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2.4. Recovery Orientation

A service with a recovery orientation focuses on the overall well-being of an individual. This includes their physical and mental health, their level of social support (from a partner, family or friends) and their level of social integration, i.e. being part of a community and taking an active part in society. Promoting recovery can include enabling access to education or helping someone find a rewarding leisure activity. Following a recovery orientation is something far wider and more ambitious than just regulating drug or alcohol use, or supporting engagement with treatment. It is about delivering a secure and rewarding life for someone, creating a life that integrates them into a community, into housing and into wider social and economic life in a positive way.

The concept of recovery can be approached from different angles((Wolf, J. (2016). Krachtwerk. Methodisch werken aan participatie en zelfregie. (Strengths Work, a Systematic Method for Participation and Self-Direction). Bussum: Coutinho.)) but centres on an individual gaining a sense of purpose, with the prospect of a better and more secure life. There is an emphasis on the person “recovering themselves”, choosing the direction for their future life.

In the Housing First model, homeless people are able to recover: meaning they are able to regain a more meaningful and hopeful life. Recovery does not mean that service users will no longer experience problems, symptoms or struggles. Nor does recovery mean that they will no longer use specialized services, medication or necessarily be able to live completely independently. The process of recovery is unique and personal. It is a process of trial and error, involving small steps forward and backward. It is a process of celebrating successful experiences, but also of experiencing feelings of pain and frustration. Within Housing First, the recovery process is individual and the support is designed to work flexibly to enable someone to choose their own path to a better life((Rapp, C. and Goscha, R. (2006). The strengths model, case management with people with psychiatric disabilities. Oxford University Press; Saleebey, D. (2006). The strengths perspective in social work practice, vol. 4. Boston: Pearson Education, Inc.)).

Services with a recovery orientation are aware that a service user may have experienced traumatic events. They are built on understanding someone using a service, in terms of their current support needs, but also in terms of their other characteristics and their experiences. A recovery-orientated service, like Housing First, seeks to maximise the strengths and potential of the people receiving support, encouraging the idea that positive change is possible. Over time, the approach may involve service users being given responsibilities, such as peer mentoring, acting as a representative of other Housing First service users or developing their own support plans. There will also be an emphasis on developing personal relationships, helping where necessary with emotional literacy (the capacity to understand and correctly process emotion) and with enabling service users to build trusting relationships. Services that adopt a recovery orientation often use motivational interviewing techniques.

Housing First actively encourages the following:

  • Use of treatment for mental health problems and other health problems
  • Harm reduction in relation to drugs and alcohol
  • Changes to behaviour in order to reduce risks to health and well-being

An awareness that positive change is possible and the opportunity to have a better life in the future is a realistic option for people using Housing First.

The recovery orientation in Housing First is a philosophy that means that the support provided by Housing First always emphasises the fact that a service user can choose a better future as a real possibility that can be achieved. Support and treatment is in place and available to enable this, but this is just one aspect of the recovery orientation, which also seeks to place the idea of recovery as a realistic prospect in the mind of everyone using Housing First.

The recovery orientation has to be carefully managed in the context of maintaining a clear and equal emphasis on choice and control and person-centred planning within Housing First. It is important that the positive messages of a recovery orientation are carefully put in place. In particular:

  • Promoting recovery must always reflect what someone wants for themselves, not anyone else’s ideas about which direction their life should take. People using Housing First must be listened to and their choices respected. The recovery orientation is one aspect of Housing First.
  • Following a recovery orientation must be realistic and grounded, but no presumptions should be made about what sort of life a Housing First service user can eventually achieve for themselves.