'Recovery Work' in Housing First Practices: Contents and Conditions

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Presentation by Judith Wolf, UMC St Radboud, Netherlands, at the 2013 FEANTSA Research Conference, Alice Salomon Hochschule Berlin, 20th September 2013

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'Recovery Work' in Housing First Practices: Contents and Conditions

  1. 1. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Housing First: what’s second? Reflections on recovery oriented support 20th September 2013 Judith Wolf
  2. 2. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg “So I thought, this is not the life that I want, this is not the life that I had in mind or had expected. And that made me wiser. I had lost my focus and my goals. I wasn’t in control anymore. That was wrong.”
  3. 3. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg Housing First: What’s second? Compelling evidence: Most homeless people can sustain ordinary housing if given right support Focus on Long-term sustainability in relation to recovery based support •Need for understanding ‘why’ & ‘how’ it works in addition to ‘whether’ (Goering, Nelson, Stefancic, Tsemberis, 2013) •Use of multiple sources: theoretical concepts, empirical data on process, output and outcome & knowledge and experience of service users and professionals •Identify & elaborate on critical ingredients and adapt to specific context
  4. 4. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg Clients’ perspective: What is essential for long-term stability? “That I will have a regular structure, a regular day-night rhythm. Not being awake all night.” “Through rest in my body and peace and quiet around me. I am not looking for trouble.” “I continue to work. That’s how I can avoid losing balance.” housing rest & routinedaily activities a supportive social environment being mentally stable sufficient income medication limited use of alcohol/drugs recall what has happend in the past companionship Professional help Access to public services
  5. 5. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg What gives my life meaning & strength? service users (n=81) & staff (n=20) Clusters 1. Living conditions (4.1) 2. Self control & goal achievement (3.9) 3. Personal acceptance & growth (3.8) 4. Meaningful relationships with others (3.8) 5 Basic necessities & self care (3.6) 6. Independence & resources (3.6) 7. Forgiveness (3.3) 8. Meaningful experiences (3.2) 9. Motivational drivers (3.0) 10. Relaxation & fun (2.9) 11. Belief & spirituality (2.7) 12. Not stealing anymore (2.5) 13. Alcohol & drug use (2.1) 10 8 5 1 2 3 4 6 9 7 12 11 13
  6. 6. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg Involvement Express empathy Explore clients’ concerns Demonstrate understanding of clients’ position Avoid judgment or blame Be reliable & trustworthy Genuinely invest in relationship Foster self-determination | satisfying basic psychological needs Competence Help develop clear and realistic expectations about behaviour change and outcomes Help clients develop appropriate goals Provide positive feedback Support self-efficacy Autonomy Avoid coercion Help develop personally meaningful rationale for engaging in behaviour Help minimize external controls Provide opportunities for participation & choice Acknowledge negative feelings associated with engaging in difficult tasks
  7. 7. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg Recovery work (Wolf, 2012, based on Rapp & Goscha, 2010)) Support service users in finding meaning, hope & perspective, and in: • securing socio-economic living conditions & supporting service users in taking their life into their own hands • connecting to other people • gaining access to community resources, care & legal rights • building a positive identity and self- esteem | a coherent sense of self “I had a negative self image. In the long run you start to believe everything they say. Now it is different… I have discovered that I can hold my ground and that I am a very social person. I now know that I can make choices myself and can reach goals. I ask questions about what I want for my future and how I can make things happen.” (service user)
  8. 8. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg Sustainable care | systemic & embedded Social isolation & boredom: • Overcoming feelings of guilt & shame • Social integration and taking on new roles Recognition of role of social environment: • Prevent exhaustion | use resources Recognition of exclusion mechanisms: • Cut back unnecessary rules and regulations, fight stigma, increase responsiveness Connections in light of prevention & recovery: • Access to community resources & strengthen alliances with job market, education, health promotion, welfare, sports, culture etc.
  9. 9. Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen” Onderzoekscentrum maatschappelijke zorg Thank you! Judith.Wolf@ radboudumc.nl ; 00 31 6 1587 2045

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