title: Examining Provider Perspectives within Housing First and Traditional Programs.
abstract: Pathways' Housing First represents a radical departure from traditional programs that serve individuals experiencing homelessness and co-occurring psychiatric and substance use disorders. This paper considered two federally funded comparison studies of Pathways' Housing First and traditional programs to examine whether differences were reflected in the perspectives of frontline providers. Both quantitative analysis of responses to structured questions with close-ended responses and qualitative analysis of open-ended responses to semistructured questions showed that Pathways providers had greater endorsement of consumer values, lesser endorsement of systems values, and greater tolerance for abnormal behavior that did not result in harm to others than their counterparts in traditional programs. Comparing provider perspectives also revealed an "implementation paradox"; traditional providers were inhibited from engaging consumers in treatment and services without housing, whereas HF providers could focus on issues other than securing housing. As programs increasingly adopt a Housing First approach, implementation challenges remain due to an existing workforce habituated to traditional services.
authors.affiliation: University of Southern California, School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089-0411.
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Henwood
authors.affiliation: Vanderbilt University Peabody College, Department of Human and Organizational Development, 230 Appleton Place, Nashville, TN 37203-5721; beth.shinn@vanderbilt.edu.
authors.forename: Marybeth
authors.initials: M
authors.lastname: Shinn
authors.affiliation: Pathways to Housing, Inc., 186 E. 123rd Street, New York NY 10035; pathman101@aol.com.
authors.forename: Sam
authors.initials: S
authors.lastname: Tsemberis
authors.affiliation: New York University, Silver School of Social Work, 1 Washington Square North, New York, NY 10003; dkp1@nyu.edu.
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Padgett
keywords: Housing First; frontline providers; homelessness; serious mental illness; supportive housing