Reviewing the research on power within client-provider relationships in health care with people who have experienced homelessness has served to remind me yet again that your research results will only be as broad as your own lens. That is, you can only ever see what you have been prejudiced to see.
Take for example the article “The Lived Experience of Homeless Men” by Lafuente and Lane (1995). In this study, the authors interviewed homeless men in a shelter to try to learn more about social disaffiliation. The concern being addressed is that social disaffiliation may be serving as a major barrier to homeless men receiving formal health services.
The authors start by outlining their conceptualization of social dissaffiliation, and it catches my eye that one path in their theory is ‘Voluntary withdrawal from the community’, and the example given is drug addiction. So, I am immediately struck that drug addiction has been set-up as a choice in the conceptualization that is driving the study. I also note that there is a question that asks the men how they feel about being socially disaffiliated. This takes for granted that all the men are socially disaffiliated because of their ‘homeless’ status.
The authors conclude that most of the men were socially disaffiliated due to life changes and personal choice to withdraw from community. Because the authors bring a lens to the project that is devoid of concepts of power relations at the interpersonal level, and power in social structures, the findings are devoid of reflections on power and both the cause and the solution to homelessness is seen to lie with the men themselves. So, their novel suggestion to health care professionals is that they create a ‘buddy’ system to connect homeless men formally with each other.
Unfortunately, I fear that research that focuses solely on personal agency, actually has the potential to further disempower people who are experiencing homelessness. I would suggest that all studies need to reflect on systems and structures of power that form our individual actions in the world, and need to work to address these as much as help the individual. However, I conclude by wondering in this, my own lens, what I am missing, and what conclusions I will never reach. Because, I can only see what I have been prejudiced to see.