Professional Skills Paper

Understanding the Ecology and Development of Children and Families Experiencing Homelessness:

Implications for Practice, Supportive Services, and Policy

Ryan P. Kilmer and James R. Cook University of North Carolina at Charlotte

Cindy Crusto Yale University School of Medicine

Katherine P. Strater and Mason G. Haber University of North Carolina at Charlotte

The experience of homelessness can pervade multiple levels and facets of a child and family’s world. In view of the historical risks in the lives of children who are experiencing homelessness (e.g., growing up under conditions of poverty, exposure to family violence),

it is clear that interventions, services, and supports need to be equally comprehensive to have a positive influence on child functioning and development. Consequently, service systems, providers, and community supports need to address the circumstances of children

and families experiencing homelessness and, more specifically, better attend to their ecologies and the diverse factors that can affect their well-being and adjustment trajectories. Such an approach is needed to better understand the range of factors and

influences on the development and adaptation of these youngsters at home, at school, and with their peers as well as to guide the identification and implementation of adequate fam- ily-centered services and supports.

F amilies represent roughly a third of the homeless popula-tion in the United States (U.S. Department of Housingand Urban Development, 2010), and approximately 1.5 million children—1 in 50 youngsters—are homeless each year in the United States (Bassuk, 2010; The National Center

on Family Homelessness [NCFH], 2009). Such figures have catalyzed proposals to end child and family homelessness (Bassuk, 2010; Shinn, 2009) and heightened research and profes-

sional focus on factors that can mitigate the negative impact of homelessness on the children and youth, and their caregivers, within those families (e.g., Bassuk, 2010; Paquette & Bassuk,

2009; Swick, 2008). Families experiencing homelessness have often experienced a

range of risks, adversities, and problems (e.g., poverty, domestic violence) that contribute to their homelessness (NCFH, 2011).

Furthermore, living without stable housing (a traumatic experi- ence in itself; see Bassuk, 2010 and Haber & Toro, 2004), a defin- ing characteristic of their circumstance, places children and

youth at additional risk for adversity exposure and difficulties in adjustment, including social and emotional problems, high risk

behaviors, and problems in health and education (Bassuk, Weinreb, Dawson, Perloff, & Buckner, 1997; NCFH, 2011; Swick, 2005). Because of the complex causes, correlates, and con-

sequences of homelessness in children and families, a comprehen- sive, multilevel framework is necessary to provide effective services and supports. Unfortunately, many interventions for

children and families experiencing homelessness continue to focus on the child(ren) or their caregiver(s) alone, without addressing caregiver–child relationships, the resources or needs

of the family system, or other relationships between families and their broader social contexts. Such practices do not fully meet the needs of children and families. A coordinated emphasis on eco- logically grounded and developmentally based efforts is more

likely to (a) address the diverse influences on the child and family and (b) minimize the degree to which services are fragmented. In this article, we advocate for service systems, providers, and

community supports to address the circumstances of children and families experiencing homelessness and, more specifically, to better attend to their ecologies and the diverse factors that

can affect their well-being. We do not comprehensively review the circumstances and issues facing children and families experi- encing homelessness (for detailed discussions, see Bassuk, 2010;

Haber & Toro, 2004) rather, our objective is to provide suffi-

This article was prepared for and reviewed by the American Ortho-

psychiatric Association Task Force on Family Homelessness.

Correspondence concerning this article should be addressed to Ryan

P. Kilmer, Department of Psychology, University of North Carolina at

Charlotte, 9201 University City Blvd., Charlotte, NC 28223. Electronic

mail may be sent to [email protected].

American Journal of Orthopsychiatry � 2012 American Orthopsychiatric Association 2012, Vol. 82, No. 3, 389–401 DOI: 10.1111/j.1939-0025.2012.01160.x

389

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cient conceptual and empirical groundwork for recommenda- tions informed by the current literature. Furthermore, because

most research on families experiencing homelessness focuses on those with young children or those with children just entering school (Haber & Toro, 2004), the emphasis of this article is on

young children and the caregiver–child dyad. Typically, in fami- lies with young children who experience homelessness, only a single parent (usually the mother) is consistently present; how- ever, other supportive adults, including fathers, may be critically

important for the child’s well-being. Regardless of who the pri- mary caregiver of a child might be, that relationship between the caregiver and the child is particularly important for the well-

being and adjustment of the child. Because the experience of homelessness can pervade multiple

levels and facets of a child’s world, particularly when the histor-

ical risks in the child’s life are considered (e.g., growing up under conditions of poverty, exposure to family violence), it is clear that interventions, services, and supports need to be

equally comprehensive to address and affect positively the vari- ous domains of child functioning and development. Bronfen- brenner’s (1977, 1979, 2005; Bronfenbrenner & Morris, 2006) ecological systems theory, also known as the bioecological

model, accounts for the child and family in context and the diverse influences on development and adaption. It therefore provides a useful framework for examining the adaptation of

children and families experiencing homelessness and for guiding interventions and system responses (see, e.g., Haber & Toro, 2004; Swick, 2005). The following sections of this article high-

light key adversities and factors to consider, describe the rele- vance of an ecological approach, and put forth actionable recommendations.

Attending to Context: Responding to Diverse Risks

Adversities faced by children and families experiencing home- lessness can be separated into three different but related catego- ries. First, a number of stressful conditions or risk factors reflect

the adversities that preceded and likely contributed to the fami- lies’ homelessness. These include poverty and its associated circumstances, trauma exposure, and risks related to personal

resources and circumstances (e.g., mental illness, limited job skills). A second set of risk factors includes the consequences of homelessness, such as social stigma exhibited by employers, busi- nesses, school personnel, and children toward people experienc-

ing homelessness as well as the disruption of social relationships (e.g., family, friends, teachers) associated with residential insta- bility. Third, other risk factors or adversities can occur as a result

of the interventions designed to address the immediate needs of children and families, such as time-limited shelters and transi- tional housing that are sometimes experienced as unsafe and sys-

tems and policies that separate families from one another and from their natural supports in the community. In combination, these various adversities are associated with a host of short- and

longer term sequelae for children experiencing homelessness, including problems with peers, physical health difficulties, and mental health challenges, including internalizing concerns (e.g., anxiety, depression, withdrawal) and externalizing problems

(e.g., aggression, acting out) as well as consequences for care-

givers’ well-being (Bassuk, 2010; Bassuk et al., 1997; NCFH, 2011; Swick, 2005). At the same time, these adversities limit fami-

lies’ access to those in their communities who can help them over- come the many difficulties they face. Examining these factors and their impact can help identify strategies for interventions

designed to facilitate positive outcomes for children and families.

Adversities That Precede Homelessness

Youngsters experiencing homelessness have typically been exposed to a range of risk factors and conditions prior to their homelessness, particularly reflecting trauma and poverty-related

adversity. By age 12, 83% of these youth have been exposed to at least one serious, violent incident, and almost 25% have wit- nessed intimate partner violence (NCFH, 2011). In addition,

63% of homeless caregivers are reported to have been in rela- tionships characterized by violence, and 92% have experienced physical or sexual abuse during their lifetimes (Bassuk et al.,

1996). Many youth experiencing homelessness have been the target of abuse, witnessed domestic violence, or been exposed to community violence (Anooshian, 2005; Haber & Toro, 2004). Family violence (intimate partner violence or child maltreatment

or both) often serves as an impetus for a caregiver (typically a mother) to leave with her child(ren). In families in which resources are scarce, this can lead to homelessness.

In addition to trauma experiences, families experiencing homelessness have also faced considerable poverty-related adversity, including lack of access to health care, food insecurity

(i.e., limited or uncertain access to adequate food; e.g., U.S. Department of Agriculture, 2009), lack of access to affordable housing, lack of stability in their housing situation (even prior to the current homelessness condition), and insufficient

resources to pay bills or buy clothes. Living under conditions of poverty is linked with higher rates of divorce, violence exposure, and substance abuse (Attar, Guerra, & Tolan, 1994; Bolland

et al., 2007; Luthar, 1999). These adversities have consequences for children, caregivers,

and the caregiver–child relationship. Relative to economically

advantaged children, those growing up in poverty evidence higher rates of depression, behavioral problems, somatic complaints, and strained peer relationships (Costello, Compton, Keeler, &

Angold, 2003; Linver, Brooks-Gunn, & Kohen, 2002; Luthar, 1999). Their caregivers are more likely to report depressive symp- toms and anxiety, feelings of victimization and life dissatisfaction, somatic complaints, and eating and sleeping difficulties (Luthar,

1999; Wadsworth & Santiago, 2008). Moreover, findings suggest that the strain of living in poverty can diminish caregivers’ capac- ity for supportive, consistent, and involved parenting (Bassuk,

2010; Luthar, 1999). Overall, caregivers raising children under conditions of poverty have been found to be less nurturant, less consistent, and less likely to utilize reasoning in their parenting;

instead, they tend to value obedience, are more punitive, and are more likely to use physical punishment as a means of discipline relative to parents who are not living under conditions of

economic disadvantage (e.g., Luthar, 1999). Beyond the powerful influences of trauma and poverty,

individual resources, circumstances, or characteristics of the caregiver, such as substance abuse, mental illness, and limited

educational and job skills, can also precede homelessness.

390 KILMER, COOK, CRUSTO, STRATER, AND HABER

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Although family homelessness is often attributed to such indi- vidual characteristics and circumstances or, more pointedly, fail-

ings of the caregiver (Bassuk, 2010; Shinn, 1997), as Swick (2005) notes, the roots of homelessness can be traced to more macro-level issues, social-contextual factors, and policies. Put

another way, it is the accumulation of factors—poverty, lack of health care, lack of sufficient housing resources and employment skills, violence in the home or other trauma exposure, substance use, and others—that leads to family homelessness.

Adversities Associated With Homelessness

The experience of becoming homeless brings with it a host of stressors—the trauma of being homeless, ongoing exposure to violence, or victimization experienced on the streets (Anooshian,

2005; Bassuk, 2010; Haber & Toro, 2004; Ryan, Kilmer, Cauce, Watanabe, & Hoyt, 2000). This ongoing trauma is a substantial risk condition (NCFH, 2011), contributing to significant strain

and distress for children and families and increasing the like- lihood that youngsters will evidence difficulties as they move along their adjustment trajectories. The experience of homelessness also disrupts a family’s social

relationships and connections, whether with friends, family, or teachers. Families are often cut off from their social networks, an event that can precede (e.g., conflict between the family and

those who had offered to share housing with them) or result from (e.g., purposefully cutting ties due to stigma) homelessness (Fischer, 2000). This disconnection affects families’ capacity to

access natural supports in the community, and the isolation of parents and children experiencing homelessness has been framed as one of the ‘‘most damaging facet[s]’’ associated with residen- tial instability (Swick, 2005, p. 195). Families who are isolated

can no longer access the resources (e.g., tangible assistance, emotional support, advice) that their social networks would naturally provide. This can be especially damaging for minority

families as this disruption violates cultural and social norms of social connectedness. Another consequence of homelessness is the social stigma

exhibited by employers, businesses, school personnel, school children, and even helping professionals. The stereotypic and judgmental views of others are experienced as ‘‘stressful and

damaging’’ (Swick, 2008, p. 150). This stigma can be viewed as generalized or external, which includes the public perceptions and actions toward people who are homeless, or more personal, involving the internalized experience of self-blame and shame

(Kidd, 2009). Youth experiencing homelessness who have been subjected to such stigma have also been reported to engage in efforts to deal with their ‘‘undesired differentness’’ (Goffman,

1963) through inclusion strategies, which are designed to help them appear like youth who are not homeless, and exclusion strategies, in which they make efforts to demonstrate that they

are tougher, stronger, and more mature than their peers. This latter strategy, however, is viewed as potentially threatening to others and may increase their stigmatization (Roschelle & Kauf-

man, 2004). Additionally, the stigma of homelessness appears to add to or exacerbate the stigma associated with other condi- tions, such as poverty, sexual orientation, poor school perfor- mance, or mental health issues (Phelan, Link, Moore, & Stueve,

1997).

Families’ experiences with the school system can also pose a variety of challenges. For one, the manner and approach of

teachers and other school personnel—salient proximal influences for children—can affect the engagement of children and parents with the school (Swick, 2005). If school personnel are perceived

as judgmental, punitive, inaccessible, or indifferent, children and their parents may be less likely to communicate openly with them and may display less interest in the school and educational activities. Further complicating their child(ren)’s educational

status, families experiencing homelessness also evidence higher rates of school mobility, which can impact school engagement, academic performance, and peer relationships (Buckner, Bassuk,

& Weinreb, 2001; Miller, 2011). Furthermore, if records have not been appropriately transferred from a prior school or dis- trict or cannot be accessed, children and youth can experience

barriers to services or inappropriate placements. Although the McKinney-Vento Homeless Assistance Act pro-

vided children experiencing homelessness more opportunity for

educational stability, they continue to face disruptions in their education and are more likely to be expelled, get suspended, or drop out of high school (NCFH, 2009). These factors may con- tribute to academic difficulties. Data suggest that, among high

school students, 11.4% of students experiencing homelessness meet grade-level standards for math proficiency, and 14.6% are proficient in reading (NCFH, 2009). These academic difficulties

also reflect, at least in part, the fact that youngsters experiencing homelessness are 4 times more likely to display developmental delays (NCFH, 1999) and are twice as likely to have a learning

disability (NCFH, 2009).

Adversities Associated With Service System Response

The structures, systems, and services intended to provide sup- port and address the needs of children and families can uninten-

tionally contribute to their adversity experiences. According to Swick (2005, p. 198), ‘‘In too many cases services for homeless and other high-risk families actually do more harm than good.’’

The reasons for the negative consequences of service system responses are manifold. For one, the limited privacy, crowded conditions, and perceived lack of safety and security in shelters

or transitional housing settings (Buckner, Bassuk, Weinreb, & Brooks, 1999; Swick, 2005) can foster discomfort, uneasiness, and fear. Children need structure, predictability, and consistency in their world—the unsafe, unpredictable living situation in

some shelters is not congruent with those needs. In addition, when faced with homelessness, families are fre-

quently fragmented to provide adequate housing and resources

to all members. In fact, approximately one in five children expe- riencing homelessness will be separated from his or her family at some point (NCFH, 1999; Paquette & Bassuk, 2009). In some

cases, care systems and settings (including homeless services and child protective services) force families to separate from one another and from their neighbors and extended family. For

instance, when families enter a shelter, they may be separated from each other because of overcrowding or shelter policies that exclude men and older adolescent boys (Paquette & Bassuk, 2009). In other cases, youth may be sent to live with friends

or extended family because of shelter policies restricting the

ECOLOGICAL APPROACH TO FAMILY HOMELESSNESS 391

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number or age of children and youth, placement in the mental health treatment system, or an attempt to avoid the trauma of

the homelessness experience (e.g., Barrow & Lawinski, 2009; Paquette & Bassuk, 2009). Some older youth may be homeless on their own in a succession of temporary arrangements (‘‘couch

surfing’’) or in situations of literal homelessness in which they are unaccompanied in shelters or on the street (Haber & Toro, 2004). Research on adolescents who are homeless on their own suggests that these youth often come from families facing the

adversities preceding and accompanying homelessness cited pre- viously (McCaskill, Toro, & Wolfe, 1998; Whitbeck & Hoyt, 1999). Additionally, some families may experience separation

for involuntary reasons such as caregiver illness, incarceration, or substance abuse and mental health treatment (Paquette & Bassuk, 2009). Whatever its basis, family separation is a signifi-

cant adversity that can place strain on children and the larger family system. As one example, alternative living arrangements to residing with family such as kinship or congregate care have

been found to predict poor outcomes in late adolescence and early adulthood (Courtney & Dworsky, 2006). Involvement in the child welfare system is another potential

source of family separation and is often experienced as an addi-

tional adversity. In fact, some have highlighted the potential for blaming of the ‘‘victim’’ in the context of programs intended to support or protect children and families experiencing homeless-

ness. Notably, a substantial proportion of youngsters and fami- lies experiencing homelessness become involved in the child welfare system, sometimes as a result of their homelessness,

which may be viewed by system workers as evidence that the caregivers are unable to safely care for their children. One report found that two thirds of mothers experiencing homeless-

ness lose custody of their children at some point (Zlotnick, Robertson, & Tam, 2003). Once in the foster care system, these children face a significant shortage of available placements, especially for teenagers, and are likely to experience several

placements in both foster care and group home settings (Zlotnick, 2009). This can minimize contact with family members and isolate youth from supportive connections as they

transition out of the foster care system into adulthood, placing them at higher risk for experiencing a range of difficulties, including homelessness as adults (Zlotnick, 2009).

Overall, the experience of homelessness brings with it many challenges, adversities, and transitions. Even within the context of service systems developed to provide assistance and support, parents and families are faced with unpredictability and a lack

of routine, concerns about safety, the judgments of providers and others, and the complexity of navigating the multiple sys- tems involved with their child(ren) and family. Many parents

feel ill equipped to negotiate these systems (e.g., social services, education, mental health), a factor that can not only limit the services and supports available to their family, but can affect

the functioning of the caregiver and the family system as well.

What Can Be Done? Using an Ecological Perspective

It is clear that multiple ecological influences, both proximal and distal, are salient to those experiencing homelessness

(Swick, 2005). Moreover, in the case of children and families

experiencing homelessness, it is necessary to account for corre- lated constraints, clusters of factors that support either positive

developmental paths or problematic trajectories (e.g., Farmer & Farmer, 2001). This notion can be daunting for those providing homeless services and supports, because it is difficult (if not

impossible) to address the full range of ecological influences. Nonetheless, it is necessary for those within our service systems to understand the contexts in which children and families func- tion and to target those influences that carry particular weight

in the development and adaptation of youngsters. As such, a central emphasis of work with children and fami-

lies experiencing homelessness—especially those with younger

children—should be strengthening the family unit, with a partic- ular emphasis on strengthening or maintaining the strength of the caregiver-child dyad. This dyad warrants clear attention,

because caregivers are a core proximal influence on children’s development and adaptation, and the caregiver–child relation- ship is a key contextual factor (one that is amenable to interven-

tion) that can have significant impact on various life domains and factors affecting a child. Caregivers play a meaningful role for children following stress or trauma (Masten, Best, & Garmezy, 1990; Masten & Coatsworth, 1998; Salmon & Bryant,

2002), providing not only nurturance, warmth, and emotional support, but aiding their children in appraising and making sense of the event, identifying ways in which they can respond,

and coaching or guiding coping (e.g., Kliewer, Sandler, & Wolchik, 1994). A positive caregiver–child relationship also sup- ports the development and enhancement of qualities and

resources associated with resilience, including a youngster’s competency beliefs, sense of worth, problem-solving skills, and other capacities (Yates, Egeland, & Sroufe, 2003). In fact, not-

withstanding the diverse samples, methods, and construct defini- tions in the resilience research base, having a responsive, supportive, competent caregiver is one of the most consistently identified protective factors (Luthar, Cicchetti, & Becker, 2000;

Wyman, Sandler, Wolchik, & Nelson, 2000), serving to forestall dysfunction and promote healthy adaptation. In turn, it is critical to attend to the needs of the caregiver.

Indeed, it has been argued that caregiver well-being is the most critical element associated with child resilience (Luthar, 2010), and it has been framed as a factor with potential cascading

effects. That is, efforts to foster caregiver well-being can have not only the intended, targeted effect, but their benefits can snowball, contributing to other important gains—for example, in child development and adjustment—in the longer term. How-

ever, mothers experiencing homelessness exhibit a range of mental health challenges (NCFH, 2011), including dispropor- tionate levels of depression, posttraumatic stress disorder, and

substance dependence (Bassuk et al., 1996; Weinreb, Buckner, Williams, & Nicholson, 2006). For instance, roughly 50% of mothers were found to have experienced a major depressive epi-

sode since becoming homeless (Weinreb et al., 2006). Maternal depression is associated with (a) lower levels of warm, positive caregiving and higher levels of hostile, negative, and disengaged

or withdrawn parenting; (b) poorer physical health and well-being in children; and (c) higher rates of child behavior problems and mental health symptoms (Lim, Wood, & Miller, 2008; National Research Council and Institute of Medicine,

2009; Palaez, Field, Pickens, & Hart, 2008). It is clear that

392 KILMER, COOK, CRUSTO, STRATER, AND HABER

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appropriate care and support for caregivers can improve their quality of life and help them provide ‘‘good growing ground’’

for their children, a particularly salient notion in light of the fact that over half of children within families experiencing homeless- ness are age 6 years or younger (U.S. Department of Housing

and Urban Development, 2010). It is important, however, to note that families experiencing

homelessness are not homogeneous (Gewirtz, DeGarmo, Plowman, August, & Realmuto, 2009; Howard, Cartwright, &

Barajas, 2009). Gewirtz et al. report that, although rates of symptoms among children and parents experiencing homeless- ness were higher compared to population-wide norms, and these

families face substantial risks, significant variation existed, with some families displaying resilience, as evidenced by child strengths, strong parenting practices, and absence of symptom-

atology. They also found that effective parenting practices (e.g., positive parenting, less coercion, use of problem solving) and, to a lesser extent, self-reported parenting self-efficacy were strongly

associated with positive child adjustment. This underscores the importance of attending to and supporting parents in their inter- actions with their children while they experience homelessness, as the literature points to the pivotal role those parent–child

relationships and interactions play in children’s general well- being and adjustment (Miller, 2011). Overall, findings such as those outlined here highlight the

need to attend to caregivers’ recent trauma exposure, trauma histories, and strain, their perceptions of their children’s needs, and their resources as well as indicators of caregiver well-being

and adjustment. It is clear that such potential influences can impact parenting and, broadly, the parent–child relationship. Ecologically grounded research can shed light on strategies for

intervention (e.g., psychoeducation, parenting training, family support, respite care, formal mental health treatment, including dyadic or attachment-based work for those with very young children) to address the multiple domains and levels through

which children and families are affected by homelessness. The intent of this material emphasizing the importance of

strong family interactions, with a focus on strengthening caregiv-

ers and the caregiver–child dyad, is not to communicate that other, broader factors and relationships are not salient. Rather, particularly among young children, caregivers and the caregiver–

child dyad are core proximal influences, ones that can fruitfully be the focus of limited resources. That said, the existing litera- ture and findings regarding the adversity exposure, challenges, and functioning of families experiencing homelessness testify to

the merit of a multilevel, ecological approach, rather than inter- ventions aimed solely at distinct components of these families’ experiences, such as housing, parenting behaviors, mental health

services, and the like. The results (and potential influences) described here highlight the salience of attending to contextual factors and their role in the child’s adaptation and functioning.

An ecological model points to the need to address broader social-contextual factors associated with homelessness from pov- erty to policies that contribute to homelessness, restrictive fund-

ing streams, or practices that affect families experiencing homelessness negatively, as well as family-focused efforts to enhance their social connectedness and build their capacity for positive parenting. To that end, these results also underscore the

importance of addressing the needs of the family system and its

members. Regardless of the specific nature of the family constel- lation, it is crucial that interventions, services, and supports fit a

family-centered model—going beyond the needs of an individual child or primary caregiver—and, within that larger orientation, individualize components of the plan of care or system response

to the needs of the family generally as well as specific family members.

Developmental Considerations

Within an ecological framework, developing plans of care or identifying services and supports for children and families expe-

riencing homelessness requires taking into account the changes in youth and their family context over time. Efforts to individu- alize services to families experiencing homelessness should

explicitly recognize this changing context and the differences in needs as children and youth move along their developmental trajectories.

When families experiencing homelessness have young chil- dren, the caregiver–child dyad is a critical area of focus, with school a salient context for action. However, it is also important to attend to older children and youth and address their needs.

For some older youth and adolescents, the dyadic relationship may be less crucial, relative to other relationships in their lives, as adolescents generally have wider, more complex social net-

works and seek support from a broader set of individuals within those networks (Collins & Steinberg, 2006; Furman & Buhr- mester, 1992). Unfortunately, youth experiencing homelessness

may have limited alternatives for the various types of support their families would normally provide, as families that are homeless tend to exhaust and often become isolated from their social resources (Shinn, Knickman, & Weitzman, 1991).

A variety of specific developmental issues should be consid- ered in serving caregivers and their older youth experiencing homelessness. First, normative development during this period

involves a shifting and renegotiation of roles in caregiver–youth relationships, such that youth are monitored less and, particu- larly with entry into adolescence, are allowed to make more of

their own choices and take on responsibilities. The process can be challenging and cause parent–child conflict or disengagement, even under relatively favorable circumstances (Smetana, Campi-

one-Barr, & Metzger, 2006). Families facing significant disad- vantages associated with homelessness may find it especially difficult to adjust to these normative developmental issues, par- ticularly if they are compounded by the individual adjustment

problems often found among adolescents from poor or residen- tially unstable families (e.g., Buu et al., 2009; Dewit, 1998; Haynie & South, 2005). Strained relationships may result in dis-

engagement of youth and family, reducing parents’ motivation to continue to provide support. In fact, this type of mechanism may contribute to the intergenerational transmission of risk for

homelessness in families (Haber & Toro, 2004; Paradise & Cauce, 2002). In addition to changes in relationships with primary caregiv-

ers, other age-related issues are critical to consider in serving older youth and families who are homeless. As youth progress in adolescence, relationships with other family members become increasingly influential, including relationships with siblings,

absent caregivers or parental figures, and stepfamily. Notably,

ECOLOGICAL APPROACH TO FAMILY HOMELESSNESS 393

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these relationships have been identified as particularly important to youth in placements outside the family (Samuels, 2009).

Youth also increase their emotional investment in and support seeking from relationships with individuals outside of the fam- ily, including extended family, peers, or nonrelated supportive

adults or natural mentors (Beam, Chen, & Greenberger, 2002). As such, interventions during these years should shift from a primary focus on the caregiver youth dyad to one in which peers and other social resources outside the family are also

emphasized. Finally, youth may also develop issues of their own that tran-

scend difficulties experienced as a function of their family situa-

tion. For example, base rates of severe emotional and behavioral disorders increase during later childhood and adoles- cence (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003).

These difficulties may need to be a focus of attention through individual- or family-level interventions. Regardless of the child or youth’s age, or the family composition, it is clear that there is

no one-size-fits-all approach to addressing the needs of children, youth, and families experiencing homelessness.

Recommendations: Addressing the Needs of Children and Families Experiencing

Homelessness

Unfortunately, many efforts to conceptualize the types of interventions needed with families experiencing homelessness focus on the use of professionals to, in some way, intervene with

families to address their needs and deficits (e.g., Swick, 2005). This deficit-focused approach unfairly categorizes or contributes to stigmatizing judgments of families who have become homeless. Although caregivers in families who become homeless may have

made nonoptimal decisions or faced difficult circumstances, such as substance abuse and mental health concerns, many people with these challenges are not homeless, and many caregivers

experiencing homelessness are not living with these risk condi- tions. Families also demonstrate different pathways to and pat- terns of homelessness; homelessness is multiply determined. In

turn, it is inappropriate to paint with a broad brush in viewing families experiencing homelessness. Instead, it is critical in work with youth and families to identify their strengths, resources, and

capacities and find ways to build upon them (Bender, Thompson, McManus, Lantry, & Flynn, 2007; Israel & Jozefowicz-Simbeni, 2009; Lindsey, 2000). Similarly, it is important to recognize that the caregivers and youngsters within these families have identities

that go beyond the challenges they face or their experience of homelessness. Such notions are important. Beyond such guiding ideas in work with these children and families, in developing

plans of care or intervening with families experiencing homeless- ness, the use of an ecologically grounded lens can point to a range of needed steps. The sections that follow describe actionable

recommendations based on an ecological framing of the issues.

Ensure Secure, Stable, and Affordable Housing

The lack of stable, consistent housing is the central, defining characteristic of families experiencing homelessness, distinguish- ing them and their experience(s) from those with stable housing

who experience other correlated conditions (e.g., poverty). The

lack of stable housing provides a significant barrier to every intervention that can help homeless children and families

become more successful and self-sufficient; consequently, there is a growing movement to provide Housing First (LaFrance Associates, 2004). This strategy works to help families quickly

access stable, sustainable, permanent housing, which, when combined with case management, enables families to take advantage of other resources they need. Critical in efforts to provide affordable permanent housing are housing subsidies

and vouchers. Indeed, Shinn (2009) describes the effectiveness of housing subsidies in helping families leave—and remain out of—shelters.

Whereas stably housed families have the opportunity to learn about the level of risk versus safety inherent in elements of day- to-day living, such as outdoor play in different areas in their

neighborhood, unstably housed families have fewer such opportunities, forcing decisions to either limit outdoor play and connection with possible playmates, become hypervigilant in

their monitoring, or accept potentially unknown levels of risk. Given that one of the key distinguishing characteristics of homeless families is their limited social networks (Shinn, 2009), stable, permanent housing can help families establish and main-

tain important relationships that can help prevent future entry into homelessness. Thus, a strong focus on secure, stable, and affordable housing that enables families to establish consistency

and routines in their day-to-day lives and be or become part of a community is a critical factor in addressing the needs of homeless families. To that end, facilitating families’ efforts to

build and maintain stable social connections must also be a priority.

Facilitate Connections to Others and the Community

Recognizing that temporary shelter is often a core part of

services for children and families who are homeless, the need for social connections remains a major issue. Families may experi- ence disruption or changes in their contacts with schools, neigh-

bors, faith communities, friends, and extended family, in addition to health and social service providers and families’ other natural supports. Thus, helping families connect with their

informal supports, build upon existing ones, and, when they move to a relatively stable living arrangement, develop new rela- tionships that are mutually beneficial and thus sustainable are fruitful steps.

In addition, given the benefits associated with social support and connectedness (Berkman & Glass, 2000; Schaefer, Coyne, & Lazarus, 1981), beyond intervening at the family level, those

working with families experiencing homelessness must take steps to link them to their broader communities (Swick, 2005). This has been an ongoing issue in professional service systems such

as mental health (e.g., Cook & Kilmer, 2010; Melton, 2010) for some time; however, regardless of the barriers and challenges involved, it is necessary to help connect families with their com-

munities and the communities’ resources, to build or strengthen their informal support network, and to help them establish a sense of place and community. All too often, interventions that are conceptualized to address the needs of homeless families

have the implicit assumption that these families lack strengths,

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that their social environments are toxic, and that professional services are the primary or sole mechanism for addressing their

needs (Bassuk, 2010). Even when families are in temporary housing and require significant support from professionals, building community is critically important.

Formal and informal opportunities for networking can help build such connections (Swick, 2005). Shelters, agencies provid- ing services and support, faith-based groups, and schools can play important roles in identifying mechanisms for connecting

families experiencing homelessness with their broader communi- ties. For example, if a family has interest in participating in or connecting with a faith-based community, efforts could be made

to facilitate that linkage, helping transport the family to services and ensuring that the family has the opportunity to attend and access events sponsored by the faith-based group (e.g., potluck

dinners). It is critical that families have the opportunity to make and build connections—and develop relationships—in settings outside the specific context of the services they receive. How-

ever, for families to do so within the broader array of commu- nity organizations and settings (i.e., not just those providing homeless services), it is critical that organizations are supportive of and receptive to their efforts to engage. For instance, schools,

generally viewed as stable, safe settings within neighborhoods and communities, can serve a critical function by sponsoring or hosting events through which parents can connect with each

other as well as with school personnel. These notions parallel the approach taken by Jacqueline

MacDonald, principal of Mayfair Elementary School, a school

opened for youngsters displaced following Hurricane Katrina (Kilmer, Gil-Rivas, & MacDonald, 2010). Although the con- text (i.e., postdisaster) is clearly different, her approach can

provide a useful model to those in other communities. She sought to develop her school’s sense of community, attending to connections between the school and the families and those among the families. The school sponsored gatherings so that

parents could meet and support one another and organized activities designed to help address parental needs. MacDonald understood the need for Mayfair to be seen as a source of

information and services as well as a setting in which parents would have a voice, particularly as it related to their chil- d(ren)’s needs, accessing community services or supports, or

even securing basic needs (Kilmer et al., 2010). School staff worked to increase parents’ awareness of supports and services in the community, such as organizing informational meetings and partnering to sponsor a resource fair. For some events,

the school even provided transportation and childcare so that parents could attend. Schools in neighborhoods with high numbers of low-income families—including those experiencing

homelessness—could take similar steps to build connections among families, provide opportunities for families to support one another, and increase awareness of resources in the com-

munity.

Provide Well-Targeted Material Support

Postdisaster intervention models and those for other large- scale traumas can serve as useful parallel examples for system response given that they highlight the need for multileveled

responses that are contextually and culturally appropriate and

point to the need for connecting families to others as well as to tangible resources in their communities (e.g., Agani, Landau, &

Agani, 2010; Kilmer & Gil-Rivas, 2010a; Landau, 2010; Wessells, 2009). Families experiencing homelessness clearly evi- dence these needs and would benefit from both social and mate-

rial support. In some instances, natural support systems and social connections can also bring linkages to tangible supports (Landau, 2010) that can, for example, assist with transportation, connect them with flexible funds to address time-limited needs,

or help ensure that they have sufficient food for their family. A key is helping families to learn about and access resources and the material or instrumental support available in their

communities.

Ensure Family-Centered Services and Supports

It is critical that services for families experiencing homeless- ness are family centered. That is, they must reflect a coordinated

approach to care that focuses on the needs of the whole family, not just the caregiver or an identified child (e.g., Bassuk, 2010). The nature of these services and supports can include a range of possibilities.

One set of services could necessarily focus on meeting par- ents’ needs, including the provision of support, work to address mental health problems (e.g., depressive or posttrau-

matic stress symptoms), and assistance in building upon or developing educational or vocational skills, or both. Address- ing these sources of distress, stress, and strain will also help

parents to be better able to draw on their resources in inter- acting with their children and supporting them. In practice contexts, those providing services would be well served to rec- ognize the strengths of families and caregivers and partner

with them in developing plans of care (Bender et al., 2007; Lindsey, 2000; Tedeschi & Kilmer, 2005); during a time when circumstances may be experienced as out of control; doing so

can help them develop a voice and feel competent and empowered. One objective would be to maximize caregiver support. Via family partner or family support programming,

efforts could help parents build their efficacy in parenting their children and in negotiating the system. This latter com- ponent aligns with work in health literacy, as it is critical for

parents to be aware of their rights and understand the pro- cesses of the service systems in which they are involved, so that they can advocate effectively for their children. Family-centered services and supports can also facilitate posi-

tive parenting (Swick, 2008). Efforts can include psychoeduca- tion for parents regarding meeting their children’s needs in the context of adversity as well as skill-building approaches

designed to foster or enhance emotionally responsive caregiving. Particularly within the constraints of temporary or transitional housing settings, such work can help parents understand the

nature of their child(ren)’s posttrauma responses and reactions, identify ways to support their child(ren) emotionally, and help guide their child(ren)’s coping. For those whose children have

been diagnosed or are struggling with behavioral or emotional concerns, practitioners can help parents (and others) recognize that youngsters have an identity as well as needs that extend beyond being diagnosed with a mental health disorder or char-

acterized as ‘‘homeless.’’

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Indeed, providers can help caregivers nurture children’s iden- tities beyond their diagnosis or current challenges. Consistent with that notion, in services directed toward meeting the needs of the child or larger family system, it is important that provid-

ers attend to multiple domains of functioning and potential needs. For example, with young children, addressing the whole child involves attending to physical and social-emotional well-

being, cognitive development, language development, social skills, and the like. Services and supports must be comprehen- sive and integrated to support positive development within a

suboptimal context, that is, one characterized by instability and adversity.

Enhance Workforce Understanding of Ecological and Developmental Issues

Across the network of homeless services, it is necessary to

develop a workforce that appreciates the range of adversities confronting children and families experiencing homelessness and the diverse ecological influences for which services and supports

must account. Preservice training as well as continuing educa- tion, professional development workshops, or structured super- vision could assist in developing and maintaining awareness and

responsiveness to these issues. Those working in homeless ser- vices certainly have first-hand knowledge of many of the chal- lenges, issues, and barriers faced by these families; however, it is important to go beyond that foundation to help providers

understand (a) the proximal and distal factors influencing fami- lies’ functioning and residential stability, (b) the consequences of fragmented services that do not adequately account for the

correlated constraints affecting a family, and (c) the need for services and supports that are developmentally grounded.

Connect Families With Developmentally Informed, Trauma-Based Services

Within the context of family-centered services and supports tailored to the child(ren) and family, appropriately addressing the trauma experiences of the children, youth, and families is an

essential step. Numerous recent reports have underscored that acknowledging and being responsive to the previous and ongo- ing trauma exposure of these children and youth is paramount

(Haber & Toro, 2004; NCFH, 2011). Indeed, because of the prominence of trauma exposure in children and their families experiencing homelessness, systems and agencies working with

individual children who are homeless and their families, as well as the specific services and supports provided, should adhere to a trauma-informed perspective and to principles of trauma- informed care (see Table 1 for selected principles; Amaro et al.,

2007; Bebout, 2001; Cooper, Masi, Dababnah, Aratani, & Knitzer, 2007; Elliott, Bjelajac, Fallot, Markoff, & Reed, 2005; Harris & Fallot, 2001; Ko & Sprague, 2007; Markoff, Fallot,

Reed, Elliott, & Bjelajac, 2005; Prescott, Soares, Konnath, & Bassuk, 2008). For children, several relevant systems need to attend to trauma-informed principles and implement trauma-

informed services and supports: education, including early care and education; child welfare; juvenile justice; health care; first responders; and community-based systems of care (e.g., Cooper et al., 2007; Ko & Sprague, 2007; Ko et al., 2008). Numerous

resources are available to assist systems and providers with moving toward greater levels of trauma-informed care, includ- ing organizational self-assessment tools that assist with deter-

mining how well trauma-informed strategies and practice are incorporated into daily programming to respond to the needs of trauma survivors. Several national centers can be resources for

Table 1. Selected Principles of Trauma-Informed Care and Revelant Resources

Approach

Conduct universal trauma exposure and mental health screening and standardized assessment of children (and, where appropriate, their family

members)

Address explicitly the impact of trauma on children and their families (using trauma-informed practices)

Focus on recovery from trauma

Use strategies that address the unique cultural experiences of children experiencing trauma

Employ an empowerment-based model to help foster children and families’ experience of power and control in their lives

Collaborate with families in the service delivery process

Organizational change and workforce development

Integrate knowledge about trauma into organizational practices

Make resources on trauma available to staff at all levels and to the families served

Train and educate staff at all levels on trauma and its impact on children and families

Employ staff who are knowledgeable about and sensitive to issues of trauma

System change

Ensure that there is a continuity of care across systems serving children and families

Relevant Selected Resources Regarding Trauma-Informed Care

National Child Traumatic Stress Network: http://www.nctsn.org

National Center for Trauma-informed Care: http://www.samhsa.gov/nctic/default.asp

National Center on Family Homelessness: http://www.familyhomelessness.org/

National Center for Children Exposed to Violence: http://www.nccev.org/

Trauma Center at Justice Resource Institute: http://www.traumacenter.org/about/about_landing.php

National Native Children’s Trauma Center: http://iers.umt.edu/National_Native_Childrens_Trauma_Center/

Indian Country Child Trauma Center: http://www.icctc.org/

Note. See, for example, Cooper et al. (2007); Harris and Fallot (2001); Ko et al. (2008); Ko and Sprague (2007).

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communities, organizations, educators, policy makers, media, and families themselves (Table 1 includes a listing).

Although the notion of trauma-informed services has gained traction in the literature and in professional communities, it is also necessary to underscore that context is critical to any consid-

eration of posttrauma adaptation or adjustment (see, e.g., Kilmer & Gil-Rivas, 2010a,b; Kilmer, Gil-Rivas, & McClintic Griese, 2011), and it is necessary to maintain an ecological focus in work with children and families who have experienced trauma. Multi-

ple social and contextual factors (e.g., available support, family history, culture, socioeconomic status, faith) may affect a child or caregiver’s reactions, responses, risks, and recovery following

trauma. Furthermore, in providing trauma-related services, it is also important to take into account the developmental differ- ences of those being served. For instance, the posttrauma

responses of children and youth of varying ages differ as a result of a host of factors, including the fact that their cognitive and affective capabilities influence how they may understand or inter-

nalize the experience (National Child Traumatic Stress Network, n.d.; Osofsky, 2004; for detailed discussions, see Kilmer & Gil-Rivas, 2010b; Salmon & Bryant, 2002). In addition, the degree to which children look to their parent or caregiver for sup-

port and guidance (e.g., Kliewer et al., 1994; Masten et al., 1990) may also vary over time. Practitioners, programs, and service sys- tems need to be aware of and adapt to these differences; services

and supports must be developmentally grounded.

Shift Practice or Policy to Better Support Older Youth

To that end, services for those experiencing homelessness must allow for flexibility in meeting youths’ needs. Among older

youth, whether with their families or unaccompanied (i.e., not in the care of a parent or guardian), practice and policy need to continue to support the parent–child dyad as well as other

youth–family connections. Addressing these needs effectively can be challenging, given the growing autonomy (and thus, dis- tinct agendas) of youth, conflict in parent–youth relationships,

and the increased complexity of youths’ family and social net- works as they get older. In addressing situations in which par- ent–youth relationships suffer from high levels of conflict or are

disengaged, but are still amenable to supportive intervention, it may be possible to use specialized family treatment strategies (e.g., Ecological Family Therapy & Family Focused Therapy; Slesnick & Prestopnik, 2009), more broadly based family preser-

vation services (Kinney, Haapala, Madsen, & Fleming, 1991), or intensive case management (Wagner et al., 1994). In addition to directly addressing problems in parent–youth relationships

preceding or exacerbated by homelessness, these strategies may help to prevent episodes of homelessness among youth or expe- dite reunification of parents with their children once a more per-

manent living arrangement is obtained. Given that most families who are homeless are female headed

with young children, it is understandable that most supports

provided in shelters and through other types of agencies would focus on this type of family. However, shelter and other service agency policies that ignore families with both caregivers present or with older children may, in fact, contribute to the processes

of family disintegration that discourage male spouses or part-

ners and older siblings from remaining with the family. Thus, shelter practices that permit residence of families including older

males—including caregivers or perhaps older siblings—may ben- efit older youth in particular. Efforts to assist older youth in homeless families through tailored support and, where appropri-

ate, reunification efforts may have long-lasting benefits. Older children and adolescents separated from their biological families are vulnerable relative to their peers in a variety of ways, includ- ing greater risks of being homeless on their own (Clark et al.,

2008; Courtney & Dworsky, 2006) and other issues that may create challenges for their continued development such as drop- out, unplanned pregnancy, and mental health and substance use

problems (Courtney & Dworsky, 2006). Addressing these issues at this critical juncture, before youth face adult legal and eco- nomic responsibilities and risks, may reduce the likelihood of

future generations of homeless families.

Intervene in Other Regular Settings for Children and Youth

Because of barriers and challenges to accessing certain ser- vices and supports, children and youth who experience home-

lessness and their families may be more likely to use or to present themselves to certain settings and services (e.g., shelters, schools, primary health care, acute hospital-based care) than

others (e.g., specialty mental health care; Kushel, Vittinghoff, & Haas, 2001; Weinreb, Nicholson, Williams, & Anthes, 2007). Therefore, it is essential to integrate needed services and sup-

ports into the settings that families are more likely to access. For example, experiencing homelessness has negative effects on young children’s mental health (DiBiase & Waddell, 1995; Shinn et al., 2008). Given increasing evidence of its effectiveness

(Brennan, Bradley, Allen, & Perry, 2008; Upshura, Wenz-Gross, & Reed, 2009), the provision of early childhood mental health consultation within early care and education settings, including

pediatric primary care clinics, can be an effective way to identify and address children’s social-emotional difficulties. Mental health consultation interventions are comprised of several com-

ponents (Duran et al., n.d.) that are wholly consistent with ecological theory. These components include promotion, pre- vention, and intervention activities; work with administrators,

teachers, and parents; and strategies at the classroom and individual child levels. Ecologically grounded mental health consultation has important implications for developing and sustaining positive, health-promoting environments and rela-

tionships for both children and their families. Within school settings, in-service and professional develop-

ment workshops could train teacher and school staff regarding

the adversity exposure and needs of those experiencing homeless- ness with goals of increasing their sensitivity to the issues and challenges experienced by families, as well as the likelihood that

they will engage parents in helpful ways. Teachers could engage in outreach to parents, helping them identify ways in which they can support their children academically within the context of

their adversity experiences or the constraints of the shelter set- ting. School staff could also integrate parents into learning opportunities or school activities for children to provide opportu- nities for their involvement at school and facilitate the parent–

child relationship (Miller, 2011; Swick, 2008). In addition to

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providing school-based services for emotional and behavioral concerns, school mental health professionals (psychologists,

social workers) could help provide staff development, work with school nurses to help meet children’s medical needs (vision and hearing as well), and assist with connections to community

resources and supports (Kabler & Weinstein, 2009; Weinreb et al., 2007).

Ensure That Services Are Culturally and Linguistically Competent

Consistent with an ecologically based approach that values

the roles of the contexts in which children and families func- tion, services and supports provided to children and youth experiencing homelessness and their families need to be respon-

sive to their unique cultural backgrounds and linguistic needs. Of particular concern among families experiencing homeless- ness is attention to the cultural aspects of socioeconomic status

as well as race, ethnicity, faith, and family background. Clearly, cultural and linguistic considerations should be central to all aspects of services systems and the provision of services and supports, including adaptation of evidence-based practices

for use with groups other than those for whom they were origi- nally developed. Families experiencing homelessness are already facing obstacles in accessing care and have significant unmet

health care needs, and language barriers can result in exclusion from programs or delays in services and supports. Therefore, removal of language barriers is essential to meaningful access

to services (Suleiman, 2003). Language-appropriate services and supports include provision of interpreter services as well as the translation of essential materials (e.g., curricula), forms (e.g., consent form), and services in families’ first or preferred

language. Linkages with agencies that provide interpreter or translation services can be a tremendous resource for those organizations that do not have sufficient funds to pay for their

own translation and interpretation services; establishing mutu- ally beneficial partnerships can help in the provision of this essential practice.

Implications for Policy, Conclusions, and Future Directions

Particularly within the context of the recent and ongoing eco- nomic downturn, the numbers of families experiencing home- lessness, as well as those at risk of homelessness, have risen in

recent years. The magnitude of the issue is great, and as we hoped to convey here, the influences on families’ well-being are numerous, the domains affected are many, and the actions

required are diverse. Circumscribed interventions or changes in practice will likely be inadequate to address the issues and adversities faced by those experiencing homelessness. Numerous

researchers in this area have detailed the need for policy change, and a multifaceted approach is necessary on that front as well. Addressing antecedents of homelessness is a core goal, and

poverty is a key target, particularly among families with young children. Duncan, Ziol-Guest, and Kalil (2010, p. 322) have urged a focus on policy steps that affect family income (e.g., the Earned Income Tax Credit) for families with young children,

noting that a $3,000 annual increase in ‘‘income between a

child’s prenatal year and fifth birthday is associated with 19% higher earnings and a 135-hr increase in work hours.’’

Steps to address the adversities faced by those experiencing homelessness are also warranted. Given the stress and stressors associated with homelessness itself, a central policy goal would

be to facilitate the rapid reintegration of families into housing (see Shinn, 2009); however, although Section 8 vouchers and supportive housing approaches can provide critical assistance and support stability for families in need, many communities

are experiencing a shortage of vouchers and subsidies. Not only are such resources necessary, it is also critical to modify policies and practices that tax and even harm families, such as those

that result in family separation. Shelters and other settings could be designed and operated in a way that better accommo- dates families with caregivers and youth of both sexes.

It is also necessary to use the infrastructures that exist to better meet the needs of children and families experiencing homelessness. For instance, local housing authorities or sup-

portive housing settings could incorporate parenting-based pre- ventive interventions, mental health screenings for children and caregivers, and afterschool programming or serve as a portal for referral to service-delivering provider agencies (e.g., Gewirtz

et al., 2009). Regardless of the specific approach employed, it is clear that

action is needed and that interventions must be comprehensive

in scope. Bassuk (2010) describes an intervention known as Building on Strengths and Advocating for Family Empower- ment (BSAFE), a time-limited model developed by the National

Center on Family Homelessness and adapted from Critical Time Intervention (Herman, Conover, Felix, Nakagawa, & Mills, 2007). Bassuk notes that the development of this year-long case

management intervention was informed by ecological theory and that BSAFE is a trauma-informed, family-centered inter- vention that focuses on (a) the connections among community- based services, (b) social networks and broader systems of care,

and (c) the housing, health, and well-being of families as they transition into the community or supportive housing settings (Bassuk, 2010). Consistent with what we have advocated here,

this approach seeks to enhance social and community connect- edness, identify the needs and develop plans for each family and family member, and facilitate links to community supports (par-

ticularly developmentally appropriate and culturally sensitive services and supports; Bassuk, 2010). This innovative model is promising; it will be necessary to evaluate rigorously not only the outcomes for children and families receiving the intervention

(including the degree to which they evidence increased social connections and linkages with their broader communities), but the process components (e.g., the specific services and supports

received and the nature and intensity of those services) as well. Doing so will yield data that can guide the refinement of the approach, including the allocation of resources to maximally

benefit families. In closing, although we have focused on diverse influences in

these families’ lives and a range of possible actionable recom-

mendations, we must underscore that stable, secure housing is the central, overarching need. If a family remains in unstable housing, it will be challenging at best to provide effective fam- ily-centered services; school-based connections will be disrupted,

and the continuity of care of services and supports will be

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compromised. Without the provision of stable housing, the abil- ity to act on the recommendations put forth here and their

potential for impact will be severely limited.

Keywords: homeless families; homeless children; homeless youth; poverty; domestic violence; trauma, caregiver–child rela- tionship; stable housing; ecological theory

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