Homeless Men Living in Transitional Housing: The BrainWise Program and Improvements in Executive Functions and Coping Self-Efficacy

Abstract

We describe an innovative approach to teaching homeless men the critical thinking skills underlying adaptive decision making and self-regulation needed to bolster resilience in the face of multiple and complex personal challenges. Single men living in a transitional housing facility for the homeless were taught the BrainWise curriculum (n = 210) along with other educational, career, and life skills programs, and tested 4 months later. This group was compared with a smaller control group (n = 61) of men from the same and similar facilities. Outcomes were measured through self-reports of executive functions (Behavior Rating Inventory of Executive Function [BRIEF]), problem solving (Wasik Problem Solving Rating Scale [WPSRS]), coping (Coping Self-Efficacy [CSE]), and knowledge of the thinking skills taught through BrainWise (BrainWise Knowledge Survey [BKS]). All measures showed adequate internal consistency reliability and less strong, but significant, test-retest stability. As expected, self-reported skills in executive function, coping self-efficacy, problem solving, and BrainWise knowledge covaried in predictable ways. The attrition between the pretest and posttest was not predicted by any of the major outcome measures. The sample of 108 men in the Treatment Group who were still in the program 4 months later exhibited significant improvements on all BRIEF composites and subscales, CSE, and the BKS, but not on the WPSRS. In contrast, the remaining 37 Control Group men showed many fewer improvements in the BRIEF scores and a decrease in the WPSRS score. The results suggest the efficacy of BrainWise and measurement of these skills in the vulnerable population of homeless individuals; however, challenges of this type of research and limitations of this study are discussed.

Life Stress and Inhibitory Control Deficits: Teaching BrainWise as a Neurocognitive Intervention in Vulnerable Populations

“…It is important to note that where there is risk, there is also substantial evidence of resilience in the face of adverse life circumstances, and this is observed both at the brain and behavioral levels [33]. Our own research has examined young adults with a childhood maltreatment history who manage to enroll in college [34] and homeless men who seek out services such as transitional housing [35]. These groups of adults are demonstrating resilience despite exposure to difficult and sometimes traumatic circumstances.…”

“…The BrainWise program is a prevention curriculum that uses a multidisciplinary approach to teach 10 thinking skills that include inhibitory control and other executive functions [35]. The program focuses on neurocognitive development and integrates findings from social science, education, and neuroscience.…”

“…The skills participants learn in BrainWise help them build connections to their Wizard Brain so that when signals are sent to the relay center, they are diverted away from the Lizard Brain and to the Wizard Brain. This simplified explanation is easy for almost anyone to understand [35]. Each time participants learns a wise way, they draw a line from the relay center/Lizard Brain to the Wizard Brain.…”

“…There is a small, emerging literature on the effect of homelessness on neuropsychological impairment, including the evidence discussed in Section 4.3, but studies with comparison groups are rare [116]. We conducted a study of the BrainWise program delivered to homeless men at a transitional housing facility [35]. The homeless organization serving the men in our study presented a rare opportunity to conduct research with a comparison group.…”

“…This provided evidence that BrainWise positively influences critical skills for adaptive functioning and resilience. These improved skills and knowledge will likely help them better face the many daily challenges, such as maintaining healthy relationships, holding jobs, and becoming productive members of society [35].…”