Adam Joy


The homeless are a vulnerable group, and research has consistently shown that the homeless experience higher rates of mental disorders, substance abuse, and physical illness than housed persons. Depressive disorders are particularly common among the homeless and have been reported at 2 to 4 times the rate found among housed individuals. The purpose of this study was to examine the relationship of individual therapy to depressive symptoms among treatment-seeking, homeless men attending a residential substance abuse recovery program in an inner-city mission. The participants were 81 men with a mean age of 39.95 years. The sample was ethnically diverse and had a modal educational level of at least some high school. All of the participants had voluntarily sought individual psychological services as an optional component of their substance abuse program in this archival study. Depressive symptoms were measured with the Beck Depression Inventory, Second Edition (BDI-II). De-identified demographic and background information was obtained from the clinical intake form used in this setting. BDI-IIs were administered at intake and following approximately 6 sessions of individual therapy for all participants. Therapy services were provided by clinical psychology doctoral students, under the supervision of licensed psychologists. The sample obtained a mean BDI-II score at intake of 21.68, indicating moderate severity of symptoms; internal consistency reliability was .935. The mean BDI-II score following approximately 6 therapy sessions was 16.36, indicating mild severity; the BDI-II internal consistency reliability at follow-up assessment was .923. As predicted, BDI-II scores were significantly lower at retest. For the men in this study, participation in individual therapy was associated with significant reduction of depressive symptoms. Participants with prominent mood complaints on the clinic intake evaluation form (n = 38) had significantly higher BDI-II scores at intake assessment than individuals with other primary complaints (n = 43), supporting the validity of the BDI-II as a measure of mood symptoms among homeless men. Other findings, clinical implications, limitations, and suggestions for future research are also explored. The results strongly supported the reliability and validity of the BDI-II as a measure of depressive symptoms and psychological distress among treatment-seeking homeless men.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Homeless men -- Mental health; Depression, Mental -- Treatment

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Mitchell, Cary;