Use of one-to-one psychotherapeutic interventions for people experiencing severe and multiple disadvantages: An evaluation of two regional pilot projects

Background: People with "severe and multiple disadvantages" (SMD) experience a combination of homelessness, mental health difficulties, alcohol or substance misuse and offending. Despite frequent and cyclical traumatic experiences being commonplace, people who experience SMD are often excluded from appropriate psychotherapeutic support. Methods: Two pilot projects which aimed to work psychologically with people accessing SMD-specific services were evaluated using a quantitative quasi-experimental design. Findings: Those receiving psychotherapeutic support were more likely to engage in positive developmental contact with external support services, and less likely to require reactive, negative contacts. They were also more likely to stay engaged with the programme's internal support services for longer than those not receiving psychotherapeutic support. Implications for practice: The findings are particularly noteworthy for future commissioning practices, as they indicate that the benefits of such interventions could be quantifiable for the wider support system. Conclusions: This research adds to a growing body of evidence that psychotherapeutic interventions can improve outcomes for people who experience SMD.