), 130-136. Merves, E. (1992). Homeless women. Beyond the bag lady myth. In M. Robertson & M. Greenblatt (Eds.), Homelessness. A national perspective. (pp. 229-244). 81 Milburn, N., & D'Ercole, A. (1991). Homeless women: Moving towards a comprehensive model. American Psychologist, 46(A11), 1161-1169. Miller, H. (1991). On the fringe: The dispossessed in America. Lexington, MA: D.C. Heath. Miller, K. K., & Weber, B. A. (2003). Persistent poverty across the rural-urban continuum. Retrieved July 30, 2012, from http://purl.umn.edu/18910 Moos, R. H., Cronkite, R. C., & Finney, J. W. (1984). Health and daily living form manual (2nd ed.). Palo Alto, CA: Center for Health Care Evaluation, Stanford University Medical Center. National Alliance to End Homelessness (2010, January). Fact sheet, questions and answers on homelessness policy and research, rural homelessness. Retrieved June 26, 2012, from National Alliance to End Homelessness website: http://www.endhomelessness.org/content/general/detail/1613. National Association of Social Workers (2008). Code of Ethics. Retrieved June 22, 2012, from http://socialworkers.org/pubs/code/code/.asp. National Center on Family Homelessness (2011, December). The characteristics and needs of families experiencing homelessness. Retrieved from http://www.familyhomelessness.org/media/306.pdf. National Coalition for the Homeless (2007, August). Homeless families with children. Retrieved from http://www.nationalhomeless.org/publications/facts/families.pdf. National Coalition for the Homeless (2009, July). Who is homeless? Retrieved from http://www.nationalhomeless.org/factsheets/who.html. 82 National Committee on Pay Equity (2010). The wage gap over time: In real dollars, women see a continuing gap. Retrieved May 30, 2012, from http://www.payequity.org/info-time.html. National Committee on Pay Equity (2012). Wage gap statistically unchanged. Retrieved May 30, 2012, from http://www.pay-equity.org National Law Center on Homelessness & Poverty (2012). Homelessness & poverty in America. Retrieved June 15, 2012, from http://www.nlchp.org/hapia.cfm. Novac, S. B., & Bourbonnais, C. (1996, November). No room of her own: A literature review on women and homelessness. Retrieved from http://ginsler.com/sites/ginsler/files/noroom.pdf. Nunez, R., & Caruso, L. (2003). Are shelters the answer to family homelessness? US Today, 131(2692), 46-49. Nunez, R., Collignon, K., Mellow, N., & Smith, A. (1998). The cycle of family homelessness: A social policy reader. New York, NY: Institute for Children and Poverty.Retrieved from http://www.eric.ed.gov/PDFS/ED425255.pdf. Nyamathi, A., Longshore, D., Galaif, E. R., & Leake, B. (2004). Motivation to stop substance use and psychological and environmental characteristics of homeless women. Addictive Behaviors, 29, 1839-1843. O'Hara, A. (2007). Housing for people with mental illness: Update of a report to the President's New Freedom Commission. Psychiatric Services, 58, 907-913. Pearlin, L. I., Lieberman, M. A., Menaghan, E. G., & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337-356. 83 Pearlin, L., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2-21. Rafferty, Y. (1991). And miles to go: Barriers to academic achievement and innovative strategies for the delivery of educational services to homeless children. New York, NY: Advocates for Children of New York. Resource Directory for Family Services in Tuolumne County (2012). Retrieved June 21, 2012, from http://www.scribd.com/doc/13318917/Tuolumne-County-PublicHealth-Resource-Directory. Robertson, M. J. (1991). Homeless women with children: the role of alcohol and other drug abuse. American Psychologist, 46(11), 1198-1204. Robertson, M.J., Greenblatt, M. (eds). (1992). Homelessness; A national perspective. New York: Plenum Press, 57-64. Rog, D., Holupka, C. S., & Patton, L. C. (2007). Characteristics and dynamics of homeless families with children. Washington, DC: U.S. Department of Health and Human Services. Rosenheck, R., Bassuk, E., & Salomon, A. (1999, April). Special populations of homeless Americans. The 1998 National Symposium on Homelessness Research, U.S. Department of Housing and Urban Development, U.S. Department of Health and Human Services. Rossi, P. H. (1989). Down and out in America: The origins of homelessness. Chicago, IL: The University of Chicago Press. 84 Rossi, P. H. (1990). The old homeless and the new homelessness in historical perspective. American Psychologist, 45(8), 954-959. Rossi, P. H. (1994). Troubling families: Family homelessness in America. American Behavioral Scientist, 37, 342-395. Roth, D., Bean, J., Lust, N., & Saveanu, T. (1985). Homeless in Ohio: A study of people in need. Columbus, OH: Ohio Department of Mental Health. Roth, D., Toomey, B, & First, R. (1987). Homeless women: Characteristics and needs. Affilia, 3, 6-19. Royce, D. (2011). Research methods in social work (6th ed.). Canada: Brooks/ColeThomson Learning. Rukmana, D. (2008). Where the homeless children and youth come from: A study of the residential origins of the homeless in Miami-Dade County, Florida. Children and Youth Services Review, 30(9), 1009-1021. Schultz-Krohn, W. (2004). The meaning of family routines in a homeless shelter. The American Journal of Occupational Therapy, 58(5), 531-542. Shinn, M. B., Rog, D. R., & Culhane, D. P. (2005). Family homelessness: Background research findings and policy options. University of Pennsylvania, Scholarly Commons, Departmental Papers. Retrieved from http://works.bepress.com/cgi/viewcontent.cgi?article=1015&context=dennis_culh ane. 85 Shinn, M., Knickman, J. R., & Weitzman, B. C. (1991). Social relationships and vulnerability to becoming homeless among poor families. American Psychologist, 46, 1180-1187. Silver, G., & Panares, R. (2000, March). The health of homeless women: Information for state maternal and child health programs. U. S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Retrieved June 15, 2012 at http://www.jhsph.edu/wchpc/publications/homeless.PDF Solarz, A. L. (1988). Homelessness: Implications for children and youth (social policy report on the Society for Research in Child Development). Washington, D.C.: Committee on Child Development and Social Policy. Solarz, A., & Bogat, G. A. (1990). When social support fails: the homeless. Journal of Community Psychology, 18, 79-96. Sonora Family Shelter (2012). Service Directory. Retrieved June 21, 2012, from http://tuolumne.networkofcare.org/mh/services/agency.aspx?pid=SonoraFamilyS helter_176_2_0. Stainbrook, K. A., & Hornik, J. (2006). Similarities in the characteristics and needs of women with children in homeless family and domestic violence shelters. Families in Society - The Journal of Contemporary Social Services, 87(1), 53-62. Stein, J., & Nyamathi, A. (1998). Gender differences in relationships among stress, coping, and health risk behaviors in impoverished, minority populations. Personality and Individual Differences, 26(1), 141-157. 86 Stoner, M. (1983). The plight of homeless women. Social Service Review, 57(4), 565581. Stovall, J., & Flaherty, J. (1994). Homeless women, disaffiliation and social services. International Journal of Social Psychiatry, 40, 135-140. Thrasher, S. P., & Mowbray, C. T. (1995). A strengths perspective: An ethnographic study of homeless women with children. Health and Social Work, 20(2), 93-101. Tischler, V., & Vostanis, P. (2007). Homeless mothers: Is there a relationship between coping strategies, mental health and goal achievement? Journal of Community & Applied Social Psychology, 17, 85-102. Toomey, B. G., First, R. J., Greenlee, R., & Cummins, L. K. (1993). Counting the rural homeless: Methodological dilemmas. Social Work Research and Abstracts, 29(4), 23-27. U. S. Conference of Mayors (2007, December). Hunger and homeless survey: A status report on hunger and homelessness in America's cities, a 23-city survey. Washington, DC: The United States Conference of Mayors. U. S. Conference of Mayors (2009). Hunger and homelessness Survey: A status report on hunger and homelessness in America's cities. Retrieved from http://usmayors.org/pressreleases/uploads/USCMHungercompleteWEB2009.pdf. 87 U. S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy (2005). Mental health and rural America: 1994-2005. Washington, DC: U.S. Government Printing Office. Retrieved June 15, 2012, from ftp://ftp.hrsa.gov/ruralhealth/RuralMentalHealth.pdf. United States Interagency Council on Homelessness, Federal Strategic Plan to Prevent and End Homelessness (2010, June). Homelessness among families with children (FSP supplemental document #5). Washington, DC Vissing, Y. (1996). Out of sight, out of mind: Homeless children and families in small town America. Lexington, KY: The University Press of Kentucky. Wagner, J., & Menke, E. M. (1991). Stressors and coping behaviors of homeless, poor and low-income mothers. Journal of Community Health Nursing, 8(2), 75-84. Weinreb, J. (1996). Housing is not enough: Helping homeless families achieve selfsufficiency. Washington, DC: Family Impact Seminar. Weinreb, L. F., & Bassuk, E. L. (1990). Substance abuse in homeless families. In E. L. Bassuk, R. W. Carman, L. F. Weinreb, & M. M. Herzig (Eds.), Community care for homeless families: A program design manual (pp. 129-146). Washington, DC: Interagency Council on the Homeless. Weir, M., Orloff, A. S., & Skocpol, T. (1988). The politics of social policy in the United States. Princeton, NJ: Prineton University Press. 88 Weitzman, B. C., Knickman, J. R., & Shinn, M. (1992). Predictors of shelter use among low-income families: Psychiatric history, substance abuse and victimization. American Journal of Public Health, 82(11), 1547-1550. Williams, M., Unrau, Y., & Grinnell, R. (1998). Introduction to social work reserach. Itasca, IL: F. E. Peacock Publisihers. Zorza, J. (1991). Woman battering: A major cause of homelessness. Clearing House Review, 24, 421-429. Zugazaga, C. B. (2007). Understanding social support of the homeless: A comparison of single men, single women, and women with children. Families in Society: The Journal of Contemporary Social Services, 89(3), 447-455.