Examining the Experiences of and Perceived Treatment Needs for Social Anxiety and Substance Use Among Homeless Men

Homelessness has been associated with high levels of alcohol and other drug use, which has in turn been linked to social anxiety. The aim of the present study was to investigate homeless individuals’ experiences of social anxiety and substance use, their treatment history, and their therapeutic needs. Two focus groups were facilitated with fourteen participants. Participants were all male and aged between 27 and 63 years (M = 45.21, standard deviation, SD = 9.90). Thematic analysis identified four key themes: (1) longstanding difficulties with social anxiety and substance use; (2) mechanisms of social anxiety, substance use, and their interaction; (3) disenfranchisement with existing treatment options; and (4) needs for future treatment. Homeless individuals with social anxiety and histories of substance use reported experiencing these difficulties for several years, perpetuated by denial and/or misunderstanding. They reported that social anxiety and substance use were parallel, mutually reinforcing processes. Participants indicated that available substance use and social anxiety interventions were not fully satisfying and emphasised the importance of practical skills and an understanding therapeutic space.