Frith Hannah, John Mary, Sharkah Leah, Iles Jane
School of Psychology, University of Surrey, Guildford, UK.
Health Expect. 2025 Jun;28(3):e70334. doi: 10.1111/hex.70334.
People experiencing homelessness experience high levels of trauma and psychological distress, but rarely access or engage with formal mental health services. The National Framework for Inclusion Health highlights collaboration between the NHS and third sector organisations as essential for reducing health inequalities. Providing clinical placements in third sector organisations for clinical psychology trainees may offer a valuable route to addressing this gap, whilst providing a beneficial learning experience.
Qualitative semi-structured interviews with clinical psychology trainees, staff in homeless settings and a clinical supervisor were used to explore perceptions of clinical placements and the benefits and challenges experienced by those involved in delivering these placements. Reflective thematic analysis was used to identify key themes in the perceptions of staff, supervisors and trainees.
Three key themes were developed. (1) Bringing a psychological mindset reflected the value that homelessness organisations placed on being helped to think about their client work through a psychological lens and extending this lens to also consider staff well-being. (2) Breaking barriers and building bridges describes how trainees were positioned as brokers who could connect homelessness organisations to formal mental health systems and could advocate for homeless people within these systems in ways which may have long-term effects. (3) Working and learning differently captures how these placements required trainees to work differently by crafting new roles and by adopting different working practices, including navigating complex issues around risk.
Clinical psychology placements within homelessness organisations may help meet the objectives of the NHS National Framework for Inclusion Health by helping create PIEs in homelessness organisations, navigating connections between statutory and third sector organisations, and creating a skilful workforce adept at managing cultural mistrust.
无家可归者遭受着高水平的创伤和心理困扰，但很少获得或参与正规的心理健康服务。《包容性健康国家框架》强调，国民保健服务体系（NHS）与第三部门组织之间的合作对于减少健康不平等至关重要。为临床心理学实习生在第三部门组织提供临床实习机会，可能是填补这一差距的宝贵途径，同时也能提供有益的学习体验。
对临床心理学实习生、无家可归者收容机构工作人员和一名临床督导进行定性半结构化访谈，以探讨对临床实习的看法以及参与提供这些实习的人员所经历的益处和挑战。采用反思性主题分析来确定工作人员、督导和实习生看法中的关键主题。
形成了三个关键主题。（1）引入心理学思维模式反映了无家可归者组织重视通过心理学视角来思考其客户工作，并将这一视角扩展到考虑员工福祉。（2）打破障碍与搭建桥梁描述了实习生如何被定位为中间人，能够将无家可归者组织与正规心理健康系统联系起来，并能在这些系统中为无家可归者进行倡导，其方式可能会产生长期影响。（3）以不同方式工作与学习体现了这些实习要求实习生通过塑造新角色和采用不同工作方式（包括应对围绕风险的复杂问题）来以不同方式工作。
在无家可归者组织内进行临床心理学实习，可能有助于实现NHS《包容性健康国家框架》的目标，具体方式包括帮助在无家可归者组织中创造积极影响、打通法定部门与第三部门组织之间的联系，以及打造一支善于管理文化不信任问题的熟练劳动力队伍。
