Nate Hoffer ’03, executive director of the Good Samaritan Shelter, with branches in Ephrata and Phoenixville in Pennsylvania
Not long after becoming executive director of the Good Samaritan Shelter in 2009, Nate Hoffer ’03 found himself sitting in the shelter living room in Phoenixville, Pennsylvania, with a young homeless man in the middle of a severe paranoid delusion. Not knowing how to respond, Hoffer wondered exactly what he’d gotten himself into.
“You can’t talk about homelessness without talking about mental health,” said Hoffer. “I certainly didn’t anticipate the extent to which I’d be dealing with it.”
In the end, Hoffer took his client to an emergency inpatient center, where the young man received the care he needed. For Hoffer, it was an early and intense introduction to his new-found role as a front-line mental health worker among the homeless in southeastern Pennsylvania.
At both of the organization’s sites – a men’s shelter in Phoenixville and a women’s and children’s shelter in Ephrata – the staff of Good Samaritan deal more with mental health issues among their clients than anything else.
With no formal training as a counselor or social worker, Hoffer sees his role as a dot-connector between Good Samaritan’s clients and various caregivers in the area. The process can be a frustrating one, though. Thanks to heavy caseloads, the waiting period before an initial assessment can last up to 30 days, during which Hoffer and his colleagues are left to assist clients as best they’re able.
Further delays often result from navigating the insurance bureaucracy, particularly for the many clients going through an initial application process for public assistance programs. At the heart of these challenges is simply overwhelming demand for mental health services.
As the importance of helping clients to access mental healthcare has become clear, Hoffer has begun hiring more staff to provide intensive case management. Staff members have also begun taking a more proactive role in managing medications for clients who need a regular therapeutic regimen to function.
Mental health, Hoffer said, remains misunderstood and underestimated as a major contributor to homelessness. Raising public awareness of this – part of his job as the agency’s executive director – would significantly improve the situation.
“Society could do a much better job of understanding the issue here,” Hoffer said. “The more everybody understands this as a need, the more there’s going to be action.”
— Andrew Jenner
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Bozkurt (2013) da geçmişe oranla bilgi teknolojilerinin fiyatının daha uygun düzeyde olduğunu ve yaygınlaşan kullanımı ile bilgisayar ve internet kullanımının, psikoloji alanında da yaygınlaşmasını sağladığını dile getirmektedir. Bu sebeplerle birlikte online terapi hizmeti veren uzmanların sayısı her geçen gün artış göstermektedir.
Ülkemizdeki uygulamalarda “online terapi” kavramının ön plana çıktığı görülmektedir (Bozkurt, 2013). Bu uygulamayı yapanlar genellikle psikologlar, psikolojik danışmanlar ve az sayıda psikiyatristlerdir. Uygulamanın etik kurallarının belirlenmesi amacıyla yönetmelik bazında ilk ciddi çalışma, Türk Psikologlar Derneği tarafından yapılmıştır (Türk Psikologlar Derneği, 2004). Günümüzde online terapi uygulamaları çoğunlukla internet yoluyla gerçekleştirilmektedir. Uzaktan psikolojik yardım uygulaması olarak eskiden daha çok kullanılan uzmanla mektuplaşma veya telefonla görüşme gibi yöntemler, internet kullanımının yaygınlaşması ile birlikte daha az uygulanır hale gelmiştir. İnternetten uygulanan online terapiler ise daha çok tercih edilmeye başlanmıştır (Childress, 2000). Online terapi uygulamalarında, internet üzerinden telefon ya da video konferansla görüntülü ve sesli olarak iletişime geçmeyi sağlayacak yollar vardır. Ancak internetten uygulanan yazılı yöntemler daha çok tercih edilmektedir. (Childress, 2000). Online terapi uygulamalarında danışanlar tarafından yazılı yöntemler daha çok tercih edilse de internet üzerinden telefonla ve görüntülü olarak görüşme uygulamaları da hasta ve terapistler için çeşitli avantajlar sağlayan yöntemler olarak geçerliliğini sürdürmektedir (McLaren, 1992).
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