Home > An ecological perspective on recovery in homelessness: the influence of key worker values on consumer self-determination.

Manning, Rachel M (2014) An ecological perspective on recovery in homelessness: the influence of key worker values on consumer self-determination. PhD thesis, National University of Ireland, Limerick.

External website: https://ulir.ul.ie/handle/10344/4235

There is much left to learn about the experience of recovery among homeless individuals. Little is known about the process involved in recovery, or about the factors that influence this process (Gillis, Dickerson & Hanson, 2010). Yet, the importance of understanding recovery among homeless individuals cannot be over-stated. Most are not only without stable home, but they also endure biomedical challenges, addiction, and mental illness (Lawless & Corr, 2005). In this thesis, recovery among homeless is examined in four life domains (physical health, substance use, mental health, and community integration). Drawing from the self-determination literature, it is hypothesized that choice and mastery play a role in the process of recovery in each of these domains (SDT; Deci & Ryan, 2002). In turn, taking an ecological perspective on self-determination, it is hypothesized that the values of homeless service providers (key workers) are factors that influence the recovery process. More, specifically, it is anticipated that the extent to which key workers hold ‘recovery’ over ‘traditional’ values will shape the provision of consumer choice, and in turn, mastery and recovery experiences (Farkas, Gagne, Anthony & Chamberlin, 2005; Bronfenbrenner, 1976).


To understand the process of recovery and the factors that influence this, two studies were conducted and are reported in this thesis. In Study 1, individuals in homeless services across Ireland were asked to complete a quantitative questionnaire at baseline, 6-months, and 12-months. Their perceptions of choice, personal mastery, and experiences in the four recovery domains of interest (physical health, substance use, mental health, and social connection) are reported. In Study 2, the key workers of these consumers were invited to take part in a semi-structured qualitative interview about their values. Key worker transcripts were analysed for assumptions, actions, and desired end-states, which were investigated as indicators of ‘traditional’ and ‘recovery’ values (Rokeach, 1973).


An integrative mixed-method analysis with the combined data from Study 1 and Study 2 was used to examine the influence of key worker values on consumer choice, mastery and recovery trajectories. Findings from Time 1 questionnaires in Study 1 showed links among choice, mastery, and each of the recovery domains of interest, bar substance use. Building on these cross-sectional findings, growth curve analyses were used to understand the direction, progress, and rate of recovery over time. It was found that substance use and psychiatric symptoms decreased, while physical and psychological components of community integration increased. Physical health did not significantly increase or decrease over the study period. Overall, trajectories indicate that recovery is possible for homeless individuals. As choice and mastery were explanatory in trajectories, these can be seen as integral in the recovery process.


Next, thematic analysis was used to understand the qualitative data from Study 2. Findings indicated, as expected, that most key workers held ‘traditional’ values. However, some key workers evidenced ‘recovery’ values in their talk too. Finally and importantly, the mixed methods analyses used to integrate findings from Study 1 and Study 2 showed that ‘recovery’ values among key workers significantly explain consumer perceptions of choice, and in turn, their personal mastery and recovery trajectories. Overall, these findings provide important insights into recovery in the context of homelessness.


Firstly, findings show that recovery is possible for individuals in homelessness (Gillis et al., 2010). Moreover, consumer choice and personal mastery showed to be part of the recovery process. Thus, findings also demonstrate that recovery is not a spontaneous or fortuitous event. Instead, it is an experience underpinned by processes of self-determination (Deci & Ryan, 2002). Finally, ‘recovery’ values were shown to be a factor that influences the recovery process, which demonstrates the role of services in consumer outcomes. Ultimately, the findings show that recovery is shaped by the ecology of homelessness, which yields important implications for researchers, practitioners, and policy makers.

Item Type
Publication Type
Drug Type
All substances
Intervention Type
General / Comprehensive, Treatment method, Harm reduction, Psychosocial treatment method, Rehabilitation/Recovery
September 2014
215 p.
Accession Number
HRB (Electronic Only)

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