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

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. 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. 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. 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. 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. 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. 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. 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. Onderzoekscentrum maatschappelijke zorg
“gedreven door kennis, bewogen door mensen”
Onderzoekscentrum maatschappelijke zorg
Thank you!
Judith.Wolf@ radboudumc.nl ; 00 31 6 1587 2045