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Homeless with Breast Cancer on Skid Row, Los Angeles: a Review of Services for Women

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Homeless with Breast Cancer on Skid Row, Los Angeles: a Review of Services for Women Pepperdine University Pepperdine Digital Commons Theses and Dissertations 2020 Homeless with breast cancer on Skid Row, Los Angeles: a review of services for women Eva Dittrich [email protected] Follow this and additional works at: https://digitalcommons.pepperdine.edu/etd Part of the Health Policy Commons, Social Psychology Commons, and the Social Work Commons Recommended Citation Dittrich, Eva, "Homeless with breast cancer on Skid Row, Los Angeles: a review of services for women" (2020). Theses and Dissertations. 1164. https://digitalcommons.pepperdine.edu/etd/1164 This Dissertation is brought to you for free and open access by Pepperdine Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Pepperdine Digital Commons. For more information, please contact [email protected], [email protected], [email protected]. HOMELESS WITH BREAST CANCER Pepperdine University Graduate School of Education and Psychology HOMELESS WITH BREAST CANCER ON SKID ROW, LOS ANGELES: A REVIEW OF SERVICES FOR WOMEN A clinical dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Psychology by Eva Dittrich July, 2020 Carrie Castañeda-Sound, Ph.D. – Dissertation Chairperson This clinical dissertation, written by Eva Dittrich under the guidance of a Faculty Committee and approved by its members, has been submitted to and accepted by the Graduate Faculty in partial fulfillment of the requirements for the degree of DOCTOR OF PSYCHOLOGY Doctoral Committee: Carrie Castañeda-Sound, Ph.D., Chairperson Robert deMayo, Ph.D. Alison Vargas, Psy.D. © Copyright by Eva Dittrich (2020) All Rights Reserved Table of Contents Page LIST OF TABLES ......................................................................................................................... vi DEDICATION .............................................................................................................................. vii VITA ............................................................................................................................................. viii ABSTRACT ................................................................................................................................... ix Chapter 1: Introduction .................................................................................................................... 1 Personal Narrative ............................................................................................................... 1 Statement of the Problem .................................................................................................... 4 Chapter 2: Literature Review .......................................................................................................... 5 Breast Cancer Overview ...................................................................................................... 5 Breast Cancer Demographics ............................................................................................ 20 Psychological Effects of Breast Cancer ............................................................................ 24 Homelessness .................................................................................................................... 30 Summary: Homeless with Breast Cancer .......................................................................... 40 Need for Further Study ...................................................................................................... 41 Research Questions ........................................................................................................... 43 Chapter 3: Methodology ................................................................................................................ 44 Research Design ................................................................................................................ 44 Systematic Review Procedure ........................................................................................... 45 Content Analysis ............................................................................................................... 46 Limitations of the Study .................................................................................................... 46 Researcher Reflexivity ...................................................................................................... 47 Chapter 4: Results .......................................................................................................................... 50 Types of Services for Homeless Women on Skid Row .................................................... 50 HOMELESS WITH BREAST CANCER v Chapter 5: Discussion .................................................................................................................... 60 Reflections ......................................................................................................................... 61 Implications ....................................................................................................................... 65 Summary ............................................................................................................................ 67 REFERENCES .............................................................................................................................. 70 APPENDIX A: Literature Review Table ...................................................................................... 75 REFERENCES FOR LITERATURE REVIEW TABLE .................................................91 APPENDIX B: Google search results for “Guide to resources on Skid Row” ........................... 104 APPENDIX C: Master list of services for women on Skid Row, Los Angeles .......................... 107 APPENDIX D: Google search results for “Homeless services women Skid Row Los Angeles, “Free services for women Skid Row Los Angeles,” and “Breast cancer homeless services Skid Row Los Angeles” ............................... 140 APPENDIX E: Pepperdine University Non-Human Subjects IRB Form ................................... 153 Running head: HOMELESS WITH BREAST CANCER vi LIST OF TABLES Page Table 1. Types of Services with Abbreviation Key....................................................... 51 Table 2. Services Available to Homeless Women on Skid Row................................... 52 Table 3. Number of Service Organizations for Homeless Women on Skid Row.......... 55 Table 4. The Twenty Most Common Service Organizations Found for Homeless Women on Skid Row……..………………………………………. 56 Table 5. Breast Cancer and Other Cancer Services for Homeless Women on Skid Row……............................................................................................... 57 Running head: HOMELESS WITH BREAST CANCER vii DEDICATION This paper is dedicated to Shobha, a brave woman in India I had the privilege to interview and photograph in 2008, who was ostracized by her family and friends and made homeless upon her breast cancer diagnosis. Your positive attitude, song, willingness to share your experience with a stranger, and determination to survive even in the harshest of circumstances have inspired me more than you may ever know. (Photograph used with permission.) Running head: HOMELESS WITH BREAST CANCER viii VITA EDUCATION HISTORY Doctor of Psychology (Psy.D.), Clinical Psychology 2015-2020 Anticipated Graduation Summer 2020 Pepperdine University, Graduate School of Education & Psychology Los Angeles, CA Master of Arts (M.A.), Psychology 2013-2015 Pepperdine University, Graduate School of Education & Psychology Los Angeles, CA Advanced Certificate, Trauma and Violence Transdisciplinary Studies 2009-2010 New York University, Graduate School of Arts & Sciences New York, NY Master of Arts (M.A.), International Service 2006-2007 Roehampton University London, England Bachelor of Arts (B.A.), Communications & Literature 2001-2004 Richmond, The American International University London, England CLINICAL EXPERIENCE Pre-Doctoral Intern, Personal Growth & Counseling Center 2019-2020 California State University, Monterey Bay Seaside, CA Practicum Trainee, Counseling & Psychological Services 2018-2019 California Lutheran University Thousand Oaks, CA Practicum Trainee 2016-2018 Pepperdine West Los Angeles Counseling Clinic Los Angeles, CA Practicum Trainee, Adult Neuropsychology 2016 UCLA Semel Institute Westwood, CA Practicum Trainee, Child Psychology 2015-2016 Juan Cabrillo Elementary School, Hawthorne, CA Running head: HOMELESS WITH BREAST CANCER ix ABSTRACT This study reviews the literature on breast cancer in general and narrows to within the context of the homeless population of Skid Row, Los Angeles, positing that the experience of breast cancer while homeless is a compounded traumatic experience with complex and numerous practical challenges. It poses the following questions: What services are available to homeless women on Skid Row, Los Angeles, the information about which can be found online? Which and how many services are dedicated to breast cancer screenings and treatment? Are other types of cancer screening and treatment services advertised on the included service organizations’ websites? A thorough online search was conducted to identify services for women living homeless on Skid Row, and a master list of 46 organizations and agencies was created to serve as the foundation for a future website and booklet that will
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